Respiratory: chronic bronchitis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Respiratory: chronic bronchitis

Sample item

A 55-year-old man who smokes has had a productive cough on most days for the last 3 months in each of 2 consecutive years. A bronchial biopsy would most likely show which change?

ANon-caseating granulomas in the bronchial mucosaBHypertrophy of submucosal mucous glands with a Reid index above 0.4CDestruction of alveolar walls distal to the terminal bronchioleDThickened basement membrane with abundant eosinophils and Curschmann spirals

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Hypertrophy of submucosal mucous glands with a Reid index above 0.4

Chronic bronchitis is a clinical diagnosis based on cough and sputum for 3 months over 2 successive years. Pathology shows enlarged mucous glands, increased goblet cells and a raised Reid index (ratio of gland thickness to wall thickness, normally below 0.4). Alveolar destruction defines emphysema and eosinophils with Curschmann spirals suggest asthma.

Option by option

A. Non-caseating granulomas in the bronchial mucosa
Non-caseating granulomas are typical of sarcoidosis.
B. Hypertrophy of submucosal mucous glands with a Reid index above 0.4 (correct)
Correct. Mucous gland hypertrophy and an increased Reid index characterise chronic bronchitis.
C. Destruction of alveolar walls distal to the terminal bronchiole
Alveolar wall destruction is the defining lesion of emphysema.
D. Thickened basement membrane with abundant eosinophils and Curschmann spirals
Eosinophils, a thick basement membrane and Curschmann spirals suggest asthma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Hypertrophy of submucosal mucous glands with a Reid index above 0.4. Chronic bronchitis is a clinical diagnosis based on cough and sputum for 3 months over 2 successive years.

Why is "Non-caseating granulomas in the bronchial mucosa" not the answer?

Non-caseating granulomas are typical of sarcoidosis.

Why is "Destruction of alveolar walls distal to the terminal bronchiole" not the answer?

Alveolar wall destruction is the defining lesion of emphysema.

Why is "Thickened basement membrane with abundant eosinophils and Curschmann…" not the answer?

Eosinophils, a thick basement membrane and Curschmann spirals suggest asthma.

What concept does this question test?

It tests Respiratory: chronic bronchitis in Pathology. Pathology shows enlarged mucous glands, increased goblet cells and a raised Reid index (ratio of gland thickness to wall thickness, normally below 0.4). Alveolar destruction defines emphysema and eosinophils with Curschmann spirals suggest asthma.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory: chronic bronchitis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.