Respiratory medicine: bronchiectasis imaging: practice question

A General Medicine 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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General Medicine · Respiratory medicine: bronchiectasis imaging

Sample item

A 40-year-old woman has had daily purulent sputum and occasional haemoptysis since childhood tuberculosis. Which HRCT finding is most characteristic of her likely condition?

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

The answer and the reasoning

D. Bronchus wider than its accompanying pulmonary artery (signet ring sign)

Bronchiectasis is defined by permanent bronchial dilatation, and HRCT shows a bronchoarterial ratio above 1, the signet ring sign, with lack of tapering and visible peripheral airways. Honeycombing suggests fibrosis. Chronic infection often involves Pseudomonas aeruginosa in advanced disease.

Option by option

  • A. Honeycombing with traction bronchiectasis in the lower zones

    Honeycombing characterises usual interstitial pneumonia and fibrosis.

  • B. Diffuse centrilobular ground-glass nodules

    Centrilobular ground-glass nodules suggest hypersensitivity pneumonitis.

  • C. Pleural plaques with calcification

    Calcified pleural plaques indicate asbestos exposure.

  • D. Bronchus wider than its accompanying pulmonary artery (signet ring sign) (correct)

    Correct. A bronchus larger than its artery is the hallmark of bronchiectasis.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Bronchus wider than its accompanying pulmonary artery (signet ring sign). Bronchiectasis is defined by permanent bronchial dilatation, and HRCT shows a bronchoarterial ratio above 1, the signet ring sign, with lack of tapering and visible peripheral airways.

Why is "Honeycombing with traction bronchiectasis in the lower zones" not the answer?

Honeycombing characterises usual interstitial pneumonia and fibrosis.

Why is "Diffuse centrilobular ground-glass nodules" not the answer?

Centrilobular ground-glass nodules suggest hypersensitivity pneumonitis.

Why is "Pleural plaques with calcification" not the answer?

Calcified pleural plaques indicate asbestos exposure.

What concept does this question test?

It tests Respiratory medicine: bronchiectasis imaging in General Medicine. Honeycombing suggests fibrosis. Chronic infection often involves Pseudomonas aeruginosa in advanced disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Respiratory medicine: bronchiectasis imaging?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.