LLD-North – Highnoon

North

The number of attempts remaining is 1

1 / 10

What is the single defining criterion of a typical UIP pattern that is not present in probable or indeterminate UIP patterns?

reticular abnormalities

honeycombing

subpleural distribution with a basal predominance

absence of features suggesting an alternative diagnosis

traction bronchiectasis

2 / 10

This 65-year-old woman with rheumatoid arthritis presents with progressive dyspnea for the last few months. Non-contrast chest CT is performed. What is the most likely diagnosis?

UIP pattern

probable UIP pattern

indeterminate for UIP pattern

alternative diagnosis

3 / 10

Which of the following about usual interstitial pneumonia (UIP) is FALSE?

any fibrotic lung disease with a honeycombing appearance should be reported as "typical UIP"

distribution is often patchy, with interspersed regions of normal peripheral lung

distribution is predominantly in the lower zone of the lungs

there is frequently a heterogeneous degree of coarseness, with both early fibrotic changes and end-stage fibrosis represented in the same patient

4 / 10

Which of the following is FALSE in fibrotic hypersensitivity pneumonitis (HP)?

air trapping, normal lung and ground glass densities are highly specific for the diagnosis

a pattern of fibrosis that is concordant with HP is termed "axially diffuse", implying both a peripheral and peribronchovascular distribution

evidence of airway involvement on CT, such as air trapping, is required as per the 2020 international clinical practice guideline for HP diagnosis

fibrotic HP commonly has an upper zone predominance

5 / 10

Which of the following zonal distributions is NOT “typical for hypersensitivity pneumonitis” in the fibrotic setting?

basilar predominant

mid-lung

random (diffuse)

relative basilar sparing

6 / 10

What CT findings exclude hypersensitivity pneumonitis as a potential differential diagnosis?

ground-glass opacities

honeycombing

reticulation

traction bronchiectasis

none of the above

7 / 10

Axial HRCT image of the chest in a 60-year-old female non-smoker with shortness of breath and a dry cough for several years. Which is the most likely diagnosis?

Langerhan's cell histiocytosis

lymphangioleimyomatosis

lymphocytic interstitial pneumonitis

chronic hypersensitivity pneumonitis

pneumocystis pneumonia

8 / 10

Which of the following definitions is FALSE for features seen in interstitial lung disease?

consolidation is an abnormal increase in lung density, equal to that of opacified pulmonary vasculature

honeycombing is clustered subpleural cystic spaces with shared walls, typically of uniform size

parenchymal bands are long, linear markings that radiate from the pleura at 90°

traction bronchiectasis refers to abnormal dilatation of airways caused by surrounding abnormal lung

9 / 10

Which of the following statements is FALSE regarding high resolution CT (HRCT) of the chest?

edge enhancement is applied in post-processing for best lung parenchymal detail

HRCT studies can be expected to image the entire volume of the lungs

post-contrast imaging allows the best delineation of airways from lung parenchyma

prone and expiratory imaging are added as required, often after real-time review of the initial supine, inspiratory examination

10 / 10

Which of the following steps would NOT be part of your protocol for a high resolution CT (HRCT) of the chest in a patient with "known interstitial lung disease"?

include expiratory imaging if the clinical or radiological differential diagnosis includes entities associated with air trapping

include prone imaging if there is posterior-limited infiltrate that may be contributed to by atelectasis

include post-contrast imaging if pulmonary nodules are present

review prior imaging to establish the pattern of fibrosis and the completeness of earlier work-up

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