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M.IMAGING > Past Paper Questions > Flashcards

Past Paper Questions Flashcards

1
Q

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

A

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

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2
Q

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
A
  • Checking the INR value
  • Check for the existence of a metal foreign body
  • providing sufficient hydration
  • checking the GFR value
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3
Q

Which isotope is used most often for the conventional pharmacomedicine?

A

Technetium 99

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4
Q

The imaging method of choice in a 20-year-old female with breast pain

A
  • breast ultrasound (#1 choice for <30yo female)
  • mammography
  • CT
  • MRI

* <30 yo: dense breast → hard to differentiate with mammography.

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5
Q

Radioactive isotope used in radiotherapy?

A

Beta emitter

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6
Q

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
A
  • kidney stone
  • foreign body
  • air-fluid levels
  • free abdominal air
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7
Q

Which one is not a part of gamma camera?

A

X-ray tube

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8
Q

In which clinical situation ultrasonography is considered as the initial imaging modality?

A

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

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9
Q

Chest X-ray can diagnose the following pathologies in case of acute chest pain, EXCEPT FOR:

A
  • aortic dissection (can’t be visualized)
  • pneumonia
  • pneumothorax
  • hydrothorax
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10
Q

True for normal gallbladder fluid appearance on imaging modalities:

A

No Doppler Signal

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11
Q

Patient case with renal failure. Question is if we should to CTA?

A

Vital patient. Do CTA

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12
Q

For which tumor is DGC (dystrophin-glycoprotein complex (DGC) diagnosis not adequate for tumor?

A

Prostate

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13
Q

Which of the following is not a common indication for PET-CT?

A

Size of primary tumor // also shape

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14
Q

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

A

a. microscopic calcification
b. weakly echogeneic, irregular structure with lobulated contour
c. hyperechoic, well-circumscribed nodule
d. marcoscopic calcification

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15
Q

High resolution CT(HRCT) is NOT the reasonable choice in the following case:

A

Cerebellopontine angle – vestibular schwannoma (acoustic neurinoma)

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16
Q

True for imaging of acute pancreatitis, EXCEPT:

A

Murphy-sign is highly sensitive

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17
Q

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

A

A) Pneumonia

B) Hydrothorax

C) Pneumothorax

D) Small circulatory congestion

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18
Q

How should a patient arrive for a non-acute abdominal-pelvic ultrasound?

A

With a full bladder

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19
Q

Which x-ray technique is applied by a conventional chest X-ray?

A

Hardbeam technique (120-140 keV)

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20
Q

US sign of the intussusception

  • target sign
  • whirpool sign
  • pseudokidney sign
  • comet sign
A

target sign. ( doughnut sign or bull’s eye sign. The appearance is generated by concentric alternating echogenic and hypoechoic bands)

whirpool sign

pseudokidney sign

comet sign

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21
Q

In case of typical liver hemangioma how can be characterize the mass in US?

A

Well rounded, hyperechoic

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22
Q

To evaluate an abdominal CT, the optimal window-setting is

A

WL=60HU; WW=360HU

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23
Q

To differentiate a T1 and T2 weighted image in MR, look for:

A

Water

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24
Q

Very small amount of free abdominal air can be reliably detected with the following imaging method?

A

(Ultrasound)?

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25
Q

Which statement is false about dynamic renal scintigraphy?

A

Used for Renal Tumors

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26
Q

Transducer used for thyroid US examination

A

Linear, 7,5-10MHz

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27
Q

Patognomic sign of GI tract perforation in an erect plain abdominal radiograph:

A

Crescent translucency under the dome of the hemidiaphragm

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28
Q

the following pathological conditions can’t generate small bowel ileus:

Crohn’s disease

coecum tumor

strangulated hernia

thrombosis of the splenic vein

A

Crohn’s disease

coecum tumor

strangulated hernia

thrombosis of the splenic vein

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29
Q

Structures with many acoustic interfaces are termed as hyperechoic or echogenic and by convention are viewed as bright areas on the image

A

TRUE

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30
Q

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.

A

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.

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31
Q

What is a radiopharmaceutical?

A

A specific molecule (specific for organ, molecule, function etc) marked with an unstable isotope.

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32
Q

Testicular imaging

A

US and MRI

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33
Q

Acoustic enhancement of ultrasonography is seen in case of:

a. renal cell carcinoma
b. gallstone
c. splenic cyst
d. liver metastasis

A

a. renal cell carcinoma
b. gallstone
c. splenic cyst
d. liver metastasis

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34
Q

In case of suspicion of intestinal perforation, oral contrast agent:

A

Can be given because iodine-containing preparations do not cause peritonitis

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35
Q

Which material of the followings is NOT used for embolisation?

a. polyvinyl alcohol molecule
b. microbubble
c. absolute alcohol
d. coil

A

a. polyvinyl alcohol molecule
b. microbubble
c. absolute alcohol
d. coil

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36
Q

During ultrasound examination, the following finding suggests a potential malignancy in the breast

A
  • 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)
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37
Q

For acute sinusitis, do you need X-Ray scan

A

acute sinusitis you need X-Ray scan (FALSE)

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38
Q

,,Gold standard” method currently in the diagnostics of renal cell cancer:

A

Contrast enhanced multiphasic abdominal CT examination

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39
Q

For double contrast bowel examination?

Distent the lumen with gas, which is a positive contrast media, because of decreasing transparency.

TRUE or FALSE

A

Distent the lumen with gas, which is a positive contrast media, because of decreasing transparency.

FALSE

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40
Q

If a pulmonary infiltrate DOES NOT resolve over time despite treatment with antimicrobial agents, think of

A

Broncho-alveolar subtype of lung cancer

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41
Q

appendicitis can be visualized with the following imaging methods:

A

with native and contrast enhanced CT examination

US examination

P-A abdominal X ray

US and abdominal CT exam

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42
Q

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

A

a. crescent-shaped
b. usually caused by rupture of the bridge veins
c. its density decreases with time
d. cannot extend into the fissure

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43
Q

can be diagnosed with high certainty in a standing, two-way chest image in the case of chest trauma, except:

A

rib surgery

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44
Q

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

A

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

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45
Q

what is the first modality choice in symptomatic bone tumors

PET-CT

Scintigraphy

X-ray

CT

A

PET-CT

Scintigraphy

X-ray

CT

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46
Q

Negative abdominal X-ray rules out the following:

  • Ileus
  • Tumor
  • Perforation of luminal organ
  • none of the others
A
  • 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!

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47
Q

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

A

a) better spatial resolution
b) can be used during pregnancy
c) ability to measure flow
c) able to differentiate between soft tissue

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48
Q

Which structures are typically echodense? Please choose the wrong answer.

a) gallstone
b) kidney stone
c) sclerotic vascular plaque
d) liver cyst

A

a) gallstone
b) kidney stone
c) sclerotic vascular plaque
d) liver cyst

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49
Q

True for imaging of acute appendicitis:

A

appendix is thickened (more than 6 mm in diameter) with enhanced Doppler-signal

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50
Q

Gold standards for differentiation between kidney cyst and cystic kidney tumor:

contrast CT

contrast MR

US or CT guided biopsy

angiography

A

contrast CT

contrast MR

US or CT guided biopsy

angiography

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51
Q

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

A

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

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52
Q

Which of the following indication is inadequate planning an MRI in head & neck region?

A

Bony skullbase evaluation in suspicion of bony fracture owing to an injury

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53
Q

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)

A

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)

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54
Q

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

A

With angiography

with abdominal US examination

native abdominal CT examinations

P-A abdominal X ray

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55
Q

for the mediastinal Lymph nodes the most acceptable imaging method is;

US

CT

scintigraphy

chest x ray

A

US

CT

scintigraphy

chest x ray

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56
Q

Does CT apply to radiation?

A

yes

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57
Q

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

A

the presence of mycoplasma or klebsiella

supraglottic cancer of larynx

broncho-alveolar subtype of lung cancer

broeck sarcoidosis

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58
Q

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

A

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

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59
Q

Which of the following modalities is NOT a functional imaging method?

A. Scintigraphy C

B. PET

C. Mammography

D. SPECT

A

A. Scintigraphy C

B. PET

C. Mammography

D. SPECT

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60
Q

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.

A

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.

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61
Q

NOT true for gadolinium-based contrast agent:

A

its risk of adverse reactions is higher in comparison to that of the iodinated contrast agents

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62
Q

When is it normal to see retroperitoneal fluid?

A

Post- surgery 1 week

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63
Q

which modality do you use in the assessment of the bony structures of the skull

US

CT

MRI

Native XR 2 Directions

A

US

CT

MRI

Native XR 2 Directions

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64
Q

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
A
  • 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
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65
Q

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

A

lower transparency and crescent shape

lower transparency ring shape with inner fluid level

lower transparency lense shape

lower transparency wedge shape

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66
Q

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
A
  • staging of abdominal region in oncologic patients
  • assessment of kidney stones
  • following up of pulmonary embolism
  • assessment of focal liver lesion of unknown dignity
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67
Q

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

A

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

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68
Q

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
A
  • 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
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69
Q

Which comment IS NOT true regarding the multidetector/ multislice CT?

A

parallel rows of detectors

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70
Q

What is the ultrasound terminology of pure fluid?

A

a) echogenic
b) hypoechoic
c) anechoic
d) echodense

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71
Q

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

A

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

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72
Q

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

A

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

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73
Q

Which x-ray technique is applied by a conventional chest x-ray?

A

Hardbeam technique (120-140keV)

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74
Q

Which PET-radiopharmaceuticals is most often used in oncology?

A

18F-Fludeoxyglucose (18F-FDG)

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75
Q

why is CT helpful in acute pancreatitis?

Cheap

avaliable everywhere

no contrast needed

helps with morphologic assessment and the reactive changes surrounding it

A

Cheap

avaliable everywhere

no contrast needed

helps with morphologic assessment and the reactive changes surrounding it

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76
Q

Most sensitive organ from radiation?

A

Gonads

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77
Q

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

A

Abdominal plain film

Abdominal US

CT native and contrast enhanced

barium meal

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78
Q

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

A

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

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79
Q

Lower electron-density regions (such as air) stop very few x-rays, therefore, lower

electron-density regions are rendered as dark on film

A

Both statements are correct and there is a connection between them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

in the case of widening of the mediastinum what pathological process couldnt be the cause of this alteration:

lymphoma

aneurysm of descending aorta

calcified pleural callus

hilar pulmonary neoplasia

A

lymphoma

aneurysm of descending aorta

calcified pleural callus

hilar pulmonary neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

To differentiate a T1 and T2 weighted image in MR, look for:

A
  • bones
  • muscles
  • aorta
  • water
82
Q

choose the correct statement regarding hyperacute cerebral infarcts:

hyperdense media sign always visible

hyperdense media sign is visible in 25-30 (50? ) of the cases

hyperdense media sign is never visible

hyperdense media sign is visible in 10- 15%of the cases

A

hyperdense media sign always visible

hyperdense media sign is visible in 25-30 (50? ) of the cases

hyperdense media sign is never visible

hyperdense media sign is visible in 10- 15%of the cases

83
Q

What is the most common indication for thyroid scintigraphy?

A

Diagnosis of hyperthyroidism

84
Q

Put the following into one row according to radiation dose:

A

Dental (lowest) → Chest → Background → Abdominal/Pelvis (highest)

85
Q

In which anatomical structure can we register Doppler signal typically?

a) biliary duct
b) common carotid artery
c) wirsung duct
d) ureter

A

a) biliary duct
b) common carotid artery
c) wirsung duct
d) ureter

86
Q

the head and neck compartments are separated into parts on the basis of the following structures

epiglottis

hyoid bone

cricoid cartilage

uvula

A

epiglottis

hyoid bone

cricoid cartilage

uvula

87
Q

true or false

Nuclear medicine has higher spatial resolution than radiology

A

Nuclear medicine has higher spatial resolution than radiology FALSE

88
Q

Which shape is generally characteristic in case of epidural bleeding…

A

lentiform

89
Q

Biopsy with CT?

A

Can take from deeper structures (with US only superficial parts can be taken)

90
Q

For mediastinal and retroperitoneal lymph nodes the most acceptable imaging method is?

A

CT

91
Q

Bi-rad scaling?

A

Mammography scaling

92
Q

During CT examinations in the Hounsfield scale the density of the …. Is fixed to zero

A

water

93
Q

Which of the followings is NOT a common indication for PET-CT?

a. determination of distant metastases
b. determination of regional lymph node metastases
c. size of the primary tumour, exact determination of local tumor spread
d. determining the dignity of solitary pulmonary nodules

A

a. determination of distant metastases
b. determination of regional lymph node metastases
c. size of the primary tumour, exact determination of local tumor spread
d. determining the dignity of solitary pulmonary nodules

94
Q

High Resolution CT (HRCT) is NOT the reasonable choice in the following case:

a. Structure of the middle ear - conductive hearing loss?
b. Bone structure of femur - osteoid osteoma?
c. Cerebellopontine angle - acoustic neurinoma (vestibular schwannoma)?
d. Structure of the lungs - restrictive pulmonary disease, fibrosis?

A

a. Structure of the middle ear - conductive hearing loss?
b. Bone structure of femur - osteoid osteoma?
c. Cerebellopontine angle - acoustic neurinoma (vestibular schwannoma)?
d. Structure of the lungs - restrictive pulmonary disease, fibrosis?

95
Q

What type of probe is used for a standard abdominal ultrasound examination in an adult patient?

  • 3-5 MHz liner
  • 7-12 MHz convex
  • 3-5 MHz convex
  • 7-12 MHz liner
A
  • 3-5 MHz liner
  • 7-12 MHz convex
  • 3-5 MHz convex (more commonly used)
  • 7-12 MHz liner
96
Q

interstitial shadows:

web-like

of vascular origin

patchy

common CT terminology for mesenteric fat

A

web-like

of vascular origin

patchy

common CT terminology for mesenteric fat

97
Q

which correlation is the most CORRECT to the application of US:

High frequency probe- deep penetration- low spatial resolution

high frequency probe- poor penetration- good spatial resolution

low frequency probe- deep penetration- good spatial resolution

low frequency probe- poor penetration – good spatial resolution

A

High frequency probe- deep penetration- low spatial resolution

high frequency probe- poor penetration- good spatial resolution

low frequency probe- deep penetration- good spatial resolution

low frequency probe- poor penetration – good spatial resolution

98
Q

Which of the following imaging methods DO NOT use ionizing radiation?

  • Ultrasound and MRI
  • CT and MRI
  • X-rays and Ultrasound
  • Fluoroscopy and Ultrasound
A
  • Ultrasound and MRI
  • CT and MRI
  • X-rays and Ultrasound
  • Fluoroscopy and Ultrasound
99
Q

MR spectroscopy is a useful method in the diagnosis of:

renal cell cancer

ovarian cancer

testicular cancer

prostate cancer

A

renal cell cancer

ovarian cancer

testicular cancer

prostate cancer

100
Q

which technique is useful to demonstrate the ascites in the abdominal cavity?

Abdominal US

abdominal CT examination

abdominal CT and US examination

Scintigrapy

A

Abdominal US

abdominal CT examination

abdominal CT and US examination

Scintigrapy

101
Q

In case of the following GFR value the patient DOES NOT need hydration prior to an i.v. contrast-enhanced CT examination.

A

GFR > 30 ml/min/1.73m2

102
Q

Which of the following statements is FALSE about dynamic renal scintigraphy?

A

Can be used for the diagnosis of renal tumors

103
Q

What is not true about gadolinium?

A

Have the same effect/side effect as iodine

104
Q

In the study of patients in the intensive care unit, the radial direction of the on- site chest recordings is:

A

Anteroposterior (AP)

105
Q

The head & neck compartments are separated into parts on the basis of the following structure…

A

Hyoid Bone

106
Q

The following conditions can affect the administration of iv. CT contrast media, EXCEPT FOR:

  • Coughing, epiphora, sense of palpation and appearance of utricaria on chest and back following the administration of a certain type and concentration of iv. Contrast media
  • Latest eGFR 28ml/min/1.73m2

-“Iodine allergy” indicated on the referral – rash appearing after using antiseptic agent on skin.

  • Diabetes, chronic kidney disease patients who are not on dialysis, intake of Metformin containing drugs on the day of examination.
A
  • Coughing, epiphora, sense of palpation and appearance of utricaria on chest and back following the administration of a certain type and concentration of iv. Contrast media
  • Latest eGFR 28ml/min/1.73m2

-“Iodine allergy” indicated on the referral – rash appearing after using antiseptic agent on skin.

  • Diabetes, chronic kidney disease patients who are not on dialysis, intake of Metformin containing drugs on the day of examination.
107
Q

Which of the followings is NOT a common indication for PET-CT?

A

a. size of the primary tumour, exact determination of local tumor spread
b. determining the dignity of solitary pulmonary nodules
c. determination of distant metastases
d. determination of regional lymph node metastases

108
Q

Does the clinical diagnosis of pneumonia contradict the negative RTG (x-ray) image?

A

No, the RTG image may be negative for the first 48 hours after the onset of symptoms.

109
Q

in case of huge left sided pleural fluid collection, the mediastinal complex will move:

moderately to the right side

the mediastinal complex will stay in an unchanged

moderately to the left side

expressely to the left

A

moderately to the right side

the mediastinal complex will stay in an unchanged

moderately to the left side

expressely to the left

110
Q

Necessary steps of patient preparation before vascular intervention, EXCEPT:

a. exclusion of aneurysm clip
b. hydration of the patient
c. measurement of INR
d. cessation of Metformin

A

a. exclusion of aneurysm clip
b. hydration of the patient
c. measurement of INR
d. cessation of Metformin

111
Q

Acoustic enhancement on ultrasonography is seen in case of:

A

Splenic Cyst

112
Q

Imaging characteristics of herpes encephalitis, EXCEPT:

a. asymmetric involvement of the temporal lobes
b. hyperintensity on T2W and FLAIR MRI
c. highly specific changes on brain CT
d. restricted diffusion on DWI MR

A

a. asymmetric involvement of the temporal lobes
b. hyperintensity on T2W and FLAIR MRI
c. highly specific changes on brain CT
d. restricted diffusion on DWI MR

113
Q

True for clinical radiography:

A

Codman triangle is a sign of agressive bone lesions (e.g. osteosarcoma)

114
Q

Pathognomonic sign of GI tract perforation in an erect plain abdominal radiograph

oral contrast material depicted in the duodenum

colon cut- off significant

broad air- fluid level in the transverse colon

crescent translucency under the dome of the hemidiaphram

A

oral contrast material depicted in the duodenum

colon cut- off significant

broad air- fluid level in the transverse colon

crescent translucency under the dome of the hemidiaphram

115
Q

Interstitial shadows

A

web-like

116
Q

Which are the guiding principles when it comes to choosing the modality to diagnose a disease?

A

Modality with high specificity, least invasive, available and most cost-effective

117
Q

First chosen imaging method in case of a neck nodule

A

US

118
Q

X-ray using technique?

A

CT (DSA)

119
Q

whats FALSE about air in abdomen:

A

X-ray is more sensitive than CT

120
Q

NOT true for MRCP (Magnetic resonance cholangiopancreatography):

a. intravenous contrast agent is unnecessary to perform this study
b. heavily T1-weighted sequence, therefore normal bile ducts and the gallbladder are hyperintense
c. may determine the cause of bile duct dilation
d. can be an alternative to ERCP

A

a. intravenous contrast agent is unnecessary to perform this study
b. heavily T1-weighted sequence, therefore normal bile ducts and the gallbladder are hyperintense
c. may determine the cause of bile duct dilation
d. can be an alternative to ERCP

121
Q

In which regions is a 3-5 MHz convex transducer used generally?

a. deep vein thrombosis evaluation
b. carotid artery scanning
c. abdominal scanning
d. thyroid nodule characterization

A

a. deep vein thrombosis evaluation
b. carotid artery scanning
c. abdominal scanning
d. thyroid nodule characterization

122
Q

In which imaging study is radiation protection mandatory?

A

Barium Swallowing

123
Q

Negative abdominal X-ray rules out the following:

a. intraabdominal free fluid
b. large gallbladder stone
c. large collection of intraabdominal free air
d. large hepatic tumor

A

a. intraabdominal free fluid
b. large gallbladder stone
c. large collection of intraabdominal free air
d. large hepatic tumor

124
Q

in case of suspected nephro- ureterolithiasis the best method for the localization of the lithiasis is:

abdominal US

intravenous urography

low dose CT

PET CT

A

abdominal US

intravenous urography

low dose CT

PET CT

125
Q

Which guidance technique is mainly used for taking biopsy of thyroid nodule?

A

Ultrasound guided

126
Q

In case of which of the following conditions would you make a Frimann-Dahl radiograph?

A

Subpulmonal fluid. Lateral decubitus position

127
Q

main component of tissue with -70 HU

fat

bone

water

air

A

fat

bone

water

air

128
Q

Which is NOT an indication for bile duct interventional radiological procedure?

  • cholangitis
  • bile duct stenosis caused by malignant tumor
  • bile stone
  • portal hypertension
A
  • cholangitis
  • bile duct stenosis caused by malignant tumor
  • bile stone
  • portal hypertension
129
Q

A young 30 years old female was admitted for the emergency department with a strong, beating like, occipital headache. What is the
first imaging method?

MR

skull X ray

CT of the brain

color duplex carotid US

A

MR

skull X ray

CT of the brain

color duplex carotid US

130
Q

How do you describe the finding of clear fluid/cyst in ultrasound?

A

Anechoic

131
Q

Which of the following is not an indication for bone scintigraphy?

A

Localization of the primary tumor. (The indication is diagnosis of bone metastasis, staging and follow up.)

132
Q

Epidural hematoma appears on CT examination usually with: * Subdural hematoma = crescent shape

Amorphic contours

ring shape

lens shape -

crescent shape

A

Amorphic contours

ring shape

lens shape - (lentiform)

crescent shape

133
Q

In case of which organ can you apply ultrasonography as the first imaging modality for adults?

A

Liver

134
Q

Which material of the followings is NOT used for embolisation?

A

microbubble

135
Q

Chest pain, dyspnea, impaired renal function (GFT = 38 ml/min/1.73m2) and D-dimer positivity in the laboratory, S1Q3 on ECG. The patient is hemodynamically instable. Does the renal impairment change the diagnostic strategy?

  • Yes, prophylactic intravenous hydration should be performed first to avoid contrast-induced acute kidney injury, then the pulmonary CT angiography may be performed
  • No, in this case chest x-ray should be performed first, and pulmonary CT angiography should only be considered upon a positive chest X-ray
  • Yest, because of the severe renal impairment only a non-contrast chest CT should be performed
  • No, acute pulmonary CT angiography must be performed because of the life-threatening emergency, the consequential contrast-induced acute kidney injury is of secondary concern
A
  • Yes, prophylactic intravenous hydration should be performed first to avoid contrast-induced acute kidney injury, then the pulmonary CT angiography may be performed
  • No, in this case chest x-ray should be performed first, and pulmonary CT angiography should only be considered upon a positive chest X-ray
  • Yest, because of the severe renal impairment only a non-contrast chest CT should be performed
  • No, acute pulmonary CT angiography must be performed because of the life-threatening emergency, the consequential contrast-induced acute kidney injury is of secondary concern
136
Q

Contrast-enhanced MRI is used in the following clinical situations, EXCEPT:

a. to detect breast implant rupture
b. to assess multifocality
c. to differentiate between scar tissue and recurrent tumor
d. to examine chest wall infiltration by breast cancer

A

a. to detect breast implant rupture
b. to assess multifocality
c. to differentiate between scar tissue and recurrent tumor
d. to examine chest wall infiltration by breast cancer

137
Q

To evaluate an abdominal CT, the optimal window setting is… on the hounsfield scale?

A

WL = 60 HU // WW = 360 HU

*WL = windowing level, WW = windowing width

138
Q

Which imaging method is applied for screening of hip dysplasia for neonates between 4-5 months

X-ray

US

MRI

None

A

X-ray

US

MRI

None

139
Q

Which of the followings is true when comparing MRI versus CT?

A

diffuse axonal injury of the brain is better depicted by MR in trauma patients

140
Q

Which of the followings has a negative CT density value?

a. chronic hematoma
b. cerebrospinal fluid
c. grey matter of the brain
d. mesenterial fat

A

a. chronic hematoma
b. cerebrospinal fluid
c. grey matter of the brain
d. mesenterial fat

141
Q

Iodinated contrast agent is applied in which radiological study?

A

DSA

142
Q

How should a patient arrive for a non-acute abdominal-pelvic ultrasound?

a. with full bladder
b. with kidney function laboratory test (GFR)
c. after colon cleansing
d. after 2-hour fasting

A

a. with full bladder
b. with kidney function laboratory test (GFR)
c. after colon cleansing
d. after 2-hour fasting

143
Q

The … classification system divides renal cystic masses into 5 categories based on imaging characteristics on contrast-CT

A

Bosniak

144
Q

What is the typical ultrasound terminology of gallstone?

a) echogenic
b) hypoechoic
c) anechoic
d) echodense

A

a) echogenic
b) hypoechoic
c) anechoic
d) echodense (bright)

145
Q

How should the patient arrive for abdominal and pelvic ultrasound? Please mark the WRONG answer

  • with kidney function results not older than one week.
  • with full bladder
  • after at least 4 hours of fasting (6~8 hours of fasting generally.)
  • with previous ultrasound reports
A
  • with kidney function results not older than one week.
  • with full bladder
  • after at least 4 hours of fasting (6~8 hours of fasting generally.)
  • with previous ultrasound reports
146
Q

Galactography is indicated:

A

a. in case of bilateral breast discharge
b. in case of mastitis
c. in case of unilateral breast discharge
d. in detection of an intracystic solid component

147
Q

Which of the followings is NOT true for a chest radiograph performed in the Intensive Care Unit?

a. cardiac contour is magnified
b. catheter position can be assessed by it
c. it is an A-P radiography
d. pleural fluid appears in the lateral sinuses

A

a. cardiac contour is magnified
b. catheter position can be assessed by it
c. it is an A-P radiography
d. pleural fluid appears in the lateral sinuses

148
Q

in case of a simple renal cyst ( with 25 mm diameter without irregular wall and without septations) how could we characterize the inner content of the cyst?

Hypoechoic

anechoic

hyperchoic

hyperdens

A

Hypoechoic

anechoic

hyperchoic

hyperdens

149
Q

What is the half-life of Technetium 99?

A

6 hours

150
Q

In case of the following GFR value, the patient does not need hydration prior to an iv. contrast enhanced CT examination

A

GFR is above 30 ml/min/1.73 m2

Hydration is given as infusion if patient with GFR <30 ml/min/1.73 m^2

151
Q

Based on the physical investigation and laboratory parameters, there is a suspicion of acute pancreatitis. Which of the following imaging methods is able to detect the complications most efficiently?

A

CT /unenhanced and contrast-enhanced study

152
Q

Which imaging modality is capable to differentiate between solid and cystic breast masses?

a. galactography
b. ultrasonography
c. PET-CT
d. mammography

A

a. galactography
b. ultrasonography
c. PET-CT
d. mammography

153
Q

What does sonoelastography mean?

  • examination of blood flow parameters in the tissue
  • examination of flow by reflections of flowing particles
  • examination of tissue elasticity by ultrasonography
  • examination of tissue contrast enhancement using microbubbles
A
  • examination of blood flow parameters in the tissue
  • examination of flow by reflections of flowing particles
  • examination of tissue elasticity by ultrasonography
  • examination of tissue contrast enhancement using microbubbles
154
Q

In which imaging study is radiation protection mandatory?

a. contrast-enhanced ultrasonography
b. sonoelastography
c. barium swallowing
d. MR angiography

A

a. contrast-enhanced ultrasonography
b. sonoelastography
c. barium swallowing
d. MR angiography

155
Q

Which investigation is strongly recommended before doing a barium enema?

a) Pelvic US
b) Cystoscopy
c) Rectoscopy
d) Urography

A

a) Pelvic US
b) Cystoscopy
c) Rectoscopy
d) Urography

156
Q

What can we investigate with myocardial scintigraphy?

A

Rate of Perfusion

157
Q

for pneumothorax in x-ray

A

Outline of lungs will disappear

158
Q

During breast ultrasound examination, the following finding suggests a potential malignancy:

A

weakly echogeneic, irregular structure with lobulated contour

159
Q

the 18 F- FDG

its tumorspecific

gives information about the glucose uptake of the tumor cells

emits only characteristic XR

useful for tumor therapy

A

its tumorspecific

gives information about the glucose uptake of the tumor cells

emits only characteristic XR

useful for tumor therapy

160
Q

The main role of MRI in oncologic imaging is

  • local tumor staging
  • overview of organ systems and local tumor staging in a short examination time
  • making large field of view (FOV) images, since image resolution is not affected by the FOV
  • Imaging the same regions as with CT scan for better documentation.
A
  • local tumor staging
  • overview of organ systems and local tumor staging in a short examination time
  • making large field of view (FOV) images, since image resolution is not affected by the FOV
  • Imaging the same regions as with CT scan for better documentation.
161
Q

Which of the following statements about isotope studies is true?

A

Most of the isotope investigations have high sensitivity.

162
Q

if you have lung cancer what kind of imaging?

A

Chest CT

163
Q

Ultrasound sign of volvulus

A

“Whirlpool sign”

164
Q

What is the shape of subarachnoid bleeding?

A

Bleeding follows the sulci and space of the subarachnoid space.

165
Q

If suspicion of acute pancreatitis, which of the following imaging methods is capable of detecting the complications most efficiently?

A. Abdominal plain film

B. Abdominal US

C. CT native and contrast enhanced

D. Barium meal

A

A. Abdominal plain film

B. Abdominal US

C. CT native and contrast enhanced

D. Barium meal

166
Q

Indications for chest x-ray:

A

Acute fever, respiratory symptoms, indicative physical examination findings, trauma, ICU patient status, chest tubes/drains/cannules/foreign bodies, acute abdomen, preoperative setting, lung screening.

167
Q

TRUE regarding intramural hematoma (IMH)

  • IMH is a type of acute aortic syndrome
  • in suspicion of IH non-contrast phase has to be performed as well
  • both are correct
  • both are false
A

- IMH is a type of acute aortic syndrome

- in suspicion of IH non-contrast phase has to be performed as well

  • both are correct
  • both are false
168
Q

What is the role of MRI in the polytrauma care algorithm?

  • A cranial MRI scan is performed in each case
  • The first step in the diagnostic algorithm: whole body MRI
  • Detection of neurological abnormalities, possible discoligamentous lesions and exclusion of intraspinal hematoma which cannot be otherwise explained by CT.
  • Plays no role at all, CT and US are enough.
A
  • A cranial MRI scan is performed in each case
  • The first step in the diagnostic algorithm: whole body MRI
  • Detection of neurological abnormalities, possible discoligamentous lesions and exclusion of intraspinal hematoma which cannot be otherwise explained by CT.
  • Plays no role at all, CT and US are enough.
169
Q

What is the frequency and probe used in abdominal ultrasound?

A

3,5-5 mHz convex probe

170
Q

Which of the following fracture-type is considered as ,,pathologic fracture”?

A

Fractures due to osteoporosis, Fracture of bones weakened by a tumor, inflammation or cyst

171
Q

Which method is used for the detection of abdominal aortic aneurysm rupture?

A

Contrast enhanced abdomino-pelvic CT – CT angiography

172
Q

What are the indications for contrast enhanced ultrasound examination? Please choose the wrong answers.

a) differential diagnosis of hepatic masses
b) for the evaluation of complex renal cysts
c) distinguishing between active and inactive Chron’s disease
d) to diagnose hepato-splenomegaly

A

a) differential diagnosis of hepatic masses
b) for the evaluation of complex renal cysts
c) distinguishing between active and inactive Chron’s disease
d) to diagnose hepato-splenomegaly

173
Q

contrast material in small intestine

A

nasojejunal tube needs to stay close

174
Q

Which of the followings has a negative CT density value?

a. mesenterial fat

b. chronic hematoma
c. cerebrospinal fluid
d. grey matter of the brain

A

a. mesenterial fat

b. chronic hematoma
c. cerebrospinal fluid
d. grey matter of the brain

175
Q

Which modality DOES NOT apply ionizing radiation?

A

Contrast enhanced US

176
Q

In the case of a polytraumatic patient which is the fastest image method to get use information about cranial, chest and abdominal condition?

A

Non contrast and contrast enhanced multidetector CT exam

177
Q

In the suspicion of esophageal perforation which of the following statements is correct regarding contrast media application:

A

Water-soluble contrast material should be used.

Note: BA containing CM can cause mediastinitis

178
Q

in diagnostic in nuclear medicine

only gamma radiation is used

only beta radiation is used

only positron emission is used

gamma and positron emision are used

A

only gamma radiation is used

only beta radiation is used

only positron emission is used

gamma and positron emision are used

179
Q

Which color indicates the flow towards the transducer conventionally in color Doppler?

a) black
b) red
c) blue
d) white

A

a) black

b) red

c) blue
d) white

180
Q

ln case of stroke, treatment strategy is primarily based on the following findings?

A

Presence of hemorrhage

181
Q

Which modality can be used in radiofrequency ablation?

A

US, MRI, X-ray, CT

182
Q

What is detected by PET camera?

A

Gamma Photons

183
Q

What kind of material is administered to the patient during an isotope examination?

A

Radiopharrnacon

184
Q

Characteristics of the AP view

  • Small amounts of pleural fluid is hard to notice on an AP chest X-ray
  • The cardiac silhouette is larger than on a PA view
  • AP view is obtained for a supine chest radiograph
  • All of the above
A
  • Small amounts of pleural fluid is hard to notice on an AP chest X-ray
  • The cardiac silhouette is larger than on a PA view
  • AP view is obtained for a supine chest radiograph
  • All of the above
185
Q

What is the typical appearance of a subarachnoid hemorrhage on CT?

  • hyperdense / in basal cistern, most commonly around the circle of Willis
  • hypodense / in basal cisterns, most commonly around the circle of Willis
  • hypodense / amorphous, within the brain
  • hyperdense / amorphous, within the brain
A
  • hyperdense / in basal cistern, most commonly around the circle of Willis
  • hypodense / in basal cisterns, most commonly around the circle of Willis
  • hypodense / amorphous, within the brain
  • hyperdense / amorphous, within the brain
186
Q

how do you call tge complex that should be evaluated in case of chronic sinusitis?

Osteomeatal complex

osteomata complex

ethimoidal complex

nasomeatal complex

A

Osteomeatal complex

osteomata complex

ethimoidal complex

nasomeatal complex

187
Q

Iodinated contrast agent is applied in which radiological study?

a. ultrasonography
b. scintigraphy
c. magnetic resonace imaging
d. digital subtraction angiography

A

a. ultrasonography
b. scintigraphy
c. magnetic resonace imaging
d. digital subtraction angiography

188
Q

Which imaging modality is capable to differentiate between solid and cystic breast masses?

A

US

189
Q

Which structures are typically anechoic? Please choose the wrong answer

a) full bladder
b) cyst
c) the lumen of greater vessels
d) acute hematoma

A

a) full bladder
b) cyst
c) the lumen of greater vessels
d) acute hematoma

190
Q

Traumatic limb RTG recordings most often in how many directions is it made?

A

2

191
Q

Acoustic shadowing on US is seen in case of

  • liver abscess
  • hyperechoic kidney tumor
  • gallstone
  • liver cyst
A
  • liver abscess
  • hyperechoic kidney tumor
  • gallstone (Cholelithiasis = hyperechoic (bright))
  • liver cyst
192
Q

Which imaging method is applied for screening of hip dysplasia for neonates between 4~5 months of age?

A

Ultrasonography

193
Q

Gall stone on ultrasound is?

A

Hyperechoic

194
Q

What is the resolution of ultrasound in soft tissue?

A

1540 m/s

195
Q

True for normal gallbladder fluid appearance on imaging modalities:

A

a. CT density is approximately -50 HU

b. no Doppler signal

C. hyperintense on T1

d. hyperechoic

196
Q

Which of the followings is a CT characteristic of pulmonary embolism?

a. double lumen in the pulmonary artery
b. widening of the aorta
c. intimal flap in the pulmonary artery
d. lack of pulmonary artery filling

A

a. double lumen in the pulmonary artery
b. widening of the aorta
c. intimal flap in the pulmonary artery
d. lack of pulmonary artery filling

197
Q

what is FALSE on double contrast bowel examination?

  • Smear mucosa with Ba- containing contrast agent
  • distend lumen with gas, which is a + contrast media, because of decreasing transparency
  • relax bowel walls with smooth muscle relaxant
  • depiction: luminal, contour, mucosal relief
A
  • Smear mucosa with Ba- containing contrast agent
  • distend lumen with gas, which is a + contrast media, because of decreasing transparency
  • relax bowel walls with smooth muscle relaxant
  • depiction: luminal, contour, mucosal relief
198
Q

What is the primary treatment option in crural arterial stenosis/occlusion?

  • hybrid operation
  • open surgery

- endovascular recanalization (minimum invasive, lower risk of amputation)

  • conservative management
A
  • hybrid operation
  • open surgery

- endovascular recanalization (minimum invasive, lower risk of amputation)

  • conservative management
199
Q

Which of the following is true?

A

Most isotope investigations have high sensitivity …

(REMEMBER: Isotope investigations have high sensitivity, but low specificity.)

200
Q

How do you call TGE ? complex that should be evaluated in case of chronic sinusitis ?

A

Ostiomeatal complex

M.IMAGING (11 decks)

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