Question 1
What is the most common cause of interstitial fibrosis?
- A. Sarcoidosis
- B. Idiopathic Pulmonary Fibrosis (IPF)
- C. Asbestosis
- D. Drug-induced fibrosis
Answer: B. Idiopathic Pulmonary Fibrosis (IPF)
Explanation: IPF is the most common cause of interstitial fibrosis, characterized by the UIP pattern on imaging and pathology.
?Idiopathic pulmonary fibrosis is the most common form of idiopathic interstitial pneumonia, presenting with a UIP pattern on imaging and pathology.?
Reference: Radiopaedia ? Idiopathic Pulmonary Fibrosis.
Question 2
Which radiological hallmark is most characteristic of interstitial fibrosis on high-resolution CT (HRCT)?
- A. Diffuse ground-glass opacities
- B. Reticulations, honeycombing, traction bronchiectasis, and bronchiolectasis
- C. Cavitary lesions and nodules
- D. Centrilobular nodules and tree-in-bud appearance
Answer: B. Reticulations, honeycombing, traction bronchiectasis, and bronchiolectasis
Explanation: These are classic findings of interstitial fibrosis, frequently subpleural in location, and key for diagnosis.
?The hallmark imaging features of interstitial fibrosis include reticulations, traction bronchiectasis, honeycombing, and architectural distortion, predominantly in subpleural locations.?
Reference: Radiographics ? HRCT of Pulmonary Fibrosis.
Question 3
Which of the following diseases predominantly affects the upper lobes in interstitial fibrosis?
- A. Asbestosis
- B. Sarcoidosis
- C. Idiopathic Pulmonary Fibrosis (IPF)
- D. Nonspecific Interstitial Pneumonia (NSIP)
Answer: B. Sarcoidosis
Explanation: Sarcoidosis often presents with upper lobe predominance, perilymphatic nodules, and bronchovascular involvement.
?Sarcoidosis is characterized by upper lobe-predominant perilymphatic nodules and fibrosis along the bronchovascular bundles.?
Reference: Radiopaedia ? Sarcoidosis.
Question 4
What distinguishes Usual Interstitial Pneumonia (UIP) from Nonspecific Interstitial Pneumonia (NSIP) on HRCT?
- A. UIP typically shows diffuse ground-glass opacities, while NSIP has honeycombing
- B. UIP has subpleural and basal predominance with honeycombing, while NSIP lacks honeycombing and shows diffuse ground-glass opacities
- C. UIP affects upper lobes, while NSIP is basal predominant
- D. UIP is associated with autoimmune diseases, while NSIP is idiopathic
Answer: B. UIP has subpleural and basal predominance with honeycombing, while NSIP lacks honeycombing and shows diffuse ground-glass opacities
Explanation: UIP?s hallmark features include honeycombing and basal predominance, whereas NSIP presents more diffusely with ground-glass opacities and uniform fibrosis.
?UIP typically demonstrates basal and subpleural fibrosis with honeycombing, while NSIP is characterized by ground-glass opacities and a lack of honeycombing.?
Reference: Fleischner Society ? Pulmonary Fibrosis Guidelines.
Question 5
Which of the following is a post-infectious cause of interstitial fibrosis?
- A. Amiodarone toxicity
- B. COVID-19-associated fibrosis
- C. Systemic sclerosis
- D. Sarcoidosis
Answer: B. COVID-19-associated fibrosis
Explanation: Viral infections like COVID-19 can cause post-viral interstitial fibrosis, often with diffuse involvement.
?Post-COVID-19 pulmonary fibrosis is characterized by persistent fibrotic changes, often diffuse, following acute viral pneumonitis.?
Reference: PubMed ? Post-COVID-19 Pulmonary Fibrosis.
Question 6
Which genetic mutation is commonly associated with familial interstitial fibrosis?
- A. CFTR gene mutation
- B. Telomerase gene mutation (TERT)
- C. BRCA1 gene mutation
- D. ALK gene mutation
Answer: B. Telomerase gene mutation (TERT)
Explanation: Mutations in telomerase-related genes are strongly associated with familial forms of interstitial fibrosis.
?Mutations in TERT and related telomerase pathway genes are frequently identified in familial interstitial lung disease.?
Reference: Radiology Key ? Familial Interstitial Lung Diseases.
Question 7
Which of the following imaging findings is NOT typical of interstitial fibrosis?
- A. Honeycombing
- B. Ground-glass opacities
- C. Tree-in-bud appearance
- D. Traction bronchiectasis
Answer: C. Tree-in-bud appearance
Explanation: Tree-in-bud appearance is seen in small airway diseases or infections, not in interstitial fibrosis.
?Tree-in-bud opacities are characteristic of airway-centered processes, such as infections, rather than interstitial fibrosis.?
Reference: Radiopaedia ? Interstitial Lung Disease.
Question 8
What is the typical distribution of fibrosis in asbestosis?
- A. Upper lobe predominant
- B. Diffuse involvement
- C. Subpleural and basal predominant
- D. Bronchovascular regions
Answer: C. Subpleural and basal predominant
Explanation: Asbestosis typically affects the subpleural regions and lower lobes, with fibrosis and pleural plaques.
?Asbestosis is characterized by subpleural fibrosis, most prominent in the lower lobes, and frequently associated with pleural plaques.?
Reference: Radiopaedia ? Asbestosis.
Question 9
Which pulmonary function test (PFT) result is most indicative of interstitial fibrosis?
- A. Obstructive pattern with reduced FEV1/FVC ratio
- B. Restrictive pattern with reduced total lung capacity (TLC)
- C. Increased residual volume (RV)
- D. Normal diffusion capacity (DLCO)
Answer: B. Restrictive pattern with reduced total lung capacity (TLC)
Explanation: Interstitial fibrosis typically causes a restrictive defect with reduced TLC and markedly reduced DLCO.
?Restrictive lung function with reduced TLC and impaired DLCO is characteristic of interstitial lung diseases.?
Reference: ATS ? Pulmonary Function Testing in Interstitial Lung Disease.
Question 10
Which of the following radiological findings suggests advanced interstitial fibrosis?
- A. Ground-glass opacities
- B. Nodules along bronchovascular bundles
- C. Honeycombing with traction bronchiectasis
- D. Mosaic attenuation
Answer: C. Honeycombing with traction bronchiectasis
Explanation: Honeycombing and traction bronchiectasis are hallmarks of advanced-stage interstitial fibrosis, particularly UIP.
?Honeycombing and traction bronchiectasis indicate irreversible, advanced fibrosis and are key features of UIP.?
Reference: Radiographics ? Advanced Pulmonary Fibrosis.