Chest imaging: double aortic arch: 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.

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Radiology · Chest imaging: double aortic arch

Sample item

An infant with stridor and dysphagia has a barium swallow showing a posterior indentation on the oesophagus and bilateral lateral indentations on the trachea on frontal view. What is the most likely cause?

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

The answer and the reasoning

D. Double aortic arch forming a complete vascular ring

A double aortic arch encircles the trachea and oesophagus and compresses both, giving a posterior oesophageal indentation and bilateral tracheal indentation. The posterior defect distinguishes it from a pulmonary artery sling.

Option by option

  • A. Tracheomalacia only

    Tracheomalacia does not indent the oesophagus.

  • B. Pulmonary artery sling

    A sling causes an anterior oesophageal indentation.

  • C. Achalasia

    Achalasia shows a dilated oesophagus with bird beak tapering.

  • D. Double aortic arch forming a complete vascular ring (correct)

    Correct. This is the classic complete vascular ring.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Double aortic arch forming a complete vascular ring. A double aortic arch encircles the trachea and oesophagus and compresses both, giving a posterior oesophageal indentation and bilateral tracheal indentation.

Why is "Tracheomalacia only" not the answer?

Tracheomalacia does not indent the oesophagus.

Why is "Pulmonary artery sling" not the answer?

A sling causes an anterior oesophageal indentation.

Why is "Achalasia" not the answer?

Achalasia shows a dilated oesophagus with bird beak tapering.

What concept does this question test?

It tests Chest imaging: double aortic arch in Radiology. The posterior defect distinguishes it from a pulmonary artery sling.

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 Chest imaging: double aortic arch?

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.