1.Coffeebeansignisseenin? a)Gastricvolvulus b)Sigmoidvolvulus c)Hypertrophicpyloricstenosis d)Midgutvolvulus CorrectAnswer-BSigmoidvolvulusREF:Wofganag5thep.846/748 Sign Disease Rattailappearance Carcinomaesophagus Birdbeakappearance Achalasia Beaksign/doubletrack/tramtrack HypertrophicpyloricstenosisMedusaheadcoloniesonCT Roundworm Pincer/claw/coiled Intussception spring/target/meniscussignCoffeebeansign Sigmoidvolvulous Leadpipeappearance Ulcerativecolitis Stringofkantor/bull'seye Chron'sdisease Thumbprintingsign Ischemiccolitis Sawtoothappeanceonbarium Diverticulosis enemaApplecoresign Carcinomacolon Corkscrewappearance Diffuseesophagealspasm Stringsign Hypertrophicpyloricstenosis
2.Rattailappearanceincontrastradiography isseenin? a)Achalasiacardia b)Carcinomaesophagus c)Corkscrewesophagus d)Diffuseesophagealspasms CorrectAnswer-BCarcinomaesophagusREF:sabiston's18'editionchapter41Seetableinthepreviousquestion"Rat-tail"appearanceonbariumstudyisseenincarcinomaesophagus.
3.Whichchamberenlargementshowsa doublerightheartborderwithawidesubcarinalangle? a)Leftatrium b)Leftventricle c)Rightatrium d)Rightventricle CorrectAnswer-AAnswer-A-LeftatriumRadiologicalsignsofleftatrialenlargement:A'double'rightheartborderElevationoftheleftmainbronchusSplayingofthecarinaEnlargementoftheleftatrialappendageTheprominenceoftheportionoftheleftheartborderattheleveloftheleftmainbronchus
4.MercedesBenzsignisseenin: a)Gallstone b)Bladderstone c)Renalstones d)Foreignbodybronchus CorrectAnswer-AGallstoneREF:Sutton'stextbookofradiology,Thedition,volume1page713MercedesBenzsign/Seagullsign/Crowfeetsign:GallbladderstoneifradiopaquehasastellatefacetedappearancewithgascontainingfissuresontheplainradiographandiscalledasMercedesBenzsign/SeagullsignorCrowfeetsign
5.Chainoflakesappearanceisseenin? a)Chronicpancreatitis b)Acutepancreatitis c)Gallstoneileus d)Sub-acuteintestinalobstruction CorrectAnswer-AChronicpancreatitisREF:Sutton'sRadiology7theditionvolume1page798,Sabistontextbookofsurgery18thedchapter5Chronicpancreatitisischaracterizedbyirregularitiesofthepancreaticducts,ductalstrictures,andareasofductdilation.Themajoraswellastheside-branchductsmaybeinvolved.Forunexplainedreasons,somepatientswithchronicpancreatitisdevelopdilatedmainpancreaticducts(largeductdisease),whereasothersretainductsofnormalorevensmallerthannormalcaliber(smallductdisease).Somepatientswithchronicpancreatitiscanbeshowntohavemajorductsthathavetheappearanceofa"chainoflakes"ora"stringofpearls"thatistheresultofsegmentsofdilatedductseparatedbyareasofductalstricture
6."Corkscrewappearance"ischaracteristic of? a)Carcinomaesophagus b)Hypertrophicpyloricstenosis c)Diffuseesophagealspasm d)Sigmoidvolvulous CorrectAnswer-CDiffuseesophagealspasmREF:Wofganag5thep.846/748 Sign Disease Rattailappearance Carcinomaesophagus Birdbeakappearance Achalasia Beaksign/doubletrack/tramtrack HypertrophicpyloricstenosisMedusaheadcoloniesonCT Roundworm Pincer/claw/coiledspring/target/ Intussception meniscussignCoffeebeansign Sigmoidvolvulous Leadpipeappearance Ulcerativecolitis Stringofkantor/bull'seye Chron'sdisease Thumbprintingsign Ischemiccolitis Sawtoothappeanceonbarium Diverticulosis enemaApplecoresign Carcinomacolon Corkscrewappearance Diffuseesophagealspasm Stringsign Hypertrophicpyloricstenosis
7.AnabsolutecontraindicationofMRIis: a)Pacemaker b)Prostheticcardiacvalves c)Insulinpump d)Choclearimplants CorrectAnswer-APacemaker[Ref:Harrison17/ep2494;GraingerDiagnosticRadiology4/ep122;variouswebsites-http://www.mr-tip.com/servl.php?ope=dbl&dbs=Prosthetic%20Heart%20Valveshttp://www.imrser.org/PDF/Shellock.HeartValves.JMRLpdf;http://www.mrtip.com/sery1.php?type=dh1&dbs=Prosthetic%20Heart%20Valves;andjournal-_RadioGraphics2004;24:1257-1267MRisconsideredamongthesafestimagingmodalitiesforpatients,evenatveryhighfieldstrengths,morethan3-4tesla.ButFerromagneticobjectsundermagneticfieldcanbevulnerableto4adverseeffects:Movement(causingstructuralinjury),Currentconduction(potentiallycausingelectricalshock),Heating(possiblycausingburninjury),andArtifactgenerationSeriousinjuriescanbecausedbyattractionofferromagneticobjectsintothemagnet,whichwouldactasmissilesifbroughttooclosetothemagnet.Ferromagneticimplants,suchasaneurysmclips,maytorque(turnortwist)duetothemagneticfield,causingdamagetovesselsandevendeath.
Metallicforeignbodiesintheeyehavemovedandcausedintraocularhemorrhage.Pacemakersandpacemakerleadsareacontraindication,asthepacemakercanmalfunctionandcausearrhythmiaorevendeath.HoweverwithgrowingexpansionofMR,increasingnumberofimplantmedicaldevicesarebeingMRsafe.SonewerpacemakerandaneurysmclipsarebeingmadewhichareMRsafe.AbsoluteContraindicationsfortheMRIscan:Electronically,magnetically,andmechanicallyactivatedimplantsFerromagneticorelectronicallyoperatedactivedeviceslikeautomaticcardioverterdefibrillatorsCardiacpacemakersMetallicsplintersintheeyeFerromagnetichaemostaticclipsinthecentralnervoussystem(CNS)Patientswithanimplantedcardiacpacemakerhavebeenscannedonrareoccasions,butpacemakersaregenerallyconsideredanabsolutecontraindication.RelativeContraindicationsfortheMRIscan:CochlearimplantsOtherpacemakers,e.g.forthecarotidsinusInsulinpumpsandnervestimulatorsLendwiresorsimilarwires(MRISafetyrisk)Prostheticheartvalves(inhigh.fields,ifdehiscenceissuspected)Haemostaticclips(body)NonierromagneticstapedialimplantsWomenwitha.first-trimesterpregnancyTattoos(onlyaprobleminhigher-strengthmagnetic.fieldi.e.morethan3tesla)1Reflittp://www.mr-tip.com/sery1.php?type=dbl&dbs=Prosthetic%20Heart%20Valvesi
8.Floatingwaterlilysignisseenin a)Aspergillosis b)Hamartoma c)Hydatidcyst d)Cavitatingmetastasis CorrectAnswer-CHydatidcyst[RefRadiologyReviewManualbyDahnert5/e,p699;vviviv.emedicine.00In/Ined/TOPIC629.htn]Separatedmembranesfloatingwiththecystgivetheappearanceofwaterlily.Itispathognomonicofhydatidcyst.
9.Thescanwithhighestsensitivitytodetectadrenalmetastasisdueto bronchogeniccarcinomais: a)ContrastEnhancedCTabdomenwithAdrenalprotocol b)PETscan c)MRIscan d)Radionuclidescan CorrectAnswer-BScanstodifferentiateadrenaladenomafromadrenalmetastasisare: CECT- ChemicalshiftMRI FDG-PETPETscanhasalmost100%sensitivityfordetectingadrenalmetastasis,soanegativestudyexcludesthepossibilityofadrenalmets.Butadenomascangivefalsepositivetest. Ref:FundamentalsofDiagnosticRadiology,Edition-4,Page-427.
10.WhichofthefollowingagentsisusedtomeasureGlomerularFiltrationRate (GFR)? a)Iodohippurate b)Tc99m-DTPA c)Tc99m-MAG3 d)Tc99m-DMSA CorrectAnswer-BTc99m-DiethyleneTriaminePentothenicAcid(DTPA)isanagentofchoicewidelyusedinmeasuringGFR.Ref:RenalDisease:TechniquesandProtocolsByMichaelSGoligorsky,Page87;PaediatricUroradiologyByRichardFotter,ALbertLBaert,Page47
11.TheCTseverityindexinacutepancreatitisisdescribedby: a)Balthazar b)Mengini c)Chapman d)Napelon CorrectAnswer-ATheCTseverityindex(CTSI)-describedbyBalthazarBalthazarCTSeverityIndexCTGradeScore A.Normal-0 B.Enlargedgland-1 C.Peri-pancreaticinflammation-2 D.Onefluidcollection-3 E.Twoormorecollections-4NecrosisScore 30%-50%-(4) >50%-(6)Ref:ACRAppropriatenessCriteria,AcutePancreatitis.
12.Radiocontrastiscontraindicatedinallofthefollowingconditionsexcept? a)Renalfailure b)Patientonmetformin c)Dehydration d)Obesity CorrectAnswer-DObesityisnotacontra-indicationfortheadministrationofradio-contrastagent.Ref:RadiologicTechnologyataGlanceByTheresaS.Reid-Paul;pages66.
13.APETscanuseswhichofthefollowingtracermaterials? a)FDG b)CDF c)ADP d)MIBG CorrectAnswer-APositronemissiontomography(PET)usespositron-emittingradioisotope(tracer)-18F-FDGAPETscanusesasmallamountofaradioactivedrug,ortracer,toshowdifferencesbetweenhealthytissueanddiseasedtissue.ThemostcommonlyusedtraceriscalledFDG(fluorodeoxyglucose),sothetestissometimescalledanFDG-PETscan.Veryexpensive.Bettercontrastandspatialresolution
14.Whichoneofthefollowinghasthemaximumionizationpotential? a)Proton b)Electron c)Heliumion d)Gamma(y)?Photon CorrectAnswer-C Heliumionhasmaximumionizingpotential.TheionizingpotentialofatomsrangesfromafeweVforalkalielementsto24.6eVforheliumwhichhasthemaximumionizingpotential.Ref:RadiationPhysicsforMedicalPhysicistsByErvinB.Podgorsak,Page7
15.AllofthefollowingaboutMRIarecorrect except: a)MRIiscontraindicatedinpatientswithpacemakers b)MRIisusefulforevaluatingbonemarrow c)MRIisbetterforcalcifiedlesions d)MRIisusefulforlocalizingsmalllesioneinthebrain CorrectAnswer-CCi.e.MRIisbetterforcalcifiedlesions*MRIisverypoorindetectionofcalcification.ItisinferiortoCTscan,mammographyandx-rayindetectingcalcification.Thatiswhyitlagsbehindmammographyinearlydetectionofnoninvasiveductalcarcinomainsitu(DCIS)Q,whichmostcommonlyhasmicrocalcificationasitsonlypresentingfeature.AndsimilarlyithasaverylimitedroleindetectionofrenalstonesandgallstonesQ.However,itisimportanttonotethatonlyupto60%ofgallstoneshaveenoughcalciumdensity(morethanthatofbile)togetvisualizedonCT.Becausofitssuperiorcalcificationdetectionabilities,MDCTisusedinAgatstonscoring(Coronarycalciumscoring)ofcalcifiedplaquesofcoronaryarteryusingcoronarycalciumasasurrogatemarkertodetectthepresenceandmeasuretheamountofcoronaryatherosclerosis.Becausewithexceptionofpatientswithrenalfailurecalcificationofarteriesoccursexclusivelyincontextofatherosclerosis.SimilarlynonenhancedhelicalCTissuperiortoallotherimagingmodalitiesindiagnosisofurinarytractcalculiQbutatthecostofhigherradiationexposure.NowthereisnoneedtosaythatMRIisbetterthatCTforevaluationofbonemarrow,smallbrainlesions,meniscus/ligamentinjuries,softtissuetumorsandmeningealpathology.ButMRIisverypoorin
softtissuetumorsandmeningealpathology.ButMRIisverypoorindetectionofcalcification.
16.Tuftingofdistalphalanxis characteristicallyseenin a)Gout b)Hyperkalemia c)Hypoparathyroidism d)Hyperparathyroidism CorrectAnswer-DAns.is.D.HyperparathyroidismAcro-osteolysisisthetermusedtodescriberesorptionofthedistalphalangealtufts.Causesare:- 1. Scleroderma2. Trauma&thermalinjury3. Hyperparathyroidism4. Epidermalysisbullosa5. Arthropathy(RA,Psoriasis)6. Neuropathy(diabetes,syringomyelia
17.CalcificationofIntervertebralDiscisseen in a)Gout b)Rheumatoid c)Alkaptonuria d)Psoriasis CorrectAnswer-CCi.e.Alkaptonuria Features Disease FishMouthVertebrae -SickelCellAnemiaQ HomocystinuriaQ CodFishVertebra -Osteomalacia,Osteoporosis, (Biconcavevertebra) Hyperparathyroid Ruggerjerseyspine -CRFinducedosteomalaciaQ (sclerosisofupper& -Osteopterosis(marbelbone lowerspineborders) disease) Calcificationof -Alkaptonuria(m.c.) IntervertebraldiscPictureFramevertebrae -Paget'sdiseaseVertebraeplana -EosinophilicgranulomaQ
18.Schober'ssignisfor: a)Flexionoflumbarspine b)Chestexpansion c)Painwithmotionofhip d)Neckpainandstiffness CorrectAnswer-AAi.e.FlexionoflumberspineSchober'stestismeasureofflexiononlumberspineQ.ThistestisdoneinankylosingspondylitisQ
19.Bonewithinboneappearanceisseenin? a)CML b)Osteoporosis c)Osteopetrosis d)Boneinfarct CorrectAnswer-CCi.e.OsteopetrosisInosteopetrosis,thereisreducedosteoclasticboneresorptionresultingindiffusesymmetricalskeletonsclerosis.Alsok/amarblebonediseased/titsstonelikequalityofbones;howeverthebonesareabnormallybrittle&fracturelikeapieceofchalk.Itcanpresentradiologicallyas?SclerosisofallbonesmoreprominentatbaseofskullQ.Sclerosisofvertebralendplate1/tcharacteristicsandwitchorbroadstripped(rugbyjerseyspine)QBoneinboneappearanceQd/tscleroticfociwithinthebone.
20."Sunrayappearance"onX-raysis suggestiveof: a)AChondrosarcoma b)Ametastatictumourinthebone c)AnOsteogenicsarcoma d)AnEwing'ssarcoma CorrectAnswer-CCi.e.OsteogenicSarcomaSunrayappearanceisclassicallyseeninosteosarcoma.Itmayalsooccurinmetastases,Ewingssarcoma,Haemangoma,Meningiomaandtuberculosis.
21.Inferiorribnotchingisseenin a)Coarctationofaorta b)Rickets c)ASD d)Multiplemyeloma CorrectAnswer-AAi.e.CoarctationofaortaInferiorribnotchingincoarctationofaortaisd/tpressureerosionofintercostalarteriesQItusuallytakesseveralyearstodevelop,soisunusualbefore10yearsofage.
22.Flaskshapedheartisseeninfollowing except: a)Ebsteinanomaly b)Pericardialeffusion c)TOF d)TAPVC CorrectAnswer-DDi.e.TAPVCDuetodilationofSVC(superiorvenacava)&leftverticalvein,TAPVC(totalanomalouspulmonaryvenousconnection/return)ofsupradiaphragmaticvarietyshowsdoublecontour/"Figgerof8"/SnowmanconfigurationofcardiacsilhouetteQ.
23.SoapBubbleappearanceinX-rayisseen in a)MultiplecysticKidney b)Neuroblastoma c)Cysticlymphagiectasis d)Meconiumileus CorrectAnswer-DDi.e.MeconiumileusSoapbubbleappearanceinXrayisseeninmeconiumileusduetoadmixtureofgaswithmeconium.
24.RimsigninIVPisseenin a)PolycysticKidney b)Hydronephrosis c)Chronicpyelonephritis d)Hypernephroma CorrectAnswer-BBi.e.HydronephrosisRimSigninNephrogram-1.Severehydronephrosisofthekidneys2.Acutecompletearterialobstruction
25.Themostaccurateinvestigationfor assessingventricularfunctionis: a)MultisliceCT b)Echocardiography c)Nuclearscan d)MRI CorrectAnswer-BBi.e.EchocardiographyTransthoracicechocardiographyisthemostcommonlyusedcardiacimagingexaminationafterthechestX-rayandprobablyapproachestheelectrocardiograminitsclinicalutility.Itisharmlessandrelativelycomfortableforthepatientandisthefirst-linetechniqueforevaluatingmostabnormalitiesofthecardiacchambers,valvesandgreatvessels. Diagnotic Chest Transthoracic Transesophageal Nuclear Multislice utility X-ray echocardiogram echocardiogram medicine CT technique AnatomyMyocardium + ++ +++ + ++ Valves + ++ +++ 0 + Coronaries 0 0 + 0 ++ Pericardium + + + 0 ++ Pulmonary +++ 0 0 0 +++ vesselsCalcification +++ + + 0 +++ FunctionMyocardium ++ ++ +++ ++ + Valves + ++ +++ 0 +
Valves + ++ +++ 0 + Coronaries 0 0 + ++ ++ LimitationsRadiation - 0 0 -- hazardRisk/ 0 0 -- - - discomfortSpatial -- - resolutionTemporal - - resolutionOperator - --- - skillCost -- +++=Majorutility;++=moderateutility,+=minorutility;0=noutility/nolimitations;-=minorlimitation---=moderatelimitation;---majorlimitation
26.Inpatientwithhighclinicalsuspicionof pulmonarythromboembolism,bestinvestigationwouldbe? a)D-dimer b)CTangiography c)Catheterangiography d)ColorDoppler CorrectAnswer-BBi.e.CTangiographySpiralorhelicalchestCTscanwithintravenouscontrast(CTpulmonaryangiography)istheprincipalimagingtestforthediagnosisofpulmonaryembolsmQ.Itacquiresimagewith<1mresolutionandvisualizesupto6thorderbranchesandsmallperipheralemboliwitharesolutionsuperiortoconventionalinvasivecontrastpulmonaryangiography.Itobtainsexcellentimagesofright&leftventricleandcanbeusedfordiagnosisaswellasriskstratification.Inpatientswithpulmonaryembolism,RVenlargementindicates5timesmorelikelihoodofdeathwithinnext30days.Inadequatebreathholdingcanimpairtheimagequalityb/ochangeinarterialflowratesandmotionartefactduringbreathing.TheadventofmultidetectorCT(MDCT)allowsexaminationofwholelungduringsinglebreath-hold.Itisnoninvasive.Ventilation-perfusionlungscanningisnowsecondlinediagnostictestaforPE,andmostlyusedinpatientswhocannottolerateintravenouscontrast.Itsutilityisgreatestwhenaccompaniedwithanormalchestx-rayimplyingthataventilation-perfusionmismatchisnotduetoparenchymaldisease.Highprobability(>80%)scanhave
2largesegmentalV-Pmismatches(perfusiondefects&normalventilation)withanormalchestradiograph.Andverylowprobabilityscanshavemicroparticles(10-1001.1m)ofTc99micro-aggregatealbumin(MAA)inpatientslyingsupine.VentilationscintigraphyisperformedbyinhalatingKrypton-81,(best),Xenon133,Tc99-diethylenetriaminepentaaceticacid(DTPA),ortechnegas.Lasttwocan'tbeadministeredduringperfusionscanasbotharelabelledwithTc99.Eightimages(anterior,posterior,obtique&lateralonbothsides)areaquired.Conventionalpulmonaryangiography:NoninvasiveCTwithcontrasthavevirtuallyreplacedinvasivepulmonaryangiographyasadiagnostictool.However,itremainsthegoldstandardtesta.
27.InvestigationofchoiceforstudyingRenal Corticalmass a)99TcDTPA b)53CrStudy c)99TcDMSA d)99TcPyrophosphate CorrectAnswer-CCi.e.99-Tc-DMSA DTPA(Renogram) DMSA(IsotopeScanning) -DTPAisfreelyfilteredat -Tc.99DMSAisusedforrenal glomeruluswithno morphological tubularreabsorptionor (anatomic)imagine excretion(i.e.GFR= -Thiscompoundgetsfixedinrenal Excretoryfunction) tubules&images -DTPAisusefulforevaluating maybeobtainedafter1-2hoursof perfusionand injection.Lesions excretoryfunctionofeach suchastumors&benignlesionsas kidneyQ cystsshowfilling -Indications: defectQ 1.Measurementofrelative -Usedtoassesscorticalfunctionof renal KidneyQanddetect functionQineachkidney. renalscarringQ. 2.UrinarytractobstructionQ 3.DiagnosisofRenovascularcauseof hypertensionQ
4.InvestigationofRenal transplantQ
28.Investigationofchoiceforscreeningof proximalinternalcarotidarterystenosisis: a)DopplerflowUSG b)CTsubstractionangiography c)MRI d)Angiography(DSA) CorrectAnswer-AAnswerisA(DopplerflowUSG):'StenosisattheoriginoftheinternalcarotidArterycanbeidentifiedandquantifiedreliablybyultrasonographythatcombinesBmodeultrasoundimagewithaDopplerultrasoundassessmentofflowvelocity.'
29.Roentgenistheunitof: March2010 a)Radioactivity b)Radiationexposure c)Absorbeddose d)Noneoftheabove CorrectAnswer-BAns.B:RadiationExposureThecurie,namedafterscientistMarieCurie,isaunitofmeasurementusedtomeasurehowradioactiveanobjectis,orhowmuchradiationitproduces.Thisisdonebyexamininghowfastitsatomsdisintegrateandmeasuringtheirdisintegrationpersecond.Roentgen,ontheotherhand,isaradiationunitthatindicateshowmuchradiationispresentintheairofaspecificenvironment.Thisisusedtoshowhowmuchradiationmaybeabsorbedbystandinginaparticularplaceforacertainamountoftime.Oneroentgenofgamma-orX-rayexposureproducesapproximately1rad(0.01gray)tissuedose.Morecommonthanthesetwoaretheradandtherem.Thesetwounitscanmeasureanytypeofionizingradiation,includingalpha,beta,neutron,gammaand"X,"anddealwithhowmuchradiationisabsorbedbyobjects.Radstandsfor"radiationabsorbeddose."Oneradequals100ergs(anenergyunit)absorbedby1gofmaterial.Radsareusedtoshowhowmuchradiationanyobject,
especiallythingslikemetalandstone,hasabsorbed.Rem(doseequivalent)isastrictlybiologicalmeasurement,andstandsfor"roentgenequivalentman,"meaningthatitisthesameessentialmeasurementasaroentgen,onlyappliedtothehumanbody,althoughthisworksonlywithgammaand"X"typesofradiation.Remisusedtodefinelimitsofexposureforpeoplewhoworkinnuclearpowerplants.Remisoftendividedinmilliremsandassignedalengthoftime,suchasmilliremsperhour.Curie/becquerelistheunitofradioactivity.
30.Adderheadappearanceisseenin: March2011 a)Posteriorurethralvalve b)Uretrocoele c)Bladdertumour d)Horseshoekidney CorrectAnswer-BAns.B:UreterocoeleThe'adderhead'onexcretoryurographyistypicalofureterocoeleUreteroceleisacysticdilatationofthedistalureter.CobraheadorAdderheadappearanceisdiagnosticofureterocele.Spiderlegappearanceinpolycystickidney.Ref:Bailey&Love,25thEdition,Page1290
31.WhitelineofFrenkelisseenin: September2008 a)Osteoporosis b)Osteomalacia c)Scurvy d)Beri-Beri CorrectAnswer-CAns.C:ScurvyClinicalsymptomsandsignsofinfantilescurvy,inorderoffrequencyareirritability,tendernessandweaknessoflowerextremities,ascorbuticrosaryofthelegs,bleedingofthegums(usuallywhereteethhaveerupted),andfever.Radiographicfindingsofscurvy:Densemetaphysealline-Thisisduetoanintensificationofthezoneofpreparatorycalcification,resultingfrommatrixformationfailing,ishasbeenreferredtoasthewhitelineofFrenkel,butisnon-specific,asitisalsoseeninhealingrickets,andleadorphosphoruspoisoning.Groundglassosteoporosis:Thisappearsattheendoftheshaftwithblurringordisappearanceoftrabecularmarkings.Haloossificationcentre:AlsocalledtheWimberger'sring,itisthesameeffectthatproducesthewhitelineofFrenkel,affectingtheepiphysealossificationcenter.Cornersign-Seenduetosubepiphysealinfarction,orseparationoftheepiphysisfromthemetaphysis.Lateralspurs-Thesemetaphysealspursprojectatrightanglestotheaxisoftheshaft,theymaybeseenduetomushroomingofepiphysisonthemetaphysis,ormayrepresentearliestcalcificationof
periosteumelevatedbyasubperiostealhemorrhage.Subperiostealhematomas-Theseoccurattheendoflongbones,seenafterabout2weeksofonsetofclinicalsymptoms;itisnottheperiostealhemorrhagethatcalcifies,buttheelevatedperiosteum,secondarytoresumptionofboneformation.Metaphysealfractures-Subperiostealcomminutedfracturesattheendoflongbones,extendingonlypartiallythroughthewidthofthebone.Atrophyscurvyline-AradiolucentzoneontheshaftsideofFrenkel'swhiteline,ithasbeenreferredtoastheTrummerfeldZone.
32.SIunitofradioactivityis: March2013(c,f) a)Rem b)Rad c)Becuerel d)Curie e)None CorrectAnswer-CAns.Ci.e.BecquerelOldunitofradioactivityisCurieandnewunit(SI)isBecquerel.
33.CSFonMRIappears: a)HyperintenseonT1weighedimageandhypointenseonT2 weighedimage b)HypointenseonT1weighedimageandhyperintenseonT2 weighedimage c)HyperintenseonT1andT2weighedimages d)HypointenseonT1andT2weighedimages CorrectAnswer-BAns.HypointenseonT1weighedimageandhyperintenseonT2weighedimageFluid-Edema,Urine,Bile,CSF-T1weightedsignallow&T2weightedsignalhigh
34.Bestimagingmodalityinpatientswith breastimplantsis: a)MRIscan b)CTscan c)Mammography d)Radionuclidescan CorrectAnswer-AAns.MRIscanItisthebestimagingmodalityforthebreastsofwomenwithimplants.MRIcanbeusefirltodistinguishscarfromrecurrenceinwomenwhohavehadpreviousbreastconservationtherapyforcancer
35.Welldefinedroundedopacityisthelung withcauseirregularcalcificationisafeatureof: a)Hamartoma b)Hydatidcyst c)Amoebicabscess d)Calung CorrectAnswer-AAns.HamartomaIrregularcentralcalcification(Popcorncalcification)ischaracteristicofhamartoma.
36.Commonlyusedtypeofradiationin radiotherapyis: a)Alpharays b)Betarays c)Gammarays d)X-rays CorrectAnswer-CAns.GammaraysRadioiodinegeneratesbothbetaandgammaraysbutpredominantlybetarays.
37.Radiationprotectionshieldsaremadeup of: a)Copper b)Silver c)Lead d)Tin CorrectAnswer-CAns.Lead
38.ThephotosensitivematerialusedinX- raysfilmsconsistof: a)Cellulose b)Silverbromide c)Zincsulphide d)Cadmiumtungstate CorrectAnswer-BAns.SilverbromideAftertheimagehasbeendeveloped,theresultantimageisthenfixedbyafixer(Hypo-sodiumthiosulphate)whichremovesunusedsilverhalide,whichwouldmakethefilmappearmilkyorcloudy.X-rayfilmshouldbedevelopedindarkroom,otherwiselightwillspoilthefilm(x-rayfilmhasphotosensitivesilverbromide).Blueandgreenlightaremostsensitivewhereasyellowandredlightareleast.
39.Amongthecausesofribnotchingare: a)Coarctationofaorta b)Congenitalinterruptionofaorta c)Chronicsuperiorvenacavaobstruction d)Alloftheabove CorrectAnswer-DAns.Alloftheabove
40.Thicknessofleadaprontoprevent radiation: a)1mm b)3mm c)0.5mm d)7mm CorrectAnswer-CAns.C.0.5mm"Itisrecommendedthatforgeneralpurposeradiographytheminimalthicknessofleadequivalentintheprotectiveapparelshouldbe0.5mm."-TextbookofRadiologyPhysicsp.39Leadapronof0.5mmthicknessreduceintensityofscatteredX-raysbyover90%.
41.Hilardanceonfluoroscopyisseenin: a)ASD b)TOF c)VSD d)TGV CorrectAnswer-AAns.ASDFluoroscopicexaminationdoneinapatientwithASDshowshilardancesignduetopulsationofcentralpulmonaryartery.CXRfeaturesofASD:ThereisnoenlargementofleftatriumexceptinfewcasesofLutembachersyndrome.TheheartinASDissometimesdisplacedtotheleft.Theascendingaortaanditsarchtendstoappearsmallerthannormal,probablyduetorotationoftheascendingaortabyenlargedrightatriumandrightventriclecausingsagittalalignmentoftheaorticarch.KerleyBlinesinapatientwithASDshouldalwayssuggestanassociatedmitralvalveabnormality(Lutembachersyndrome).TheGooseneckdeformityisseeninASDoncardioangiography.Ref:ClinicalDiagnosisofCongenitalHeartDiseaseByM.Satpathypage78,Radiodiagnosis,NuclearMedicine,RadiotherapyandRadiationOncologyByBipinValchandjiDagapage139.
42.HalflifeofTechnetium99is: a)2hours b)6hours c)12hours d)24hours CorrectAnswer-BAns.6hoursTc-99-Technitium-6hoursHalflife(tin)ofradium(Ra226)is1602-1626years(longest)Q;Cesium(137Cs)is30yearsQ;Cobalt(60Co)is5.2yearsQ;iridium(1921r)is74.5daysQ;Iodine(P31)is8daysQ;1123is13hoursQ;technitium(Tc99)is6hoursQ;and1132is2.3hoursQ.
43.Popcorncalcificationisseenin: a)Pulmonaryhamartoma b)Fungalinfection c)Metastasis d)Tuberculosis CorrectAnswer-AAns.PulmonaryhamartomaPopcorncalcificationoPopcorncalcificationisaclusterofsharplydefined,irregularlylobulated,calcification,usuallyinapulmonarynodule.oPopcorncalcificationischaracteristicofhamartomaonchestX-rayexamination.oItmayalsobeseeninmediastinallymphnodesofacutehistoplasmosis.Egg-shellcalcificationoEgg-shellcalcificationmeansperipheralrimcalcificationoflymphnodes:oItisseenin:NSilicosis(mostcommoncause)(vi)Histoplasmosis(vii)Tuberculosis(ii)Coalworkerpneumoconiosis(v)Sarcoidosis(viii)Coccidiodomycosis(iii)Lymphomafollowingradiotherapy(vi)Progressivemassivefibrosis
44.Theprincipleusedinradiotherapyis: a)Cytoplasmiccoagulation b)Ionisingthemolecules c)DNAdamage d)Lowdosecausestissuenecrosis CorrectAnswer-CAns.DNAdamageRadiotherapyisthetreatmentofcancerwithionizingradiation.ItworksbydamagingtheDNAwithinthetumorcells,makingthemunabletodivideandgrow.Thegoalofradiationtherapyistomaximizethedosetotumorcellswhileminimizingexposuretonormal,healthycells. Ref:EmamiBetal.1991
45.Inapatientwithrenalcellcarcinomawith athrombusinIVCrenalvein,whichisthebestinvestigationfordiagnosis? a)CTscan b)Angiography c)Colourdopplerimaging d)IVP CorrectAnswer-AAns.CTscanInvestigationofchoiceinRCC-CTscan.
46.TheX-rayviewforsupraorbitalfissureis: a)Towne's b)Caldwell c)AP d)nasal CorrectAnswer-BAns.CaldwellSuperiororbitalfissurecanalsobeseenonwater'sview,butbestiscaldwellview."Thesuperiororbitalfissurecaneasilyindentifiedandnormallyhasaslightlyconcavelateralappearacne"-Textbookoforalradiology
47.Whichofthefollowingtechniquesuses piezoelectriccrystals? a)Ultrasonography b)NMRimaging c)X-raydiffraction d)Xeroradiography CorrectAnswer-AAns.UltrasonographyUltrasonographyisbasedonpiezoelectriceffect.MRIisbasedongyeromagneticpropertyofproton(IP).
48."Stringofbeads"appearanceon horizontalabdominalviewX-rayissuggestiveof: a)Intussusception b)Sigmoidvolvulus c)Smallbowelobstruction d)Largebowelobstruction CorrectAnswer-CAns.SmallbowelobstructionStringofbeadssignisvirtuallydiagnosticofsmallbowelobstruction
49.Puffofsmokeappearanceoncerebral angiographyisseenin: a)ACAaneurysm b)Cavernoussinusthrombosis c)Moyamoyadisease d)VeinofGalenmalformation CorrectAnswer-CAns.c.MoyamoyadiseaseMoyamoyadiseaseisanidiopathic,noninflammatory,nonatheroscleroticprogressivevasculo-occlusivediseaseinvolvingthecircleofWillis,typicallythesupraclinoidinternalcarotidarteries.Smallabnormalnet-likevesselsproliferategivingthecharacteristic"puffofsmoke"appearanceondirectangiography.CTAandMRAisnotalwaysabletodemonstratethisappearanceonaccountoflowerflowandspatialresolution.
50.Whichofthefollowingiswatersoluble contrast? a)Barium b)Iodine c)Bromium d)Calcium CorrectAnswer-BAnswer-B.IodineRadiocontrastagentsaretypicallyiodine,barium-sulphateorgadoliniumbasedcompounds.
51.Solitarylyticlesionsseenin a)Atherosclerosis b)Multiplemyeloma c)Mitralstenosis d)Osteoblast CorrectAnswer-BAnswer-B.MultiplemyelomaF:fibrousdysplasia(FD)orfibrouscorticaldefect(FCD)O:osteoblastomaG:giantcelltumor(GCT)M:metastasis(es)/myelomaA:aneurysmalbonecyst(ABC)C:chondroblastomaorchondromyxoidfibromaH:hyperparathyroidism(browntumor)I:infection(osteomyelitis)N:non-ossifyingfibroma(NOF)E:enchondromaoreosinophilicgranuloma(EG)S:simple(unicameral)bonecyst
52.Confusionassessmentscaleusedfor whichofthefollowing? a)Schizophrenia b)Delirium c)Dementia d)Depression CorrectAnswer-BAns:B.DeliriumConfusionAssessmentMethod(CAM),awidely-usedinstrumentanddiagnosticalgorithmforidentificationofdelirium.TheCAMinstrumentassessesthepresence,severity,andfluctuationof9deliriumfeatures:AcuteonsetInattentionDisorganizedthinkingAlteredlevelofconsciousnessDisorientationMemoryimpairmentPerceptualdisturbancesPsychomotoragitationorretardationAlteredsleep-wakecycle.TheCAMdiagnosticalgorithmisbasedonfourcardinalfeaturesofdelirium:AcuteonsetandfluctuatingcourseInattentionDisorganizedthinkingAlteredlevelofconsciousness.
53.HummingbirdsigninbrainMRIisseenin ? a)Multiplesclerosis b)Progressivesupranuclearpalsy c)Parkinson'sdisease d)Alzheimerdisease CorrectAnswer-BAns.is'b'i.e.,Progressivesupranuclearpalsy[RefClinicalneurology-113]HummingbirdsignonbrainMRIisaradiologicalsignofprogressivesupranuclearpalsy.
54.TigriodpatternonMRIisseenin- a)Wilson'sdisease b)Metachromaticleukodystrophy c)Parkinsonism d)GBsyndrome CorrectAnswer-BAnswer-B.MetachromaticleukodystrophyItischaracteristicallyseenin-MetachromaticleukodystrophyPelizaeus-MerzbacherdiseaseAutosomalrecessivespasticataxiaofcharlevoix.
55.Whichofthefollowingisnota contraindicationofMRI a)Cardiacpacemaker b)Cochlearimplant c)Ryle'stube d)Metallicsplinterineye CorrectAnswer-CAnswer-C.Ryle'stubeContraindicationsforMRIA)AbsoluteElectronically,magnetically,andmechanicallyactivatedimplants.Ferromagneticorelectronicallyoperatedactivedeviceslikeautomaticcardioverterdefibrillators.CardiacpacemakerMetallicsplintersintheeye.FerromagnetichaemostaticclipsintheCNS.B)RelativecontraindicationsCochlearimplantsProstheticheartvalvesOtherpacemakers,e.g.,forCarotidsinusHaemostaticclipsInsulinpumpsandnervestimulatorsNon-ferromagenticstapedialimplantsLeadwiresorsimilarwiresWomenwithafirst-trimesterpregnancy
56.Allaredonetominimizeradiation, exposuretothepatientunderfluroscopy,except a)Decreaseinfieldofview b)IncreasingtheKvofradiation c)Decreasingfluroscopictime d)Usinglowdoseofradiation CorrectAnswer-AAnswer-A.DecreaseinfieldofviewDecreasingthefieldofviewduringfluroscopyincreasetheradiationdoserate:- 1. Fieldofviewdiameter25cmhasdoserate0.3mGy/s2. Fieldofviewdiameter17cmhasdose0.6mGy/s
57.Investigationofchoiceforsofttissue sarcomais- a)CT b)MRI c)Ultrasound d)X-ray CorrectAnswer-BAnswer-B.MRI"AnypatientwithasuspectedSTSshouldbereferredtoadiagnosticcentrefortripleassessmentwithclinicalhistory,imagingandbiopsy.WhilstthepreferredmethodofimagingisMRI,otheroptionsincludingcomputerizedtomography(CT)orultrasoundmaybeappropriatedependingonlocalexpertise."
58.Amountofradiationexposurein1CT- scanofchestis a)1mSv b)3mSv c)5mSv d)7mSv CorrectAnswer-DAnswer-D.7mSvCTchestcausesradiationexposureof7mSv.CTabdomen-pelviscausesradiationexposureof10mSv.CTheadcausesradiationexposureof2mSv.
59.Whichofthefollowingisalatesevere adverseeffectofradiationtherapy a)Nausea b)Erythema c)Anemia d)Osteoradionecrosis CorrectAnswer-DAnswer-D.OsteoradionecrosisOsteoradionecrosisisalatecomplicationofradiationwhilenausea,erythemaandanemiaareearlycomplications.
60.SkylineviewX-rayisusefulindiagnosing - a)Patellofemoralproblem b)Radioulnarsproblem c)Tibiofibularproblem d)Skullfracture CorrectAnswer-AAnswer-A.PatellofemoralproblemA'Skyline'or'Sunrise'or'sunset'or'axial'or'tangential'or'mountainview'givesmostinformationaboutpatellofemoraljoint.
61.SubstanceusedforPETscanis a)18FPCT b)Gadolinium c)Gastrogarfin d)Iodine CorrectAnswer-AAnswer-A.18FPCTFluorine-18-labeled2Ali-carbomethoxy-3AY-(4-chloropheny1)-8-(-3-fluoropropyl)nortropane(FPCT)hasbeensynthesizedasanewdopaminetransporterimagingagent.OthersubstancesusedforPETscanare: 1. FDG2. 64Cu-ATSM(4Cudiacetyl-bis(N4-methylthiosemicarbazone)3. 18F-fluoride4. FLT(3'-deoxy-3'-[18F]fluorothymidine)5. FMISO(18F-fluoromisonidazole)6. Gallium7. Technetium-99m8. Thallium
62.Sausagefingerappearanceisseenin- a)Psoriaticarthritis b)Rickets c)Hyperthyroidism d)Addison'sdisease CorrectAnswer-AAnswer-A.PsoriaticarthritisThecommoncausesofsausagedigitare:Psoriaticarthropathy.AnkylosingspondylitisTuberculosisOsteomyelitis.SicklecelldiseaseLeprosy
63.WhichcommontracerinPETisusually administeredintheformofaglucosesugar a)Oxygen15 b)Fluorine18 c)Saccharide-12 d)Aluminum-12 CorrectAnswer-BAnswer-B.Fluorine18Fluorine-18isusedintheformofFDGinPETscan.ThemostcommontracerhasacomplicatednamebutismostlyknownasFDG(whichstandsfor2-[18F]fluoro-2-deoxy-D-glucose).ThebiologicallyactivemoleculemostcommonlyusedforPETis2-deoxy-2-18F-fluoro--D-glucose(18F-FDG),ananalogueofglucose,forearlydetectionoftumors.
64.Investigationofchoiceforacute subarachnoidhemorrhageis- a)MRI b)CTscan c)EnhanceMRI d)Angiography CorrectAnswer-BAnswer-B.CTscanInvestigationofchoiceforacuteSAH-CTscanInvestigationofchoiceforchronicSAH-MRI
65.Intraoperativeradiotherapyisusedin a)Gastriccancer b)Coloncarcinoma c)Pancreaticcarcinoma d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveIntraoperativeradiotherapycanbeusedIn- 1. Pancreaticcarcinoma2. Retroperitonealsarcomas3. Gastriccarcinoma4. Genitourinarycancers5. Colorectalcarcinoma6. Braintumor7. Head&Neckcancers8. Somegynecologicalmalignancies
66.Preciselydirectedhighdoseradiationis usedin a)IMRT b)EBRT c)Stereotecticradiosurgery d)Noneoftheabove CorrectAnswer-AAnswer-A.IMRTIntensitymodulatedradiationtherapy(IMRT)isanadvancedmodeofhighprecisionradiotherapythatutilizescomputercontrolledX-rayacceleratorstodeliverpreciseradiationdosestoamalignanttumourorspecificareaswithinthetumour.
67.EpiduralhematomaonCTscanshows- a)Crescentshapedhyperdenselesion b)Biconvexhyperdenselesion c)Biconcavehyperdenselesion d)Crescentshapedhypodenselesion CorrectAnswer-BAnswer-B.BiconvexhyperdenselesionAcuteextradural(epidural)hematomaisbiconvexhyperdenseormixeddensitylesion.Extradural(epidural)hematomaappearanceradiolgically:-Biconvex(lensshapedorlenticular)InAcutecases4Hyperdense(2/3)ormixeddensity(1/3).Inchroniccases4Hypodense
68.Notusedforinternalradiotherapy a)Iodine-125 b)Iodine-131 c)Cobalt-60 d)Iridium-192 CorrectAnswer-BAnswer-B.Iodine-131lsotpesusedforinternalradiotherapy(brachytherapy)A)InterstitialbrachytherapyPermanentimplantsofinterstitialbrachytherapy:-Cesium-131,Yttrium,Gold-198(Au-198),125I,Radon-222(Rn-222),Pallidum-103(Pd-103).TemporaryimplantsofInterstitialbrachytherapy:-Iridium-192(Ir-192),Cesium-137(Cs-137),Cobalt-60(Co-60),Californium,Radium-226(Ra-226),Tantolum.
69.Radioiodinegenerateswhichtypeof radiation a)X-rays b)Alphaandbetarays c)Betaandgammarays d)Alphaandbetarays CorrectAnswer-CAnswer-C.BetaandgammaraysRadioiodinegeneratesbothbetaandgammaraysbutpredominantlybetarays.
70.Radioactiveiodineisadministered throughwhichroute a)Intravenous b)Subcutaneous c)Oral d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveRadioactiveiodineisadministeredorallyaswellasparentrallyi.e.IV,SC&IM.
71.Investigationofchoiceforacute intracerebralhemorrhageis- a)NCCT b)MRI c)PETscan d)Noneoftheabove CorrectAnswer-AAnswer-A.NCCT"NCCTremainsthemainstayofemergencyimagingofstrokeinordertoexcludeintracranialhemorrhage"."Ininvestigationofstrokewithdelayedpresentationgradient-echoMRIistheinvestigationofchoiceforexclusionofoldhemorrhage".
72."Treeinbudappearance"onCTisseen in a)Pulmonarytuberculosis b)Silicosis c)Pulmonaryhydatidcyst d)Smallcellcarcinoma CorrectAnswer-AAnswer-A.Pulmonarytuberculosis ItisusuallyvisibleonstandardCT,however,itisbestseenonHRCTchest. Typicallythecentrilobularnodulesare2-4mmindiameterandperipheral,within5mmof thepleuralsurface. Theconnectiontoopacifiedorthickenedbranchingstructuresextendsproximally (representingthedilatedandopacifiedbronchiolesorinflamedarterioles) AssociatedCTfindingsofbronchiolitisareseeninabout70%ofpatientswith bronchiectasis.Smallcentrilobularnodularandlinearbranchingopacities(tree-in-budsign) expressinflammatoryandinfectiousbronchiolitisPathogenesis-Thetree-in-budsignoccursasaresultofanumberofprocesses,althoughoftentheyco-existinthesamecondition:a.bronchiolesfilledwithpusorinflammatoryexudatee.g.pulmonarytuberculosis,aspirationbronchopneumonia b.bronchiolitis:thickeningofbronchiolarwallsandbronchovascularbundlee.g.cytomegaloviruspneumonitis,obliterativebronchiolitis c.bronchiectasiswithmucusplugginge.g.cysticfibrosis d.tumorembolitocentrilobulararteries(orcarcinomatousendarteritis)e.g.breastcancer,stomachcancer
e.bronchovascularinterstitialinfiltratione.g.sarcoidosis,lymphoma,leukemia
73.Investigationofchoicetoevaluate intracranialhemorrhageoflessthan48hoursis- a)CTscan b)MRI c)PET d)SPECT CorrectAnswer-AAnswer-A.CTscanPrimaryprocedureofchoiceforevaluatingintracranialcomplicationsofacuteheadinjury4CTscan.Bestmodalityforassessingfracturesoftheskullbase,calvariumandfacialbone4CTscan.Investigationofchoicefordemyelinatingdisorders4MRI.
74.Investigationofchoiceforlungabscess is a)ChestX-ray b)CECTscan c)MRI d)Ultrasound CorrectAnswer-BAnswer-B.CECTscanContrastenhancedCTinusuallyconsideredtobeinvestigationofchoiceforlungabscess,showingacavitywiththickwallsandcentralmobilefluid.Ithelpstodifferentiateabscessfromempyma,necrotizingpneumonia,sequestration,pneumatoceleorunderlyingcongenitalabnormalitiessuchasbronchogeniccyst.
75.CTofgastricVolvulusshows- a)Shortenedtwistedstomach b)Enlargedtwistedstomach c)Normaltwistedstomach d)Noneoftheabove CorrectAnswer-BAnswer-B.EnlargedtwistedstomachCTscanofgastricVolvulusshowsenlargedtwistedstomachinthoraxwithoneormoresitesoftorsion.Itisusefulinshowingthesitesofischemia.
76.OnCTchest'halosign'isnotedin a)Pulmonaryhydatidcyst b)Invasivepulmonaryaspergilossis c)Roundpneumonia d)Bronchiectasis CorrectAnswer-BAnswer-B.InvasivepulmonaryaspergilossisThehalosign(HS)inchestimagingisafeatureseenonlungwindowsettings(typicallyHRCT),groundglassopacitysurroundingapulmonarynoduleormassandrepresentshemorrhage.Itistypicallyseeninangioinvasiveaspergillosis.
77.
A50yearoldmalepresentswithfeverandmalaisefor4months&paininthekneesandankles.BloodtestsarenormalapartfromaraisedESR.Chestx-rayshowsbilateralhilaradenopathyandpulmonaryinfiltratesmostsevereintheupperandmidzones.Mantouxtestisnegative.Whatisthemostlikelydiagnosis a)Tuberculosis b)Sarcoidosis c)Asbestosis d)Berylliosis CorrectAnswer-BAnswer-B.SarcoidosisSarcoidosisisthemostlikelydiagnosisgiventhepresentationwithmalaise,arthralgiaandachestx-rayshowingbilateralhilaradenopathy."Thecharacteristicradiologicalfindinginpatientswithpulmonarysarcoidosisisbilateralhilarlymphadenopathy"
78.Ultrasonographicfindingofautosomal recessivepolycystickidneydisease[ARPKD]areallexcept a)Cystsmorethan2cm b)Corticomedullarydifferentiationiseventuallylost c)Enlargedkidney d)Oligohydramnios CorrectAnswer-AAnswer-A.Cystsmorethan2cmOnantenatalultrasoundassociatedoligohydramniosmaybeidentifiedCystsInitiallytoosmalltoresolvebutwithtimemaybecomediscernibleUnlikeADPKDthecystsrarelyexceed1-2cmindiameterThekidneysappearenlargedandechogenicbutusuallyretainareniformshapeMedullarypyramids
79.22-year-oldwomenpresentstothe emergencydepartmentwithachiefcomplaintofsevereleftupperquadrant[LUQ]painafterbeingpunchedbyherhusband.Herbloodpressureis110/76,herpulseis80bpm,andherrespirationrateis24breathsperminute.Thebestmeanstoestablishadiagnosisiswhichofthefollowing? a)Four-quadranttapoftheabdomen b)CToftheabdomen c)Peritoneallavage d)Uppergastrointestinal[GI]series CorrectAnswer-BAnswer-B.CToftheabdomenClinicalpictureofthepatientinabovequestionindicatesthatpatientishemodynamicallystable.ThereforebestmodeofevaluationshouldbeCTscanofabdomentoseetheextentofinjury.Ifthepatientsishemodynamicallystableandcanbeshifted-CTscan
80.A35year-oldfemalepresentedtothe emergencydepartmentwiththesuddenonsetofsevereepigastricpain.Shehadahistoryofheartburnanddyspepticsymptomsforpast10years.Onphysicalexam,shehadatemperatureof101.4?F,apulseof118andabloodpressureof128/72.Abdomenwastender&rigid.ExpectedfindingonX-raywillbe a)Bloodunderdiaphragm b)Airunderdiaphragm c)Hazylungfields d)Prominentmarkings CorrectAnswer-BAnswer-B.AirunderdiaphragmAboveclinicalpictureissuggestiveofperforatedpepticulcer,Whichisthemostcommoncauseofpneumoperitoneum(airunderdiaphragm).Perforationresultsinpneumoperitoneumandthebestviewtoseepneumoperitoneumischestx-rayinerectpositionwhichdetectsairunderthedomesofdiaphragm.
81.FollowingX-rayfindingisassociatedwith Chilaiditisyndrome- a)Pseudopneumoperitoneum b)Pseudopneumothorax c)Pneumothorax d)Hydropneumothorax CorrectAnswer-AAnswer-A.PseudopneumoperitoneumChilaiditisyndromeistheanteriorinterpositionofthecolon(usuallytranversecolon)totheliverreachingtheunder-surfaceoftherighthemidiaphragmwithassociatedupperabdominalpain.Itisoneofthecausesofpseudopneumoperitoneum
82.A50year-oldchronicalcoholicmale patient,afteralargebingeofalcohol,presentedtotheemergencydepartmentinsubconsciousstate.Hevomitedseveraltimes,fewofthemmixedwithblood.Hehadahistoryofheartburnanddyspepticsymptomsforpastfewtears.Onphysicalexam,hehadatemperatureof102?F,apulseof110,respiratoryrateof20perminuteandabloodpressureof90/60.Onphysicalexaminationtherewasabdominalguardingandtenderness.AplaneerectchestX-rayrevealsairunderdiaphragm.Probablediagnosisis a)Perforatedpepticulcer b)AcuteMI c)Dissectedabdominalaorta d)Noneoftheabove CorrectAnswer-AAnswer-A.PerforatedpepticulcerHistoryofheartburnanddyspepsia,acuteonsetofbloodyvomitingafterbingealcohol,generalandphysicalexaminationfindingsandairunderdiaphragmonchestX-ray,alltheseindicatetowardstheperforationofpepticulcer.
perforationofpepticulcer.
83.RingenhancinglesiononCTisafeature of a)Toxoplasmsis b)Intracranialhemorrhage c)Cysts d)Hamartoma CorrectAnswer-AAnswer-A.ToxoplasmsisRingenhancingbrainlesions 1. Neoplasms:-Highgradeglioma,meningioma,lymphoma,acoustic schwannoma,craniopharyngioma,metastasis. 2. Abscess:-Pyogenic,tuberculoma,toxoplasmosis,cysticercosis, empyema. 3. Hemorrhagic-ischemiclesion:-Resolvinginfarction,Aging hematoma,operativebedfollowingresection. 4. Demyelinatingdisorder
84.Aboutlipoma,radiologicallytrueis- a)LowattenuationonCT b)AnechoiconUS c)Hypo-intenseonT1-MRI d)Hypo-intenseonT2-MRI CorrectAnswer-AAnswer-A.LowattenuationonCTLipomasarebenignfattumorswhichshowVariableechosonUSHyper-intenseshadowsonbothT1&T2MRILowattenuationonCT.
85.USGisdonetovisualizeallexcept- a)Fluid b)Bile c)Bloodflow d)Bone CorrectAnswer-DAnswer-D.BoneUSGisdonetovisualizesofttissuesandfluids.Butnotforbone.
86.RegardingHRCT,allaretrueexcept- a)MeanshighreconstructionCTimaging b)Hasnarrowbeamcollimation c)Investigationofchoiceforinterstitiallungdisease d)Hassmallfieldofvision CorrectAnswer-AAnswer-A.MeanshighreconstructionCTimagingPrinciplesofHRCT(HighresolutionCT)are: 1. Narrowbeamcollimation(Thincollimation)2. Highfrequencyreconstructionalgorythm,e.g.,bonealgorithm3. Smallfieldofvision
87.Allofthefollowingaretrueaboutneutron contraststudyexcept- a)Providesspatialresolution b)Hydrogenandboronhavehighneutroncrosssection c)Allowsvisualizationoflightelementsinsideheavymetallic objects d)Isanexampleofdestructivetesting CorrectAnswer-DAnswer-D.IsanexampleofdestructivetestingNeutronsinteractwithmatterinawaythatisquitecomplementarytoX-rays,andsoneutronimagingandneutronradiographyareimportanttechniquesfornon-destructivetesting,mostsuitedforvisualizationoflightelementsintheinteriorof(heavy)metallicobjects.Examplesofhighabsorptioncross-sectionmaterialsincludehydrogenandboronwhileironhaslowerneutroncross-section.
88.InnormalX-rayofshoulderwhichis superiormoststructure- a)Greatertubercle b)Surgicalneckofhumerus c)Coracoidprocess d)Headofhumerus CorrectAnswer-CAnswer-C.CoracoidprocessFromsuperiortoinferior(importantstructureonX-raysholder):-Clavicle:Acromian:Coracoid:Superiormarginofhumeralhead:greatertubercle:anatomicalneck:surgicalneck.
89.MaximalvalveofHUUnit- a)Water b)Fat c)Softtissue d)Bone CorrectAnswer-DAnswer-D.BoneBonehasmaximumHU+1000
90.Piezoelectriccrystalmostwidelyusedin ultrasonographyprobesis- a)Quartz b)Molybdenum c)Titanium d)Leadzirconatetitanate CorrectAnswer-DAnswer-D.LeadzirconatetitanateLeadzirconatetitanate(PZT)isthemostwidelyusedmaterialintheultrasoundtransducers/probesreplacingthefirstlydiscoveredbariumtitanate.
91.Mostsensitiveinvestigationforminimum gasinabdomenis- a)ChestX-rayAPView b)CTScan c)X-rayabdomeninsupineposition d)X-rayabdomeninerectposition CorrectAnswer-BAnswer-B.CTScanCTScanissuperiortoplainradiographsindetectionofminutequatitiesofpneumoperitoneumThusCTScanisregardedasthemostsensitiveinvestigationfordetectionofminutequantitiesofintraperitonealgas.BestradiographicviewforpneumoperitoneumisChestx-ray.Itisusuallythefirstinvestigationofchoice.
92.Cottonwoolskullisaradiologicalfeature of- a)Pagetsdisease b)Eosinophilicgranuloma c)Fibrousdysplasia d)Fibrousdysplasia CorrectAnswer-AAnswer-A.PagetsdiseaseCottonwoolskull-Paget'sdiseaseGroundglassskull-FibrousdysplasiaPunchedout/Raindroplesionofskull-MultiplemyelomaGeographicskull-Eosinophilicgranuloma
93.Themostsensitiveimagingmodalityfor diagnosisofuretericstoneinpatientwithacuterenalcolicis- a)XrayKUB b)USG c)NoncontrastCTabdomen d)ContrastenhancedCTabdomen CorrectAnswer-CAnswer-C.NoncontrastCTabdomenNon-contrastspiralCThasnowbecometheinvestigationofchoicetodiagnoserenalanduretericstones.Investigationofchoiceforrenalanduretericstonesnon-contrastspiralCT
94.Radiologicalfeaturesofcoarctationof aortais/are- a)Reversefigureof3sign b)Docksign c)Doubleaorticknuckle d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveRadiologicalsignsofCOAare:i)Reversefigureof3sign(doublebulgesignorEsign),ii)Dock'ssign;iii)Doubleaorticknuckle.GlobularheartwitholigemiclungfieldsReversefigureof'3'signDoubleaorticknuckle
95.Eyeoftigerappearanceisseenin- a)HallevordenSpatza b)Suparanuclearpalsy c)Levodopa-responsive d)All CorrectAnswer-DAnswer-D.AllThisappearancecanbeseenin: 1. Hallervorden-Spatzsyndrome:classicalbutnot100% pathognomonic 2. Progressivesupranuclearpalsy3. Early-onsetlevodopa-responsiveparkinsonism4. Cortical-basalganglionicdegeneration
96.Followingaresuggestiveofbenignlesion onmammogram- a)Macrocalcification b)Floatingcalcification c)Tramlinecalcification d)Alltheabove CorrectAnswer-DAnswer-D.AlltheaboveCalcificationpatternsinbenignlesionsofbreastonmammography: 1. Macrocalcification2. Popcorn(infibroadenoma)3. Rodlikewide-spread4. Eggshellcurvilinear5. Tramline/tortous
97.Anamolyscandoneathowmanyweeks ofgestation- a)14 b)16 c)18 d)20 CorrectAnswer-DAnswer-D.20AnamolyScanisdonebetween18-21weeksofpregnancy.Itisalsocalledasmidpregnancyor20-weekscan.
98.Flowingwaxappearanceonanteriorand posteriorbordersofvertebraeisseenin- a)Ankylosingspondylitis b)DISH c)Psoriaticarthropathy d)Rheumatoidarthritis CorrectAnswer-BAnswer-B.DISHDiffuseidiopathicskeletalhyperostosis:DISH(hyperostoticspondylosis,Forestier'sdisease)isamultifocalentityofolderpeoplecharacterizedby'flowingossificationsofthespine"involvingfourormorecontiguousvertebraeandhyperostosisofsomeligamentousattachments.
99.Radiologicalviewwhichbestshows maxillarysinusandorbitis- a)Water'sview b)Caldwellview c)Lateralview d)Towneview CorrectAnswer-AAnswer-A.Water'sviewBestviewformaxillarysinusWater'sview(occipito-mentalview)BestviewforfrontalsinusCaldwellview(occipito-frontalview)BestviewforsphenoidsinusBasalview(submentoverticalview)
100.Bestviewforsphenoidsinusis- a)Water'sview b)Caldwellview c)Basalview d)Towne'sview CorrectAnswer-CAnswer-C.BasalviewBestviewformaxillarysinusWater'sview(occipito-mentalview)BestviewforfrontalsinusCaldwellview(occipito-frontalview)BestviewforsphenoidsinusBasalview(submentoverticalview)
101.Followingaretheindicationsofbarium mealX-rayexcept- a)Duodenalulcer b)Carcinomastomach c)Carcinomaheadofpancreas d)IschemicColitis CorrectAnswer-DAnswer-D.IschemicColitisIndicationsforBariummealX-rayDuodenalulcerPeriampularycarcinomaPsendocystofpancreasCarcinomastomachChronicduodenalileusCarcinomaheadofpancreasDuodenaldiverticula
102.Inachildrenectopickidneyscanbe diagnosedby- a)DTPA b)DMSA c)MAG3 d)Noneoftheabove CorrectAnswer-BAnswer-B.DMSAIndicationsforstaticrenalscintigraphy(Tc-99m-DMSA): 1. Assessmentofrefluxnephropathy(scars)2. Spaceoccupyinglesions(corticalmass)3. Investigationofhorseshoe,solitaryorectopickidney
103.Firstlineinvestigationfordeepvenous thrombosisis- a)Ultrasonography b)Venography c)MRI d)Nuclearimaging CorrectAnswer-AAnswer-A.UltrasonographyUltrasonographyisthecurrentfirst-lineimagingexaminationforDVTbecauseofitsrelativeeaseofuse.
104.Whichofthefollowingisnotachest radiographicfeatureofleftatrialenlargement? a)Doubleleftheartborder b)Elevatedleftmainbronchous c)Splayingofcarina d)Enlargementofleftatrilaappendage CorrectAnswer-AAnswer-A.DoubleleftheartborderSingsofleftatrialenlargementStraighteningofleftheartborder(duetoenlargementofleftatrialappendage).Elevationofleftmainbronchuswithwidening(Splaying)ofcarina.Doubledensity(atrial)sign.Posteriordisplacementofesophagusonbariumswallow.
105.HRCTfeaturesofinterstitialpneumonia areallexcept- a)Reticularopacities b)Honeycombing c)Groundglassopacities d)Nobronchieactaticfeatures CorrectAnswer-DAnswer-D.NobronchieactaticfeaturesClassicalHRCTfeaturesofinterstitialpneumoniaare: 1. Reticularopacitiesinbasalandperipheraldistribution.2. Tractionbronchiestasis.3. Honeycombing(clusteredairspaces3-10mmdiameter/insubpleural location.
106.Followingarethecausesofcavityin lungsexcept- a)Staphylococcus b)Wegeners c)Hydatid d)Sarcoidosis CorrectAnswer-DAnswer-D.SarcoidosisCausesoflungcavitiesare:1)Necrotizinginfections2)Vascular:Pulmonaryinfarction.3)Neoplastic: 1. Carcinomabronchus:-Especiallysquamouscellcarcinoma.2. Metastases3. Lymphoma 4)Granulomas:-Wegener'sgranulomatosis,Rheumatoidarthritis(alsoKaplan'ssyndrome)5)Abnormallung:-Infectedemphysematosbulla,sequestratedsegment,bronchogeniccyst.6)Traumatic:-Haematoma
107.Beadedlumenwithfimbrialfluidisseen in- a)TBoffallopiantube b)TBofendometrium c)TBofOvary d)None CorrectAnswer-AAnswer-A.TBoffallopiantubeFallopiantubeisthemostcommonsiteoffemalegenitaltractwhichisaffectedintuberculosis.Onhysterosalpingography,thefallopiantubeoftenshowraggedoutlineswithmultiplestrictures,givingabeadedappearance;insomepatientstheentiretubeappearsrigidandmayexhibitsmallterminalsacculationoftheampullaryend.
108.Followingareradiologicalfindingsin rheumatoidarthritisexcept- a)Symmetricalinvolvement b)Juxta-articiularosteopenia c)Marginalerosion d)Subchondralsclerosis CorrectAnswer-DAnswer-D.SubchondralsclerosisRheumatoidarthritisBilateralsymmetricalinvolvementMarginalerosionAnkylosisPeriarticularsofttissueswellingSubchondralcystsSubluxationordislocationJuxta-articularosteopeniaNarrowingofjointspace(Later)Arthritismultilans(late)
109.Whichofthefollowingis/areradiological featuresoffluorosis? a)Osteosclerosis b)Corticalthickening c)Enthesopathy d)Alltheabove CorrectAnswer-DAnswer-D.AlltheaboveRadiologicalfeaturesoffluorosisare:Osteosclerosis-particularlyaffectingtheaxialskeleton.Corticalthickeningwithencroachmentonmedullarycavity.Enthesopathywithligamentousossification.Largespinalosteophytes.
110.Depthofgastriccarcinomasisassessed by- a)Abdominalultrasound b)Bariummeal c)Endoluminalultrasound d)Laproscopy CorrectAnswer-CAnswer-C.EndoluminalultrasoundFivelayersofthegastricwallcanbeidentifiedbyendoluminalultrasoundandthedepthofinvasionoftumorcanbeassessedbyexquisiteaccuracy.
111.Radiologicalsignsofacutepancreatitis onplainradiographyare- a)Sentinelloopsign b)Coloncutoffsign c)Renalhalosign d)Alltheabove CorrectAnswer-DAnswer-D.AlltheaboveRadiologicalfeaturesofacutepancreatitis:- 1. AirinduodenalC-loop2. Coloncutoffsign3. Gaslessabdomen4. Sentinalloopsign5. RenalHalosign
112.MostsensitiveinvestigationforDiffuse axonalinjuryis- a)MRI b)CT c)Xray d)PETscan CorrectAnswer-AAnswer-A.MRIMRIisthemostsensitiveinvestigationfordiffuseaxonalinjuries.ItshowsmultiplesmallfacesofincreasedintensityonT,IATanddecreasedintensityonTy.
113.MostcommonviewusedforX-raychest - a)PAview b)APview c)Lateralview d)Obliqueview CorrectAnswer-AAnswer-A.PAviewImportantviewsforchestx-rayare: 1. Posterior-anteriorview(PAview)2. Anterior-posteriorview(APview)3. Lateralview4. Lateraldecubitusview
114.Bestinvestigationforbonemetastases is- a)MRI b)CT c)BoneScan d)XRay CorrectAnswer-CAnswer-C.BoneScanBonescan(scintigraphy)istheinvestigationofchoiceforbonemetastasis.
115.Doubletracksignisseenin- a)Duodenalatresia b)CHPS c)Gastriculcer d)Achalasia CorrectAnswer-BAnswer-B.CHPSDouble/tripletracksignisseenincongenitalhypertrophicpyloricstenosis.
116.HalflifeofRa-226- a)8days b)28years c)16-22years d)38years CorrectAnswer-CAnswer-C.16-22yearsHalflifeofRa-226is16-22years.
117.Whichviewistakenforaorticwindow- a)AP b)LAO c)RAO d)LPO CorrectAnswer-BAnswer-B.LAO`Aleftanterioroblique(LAO)viewisusefultoassessthoracicaorta,aorticwindowandthechamberofheart".ClinicalradiologyAorticwindowisthespacebetweenascendinganddescendingthoracicaorta.
118.Theprimarydiagnosticevaluationfor developmentaldyslasiaofhipis- a)Clinicalexamination b)X-ray c)USG d)CTScan CorrectAnswer-CAnswer-C.USGUltrasonographyisnowtheprimaryimagingtechniqueinthediagnosisandfollowupofDDHandhasbeenshowntobemoreaccuratethanclinicalandradiologicalassessmentwithasensitivityof100%andspecificityof98%.
119.Investigationofchoiceforpancoast tumoris- a)MRI b)HRCT c)CECT d)Bronchography CorrectAnswer-AAnswer-A.MRIRadiologicalinvestigationofchoiceforpubnonarymalignenciesisCTscanexcepinsuperiorsulcus(pancoasttumor)whereMRIispreferred.
120.Dopplereffectresultsfromchangein- a)Amplitudeofsound b)Frequencyofsound c)Directionofsound d)Noneoftheabove CorrectAnswer-BAnswer-B.FrequencyofsoundTheDopplereffectresultsfromanapparentshiftinsoundfrequencyassoundwavearereflectedfrommovingtargets,usuallybloodcells.Ifmotionistowardthetransducer,thefrequencyofreturningechoishigherthatofthetransmittedsound.
121.X-rayArtifactis- a)Aradiolucentarea b)Anyabnormalopacityintheradiograph c)Producedwhenpatientmoveswhiletakingtheshoot d)Alltheabove CorrectAnswer-CAnswer-C.ProducedwhenpatientmoveswhiletakingtheshootArtifactscanpresentinavarietyofwaysincludingabnormalshadownotedonaradiographordegradedimagequalityandhavebeenproducedbyartificialmeansfromhardwarefailure,operatorerrorandsoftware(post-processing)artifacts.Commoncauses:-ImproperhandlingofthefilmsErrorswhileprocessingthefilmsPatientmovementwhiletakingtheshoot
122.FrequencyofultrasoundwavesinUSG- a)2000Hz b)5000Hz c)<2MHz d)>2MHz CorrectAnswer-DAnswer-D.>2MHzTheultrasoundmachineemitshigh-frequencysoundwaves,rangingfrom2-15MHz.Whosefrequenciesareconsiderablyabovetheupperlimitofhumanear'saudiblerange,i.e.,greaterthan20000Hz.Speedofthesesoundwavesinthebodyis1540m/s(incomparisontoair,wherevelocityofsoundwaveis330m/s).
123.Gyromagneticpropertyofprotonisseen in- a)MRI b)CT c)PETscan d)USG CorrectAnswer-AAnswer-A.MRIUltrasonographyisbasedonpiezoelectriceffect.MRIisbasedongyeromagneticpropertyofprotonW9.
124.EnhancementinCTcontrastisdueto- a)Iodine b)Gadolinium c)Silver d)Mercury CorrectAnswer-AAnswer-A.IodineIodinatedcontrastsarethemostcommonlyusedradiocontrastmediainradiographyandCT.GadoliniumisthemostcommonlyusedMRcontrastagent.
125.Whichdelivershighestdoseofradiation - a)Cardiacperfusionscan b)CTchest c)CTbrain d)Mammogram CorrectAnswer-AAnswer-A.CardiacperfusionscanMedicaldiagnosticimagingisamajorsourceofradiationexposuretoclinitiansandthepatients.Followingtabledepictstheradiationexposurethroughtheroutinemedicalimaging.
126.Bestviewforcollapseofmiddlelobe lungis- a)Lateral b)AP c)Oblique d)Lordotic CorrectAnswer-DAnswer-D.LordoticThelordoticviewisalsousefulforrecognizingcollapseoflingulaormiddlelobewhentheseareasbecomeverythinandcastminimalshadowonthePAview.
127.Doubleshadowbehindrightatriumand straighteningofleftmainbronchusindicates- a)Rightatriumenlargement b)Rightventricleenlargement c)Leftatriumenlargement d)Leftventricleenlargement CorrectAnswer-CAnswer-C.LeftatriumenlargementLeftatriumenlargementRefSutton7h/ep.280-350]
128.Leftatrialenlargementisseenin- a)Mitralstenosis b)Tricuspidregurgitation c)AR d)None CorrectAnswer-AAnswer-A.MitralstenosisDuetoleftatrialenlargement:-Straighteningofleftheartborder,elevationofleftmainbronchuswithwideningofcarina,doubleatrialshadow(Doubledensitysign),posteriordisplacementofesophagusonbariumswallow,Prominentposterosuperiorpartofcardiacshadow.
129.AirbronchogramonchestXraydenotes - a)Intrapulmonarylesion b)Extrapulmonarylesion c)Intrathoraciclesion d)Extrathoraciclesion CorrectAnswer-AAnswer-A.IntrapulmonarylesionAirinbronchiisvisualizeditiscalledairbronchogram.Airbronchogramindicatesintrapulmonarypathology,Itexcludesanypleuralormediastinalpathology.
130.Calcifiedpulmonarymetastasisisseen inwhichcarcinoma- a)Pancreaticcarcinoma b)Thyroidcarcinoma c)Endometrialcarcinoma d)None CorrectAnswer-BAnswer-B.ThyroidcarcinomaDifferentialdiagnosisofcalcifiedpulmonarymetastasis:- 1. Osteosarcoma2. Coloncarcinoma3. Chondrosarcoma4. Giantcelltumorofbone5. Thyroidcarcinoma6. Ovariancancer7. Synovialsarcoma8. Breastcarcinoma
131.Differentialdiagnosisofsolitary pulmonarynoduleareallexcept- a)Bronchogeniccarcinoma b)Mycetoma c)Tuberculoma d)Hamartoma CorrectAnswer-BAnswer-B.MycetomaGranulomas:-Tuberculoma(mostcommoncause),Histoplasma,Coccidioidomycosis,cryptococcosis.Otherinfections:-Organizingpneumonia,hydatidcyst.Benignneoplams:-Hamartoma,Fibroma,Neurofibroma,Carcinoidtumours,Lipoma,BronchialadenomaMalignantneoplasm:-Carcinomabronchus,Alveolarcellcarcinoma,metastasis(frombreast,Sarcoma,Renalcellcarcinoma,Seminoma),Pulmonaryblastoma,Pulmonarysarcoma.Inflammatory-Wegener'sgranulomatosis,rheumatoidarthritis,Sarcoidosis.Congenital:-Sequestration,Bronchogeniccyst,AVmalformation.Miscellaneous:-Pulmonaryinfarct,Roundedatelectasis,Mucoidimpaction.
132.Thesignwithpatchofdullnessbeneath theangleofleftscapulainapatientwithpericardialeffusionisnamedas- a)Carvallo'ssign b)Ewart'ssign c)Homan'ssign d)Hoffmann'ssign CorrectAnswer-BAnswer-B.Ewart'ssignHeartsoundsbecomefaint-Theapeximpulsevanishes;butsometimesitremainspalpable,medialtotheleftborderofcardiacdullness.Thebaseoftheleftlungmaybecompressedbypericardialfluid,producingEwart'ssign,apatchofdullnessbeneaththeangleoftheleftscapula.Thechestroentgenogrammayshowa"waterbottle"or"flaskshaped"configurationofthecardiacsilhouette
133.Waterbottleheartisseenin- a)PDA b)Chronicemphysema c)Pericardialeffusion d)Constrictivepericarditis CorrectAnswer-CAnswer-C.Pericardialeffusion"Water-bottle"orflaskedshapedormoneybagheart-Pericardialeffusion,hypothyroidism
134.Forpericardialcalcifications,whichis thebestinvestigation- a)MRI b)Transesophagealechocardiography c)USG d)CTscan CorrectAnswer-DAnswer-D.CTscanCTisthebestmethodfordepictionofpericardialcalcification,afindingsuggestiveofconstrictivepericarditisintheappropriateclinicalsetting.
135.Fluorescinangiographyisusedto examine- a)Ciliaryvasculature b)Retinalvasculature c)Cornealvasculature d)Conjuctivalvasculature CorrectAnswer-BAnswer-B.RetinalvasculatureFluoresceinangiographyisaradiologicalexaminationofretinalvasculatureaftertheadministrationofafluoresceindye.
136.Bariumswallowisusedfor- a)Colon b)Esophagus c)Duodenum d)Jejunum CorrectAnswer-BAnswer-B.EsophagusBariumswallow-Mainlyforesophagus
137.Pulledupcecumisseenin- a)IleocecalTB b)Carcinomacecum c)Intussuption d)Carcinoma CorrectAnswer-AAnswer-A.IleocecalTBConicalcecumorAmputedcecumCecumisshrunkeninsizeandpulledoutoftheiliacfossaduefibrosisandcontractionofmesocolon.Stierlinsign:-Narrowingofterminalileumwithrapidemptyingintoashortened,rigidorobliteratedcecum.Stringsign
138.Thestudyusingbariumforsmall intestineisknownas- a)Bariummealfollowthrough b)Bariumswallow c)Bariumenema d)Noneoftheabove CorrectAnswer-AAnswer-A.BariummealfollowthroughInmostcasesthejejunumandIleumareexaminedfollowingthebariumexaminationoftheuppergastrointestinaltract,referredtoasthe"bariummealandfollowthrough"orsimply"bariumfollowthrough".
139.Investigationwithleastradiationdosein thediagnosisMeckel'sdiverticulumis- a)CT b)MRI c)Contrastradiography d)Technetium-99mscanning CorrectAnswer-CAnswer-C.ContrastradiographyItisageneralrulethattheascendingorderoftheradiationdoseisMRI<X-ray<CT-Scan.Technetium-99mhastheradiationexposuremorethanX-raybutlessthanCT-Scan.Socontrastradiographywillhavetheminimumradiationexposureasitinvolvestakingaradiographaftersmallbowelenemafordiagnosisofmeckel'sdiverticulum.
140.EndoscopicUSGcriteriaforchronic pancreatitis,whenechogeniclesionis- a)>1mm b)1.5mm c)>2mm d)>3mm CorrectAnswer-DAnswer-D.>3mmParenchymalfeaturesEcho-poorlesionEcho-richlesion(>3mmindiameter)AccenuationoflobularpatternGlandsize,cystDuctalfeaturesIncreasedductwallechogenicityNarrowing,dilatationCalculi
141.Mostsensitivetesttodetectearlyrenal TBis- a)Intravenousurography b)CT c)MRI d)USG CorrectAnswer-AAnswer-A.IntravenousurographyIVPremainstheprimarymodalityusedtoimagethepatientswithrenal,ureteric,andbladdertuberculosis.EarlyfindingsarebestdetectedonIVP.ItistheinvestigationofchoiceforurinaryTB.
142.Investigationofchoiceforfocal neurologicdeficitinemergencyroomis- a)CT b)MRI c)Lumbarpuncture d)CECT CorrectAnswer-AAnswer-A.CTInIndiansetupCTScanistheinvestigationofchoiceintheemergencyroomtoscreenpatientsofacutefocalneurologicdeficit.
143.CTScanfindingincarotidcavernous sinusfistulais- a)Enlargedsuperiorophthalmicvein b)Enlargedinferiorophthalmicvein c)Enlargedsuperiorophthalmicartery d)Enlargedinferiorophthalmicartery CorrectAnswer-AAnswer-A.EnlargedsuperiorophthalmicveinContrast-enhancedCTscanandMRIwilldemonstrateadilatedsuperiorophthalmicveinandcavernoussinus.Ultrasonographymayalsodemonstratesuperiorophthalmicveinengorgement.Magneticresonanceangiography(MRA)isalsoveryusefulinidentifyingfistulasaswellasparticularvesselinvolvement.
144.Onimagningdiffuseaxonalinjuryis characterizedby- a)Multiplesmallpetechialhemorrhage b)Patchilldefinedlowdensitylesionmixedwithsmallhyperdens ofpetechialhemorrhage c)Crescenticextra-axialhematoma d)Whitematterlucencies CorrectAnswer-AAnswer-A.MultiplesmallpetechialhemorrhageMultiplesmallpetechialhemorrhage<2cmdiameterincerebralhemisphere.
145.Rheseviewisusedfor- a)Superiororbitalforamen b)Inferiororbitalforamen c)Opticforamen d)Sellaturcica CorrectAnswer-CAnswer-C.OpticforamenOpticforamen-Rheseview
146.Prevertebralspacethicknessinadultis- a)7mm b)14mm c)22mm d)30mm CorrectAnswer-A:CAnswer-A&C.22mm(A)7mm<7mmatC1level<5mmatC3-C9level<22mmatC6level
147.Osteolyticmetastasisisseenwith- a)Lung b)Kidney c)Thyroid d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveOsteolytic,characterizedbydestructionofnormalbone,presentinmultiplemyeloma(MM),renalcellcarcinoma,melanoma,non-smallcelllungcancer,non-hodgkinlymphoma,thyroidcancerorlangerhans-cellhistiocytosis.
148.Investigationofchoiceinwholebody imaginginmetastasisis- a)MagneticResonanceImaging b)Angiography c)Venography d)CTScan CorrectAnswer-AAnswer-A.MagneticResonanceImagingWhole-bodyMRimagingwithuseofarollingtableplatforminconjunctionwithfastT2-weightedturbospin-echoand3Dgradient-echosequencesisatime-savingandaccuratealternativetoconventionalmultimodalityevaluationofpatientswithtumorsformetastases.
149.Tsignisseenin- a)GenitalTB b)Membraneintwinpregnancy c)Molarpregnancy d)Choriocarcinoma CorrectAnswer-BAnswer-B.Membraneintwinpregnancy'Tsign'referstoappearanceoftheinter-twinmembraneinamonochorionictwinpregnancy.
150.Investigationofchoiceincongenital uterineanamolyis- a)MRI b)CT c)HSG d)Hysteroscopy CorrectAnswer-DAnswer-D.HysteroscopyHysteroscopyisthegoldstandardinthediagnosisaswellastherapeuticmanagement.
151.Maximumradiationdosetolerabletissue is- a)Hemopoietictissue b)Testis c)Ovary d)Bone CorrectAnswer-DAnswer-D.BoneHighlyradiosensitiveLymphoidtissueBonemarrowGITepitheliumGonads(Testis,ovary)Embryonictissue
152.Epidermoidcystcanbedifferentiated fromarachnoidcystby- a)MRI b)USG c)Myelography d)CTscan CorrectAnswer-AAnswer-A.MRIMyelographycannotdifferentiatereliablybetweenanepidermoidcystandanoncommunicatingarachnoidcyst.IthaslargelybeenreplacedbyMRI.
153.SoapbubbleappearanceonMRIbrainis characteristicof? a)Tubercularmeningitis b)Neurocysticercosis c)Cryptococcalcysts d)Ependymoma CorrectAnswer-CAnswer-C.CryptococcalcystsCryptococcomasT1:lowsignalT2/FLAIR:highsignalT1C+(Gd):variable,rangingfromnoenhancementtoperipheralnodularenhancement.GelatinouspseudocystscausedbyCryptococcustendtogivea"soapbubble"appearanceonMRI.MRIfindingsinneuralcryptococcosis.
154.T2imageinMRIis- a)Goodtodetectpathology b)Goodtodetectanatomy c)Goodforboth d)Goodfornone CorrectAnswer-AAnswer-A.GoodtodetectpathologyManypulse-sequencetechniquesareusedinMRI,butmostclassicareT1andT2weightedimages.Asageneralrule,TI-weightedimagesaregoodforviewinganatomy,andT2weightedimagesaregoodfordetectingpathology.[RefFundamentalsofdiagnosticradiologyp.18]
155.Keyholesignonultrasoundisseenin- a)Polycystickidney b)Hydronephrosis c)Chronicpyelonephritis d)Posteriorurethralvalves CorrectAnswer-DAnswer-D.PosteriorurethralvalvesThekeyholesignisanultrasonographicsignseeninboyswithposteriorurethralvalves.ltreferstotheappearanceoftheproximalurethra(whichisdilated)andassociatedthickwalleddistendedbladderwhichonultrasoundmayresembleakeyhole.
156.MIBGdoseis- a)40-80MBq b)80-100MBq c)100-120MBq d)120-150MBq CorrectAnswer-AAnswer-A.40-80MBqMIBGscanisascintigraphicstudythatusesmetaiodobenzylguanidinelabeledtoIodine-123orIodine-131.Theactivityadministeredtoadultsshouldbe:for131I-mIBG:40-80MBq(1.2-2.2mCi);for123ImIBG:400MBq(10.8mCi).ForminimumandmaximumrecommendedactivitiesinchildrenoneshouldconsulttheGuidelinesforRadioiodinatedMIBGScintigraphyinChildren(minimumactivity20MBqfor123I-mIBGand35MBqfor131I-nIBG;maximumactivity400MBqfor123I-mIBGand80MBqfor131I-mIBG).
157.Bariummealfollowthroughishelpfulin diagnosing- a)Colonicstricture b)Ilealstricture c)Rectalstricture d)Esophagealstricture CorrectAnswer-BAnswer-B.IlealstrictureFollowingabnormalitiesofsmallintestinecanbeidentified:- 1. Malabsorption2. BD(CD&UC)3. Tumorsofsmallintestine4. Smallbowelobstruction5. Intestinalstrtcture
158.Radiographicsigncharacteristicof pulmonaryedemais- a)Westermark'ssign b)Hampton'shump c)Pallasign d)Batwingsign CorrectAnswer-DAnswer-D.BatwingsignAcutepulmonaryedema:-Acutepulmonaryedemaischaracterizedbycentrallylocatedalveolarsign,withhazyorfluffyincreaseddensityinperihilardistribution,creatingabat-wingorangel-wingpaftern.Thereisrelativesparingofthemoreperipheralzonesoflungfields.Airbronchogrambecomeevidentasedemabecomesmoreopaque.
159.Gammaknifeutilizes- a)Strontium89 b)1-131 c)Cobalt-60 d)P-32 CorrectAnswer-CAnswer-C.Cobalt-60GammaknifecontainsCobalt-60sourcesofapproximately30curisplacedincirculararrayinaheavilyshieldedunit.Theunitdirectsthegammarirystothetarget.
160.SnowstormappearanceonchestX-ray isseenin- a)Anthracosis b)Byssinosis c)Silicosis d)Bagassosis CorrectAnswer-CAnswer-C.SilicosisSimpleformz-Multiplesmallrounded(nodular)opacitiesinthelungparenchyna(snowstonnappeoraace).Thesenodulestendtobelocatedpredominantlyinthemiddleandupperlungfieldswithrelativesparingoflowerlungfields(ThoughIowerlungfieldscanalsobeinvolvedlaterindiseaseprocess).Thereisbilateralhilarlymphadenopathywithcharacteristiceggshellcalcification.
161."Drooplilysign"isseenin- a)"Drooplilysign"isseenin b)Duplicatedcollectingsystem c)Chronicpyelonephritis d)Hypernephroma CorrectAnswer-BAnswer-B.DuplicatedcollectingsystemThedroopinglilysrgl(droppingflowersign)isaurographicsigninsomepatientswithaduplicatedcollectingsystem.Itreferstotheinferolateraldisplacementoftheopacifiedlowerpolemoietyduetoanobstructed(andunopacified)upperpolemoeity.
162.Sonographicappearanceofhydatidcyst is- a)Hyperechoicaseptatelesion b)Hypoechoicaseptatelesion c)Hyperechoicseptatelesion d)Hypoechoicseptatelesion CorrectAnswer-DAnswer-D.HypoechoicseptatelesionTypeI(Simplecyst):-Single(solitary)hnrcechoic/anechoicaseptate(withoutsepta)lesion.Thediagnosisofhydatidcystmaybeconsideredwhenfocalthickeningofwallispresentorwhenhlperechoicspots,duetohydatidsand,appearinthedependentareas.
163.SIunitofabsorbeddoseis- a)Becquerel b)Columb/cm c)Gray d)Sievert[Sv] CorrectAnswer-CAnswer-C.GrayOldunitofabsorbeddoseisRadandnewunit(SI)isGray.
164.Stenver'sviewisusedfor- a)Superiororbitalforamen b)Inferiororbitalforamen c)Internalauditorycanal d)Sellaturcica CorrectAnswer-CAnswer-C.InternalauditorycanalSkulltrauma(sellaturcica)(pituitaryfossa)-LateralviewInternalauditoryview(bothside)-Stenver'sview
165.Acutemyocarditisschintigraphyisdone with- a)Thallium b)Technetium c)Gallium d)None CorrectAnswer-CAnswer-C.GalliumGallium-67uptakeisincreasedininflamedmyocardium.Gallium-67citrateinjectedintravenouslybindstotransferrin,anditisincorporatedintothetransferrinreceptorofinflammatorycellsormalignanttumorcells.Gallium-67scintigraphyisusefulforexaminationofheartdiseaseincludingcardiacsarcoidosisandacutemyocarditis
166.Radiationusedmostcommonlyforpain managementduetobonemetastasisis- a)Co60 b)Iridium192 c)Tritium d)Tin-117 CorrectAnswer-AAnswer-A.Co60Radiopharmaceuticals(radioactiveisotopes)usedformetastaticbonepainarestrontium(Sr89),Samarium(Sm153),rhenium(Re186),Phosphorus-32andTin-117(Sn-177).
167.Minimumradiationdosewhichmaylead tooligospermiais- a)<1Gy b)2-3Gy c)7-10Gy d)15Gy CorrectAnswer-AAnswer-A.<1GyFractionateddoses0.7-0.9Gyleadtooligospermia/azoospermiabutwithfrequentrecoveryat1-1.5years.Permanentazoospermiamayoccurafterfractionateddosesaslowas1.2Gy,andislikely>2Gy.
168.Halflifeoftritiumis- a)10.2years b)12.3years c)15.5years d)20.7years CorrectAnswer-BAnswer-B.12.3yearsTritium(hydrogen-3)isaradioactiveisotopeofhydrogen.Thenucleusoftritium(sometimescalledatriton)containsoneprotonandtwoneutrons.Whereasthenucleusofprotiumcontainsoneprotonandnoneutrons.Tritiumhasahalf-lifeof12.3years
169.Safelightinradiographicdarkroomis ideallyshouldbeoffollowingcolor- a)Red b)Yellow c)Purple d)Blue CorrectAnswer-AAnswer-A.RedRed-Somebluesensitivematerials,mostphototypesettingmaterials,mostblueandmostgreensensitivemedicalx-rayfilms(usedindarkroom).Darkamber-Colornegativepapersandmaterials,panchromaticblackandwhitepapers.Amber-Colornegativepapers,panchromaticblackandwhitepapers
170.Leastpenetratingpoweramong followingmentionedraysisin- a)Alpharays b)Betarays c)Gammarays d)X-ray CorrectAnswer-AAnswer-A.AlpharaysPenetrationpower:Gammarays>Xrays>Betaparticle>Alphaparticle(orheliumion)Ionizing&damagingpower:Alphaparticle(orheliumion)>Betaparticle>Xray>GammarayAlphaparticles(Heliumnuclei)havehighestionizingpowerbecausetheyhavealargecharge.Alphaparticleshavethehighestdamagingpowerastheyarerelativelyslowandheavy.
171.Non-ionizingradiationamongthe followingis- a)MRI b)CTScan c)X-ray d)Positionemissionscintigraphy CorrectAnswer-AAnswer-A.MRINon-ionizingradiation-USGMRIThermography(infraredrays)UVraysRadiofrequencywavesMicrowaves
172.MechanismofheatlossinmodernX-ray tubeis a)Radiation b)Evaporation c)Conduction d)Convection CorrectAnswer-AAns.A.RadiationThemechanismofheatlossinthemodernX-raytubeisradiation.ClassicalX-raytube:Theoutertubeismadeupofglass.Cathode-tungstenfilament.Ananodeisthetargetandismadeoftungsten.Themechanismofheatlossisconduction.Theatomicnumberoftungstenis74.ModernX-raytube:TheoutertubeismadeupofstainlesssteelCathode-tungsten+thoriumAnode-tungsten+10%rhenium.Ananodeisrotatingandthemechanismofheatlossisradiation.
173.Nonionicdyeis a)Ioxaglate b)lohexol c)Iothalamate d)None CorrectAnswer-BAnswer-B.IohexolIohexolisanonionicmonomercontrastagent.Thenon-iodineradicalsatpositions1,3and5(includingtheioniccarboxylradical)werereplacedbylongaminohydrocarbonsthatprovideadequatesolubilitywithoutionizing.Examplesofthistypeofcompoundareiopromide,iohexol,iopamidol,ioversol,iopentol,iobitridol,andiomeprol.
174.HUismeasureof a)CT b)MRI c)PET d)USG CorrectAnswer-AAnswer-A.CTHounsfield'scontributionismemorializedintheHounsfieldscale,whichisusedtomeasurethex-rayattenuationinCTscanning.Waterisarbitrarilyassignedavalueof0Hounsfieldunits(HU).[RefEssentialradiologyp.86]
175.WhichlookssameonTi&T2onMRI a)Gallbladder b)Fat c)Kidney d)CSF CorrectAnswer-BAnswer-B.FatFat(adiposetissue)hashighsignalintensityonbothT1&T2images.OtherthreeoptionshavelowsignalintesityonT1andhighsignalintensityonT2images.
176.HypertranslucentchestX-rayisseenin allexcept a)Mcleodsyndrome b)Emphysema c)Pneumonectomy d)Polandsyndrome CorrectAnswer-CAnswer-C.PneumonectomyCausesofopaquehemithoraxTechnical:-Rotation,Scoliosis.Pleural:-Pleuraleffusion,Pleuralthickening,Mesothelioma.Surgical:-Pneumonectomy,Thoracoplasty.Congenital:-Pulmonaryagenesis.Mediastinal:-Grosscardiomegaly,tumors.Pulmonary:-Collapse,Consolidation,fibrosis,Foreignbody.Diaphragmatichernia
177.WhatisnotseenonchestX-rayin pulmonaryarteryhypertension a)Enlargementofcentralarteries b)Peripheralprunning c)Narrowingofcentralarteries d)None CorrectAnswer-CAnswer-C.NarrowingofcentralarteriesCharacteristicradiologicalfeatureofpulmonaryhypertensionisenlargementofcentralarterieswithperipheralprunning.Increasedpulmonaryarterypressureandpulmonaryvascularresistancecharacterizepulmonaryhypertension.PAHisdefinedassystolicpressureinthepulmonaryarteryexceeding30mmHg.
178.ColonisidentifiedonX-ray a)Haustra b)Valvulaeconniventes c)Stringofbeadssign d)Morenumberofloops CorrectAnswer-AAnswer-A.HaustraHaustra(incompletebandacrossthebowelgasshadow)areseenincolon.
179.Doubletracksignisseenin a)Duodenalatresia b)CHPS c)Gastriculcer d)Achalasia CorrectAnswer-BAnswer-B.CHPSDouble/tripletracksignisseenincongenitalhypertrophicpyloricstenosis.
180.Investigationofchoiceformultiple sclerosis a)CT b)MRI c)USG d)PET CorrectAnswer-BAnswer-B.MRIMRIistheinvestigationofchoicefordemyelinatingdisorder,e.g.multiplesclerosis.
181.Investigationofchoiceforintramedullary SOLis- a)MRI b)USG c)CT d)X-ray CorrectAnswer-AAnswer-A.MRIInvestigationofchoiceforintramedullaryspaceoccupylesionisMRI.
182.VonRosen'sviewisfor a)CDH b)Perthe'sdisease c)CTEV d)None CorrectAnswer-AAnswer-A.CDHInVonRosen'sviewisusedinDDH/CDH.
183.Nuchaltranslucencyisusedin a)Headscan b)MRIneck c)ANCUSG d)Anthropometry CorrectAnswer-CAnswer-C.ANCUSGNuchaltranslucencyisusedforscreeningofdownsyndromeinantenatalUSG.
184.Half-lifeofIodine131is a)8hours b)8days c)8weeks d)8months CorrectAnswer-BAnswer-B.8daysIodine-131Halflife8daysIodine-123-3Halflife13hoursIodine-132Halflife2.3hours
185.Dyeusedindiagnosisofesophageal perforation: a)Iohexol b)Bariumsulphate c)Gadolinium d)Iodinedye CorrectAnswer-BAnswer-B.BariumsulphateBariumsulfateinsuspensionisfrequentlyusedmedicallyasaradiocontrastagentforX-rayimagingandotherdiagnosticprocedures.ItismostoftenusedinimagingoftheGItractduringwhatiscolloquiallyknownasa"bariummeal".Fluoroscopymostsensitivewithinthefirst24hours.patientexaminedsemi-supine(~20degrees)onfluoroscopytableawater-solubleagentshouldbeusedinitiallyasbariumcancausemediastinitisesophagealperforationmayberepresentedasmucosalirregularityorgrossextraluminalcontrastextravasationsomeauthorssuggesttheuseofsmallamountsofloworhighconcentrationsofbariumifnoleakisevidentoninitialscreeningwithwatersolublecontrastIohexol,tradenamesOmnipaqueamongothers,isacontrastagentusedduringX-rays.Thisincludeswhenvisualizingarteries,veins,ventriclesofthebrain,theurinarysystem,andjoints,aswellasduringcomputertomography.Itisgivenbymouth,injectionintoavein,orintoabodycavity.
186.Braggpeakeffectpronouncedin: a)Xray b)Proton c)Neutron d)Electron CorrectAnswer-BAnswer-B.ProtonNowadaysprotontherapy(PT)representsanestablishedalternativetophotonradiotherapyforthetreatmentofspecifictypesofcancer.Thetherapeuticuseofprotonbeams(andofchargedparticlesingeneral)ismotivatedprimarilybytheirinverteddepth-doseprofilecomparedtophotons,beingcharacterizedbytheso-calledBraggpeak.Severalbeamsofdifferentenergycanthenbecombinedinordertoachievetheprescribeddoseinaregionaslargeasthetargetvolume,resultingintheproductionofwhatisdefinedastheSpread-OutBraggPeak(SOBP).
187.SaltandPepperpotappearanceofskull seenin: a)Hyperparathyroidism b)Multiplemyeloma c)Hyperthyroidism d)Pseudohyperparathyroidism CorrectAnswer-AAnswer-A.HyperparathyroidismPepperpotskullisoccasionallyusedinplaceofsaltandpepperskulltodescribethetypicalradiographicappearanceofmultiplesmallradiolucentlesionsoftheskullvault.Inprimaryhyperparathyroidism,extensiveresorptionboneintheskullincombinationwithcysticareasofosteopeniaaretermedpepperpotskull.Classicallyseeninhyperparathyroidism,andisoccasionallyused(inaccurately)todescribetheraindropskullofmultiplemyeloma. :SullX-raywithatypical"pepper-pot"appearance
188.ImagingtechniquesusedinUterus anomaliesEXCEPT: a)HSG b)MRIguidedHSG c)CTguidedHSG d)USG CorrectAnswer-CAnswerC.CTguidedHSGImagingstudies,suchasahysterosalpingogram(HSG)andultrasound,oranMRIarerequiredtovisualisetheuterusandconfirmthatacongenitaluterineanomalyispresent.Ahysterosalpingogramisnotconsideredasusefulduetotheinabilityofthetechniquetoevaluatetheexteriorcontouroftheuterusanddistinguishbetweenabicornuateandseptateuterus.Inaddition,laparoscopyand/orhysteroscopymaybeindicated.
189.Whichisthetreatmentofchoicefor irradiationinChordoma? a)Protons b)Electrons c)Gammaradiation d)3D-CRT CorrectAnswer-AAnswer:A-ProtonTherapyChordoma:Slow-growingneoplasmArisingfromcellularremnantsofnotochord.Arisefromboneinskullbaseandalongspinalcord.Mostcommonlocations-CraniallyatclivusInsacrumatbottomofspineRadiationtherapy:ArerelativelyradioresistantHighdosesofradiationrequiredtocontrol.Hence,highfocusradiationlikeprotontherapyandcarboniontherapyarepreferredthanconventionalradiationmethods.Closeproximitytovitalstructureslikebrainstem,requireshighprecisionandaccuracyforanyplannedsurgicalresection.Radiationwithhighaccuracyandminimaldamagewithmaximalsafetyisdelivered.
190.Cancerpatientundergoesradiotherapy, pickthetruestatementforradiosensitivityoftissues? a)Rapidlydividingcellsareresistanttoradiation b)GImucosaisoneofthemostradioresistanttissuesinthebody c)Theintensityofradiationisinverselyproportionaltothesquare ofdistancefromthesource d)Smallbloodvesselsareleastresistanttoradiation CorrectAnswer-CAnswer-C-TheintensityofradiationisinverselyproportionaltothesquareofdistancefromthesourceTheinversesquarelawdescribestheprincipleofdosereductionasthedistancefromthesourceincreases.Thedoseisproportionaltotheinverseofthesquareoftheradius.Thusifyoudoublethedistanceyoureducethedosebyafactoroffour.Ref-1.ShafieiSA,HasanzadehH,ShafieiSA.Asimplecalculationmethodfordeterminationofequivalentsquarefield.JMedPhys.2012;37(2):107-11.DOI:10.4103/0971-6203.94746-FreetextatPubMed-Pubmedcitation
2.Rattailappearanceincontrastradiography isseenin? a)Achalasiacardia b)Carcinomaesophagus c)Corkscrewesophagus d)Diffuseesophagealspasms CorrectAnswer-BCarcinomaesophagusREF:sabiston's18'editionchapter41Seetableinthepreviousquestion"Rat-tail"appearanceonbariumstudyisseenincarcinomaesophagus.
3.Whichchamberenlargementshowsa doublerightheartborderwithawidesubcarinalangle? a)Leftatrium b)Leftventricle c)Rightatrium d)Rightventricle CorrectAnswer-AAnswer-A-LeftatriumRadiologicalsignsofleftatrialenlargement:A'double'rightheartborderElevationoftheleftmainbronchusSplayingofthecarinaEnlargementoftheleftatrialappendageTheprominenceoftheportionoftheleftheartborderattheleveloftheleftmainbronchus
4.MercedesBenzsignisseenin: a)Gallstone b)Bladderstone c)Renalstones d)Foreignbodybronchus CorrectAnswer-AGallstoneREF:Sutton'stextbookofradiology,Thedition,volume1page713MercedesBenzsign/Seagullsign/Crowfeetsign:GallbladderstoneifradiopaquehasastellatefacetedappearancewithgascontainingfissuresontheplainradiographandiscalledasMercedesBenzsign/SeagullsignorCrowfeetsign
5.Chainoflakesappearanceisseenin? a)Chronicpancreatitis b)Acutepancreatitis c)Gallstoneileus d)Sub-acuteintestinalobstruction CorrectAnswer-AChronicpancreatitisREF:Sutton'sRadiology7theditionvolume1page798,Sabistontextbookofsurgery18thedchapter5Chronicpancreatitisischaracterizedbyirregularitiesofthepancreaticducts,ductalstrictures,andareasofductdilation.Themajoraswellastheside-branchductsmaybeinvolved.Forunexplainedreasons,somepatientswithchronicpancreatitisdevelopdilatedmainpancreaticducts(largeductdisease),whereasothersretainductsofnormalorevensmallerthannormalcaliber(smallductdisease).Somepatientswithchronicpancreatitiscanbeshowntohavemajorductsthathavetheappearanceofa"chainoflakes"ora"stringofpearls"thatistheresultofsegmentsofdilatedductseparatedbyareasofductalstricture
6."Corkscrewappearance"ischaracteristic of? a)Carcinomaesophagus b)Hypertrophicpyloricstenosis c)Diffuseesophagealspasm d)Sigmoidvolvulous CorrectAnswer-CDiffuseesophagealspasmREF:Wofganag5thep.846/748 Sign Disease Rattailappearance Carcinomaesophagus Birdbeakappearance Achalasia Beaksign/doubletrack/tramtrack HypertrophicpyloricstenosisMedusaheadcoloniesonCT Roundworm Pincer/claw/coiledspring/target/ Intussception meniscussignCoffeebeansign Sigmoidvolvulous Leadpipeappearance Ulcerativecolitis Stringofkantor/bull'seye Chron'sdisease Thumbprintingsign Ischemiccolitis Sawtoothappeanceonbarium Diverticulosis enemaApplecoresign Carcinomacolon Corkscrewappearance Diffuseesophagealspasm Stringsign Hypertrophicpyloricstenosis
7.AnabsolutecontraindicationofMRIis: a)Pacemaker b)Prostheticcardiacvalves c)Insulinpump d)Choclearimplants CorrectAnswer-APacemaker[Ref:Harrison17/ep2494;GraingerDiagnosticRadiology4/ep122;variouswebsites-http://www.mr-tip.com/servl.php?ope=dbl&dbs=Prosthetic%20Heart%20Valveshttp://www.imrser.org/PDF/Shellock.HeartValves.JMRLpdf;http://www.mrtip.com/sery1.php?type=dh1&dbs=Prosthetic%20Heart%20Valves;andjournal-_RadioGraphics2004;24:1257-1267MRisconsideredamongthesafestimagingmodalitiesforpatients,evenatveryhighfieldstrengths,morethan3-4tesla.ButFerromagneticobjectsundermagneticfieldcanbevulnerableto4adverseeffects:Movement(causingstructuralinjury),Currentconduction(potentiallycausingelectricalshock),Heating(possiblycausingburninjury),andArtifactgenerationSeriousinjuriescanbecausedbyattractionofferromagneticobjectsintothemagnet,whichwouldactasmissilesifbroughttooclosetothemagnet.Ferromagneticimplants,suchasaneurysmclips,maytorque(turnortwist)duetothemagneticfield,causingdamagetovesselsandevendeath.
Metallicforeignbodiesintheeyehavemovedandcausedintraocularhemorrhage.Pacemakersandpacemakerleadsareacontraindication,asthepacemakercanmalfunctionandcausearrhythmiaorevendeath.HoweverwithgrowingexpansionofMR,increasingnumberofimplantmedicaldevicesarebeingMRsafe.SonewerpacemakerandaneurysmclipsarebeingmadewhichareMRsafe.AbsoluteContraindicationsfortheMRIscan:Electronically,magnetically,andmechanicallyactivatedimplantsFerromagneticorelectronicallyoperatedactivedeviceslikeautomaticcardioverterdefibrillatorsCardiacpacemakersMetallicsplintersintheeyeFerromagnetichaemostaticclipsinthecentralnervoussystem(CNS)Patientswithanimplantedcardiacpacemakerhavebeenscannedonrareoccasions,butpacemakersaregenerallyconsideredanabsolutecontraindication.RelativeContraindicationsfortheMRIscan:CochlearimplantsOtherpacemakers,e.g.forthecarotidsinusInsulinpumpsandnervestimulatorsLendwiresorsimilarwires(MRISafetyrisk)Prostheticheartvalves(inhigh.fields,ifdehiscenceissuspected)Haemostaticclips(body)NonierromagneticstapedialimplantsWomenwitha.first-trimesterpregnancyTattoos(onlyaprobleminhigher-strengthmagnetic.fieldi.e.morethan3tesla)1Reflittp://www.mr-tip.com/sery1.php?type=dbl&dbs=Prosthetic%20Heart%20Valvesi
8.Floatingwaterlilysignisseenin a)Aspergillosis b)Hamartoma c)Hydatidcyst d)Cavitatingmetastasis CorrectAnswer-CHydatidcyst[RefRadiologyReviewManualbyDahnert5/e,p699;vviviv.emedicine.00In/Ined/TOPIC629.htn]Separatedmembranesfloatingwiththecystgivetheappearanceofwaterlily.Itispathognomonicofhydatidcyst.
9.Thescanwithhighestsensitivitytodetectadrenalmetastasisdueto bronchogeniccarcinomais: a)ContrastEnhancedCTabdomenwithAdrenalprotocol b)PETscan c)MRIscan d)Radionuclidescan CorrectAnswer-BScanstodifferentiateadrenaladenomafromadrenalmetastasisare: CECT- ChemicalshiftMRI FDG-PETPETscanhasalmost100%sensitivityfordetectingadrenalmetastasis,soanegativestudyexcludesthepossibilityofadrenalmets.Butadenomascangivefalsepositivetest. Ref:FundamentalsofDiagnosticRadiology,Edition-4,Page-427.
10.WhichofthefollowingagentsisusedtomeasureGlomerularFiltrationRate (GFR)? a)Iodohippurate b)Tc99m-DTPA c)Tc99m-MAG3 d)Tc99m-DMSA CorrectAnswer-BTc99m-DiethyleneTriaminePentothenicAcid(DTPA)isanagentofchoicewidelyusedinmeasuringGFR.Ref:RenalDisease:TechniquesandProtocolsByMichaelSGoligorsky,Page87;PaediatricUroradiologyByRichardFotter,ALbertLBaert,Page47
11.TheCTseverityindexinacutepancreatitisisdescribedby: a)Balthazar b)Mengini c)Chapman d)Napelon CorrectAnswer-ATheCTseverityindex(CTSI)-describedbyBalthazarBalthazarCTSeverityIndexCTGradeScore A.Normal-0 B.Enlargedgland-1 C.Peri-pancreaticinflammation-2 D.Onefluidcollection-3 E.Twoormorecollections-4NecrosisScore 30%-50%-(4) >50%-(6)Ref:ACRAppropriatenessCriteria,AcutePancreatitis.
12.Radiocontrastiscontraindicatedinallofthefollowingconditionsexcept? a)Renalfailure b)Patientonmetformin c)Dehydration d)Obesity CorrectAnswer-DObesityisnotacontra-indicationfortheadministrationofradio-contrastagent.Ref:RadiologicTechnologyataGlanceByTheresaS.Reid-Paul;pages66.
13.APETscanuseswhichofthefollowingtracermaterials? a)FDG b)CDF c)ADP d)MIBG CorrectAnswer-APositronemissiontomography(PET)usespositron-emittingradioisotope(tracer)-18F-FDGAPETscanusesasmallamountofaradioactivedrug,ortracer,toshowdifferencesbetweenhealthytissueanddiseasedtissue.ThemostcommonlyusedtraceriscalledFDG(fluorodeoxyglucose),sothetestissometimescalledanFDG-PETscan.Veryexpensive.Bettercontrastandspatialresolution
14.Whichoneofthefollowinghasthemaximumionizationpotential? a)Proton b)Electron c)Heliumion d)Gamma(y)?Photon CorrectAnswer-C Heliumionhasmaximumionizingpotential.TheionizingpotentialofatomsrangesfromafeweVforalkalielementsto24.6eVforheliumwhichhasthemaximumionizingpotential.Ref:RadiationPhysicsforMedicalPhysicistsByErvinB.Podgorsak,Page7
15.AllofthefollowingaboutMRIarecorrect except: a)MRIiscontraindicatedinpatientswithpacemakers b)MRIisusefulforevaluatingbonemarrow c)MRIisbetterforcalcifiedlesions d)MRIisusefulforlocalizingsmalllesioneinthebrain CorrectAnswer-CCi.e.MRIisbetterforcalcifiedlesions*MRIisverypoorindetectionofcalcification.ItisinferiortoCTscan,mammographyandx-rayindetectingcalcification.Thatiswhyitlagsbehindmammographyinearlydetectionofnoninvasiveductalcarcinomainsitu(DCIS)Q,whichmostcommonlyhasmicrocalcificationasitsonlypresentingfeature.AndsimilarlyithasaverylimitedroleindetectionofrenalstonesandgallstonesQ.However,itisimportanttonotethatonlyupto60%ofgallstoneshaveenoughcalciumdensity(morethanthatofbile)togetvisualizedonCT.Becausofitssuperiorcalcificationdetectionabilities,MDCTisusedinAgatstonscoring(Coronarycalciumscoring)ofcalcifiedplaquesofcoronaryarteryusingcoronarycalciumasasurrogatemarkertodetectthepresenceandmeasuretheamountofcoronaryatherosclerosis.Becausewithexceptionofpatientswithrenalfailurecalcificationofarteriesoccursexclusivelyincontextofatherosclerosis.SimilarlynonenhancedhelicalCTissuperiortoallotherimagingmodalitiesindiagnosisofurinarytractcalculiQbutatthecostofhigherradiationexposure.NowthereisnoneedtosaythatMRIisbetterthatCTforevaluationofbonemarrow,smallbrainlesions,meniscus/ligamentinjuries,softtissuetumorsandmeningealpathology.ButMRIisverypoorin
softtissuetumorsandmeningealpathology.ButMRIisverypoorindetectionofcalcification.
16.Tuftingofdistalphalanxis characteristicallyseenin a)Gout b)Hyperkalemia c)Hypoparathyroidism d)Hyperparathyroidism CorrectAnswer-DAns.is.D.HyperparathyroidismAcro-osteolysisisthetermusedtodescriberesorptionofthedistalphalangealtufts.Causesare:- 1. Scleroderma2. Trauma&thermalinjury3. Hyperparathyroidism4. Epidermalysisbullosa5. Arthropathy(RA,Psoriasis)6. Neuropathy(diabetes,syringomyelia
17.CalcificationofIntervertebralDiscisseen in a)Gout b)Rheumatoid c)Alkaptonuria d)Psoriasis CorrectAnswer-CCi.e.Alkaptonuria Features Disease FishMouthVertebrae -SickelCellAnemiaQ HomocystinuriaQ CodFishVertebra -Osteomalacia,Osteoporosis, (Biconcavevertebra) Hyperparathyroid Ruggerjerseyspine -CRFinducedosteomalaciaQ (sclerosisofupper& -Osteopterosis(marbelbone lowerspineborders) disease) Calcificationof -Alkaptonuria(m.c.) IntervertebraldiscPictureFramevertebrae -Paget'sdiseaseVertebraeplana -EosinophilicgranulomaQ
18.Schober'ssignisfor: a)Flexionoflumbarspine b)Chestexpansion c)Painwithmotionofhip d)Neckpainandstiffness CorrectAnswer-AAi.e.FlexionoflumberspineSchober'stestismeasureofflexiononlumberspineQ.ThistestisdoneinankylosingspondylitisQ
19.Bonewithinboneappearanceisseenin? a)CML b)Osteoporosis c)Osteopetrosis d)Boneinfarct CorrectAnswer-CCi.e.OsteopetrosisInosteopetrosis,thereisreducedosteoclasticboneresorptionresultingindiffusesymmetricalskeletonsclerosis.Alsok/amarblebonediseased/titsstonelikequalityofbones;howeverthebonesareabnormallybrittle&fracturelikeapieceofchalk.Itcanpresentradiologicallyas?SclerosisofallbonesmoreprominentatbaseofskullQ.Sclerosisofvertebralendplate1/tcharacteristicsandwitchorbroadstripped(rugbyjerseyspine)QBoneinboneappearanceQd/tscleroticfociwithinthebone.
20."Sunrayappearance"onX-raysis suggestiveof: a)AChondrosarcoma b)Ametastatictumourinthebone c)AnOsteogenicsarcoma d)AnEwing'ssarcoma CorrectAnswer-CCi.e.OsteogenicSarcomaSunrayappearanceisclassicallyseeninosteosarcoma.Itmayalsooccurinmetastases,Ewingssarcoma,Haemangoma,Meningiomaandtuberculosis.
21.Inferiorribnotchingisseenin a)Coarctationofaorta b)Rickets c)ASD d)Multiplemyeloma CorrectAnswer-AAi.e.CoarctationofaortaInferiorribnotchingincoarctationofaortaisd/tpressureerosionofintercostalarteriesQItusuallytakesseveralyearstodevelop,soisunusualbefore10yearsofage.
22.Flaskshapedheartisseeninfollowing except: a)Ebsteinanomaly b)Pericardialeffusion c)TOF d)TAPVC CorrectAnswer-DDi.e.TAPVCDuetodilationofSVC(superiorvenacava)&leftverticalvein,TAPVC(totalanomalouspulmonaryvenousconnection/return)ofsupradiaphragmaticvarietyshowsdoublecontour/"Figgerof8"/SnowmanconfigurationofcardiacsilhouetteQ.
23.SoapBubbleappearanceinX-rayisseen in a)MultiplecysticKidney b)Neuroblastoma c)Cysticlymphagiectasis d)Meconiumileus CorrectAnswer-DDi.e.MeconiumileusSoapbubbleappearanceinXrayisseeninmeconiumileusduetoadmixtureofgaswithmeconium.
24.RimsigninIVPisseenin a)PolycysticKidney b)Hydronephrosis c)Chronicpyelonephritis d)Hypernephroma CorrectAnswer-BBi.e.HydronephrosisRimSigninNephrogram-1.Severehydronephrosisofthekidneys2.Acutecompletearterialobstruction
25.Themostaccurateinvestigationfor assessingventricularfunctionis: a)MultisliceCT b)Echocardiography c)Nuclearscan d)MRI CorrectAnswer-BBi.e.EchocardiographyTransthoracicechocardiographyisthemostcommonlyusedcardiacimagingexaminationafterthechestX-rayandprobablyapproachestheelectrocardiograminitsclinicalutility.Itisharmlessandrelativelycomfortableforthepatientandisthefirst-linetechniqueforevaluatingmostabnormalitiesofthecardiacchambers,valvesandgreatvessels. Diagnotic Chest Transthoracic Transesophageal Nuclear Multislice utility X-ray echocardiogram echocardiogram medicine CT technique AnatomyMyocardium + ++ +++ + ++ Valves + ++ +++ 0 + Coronaries 0 0 + 0 ++ Pericardium + + + 0 ++ Pulmonary +++ 0 0 0 +++ vesselsCalcification +++ + + 0 +++ FunctionMyocardium ++ ++ +++ ++ + Valves + ++ +++ 0 +
Valves + ++ +++ 0 + Coronaries 0 0 + ++ ++ LimitationsRadiation - 0 0 -- hazardRisk/ 0 0 -- - - discomfortSpatial -- - resolutionTemporal - - resolutionOperator - --- - skillCost -- +++=Majorutility;++=moderateutility,+=minorutility;0=noutility/nolimitations;-=minorlimitation---=moderatelimitation;---majorlimitation
26.Inpatientwithhighclinicalsuspicionof pulmonarythromboembolism,bestinvestigationwouldbe? a)D-dimer b)CTangiography c)Catheterangiography d)ColorDoppler CorrectAnswer-BBi.e.CTangiographySpiralorhelicalchestCTscanwithintravenouscontrast(CTpulmonaryangiography)istheprincipalimagingtestforthediagnosisofpulmonaryembolsmQ.Itacquiresimagewith<1mresolutionandvisualizesupto6thorderbranchesandsmallperipheralemboliwitharesolutionsuperiortoconventionalinvasivecontrastpulmonaryangiography.Itobtainsexcellentimagesofright&leftventricleandcanbeusedfordiagnosisaswellasriskstratification.Inpatientswithpulmonaryembolism,RVenlargementindicates5timesmorelikelihoodofdeathwithinnext30days.Inadequatebreathholdingcanimpairtheimagequalityb/ochangeinarterialflowratesandmotionartefactduringbreathing.TheadventofmultidetectorCT(MDCT)allowsexaminationofwholelungduringsinglebreath-hold.Itisnoninvasive.Ventilation-perfusionlungscanningisnowsecondlinediagnostictestaforPE,andmostlyusedinpatientswhocannottolerateintravenouscontrast.Itsutilityisgreatestwhenaccompaniedwithanormalchestx-rayimplyingthataventilation-perfusionmismatchisnotduetoparenchymaldisease.Highprobability(>80%)scanhave
2largesegmentalV-Pmismatches(perfusiondefects&normalventilation)withanormalchestradiograph.Andverylowprobabilityscanshavemicroparticles(10-1001.1m)ofTc99micro-aggregatealbumin(MAA)inpatientslyingsupine.VentilationscintigraphyisperformedbyinhalatingKrypton-81,(best),Xenon133,Tc99-diethylenetriaminepentaaceticacid(DTPA),ortechnegas.Lasttwocan'tbeadministeredduringperfusionscanasbotharelabelledwithTc99.Eightimages(anterior,posterior,obtique&lateralonbothsides)areaquired.Conventionalpulmonaryangiography:NoninvasiveCTwithcontrasthavevirtuallyreplacedinvasivepulmonaryangiographyasadiagnostictool.However,itremainsthegoldstandardtesta.
27.InvestigationofchoiceforstudyingRenal Corticalmass a)99TcDTPA b)53CrStudy c)99TcDMSA d)99TcPyrophosphate CorrectAnswer-CCi.e.99-Tc-DMSA DTPA(Renogram) DMSA(IsotopeScanning) -DTPAisfreelyfilteredat -Tc.99DMSAisusedforrenal glomeruluswithno morphological tubularreabsorptionor (anatomic)imagine excretion(i.e.GFR= -Thiscompoundgetsfixedinrenal Excretoryfunction) tubules&images -DTPAisusefulforevaluating maybeobtainedafter1-2hoursof perfusionand injection.Lesions excretoryfunctionofeach suchastumors&benignlesionsas kidneyQ cystsshowfilling -Indications: defectQ 1.Measurementofrelative -Usedtoassesscorticalfunctionof renal KidneyQanddetect functionQineachkidney. renalscarringQ. 2.UrinarytractobstructionQ 3.DiagnosisofRenovascularcauseof hypertensionQ
4.InvestigationofRenal transplantQ
28.Investigationofchoiceforscreeningof proximalinternalcarotidarterystenosisis: a)DopplerflowUSG b)CTsubstractionangiography c)MRI d)Angiography(DSA) CorrectAnswer-AAnswerisA(DopplerflowUSG):'StenosisattheoriginoftheinternalcarotidArterycanbeidentifiedandquantifiedreliablybyultrasonographythatcombinesBmodeultrasoundimagewithaDopplerultrasoundassessmentofflowvelocity.'
29.Roentgenistheunitof: March2010 a)Radioactivity b)Radiationexposure c)Absorbeddose d)Noneoftheabove CorrectAnswer-BAns.B:RadiationExposureThecurie,namedafterscientistMarieCurie,isaunitofmeasurementusedtomeasurehowradioactiveanobjectis,orhowmuchradiationitproduces.Thisisdonebyexamininghowfastitsatomsdisintegrateandmeasuringtheirdisintegrationpersecond.Roentgen,ontheotherhand,isaradiationunitthatindicateshowmuchradiationispresentintheairofaspecificenvironment.Thisisusedtoshowhowmuchradiationmaybeabsorbedbystandinginaparticularplaceforacertainamountoftime.Oneroentgenofgamma-orX-rayexposureproducesapproximately1rad(0.01gray)tissuedose.Morecommonthanthesetwoaretheradandtherem.Thesetwounitscanmeasureanytypeofionizingradiation,includingalpha,beta,neutron,gammaand"X,"anddealwithhowmuchradiationisabsorbedbyobjects.Radstandsfor"radiationabsorbeddose."Oneradequals100ergs(anenergyunit)absorbedby1gofmaterial.Radsareusedtoshowhowmuchradiationanyobject,
especiallythingslikemetalandstone,hasabsorbed.Rem(doseequivalent)isastrictlybiologicalmeasurement,andstandsfor"roentgenequivalentman,"meaningthatitisthesameessentialmeasurementasaroentgen,onlyappliedtothehumanbody,althoughthisworksonlywithgammaand"X"typesofradiation.Remisusedtodefinelimitsofexposureforpeoplewhoworkinnuclearpowerplants.Remisoftendividedinmilliremsandassignedalengthoftime,suchasmilliremsperhour.Curie/becquerelistheunitofradioactivity.
30.Adderheadappearanceisseenin: March2011 a)Posteriorurethralvalve b)Uretrocoele c)Bladdertumour d)Horseshoekidney CorrectAnswer-BAns.B:UreterocoeleThe'adderhead'onexcretoryurographyistypicalofureterocoeleUreteroceleisacysticdilatationofthedistalureter.CobraheadorAdderheadappearanceisdiagnosticofureterocele.Spiderlegappearanceinpolycystickidney.Ref:Bailey&Love,25thEdition,Page1290
31.WhitelineofFrenkelisseenin: September2008 a)Osteoporosis b)Osteomalacia c)Scurvy d)Beri-Beri CorrectAnswer-CAns.C:ScurvyClinicalsymptomsandsignsofinfantilescurvy,inorderoffrequencyareirritability,tendernessandweaknessoflowerextremities,ascorbuticrosaryofthelegs,bleedingofthegums(usuallywhereteethhaveerupted),andfever.Radiographicfindingsofscurvy:Densemetaphysealline-Thisisduetoanintensificationofthezoneofpreparatorycalcification,resultingfrommatrixformationfailing,ishasbeenreferredtoasthewhitelineofFrenkel,butisnon-specific,asitisalsoseeninhealingrickets,andleadorphosphoruspoisoning.Groundglassosteoporosis:Thisappearsattheendoftheshaftwithblurringordisappearanceoftrabecularmarkings.Haloossificationcentre:AlsocalledtheWimberger'sring,itisthesameeffectthatproducesthewhitelineofFrenkel,affectingtheepiphysealossificationcenter.Cornersign-Seenduetosubepiphysealinfarction,orseparationoftheepiphysisfromthemetaphysis.Lateralspurs-Thesemetaphysealspursprojectatrightanglestotheaxisoftheshaft,theymaybeseenduetomushroomingofepiphysisonthemetaphysis,ormayrepresentearliestcalcificationof
periosteumelevatedbyasubperiostealhemorrhage.Subperiostealhematomas-Theseoccurattheendoflongbones,seenafterabout2weeksofonsetofclinicalsymptoms;itisnottheperiostealhemorrhagethatcalcifies,buttheelevatedperiosteum,secondarytoresumptionofboneformation.Metaphysealfractures-Subperiostealcomminutedfracturesattheendoflongbones,extendingonlypartiallythroughthewidthofthebone.Atrophyscurvyline-AradiolucentzoneontheshaftsideofFrenkel'swhiteline,ithasbeenreferredtoastheTrummerfeldZone.
32.SIunitofradioactivityis: March2013(c,f) a)Rem b)Rad c)Becuerel d)Curie e)None CorrectAnswer-CAns.Ci.e.BecquerelOldunitofradioactivityisCurieandnewunit(SI)isBecquerel.
33.CSFonMRIappears: a)HyperintenseonT1weighedimageandhypointenseonT2 weighedimage b)HypointenseonT1weighedimageandhyperintenseonT2 weighedimage c)HyperintenseonT1andT2weighedimages d)HypointenseonT1andT2weighedimages CorrectAnswer-BAns.HypointenseonT1weighedimageandhyperintenseonT2weighedimageFluid-Edema,Urine,Bile,CSF-T1weightedsignallow&T2weightedsignalhigh
34.Bestimagingmodalityinpatientswith breastimplantsis: a)MRIscan b)CTscan c)Mammography d)Radionuclidescan CorrectAnswer-AAns.MRIscanItisthebestimagingmodalityforthebreastsofwomenwithimplants.MRIcanbeusefirltodistinguishscarfromrecurrenceinwomenwhohavehadpreviousbreastconservationtherapyforcancer
35.Welldefinedroundedopacityisthelung withcauseirregularcalcificationisafeatureof: a)Hamartoma b)Hydatidcyst c)Amoebicabscess d)Calung CorrectAnswer-AAns.HamartomaIrregularcentralcalcification(Popcorncalcification)ischaracteristicofhamartoma.
36.Commonlyusedtypeofradiationin radiotherapyis: a)Alpharays b)Betarays c)Gammarays d)X-rays CorrectAnswer-CAns.GammaraysRadioiodinegeneratesbothbetaandgammaraysbutpredominantlybetarays.
37.Radiationprotectionshieldsaremadeup of: a)Copper b)Silver c)Lead d)Tin CorrectAnswer-CAns.Lead
38.ThephotosensitivematerialusedinX- raysfilmsconsistof: a)Cellulose b)Silverbromide c)Zincsulphide d)Cadmiumtungstate CorrectAnswer-BAns.SilverbromideAftertheimagehasbeendeveloped,theresultantimageisthenfixedbyafixer(Hypo-sodiumthiosulphate)whichremovesunusedsilverhalide,whichwouldmakethefilmappearmilkyorcloudy.X-rayfilmshouldbedevelopedindarkroom,otherwiselightwillspoilthefilm(x-rayfilmhasphotosensitivesilverbromide).Blueandgreenlightaremostsensitivewhereasyellowandredlightareleast.
39.Amongthecausesofribnotchingare: a)Coarctationofaorta b)Congenitalinterruptionofaorta c)Chronicsuperiorvenacavaobstruction d)Alloftheabove CorrectAnswer-DAns.Alloftheabove
40.Thicknessofleadaprontoprevent radiation: a)1mm b)3mm c)0.5mm d)7mm CorrectAnswer-CAns.C.0.5mm"Itisrecommendedthatforgeneralpurposeradiographytheminimalthicknessofleadequivalentintheprotectiveapparelshouldbe0.5mm."-TextbookofRadiologyPhysicsp.39Leadapronof0.5mmthicknessreduceintensityofscatteredX-raysbyover90%.
41.Hilardanceonfluoroscopyisseenin: a)ASD b)TOF c)VSD d)TGV CorrectAnswer-AAns.ASDFluoroscopicexaminationdoneinapatientwithASDshowshilardancesignduetopulsationofcentralpulmonaryartery.CXRfeaturesofASD:ThereisnoenlargementofleftatriumexceptinfewcasesofLutembachersyndrome.TheheartinASDissometimesdisplacedtotheleft.Theascendingaortaanditsarchtendstoappearsmallerthannormal,probablyduetorotationoftheascendingaortabyenlargedrightatriumandrightventriclecausingsagittalalignmentoftheaorticarch.KerleyBlinesinapatientwithASDshouldalwayssuggestanassociatedmitralvalveabnormality(Lutembachersyndrome).TheGooseneckdeformityisseeninASDoncardioangiography.Ref:ClinicalDiagnosisofCongenitalHeartDiseaseByM.Satpathypage78,Radiodiagnosis,NuclearMedicine,RadiotherapyandRadiationOncologyByBipinValchandjiDagapage139.
42.HalflifeofTechnetium99is: a)2hours b)6hours c)12hours d)24hours CorrectAnswer-BAns.6hoursTc-99-Technitium-6hoursHalflife(tin)ofradium(Ra226)is1602-1626years(longest)Q;Cesium(137Cs)is30yearsQ;Cobalt(60Co)is5.2yearsQ;iridium(1921r)is74.5daysQ;Iodine(P31)is8daysQ;1123is13hoursQ;technitium(Tc99)is6hoursQ;and1132is2.3hoursQ.
43.Popcorncalcificationisseenin: a)Pulmonaryhamartoma b)Fungalinfection c)Metastasis d)Tuberculosis CorrectAnswer-AAns.PulmonaryhamartomaPopcorncalcificationoPopcorncalcificationisaclusterofsharplydefined,irregularlylobulated,calcification,usuallyinapulmonarynodule.oPopcorncalcificationischaracteristicofhamartomaonchestX-rayexamination.oItmayalsobeseeninmediastinallymphnodesofacutehistoplasmosis.Egg-shellcalcificationoEgg-shellcalcificationmeansperipheralrimcalcificationoflymphnodes:oItisseenin:NSilicosis(mostcommoncause)(vi)Histoplasmosis(vii)Tuberculosis(ii)Coalworkerpneumoconiosis(v)Sarcoidosis(viii)Coccidiodomycosis(iii)Lymphomafollowingradiotherapy(vi)Progressivemassivefibrosis
44.Theprincipleusedinradiotherapyis: a)Cytoplasmiccoagulation b)Ionisingthemolecules c)DNAdamage d)Lowdosecausestissuenecrosis CorrectAnswer-CAns.DNAdamageRadiotherapyisthetreatmentofcancerwithionizingradiation.ItworksbydamagingtheDNAwithinthetumorcells,makingthemunabletodivideandgrow.Thegoalofradiationtherapyistomaximizethedosetotumorcellswhileminimizingexposuretonormal,healthycells. Ref:EmamiBetal.1991
45.Inapatientwithrenalcellcarcinomawith athrombusinIVCrenalvein,whichisthebestinvestigationfordiagnosis? a)CTscan b)Angiography c)Colourdopplerimaging d)IVP CorrectAnswer-AAns.CTscanInvestigationofchoiceinRCC-CTscan.
46.TheX-rayviewforsupraorbitalfissureis: a)Towne's b)Caldwell c)AP d)nasal CorrectAnswer-BAns.CaldwellSuperiororbitalfissurecanalsobeseenonwater'sview,butbestiscaldwellview."Thesuperiororbitalfissurecaneasilyindentifiedandnormallyhasaslightlyconcavelateralappearacne"-Textbookoforalradiology
47.Whichofthefollowingtechniquesuses piezoelectriccrystals? a)Ultrasonography b)NMRimaging c)X-raydiffraction d)Xeroradiography CorrectAnswer-AAns.UltrasonographyUltrasonographyisbasedonpiezoelectriceffect.MRIisbasedongyeromagneticpropertyofproton(IP).
48."Stringofbeads"appearanceon horizontalabdominalviewX-rayissuggestiveof: a)Intussusception b)Sigmoidvolvulus c)Smallbowelobstruction d)Largebowelobstruction CorrectAnswer-CAns.SmallbowelobstructionStringofbeadssignisvirtuallydiagnosticofsmallbowelobstruction
49.Puffofsmokeappearanceoncerebral angiographyisseenin: a)ACAaneurysm b)Cavernoussinusthrombosis c)Moyamoyadisease d)VeinofGalenmalformation CorrectAnswer-CAns.c.MoyamoyadiseaseMoyamoyadiseaseisanidiopathic,noninflammatory,nonatheroscleroticprogressivevasculo-occlusivediseaseinvolvingthecircleofWillis,typicallythesupraclinoidinternalcarotidarteries.Smallabnormalnet-likevesselsproliferategivingthecharacteristic"puffofsmoke"appearanceondirectangiography.CTAandMRAisnotalwaysabletodemonstratethisappearanceonaccountoflowerflowandspatialresolution.
50.Whichofthefollowingiswatersoluble contrast? a)Barium b)Iodine c)Bromium d)Calcium CorrectAnswer-BAnswer-B.IodineRadiocontrastagentsaretypicallyiodine,barium-sulphateorgadoliniumbasedcompounds.
51.Solitarylyticlesionsseenin a)Atherosclerosis b)Multiplemyeloma c)Mitralstenosis d)Osteoblast CorrectAnswer-BAnswer-B.MultiplemyelomaF:fibrousdysplasia(FD)orfibrouscorticaldefect(FCD)O:osteoblastomaG:giantcelltumor(GCT)M:metastasis(es)/myelomaA:aneurysmalbonecyst(ABC)C:chondroblastomaorchondromyxoidfibromaH:hyperparathyroidism(browntumor)I:infection(osteomyelitis)N:non-ossifyingfibroma(NOF)E:enchondromaoreosinophilicgranuloma(EG)S:simple(unicameral)bonecyst
52.Confusionassessmentscaleusedfor whichofthefollowing? a)Schizophrenia b)Delirium c)Dementia d)Depression CorrectAnswer-BAns:B.DeliriumConfusionAssessmentMethod(CAM),awidely-usedinstrumentanddiagnosticalgorithmforidentificationofdelirium.TheCAMinstrumentassessesthepresence,severity,andfluctuationof9deliriumfeatures:AcuteonsetInattentionDisorganizedthinkingAlteredlevelofconsciousnessDisorientationMemoryimpairmentPerceptualdisturbancesPsychomotoragitationorretardationAlteredsleep-wakecycle.TheCAMdiagnosticalgorithmisbasedonfourcardinalfeaturesofdelirium:AcuteonsetandfluctuatingcourseInattentionDisorganizedthinkingAlteredlevelofconsciousness.
53.HummingbirdsigninbrainMRIisseenin ? a)Multiplesclerosis b)Progressivesupranuclearpalsy c)Parkinson'sdisease d)Alzheimerdisease CorrectAnswer-BAns.is'b'i.e.,Progressivesupranuclearpalsy[RefClinicalneurology-113]HummingbirdsignonbrainMRIisaradiologicalsignofprogressivesupranuclearpalsy.
54.TigriodpatternonMRIisseenin- a)Wilson'sdisease b)Metachromaticleukodystrophy c)Parkinsonism d)GBsyndrome CorrectAnswer-BAnswer-B.MetachromaticleukodystrophyItischaracteristicallyseenin-MetachromaticleukodystrophyPelizaeus-MerzbacherdiseaseAutosomalrecessivespasticataxiaofcharlevoix.
55.Whichofthefollowingisnota contraindicationofMRI a)Cardiacpacemaker b)Cochlearimplant c)Ryle'stube d)Metallicsplinterineye CorrectAnswer-CAnswer-C.Ryle'stubeContraindicationsforMRIA)AbsoluteElectronically,magnetically,andmechanicallyactivatedimplants.Ferromagneticorelectronicallyoperatedactivedeviceslikeautomaticcardioverterdefibrillators.CardiacpacemakerMetallicsplintersintheeye.FerromagnetichaemostaticclipsintheCNS.B)RelativecontraindicationsCochlearimplantsProstheticheartvalvesOtherpacemakers,e.g.,forCarotidsinusHaemostaticclipsInsulinpumpsandnervestimulatorsNon-ferromagenticstapedialimplantsLeadwiresorsimilarwiresWomenwithafirst-trimesterpregnancy
56.Allaredonetominimizeradiation, exposuretothepatientunderfluroscopy,except a)Decreaseinfieldofview b)IncreasingtheKvofradiation c)Decreasingfluroscopictime d)Usinglowdoseofradiation CorrectAnswer-AAnswer-A.DecreaseinfieldofviewDecreasingthefieldofviewduringfluroscopyincreasetheradiationdoserate:- 1. Fieldofviewdiameter25cmhasdoserate0.3mGy/s2. Fieldofviewdiameter17cmhasdose0.6mGy/s
57.Investigationofchoiceforsofttissue sarcomais- a)CT b)MRI c)Ultrasound d)X-ray CorrectAnswer-BAnswer-B.MRI"AnypatientwithasuspectedSTSshouldbereferredtoadiagnosticcentrefortripleassessmentwithclinicalhistory,imagingandbiopsy.WhilstthepreferredmethodofimagingisMRI,otheroptionsincludingcomputerizedtomography(CT)orultrasoundmaybeappropriatedependingonlocalexpertise."
58.Amountofradiationexposurein1CT- scanofchestis a)1mSv b)3mSv c)5mSv d)7mSv CorrectAnswer-DAnswer-D.7mSvCTchestcausesradiationexposureof7mSv.CTabdomen-pelviscausesradiationexposureof10mSv.CTheadcausesradiationexposureof2mSv.
59.Whichofthefollowingisalatesevere adverseeffectofradiationtherapy a)Nausea b)Erythema c)Anemia d)Osteoradionecrosis CorrectAnswer-DAnswer-D.OsteoradionecrosisOsteoradionecrosisisalatecomplicationofradiationwhilenausea,erythemaandanemiaareearlycomplications.
60.SkylineviewX-rayisusefulindiagnosing - a)Patellofemoralproblem b)Radioulnarsproblem c)Tibiofibularproblem d)Skullfracture CorrectAnswer-AAnswer-A.PatellofemoralproblemA'Skyline'or'Sunrise'or'sunset'or'axial'or'tangential'or'mountainview'givesmostinformationaboutpatellofemoraljoint.
61.SubstanceusedforPETscanis a)18FPCT b)Gadolinium c)Gastrogarfin d)Iodine CorrectAnswer-AAnswer-A.18FPCTFluorine-18-labeled2Ali-carbomethoxy-3AY-(4-chloropheny1)-8-(-3-fluoropropyl)nortropane(FPCT)hasbeensynthesizedasanewdopaminetransporterimagingagent.OthersubstancesusedforPETscanare: 1. FDG2. 64Cu-ATSM(4Cudiacetyl-bis(N4-methylthiosemicarbazone)3. 18F-fluoride4. FLT(3'-deoxy-3'-[18F]fluorothymidine)5. FMISO(18F-fluoromisonidazole)6. Gallium7. Technetium-99m8. Thallium
62.Sausagefingerappearanceisseenin- a)Psoriaticarthritis b)Rickets c)Hyperthyroidism d)Addison'sdisease CorrectAnswer-AAnswer-A.PsoriaticarthritisThecommoncausesofsausagedigitare:Psoriaticarthropathy.AnkylosingspondylitisTuberculosisOsteomyelitis.SicklecelldiseaseLeprosy
63.WhichcommontracerinPETisusually administeredintheformofaglucosesugar a)Oxygen15 b)Fluorine18 c)Saccharide-12 d)Aluminum-12 CorrectAnswer-BAnswer-B.Fluorine18Fluorine-18isusedintheformofFDGinPETscan.ThemostcommontracerhasacomplicatednamebutismostlyknownasFDG(whichstandsfor2-[18F]fluoro-2-deoxy-D-glucose).ThebiologicallyactivemoleculemostcommonlyusedforPETis2-deoxy-2-18F-fluoro--D-glucose(18F-FDG),ananalogueofglucose,forearlydetectionoftumors.
64.Investigationofchoiceforacute subarachnoidhemorrhageis- a)MRI b)CTscan c)EnhanceMRI d)Angiography CorrectAnswer-BAnswer-B.CTscanInvestigationofchoiceforacuteSAH-CTscanInvestigationofchoiceforchronicSAH-MRI
65.Intraoperativeradiotherapyisusedin a)Gastriccancer b)Coloncarcinoma c)Pancreaticcarcinoma d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveIntraoperativeradiotherapycanbeusedIn- 1. Pancreaticcarcinoma2. Retroperitonealsarcomas3. Gastriccarcinoma4. Genitourinarycancers5. Colorectalcarcinoma6. Braintumor7. Head&Neckcancers8. Somegynecologicalmalignancies
66.Preciselydirectedhighdoseradiationis usedin a)IMRT b)EBRT c)Stereotecticradiosurgery d)Noneoftheabove CorrectAnswer-AAnswer-A.IMRTIntensitymodulatedradiationtherapy(IMRT)isanadvancedmodeofhighprecisionradiotherapythatutilizescomputercontrolledX-rayacceleratorstodeliverpreciseradiationdosestoamalignanttumourorspecificareaswithinthetumour.
67.EpiduralhematomaonCTscanshows- a)Crescentshapedhyperdenselesion b)Biconvexhyperdenselesion c)Biconcavehyperdenselesion d)Crescentshapedhypodenselesion CorrectAnswer-BAnswer-B.BiconvexhyperdenselesionAcuteextradural(epidural)hematomaisbiconvexhyperdenseormixeddensitylesion.Extradural(epidural)hematomaappearanceradiolgically:-Biconvex(lensshapedorlenticular)InAcutecases4Hyperdense(2/3)ormixeddensity(1/3).Inchroniccases4Hypodense
68.Notusedforinternalradiotherapy a)Iodine-125 b)Iodine-131 c)Cobalt-60 d)Iridium-192 CorrectAnswer-BAnswer-B.Iodine-131lsotpesusedforinternalradiotherapy(brachytherapy)A)InterstitialbrachytherapyPermanentimplantsofinterstitialbrachytherapy:-Cesium-131,Yttrium,Gold-198(Au-198),125I,Radon-222(Rn-222),Pallidum-103(Pd-103).TemporaryimplantsofInterstitialbrachytherapy:-Iridium-192(Ir-192),Cesium-137(Cs-137),Cobalt-60(Co-60),Californium,Radium-226(Ra-226),Tantolum.
69.Radioiodinegenerateswhichtypeof radiation a)X-rays b)Alphaandbetarays c)Betaandgammarays d)Alphaandbetarays CorrectAnswer-CAnswer-C.BetaandgammaraysRadioiodinegeneratesbothbetaandgammaraysbutpredominantlybetarays.
70.Radioactiveiodineisadministered throughwhichroute a)Intravenous b)Subcutaneous c)Oral d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveRadioactiveiodineisadministeredorallyaswellasparentrallyi.e.IV,SC&IM.
71.Investigationofchoiceforacute intracerebralhemorrhageis- a)NCCT b)MRI c)PETscan d)Noneoftheabove CorrectAnswer-AAnswer-A.NCCT"NCCTremainsthemainstayofemergencyimagingofstrokeinordertoexcludeintracranialhemorrhage"."Ininvestigationofstrokewithdelayedpresentationgradient-echoMRIistheinvestigationofchoiceforexclusionofoldhemorrhage".
72."Treeinbudappearance"onCTisseen in a)Pulmonarytuberculosis b)Silicosis c)Pulmonaryhydatidcyst d)Smallcellcarcinoma CorrectAnswer-AAnswer-A.Pulmonarytuberculosis ItisusuallyvisibleonstandardCT,however,itisbestseenonHRCTchest. Typicallythecentrilobularnodulesare2-4mmindiameterandperipheral,within5mmof thepleuralsurface. Theconnectiontoopacifiedorthickenedbranchingstructuresextendsproximally (representingthedilatedandopacifiedbronchiolesorinflamedarterioles) AssociatedCTfindingsofbronchiolitisareseeninabout70%ofpatientswith bronchiectasis.Smallcentrilobularnodularandlinearbranchingopacities(tree-in-budsign) expressinflammatoryandinfectiousbronchiolitisPathogenesis-Thetree-in-budsignoccursasaresultofanumberofprocesses,althoughoftentheyco-existinthesamecondition:a.bronchiolesfilledwithpusorinflammatoryexudatee.g.pulmonarytuberculosis,aspirationbronchopneumonia b.bronchiolitis:thickeningofbronchiolarwallsandbronchovascularbundlee.g.cytomegaloviruspneumonitis,obliterativebronchiolitis c.bronchiectasiswithmucusplugginge.g.cysticfibrosis d.tumorembolitocentrilobulararteries(orcarcinomatousendarteritis)e.g.breastcancer,stomachcancer
e.bronchovascularinterstitialinfiltratione.g.sarcoidosis,lymphoma,leukemia
73.Investigationofchoicetoevaluate intracranialhemorrhageoflessthan48hoursis- a)CTscan b)MRI c)PET d)SPECT CorrectAnswer-AAnswer-A.CTscanPrimaryprocedureofchoiceforevaluatingintracranialcomplicationsofacuteheadinjury4CTscan.Bestmodalityforassessingfracturesoftheskullbase,calvariumandfacialbone4CTscan.Investigationofchoicefordemyelinatingdisorders4MRI.
74.Investigationofchoiceforlungabscess is a)ChestX-ray b)CECTscan c)MRI d)Ultrasound CorrectAnswer-BAnswer-B.CECTscanContrastenhancedCTinusuallyconsideredtobeinvestigationofchoiceforlungabscess,showingacavitywiththickwallsandcentralmobilefluid.Ithelpstodifferentiateabscessfromempyma,necrotizingpneumonia,sequestration,pneumatoceleorunderlyingcongenitalabnormalitiessuchasbronchogeniccyst.
75.CTofgastricVolvulusshows- a)Shortenedtwistedstomach b)Enlargedtwistedstomach c)Normaltwistedstomach d)Noneoftheabove CorrectAnswer-BAnswer-B.EnlargedtwistedstomachCTscanofgastricVolvulusshowsenlargedtwistedstomachinthoraxwithoneormoresitesoftorsion.Itisusefulinshowingthesitesofischemia.
76.OnCTchest'halosign'isnotedin a)Pulmonaryhydatidcyst b)Invasivepulmonaryaspergilossis c)Roundpneumonia d)Bronchiectasis CorrectAnswer-BAnswer-B.InvasivepulmonaryaspergilossisThehalosign(HS)inchestimagingisafeatureseenonlungwindowsettings(typicallyHRCT),groundglassopacitysurroundingapulmonarynoduleormassandrepresentshemorrhage.Itistypicallyseeninangioinvasiveaspergillosis.
77.
A50yearoldmalepresentswithfeverandmalaisefor4months&paininthekneesandankles.BloodtestsarenormalapartfromaraisedESR.Chestx-rayshowsbilateralhilaradenopathyandpulmonaryinfiltratesmostsevereintheupperandmidzones.Mantouxtestisnegative.Whatisthemostlikelydiagnosis a)Tuberculosis b)Sarcoidosis c)Asbestosis d)Berylliosis CorrectAnswer-BAnswer-B.SarcoidosisSarcoidosisisthemostlikelydiagnosisgiventhepresentationwithmalaise,arthralgiaandachestx-rayshowingbilateralhilaradenopathy."Thecharacteristicradiologicalfindinginpatientswithpulmonarysarcoidosisisbilateralhilarlymphadenopathy"
78.Ultrasonographicfindingofautosomal recessivepolycystickidneydisease[ARPKD]areallexcept a)Cystsmorethan2cm b)Corticomedullarydifferentiationiseventuallylost c)Enlargedkidney d)Oligohydramnios CorrectAnswer-AAnswer-A.Cystsmorethan2cmOnantenatalultrasoundassociatedoligohydramniosmaybeidentifiedCystsInitiallytoosmalltoresolvebutwithtimemaybecomediscernibleUnlikeADPKDthecystsrarelyexceed1-2cmindiameterThekidneysappearenlargedandechogenicbutusuallyretainareniformshapeMedullarypyramids
79.22-year-oldwomenpresentstothe emergencydepartmentwithachiefcomplaintofsevereleftupperquadrant[LUQ]painafterbeingpunchedbyherhusband.Herbloodpressureis110/76,herpulseis80bpm,andherrespirationrateis24breathsperminute.Thebestmeanstoestablishadiagnosisiswhichofthefollowing? a)Four-quadranttapoftheabdomen b)CToftheabdomen c)Peritoneallavage d)Uppergastrointestinal[GI]series CorrectAnswer-BAnswer-B.CToftheabdomenClinicalpictureofthepatientinabovequestionindicatesthatpatientishemodynamicallystable.ThereforebestmodeofevaluationshouldbeCTscanofabdomentoseetheextentofinjury.Ifthepatientsishemodynamicallystableandcanbeshifted-CTscan
80.A35year-oldfemalepresentedtothe emergencydepartmentwiththesuddenonsetofsevereepigastricpain.Shehadahistoryofheartburnanddyspepticsymptomsforpast10years.Onphysicalexam,shehadatemperatureof101.4?F,apulseof118andabloodpressureof128/72.Abdomenwastender&rigid.ExpectedfindingonX-raywillbe a)Bloodunderdiaphragm b)Airunderdiaphragm c)Hazylungfields d)Prominentmarkings CorrectAnswer-BAnswer-B.AirunderdiaphragmAboveclinicalpictureissuggestiveofperforatedpepticulcer,Whichisthemostcommoncauseofpneumoperitoneum(airunderdiaphragm).Perforationresultsinpneumoperitoneumandthebestviewtoseepneumoperitoneumischestx-rayinerectpositionwhichdetectsairunderthedomesofdiaphragm.
81.FollowingX-rayfindingisassociatedwith Chilaiditisyndrome- a)Pseudopneumoperitoneum b)Pseudopneumothorax c)Pneumothorax d)Hydropneumothorax CorrectAnswer-AAnswer-A.PseudopneumoperitoneumChilaiditisyndromeistheanteriorinterpositionofthecolon(usuallytranversecolon)totheliverreachingtheunder-surfaceoftherighthemidiaphragmwithassociatedupperabdominalpain.Itisoneofthecausesofpseudopneumoperitoneum
82.A50year-oldchronicalcoholicmale patient,afteralargebingeofalcohol,presentedtotheemergencydepartmentinsubconsciousstate.Hevomitedseveraltimes,fewofthemmixedwithblood.Hehadahistoryofheartburnanddyspepticsymptomsforpastfewtears.Onphysicalexam,hehadatemperatureof102?F,apulseof110,respiratoryrateof20perminuteandabloodpressureof90/60.Onphysicalexaminationtherewasabdominalguardingandtenderness.AplaneerectchestX-rayrevealsairunderdiaphragm.Probablediagnosisis a)Perforatedpepticulcer b)AcuteMI c)Dissectedabdominalaorta d)Noneoftheabove CorrectAnswer-AAnswer-A.PerforatedpepticulcerHistoryofheartburnanddyspepsia,acuteonsetofbloodyvomitingafterbingealcohol,generalandphysicalexaminationfindingsandairunderdiaphragmonchestX-ray,alltheseindicatetowardstheperforationofpepticulcer.
perforationofpepticulcer.
83.RingenhancinglesiononCTisafeature of a)Toxoplasmsis b)Intracranialhemorrhage c)Cysts d)Hamartoma CorrectAnswer-AAnswer-A.ToxoplasmsisRingenhancingbrainlesions 1. Neoplasms:-Highgradeglioma,meningioma,lymphoma,acoustic schwannoma,craniopharyngioma,metastasis. 2. Abscess:-Pyogenic,tuberculoma,toxoplasmosis,cysticercosis, empyema. 3. Hemorrhagic-ischemiclesion:-Resolvinginfarction,Aging hematoma,operativebedfollowingresection. 4. Demyelinatingdisorder
84.Aboutlipoma,radiologicallytrueis- a)LowattenuationonCT b)AnechoiconUS c)Hypo-intenseonT1-MRI d)Hypo-intenseonT2-MRI CorrectAnswer-AAnswer-A.LowattenuationonCTLipomasarebenignfattumorswhichshowVariableechosonUSHyper-intenseshadowsonbothT1&T2MRILowattenuationonCT.
85.USGisdonetovisualizeallexcept- a)Fluid b)Bile c)Bloodflow d)Bone CorrectAnswer-DAnswer-D.BoneUSGisdonetovisualizesofttissuesandfluids.Butnotforbone.
86.RegardingHRCT,allaretrueexcept- a)MeanshighreconstructionCTimaging b)Hasnarrowbeamcollimation c)Investigationofchoiceforinterstitiallungdisease d)Hassmallfieldofvision CorrectAnswer-AAnswer-A.MeanshighreconstructionCTimagingPrinciplesofHRCT(HighresolutionCT)are: 1. Narrowbeamcollimation(Thincollimation)2. Highfrequencyreconstructionalgorythm,e.g.,bonealgorithm3. Smallfieldofvision
87.Allofthefollowingaretrueaboutneutron contraststudyexcept- a)Providesspatialresolution b)Hydrogenandboronhavehighneutroncrosssection c)Allowsvisualizationoflightelementsinsideheavymetallic objects d)Isanexampleofdestructivetesting CorrectAnswer-DAnswer-D.IsanexampleofdestructivetestingNeutronsinteractwithmatterinawaythatisquitecomplementarytoX-rays,andsoneutronimagingandneutronradiographyareimportanttechniquesfornon-destructivetesting,mostsuitedforvisualizationoflightelementsintheinteriorof(heavy)metallicobjects.Examplesofhighabsorptioncross-sectionmaterialsincludehydrogenandboronwhileironhaslowerneutroncross-section.
88.InnormalX-rayofshoulderwhichis superiormoststructure- a)Greatertubercle b)Surgicalneckofhumerus c)Coracoidprocess d)Headofhumerus CorrectAnswer-CAnswer-C.CoracoidprocessFromsuperiortoinferior(importantstructureonX-raysholder):-Clavicle:Acromian:Coracoid:Superiormarginofhumeralhead:greatertubercle:anatomicalneck:surgicalneck.
89.MaximalvalveofHUUnit- a)Water b)Fat c)Softtissue d)Bone CorrectAnswer-DAnswer-D.BoneBonehasmaximumHU+1000
90.Piezoelectriccrystalmostwidelyusedin ultrasonographyprobesis- a)Quartz b)Molybdenum c)Titanium d)Leadzirconatetitanate CorrectAnswer-DAnswer-D.LeadzirconatetitanateLeadzirconatetitanate(PZT)isthemostwidelyusedmaterialintheultrasoundtransducers/probesreplacingthefirstlydiscoveredbariumtitanate.
91.Mostsensitiveinvestigationforminimum gasinabdomenis- a)ChestX-rayAPView b)CTScan c)X-rayabdomeninsupineposition d)X-rayabdomeninerectposition CorrectAnswer-BAnswer-B.CTScanCTScanissuperiortoplainradiographsindetectionofminutequatitiesofpneumoperitoneumThusCTScanisregardedasthemostsensitiveinvestigationfordetectionofminutequantitiesofintraperitonealgas.BestradiographicviewforpneumoperitoneumisChestx-ray.Itisusuallythefirstinvestigationofchoice.
92.Cottonwoolskullisaradiologicalfeature of- a)Pagetsdisease b)Eosinophilicgranuloma c)Fibrousdysplasia d)Fibrousdysplasia CorrectAnswer-AAnswer-A.PagetsdiseaseCottonwoolskull-Paget'sdiseaseGroundglassskull-FibrousdysplasiaPunchedout/Raindroplesionofskull-MultiplemyelomaGeographicskull-Eosinophilicgranuloma
93.Themostsensitiveimagingmodalityfor diagnosisofuretericstoneinpatientwithacuterenalcolicis- a)XrayKUB b)USG c)NoncontrastCTabdomen d)ContrastenhancedCTabdomen CorrectAnswer-CAnswer-C.NoncontrastCTabdomenNon-contrastspiralCThasnowbecometheinvestigationofchoicetodiagnoserenalanduretericstones.Investigationofchoiceforrenalanduretericstonesnon-contrastspiralCT
94.Radiologicalfeaturesofcoarctationof aortais/are- a)Reversefigureof3sign b)Docksign c)Doubleaorticknuckle d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveRadiologicalsignsofCOAare:i)Reversefigureof3sign(doublebulgesignorEsign),ii)Dock'ssign;iii)Doubleaorticknuckle.GlobularheartwitholigemiclungfieldsReversefigureof'3'signDoubleaorticknuckle
95.Eyeoftigerappearanceisseenin- a)HallevordenSpatza b)Suparanuclearpalsy c)Levodopa-responsive d)All CorrectAnswer-DAnswer-D.AllThisappearancecanbeseenin: 1. Hallervorden-Spatzsyndrome:classicalbutnot100% pathognomonic 2. Progressivesupranuclearpalsy3. Early-onsetlevodopa-responsiveparkinsonism4. Cortical-basalganglionicdegeneration
96.Followingaresuggestiveofbenignlesion onmammogram- a)Macrocalcification b)Floatingcalcification c)Tramlinecalcification d)Alltheabove CorrectAnswer-DAnswer-D.AlltheaboveCalcificationpatternsinbenignlesionsofbreastonmammography: 1. Macrocalcification2. Popcorn(infibroadenoma)3. Rodlikewide-spread4. Eggshellcurvilinear5. Tramline/tortous
97.Anamolyscandoneathowmanyweeks ofgestation- a)14 b)16 c)18 d)20 CorrectAnswer-DAnswer-D.20AnamolyScanisdonebetween18-21weeksofpregnancy.Itisalsocalledasmidpregnancyor20-weekscan.
98.Flowingwaxappearanceonanteriorand posteriorbordersofvertebraeisseenin- a)Ankylosingspondylitis b)DISH c)Psoriaticarthropathy d)Rheumatoidarthritis CorrectAnswer-BAnswer-B.DISHDiffuseidiopathicskeletalhyperostosis:DISH(hyperostoticspondylosis,Forestier'sdisease)isamultifocalentityofolderpeoplecharacterizedby'flowingossificationsofthespine"involvingfourormorecontiguousvertebraeandhyperostosisofsomeligamentousattachments.
99.Radiologicalviewwhichbestshows maxillarysinusandorbitis- a)Water'sview b)Caldwellview c)Lateralview d)Towneview CorrectAnswer-AAnswer-A.Water'sviewBestviewformaxillarysinusWater'sview(occipito-mentalview)BestviewforfrontalsinusCaldwellview(occipito-frontalview)BestviewforsphenoidsinusBasalview(submentoverticalview)
100.Bestviewforsphenoidsinusis- a)Water'sview b)Caldwellview c)Basalview d)Towne'sview CorrectAnswer-CAnswer-C.BasalviewBestviewformaxillarysinusWater'sview(occipito-mentalview)BestviewforfrontalsinusCaldwellview(occipito-frontalview)BestviewforsphenoidsinusBasalview(submentoverticalview)
101.Followingaretheindicationsofbarium mealX-rayexcept- a)Duodenalulcer b)Carcinomastomach c)Carcinomaheadofpancreas d)IschemicColitis CorrectAnswer-DAnswer-D.IschemicColitisIndicationsforBariummealX-rayDuodenalulcerPeriampularycarcinomaPsendocystofpancreasCarcinomastomachChronicduodenalileusCarcinomaheadofpancreasDuodenaldiverticula
102.Inachildrenectopickidneyscanbe diagnosedby- a)DTPA b)DMSA c)MAG3 d)Noneoftheabove CorrectAnswer-BAnswer-B.DMSAIndicationsforstaticrenalscintigraphy(Tc-99m-DMSA): 1. Assessmentofrefluxnephropathy(scars)2. Spaceoccupyinglesions(corticalmass)3. Investigationofhorseshoe,solitaryorectopickidney
103.Firstlineinvestigationfordeepvenous thrombosisis- a)Ultrasonography b)Venography c)MRI d)Nuclearimaging CorrectAnswer-AAnswer-A.UltrasonographyUltrasonographyisthecurrentfirst-lineimagingexaminationforDVTbecauseofitsrelativeeaseofuse.
104.Whichofthefollowingisnotachest radiographicfeatureofleftatrialenlargement? a)Doubleleftheartborder b)Elevatedleftmainbronchous c)Splayingofcarina d)Enlargementofleftatrilaappendage CorrectAnswer-AAnswer-A.DoubleleftheartborderSingsofleftatrialenlargementStraighteningofleftheartborder(duetoenlargementofleftatrialappendage).Elevationofleftmainbronchuswithwidening(Splaying)ofcarina.Doubledensity(atrial)sign.Posteriordisplacementofesophagusonbariumswallow.
105.HRCTfeaturesofinterstitialpneumonia areallexcept- a)Reticularopacities b)Honeycombing c)Groundglassopacities d)Nobronchieactaticfeatures CorrectAnswer-DAnswer-D.NobronchieactaticfeaturesClassicalHRCTfeaturesofinterstitialpneumoniaare: 1. Reticularopacitiesinbasalandperipheraldistribution.2. Tractionbronchiestasis.3. Honeycombing(clusteredairspaces3-10mmdiameter/insubpleural location.
106.Followingarethecausesofcavityin lungsexcept- a)Staphylococcus b)Wegeners c)Hydatid d)Sarcoidosis CorrectAnswer-DAnswer-D.SarcoidosisCausesoflungcavitiesare:1)Necrotizinginfections2)Vascular:Pulmonaryinfarction.3)Neoplastic: 1. Carcinomabronchus:-Especiallysquamouscellcarcinoma.2. Metastases3. Lymphoma 4)Granulomas:-Wegener'sgranulomatosis,Rheumatoidarthritis(alsoKaplan'ssyndrome)5)Abnormallung:-Infectedemphysematosbulla,sequestratedsegment,bronchogeniccyst.6)Traumatic:-Haematoma
107.Beadedlumenwithfimbrialfluidisseen in- a)TBoffallopiantube b)TBofendometrium c)TBofOvary d)None CorrectAnswer-AAnswer-A.TBoffallopiantubeFallopiantubeisthemostcommonsiteoffemalegenitaltractwhichisaffectedintuberculosis.Onhysterosalpingography,thefallopiantubeoftenshowraggedoutlineswithmultiplestrictures,givingabeadedappearance;insomepatientstheentiretubeappearsrigidandmayexhibitsmallterminalsacculationoftheampullaryend.
108.Followingareradiologicalfindingsin rheumatoidarthritisexcept- a)Symmetricalinvolvement b)Juxta-articiularosteopenia c)Marginalerosion d)Subchondralsclerosis CorrectAnswer-DAnswer-D.SubchondralsclerosisRheumatoidarthritisBilateralsymmetricalinvolvementMarginalerosionAnkylosisPeriarticularsofttissueswellingSubchondralcystsSubluxationordislocationJuxta-articularosteopeniaNarrowingofjointspace(Later)Arthritismultilans(late)
109.Whichofthefollowingis/areradiological featuresoffluorosis? a)Osteosclerosis b)Corticalthickening c)Enthesopathy d)Alltheabove CorrectAnswer-DAnswer-D.AlltheaboveRadiologicalfeaturesoffluorosisare:Osteosclerosis-particularlyaffectingtheaxialskeleton.Corticalthickeningwithencroachmentonmedullarycavity.Enthesopathywithligamentousossification.Largespinalosteophytes.
110.Depthofgastriccarcinomasisassessed by- a)Abdominalultrasound b)Bariummeal c)Endoluminalultrasound d)Laproscopy CorrectAnswer-CAnswer-C.EndoluminalultrasoundFivelayersofthegastricwallcanbeidentifiedbyendoluminalultrasoundandthedepthofinvasionoftumorcanbeassessedbyexquisiteaccuracy.
111.Radiologicalsignsofacutepancreatitis onplainradiographyare- a)Sentinelloopsign b)Coloncutoffsign c)Renalhalosign d)Alltheabove CorrectAnswer-DAnswer-D.AlltheaboveRadiologicalfeaturesofacutepancreatitis:- 1. AirinduodenalC-loop2. Coloncutoffsign3. Gaslessabdomen4. Sentinalloopsign5. RenalHalosign
112.MostsensitiveinvestigationforDiffuse axonalinjuryis- a)MRI b)CT c)Xray d)PETscan CorrectAnswer-AAnswer-A.MRIMRIisthemostsensitiveinvestigationfordiffuseaxonalinjuries.ItshowsmultiplesmallfacesofincreasedintensityonT,IATanddecreasedintensityonTy.
113.MostcommonviewusedforX-raychest - a)PAview b)APview c)Lateralview d)Obliqueview CorrectAnswer-AAnswer-A.PAviewImportantviewsforchestx-rayare: 1. Posterior-anteriorview(PAview)2. Anterior-posteriorview(APview)3. Lateralview4. Lateraldecubitusview
114.Bestinvestigationforbonemetastases is- a)MRI b)CT c)BoneScan d)XRay CorrectAnswer-CAnswer-C.BoneScanBonescan(scintigraphy)istheinvestigationofchoiceforbonemetastasis.
115.Doubletracksignisseenin- a)Duodenalatresia b)CHPS c)Gastriculcer d)Achalasia CorrectAnswer-BAnswer-B.CHPSDouble/tripletracksignisseenincongenitalhypertrophicpyloricstenosis.
116.HalflifeofRa-226- a)8days b)28years c)16-22years d)38years CorrectAnswer-CAnswer-C.16-22yearsHalflifeofRa-226is16-22years.
117.Whichviewistakenforaorticwindow- a)AP b)LAO c)RAO d)LPO CorrectAnswer-BAnswer-B.LAO`Aleftanterioroblique(LAO)viewisusefultoassessthoracicaorta,aorticwindowandthechamberofheart".ClinicalradiologyAorticwindowisthespacebetweenascendinganddescendingthoracicaorta.
118.Theprimarydiagnosticevaluationfor developmentaldyslasiaofhipis- a)Clinicalexamination b)X-ray c)USG d)CTScan CorrectAnswer-CAnswer-C.USGUltrasonographyisnowtheprimaryimagingtechniqueinthediagnosisandfollowupofDDHandhasbeenshowntobemoreaccuratethanclinicalandradiologicalassessmentwithasensitivityof100%andspecificityof98%.
119.Investigationofchoiceforpancoast tumoris- a)MRI b)HRCT c)CECT d)Bronchography CorrectAnswer-AAnswer-A.MRIRadiologicalinvestigationofchoiceforpubnonarymalignenciesisCTscanexcepinsuperiorsulcus(pancoasttumor)whereMRIispreferred.
120.Dopplereffectresultsfromchangein- a)Amplitudeofsound b)Frequencyofsound c)Directionofsound d)Noneoftheabove CorrectAnswer-BAnswer-B.FrequencyofsoundTheDopplereffectresultsfromanapparentshiftinsoundfrequencyassoundwavearereflectedfrommovingtargets,usuallybloodcells.Ifmotionistowardthetransducer,thefrequencyofreturningechoishigherthatofthetransmittedsound.
121.X-rayArtifactis- a)Aradiolucentarea b)Anyabnormalopacityintheradiograph c)Producedwhenpatientmoveswhiletakingtheshoot d)Alltheabove CorrectAnswer-CAnswer-C.ProducedwhenpatientmoveswhiletakingtheshootArtifactscanpresentinavarietyofwaysincludingabnormalshadownotedonaradiographordegradedimagequalityandhavebeenproducedbyartificialmeansfromhardwarefailure,operatorerrorandsoftware(post-processing)artifacts.Commoncauses:-ImproperhandlingofthefilmsErrorswhileprocessingthefilmsPatientmovementwhiletakingtheshoot
122.FrequencyofultrasoundwavesinUSG- a)2000Hz b)5000Hz c)<2MHz d)>2MHz CorrectAnswer-DAnswer-D.>2MHzTheultrasoundmachineemitshigh-frequencysoundwaves,rangingfrom2-15MHz.Whosefrequenciesareconsiderablyabovetheupperlimitofhumanear'saudiblerange,i.e.,greaterthan20000Hz.Speedofthesesoundwavesinthebodyis1540m/s(incomparisontoair,wherevelocityofsoundwaveis330m/s).
123.Gyromagneticpropertyofprotonisseen in- a)MRI b)CT c)PETscan d)USG CorrectAnswer-AAnswer-A.MRIUltrasonographyisbasedonpiezoelectriceffect.MRIisbasedongyeromagneticpropertyofprotonW9.
124.EnhancementinCTcontrastisdueto- a)Iodine b)Gadolinium c)Silver d)Mercury CorrectAnswer-AAnswer-A.IodineIodinatedcontrastsarethemostcommonlyusedradiocontrastmediainradiographyandCT.GadoliniumisthemostcommonlyusedMRcontrastagent.
125.Whichdelivershighestdoseofradiation - a)Cardiacperfusionscan b)CTchest c)CTbrain d)Mammogram CorrectAnswer-AAnswer-A.CardiacperfusionscanMedicaldiagnosticimagingisamajorsourceofradiationexposuretoclinitiansandthepatients.Followingtabledepictstheradiationexposurethroughtheroutinemedicalimaging.
126.Bestviewforcollapseofmiddlelobe lungis- a)Lateral b)AP c)Oblique d)Lordotic CorrectAnswer-DAnswer-D.LordoticThelordoticviewisalsousefulforrecognizingcollapseoflingulaormiddlelobewhentheseareasbecomeverythinandcastminimalshadowonthePAview.
127.Doubleshadowbehindrightatriumand straighteningofleftmainbronchusindicates- a)Rightatriumenlargement b)Rightventricleenlargement c)Leftatriumenlargement d)Leftventricleenlargement CorrectAnswer-CAnswer-C.LeftatriumenlargementLeftatriumenlargementRefSutton7h/ep.280-350]
128.Leftatrialenlargementisseenin- a)Mitralstenosis b)Tricuspidregurgitation c)AR d)None CorrectAnswer-AAnswer-A.MitralstenosisDuetoleftatrialenlargement:-Straighteningofleftheartborder,elevationofleftmainbronchuswithwideningofcarina,doubleatrialshadow(Doubledensitysign),posteriordisplacementofesophagusonbariumswallow,Prominentposterosuperiorpartofcardiacshadow.
129.AirbronchogramonchestXraydenotes - a)Intrapulmonarylesion b)Extrapulmonarylesion c)Intrathoraciclesion d)Extrathoraciclesion CorrectAnswer-AAnswer-A.IntrapulmonarylesionAirinbronchiisvisualizeditiscalledairbronchogram.Airbronchogramindicatesintrapulmonarypathology,Itexcludesanypleuralormediastinalpathology.
130.Calcifiedpulmonarymetastasisisseen inwhichcarcinoma- a)Pancreaticcarcinoma b)Thyroidcarcinoma c)Endometrialcarcinoma d)None CorrectAnswer-BAnswer-B.ThyroidcarcinomaDifferentialdiagnosisofcalcifiedpulmonarymetastasis:- 1. Osteosarcoma2. Coloncarcinoma3. Chondrosarcoma4. Giantcelltumorofbone5. Thyroidcarcinoma6. Ovariancancer7. Synovialsarcoma8. Breastcarcinoma
131.Differentialdiagnosisofsolitary pulmonarynoduleareallexcept- a)Bronchogeniccarcinoma b)Mycetoma c)Tuberculoma d)Hamartoma CorrectAnswer-BAnswer-B.MycetomaGranulomas:-Tuberculoma(mostcommoncause),Histoplasma,Coccidioidomycosis,cryptococcosis.Otherinfections:-Organizingpneumonia,hydatidcyst.Benignneoplams:-Hamartoma,Fibroma,Neurofibroma,Carcinoidtumours,Lipoma,BronchialadenomaMalignantneoplasm:-Carcinomabronchus,Alveolarcellcarcinoma,metastasis(frombreast,Sarcoma,Renalcellcarcinoma,Seminoma),Pulmonaryblastoma,Pulmonarysarcoma.Inflammatory-Wegener'sgranulomatosis,rheumatoidarthritis,Sarcoidosis.Congenital:-Sequestration,Bronchogeniccyst,AVmalformation.Miscellaneous:-Pulmonaryinfarct,Roundedatelectasis,Mucoidimpaction.
132.Thesignwithpatchofdullnessbeneath theangleofleftscapulainapatientwithpericardialeffusionisnamedas- a)Carvallo'ssign b)Ewart'ssign c)Homan'ssign d)Hoffmann'ssign CorrectAnswer-BAnswer-B.Ewart'ssignHeartsoundsbecomefaint-Theapeximpulsevanishes;butsometimesitremainspalpable,medialtotheleftborderofcardiacdullness.Thebaseoftheleftlungmaybecompressedbypericardialfluid,producingEwart'ssign,apatchofdullnessbeneaththeangleoftheleftscapula.Thechestroentgenogrammayshowa"waterbottle"or"flaskshaped"configurationofthecardiacsilhouette
133.Waterbottleheartisseenin- a)PDA b)Chronicemphysema c)Pericardialeffusion d)Constrictivepericarditis CorrectAnswer-CAnswer-C.Pericardialeffusion"Water-bottle"orflaskedshapedormoneybagheart-Pericardialeffusion,hypothyroidism
134.Forpericardialcalcifications,whichis thebestinvestigation- a)MRI b)Transesophagealechocardiography c)USG d)CTscan CorrectAnswer-DAnswer-D.CTscanCTisthebestmethodfordepictionofpericardialcalcification,afindingsuggestiveofconstrictivepericarditisintheappropriateclinicalsetting.
135.Fluorescinangiographyisusedto examine- a)Ciliaryvasculature b)Retinalvasculature c)Cornealvasculature d)Conjuctivalvasculature CorrectAnswer-BAnswer-B.RetinalvasculatureFluoresceinangiographyisaradiologicalexaminationofretinalvasculatureaftertheadministrationofafluoresceindye.
136.Bariumswallowisusedfor- a)Colon b)Esophagus c)Duodenum d)Jejunum CorrectAnswer-BAnswer-B.EsophagusBariumswallow-Mainlyforesophagus
137.Pulledupcecumisseenin- a)IleocecalTB b)Carcinomacecum c)Intussuption d)Carcinoma CorrectAnswer-AAnswer-A.IleocecalTBConicalcecumorAmputedcecumCecumisshrunkeninsizeandpulledoutoftheiliacfossaduefibrosisandcontractionofmesocolon.Stierlinsign:-Narrowingofterminalileumwithrapidemptyingintoashortened,rigidorobliteratedcecum.Stringsign
138.Thestudyusingbariumforsmall intestineisknownas- a)Bariummealfollowthrough b)Bariumswallow c)Bariumenema d)Noneoftheabove CorrectAnswer-AAnswer-A.BariummealfollowthroughInmostcasesthejejunumandIleumareexaminedfollowingthebariumexaminationoftheuppergastrointestinaltract,referredtoasthe"bariummealandfollowthrough"orsimply"bariumfollowthrough".
139.Investigationwithleastradiationdosein thediagnosisMeckel'sdiverticulumis- a)CT b)MRI c)Contrastradiography d)Technetium-99mscanning CorrectAnswer-CAnswer-C.ContrastradiographyItisageneralrulethattheascendingorderoftheradiationdoseisMRI<X-ray<CT-Scan.Technetium-99mhastheradiationexposuremorethanX-raybutlessthanCT-Scan.Socontrastradiographywillhavetheminimumradiationexposureasitinvolvestakingaradiographaftersmallbowelenemafordiagnosisofmeckel'sdiverticulum.
140.EndoscopicUSGcriteriaforchronic pancreatitis,whenechogeniclesionis- a)>1mm b)1.5mm c)>2mm d)>3mm CorrectAnswer-DAnswer-D.>3mmParenchymalfeaturesEcho-poorlesionEcho-richlesion(>3mmindiameter)AccenuationoflobularpatternGlandsize,cystDuctalfeaturesIncreasedductwallechogenicityNarrowing,dilatationCalculi
141.Mostsensitivetesttodetectearlyrenal TBis- a)Intravenousurography b)CT c)MRI d)USG CorrectAnswer-AAnswer-A.IntravenousurographyIVPremainstheprimarymodalityusedtoimagethepatientswithrenal,ureteric,andbladdertuberculosis.EarlyfindingsarebestdetectedonIVP.ItistheinvestigationofchoiceforurinaryTB.
142.Investigationofchoiceforfocal neurologicdeficitinemergencyroomis- a)CT b)MRI c)Lumbarpuncture d)CECT CorrectAnswer-AAnswer-A.CTInIndiansetupCTScanistheinvestigationofchoiceintheemergencyroomtoscreenpatientsofacutefocalneurologicdeficit.
143.CTScanfindingincarotidcavernous sinusfistulais- a)Enlargedsuperiorophthalmicvein b)Enlargedinferiorophthalmicvein c)Enlargedsuperiorophthalmicartery d)Enlargedinferiorophthalmicartery CorrectAnswer-AAnswer-A.EnlargedsuperiorophthalmicveinContrast-enhancedCTscanandMRIwilldemonstrateadilatedsuperiorophthalmicveinandcavernoussinus.Ultrasonographymayalsodemonstratesuperiorophthalmicveinengorgement.Magneticresonanceangiography(MRA)isalsoveryusefulinidentifyingfistulasaswellasparticularvesselinvolvement.
144.Onimagningdiffuseaxonalinjuryis characterizedby- a)Multiplesmallpetechialhemorrhage b)Patchilldefinedlowdensitylesionmixedwithsmallhyperdens ofpetechialhemorrhage c)Crescenticextra-axialhematoma d)Whitematterlucencies CorrectAnswer-AAnswer-A.MultiplesmallpetechialhemorrhageMultiplesmallpetechialhemorrhage<2cmdiameterincerebralhemisphere.
145.Rheseviewisusedfor- a)Superiororbitalforamen b)Inferiororbitalforamen c)Opticforamen d)Sellaturcica CorrectAnswer-CAnswer-C.OpticforamenOpticforamen-Rheseview
146.Prevertebralspacethicknessinadultis- a)7mm b)14mm c)22mm d)30mm CorrectAnswer-A:CAnswer-A&C.22mm(A)7mm<7mmatC1level<5mmatC3-C9level<22mmatC6level
147.Osteolyticmetastasisisseenwith- a)Lung b)Kidney c)Thyroid d)Alloftheabove CorrectAnswer-DAnswer-D.AlloftheaboveOsteolytic,characterizedbydestructionofnormalbone,presentinmultiplemyeloma(MM),renalcellcarcinoma,melanoma,non-smallcelllungcancer,non-hodgkinlymphoma,thyroidcancerorlangerhans-cellhistiocytosis.
148.Investigationofchoiceinwholebody imaginginmetastasisis- a)MagneticResonanceImaging b)Angiography c)Venography d)CTScan CorrectAnswer-AAnswer-A.MagneticResonanceImagingWhole-bodyMRimagingwithuseofarollingtableplatforminconjunctionwithfastT2-weightedturbospin-echoand3Dgradient-echosequencesisatime-savingandaccuratealternativetoconventionalmultimodalityevaluationofpatientswithtumorsformetastases.
149.Tsignisseenin- a)GenitalTB b)Membraneintwinpregnancy c)Molarpregnancy d)Choriocarcinoma CorrectAnswer-BAnswer-B.Membraneintwinpregnancy'Tsign'referstoappearanceoftheinter-twinmembraneinamonochorionictwinpregnancy.
150.Investigationofchoiceincongenital uterineanamolyis- a)MRI b)CT c)HSG d)Hysteroscopy CorrectAnswer-DAnswer-D.HysteroscopyHysteroscopyisthegoldstandardinthediagnosisaswellastherapeuticmanagement.
151.Maximumradiationdosetolerabletissue is- a)Hemopoietictissue b)Testis c)Ovary d)Bone CorrectAnswer-DAnswer-D.BoneHighlyradiosensitiveLymphoidtissueBonemarrowGITepitheliumGonads(Testis,ovary)Embryonictissue
152.Epidermoidcystcanbedifferentiated fromarachnoidcystby- a)MRI b)USG c)Myelography d)CTscan CorrectAnswer-AAnswer-A.MRIMyelographycannotdifferentiatereliablybetweenanepidermoidcystandanoncommunicatingarachnoidcyst.IthaslargelybeenreplacedbyMRI.
153.SoapbubbleappearanceonMRIbrainis characteristicof? a)Tubercularmeningitis b)Neurocysticercosis c)Cryptococcalcysts d)Ependymoma CorrectAnswer-CAnswer-C.CryptococcalcystsCryptococcomasT1:lowsignalT2/FLAIR:highsignalT1C+(Gd):variable,rangingfromnoenhancementtoperipheralnodularenhancement.GelatinouspseudocystscausedbyCryptococcustendtogivea"soapbubble"appearanceonMRI.MRIfindingsinneuralcryptococcosis.
154.T2imageinMRIis- a)Goodtodetectpathology b)Goodtodetectanatomy c)Goodforboth d)Goodfornone CorrectAnswer-AAnswer-A.GoodtodetectpathologyManypulse-sequencetechniquesareusedinMRI,butmostclassicareT1andT2weightedimages.Asageneralrule,TI-weightedimagesaregoodforviewinganatomy,andT2weightedimagesaregoodfordetectingpathology.[RefFundamentalsofdiagnosticradiologyp.18]
155.Keyholesignonultrasoundisseenin- a)Polycystickidney b)Hydronephrosis c)Chronicpyelonephritis d)Posteriorurethralvalves CorrectAnswer-DAnswer-D.PosteriorurethralvalvesThekeyholesignisanultrasonographicsignseeninboyswithposteriorurethralvalves.ltreferstotheappearanceoftheproximalurethra(whichisdilated)andassociatedthickwalleddistendedbladderwhichonultrasoundmayresembleakeyhole.
156.MIBGdoseis- a)40-80MBq b)80-100MBq c)100-120MBq d)120-150MBq CorrectAnswer-AAnswer-A.40-80MBqMIBGscanisascintigraphicstudythatusesmetaiodobenzylguanidinelabeledtoIodine-123orIodine-131.Theactivityadministeredtoadultsshouldbe:for131I-mIBG:40-80MBq(1.2-2.2mCi);for123ImIBG:400MBq(10.8mCi).ForminimumandmaximumrecommendedactivitiesinchildrenoneshouldconsulttheGuidelinesforRadioiodinatedMIBGScintigraphyinChildren(minimumactivity20MBqfor123I-mIBGand35MBqfor131I-nIBG;maximumactivity400MBqfor123I-mIBGand80MBqfor131I-mIBG).
157.Bariummealfollowthroughishelpfulin diagnosing- a)Colonicstricture b)Ilealstricture c)Rectalstricture d)Esophagealstricture CorrectAnswer-BAnswer-B.IlealstrictureFollowingabnormalitiesofsmallintestinecanbeidentified:- 1. Malabsorption2. BD(CD&UC)3. Tumorsofsmallintestine4. Smallbowelobstruction5. Intestinalstrtcture
158.Radiographicsigncharacteristicof pulmonaryedemais- a)Westermark'ssign b)Hampton'shump c)Pallasign d)Batwingsign CorrectAnswer-DAnswer-D.BatwingsignAcutepulmonaryedema:-Acutepulmonaryedemaischaracterizedbycentrallylocatedalveolarsign,withhazyorfluffyincreaseddensityinperihilardistribution,creatingabat-wingorangel-wingpaftern.Thereisrelativesparingofthemoreperipheralzonesoflungfields.Airbronchogrambecomeevidentasedemabecomesmoreopaque.
159.Gammaknifeutilizes- a)Strontium89 b)1-131 c)Cobalt-60 d)P-32 CorrectAnswer-CAnswer-C.Cobalt-60GammaknifecontainsCobalt-60sourcesofapproximately30curisplacedincirculararrayinaheavilyshieldedunit.Theunitdirectsthegammarirystothetarget.
160.SnowstormappearanceonchestX-ray isseenin- a)Anthracosis b)Byssinosis c)Silicosis d)Bagassosis CorrectAnswer-CAnswer-C.SilicosisSimpleformz-Multiplesmallrounded(nodular)opacitiesinthelungparenchyna(snowstonnappeoraace).Thesenodulestendtobelocatedpredominantlyinthemiddleandupperlungfieldswithrelativesparingoflowerlungfields(ThoughIowerlungfieldscanalsobeinvolvedlaterindiseaseprocess).Thereisbilateralhilarlymphadenopathywithcharacteristiceggshellcalcification.
161."Drooplilysign"isseenin- a)"Drooplilysign"isseenin b)Duplicatedcollectingsystem c)Chronicpyelonephritis d)Hypernephroma CorrectAnswer-BAnswer-B.DuplicatedcollectingsystemThedroopinglilysrgl(droppingflowersign)isaurographicsigninsomepatientswithaduplicatedcollectingsystem.Itreferstotheinferolateraldisplacementoftheopacifiedlowerpolemoietyduetoanobstructed(andunopacified)upperpolemoeity.
162.Sonographicappearanceofhydatidcyst is- a)Hyperechoicaseptatelesion b)Hypoechoicaseptatelesion c)Hyperechoicseptatelesion d)Hypoechoicseptatelesion CorrectAnswer-DAnswer-D.HypoechoicseptatelesionTypeI(Simplecyst):-Single(solitary)hnrcechoic/anechoicaseptate(withoutsepta)lesion.Thediagnosisofhydatidcystmaybeconsideredwhenfocalthickeningofwallispresentorwhenhlperechoicspots,duetohydatidsand,appearinthedependentareas.
163.SIunitofabsorbeddoseis- a)Becquerel b)Columb/cm c)Gray d)Sievert[Sv] CorrectAnswer-CAnswer-C.GrayOldunitofabsorbeddoseisRadandnewunit(SI)isGray.
164.Stenver'sviewisusedfor- a)Superiororbitalforamen b)Inferiororbitalforamen c)Internalauditorycanal d)Sellaturcica CorrectAnswer-CAnswer-C.InternalauditorycanalSkulltrauma(sellaturcica)(pituitaryfossa)-LateralviewInternalauditoryview(bothside)-Stenver'sview
165.Acutemyocarditisschintigraphyisdone with- a)Thallium b)Technetium c)Gallium d)None CorrectAnswer-CAnswer-C.GalliumGallium-67uptakeisincreasedininflamedmyocardium.Gallium-67citrateinjectedintravenouslybindstotransferrin,anditisincorporatedintothetransferrinreceptorofinflammatorycellsormalignanttumorcells.Gallium-67scintigraphyisusefulforexaminationofheartdiseaseincludingcardiacsarcoidosisandacutemyocarditis
166.Radiationusedmostcommonlyforpain managementduetobonemetastasisis- a)Co60 b)Iridium192 c)Tritium d)Tin-117 CorrectAnswer-AAnswer-A.Co60Radiopharmaceuticals(radioactiveisotopes)usedformetastaticbonepainarestrontium(Sr89),Samarium(Sm153),rhenium(Re186),Phosphorus-32andTin-117(Sn-177).
167.Minimumradiationdosewhichmaylead tooligospermiais- a)<1Gy b)2-3Gy c)7-10Gy d)15Gy CorrectAnswer-AAnswer-A.<1GyFractionateddoses0.7-0.9Gyleadtooligospermia/azoospermiabutwithfrequentrecoveryat1-1.5years.Permanentazoospermiamayoccurafterfractionateddosesaslowas1.2Gy,andislikely>2Gy.
168.Halflifeoftritiumis- a)10.2years b)12.3years c)15.5years d)20.7years CorrectAnswer-BAnswer-B.12.3yearsTritium(hydrogen-3)isaradioactiveisotopeofhydrogen.Thenucleusoftritium(sometimescalledatriton)containsoneprotonandtwoneutrons.Whereasthenucleusofprotiumcontainsoneprotonandnoneutrons.Tritiumhasahalf-lifeof12.3years
169.Safelightinradiographicdarkroomis ideallyshouldbeoffollowingcolor- a)Red b)Yellow c)Purple d)Blue CorrectAnswer-AAnswer-A.RedRed-Somebluesensitivematerials,mostphototypesettingmaterials,mostblueandmostgreensensitivemedicalx-rayfilms(usedindarkroom).Darkamber-Colornegativepapersandmaterials,panchromaticblackandwhitepapers.Amber-Colornegativepapers,panchromaticblackandwhitepapers
170.Leastpenetratingpoweramong followingmentionedraysisin- a)Alpharays b)Betarays c)Gammarays d)X-ray CorrectAnswer-AAnswer-A.AlpharaysPenetrationpower:Gammarays>Xrays>Betaparticle>Alphaparticle(orheliumion)Ionizing&damagingpower:Alphaparticle(orheliumion)>Betaparticle>Xray>GammarayAlphaparticles(Heliumnuclei)havehighestionizingpowerbecausetheyhavealargecharge.Alphaparticleshavethehighestdamagingpowerastheyarerelativelyslowandheavy.
171.Non-ionizingradiationamongthe followingis- a)MRI b)CTScan c)X-ray d)Positionemissionscintigraphy CorrectAnswer-AAnswer-A.MRINon-ionizingradiation-USGMRIThermography(infraredrays)UVraysRadiofrequencywavesMicrowaves
172.MechanismofheatlossinmodernX-ray tubeis a)Radiation b)Evaporation c)Conduction d)Convection CorrectAnswer-AAns.A.RadiationThemechanismofheatlossinthemodernX-raytubeisradiation.ClassicalX-raytube:Theoutertubeismadeupofglass.Cathode-tungstenfilament.Ananodeisthetargetandismadeoftungsten.Themechanismofheatlossisconduction.Theatomicnumberoftungstenis74.ModernX-raytube:TheoutertubeismadeupofstainlesssteelCathode-tungsten+thoriumAnode-tungsten+10%rhenium.Ananodeisrotatingandthemechanismofheatlossisradiation.
173.Nonionicdyeis a)Ioxaglate b)lohexol c)Iothalamate d)None CorrectAnswer-BAnswer-B.IohexolIohexolisanonionicmonomercontrastagent.Thenon-iodineradicalsatpositions1,3and5(includingtheioniccarboxylradical)werereplacedbylongaminohydrocarbonsthatprovideadequatesolubilitywithoutionizing.Examplesofthistypeofcompoundareiopromide,iohexol,iopamidol,ioversol,iopentol,iobitridol,andiomeprol.
174.HUismeasureof a)CT b)MRI c)PET d)USG CorrectAnswer-AAnswer-A.CTHounsfield'scontributionismemorializedintheHounsfieldscale,whichisusedtomeasurethex-rayattenuationinCTscanning.Waterisarbitrarilyassignedavalueof0Hounsfieldunits(HU).[RefEssentialradiologyp.86]
175.WhichlookssameonTi&T2onMRI a)Gallbladder b)Fat c)Kidney d)CSF CorrectAnswer-BAnswer-B.FatFat(adiposetissue)hashighsignalintensityonbothT1&T2images.OtherthreeoptionshavelowsignalintesityonT1andhighsignalintensityonT2images.
176.HypertranslucentchestX-rayisseenin allexcept a)Mcleodsyndrome b)Emphysema c)Pneumonectomy d)Polandsyndrome CorrectAnswer-CAnswer-C.PneumonectomyCausesofopaquehemithoraxTechnical:-Rotation,Scoliosis.Pleural:-Pleuraleffusion,Pleuralthickening,Mesothelioma.Surgical:-Pneumonectomy,Thoracoplasty.Congenital:-Pulmonaryagenesis.Mediastinal:-Grosscardiomegaly,tumors.Pulmonary:-Collapse,Consolidation,fibrosis,Foreignbody.Diaphragmatichernia
177.WhatisnotseenonchestX-rayin pulmonaryarteryhypertension a)Enlargementofcentralarteries b)Peripheralprunning c)Narrowingofcentralarteries d)None CorrectAnswer-CAnswer-C.NarrowingofcentralarteriesCharacteristicradiologicalfeatureofpulmonaryhypertensionisenlargementofcentralarterieswithperipheralprunning.Increasedpulmonaryarterypressureandpulmonaryvascularresistancecharacterizepulmonaryhypertension.PAHisdefinedassystolicpressureinthepulmonaryarteryexceeding30mmHg.
178.ColonisidentifiedonX-ray a)Haustra b)Valvulaeconniventes c)Stringofbeadssign d)Morenumberofloops CorrectAnswer-AAnswer-A.HaustraHaustra(incompletebandacrossthebowelgasshadow)areseenincolon.
179.Doubletracksignisseenin a)Duodenalatresia b)CHPS c)Gastriculcer d)Achalasia CorrectAnswer-BAnswer-B.CHPSDouble/tripletracksignisseenincongenitalhypertrophicpyloricstenosis.
180.Investigationofchoiceformultiple sclerosis a)CT b)MRI c)USG d)PET CorrectAnswer-BAnswer-B.MRIMRIistheinvestigationofchoicefordemyelinatingdisorder,e.g.multiplesclerosis.
181.Investigationofchoiceforintramedullary SOLis- a)MRI b)USG c)CT d)X-ray CorrectAnswer-AAnswer-A.MRIInvestigationofchoiceforintramedullaryspaceoccupylesionisMRI.
182.VonRosen'sviewisfor a)CDH b)Perthe'sdisease c)CTEV d)None CorrectAnswer-AAnswer-A.CDHInVonRosen'sviewisusedinDDH/CDH.
183.Nuchaltranslucencyisusedin a)Headscan b)MRIneck c)ANCUSG d)Anthropometry CorrectAnswer-CAnswer-C.ANCUSGNuchaltranslucencyisusedforscreeningofdownsyndromeinantenatalUSG.
184.Half-lifeofIodine131is a)8hours b)8days c)8weeks d)8months CorrectAnswer-BAnswer-B.8daysIodine-131Halflife8daysIodine-123-3Halflife13hoursIodine-132Halflife2.3hours
185.Dyeusedindiagnosisofesophageal perforation: a)Iohexol b)Bariumsulphate c)Gadolinium d)Iodinedye CorrectAnswer-BAnswer-B.BariumsulphateBariumsulfateinsuspensionisfrequentlyusedmedicallyasaradiocontrastagentforX-rayimagingandotherdiagnosticprocedures.ItismostoftenusedinimagingoftheGItractduringwhatiscolloquiallyknownasa"bariummeal".Fluoroscopymostsensitivewithinthefirst24hours.patientexaminedsemi-supine(~20degrees)onfluoroscopytableawater-solubleagentshouldbeusedinitiallyasbariumcancausemediastinitisesophagealperforationmayberepresentedasmucosalirregularityorgrossextraluminalcontrastextravasationsomeauthorssuggesttheuseofsmallamountsofloworhighconcentrationsofbariumifnoleakisevidentoninitialscreeningwithwatersolublecontrastIohexol,tradenamesOmnipaqueamongothers,isacontrastagentusedduringX-rays.Thisincludeswhenvisualizingarteries,veins,ventriclesofthebrain,theurinarysystem,andjoints,aswellasduringcomputertomography.Itisgivenbymouth,injectionintoavein,orintoabodycavity.
186.Braggpeakeffectpronouncedin: a)Xray b)Proton c)Neutron d)Electron CorrectAnswer-BAnswer-B.ProtonNowadaysprotontherapy(PT)representsanestablishedalternativetophotonradiotherapyforthetreatmentofspecifictypesofcancer.Thetherapeuticuseofprotonbeams(andofchargedparticlesingeneral)ismotivatedprimarilybytheirinverteddepth-doseprofilecomparedtophotons,beingcharacterizedbytheso-calledBraggpeak.Severalbeamsofdifferentenergycanthenbecombinedinordertoachievetheprescribeddoseinaregionaslargeasthetargetvolume,resultingintheproductionofwhatisdefinedastheSpread-OutBraggPeak(SOBP).
187.SaltandPepperpotappearanceofskull seenin: a)Hyperparathyroidism b)Multiplemyeloma c)Hyperthyroidism d)Pseudohyperparathyroidism CorrectAnswer-AAnswer-A.HyperparathyroidismPepperpotskullisoccasionallyusedinplaceofsaltandpepperskulltodescribethetypicalradiographicappearanceofmultiplesmallradiolucentlesionsoftheskullvault.Inprimaryhyperparathyroidism,extensiveresorptionboneintheskullincombinationwithcysticareasofosteopeniaaretermedpepperpotskull.Classicallyseeninhyperparathyroidism,andisoccasionallyused(inaccurately)todescribetheraindropskullofmultiplemyeloma. :SullX-raywithatypical"pepper-pot"appearance
188.ImagingtechniquesusedinUterus anomaliesEXCEPT: a)HSG b)MRIguidedHSG c)CTguidedHSG d)USG CorrectAnswer-CAnswerC.CTguidedHSGImagingstudies,suchasahysterosalpingogram(HSG)andultrasound,oranMRIarerequiredtovisualisetheuterusandconfirmthatacongenitaluterineanomalyispresent.Ahysterosalpingogramisnotconsideredasusefulduetotheinabilityofthetechniquetoevaluatetheexteriorcontouroftheuterusanddistinguishbetweenabicornuateandseptateuterus.Inaddition,laparoscopyand/orhysteroscopymaybeindicated.
189.Whichisthetreatmentofchoicefor irradiationinChordoma? a)Protons b)Electrons c)Gammaradiation d)3D-CRT CorrectAnswer-AAnswer:A-ProtonTherapyChordoma:Slow-growingneoplasmArisingfromcellularremnantsofnotochord.Arisefromboneinskullbaseandalongspinalcord.Mostcommonlocations-CraniallyatclivusInsacrumatbottomofspineRadiationtherapy:ArerelativelyradioresistantHighdosesofradiationrequiredtocontrol.Hence,highfocusradiationlikeprotontherapyandcarboniontherapyarepreferredthanconventionalradiationmethods.Closeproximitytovitalstructureslikebrainstem,requireshighprecisionandaccuracyforanyplannedsurgicalresection.Radiationwithhighaccuracyandminimaldamagewithmaximalsafetyisdelivered.
190.Cancerpatientundergoesradiotherapy, pickthetruestatementforradiosensitivityoftissues? a)Rapidlydividingcellsareresistanttoradiation b)GImucosaisoneofthemostradioresistanttissuesinthebody c)Theintensityofradiationisinverselyproportionaltothesquare ofdistancefromthesource d)Smallbloodvesselsareleastresistanttoradiation CorrectAnswer-CAnswer-C-TheintensityofradiationisinverselyproportionaltothesquareofdistancefromthesourceTheinversesquarelawdescribestheprincipleofdosereductionasthedistancefromthesourceincreases.Thedoseisproportionaltotheinverseofthesquareoftheradius.Thusifyoudoublethedistanceyoureducethedosebyafactoroffour.Ref-1.ShafieiSA,HasanzadehH,ShafieiSA.Asimplecalculationmethodfordeterminationofequivalentsquarefield.JMedPhys.2012;37(2):107-11.DOI:10.4103/0971-6203.94746-FreetextatPubMed-Pubmedcitation