Systemic pathology: chronic beryllium disease: 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 · Systemic pathology: chronic beryllium disease

Sample item

A 38-year-old man who worked in an electronics and alloy factory has cough, dyspnoea and bilateral hilar lymphadenopathy. Lung biopsy shows non-caseating granulomas, closely resembling sarcoidosis. Which test best identifies the cause?

ASerum angiotensin-converting enzyme levelBTuberculin skin testCKveim-Siltzbach testDBeryllium lymphocyte proliferation test

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

The answer and the reasoning

D. Beryllium lymphocyte proliferation test

Chronic beryllium disease is a type IV hypersensitivity granulomatous lung disease that mimics sarcoidosis and occurs in workers exposed to beryllium metal and alloys. The beryllium lymphocyte proliferation test detects sensitised T cells and distinguishes it from sarcoidosis.

Option by option

A. Serum angiotensin-converting enzyme level
Serum ACE is a non-specific marker of granuloma burden and cannot identify an occupational cause.
B. Tuberculin skin test
The tuberculin test detects exposure to mycobacteria, and tuberculosis shows caseating granulomas.
C. Kveim-Siltzbach test
The Kveim-Siltzbach test is a skin test for sarcoidosis and cannot identify beryllium.
D. Beryllium lymphocyte proliferation test (correct)
Correct. A positive beryllium lymphocyte proliferation test shows specific sensitisation.

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 D, Beryllium lymphocyte proliferation test. Chronic beryllium disease is a type IV hypersensitivity granulomatous lung disease that mimics sarcoidosis and occurs in workers exposed to beryllium metal and alloys.

Why is "Serum angiotensin-converting enzyme level" not the answer?

Serum ACE is a non-specific marker of granuloma burden and cannot identify an occupational cause.

Why is "Tuberculin skin test" not the answer?

The tuberculin test detects exposure to mycobacteria, and tuberculosis shows caseating granulomas.

Why is "Kveim-Siltzbach test" not the answer?

The Kveim-Siltzbach test is a skin test for sarcoidosis and cannot identify beryllium.

What concept does this question test?

It tests Systemic pathology: chronic beryllium disease in Pathology. The beryllium lymphocyte proliferation test detects sensitised T cells and distinguishes it from sarcoidosis.

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 Systemic pathology: chronic beryllium disease?

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.