Question 1
What is the most common cause of mucoid impaction in the lungs?
- A. Chronic bronchitis
- B. Allergic bronchopulmonary aspergillosis (ABPA)
- C. Cystic fibrosis
- D. Aspiration
Answer: A. Chronic bronchitis
Explanation: Chronic bronchitis is the most common cause of mucoid impaction due to mucus hypersecretion and impaired mucociliary clearance.
?Chronic bronchitis, often associated with smoking, is a frequent cause of mucoid impaction due to excess mucus production.?
Reference: Fleischner Society Glossary (Fleischner Society).
Question 2
What imaging pattern is most commonly associated with ABPA-related mucoid impaction?
- A. Ground-glass opacity
- B. Mosaic attenuation
- C. Centrilobular nodules
- D. Finger-in-glove appearance
Answer: D. Finger-in-glove appearance
Explanation: The finger-in-glove pattern represents mucus-filled dilated bronchi, commonly seen in ABPA.
?The finger-in-glove appearance on imaging is characteristic of ABPA due to central mucus plugging.?
Reference: Radiopaedia (Radiopaedia).
Question 3
Which feature helps differentiate mucoid impaction from normal vascular shadows on imaging?
- A. Air bronchograms
- B. Consolidation with air-fluid levels
- C. Tubular branching opacity without tapering
- D. Nodular appearance with cavitation
Answer: C. Tubular branching opacity without tapering
Explanation: Mucoid impaction appears as non-tapering tubular branching opacities, distinguishing it from normal vascular structures.
?Mucoid impaction produces branching opacities resembling fingers in a glove, distinct from vascular tapering.?
Reference: Fleischner Society Glossary (Fleischner Society).
Question 4
What is a common location for mucoid impaction caused by aspiration?
- A. Lower lobes
- B. Upper lobes
- C. Middle lobe
- D. Central bronchi
Answer: A. Lower lobes
Explanation: Aspiration often leads to mucoid impaction in the lower lobes due to gravity-dependent pooling of gastric contents.
?Aspiration-related mucoid impaction frequently affects the lower lobes because of gravity-dependent mucus accumulation.?
Reference: Radiopaedia (Radiopaedia).
Question 5
Which finding on CT is most suggestive of bronchial wall thickening?
- A. Air trapping with mosaic attenuation
- B. Bronchial wall thickness exceeding 40?50% of the lumen diameter
- C. Nodules along bronchovascular bundles
- D. Presence of air bronchograms in opacified regions
Answer: B. Bronchial wall thickness exceeding 40?50% of the lumen diameter
Explanation: Thickened bronchial walls are indicated when the wall thickness exceeds 40?50% of the lumen diameter or is disproportionately larger than adjacent airways.
?Bronchial wall thickening is confirmed when wall thickness exceeds half the lumen diameter or neighboring airway walls of similar size.?
Reference: Radiology Key (Radiology Key).
Question 6
What is the most reliable imaging criterion to assess bronchial wall thickening?
- A. Absolute measurement of wall thickness alone
- B. Visual estimation of airway diameter
- C. Comparison of wall thickness to adjacent pulmonary artery diameter
- D. Assessment based on location alone
Answer: C. Comparison of wall thickness to adjacent pulmonary artery diameter
Explanation: Comparing the airway wall thickness to the adjacent pulmonary artery diameter helps identify bronchial wall thickening accurately.
?Bronchial wall thickening is confirmed if the airway wall thickness exceeds the diameter of the adjacent pulmonary artery.?
Reference: Fleischner Society Glossary (Fleischner Society).
Question 7
Which congenital condition is commonly associated with focal mucoid impaction?
- A. Bronchial atresia
- B. Kartagener syndrome
- C. Cystic fibrosis
- D. Bronchopulmonary sequestration
Answer: A. Bronchial atresia
Explanation: Bronchial atresia leads to focal mucoid impaction in the bronchi, often affecting the apicoposterior segment of the left upper lobe.
?Bronchial atresia typically causes focal mucoid impaction in the segmental bronchi, with associated hyperinflation.?
Reference: Radiopaedia (Radiopaedia).
Question 8
High-attenuation mucus within impacted bronchi on CT suggests which diagnosis?
- A. Tuberculosis
- B. Asthma
- C. ABPA
- D. Foreign body aspiration
Answer: C. ABPA
Explanation: High-attenuation mucus on CT is characteristic of ABPA and reflects calcium or fungal material in the impacted mucus.
?High-attenuation mucus is a hallmark feature of ABPA, often seen in central airways.?
Reference: Radiology Journal (Radiology).
Question 9
What is the appropriate treatment for mucoid impaction in chronic bronchitis?
- A. Bronchodilators and mucolytics
- B. Antifungal therapy
- C. Surgical intervention
- D. Immunosuppressive therapy
Answer: A. Bronchodilators and mucolytics
Explanation: Bronchodilators and mucolytics are essential for improving airway clearance and managing mucus hypersecretion in chronic bronchitis.
?Bronchodilators and mucolytics improve mucus clearance and reduce hypersecretion in chronic bronchitis.?
Reference: ATS Guidelines (American Thoracic Society).
Question 10
What imaging finding would suggest bronchiectasis in the presence of mucoid impaction?
- A. Finger-in-glove appearance of branching opacities
- B. Ground-glass opacities with septal thickening
- C. Air trapping with mosaic attenuation
- D. Dilated bronchi failing to taper toward the periphery
Answer: D. Dilated bronchi failing to taper toward the periphery
Explanation: Bronchiectasis is characterized by dilated airways that fail to taper normally, often associated with mucoid impaction.
?Bronchiectasis is confirmed by dilated bronchi that fail to taper toward the periphery on imaging.?
Reference: Fleischner Society Glossary (Fleischner Society).