Chest and cardiac imaging: chronic thromboembolic pulmonary hypertension: 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 and cardiac imaging: chronic thromboembolic pulmonary hypertension

Sample item

Six months after a pulmonary embolism, a patient has persistent breathlessness and echocardiographic pulmonary hypertension. Which investigation is preferred to screen for chronic thromboembolic disease?

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

The answer and the reasoning

B. Ventilation-perfusion scintigraphy

A normal V/Q scan effectively excludes chronic thromboembolic pulmonary hypertension, and it is more sensitive than CT angiography for chronic disease. Positive scans are followed by pulmonary angiography. Radiographs, D-dimer and ECG cannot screen for it.

Option by option

  • A. Electrocardiogram

    The ECG may show strain but cannot identify thromboembolic obstruction.

  • B. Ventilation-perfusion scintigraphy (correct)

    Correct. V/Q scintigraphy is the preferred screening test.

  • C. Chest radiograph

    A chest radiograph is nonspecific and often normal.

  • D. D-dimer assay

    D-dimer is not reliable in chronic organised thrombus.

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 B, Ventilation-perfusion scintigraphy. A normal V/Q scan effectively excludes chronic thromboembolic pulmonary hypertension, and it is more sensitive than CT angiography for chronic disease.

Why is "Electrocardiogram" not the answer?

The ECG may show strain but cannot identify thromboembolic obstruction.

Why is "Chest radiograph" not the answer?

A chest radiograph is nonspecific and often normal.

Why is "D-dimer assay" not the answer?

D-dimer is not reliable in chronic organised thrombus.

What concept does this question test?

It tests Chest and cardiac imaging: chronic thromboembolic pulmonary hypertension in Radiology. Positive scans are followed by pulmonary angiography. Radiographs, D-dimer and ECG cannot screen for it.

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 Chest and cardiac imaging: chronic thromboembolic pulmonary hypertension?

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.