The Common Vein

Question 1

Which of the following is a hallmark finding of interstitial lung abnormalities (ILAs) on high-resolution CT?
Options:
A. Reticular abnormalities
B. Centrilobular nodules
C. Pleural effusion
D. Tree-in-bud opacities

Correct Answer:
A. Reticular abnormalities

Explanation:
Reticular abnormalities, which appear as fine linear opacities forming a network pattern, are a hallmark finding of ILAs and represent interstitial involvement.

Reference:

• Radiopaedia: Interstitial Lung Abnormalities
  “ILAs are often characterized by reticular changes, subpleural fibrosis, and ground-glass opacities on CT imaging.”

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Question 2

Which distribution is most commonly associated with ILAs?
Options:
A. Apical
B. Basal and subpleural
C. Central perihilar
D. Diffuse midlung

Correct Answer:
B. Basal and subpleural

Explanation:
ILAs typically have a basal and subpleural predominance, reflecting early fibrotic changes or prior injury.

Reference:

• Radiology Key: Interstitial Abnormalities
  “Interstitial abnormalities typically appear in the basal and subpleural regions, especially in early stages of fibrotic lung diseases.”

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Question 3

Which of the following is NOT commonly associated with ILAs?
Options:
A. Subpleural fibrosis
B. Reticular changes
C. Traction bronchiectasis
D. Large pleural effusions

Correct Answer:
D. Large pleural effusions

Explanation:
ILAs are interstitial findings and do not typically involve large pleural effusions, which are more associated with other processes such as infection or malignancy.

Reference:

• Fleischner Society: Imaging Features of ILAs
  “ILAs are subtle interstitial changes and do not involve pleural abnormalities as primary findings.”

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Question 4

Which condition is most commonly associated with progression from ILA to interstitial lung disease (ILD)?
Options:
A. Sarcoidosis
B. Idiopathic pulmonary fibrosis
C. Pneumocystis pneumonia
D. Pulmonary embolism

Correct Answer:
B. Idiopathic pulmonary fibrosis

Explanation:
Idiopathic pulmonary fibrosis is the most common progressive fibrotic ILD, and ILAs can represent early findings in its development.

Reference:

• Radiopaedia: Idiopathic Pulmonary Fibrosis
  “ILAs may be an early or asymptomatic precursor to idiopathic pulmonary fibrosis (IPF).”

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Question 5

What is the significance of bronchiolectasis in the context of ILAs?
Options:
A. It indicates airway inflammation.
B. It represents fibrotic retraction of small airways.
C. It suggests acute infection.
D. It is unrelated to interstitial abnormalities.

Correct Answer:
B. It represents fibrotic retraction of small airways.

Explanation:
Bronchiolectasis in ILAs reflects fibrotic processes leading to traction and dilation of small airways in affected lung regions.

Reference:

• Radiopaedia: Interstitial Lung Abnormalities
  “Bronchiolectasis is commonly observed in fibrotic regions and reflects retraction caused by interstitial fibrosis.”

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Question 6

Which of the following is a typical size descriptor for ILAs?
Options:
A. Patchy
B. Segmental or subsegmental
C. Diffuse
D. Micronodular

Correct Answer:
B. Segmental or subsegmental

Explanation:
ILAs are most commonly focal and distributed in segmental or subsegmental portions of the lung. Diffuse changes may occur in advanced disease, but this is less common.

Reference:

• Radiopaedia: Interstitial Lung Abnormalities
  “ILAs are often segmental or subsegmental in distribution, reflecting their focal nature in early interstitial changes.”

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Question 7

Which condition is associated with arcade fibrosis in the context of ILAs?
Options:
A. Pulmonary alveolar proteinosis
B. Connective tissue disease-associated ILD
C. Lymphangitic carcinomatosis
D. Acute eosinophilic pneumonia

Correct Answer:
B. Connective tissue disease-associated ILD

Explanation:
Arcade fibrosis, representing fibrotic changes along bronchovascular bundles, is a common feature of connective tissue disease-associated interstitial lung disease.

Reference:

• Fleischner Society: Thoracic Imaging Terms
  “Arcade fibrosis is often seen in early connective tissue disease-associated ILD and reflects fibrosis along bronchovascular structures.”

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Question 8

Which imaging finding is the least specific for ILAs?
Options:
A. Reticular changes
B. Ground-glass opacities
C. Subpleural fibrosis
D. Tree-in-bud opacities

Correct Answer:
D. Tree-in-bud opacities

Explanation:
Tree-in-bud opacities are indicative of airway-centered processes such as infection or aspiration, not typically associated with ILAs.

Reference:

• Radiopaedia: Tree-in-Bud Pattern
  “Tree-in-bud opacities are airway-centric and commonly reflect infectious bronchiolitis.”

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Question 9

Which population is at greatest risk for developing age-related ILAs?
Options:
A. Smokers
B. Individuals over 60 years of age
C. Patients with connective tissue diseases
D. Cancer survivors post-radiation therapy

Correct Answer:
B. Individuals over 60 years of age

Explanation:
Age-related ILAs are commonly seen in individuals over 60 years of age and may represent normal aging changes or early fibrotic ILD.

Reference:

• Radiology Key: Interstitial Abnormalities in Older Adults
  “Age-related ILAs are most prevalent in individuals above 60 years and are often associated with subpleural changes.”

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Question 10

Which of the following imaging findings suggests progression of ILAs to fibrotic ILD?
Options:
A. Reticular abnormalities
B. Subpleural honeycombing
C. Segmental nodular opacities
D. Pleural effusion

Correct Answer:
B. Subpleural honeycombing

Explanation:
Subpleural honeycombing is a hallmark of progressive fibrotic ILD, indicating irreversible architectural distortion and advanced fibrosis.

Reference:

• Radiopaedia: Interstitial Lung Disease Imaging
  “Honeycombing reflects irreversible fibrosis and architectural distortion, marking progression to end-stage fibrotic lung disease.”