Respiratory medicine: silicosis: practice question

A General Medicine 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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General Medicine · Respiratory medicine: silicosis

Sample item

A 45-year-old man has worked in a sandstone quarry for 20 years and has progressive breathlessness. The radiograph shows multiple small nodules in the upper zones and eggshell calcification of the hilar lymph nodes. Which complication should be screened for regularly?

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

The answer and the reasoning

A. Pulmonary tuberculosis

Silica impairs macrophage function, so silicosis markedly increases the risk of mycobacterial infection, and TB is the most important complication, particularly in India where both are common. Silica is also classified as a carcinogen for lung cancer. Mesothelioma is characteristic of asbestos.

Option by option

  • A. Pulmonary tuberculosis (correct)

    Correct. Silica-damaged macrophages permit mycobacterial growth, so TB screening is essential.

  • B. Hepatocellular carcinoma

    Hepatocellular carcinoma is linked to hepatitis B and C, cirrhosis and aflatoxin, not silica.

  • C. Bladder cancer

    Bladder cancer is linked to aromatic amines, smoking and schistosomiasis.

  • D. Malignant mesothelioma

    Mesothelioma is linked to asbestos fibres, not crystalline silica.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Pulmonary tuberculosis. Silica impairs macrophage function, so silicosis markedly increases the risk of mycobacterial infection, and TB is the most important complication, particularly in India where both are common.

Why is "Hepatocellular carcinoma" not the answer?

Hepatocellular carcinoma is linked to hepatitis B and C, cirrhosis and aflatoxin, not silica.

Why is "Bladder cancer" not the answer?

Bladder cancer is linked to aromatic amines, smoking and schistosomiasis.

Why is "Malignant mesothelioma" not the answer?

Mesothelioma is linked to asbestos fibres, not crystalline silica.

What concept does this question test?

It tests Respiratory medicine: silicosis in General Medicine. Silica is also classified as a carcinogen for lung cancer. Mesothelioma is characteristic of asbestos.

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 medicine: silicosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.