Question 1
Which part of the secondary lobule is primarily affected in paraseptal emphysema?
A. Central portion
B. Peripheral portion
C. Entire lobule
D. Interlobular septa
Answer: B. Peripheral portion
Explanation: Paraseptal emphysema specifically affects the peripheral portion of the secondary lobule near the pleura and interlobular septa.
Reference:
Radiopaedia: Paraseptal Emphysema. “The peripheral portions of the secondary lobule are predominantly affected.”
Link
Question 2
Which of the following is a common radiologic finding in paraseptal emphysema?
A. Ground-glass opacities
B. Subpleural bullae
C. Peribronchial cuffing
D. Mosaic attenuation
Answer: B. Subpleural bullae
Explanation: Paraseptal emphysema manifests radiologically as thin-walled, air-filled spaces (bullae) located at the periphery of the secondary lobules near the pleura.
Reference:
Radiology Key: Imaging Features of Paraseptal Emphysema. “Subpleural bullae are characteristic findings.”
Link
Question 3
Paraseptal emphysema is most commonly associated with which complication?
A. Pulmonary fibrosis
B. Pneumothorax
C. Pleural effusion
D. Pulmonary hypertension
Answer: B. Pneumothorax
Explanation: Subpleural bullae located at the periphery of the secondary lobules can rupture, causing air to leak into the pleural cavity and leading to spontaneous pneumothorax.
Reference:
Radiopaedia: Complications of Paraseptal Emphysema. “Pneumothorax is a primary complication due to bulla rupture.”
Link
Question 4
What is the predominant location of paraseptal emphysema in the lung?
A. Upper lobes
B. Lower lobes
C. Middle lobe
D. Diffuse
Answer: A. Upper lobes
Explanation: Paraseptal emphysema typically affects the periphery of secondary lobules in the upper lobes, particularly subpleural regions.
Reference:
Radiographics: Patterns of Emphysema. “Paraseptal emphysema is frequently located in the upper lobes near the pleura.”
Link
Question 5
Which of the following conditions is a recognized cause of paraseptal emphysema?
A. Smoking
B. Alpha-1 antitrypsin deficiency
C. Pulmonary embolism
D. Bronchial asthma
Answer: A. Smoking
Explanation: Smoking induces inflammation and protease activity, leading to alveolar wall destruction, especially in the peripheral portions of secondary lobules.
Reference:
PubMed: Smoking and Paraseptal Emphysema. “Smoking is a major risk factor for developing paraseptal emphysema.”
Link
Question 6
What differentiates a bulla from a cyst in paraseptal emphysema?
A. Bulla contains fluid, cyst contains air
B. Bulla lacks epithelial lining, cyst has epithelial lining
C. Bulla is smaller than a cyst
D. Bulla is a congenital abnormality, cyst is acquired
Answer: B. Bulla lacks epithelial lining, cyst has epithelial lining
Explanation: Bullae are air-filled spaces formed by alveolar wall destruction in the periphery of secondary lobules and lack epithelial or fibrous lining, unlike cysts.
Reference:
Radiology Key: Differentiating Bullae and Cysts. “Bullae lack epithelial lining, differentiating them from cysts.”
Link
Question 7
Which imaging modality is most sensitive for detecting bullae in paraseptal emphysema?
A. Chest X-ray
B. CT scan
C. MRI
D. Ultrasound
Answer: B. CT scan
Explanation: CT scans are more sensitive than chest X-rays for detecting bullae and assessing their size and distribution in the periphery of secondary lobules.
Reference:
Radiopaedia: Imaging of Paraseptal Emphysema. “CT is the gold standard for detecting and characterizing bullae.”
Link
Question 8
What is the typical size of bullae seen in paraseptal emphysema?
A. <1 cm
B. 1-2 cm
C. >1 cm
D. Variable
Answer: C. >1 cm
Explanation: Bullae are defined as airspaces larger than 1 cm, which form from the destruction of alveolar walls at the periphery of secondary lobules.
Reference:
Fleischner Society Glossary: Definition of Bullae. “Bullae are airspaces larger than 1 cm in diameter.”
Link
Question 9
Which population is most commonly affected by paraseptal emphysema?
A. Young, thin males
B. Elderly females
C. Children with asthma
D. Smokers with COPD
Answer: A. Young, thin males
Explanation: Paraseptal emphysema frequently affects young, thin males, particularly those prone to spontaneous pneumothorax.
Reference:
Radiographics: Clinical Features of Paraseptal Emphysema. “Young, thin males are a typical demographic for paraseptal emphysema.”
Link
Question 10
What is the main histopathological finding in paraseptal emphysema?
A. Alveolar wall thickening
B. Loss of distal alveolar walls in the periphery of secondary lobules
C. Fibrosis of interlobular septa
D. Peribronchial lymphocytic infiltration
Answer: B. Loss of distal alveolar walls in the periphery of secondary lobules
Explanation: Paraseptal emphysema is characterized by localized destruction of alveolar walls in the periphery of secondary lobules, leading to airspace enlargement.
Reference:
PubMed: Histopathology of Paraseptal Emphysema. “Loss of alveolar walls in subpleural regions is the hallmark of paraseptal emphysema.”
Link