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Question 1:
What does the term “diffuse lung changes” refer to?
A. Localized lung lesions in a specific lobe
B. Widespread alterations in lung parenchyma or interstitium
C. Isolated airway obstruction
D. Pleural effusions only

Correct Answer: B. Widespread alterations in lung parenchyma or interstitium
References:

  • The Fleischner Society Glossary defines “diffuse” as involvement of both lungs extensively, indicating widespread parenchymal or interstitial changes.
  • Radiopaedia describes diffuse lung changes as encompassing widespread patterns like ground-glass opacities or reticular changes.

Question 2:
Which of the following is a most common cause of diffuse lung changes?
A. Smoking-related pulmonary Langerhans cell histiocytosis
B. Asbestosis
C. Usual interstitial pneumonia (UIP)
D. Viral pneumonia

Correct Answer: D. Viral pneumonia
References:

  • Viral pneumonia is highlighted in Radiopaedia as a frequent cause of diffuse lung changes, often presenting with ground-glass opacities and consolidations.
  • The Fleischner Society mentions viral pneumonias as acute interstitial lung abnormalities.

Question 3:
Which imaging finding is NOT commonly associated with diffuse lung changes?
A. Ground-glass opacities
B. Consolidation
C. Subpleural sparing
D. Reticular or nodular patterns

Correct Answer: C. Subpleural sparing
References:

  • Subpleural sparing is a specific pattern noted in NSIP (Non-Specific Interstitial Pneumonia) but is not a generalized feature of diffuse lung changes, as noted by the Fleischner Society Glossary.
  • Typical diffuse lung changes involve ground-glass opacities, reticular patterns, and sometimes nodules.

Question 4:
Which of the following conditions is not typically linked to diffuse lung changes?
A. Systemic lupus erythematosus (SLE)
B. Bacterial pneumonia
C. Hepatopulmonary syndrome
D. Hypersensitivity pneumonitis

Correct Answer: C. Hepatopulmonary syndrome
References:

  • RadiologyKey clarifies that hepatopulmonary syndrome predominantly affects pulmonary vasculature, causing hypoxemia rather than diffuse parenchymal lung changes.
  • SLE, bacterial pneumonia, and hypersensitivity pneumonitis are well-documented causes of diffuse lung changes.

Question 5:
What is the hallmark imaging feature of usual interstitial pneumonia (UIP) in diffuse lung changes?
A. Ground-glass opacities
B. Central lung predominance
C. Peripheral honeycombing
D. Lymphangitic nodularity

Correct Answer: C. Peripheral honeycombing
References:

  • Radiopaedia describes UIP as characterized by basal and peripheral honeycombing, with little to no ground-glass opacity in advanced stages.
  • The Fleischner Society identifies honeycombing as a definitive feature of UIP in imaging.

Question 6:
Which diagnostic tool is considered most specific for characterizing diffuse lung changes?
A. Chest X-ray (CXR)
B. High-resolution computed tomography (CT)
C. Pulmonary function tests (PFTs)
D. Bronchoscopy

Correct Answer: B. High-resolution computed tomography (CT)
References:

  • The Fleischner Society Glossary emphasizes the superiority of high-resolution CT for identifying patterns such as reticular changes, ground-glass opacities, and honeycombing.
  • Radiopaedia also notes CT’s role in distinguishing acute versus chronic diffuse lung changes.

Question 7:
Which pulmonary function test (PFT) result is most commonly seen in fibrotic diffuse lung diseases?
A. Obstructive pattern
B. Restrictive pattern
C. Mixed obstructive-restrictive pattern
D. Normal spirometry

Correct Answer: B. Restrictive pattern
References:

  • Fibrotic interstitial lung diseases are associated with restrictive lung patterns due to reduced compliance and lung volumes, as per Radiopaedia and the Fleischner Society Glossary.

Question 8:
Which condition is most associated with diffuse lung changes characterized by cystic spaces in the upper lobes?
A. Lymphangioleiomyomatosis (LAM)
B. Pulmonary Langerhans cell histiocytosis (PLCH)
C. Asbestosis
D. Cryptogenic organizing pneumonia (COP)

Correct Answer: B. Pulmonary Langerhans cell histiocytosis (PLCH)
References:

  • PLCH is described by Radiopaedia as a smoking-related disease predominantly affecting the upper lobes with cystic and nodular changes.

Question 9:
Which environmental exposure is a known cause of diffuse lung changes?
A. Gold salt inhalation
B. Asbestos exposure
C. Mercury vapor exposure
D. Silica-free dust inhalation

Correct Answer: B. Asbestos exposure
References:

  • Asbestos exposure causes diffuse interstitial fibrosis (asbestosis), well-documented in both the Fleischner Society Glossary and Radiopaedia.

Question 10:
What imaging modality is most useful for detecting metabolic activity in inflammatory or neoplastic causes of diffuse lung changes?
A. Ultrasound
B. MRI
C. PET-CT
D. Angiography

Correct Answer: C. PET-CT
References:

  • Radiopaedia highlights PET-CT as effective for identifying active inflammation or malignancy in diffuse lung diseases.