Cardiac imaging: Eisenmenger syndrome: practice question

A Radiology 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.

Try it

Radiology · Cardiac imaging: Eisenmenger syndrome

Sample item

A 28-year-old woman with a long-standing ventricular septal defect is now cyanosed. A chest radiograph shows very large central pulmonary arteries that taper abruptly with clear peripheral lung fields. What explains these findings?

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

The answer and the reasoning

A. Shunt reversal from raised pulmonary vascular resistance (Eisenmenger syndrome)

Chronic high flow causes pulmonary vascular remodelling and a rise in resistance, which finally reverses the shunt to right to left and causes cyanosis. The radiograph changes from plethora to central dilatation with peripheral pruning.

Option by option

  • A. Shunt reversal from raised pulmonary vascular resistance (Eisenmenger syndrome) (correct)

    Correct. Large central arteries with pruned periphery and cyanosis signify Eisenmenger syndrome.

  • B. Acute pulmonary oedema

    Pulmonary oedema would give perihilar haze and septal lines.

  • C. Pulmonary stenosis with oligaemia from birth

    Pulmonary stenosis would give a small pulmonary artery and oligaemic lungs.

  • D. Increasing left to right shunt with plethora

    A growing left to right shunt would show plethora and not cyanosis.

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.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Shunt reversal from raised pulmonary vascular resistance (Eisenmenger syndrome). Chronic high flow causes pulmonary vascular remodelling and a rise in resistance, which finally reverses the shunt to right to left and causes cyanosis.

Why is "Acute pulmonary oedema" not the answer?

Pulmonary oedema would give perihilar haze and septal lines.

Why is "Pulmonary stenosis with oligaemia from birth" not the answer?

Pulmonary stenosis would give a small pulmonary artery and oligaemic lungs.

Why is "Increasing left to right shunt with plethora" not the answer?

A growing left to right shunt would show plethora and not cyanosis.

What concept does this question test?

It tests Cardiac imaging: Eisenmenger syndrome in Radiology. The radiograph changes from plethora to central dilatation with peripheral pruning.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Cardiac imaging: Eisenmenger syndrome?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.