Surgery MCQs Q19

A 39-year-old woman’s chest radiograph shows bilateral cystic changes with tram-line shadows. She has a history of recurrent severe chest infections since childhood and recently developed hemoptysis.

👉 Question:
What is the most probable diagnosis?

Options:
A. Carcinoma of lung
B. Hamartoma
C. Lung abscess
D. Pulmonary embolism
E. Bronchiectasis

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✅ Correct Answer:
E. Bronchiectasis

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📚 Explanation:

• E. ✅ The patient’s history of recurrent chest infections, hemoptysis, and radiographic features of bilateral cystic changes and tram-line shadows are classic for bronchiectasis, a chronic irreversible dilatation of bronchi.
• A. Carcinoma of lung ❌ – Usually presents as a solitary mass, not bilateral cystic changes with tram-line shadows.
• B. Hamartoma ❌ – Typically appears as a solitary pulmonary nodule (“coin lesion”) on imaging; no cystic changes or recurrent infections.
• C. Lung abscess ❌ – Usually a single cavitary lesion with air-fluid level; history of recurrent infections since childhood is uncommon.
• D. Pulmonary embolism ❌ – May cause wedge-shaped infarcts but does not produce cystic changes or tram-line shadows.

🧠 High-Yield Points:

• 💡 Bronchiectasis is a chronic irreversible dilatation of bronchi due to repeated infections or obstruction.
• 💡 Radiographic features: tram-track shadows, cystic changes, honeycombing.
• 💡 Common causes: post-infectious (e.g., childhood pneumonia), cystic fibrosis, immunodeficiency.
• 💡 Symptoms: chronic productive cough, recurrent infections, hemoptysis.
• 💡 Management: antibiotics for infections, physiotherapy, treatment of underlying cause.

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📖 Read Related Topic:

Click here for full topic: Bronchiectasis – Diagnosis & Management

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