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Silicosis — SCE Respiratory MCQ

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HardOccupational Lung DiseaseSilicosisSCE Respiratory

A 50-year-old man who sandblasts denim develops progressive dyspnoea. CXR shows bilateral upper-zone nodules with eggshell calcification of hilar nodes. Spirometry is restrictive and TB tests are negative. What is the most likely diagnosis?

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Correct answer: A — Silicosis

The best answer is “Silicosis”. The clinical pattern, physiology and imaging described are most consistent with Silicosis. The competing diagnoses may share individual findings, but do not account for the complete combination in the stem. The remaining choices—“Asbestosis, after specialist assessment”, “Hypersensitivity pneumonitis, within a respiratory pathway”, “Idiopathic pulmonary fibrosis”, “Beryllium sensitisation in the absence of disease”—are credible in related respiratory presentations, but each addresses a different diagnostic, staging or management decision and does not fit the decisive findings and pathway position in this stem.

Reference: British Thoracic Society pulmonary nodule guideline: https://thorax.bmj.com/content/70/Suppl_2/ii1