Chest imaging: ARDS: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest imaging: ARDS

Sample item

A patient with sepsis and severe hypoxaemia has bilateral diffuse airspace opacities on CT with a gradient favouring the dependent regions and a normal heart size. Which statement is correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. The picture is typical of ARDS with non-cardiogenic oedema

In ARDS the capillary leak causes diffuse alveolar damage with bilateral dependent opacification, normal heart size and usually no pleural effusion. Cardiogenic oedema has cardiomegaly, septal lines and effusions. Prone ventilation redistributes the dependent opacities.

Option by option

  • A. Pneumothorax is certain

    Pneumothorax produces lucency and not diffuse opacities.

  • B. This is a normal finding in sepsis

    Diffuse opacities are not normal.

  • C. Cardiogenic oedema is certain because bilateral opacities occur

    Cardiogenic oedema is accompanied by a large heart and effusions.

  • D. The picture is typical of ARDS with non-cardiogenic oedema (correct)

    Correct. A normal-sized heart with diffuse dependent airspace opacities suggests ARDS.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, The picture is typical of ARDS with non-cardiogenic oedema. In ARDS the capillary leak causes diffuse alveolar damage with bilateral dependent opacification, normal heart size and usually no pleural effusion.

Why is "Pneumothorax is certain" not the answer?

Pneumothorax produces lucency and not diffuse opacities.

Why is "This is a normal finding in sepsis" not the answer?

Diffuse opacities are not normal.

Why is "Cardiogenic oedema is certain because bilateral opacities occur" not the answer?

Cardiogenic oedema is accompanied by a large heart and effusions.

What concept does this question test?

It tests Chest imaging: ARDS in Radiology. Cardiogenic oedema has cardiomegaly, septal lines and effusions. Prone ventilation redistributes the dependent opacities.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest imaging: ARDS?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.