Past Paper Questions Flashcards
True for imaging of acute pancreatitis, EXCEPT:
a. vascular usuration can be treated by intravascular embolization
b. pancreas is widened on ultrasonography
c. Murphy-sign is highly sensitive
d. peripancreatic fat has increased CT density
The following preparations are necessary before a vascular interventional radiological procedure, EXCEPT for:
- Checking the INR value
- Check for the existence of a metal foreign body
- providing sufficient hydration
- checking the GFR value
Which isotope is used most often for the conventional pharmacomedicine?
Technetium 99
The imaging method of choice in a 20-year-old female with breast pain
- breast ultrasound (#1 choice for <30yo female)
- mammography
- CT
- MRI
* <30 yo: dense breast → hard to differentiate with mammography.
Radioactive isotope used in radiotherapy?
Beta emitter
Acute abdominal X-ray is generally used in everyday clinical practice to detect the following, EXCEPT
*Good for: Air-Fluid level in bowels, distended bowels, FBs, general overview, free abdominal air
- kidney stone
- foreign body
- air-fluid levels
- free abdominal air
Which one is not a part of gamma camera?
X-ray tube
In which clinical situation ultrasonography is considered as the initial imaging modality?
a. 34 year-old female patient with a palpable mass
b. 42 year-old female patient with a palpable mass
c. 27 year-old female patient with a palpable mass
d. 50 year-old female patient’s screening examination
Chest X-ray can diagnose the following pathologies in case of acute chest pain, EXCEPT FOR:
- aortic dissection (can’t be visualized)
- pneumonia
- pneumothorax
- hydrothorax
True for normal gallbladder fluid appearance on imaging modalities:
No Doppler Signal
Patient case with renal failure. Question is if we should to CTA?
Vital patient. Do CTA
For which tumor is DGC diagnosis not adequate for tumor?
Prostate
Which of the following is not a common indication for PET-CT?
Size of primary tumor // also shape
During breast ultrasound examination, the following finding suggests a potential malignancy:
a. microscopic calcification
b. weakly echogeneic, irregular structure with lobulated contour
c. hyperechoic, well-circumscribed nodule
d. marcoscopic calcification
High resolution CT(HRCT) is NOT the reasonable choice in the following case:
Cerebellopontine angle – vestibular schwannoma (acoustic neurinoma)
True for imaging of acute pancreatitis, EXCEPT:
Murphy-sign is highly sensitive
What could be the most likely clinical diagnosis of this description: An inhomogeneous infiltrate is seen in the upper left lobe?
A) Pneumonia
B) Hydrothorax
C) Pneumothorax
D) Small circulatory congestion
How should a patient arrive for a non-acute abdominal-pelvic ultrasound?
With a full bladder
Which x-ray technique is applied by a conventional chest X-ray?
Hardbeam technique (120-140 keV)
US sign of the intussusception
target sign
whirpool sign
pseudokidney sign
comet sign
In case of typical liver hemangioma how can be characterize the mass in US?
Well rounded, hyperechoic
To evaluate an abdominal CT, the optimal window-setting is
WL=60HU; WW=360HU
Which correlation is the most CORRECT to the application of ultrasonography?
High frequency probe - poor penetration- good spatial resolution
To differentiate a T1 and T2 weighted image in MR, look for:
Water
NOT true for MRCP (Magnetic resonance cholangiopancreatography):
heavily T1-weighted sequence, therefore normal bile ducts and the gallbladder are hyperintense
Very small amount of free abdominal air can be reliably detected with the following imaging method?
(Ultrasound)?
Which statement is false about dynamic renal scintigraphy?
Used for Renal Tumors
Transducer used for thyroid US examination
Linear, 7,5-10MHz
Patognomic sign of GI tract perforation in an erect plain abdominal radiograph:
Crescent translucency under the dome of the hemidiaphragm
the following pathological conditions can’t generate small bowel ileus:
Crohn’s disease
coecum tumor
strangulated hernia
thrombosis of the splenic vein
Structures with many acoustic interfaces are termed as hyperechoic or echogenic and by convention are viewed as bright areas on the image
TRUE
Which of the following statements about isotope studies is true?
a. Most of the isotope investigations have high specificity.
b. Most of the isotope investigations have high sensitivity and specificity.
c. Most of the isotope investigations have high sensitivity.
d. Isotope investigations have no adverse or bionegative effects.
What is a radiopharmaceutical?
A specific molecule (specific for organ, molecule, function etc) marked with an unstable isotope.
Testicular imaging
US and MRI
Acoustic enhancement of ultrasonography is seen in case of:
a. renal cell carcinoma
b. gallstone
c. splenic cyst
d. liver metastasis
In case of suspicion of intestinal perforation, oral contrast agent:
Can be given because iodine-containing preparations do not cause peritonitis
Which material of the followings is NOT used for embolisation?
a. polyvinyl alcohol molecule
b. microbubble
c. absolute alcohol
d. coil
During ultrasound examination, the following finding suggests a potential malignancy in the breast
- calcification due to fat necrosis - B9 (mnemonics for Benign)
- encapsulated fluid collection (irreg. border)
- hypoechoic, irregular structure with lobulated contour (hyperdense)
- microscopic calcifications (only reliably determined in mammograms, not US)
chose the false answer
acute sinusitis you need X-Ray scan (false)
,,Gold standard” method currently in the diagnostics of renal cell cancer:
Contrast enhanced multiphasic abdominal CT examination
Which statement is FALSE on double contrast bowel examination?
Distent the lumen with gas, which is a positive contrast media, because of decreasing transparency.
If a pulmonary infiltrate DOES NOT resolve over time despite treatment with antimicrobial agents, think of
Broncho-alveolar subtype of lung cancer
appendicitis can be visualized with the following imaging methods:
with native and contrast enhanced CT examination
US examination
P-A abdominal X ray
US and abdominal CT exam
Which of the followings is NOT true for subdural hematoma?
a. crescent-shaped
b. usually caused by rupture of the bridge veins
c. its density decreases with time
d. cannot extend into the fissure
can be diagnosed with high certainty in a standing, two-way chest image in the case of chest trauma, except:
rib surgery
Which of the followings is NOT true for a chest radiograph performed in the Intensive Care Unit:
a. pleural fluid appears in the lateral sinuses
b. cardiac contour is magnified
c. it is an A-P radiography
d. catheter position can be assessed by it
what is the first modality choice in symptomatic bone tumors
PET-CT
Scintigraphy
X-ray
CT
Negative abdominal X-ray rules out the following:
- Ileus (well visualized)
- Tumor
- Perforation of luminal organ
- none of the others
Lecture: However, not all cases of ileus or perforation can be proven with X-ray. A negative abdominal X-ray does not rule out ileus, perforation or tumor!
What are the most important advantages of ultrasound over x-ray examination? Please choose the wrong answer
a) better spatial resolution
b) can be used during pregnancy
c) ability to measure flow
c) able to differentiate between soft tissue
Which structures are typically echodense? Please choose the wrong answer.
a) gallstone
b) kidney stone
c) sclerotic vascular plaque
d) liver cyst
True for imaging of acute appendicitis:
appendix is thickened (more than 6 mm in diameter) with enhanced Doppler-signal
Gold standards for differentiation between kidney cyst and cystic kidney tumor:
contrast CT
contrast MR
US or CT guided biopsy
angiography
NOT true for gadolinium-based contrast agent:
a. due to its T1-shortening effect, it will appear hyperintense on T1-weighted images
b. its risk of adverse reactions is higher in comparison to that of the iodinated contrast agents
c. unnecessary to administer it in TOF angiography
d. not recommended to use it in pregnancy
Which of the following indication is inadequate planning an MRI in head & neck region?
Bony skullbase evaluation in suspicion of bony fracture owing to an injury
True for clinical radiography:
a. at least 3 views are mandatory in bone fractures
b. x-ray film can reveal ostemyelitis within the first 3 days
c. diagnosis of acute sinusitis is based on sinus x-ray
d. Codman triangle is a sign of agressive bone lesions (e.g. osteosarcoma)
How could we demonstrate a calcified stone in the gallbladder, with 30 mm in diameter?
With angiography
with abdominal US examination
native abdominal CT examinations
P-A abdominal X ray
for the mediastinal Lymph nodes the most acceptable imaging method is;
US
CT
scintigraphy
chest x ray
Does CT apply to radiation?
yes
If a pulmonary infiltrate does not resolve over time despite treatment with antimicrobial agents, be suspicious of:
the presence of mycoplasma or klebsiella
supraglottic cancer of larynx
broncho-alveolar subtype of lung cancer
broeck sarcoidosis
Which of the followings is true when comparing MRI versus CT?
a. both imaging modality can visualize multiple anatomical regions in a short examination time.
b. both uses X-ray, but the does used in MRI is lower.
c. MR imaging of the posterior fossa of the brain is limited due to artefact from the dense bone
d. diffuse axonal injury of the brain is better depicted by MR in trauma patients
Which of the following modalities is NOT a functional imaging method?
A. Scintigraphy C
B. PET
C. Mammography
D. SPECT
What are the characteristics of clinical ultrasound examinations? Please choose the wrong answer.
a) It can be used to examine the brain in newborns.
b) It is capable to measure flow rate.
c) A higher frequency transducer can be used to examine deeper layers
d) Vascularization can be visualized using i.v contrast media.
NOT true for gadolinium-based contrast agent:
its risk of adverse reactions is higher in comparison to that of the iodinated contrast agents
When is it normal to see retroperitoneal fluid?
Post- surgery 1 week
which modality do you use in the assessment of the bony structures of the skull
US
CT
MRI
Native XR 2 Directions
Not true for gadolinium based contrast agents
- low-risk intravenous contrast agents can be used cautiously in patients with advanced renal impairment. (GFR 30ml/min/1.73m2)
- the risk of adverse reactions is the same as with iodinated contrast agents
- since they have T1-shortening effect, they will be hyperintense on T1-weighted images.
- intravenous contrast agents with a high risk of causing nephrogenic systemic fibrosis (NSF) have been withdrawn from the market
pulmonary abscess usually appears on the chest x ray with:
lower transparency and crescent shape
lower transparency ring shape with inner fluid level
lower transparency lense shape
lower transparency wedge shape
Noncontrast CT is appropriate for:
- staging of abdominal region in oncologic patients
- assessment of kidney stones
- following up of pulmonary embolism
- assessment of focal liver lesion of unknown dignity
Which of the followings is a CT characteristic of pulmonary embolism?
a. double lumen in the pulmonary artery
b. widening of the aorta
c. lack of pulmonary artery filling
d. intimal flap in the pulmonary artery
Free peritoneal air
- can be detected with the usage of barium contrast material
- is always abnormal
- is a sign of parenchymal organ perforation
- is more sensitively detected with X-ray than CT
Which comment IS NOT true regarding the multidetector/ multislice CT?
parallel rows of detectors
What is the ultrasound terminology of pure fluid?
a) echogenic
b) hypoechoic
c) anechoic
d) echodense
True for imaging of acute appendicitis:
a. ultrasonography is a very sensitive modality in obese patients
b. iv. contrast administration is unnecessary to diagnose periappendicular abscess
c. appendix is thickened (more than 6 mm in diameter) with enhanced Doppler-signal
d. CT is always necessary
True for triple-rule-out CT:
a. deep venous thrombosis can be excluded by it
b. quality of the study worsens in patients with increased heart rate
c. intravenous contrast agent is unnecessary
d. Stanford A and B aortic dissecton cannot be differentiated by it
Which x-ray technique is applied by a conventional chest x-ray?
Hardbeam technique (120-140keV)
Which PET-radiopharmaceuticals is most often used in oncology?
18F-Fludeoxyglucose (18F-FDG)
why is CT helpful in acute pancreatitis?
Cheap
avaliable everywhere
no contrast needed
helps with morphologic assessment and the reactive changes surrounding it
Most sensitive organ from radiation?
Gonads
Which of the following imaging methods is capable of detecting complications most efficiently?
Abdominal plain film
Abdominal US
CT native and contrast enhanced
barium meal
Noncontrast CT is appropriate for:
a. Staging of abdominal region in oncologic patients
b. Assessment of focal kidney lesion of unknown dignity
c. Follow-up of oncologic patient
d. Assessment of pulmonary fibrosis
Lower electron-density regions (such as air) stop very few x-rays, therefore, lower
electron-density regions are rendered as dark on film
Both statements are correct and there is a connection between them