File 11

Question 1

Patient has recent insertion of tunneled line, while removing the pealing cover and guide wire, a click was heard, the patient become gasping for air, hypotensive, tachycardiac. what is complication encountered?

A) Air embolism
B) Pneumothorax
C) Vascular injury
D) Cardiac arrhythmia

Answer 1

A) Air embolism

Question 2

Brain infraction what is the best sequence to evaluate for core infarction:
A) DWI
B) CT perfusion

Answer 2

A) DWI

Best diagnostic clue
o High signal on DWI + low signal on ADC = reduced diffusivity

Question 3

Case scenario describing liver appearance with flip flop enhancement what to expect to see:
A) No flow in hepatic veins
B) Sparing caudate and

Answer 3

A) No flow in hepatic veins

(describing Budd Chiari)

Question 4

Liver cirrhosis with multiple lesions showing washout and signs of portal hypertension, there was a circumferential bowel thickening involving ascending colon, what is the most likely cause of bowel thickening:

A) Mesenteric venous congestion
B) Bowel ischemia
C) Cancer
D) Clostridium difficile

Answer 4

A) Mesenteric venous congestion

Question 5

Patient with silicone breast implants, with isolated intracapsular implant rupture, what to do next:

A) Nothing
B) Refer to surgery

Answer 5

B) Refer to surgery

Question 6

MRI spine from the ER patient with long history, (looks like cauda equina syndrome), MRI showed cord compression, what to do:

A) Call them and inform them of the findings right away
B) Dictate the case then call them
C) Just dictate the case

Answer 6

A) Call them and inform them of the findings right away

Question 7

Patient with leukemia post chemotherapy, his outpatient CT demonstrates bilateral ground glass opacity, what would you do:

A) Discharge the patient
B) Call the referring physician and discuss the findings, do as he recommend, and talk to the patient
C) Do nothing
D) Go talk to the patient

Answer 7

B) Call the referring physician and discuss the findings, do as he recommend, and talk to the patient

Question 8

Patient came to you worried and asked to do many investigations and test. She says she is covered by insurance which will pay for it?

A) Do the tests because the insurance will pay
B) Do only what is necessary

Answer 8

B) Do only what is necessary

Question 9

100 patients with positive PCR for COVID 19, Only the positive patients underwent CT. 90 of them had positive findings, 10 has negative findings, what is the sensitivity:

A) 90% of the scanned population
B) 90% of all population
C) 45% of population

Answer 9

A) 90% of the scanned population

Question 10

Patient did CT which reported by a doctor as unremarkable, after couple of days MRI done for the spine and shows sizable right nerve root lesion, what was the mistake:

A) Satisfaction of search
B) Underreading
C) Knowledge

Answer 10

A) Satisfaction of search

Question 11

Radiologist write in the CT abdomen report of pediatric patient: central partial hypodensity in IVC due to thrombus (it was flow artifact), what type of error?

A) Over reliance
B) Technique
C) Faulty reasoning

Answer 11

B) Technique

Question 12

The first action to be taken with staff with poor interpersonal skills:

A) Verbal reprimand
B) Written
C) Coaching

Answer 12

A) Verbal reprimand

Question 13

Female patient will undergo some breast procedure, the benefits and complications were discussed with the patient and her son before starting of procedure and she accept, consent should be signed by?

A) Patient herself
B) Son
C) Both mother and son
D) You will sign it

Answer 13

A) Patient herself

Question 14

What is the most common error in the hospital in patient settings?

A) Diagnostic
B) Medication
C) Procedure

Answer 14

B) Medication

Question 15

Left brachiocephalic vein tributary (Provided image of mediastinal vessels Angiography with identify the arrow):

Answer 15

Left superior intercostal vein.

Question 16

Angio picture with an arrow pointing to?

A) Gastroduodenal artery
B) Celiac axis
C) SMA
D) Replaced Rt hepatic

Answer 16

Depend on the arrow

Question 17

IVC placement:

Answer 17

Below the renal veins.

Question 18

A pregnant lady with right flank pain. US showed hydroureteronephrosis, which of the following compress the ureter against gravid uterus:

Answer 18

Iliopsoas muscle

Question 19

Long scenario about elderly with prostatic lesion, MRI image was provided, asking about the draining lymph nodes of the prostate:

Answer 19

Obturator lymph nodes

Question 20

True negative means:

Answer 20

Specificity (true negative rate):
o The probability of a negative test, conditioned on truly being negative.

Question 21

A male patient did void cystourethrogram, there was an outpouching from the urinary bladder arise at the vesicoureteric junction. What is the diagnosis:

Answer 21

Hutch diverticulum.

Question 22

Situs solitus means:

Answer 22

Normal position of thoracic and abdominal organs.

Situs inversus → mirror image of internal organs normal positioning.
Situs solitus → Normal positioning of the organs.

Question 23

Fetal head ultrasound (A sagittal view provided):

A) Superior sagittal sinus
B) Inferior sagittal sinus
C) Straight sinus
D) Transverse sinus

Answer 23

A) Superior sagittal sinus

Question 24

Hand x-ray, what is the diagnosis.

Answer 24

Mallet fracture.

(Image provided shows 5th finger distal phalanx fracture).

Question 25

Haller index:
A) Maximal transverse diameter/narrowest AP length
B) Narrowest AP length/maximal transverse diameter
C) Maximal transverse diameter × narrowest AP length
D) Maximal transverse diameter × narrowest AP length /2

Answer 25

A) Maximal transverse diameter/narrowest AP length

The Haller index is calculated by dividing the transverse diameter of the chest by the anteriorposterior distance on CT of the chest on the axial slice that demonstrates the smallest distance between the anterior surface of the vertebral body and the posterior surface of the sternum.

Question 26

Patient presented after trauma and CT urogram was done. Contrast extravasation in which space would indicate extraperitoneal rupture?

Answer 26

A) Perivesical

Question 27

Pediatric hip US. What is the normal diameter of joint capsule?
A) < 5 mm (0.5 cm).
B) 15mm
C) 7mm
D) 10mm

Answer 27

A) < 5 mm (0.5 cm).

Question 28

Which of the following represent left ventricular enlargement on chest X ray:

Answer 28

Rounded apex.

left ventricular dilatation
left ventricular hypertrophy: may show rounding of the cardiac apex
Hoffman-Rigler sign
Shmoo sign

Question 29

ICU patient with SOB (provided CXR showed right deep sulcus sign= right pneumothorax), what is the next step to confirm:

Answer 29

Left lateral decubitus

Question 30

Neonate with history of projectile vomiting. Provided US images, Dx?

A) Hypertrophic pyloric stenosis.
B) Intussception.
C) Duodenal atresia.

Answer 30

Projectile → Duodenal atresia
Non-projectile → HPS

Question 31

A 55 y.o female presented to ER with acute left hip pain (provided x-ray of the left hip AP and AP with external rotation).

A) Synovial tendinitis
B) Calcified tendinitis
C) Osteosarcoma.
D) Avulsion fracture

Answer 31

B) Calcified tendinitis

Question 32

You were observing the technician while doing CT PE during on call
and you noticed the contrast fill the right heart chambers without specification of left and IVC layering… What you’ll do?

A) Ask him to take delayed images.
B) Call your consultant
C) Call the referring physician
D) Announce code blue

Answer 32

D) Announce code blue

Question 33

What does the structure arise from descending aorta in the posterior mediastinum and supply a high- pressure oxygenated blood to supporting lung structures:

Answer 33

Left bronchial artery.

Question 34

Female patient with history of long-term use of oral contraceptive pills. CT scan of the abdomen show hepatic enhancing lesion with fluid collection in the right anterior pararenal space. In which liver segment this lesion is located? (Liver segment related to peritoneal spaces)

A) 1
B) 3
C) 6
D) 2

Answer 34

A) 1

I or VI

Question 35

Normal upper limit of the gallbladder wall thickness:

A) 2mm
B) 3mm
C) 4mm
D) 5mm

Answer 35

B) 3mm

• US: normal limits of the gallbladder wall thickness (3 mm)
• Post-prandial → 5 mm

Question 36

Patient with ESRD underwent nuclear scan (PET scan) which showed multiple areas of focal uptake. What is the cause?

A) Prostate ca with mets
B) Lung ca with mets
C) Parathyroid adenoma with brown tumor
D) Heart failure with implanted cardioverter-defibrillator (ICD)

Answer 36

C) Parathyroid adenoma with brown tumor

Question 37

A 25-year-old female referred as a case of right breast mass. Next proper investigation is:

Answer 37

Bilateral US (<30 years old)

Notes:
The indications for performing breast ultrasound are characterization of palpable abnormalities, further
characterization of mammographic findings, first-line evaluation of a breast abnormality in a young
(under age 30), pregnant, or lactating woman, guidance for interventional procedures, and evaluation
of breast implants.

Question 38

Diabetic patient presented with foot ulcer, swelling of left big toe, leukocytosis other signs of diabetic foot, Initial investigation according to ACR:

A) Xray
B) MRI
C) 3-phase bone scan
D) CT

Answer 38

A) Xray

to rule out charcot and osteomylitis

Question 39

Elderly presented with symptoms of small bowel obstruction. abdomen radiograph attached (It almost shows dilated 3 small bowel loops with air fluid level at the upper mid abdomen). Where is the level of obstruction?

A) Mid jejunum
B) Terminal ileum
C) Hepatic flexure
D) Pyloric antrum

Answer 39

A) Mid jejunum

Question 40

During enhanced CT scan. The patient had pain and bulge at the cannula site with paresthesia. what to do next:

A) Aspirate the injected contrast.
B) Give prednisone
C) Call the ER physician
D) Surgical consultation

Answer 40

D) Surgical consultation

Question 41

Asthmatic patients want to do CT with contrast:

A) Oral prednisone 48 and 24 hr
B) Oral prednisone 24 and 12 hrs.
C) Oral prednisone 13, 7, 1 hr.

Answer 41

C) Oral prednisone 13, 7, 1 hr.