Download PGI PG 2020 May radio Solved Question Paper

1.SIunitofradioactivityis:
March2013(c,f)
a)Rem
b)Rad
c)Becuerel

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d)Curie
e)None
CorrectAnswer-C
Ans.Ci.e.Becquerel

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2.Doserateinlinearacceleratorismeasured

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as?
a)Rads/minute
b)Rads/second
c)Roentgen/second
d)Curie/minute

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e)None
CorrectAnswer-A
Ans.is'a'i.e.,Rads/minute
[Ref,Innovationinradiationoncologyp.100)
Thedoserateinteletherapy(includinglinearaccelerator)is

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measuredinmonitorunitorradperminute,
Amonitorunitisameasureofmachineoutputfromaclinical
acceleratorforradiationtherapysuchaslinearacceleratororan
orthovoltageunit.

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3.Teletherapyuses?

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a)Electron
b)X-rays
c)Gammarays
d)Betarays
e)Protons/neutron

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CorrectAnswer-A:B:C:E
Ans.is'a'i.e.,Electron,'b'i.e.,X-rays,'c'i.e.,Gammarays&(e'
i.e.,Protons/neutrons
[Ref:Radiotherapy&brachyther-apybyAlessandracanerp.19;
Radiationphysicsp.210-217;SumerSethi&/ep.177,184]

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Externalbeamradiotherapy(EBRT)orTeletherapy:-
Inteletherapythesourceofradiationisdistantfromthepatient.
Teletherapymaybegivenbythefollowing:
1. X-raysbeams(Linearacceleration)
2. Gammarays:-Cobalt-60beamorCesium-I37.

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3. Particulatebeams

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4.RadiologicalsignsofNF-1include?
a)Scoliosis
b)Wideningofintercostalspace
c)Posteriorvertebralscalloping

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d)Sphenoidwingdysplasia
e)Narrowingofneuralforamina
CorrectAnswer-A:C:D
Ans.is'a'i.e.,Scoliosis,'c'i.e.,Posteriorvertebralscalloping
&'d'i.e.,Sphenoidwingdysplasia

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[Ref:https://radio-paedia.org/articles/neurofbromatosis-
type-1]
RadiographicfeaturesofNF1
Progressivesphenoid.wingdysplasia
Kyphoscoliosis

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Posteriorvestibularscalloping

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5.Clawsignonradiographyisseenin?
a)IleocoecalTB
b)Ischemiccolitis
c)Crohn'sdisease

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d)Ulcerativecolitis
e)Intussusceptions
CorrectAnswer-E
Ans.is'e'i.e.,Intussusceptions
[Refwww.ncbi.nlm.nih.gov/]

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Radiologicalsignsofintussusceptions
Clawsign
Meniscussign
Emptyrightiliacfossa
Coiledspringsign

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Pincersign

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6.Radiologicaltestswhichareusedtosee
whitematterofbrainare?
a)SkullX-ray
b)CT

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c)PET
d)MRI
e)MagneticResonanceSpectroscopy
CorrectAnswer-A:B:C:D:E
Ans.is'All'i.e.,(a,b,c,d&e)

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[Refwww.ncbi.nlm.nih.gov]
'Skullx-rayswerehistoricalusefulandcapableofidentifyingthe
gyriformcalcificationofthesubcorticalwhitematteralthoughtheyno
longerplayasignificantroleinthediagnosisormanagementofthis
condition.

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Thefindingusuallybecomesevidentbetween2and7yearsofage"
Whitematterdiseaseimaging
Investigationofchoiceforwhitematterdisease>MRI(CTissecond
choice).

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7.Posteriorurethralvalvesinchildren/infants

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arediagnosedby?
a)CT
b)HRCT
c)Prenatalultrasound
d)Postnatalultrasound

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e)Micturatingcystourethrography
CorrectAnswer-C:D:E
Ans.is'c'i.e.,Prenatalultrasound,'d'i.e.,Postnatalultrasound
&'e'i.e.,Micturatingcystourethrography
[RefClinicalpediatricnephrology3dletp94;Nekon18th/ep.2241]

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RadiographicinvestigationsforPosteriorurethralvalves
(PUVs)
Ultrasound
A.Antenatalultrasound
B.Postnatalultrasound

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C.Voidingcystourethrogram(VCUG\bestimagingtechnique)

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8.Naturalradio-isotopesare?
a)Radium226
b)Cesium137
c)Strontium90

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d)Iridium192
e)Cobalt60
CorrectAnswer-A:B:C
Ans.is'a'i.e.,Radium226,'b'i.e.,Cesium137&'c'i.e.,Strontium
90

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[Relhttps://www.britannica.com/science/radioactive-isotope;
https://www.chemicool.com/examples/natural-radioactive-
elements.htmlf]
Naturalsourcesofradiation(Backgroundradiation)
Hydrogen(H-3),beryllium(Be-l0),carbon(C-14),radium(Ra-226).

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Radon(Rn-222),cesium(Cs-37),sodium(Na-22),silicon(Si-32),
chlorine(Cl-36),argon(Ar-39),krypton(Kr-81,Kr-78),iodine(I-129,
I-131),potassium(K-40),strontium(Sr90).calcium(Ca-a8),
germanium(Ge-76),zirconium-(2r-96),samarium,(Sm-147,
I48)selenium(Se-82),rubidium(Ru-87),molybdenum(Mo-100),

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cadmium(Cd-113,Cd-l16),xenon(Xe-136),barium(Ba-130),
gadolinium(Gd-152),tungsten(Tn-180),platinum(Pt-190),bismuth
(Bi-209),thorium(Th-232,Th-230)anduranium(u-23s,236,237,
238)

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9.Trueaboutfindingofpleuraleffusion:

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a)CTscancandistinguishbetweenapleuraleffusionanda
pleuralempyema
b)USGcandetectverysmallamountoffluid
c)X-ray-homogenousopacitywithobliterationofCPangle
d)MRIcannotdifferentiatemalignantfrombenignpleuraldisease

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e)MRIcandifferentiatemalignantfrombenignpleuraldisease
CorrectAnswer-A:B:C:E
Ans.,A,CTscancandistinguishbetweenapleuraleffusionand
apleuralempyemaB,USGcandetectverysmallamountof
fluidCX-ray-homogenousopacitywithobliterationofCP

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angle&EMRIcandifferentiatemalignantfrombenignpleural
disease
Ref:SumerSethi6th/49;DahnertRadiologyManual7th/446;WHO
ManualofRadiographicInterpretation2002/4I_42
Imagingcriteriaare:

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Homogenousdensity
Densityindependentportion
Upright:CostophrenicangleinpAview
Lateralyiew:Anteriorandposteriorportionsofgutter
Lateraldecubitusposition:Alongsides

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Supineposition:Alongposteriorly,givingdiffusehazinessonthe
sideofeffusion
Silhouetteofupperlimitofdensity
UppermarginhighinaxillainpAview(yellowarrows)
Uppermarginhighanteriorlyandposteriorlyinlateralview

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Thisisjustanillusion

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Lossofsilhouette:Intheimagesbelownotelackofidentifiableleft
diaphragmbeforeandvisiblediaphragmafterclearanceoffluid
(Silhouettesignprinciple)
Mediastinalshift

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PleuralEffusion-X-Ray
First300mlnotvisualizedonPAyiew
Lateraldecubitusviewsmaydetectaslittleas25ml
PleuraleffusiononCTscan:
CTscanningisexcellentatdetectingsmallamountsoffluidandis

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alsooftenabletoidentifyunderlyingintrathoraciccauses(e.9.
malignantpleuraldepositsorprimarylungneoplasms)aswellas
subdiaphragmaticdiseases1e.g.subdiaphragmaticabscess).

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10.TrueaboutUSG:
a)Usesmostcommonlyfrequencyof20-50MHzfordiagnostic

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ultrasound
b)Workonprincipleofpiezoelectriceffect
c)Ultrasonicwavesonlypenetratesgas,notliquid
d)Gasfilledmicrobubblesareusedascontrastmedia
e)None

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CorrectAnswer-B:D
Ans.B.Workonprincipleofpiezoelectriceffect&D.Gasfilled
microbubblesareusedascontrastmedia
RefSumerSethi6th/9-10;Radiology&ImagingbyThayalan334-
40

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Contrast-enhancedUltrasound(CEUS):
Applicationofultrasoundcontrastmediumtotraditionalmedical
sonography.
Commerciallyavailablecontrastmediaaregx-filled(airor
perfluorocarbon)microbubblesthatareadministeredintravenously

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tothesysferniccirculation.
Microbubbleshaveahighdegreeofechogenicity(theabilityofan
objecttoreflectultrasoundwaves)

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11.ContrastagentwhicharenotusedforCT
scan:

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a)Water
b)CO2
c)Bariumcompounds
d)Iodinatedhigh-osmolalitycontrastmedia
e)Polyethyleneglycol

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CorrectAnswer-B
Ans.B.CO2
RefSumerSethi6th/20;Radiology6ImagingbyThayalan159;
DahnertRadiologyManual7th/1147-48
Radiocontrastagentsareatypeofmedicalcontrastmediumusedto

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improvethevisibilityofinternalbodilystructuresinX-ray-based
imagingtechniquessuchascomputedtomography(CT),
radiography&fluoroscopy.
Radiocontrastagentsaretypicallyiodineorbariumcompounds.
Whenanagentimprovesvisibilityofanarea,itiscalled"contrast

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enhancing
Gadoliniumisakeycomponentofthecontrastmaterialmostoften
usedinmagneticresonance(MR)exams.
Saline(saltwater)andairarealsousedascontrastmaterialsin
imagingexams.

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Bariumsulfatecontrastmediacontinuetobethepreferredagents
foropacificationofthegastrointestinaltractforconventional
fluoroscopicexaminations
Thecurrentuseofiodinatedwater-solublecontrastmediais

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primarilylimitedtoselectsituations

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Twocommercidwater-solubleiodinatedhigh-osmolalitycontrast
media(HOCMs)specificallydesignedforentericopacificationarein
commonuse.Gastrografinand,Gastroview

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12.TrueaboutsignalcharacteristicofCSFon
MRI&FLAIR:

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a)HyperintenseonT1WI
b)HypointenseonTIWI
c)HyperintenseonT2WI
d)FLAIRreducesCSFsignal
e)FLAIRincreasesCSFsignal

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CorrectAnswer-B:C:D
Ans.B,HypointenseonTIWIC,HyperintenseonT2WI&
D,FLAIRreducesCSFsignal
Ref:SumerSethi6th/15;Radiology6ImagingbyThayalanIst/386-
89]

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MRISignalCharacteristic
CSF:HypointenseonTIWI,hyperintenseonT2W1.
Grey/Whitematter:Greymatterisgrey&whitematterswhiten
T1W1&relationshipisreversedonT2W1.
Thefluid,-attenuatedinversion-recovery(FLAIR)useslongerT1

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(2400ms)&TR(7000ms)toreducethesignallevelofCSF&other
tissuewithlongTlrelaxationconstant.
ItreducesCSFsignal&otherwater-boundanatomyinMRimage
byusingaTldetectedatornearthebouncepointofCSF.
FLAIRMRItechniquesconsistofaninversionrecoverypulsetonull

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thesignalfromCSFandalongechotimetoproduceaheavilyT2-
weightedsequence.

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13.PreciseFNACcanbeobtainedbyusing:
a)USG
b)CT

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c)EndoscopicUSG
d)MRI
e)Plain-Xray
CorrectAnswer-A
Ans.A.USG

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RefDahnertRadiologyManual7th/368;Harshmohan7th/902-
l3;Robbins9th/333
RadiologicalimagingAidsforFNAC:
Non-palpablelesionrequiresomeformoflocalizationbyradiological
aidsforFNACtobecarriedout.

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PlainX-rayfilmsareusuallyadequateforlesionswithinbones&for
somelesionswithinthechest
FNACofchestmayalsobeattemptedunderimageamplified
fluoroscopywhichallowsvisualizationofneedleplacementonthe
televisionmonitor

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CTguidanceisalsousedforlesionswithinthechestdyAbdomen.
Themostversatileradiologicalaidisultrasonographicguidance
(USG)whichallowdirectvisualizationoFneedleplacementinreal
time&isfreefromradiationhazards.
ItisanextremelyvaluableaidforFNACofthyroidnodules,soft

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tissuemasses,intra-abdominallesionsdtforintrathoracicwhich
aboutthechestwall,butnohelpindeepintrathoraciclesionsorin
bonylesions
PrecisionofUSGandCTscaniscomparableforguidanceinFNAC

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fromthoracicmasslesions

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14.Gammaradiationis/areproducedby:
a)Co-60
b)Caesium-137
c)P-32
d)Iridium-192

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e)Strontium-90
CorrectAnswer-A:B:D
Ans.A,Co-60B,Caesium-137&D,Iridium-192
[Ref:SumerSethi6th/177,184;Radiology6ImagingbyThayalan
lst/17,278

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Radiationemitted-Radionuclide
Gammarays-
Radium-226
Caesium-137
Cobalt-60

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iridium-192
Gold-198
Samarium-153
Betarays:
Strontium-90

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Yttrium-90
Phosphorus-32
Rhenium-188
Combinationofgammaandbetarays:
Rhenium-186

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iodine-131

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15.Allaretrueaboutgammaknifeexcept:
a)Focussedradiationisdeliveredtotumor
b)Provideequalexposuretosurroundinghealthytissue
c)Itisatypeofstereotacticsurgery

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d)Primarilyusedforsmallbraintumours
e)UsesCo-60assourceofradiation
CorrectAnswer-B
Ans.B.Provideequalexposuretosurroundinghealthytissue
Ref:SumerSethi6th/196-97

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StereotacticRadiosurgerY:
Goalofstereotacticradiosurgeryistodeliverenoughradiationto
destroyorstopthegtorvfhofalesionpreviouslydefinedby
specializedimagingtechniqueswithoutadverselyaffecting
surroundingtissue.

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GammaKnifeRadiosurgery:
Gammakniferadiosurgerykatypeofradiationtherapyusedtotreat
tumorsandotherabnormalitiesinthebrain.
Closeto200tinybearnsofradiationonatumor.
Gammaknife:

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TheGammaKnifeisanadvancedradiationtreatmentforadultsand
childrenwithsmalltomediumbraintumors,abnormalbloodvessel
formationscalledartetiotenotrsmalformations,epilepsy,trigeminal
neuralgia,anerve.ott-ditiottthatcauseschronicpain,andother
neurologicalconditions.

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The'blades"oftheGammaKnife"arethebeamsofgammaradiation
programmedtotargetthelesionatthepointwheretheyintersect.
GammaKnifeenablespatientstoundergoanon-invasiveformof

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brainsurgerywithoutsurgicalrisks,alonghospitalstayor
subsequentrehabilitation.

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16.Whichofthefollowingcell(s)areless
radiosensitive:
a)Osteocyte
b)Erythroblasts
c)Chondrocyte

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d)Spermatogonia
e)Lymphocyte
CorrectAnswer-A:C
Ans.A,Osteocyte&C,Chondrocyte
Ref:SumerSethi6th/174;Radiology&ImagingbyThayalanIst/310

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Mostradiosensitivebloodcell-Lymphocyte
Leastradiosensitivebloodcell-platelet
Mostradiosensitivetissueofbody-Bonemarrow
Leastradiosensitivetissttcofbody-Nervoustissue/brain
HighRadiosensitive-Lymphoidorgans,bonemarrowblood,testes,

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ovaries,intestines
LowRadiosensitive-Muscle,brain,spinalcord

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17.Trueaboutphotodynamictherapyofhead
&neckcancer:
a)Tumoursensitizerisused

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b)Singletoxygenisproducedintumourcell
c)Aftertherapy,radiosensitizermayremainwithtumourcell
d)Hemoporphyringivenasradiosensitizer
e)Photosensitivityisaside-effectaftertherapy
CorrectAnswer-A:B:C:E

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Ans.A,TumoursensitizerisusedB,Singletoxygenisproduced
intumourcellC,Aftertherapy,radiosensitizermayremainwith
tumourcell&E,Photosensitivityisaside-effectaftertherapy
RefSabiston236;Ballenger\Otorhinolaryngology16th/1324
Photodynamictherapyisanewtreatmentthatallowsdestruction

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ofcancercellsandhasrecentlybeenexpandedtotheeradicationof
metaplasticcells,
Itbeginswiththeadministrationofatargetspecificphotosensitizer
thatiseventuallyconcentratedinthetargettissue.
Thephotosensitizingagentisthenactivatedwithawavelength-

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specificlightenergysource,whichleadstogenerationoffree
radicalscytotoxictothetargettissue.
Applicationsreportedintheliteratureincludetreatingearly
radiographicallydetected,non-smallcelllungcancer,pancreatic
cancersquamouscellandbasalcellcarcinomaoftheskin,recurrent

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superficialbladdercancer,Chestwallinvolvementfrombreast
cancerandevenchestwallrecurrenceofbreastcancer.
Givensystemically,thesedrugsarepreferentiallytakenupintumor

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cells,renderingthemmoresensitivetolight-mediatedcellkilling
thantheirsurroundingtissues.

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18.Chestroentgenogramfeature(s)ofstage-
2SarcoidosisinScaddingscoringsystem
:
a)Bilateralhilarlymphadenopathy
b)Mediastinallymphadenopathy

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c)Upperlobeparenchymalinfiltrates
d)Enlargedparatrachealnodes
e)Pulmonaryfibrosis
CorrectAnswer-A:C
Ans.A,Bilateralhilarlymphadenopathy&C,Upperlobe

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parenchymalinfiltrates
StandardscoringsystemdescribedbyScaddingin1961forchest
roentgenograms.
Stage1-Hilaradenopathyalone,oftenwithrightparatracheal
involvement.

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Stage2-Combinationofadenopathyplusinfiltrates.
BHLandparenchymalinfiltrates.
Patientsmaypresentwithbreathlessnessorcough.
Themajorityofcasesresolvespontaneously.
Stage3revealsinfiltratesalone.

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Stage4consistsoffibrosis.
Usuallytheinfiltratesinsarcoidosisarepredominantlyanupperlobe
process.
Onlyinafewnoninfectiousdiseasesisanupperlobepredominance
noted.

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19.Standardtreatmentofwhole-brain
radiotherapy(WBRT)forbrainMetastasis
:
a)20grays(Gy)in10fractions
b)30grays(Gy)in10fractions

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c)30grays(Gy)in5fractions
d)15grays(Gy)in10fractions
e)None
CorrectAnswer-B
Ans.B,30grays(Gy)in10fractions

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Whole-brainradiotherapy(WBRT)to30grays(Gy)in10fractions-
Standardtreatmentinpatientswithmultiplebrainmetastases.
Currentstudyinvestigatedthepotentialbenefitofdoseescalation
beyond30Gy.

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20.Eggshellcalcificationisseenin?

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a)Silicosis
b)Sarcoidosis
c)Lymphomaaftertreatment
d)Aspergilloma
e)TB

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CorrectAnswer-A:B:C:E
Ans.(A)Silicosis(B)Sarcoidosis(C)Lymphomaaftertreatment
(E)TB
Calcificationpatternsonchestradiograph
Egg-shellcalcificationoflymphnodes:

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Definedasshelikecalcificationsupto2mmthickinperipheryofat
leasttwolymphnodesinatleastoneofwhich,theringof
calcificationmustbecompleteandoneoftheaffectedlymphnodes
mustbeatleastIcminmaximumdiameter.
Importantcausesare:-

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Progressivemassivefibrosis(PMF)
Coccidioidomycosis
Tuberculosis
Silicosis(m.c.cause)
Coalworker'sPneumoconiosis

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Sarcoidosis
Blastomycosis
Histoplasmosis
Scleroderma
Lymphomafollowingradiation

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Amyloidosis

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21.Hilarlymphnodecalcificationisseenin?
a)Silicosis
b)Amyloidosis
c)Beryliosis

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d)Asbestosis
e)Scleroderma
CorrectAnswer-A:B:E
Ans.(A)Silicosis(B)Amyloidosis(E)Scleroderma
Irregularcentralpopcorncalcification:

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Itisaclusterofsharplydefinedirregularlylobulatedcalcification
usuallyinpulmonarynodule.
Itischaracteristicofhamartoma.
Laminatedorcentralpattern:
Granuloma

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PunctatePattern:
Tuberculomaorcoccidioidomycosis

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22.Radiologicalsignsofintestinal
perforationis/are-
a)Pneumoperitoneum

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b)Regler'ssign
c)Caterpillarsign
d)Bearsign
e)Footballsign
CorrectAnswer-A:B:E

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Ans.(A)Pneumoperitoneum(B)Regler'ssign(E)Footballsign
Perforationresultsinpneumoperitoneum:
BestviewtoseePneumoPeritoneumischestx-rayinerectposition
whichdetectsairunderthedomeofthediaphragm.
1-2mloffreeaircanbedetectedundertherightdome(betweenthe

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liveranilrightilomeofdiaphragm)providedthepatientismadeto
standorsitatleast10minutespriortotakingradiograPh.
Visualizationoffalciformligamentduetothepresenceofairon
eithersideoftheligament-Falciformligamentsign.
Footballsign:

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Presenceoflargequantitiesofairwhichformaninterfacewithfree
intraperitonealfluid.
Regler'ssignordoublewallsign:
Visualizationofbothaspectsofbowelwallduetothepresenceof
intraluminalaswellasextraluminalair.

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Cupolasign:
Largeamountofgasunderthediaphragm.Itshouldbenotedthat
airisvisualizedbelowthecentraltendonofdiaphragmnotbelowthe

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domeasoccurinuprightx-rays.
Inverted'V'sign:

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Lateralumbilicalligamentisvisualizedinlowerabdomen.
Trianglesign(Doge'scapsign):
Triangular(doge'scap),crescentshapedorsemicircularcollection
ofairintheMorison'spouch.

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23.Unit(s)ofabsorbedradiation?

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a)Rad
b)Gray
c)Curie
d)Rem
e)Sievert

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CorrectAnswer-A:B
Ans.(A)Rad(B)Gray
[Ref:Bhadhury2d/ep.197&Internetsource]
SIunit
Conventionalunit

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Radioactivity
Becquerel(Bq) Curie(Ci)
1Bq=1disintegrationpersecond
1Ci=3.7?1010disintegrationsper
second=37GBq

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Absorbeddose
Gray(Gy)
rad
1Gy=1J/kg=100rad
Effectivedose

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Sievert(Sv)
rem
1Sv=100rem
Linearenergytransfer Newton(N)
keV/m

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1N=1J/m
1keV/m=1.6?10-13N

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24.Isotope(s)usedforbrachytherapyis/are?
a)Radon-222
b)Radium-226

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c)Iodine-125
d)Cobalt-60
e)Cesium-137
CorrectAnswer-A:B:C:D
Ans.(A)Radon-222(B)Radium-226(C)Iodine-125(D)Cobalt-

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60
[Ref:Prez&Brandy'sRadiationOncologist5th/ep,54]
Threemaintypesofradiotherapydependinguponthepositionofthe
sourceofradiation.
Externalbeamradiotherapy(EBRT)orTeletherapy:

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X-raysbeams(Linearacceleration).
Gammarays:-Cobalt-60beamorCesium137.
Particulatebeams
Internalradiotherapyorbrachytherapy:
Inbrachytherapy,theradiationsourceinclosecontactwithtumor.

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TheprincipleistouseanIntraorfuxtalesionalradiationimplantto
irradiatethetumorinvicinity.Sealedsourceinplacedwithinornear
thetumori.e.,Shortdistancetherapy.
Subtypes:
Interstitial

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Removable/Temporarysourcesor
Permanentsourcesor
implants
implants
Iridium-192(Ir-192)

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Cesium-131(Cs-131)
Yttrium

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Yttrium
Cesium-137(Cs-137)
Cobalt-60(Co-60)

--- Content provided by FirstRanker.com ---

Gold-198(Au-198)
Californum
125I
Radium-226(Ra-226)
Radon-222(Rn-222)

--- Content provided by FirstRanker.com ---

Tantalum
Pallidum-103(Pd-103)
Note:Co-60andCs-137areusedforbothteletherapyand
brachytherapy.
Intracavitary:

--- Content provided by FirstRanker.com ---

Mostimportantuseofintracavitaryradiationisinpatientswith
cancerofthecervixafterexternalradiation.
Itisalsousedincancerofuterus,esophagealcancerandlung
cancer.
Removable

--- Content provided by FirstRanker.com ---

Permanent
Radium
Colloidalradioactivegold
Cesium?137 Yttrium
Coblat?60

--- Content provided by FirstRanker.com ---

Radioactiveiodine(131I)
Mould:
Usedinpeniscarcinoma
Highdoseradiation:
MostcommonradioisotopeusedforHDRbrachytherapyisiridium-

--- Content provided by FirstRanker.com ---

I92.
OtherisotopeswhichhavebeenusedareCobalt-60andcesium-
137

---

25.Isotope(s)usedformetastaticbonepain
is/are?

--- Content provided by FirstRanker.com ---

a)Strontium-89
b)Samarium-153
c)Phosphorus-32
d)Thallium
e)Selenium

--- Content provided by FirstRanker.com ---

CorrectAnswer-A:B:C
Ans.(A)Strontium-89(B)Samarium-153(C)Phosphorus-32
[Ref:Radiationoncologyth/eP.141]
Radiopharmaceuticals(radioactiveisotopes)usedformetastatic
bonepainarestrontium(Sr-89),Samarium(Sm-153),rhenium

--- Content provided by FirstRanker.com ---

(Re-186),Phosphorus-32andTin-117(Sn-177).

---

26.Drug(s)usedforradiationprotection
is/are?
a)Metronidazole
b)Amifostine

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c)Actinomycin-D
d)Pentoxiphylline
e)Hydroxyurea
CorrectAnswer-A:D
Ans.(A)Metronidazole(D)Pentoxiphylline

--- Content provided by FirstRanker.com ---

[Ref:Orfordoncologist2nd/ep.462]
Radiosensitizers:
Radiosensitizersarecompoundsthatapparentlypromotefixationof
thefreeradicalsproducedbyradiationdamageatmolecularlevel.
A)Hypoxiccellradiosensitizers:

--- Content provided by FirstRanker.com ---

Nitroimidazoles:Metronidazole,Misonidazole,Etanidazole,
Nimorazole,Pimonidazole
Anticancers:-ActinomycinD(Dactinomycin),Bleomycin,Cisplatin,
Doxorubicin,5-FU,
Fludarabine,Gemcitabine,Hydroxyurea,Paclitaxel,mitomycin-C,

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Topotecan,Vinorelbine.
Hyperbaricoxygen(mostpotent)
B)Nonhypoxiccellradiosensitizers:
Haloginatedpyrimidines:-BUdR,IUdR.
Cisplatinand5-FUaretwoofthemostcommonlyused

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radiosensitizingagents.

---

27.Feature(s)ofcrohn'sdiseaseis/are-
a)Pipestemcolon
b)Pseudosacculation
c)Lossofhaustrasion

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d)Cobblestoneappearance
e)Stringsignofkantor
CorrectAnswer-B:D:E
Ans.(B)Pseudosacculation(D)Cobblestoneappearance
(E)Stringsignofkantor

--- Content provided by FirstRanker.com ---

RadiologicalfindingsofCDare:-
EarliestchangesareaPhthouslesionsorerosions(centralflecksof
bariumsurroundedbyatranslucenthalo).Theselesionsarealso
knownasTargetlesionsorBull'seye.
StringsignofKantor:-Greatlynarrowedterminalileumdueto

--- Content provided by FirstRanker.com ---

inflammationandfibrosis.
'Creeping-faf"sign(OnCT):-Inflammatorychangesintheadjacent
mesentericfat.
Combsign:-Prominentvasarectaofmesentericvessels.
Discontinuousinvolvement(Skipareasarepresent).

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Cobblestoneappearance
Raspberryrosethornappearance
Pseudosacculation

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28.Neoadjuvantchemotherapystandsfor-
a)Chemotherapyalongwithsurgery

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b)Chemotherapybeforesurgery
c)Chemotherapyaftersurgery
d)Chemotherapyalongwithradiationtherapy
e)Chemotherapyafterradiationtherapy
CorrectAnswer-B

--- Content provided by FirstRanker.com ---

Ans.B.Chemotherapybeforesurgery
[Ref:Katzung13th/ep.919-20;chemoth.com/neoadjuvant-
chemotherapy]
NeoadiuvantchemotherapyreferstoCombinationofChemotherapy
andsurgery/radiotherapyinwhichchemotherapyisgivenpriorto

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surgery/radiotherapy.

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29.Trueaboutconcomitant
chemoradiotherapy-
a)Chemotherapyandradiotherapybothgivensimultaneously
b)Radiotherapyactslocoregionallyandchemotherapyacts

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againstdistantmicrometastases
c)Radiotherapyactsassensitizingagent
d)Chemotherapymayactassensitizingagent
e)None
CorrectAnswer-A:B:D

--- Content provided by FirstRanker.com ---

Ans.(A)Chemotherapyandradiotherapybothgiven
simultaneously(B)Radiotherapyactslocoregionallyand
chemotherapyactsagainstdistantmicrometastases
(D)Chemotherapymayactassensitizingagent
Concomitantchemoradiotherapy

--- Content provided by FirstRanker.com ---

Radiotherapyandchemotherapyaregivensimultaneously.
Threeclinicalrationalessupporttheuseofchemotherapydelivered
concurrentlywithradiation.
First,concomitantchemoradiotherapycanbeusedwithorgan-
preservingintent,resultinginimprovedcosmesisandfunction

--- Content provided by FirstRanker.com ---

comparedwithsurgicalresectionwithorwithoutadjuvanttreatment.
Second,chemotherapycanactasaradiosensitizer,improvingthe
probabilityoflocalcontroland,insomecases,survival,byaidingthe
destructionofradioresistantclones.
Third,chemotherapygivenaspartofconcurrentchemoradiation

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mayactsystemicallyandpotentiallyeradicatedistant
micrometastases.

---

---

30.Whichofthefollowingis/aretrueabout
brachytherapythanteletherapy-
a)Moreeffectiveincarcinomacervix

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b)Sameproportionofradiationisdeliveredtoboth-tumour&
normaltissue
c)Betterthanteletherapyforlarge&bulkytumour
d)Deliverhigherdoseofradiationtotumour
e)Lessdamagetonormaltissue

--- Content provided by FirstRanker.com ---

CorrectAnswer-A:D:E
Ans.(A)Moreeffectiveincarcinomacervix(D)Betterthan
teletherapyforlarge&bulkytumour(E)Lessdamagetonormal
tissue
Advantageofbrachytherapyisthatitdelivershighradiationdoseto

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tumorlocallywithhighlocalcontrol.
Damagetonormaltissueislessastheirisrapidfall-offofradiation
aroundthesource.
Thistechniqueisparticularlyusefulintreatingcancersofcemix,
uterus,vaginaandcertainHandNcancers.

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Itcanalsobeusedtotreatbreast,brain,skin,esophageal,soft
tissue,lung,bladderandprostatecancer.

---

31.Featuresofstrontium89incomparisonto
phosphorus-32-
a)Longert-1/2

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b)Deeperpenetration
c)EmitsbetarayswhileP-32emitsalpharays
d)Lessertoxicity
e)None
CorrectAnswer-A:D

--- Content provided by FirstRanker.com ---

Ans.(A)Longert-1/2(D)Lessertoxicity
[ReJ:ReviewofRadiologybySumerSethiCh/ep.184;Harrison
l9h/ep.363e-3;Bonica'sManagementofPuinbyScottFishmanp'
655]
Half-lifeofP-32is14.3daysandstrontium-89is50.5days.

--- Content provided by FirstRanker.com ---

SofttissuepenetrationofP-32is8mmandstrontium-89is2.4mm.
BothP-32andStrontium-89emitB-rays.
P-32ismoderatelytoxicwhereasstrontiumhaslowtoxicity.

---

32.Whichofthefollowingis/areusedin
neuroendocrinetumorevaluation:

--- Content provided by FirstRanker.com ---

a)68Ga-DOTA-TOC
b)MIBG
c)68Ga-DOTA-NOC
d)F-18Fluorodopa
e)68Ga-DOTA-TATE

--- Content provided by FirstRanker.com ---

CorrectAnswer-A:B:C:D:E
Ans.(A)68Ga-DOTA-TOC(B)MIBG(C)68Ga-DOTA-NOC(D)F-
18Fluorodopa(E)68Ga-DOTA-TATE
Gallium68DOTATOC/DOTANOC:
Forimagingofneuroendocrinetumors.

--- Content provided by FirstRanker.com ---

HighersensitivityforGIneuroendocrinetumors
F-18Fluorodopa:Dopamineanalogue:
Themostspecific&sensitiveagentforimagingofneuroendocrine
tumorsespeciallypheochromocytoma(adrenal&extra-adrenal)&
neuroblastoma

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ScintigraphyofneuroendocrineTumors:
I-131Metaiodobenzylguanidine(MlBG)Sensitivity-77-100%.
I-123Metaiodobenzylguanidine(MIBG).
GlucoseAnalogs2-(fluorine-r8)fluoro-2-deoxy-D-glucose
(FDG)Uptake

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33.USGis/arebasedon:
a)Piezoelectriceffect
b)Diamagneticeffect
c)Paramagneticeffect
d)Ferromagneticeffect

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e)Electromagneticeffect
CorrectAnswer-A
Ans.A.Piezoelectriceffect
[Ref:ReviewRadiologybySumerSethi6th/9-11]
Ultrasonography:

--- Content provided by FirstRanker.com ---

Ultrasonicimage(sonographic/echographic)isbasedonmechanical
oscillationsofthecrystalexcitedbyelectricalpulses(Piezoelectric
effect).

---

34.X-rayfeature(s)ofLeftAtrial
Hypertrophy:

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a)Bootshapedheart
b)Widenedcarina
c)Straightenedleftborder
d)Doubleatrialshadow
e)Moneybagappearance

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CorrectAnswer-B:C:D
Ans.(B)Widenedcarina(C)Straightenedleftborder(D)Double
atrialshadow
[Ref:PJM20th/228;DahnertRadiologymanual5th/575,636-
637;ReviewradiologybySumerSethi6th/76-77,80]

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X-rayfeatureofleftAtrialHypertrophy:
Doubleatrialshadow(Doubledensityseenthroughrightupper
border)
Straightenedleftborder
Leftbronchusliftedupwithwidenedcarina

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EsophaguscurvingaroundthedilatedLeftatrium.
Splayingofmainstembronchi(i.e.Increasedcarinalangle)
Smallaorta(duetoincreaseoffuruardcardiacoutput)
Normal/UndersizedLV

---

35.Whichofthefollowingis/arecommon

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radiationinducedcancers:
a)Breastcancer
b)Gonadalcancer
c)Leukaemia
d)Renalcellcarcinoma

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e)Prostatecancer
CorrectAnswer-A:B:C
Ans.(A)Breastcancer(B)Gonadalcancer(C)Leukaemia
[Ref:DahnertRadiologymanual7th/574,154,408,313.]
Mostcommonlyoccuringradiation-inducedcancerisLeukemia.

--- Content provided by FirstRanker.com ---

Cancerinductionisthelargestriskofradiationexposure
encounteredinradiology.
Bonemarrow,gastrointestinaltract&mucosa,breasttissue,gonads
&lymphatictissuearemostsusceptibletoradiationinduced
malignancy.

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Cancerriskishigherforchildrenthanforadults

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36.Waterlilysignisseenin:
a)Hydatidcystoflung
b)Aspergillomalung
c)T.B

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d)Silicosis
e)Hemartomalung
CorrectAnswer-A
Ans.(A)Hydatidcystoflung
[RefReviewofRadiologybySumerSethi6th/59;DahnertRadiology

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manual5th/493]
HydatidLung
Noorrarecalcificationinlung
WaterlilysignorCamalotesign(inchestX-ray)
LungEchinococcosis:

--- Content provided by FirstRanker.com ---

Waterlilysign:
Completelycollapsedcrumpledcystmembranefloatingonthecyst
fluid
SignofCamelot
Serpentsign

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Cumbosign
Meniscussign
Crescentsign
Hamartomalung.
Carney'striad&calcification

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Silicosis:Eggshellcalcification.

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37.Whichofthefollowingdonotuse
radiation:
a)MRI
b)CT

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c)USG
d)SPECT
e)PET
CorrectAnswer-A:C
Ans.(A)MRI(C)USG

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[R4L6B26th/174;ReviewofRadiologybySumerSethi6th/5'9;
DahnertRadiologymanuatsth/1070-71]
Ultrasound:
Secondcommonestmethodofimaging.
Itreliesonhigh-frequencysoundwavesgeneratedbyatransducer

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containingpiezoelectricmaterial.
MRI:
MRIreliesonthefactthatnucleicontaininganoddnumberof
protonsorelectronshaveacharacteristicmotioninamagneticfield
(precession)andproduceamagneticmomentasaresultofthis

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motion.
Abriefradiofrequencypulseisthenappliedtoalterthemotionofthe
nuclei.

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38.Whichofthefollowingisnon-ionising
radiation:

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a)X-ray
b)13-rays
c)a-rays
d)Microwave
e)yrays

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CorrectAnswer-D
Ans.(D)Microwave
[RefRobbins9th/428;ReviewofRadiologybySumerSethi6th/166;
L6.826th/172]
TheenergyofnonionizingradiationsuchasUVandinfraredlight,

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microwave&soundwaves,canmoveatomsinamoleculeorcause
themtovibrate.

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39.Onx-ray,smallbowelcanbe
differentiatedbylargebowelbyhaving:
a)Stringofbeadssign

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b)Haustarions
c)Peripherallyplacedconcavecoilofintestine
d)Airfluidlevel
e)Valvulaeconniventes
CorrectAnswer-A:D:E

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Ans.(A)Stringofbeadssign(D)Airfluidlevel(E)Valvulae
conniventes
[Ref.BDC6th/Vol.II438;ReviewRadiologybySumerSethi
6th/123;Grainger&AllisoniDiagnosticRadiology6th/598,602;
DahnertRadiologymanual5th/767;L6B26th/I143-44]

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Dilatedloopsofsmallintestinearereadilyidentifiediftheyaregas
filledonsupineradiographs.
Thestringsofbeadssign,causedbyalineofgasbubblestrapped
b/wthevalvulascontents,isseenonlywhenverydilatedsmall
bowelisalmostcomPletelyfilledwithfluid&isvirtuallydiagnosticof

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smallbowelobstruction.

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40.Forradiotherapyanisotopeispacedinor
aroundcanecrsite.Itiscalledas:
a)Brachytherapy
b)Teletherapy

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c)Externalbeamtherapy
d)IntensityMedulatedradiotherapy
e)None
CorrectAnswer-A
Ans.(A)Brachytherapy

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[Ref.RadiologybySumerSethi6th/176;Grainger&Allison\
DiagnosticRadiology6th/1737]
Brachytherapy:
Itreferstosituationsinwhicharadioisotopeisplacedontoorinside
thepatient.

--- Content provided by FirstRanker.com ---

Thesourcecanbeplacedintothetargettissuesortumouritself
suchasprostateorbreast(interstitialbrachytherapy,intoabody
cavitysuchastheuterinecavity,oesophagusorbronchus
(intracavity/intraluminalbrachytherapy)otontotheskinsurfaceto
treatacutaneousmalignancy

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---

41.Normalbraincalcificationis/arepresent
in:
a)Pinealgland
b)Choroidsplexus
c)Thalamus

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d)Duramater
e)Hypothalamus
CorrectAnswer-A:B:D
Ans.(A)Pinealgland(B)Choroidsplexus(D)Duramater
[ReviewofRadiologybySumerSethi6th/137]

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NormalIntracranialCalcification:
Pineal,habenulae
ChoroidPlexus
Dura(falx,tentorium,overvault)
Ligaments(petroclinoid&interclinoid)

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Pacchionianbodies
BasalGangliadentatenucleus
Pituitary
Lens

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42.Whichofthefollowingistrueregarding

--- Content provided by FirstRanker.com ---

MRI:
a)MRIisbetterthanCTscanforbonylesion
b)GreymatterisgreyonTIWI
c)Usesdyegadolinium
d)Gadoliniumissaferthaniodinebasedcontrastagent

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e)Canbeusedinmultipleplain
CorrectAnswer-B:C:D:E
Ans.(B)GreymatterisgreyonTIWI(C)Usesdye
gadolinium(D)Gadoliniumissaferthaniodinebasedcontrast
agent(E)Canbeusedinmultipleplain

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[RefSumerSethi2nd/9-10;mriscans.cliniccompare.co.uHmri-scan-
with-contrast-dye;DahnertradiologyReviewManual5th/1079;
Bhadury2nd/177;blog.radiolog.ucsf.edu;www.difren.com/dffirence
/CT-Scan-r,s-MRI]
MRI:

--- Content provided by FirstRanker.com ---

ThecontrastdyeusedintheseMRIScansisgenerallygadoliniumat
complicationsarerarerincomparisontothelodineorigindyewed
forX-raysandCTscan
Inspine&formusculoskeletalproblems,MRIisthepreferred
option.

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MRimaginghastraditionallybeenusedforneurologicindications,
includingbraintumors,acuteischemia,infection,andcongmltal
abnormalities.
Greymatterisgrey&whitematteriswhiteonT1W1&relationship
isreversedonT2W1.

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---

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43.AllaretrueregardingPETscanexcept:
a)Helpinassessmentofbothanatomical&functionalstatusof
tissue
b)Donotposeanyradiationexposuretopatient
c)SuperiortoCTforanatomicaldetail

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d)FDGisused
e)None
CorrectAnswer-B:C
Ans.(B)Donotposeanyradiationexposureto
patient(C)SuperiortoCTforanatomicaldetail

--- Content provided by FirstRanker.com ---

[RefLeB25th/136-37;DahnertRadiologymanuel5th/1085;L&B
25th/136,BasicRadiologybyLange2004;raiiegTaphics.rsna.org/
content/23/2/315full]
PositronEmissionTomography(PET):
Themostcommonlyusedradiolabeledtraceris18F-2-fluoro-2-

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deoxy-D-glucose(FDG),althoughothertracerscanalsobeusedin
ordertoassessmetabolicfunctionssuchasoxygenandglucose
consumptionandbloodflow.
Areasofhighmetabolicactivity(i.e.,cerebralcortex,deepgray
nuclei)demonstrategreaterradiopharmaceuticaluptakethanilo

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arcasoflowmetabolicactivity,suchaswhitematterorcerebrospinal
fluid.Thebonesofthcskullandscalpsofttissuesare,forthemost
part,invisible.
Anatomicresolution,althoughnotasgoodaswithCTorMRi
imaging.

--- Content provided by FirstRanker.com ---

Strengths:
Allows/functionalimaging

---

Allowsimagingofthewholebody
Bonescanhasahighsensitivityformetastaticbonedisease,
fracturesandinfection

--- Content provided by FirstRanker.com ---

Drawbacks:
Highcost,verylimitedavailabilityandrelativelylowspatial
resolution.

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44.Falseincreaseinsizeofheartonchestx-
rayPAviewis/areseenin:

--- Content provided by FirstRanker.com ---

a)Rotationofpatient
b)Supineview
c)Filmtakeninexpiration
d)Pneumonia
e)None

--- Content provided by FirstRanker.com ---

CorrectAnswer-A:B
Ans.(A)Rotationofpatient(B)Supineview
[Ref:WHORadiographicManual2002/32-33;BasicRadiology
(Lange)2004/Heartimaging]
Causesofpseudoincreasedsizeofheart:

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ChestX-rayshouldbetakeninfullinspiration&correctlycentered:
Afilmtakeninexpirationcancauseconfusion.
Itmaysimulatediseasese.g.,pulmonarycongestion,cardiomegaly
orawidemediastinum'
InSupinechestview:

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TheHeartappearsenlarged&mediastinummayaPPearwide
perhaps10cm.
MediastinalWidening:
Wideningofthemediastinumismostoftenduetotechnicalfactors
suchasPatientpositioningortheprojectionused.

--- Content provided by FirstRanker.com ---

Rotation,incompleteinspiration,oranAPview,mayallexaggerate
thewidthofthemediastinum,aswellasheartsize.

---

---

45.Side-effects(s)ofPituitaryirradiation:
a)Hypopituiarism
b)Decreaseriskofsecondarytumor

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c)Opticnervedamage
d)Increasedriskofcerebrovascularaccident
e)None
CorrectAnswer-A:C:D
Ans.(A)Hypopituiarism(C)Opticnervedamage(D)Increased

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riskofcerebrovascularaccident
[RefHarrison19th/2263-64,18th/2886,2829;CMDT2016/1087,
06/1115;Devita7th/1844;LeibelPhilip2nd/489]
S/EofPituitaryirradiation:
Hypopituitarism,somedegreeofmemoryimpairment,increased

--- Content provided by FirstRanker.com ---

longtermnskofsecondtumor&smallvesselischemicepisode.

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46.TruestatementregardingIodine-131:
a)Itistheonlyisotopeofiodineusedforthyroid
b)Contraindicatedinpregnancy
c)Emitsarays

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d)Emits13rays
e)Emitsyrays
CorrectAnswer-B:D:E
Ans.(B)Contraindicatedinpregnancy(D)Emits13rays
(E)Emitsyrays

--- Content provided by FirstRanker.com ---

[Ref:DahnertRadiologymanual5th/1087:88;ReviewofRadiology
bySumerSethi2nd/101;Harrisontgth/263e-3,18th/2932,t7g1,
17th/1360;DuttaGynaecology5th/484,4th/465;MeredithRadiation
Physics&NuclearMedicine/28]
(Iodine)I-131:

--- Content provided by FirstRanker.com ---

Emitsbeta&gammarays.
Contraindicatedduringpregnancy.
Foetalthyroidwillbedestroyedresultingincretinism,other
abnormalitiesifgivenduringthefirsttrimester.
I-127-Stableisotopeofiodine.

--- Content provided by FirstRanker.com ---

I-131-Radioactiveisotopeofmedicalimportance.
I-123-Agentofchoiceforthyroidimaging.
ForradioactiveiodinescanningI-131&I-123areused.
Fortreatmenthypothyroidism&thyroidcancerI-131isused.

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47.18-FDGstandsfor:

--- Content provided by FirstRanker.com ---

a)18-Fluorodeoxyglucose
b)18-Fluorodioxyglucose
c)18-Fluorodeoxygalactose
d)18-Fluorodioxygalactose
e)18-Fluorodeoxyglycogen

--- Content provided by FirstRanker.com ---

CorrectAnswer-A
Ans.(A)18-Fluorodeoxyglucose
[RefSumerSethi2nd/16;Grainger&AllisonRadiology6th/141]
18F-2-Fluoro-2-deoxy-D-glucose(FDG)
DyeusedinPETscans.

--- Content provided by FirstRanker.com ---

Themostcommonlyusedradiolabeledtraceris18F-2-Fluoro-2-
deoxy-D-glucose(FDG).
InPEThelpsassessmetabolicfunctionssuchasoxygenand
glucoseconsumptionandbloodflow.

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48.Half-lifeofradiumis:

--- Content provided by FirstRanker.com ---

a)14day
b)27day
c)1626years
d)5.25yr
e)None

--- Content provided by FirstRanker.com ---

CorrectAnswer-C
Ans.(C)1626years
[Ref:Harrison19the/p263e-3]
Half-lifeofRa-226:1626years

---

49.1curieisequivalentto:

--- Content provided by FirstRanker.com ---

a)1.7x1010disintegration/second
b)2.7x1010disintegration/second
c)3.7x1010disintegration/second
d)4.7x1010disintegration/second
e)5.7x1010disintegration/second

--- Content provided by FirstRanker.com ---

CorrectAnswer-C
Ans.(C)3.7x1010disintegration/second
[Ref:SumerSethi2nd/94-95;Grainger&AllisonRadiology6th/118;
RadiologybyS.Bhailury2nd/197;Harrison19th/263e-1,18th/1788;
http://www.nrc.gov/reading-rm/doc-collections/cfr]

--- Content provided by FirstRanker.com ---

RadiologybyS.Bhadury2ndl197:Writes:
1Bq=1disintegration/second
1Curie(Ci)=3.7x10(10)disintegration/second
1Ciisequalto37gigabecquerel
1gray(Gy)=100rads10mGy=1rad1mGy=100mradGray

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(Gy)istheSIunitofabsorbeddose.
Onegrayisequaltoanabsorbeddoseof1foule/kilogram(100
rads).

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50.RadiationnotemittedbyCo-60:
a)arays

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b)13rays
c)yrays
d)Positron
e)6rays
CorrectAnswer-A:D:E

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Ans.A,araysD,Positron&E,6rays
[Ref:Harrison19th/263e3,18th/1790;SumerSethi2nd/88;Grainger
(tAllisonRadiology6th/118]
Cobalt(Co-60)-beta,gammaraysemitted.

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51.Whichofthefollowingareasarenot

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examinedinFAST:
a)Perisplenic
b)Perihepatic
c)Suprapubic
d)Chest

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e)None
CorrectAnswer-E
Ans.(E)NONE
[Ref:L6B26th/187;Manipal4th/886]
FAST:4acousticwindow-pericardial,perihepatic,perisplenicor

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pelvic.
Thefourclassicareasthatareexaminedforfreefluidarethe
perihepaticspace(alsocalledMorison'spouchorthehepatorenal
recess),perisplenicspace,pericardium&pelvis.

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