Chest and cardiac imaging: split pleura sign: 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 and cardiac imaging: split pleura sign

Sample item

Contrast CT in a febrile patient with a loculated effusion shows thickened, enhancing visceral and parietal pleura separated by fluid. What does this indicate?

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

The answer and the reasoning

B. Empyema

The split pleura sign shows inflamed, enhancing pleural layers around a fluid collection and supports empyema. Pleural thickening with a loculated collection also changes management towards drainage.

Option by option

  • A. Malignant pleural mesothelioma

    Mesothelioma produces nodular pleural thickening, often encasing the lung, without a fluid-bounded split.

  • B. Empyema (correct)

    Correct. Enhancing, thickened pleural layers enclosing fluid is the sign of empyema.

  • C. Transudative effusion from heart failure

    A transudate has thin, non-enhancing pleura and is usually bilateral and free flowing.

  • D. Haemothorax

    A haemothorax is hyperdense fluid after trauma, without thick enhancing pleural layers.

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 B, Empyema. The split pleura sign shows inflamed, enhancing pleural layers around a fluid collection and supports empyema.

Why is "Malignant pleural mesothelioma" not the answer?

Mesothelioma produces nodular pleural thickening, often encasing the lung, without a fluid-bounded split.

Why is "Transudative effusion from heart failure" not the answer?

A transudate has thin, non-enhancing pleura and is usually bilateral and free flowing.

Why is "Haemothorax" not the answer?

A haemothorax is hyperdense fluid after trauma, without thick enhancing pleural layers.

What concept does this question test?

It tests Chest and cardiac imaging: split pleura sign in Radiology. Pleural thickening with a loculated collection also changes management towards drainage.

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 Chest and cardiac imaging: split pleura sign?

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.