skip to main content

Hypersensitivity pneumonitis — SCE Respiratory MCQ

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

EasyILDHypersensitivity pneumonitisSCE Respiratory

A 45-year-old pigeon breeder has episodic fever, cough and dyspnoea after cleaning the loft. HRCT shows centrilobular ground-glass nodules, mosaic attenuation and air trapping on expiratory images. BAL lymphocytes are 48% and serum precipitins to avian antigens are positive. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: A — Antigen avoidance with specialist ILD follow-up

The exposure history, HRCT small-airways pattern and BAL lymphocytosis are typical of hypersensitivity pneumonitis, so antigen identification and avoidance are central. Antifibrotics may be considered in progressive fibrotic disease but do not replace exposure control. TB therapy, inhaled corticosteroid alone and pleurodesis are not appropriate for this syndrome.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/