MCQ Endobronchial Finding

MCQ 1

Question:
Which imaging modality is considered the gold standard for evaluating endobronchial lesions?

A. Chest X-ray (CXR)
B. Bronchoscopy
C. Computed Tomography (CT)
D. Magnetic Resonance Imaging (MRI)

Answer:
B. Bronchoscopy

Comment:
Bronchoscopy allows direct visualization of the bronchial lumen and is considered the gold standard for evaluating endobronchial lesions, enabling tissue biopsy and definitive diagnosis.

  • Option A (Chest X-ray): While it may suggest abnormalities, it lacks the resolution to identify most endobronchial findings.
  • Option C (CT): CT provides detailed imaging but does not allow direct visualization or tissue sampling.
  • Option D (MRI): MRI is not commonly used for endobronchial evaluation due to its limited resolution in lung imaging compared to CT.

Literature Reference:
“Bronchoscopy is the gold standard for the diagnosis of endobronchial abnormalities, allowing direct visualization and biopsy.”
Source: Radiopaedia

MCQ 2

Question:
What is the most common primary malignancy presenting as an endobronchial lesion?

A. Small cell carcinoma
B. Adenocarcinoma
C. Squamous cell carcinoma
D. Large cell carcinoma

Answer:
C. Squamous cell carcinoma

Comment:
Squamous cell carcinoma is the most common primary malignancy presenting as an endobronchial lesion due to its central location and propensity to involve the airways.

  • Option A (Small cell carcinoma): Typically arises centrally but is less likely to present as a discrete endobronchial mass.
  • Option B (Adenocarcinoma): More commonly peripheral and less likely to directly involve the bronchi.
  • Option D (Large cell carcinoma): Rarely presents as an endobronchial lesion.

Literature Reference:
“Squamous cell carcinoma often presents as a central, endobronchial mass due to its proximity to the major airways.”
Source: Radiology Key

MCQ 3

Question:
What characteristic finding on CT is commonly associated with mucus plugs?

A. Ground-glass opacity
B. Low-attenuation material with air bubbles
C. Cavitation with thick walls
D. Enhancing central nodule

Answer:
B. Low-attenuation material with air bubbles

Comment:
Mucus plugs are seen on CT as low-attenuation material within the airways, often containing trapped air bubbles, which is a distinctive feature.

  • Option A (Ground-glass opacity): Represents a nonspecific finding associated with alveolar or interstitial processes.
  • Option C (Cavitation with thick walls): Commonly seen in infections or malignancies, not in mucus plugs.
  • Option D (Enhancing central nodule): Suggestive of a neoplastic process, not mucus plugs.

Literature Reference:
“Mucus plugs appear as low-attenuation material, sometimes containing air bubbles, within the airways.”
Source: Radiopaedia

MCQ 4

Question:
Which infection is most likely to cause endobronchial lesions?

A. Tuberculosis
B. Influenza
C. Pneumocystis jiroveci pneumonia
D. Streptococcus pneumoniae

Answer:
A. Tuberculosis

Comment:
Tuberculosis can cause endobronchial lesions due to direct invasion of the bronchial wall by the infection.

  • Option B (Influenza): Typically causes diffuse viral pneumonitis, not endobronchial lesions.
  • Option C (Pneumocystis jiroveci pneumonia): Commonly causes diffuse interstitial disease without endobronchial involvement.
  • Option D (Streptococcus pneumoniae): Causes alveolar consolidation but not endobronchial lesions.

Literature Reference:
“Endobronchial tuberculosis is a distinct form of tuberculosis that affects the bronchial wall, leading to airway narrowing and obstruction.”
Source: PubMed

MCQ 5

Question:
Which imaging feature suggests a carcinoid tumor in the airway?

A. Peripheral cavitary nodule
B. Central calcified mass
C. Well-defined, lobulated endobronchial lesion
D. Patchy ground-glass opacity

Answer:
C. Well-defined, lobulated endobronchial lesion

Comment:
Carcinoid tumors often present as well-defined, lobulated lesions within the bronchial lumen.

  • Option A (Peripheral cavitary nodule): More typical of infections or certain malignancies like squamous cell carcinoma.
  • Option B (Central calcified mass): Seen in some granulomatous infections, not typical for carcinoids.
  • Option D (Patchy ground-glass opacity): Nonspecific and not indicative of carcinoid tumors.

Literature Reference:
“Carcinoid tumors typically appear as well-defined, lobulated masses within the central airways.”
Source: Radiopaedia

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MCQ 6

Question:
What imaging sign is indicative of foreign body aspiration in the airway?

A. Hyperinflation of one lung
B. Diffuse alveolar consolidation
C. Central cavitation
D. Tree-in-bud opacities

Answer:
A. Hyperinflation of one lung

Comment:
Foreign body aspiration often leads to hyperinflation of the affected lung due to a ball-valve effect where air enters but cannot escape.

  • Option B (Diffuse alveolar consolidation): Seen in pneumonia, not specific for foreign body aspiration.
  • Option C (Central cavitation): Associated with infections or malignancies, not foreign bodies.
  • Option D (Tree-in-bud opacities): Indicative of endobronchial infections, not foreign body aspiration.

Literature Reference:
“Hyperinflation of the affected lung is a classic finding in foreign body aspiration, especially in pediatric patients.”
Source: Radiographics

MCQ 7

Question:
Which of the following is a typical cause of endobronchial inflammation?

A. Aspergillosis
B. Sarcoidosis
C. Squamous cell carcinoma
D. Adenocarcinoma

Answer:
B. Sarcoidosis

Comment:
Sarcoidosis can cause endobronchial inflammation due to granulomatous involvement of the airway.

  • Option A (Aspergillosis): Primarily affects lung parenchyma or sinuses, not typically endobronchial.
  • Option C (Squamous cell carcinoma): A neoplastic process, not inflammatory.
  • Option D (Adenocarcinoma): Usually involves peripheral airways, not the bronchial lumen.

Literature Reference:
“Sarcoidosis frequently involves the airway, causing inflammation and airway obstruction.”
Source: ATS Journals

MCQ 8

Question:
What is the most common benign tumor presenting as an endobronchial lesion?

A. Hemangioma
B. Lipoma
C. Carcinoid tumor
D. Hamartoma

Answer:
C. Carcinoid tumor

Comment:
Carcinoid tumors are the most common benign tumors found in the central airways, often presenting with hemoptysis or obstruction.

  • Option A (Hemangioma): Rarely involves the bronchial tree.
  • Option B (Lipoma): Rare and typically peripherally located.
  • Option D (Hamartoma): More commonly peripheral rather than endobronchial.

Literature Reference:
“Bronchial carcinoid tumors account for the majority of benign endobronchial lesions.”
Source: AJR

MCQ 9

Question:
Which diagnostic procedure confirms the presence of endobronchial tuberculosis?

A. CT scan
B. Bronchoscopy with biopsy
C. Sputum culture
D. Skin tuberculin test

Answer:
B. Bronchoscopy with biopsy

Comment:
Bronchoscopy with biopsy is the most definitive diagnostic procedure for endobronchial tuberculosis, allowing visualization and histopathological confirmation.

  • Option A (CT scan): Suggestive but not confirmatory.
  • Option C (Sputum culture): Confirms pulmonary tuberculosis but does not directly identify endobronchial involvement.
  • Option D (Skin tuberculin test): Indicates exposure but does not confirm endobronchial disease.

Literature Reference:
“Bronchoscopy is essential for the diagnosis of endobronchial tuberculosis, providing direct visualization and tissue sampling.”
Source: PubMed

MCQ 10

Question:
Which endobronchial finding is most commonly associated with bronchiectasis?

A. Mucus plugging
B. Mass lesion
C. Cavitation
D. Tree-in-bud opacities

Answer:
A. Mucus plugging

Comment:
Mucus plugging is commonly associated with bronchiectasis, leading to recurrent infections and impaired clearance.

  • Option B (Mass lesion): Not associated with bronchiectasis.
  • Option C (Cavitation): Seen in infections or malignancies, not bronchiectasis.
  • Option D (Tree-in-bud opacities): Suggestive of small airway disease or infection, not mucus plugging.

Literature Reference:
“Mucus plugging is frequently seen in bronchiectasis and contributes to chronic infection and airway damage.”
Source: Radiopaedia

MCQ 11

Question:
What does the “tip of the iceberg” sign in endobronchial imaging represent?

A. A central mass with peripheral calcifications
B. An endoluminal lesion with a larger extraluminal component
C. A mucus plug with trapped air bubbles
D. A cavitating lesion with air-fluid levels

Answer:
B. An endoluminal lesion with a larger extraluminal component

Comment:
The “tip of the iceberg” sign is seen in carcinoid tumors and refers to a small visible intraluminal lesion in the airway, while a larger component extends extraluminally into the surrounding lung parenchyma.

  • Option A (A central mass with peripheral calcifications): Typical of granulomatous infections, not carcinoid tumors.
  • Option C (A mucus plug with trapped air bubbles): Reflects mucoid impaction, unrelated to the “tip of the iceberg” sign.
  • Option D (A cavitating lesion with air-fluid levels): Seen in necrotic infections or malignancies, not indicative of carcinoid tumors.

Literature Reference:
“The ‘tip of the iceberg’ sign is characterized by a small endoluminal lesion with a larger extraluminal mass, commonly seen in carcinoid tumors.”
Source: Radiology Key

MCQ 12

Question:
Which nuclear medicine imaging modality is most sensitive for detecting endobronchial carcinoid tumors?

A. Gallium-68 DOTATATE PET/CT
B. Fluorodeoxyglucose (FDG) PET/CT
C. Indium-111 Octreotide (Octreoscan)
D. Technetium-99m MDP bone scan

Answer:
A. Gallium-68 DOTATATE PET/CT

Comment:
Gallium-68 DOTATATE PET/CT is the most sensitive nuclear medicine modality for detecting neuroendocrine tumors, including endobronchial carcinoids, due to its high affinity for somatostatin receptors.

  • Option B (FDG PET/CT): Typically used for highly metabolic malignancies but is less sensitive for carcinoid tumors due to their lower metabolic activity.
  • Option C (Indium-111 Octreotide): Useful for somatostatin receptor imaging but has largely been replaced by Gallium-68 DOTATATE PET/CT for superior sensitivity and resolution.
  • Option D (Technetium-99m MDP bone scan): Used for skeletal pathology and not relevant for carcinoid tumors.

Literature Reference:
“Gallium-68 DOTATATE PET/CT offers superior sensitivity for detecting neuroendocrine tumors compared to traditional imaging modalities.”
Source: Radiopaedia