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Non-resolving pneumonia — SCE Respiratory MCQ

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HardRespiratory InfectionsNon-resolving pneumoniaSCE Respiratory

A 67-year-old smoker has persistent right-middle-lobe collapse 6 weeks after pneumonia and a normal sputum culture. Which sequence best evaluates an occult central lesion?

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

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Correct answer: C — Contrast CT then bronchoscopy for possible endobronchial obstruction

Explanation lettering: B = shown as A · A = shown as B · E = shown as D · D = shown as E

C is correct. Persistent lobar collapse in a high-risk patient requires contrast CT to define a central mass, nodes and alternative causes, followed by bronchoscopy when endobronchial obstruction is suspected and tissue/airway visualization is needed. Annual radiography delays diagnosis. PET-CT generally follows diagnostic CT and tissue planning. Serum markers cannot rule out lung cancer, and prolonged empirical antibiotics without imaging are unsafe.

Reference: NICE NG122 lung cancer recommendations: https://www.nice.org.uk/guidance/ng122/chapter/Recommendations