Chest imaging: Pneumocystis pneumonia: 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: Pneumocystis pneumonia

Sample item

A patient with advanced HIV has dyspnoea and hypoxia. A chest radiograph is near normal, but HRCT shows extensive bilateral perihilar ground glass opacities. What is the most likely infection?

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

The answer and the reasoning

C. Pneumocystis jirovecii pneumonia

PJP typically shows bilateral perihilar ground glass opacities on CT, often with cysts (pneumatoceles) and relative peripheral sparing. A normal radiograph does not exclude it. Cotrimoxazole is the treatment of choice.

Option by option

  • A. Lobar pneumococcal pneumonia

    Pneumococcal pneumonia is lobar and not typically diffuse ground glass.

  • B. Aspergilloma

    Aspergilloma forms a mass within a pre-existing cavity.

  • C. Pneumocystis jirovecii pneumonia (correct)

    Correct. Bilateral perihilar ground glass in advanced HIV suggests PJP.

  • D. Lung abscess from anaerobes

    Lung abscess shows a cavity with an air-fluid level.

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 C, Pneumocystis jirovecii pneumonia. PJP typically shows bilateral perihilar ground glass opacities on CT, often with cysts (pneumatoceles) and relative peripheral sparing.

Why is "Lobar pneumococcal pneumonia" not the answer?

Pneumococcal pneumonia is lobar and not typically diffuse ground glass.

Why is "Aspergilloma" not the answer?

Aspergilloma forms a mass within a pre-existing cavity.

Why is "Lung abscess from anaerobes" not the answer?

Lung abscess shows a cavity with an air-fluid level.

What concept does this question test?

It tests Chest imaging: Pneumocystis pneumonia in Radiology. A normal radiograph does not exclude it. Cotrimoxazole is the treatment of choice.

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 imaging: Pneumocystis pneumonia?

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.