skip to main content

Chronic HP — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRespiratoryChronic HPRACP Adult Medicine

A 50-year-old man presents with progressive breathlessness, dry cough, and weight loss. HRCT shows ground-glass opacities and reticulation in a geographic distribution with mosaic attenuation and air trapping. He keeps budgerigars at home. There are no honeycombing or upper-lobe changes. What is the most likely ILD?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Chronic hypersensitivity pneumonitis

GGO with reticulation, mosaic attenuation, air trapping, and bird exposure is chronic HP. Geographic distribution and mosaic attenuation (reflecting air trapping from bronchiolitis) are key CT features distinguishing HP from IPF (which shows UIP pattern: basal/peripheral honeycombing). Allergen avoidance is paramount. Immunosuppression (prednisolone ± mycophenolate) for inflammatory disease. Antifibrotic (nintedanib — INBUILD trial) for progressive fibrotic HP.

Reference: eTG Respiratory – 2024 – HP; ATS/JRS/ALAT 2020 HP