Respiratory medicine: 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

Sample item

A 30-year-old woman who is otherwise well has painful red nodules on her shins, ankle arthritis and bilateral symmetrical hilar lymphadenopathy on chest radiograph. What is the most likely diagnosis?

APulmonary tuberculosis with a primary complexBLymphomaCSmall cell lung cancerDSarcoidosis

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

The answer and the reasoning

D. Sarcoidosis

Erythema nodosum, ankle arthritis and bilateral hilar lymphadenopathy form the Löfgren syndrome, an acute presentation of sarcoidosis. The symmetry and the well appearance of the patient are characteristic. Lymphoma and tuberculosis usually cause constitutional symptoms or asymmetrical nodes.

Option by option

A. Pulmonary tuberculosis with a primary complex
A tuberculous primary complex usually produces unilateral hilar nodes with a parenchymal focus.
B. Lymphoma
Lymphoma causes nodes with systemic features, and symmetrical hilar nodes with erythema nodosum are not typical.
C. Small cell lung cancer
Small cell cancer produces a central mass, often in a smoker, not symmetrical nodes with erythema nodosum.
D. Sarcoidosis (correct)
Correct. This triad is the classic acute presentation of sarcoidosis, and it often resolves on its own.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Sarcoidosis. Erythema nodosum, ankle arthritis and bilateral hilar lymphadenopathy form the Löfgren syndrome, an acute presentation of sarcoidosis.

Why is "Pulmonary tuberculosis with a primary complex" not the answer?

A tuberculous primary complex usually produces unilateral hilar nodes with a parenchymal focus.

Why is "Lymphoma" not the answer?

Lymphoma causes nodes with systemic features, and symmetrical hilar nodes with erythema nodosum are not typical.

Why is "Small cell lung cancer" not the answer?

Small cell cancer produces a central mass, often in a smoker, not symmetrical nodes with erythema nodosum.

What concept does this question test?

It tests Respiratory medicine in General Medicine. The symmetry and the well appearance of the patient are characteristic. Lymphoma and tuberculosis usually cause constitutional symptoms or asymmetrical nodes.

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?

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.