Past Paper Questions

Question 1

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

Answer 1

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

Question 2

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

Answer 2

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

Question 3

Which isotope is used most often for the conventional pharmacomedicine?

Answer 3

Technetium 99

Question 4

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

Answer 4

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

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

Question 5

Radioactive isotope used in radiotherapy?

Answer 5

Beta emitter

Question 6

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

Answer 6

• kidney stone
• foreign body
• air-fluid levels
• free abdominal air

Question 7

Which one is not a part of gamma camera?

Answer 7

X-ray tube

Question 8

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

Answer 8

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

Question 9

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

Answer 9

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

Question 10

True for normal gallbladder fluid appearance on imaging modalities:

Answer 10

No Doppler Signal

Question 11

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

Answer 11

Vital patient. Do CTA

Question 12

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

Answer 12

Prostate

Question 13

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

Answer 13

Size of primary tumor // also shape

Question 14

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

Answer 14

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

Question 15

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

Answer 15

Cerebellopontine angle – vestibular schwannoma (acoustic neurinoma)

Question 16

True for imaging of acute pancreatitis, EXCEPT:

Answer 16

Murphy-sign is highly sensitive

Question 17

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

Answer 17

A) Pneumonia

B) Hydrothorax

C) Pneumothorax

D) Small circulatory congestion

Question 18

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

Answer 18

With a full bladder

Question 19

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

Answer 19

Hardbeam technique (120-140 keV)

Question 20

US sign of the intussusception

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

Answer 20

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

Question 21

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

Answer 21

Well rounded, hyperechoic

Question 22

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

Answer 22

WL=60HU; WW=360HU

Question 23

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

Answer 23

Water

Question 24

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

Answer 24

(Ultrasound)?

Question 25

Which statement is **false** about dynamic renal scintigraphy?

Answer 25

Used for Renal Tumors

Question 26

Transducer used for thyroid US examination

Answer 26

Linear, 7,5-10MHz

Question 27

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

Answer 27

Crescent translucency under the dome of the hemidiaphragm

Question 28

the following pathological conditions can't generate small bowel ileus: Crohn’s disease coecum tumor strangulated hernia thrombosis of the splenic vein

Answer 28

Crohn’s disease coecum tumor strangulated hernia ***thrombosis of the splenic vein***

Question 29

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

Answer 29

TRUE

Question 30

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.

Answer 30

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.

Question 31

What is a radiopharmaceutical?

Answer 31

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

Question 32

Testicular imaging

Answer 32

US and MRI

Question 33

Acoustic enhancement of ultrasonography is seen in case of: a. renal cell carcinoma b. gallstone c. splenic cyst d. liver metastasis

Answer 33

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

Question 34

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

Answer 34

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

Question 35

Which material of the followings is NOT used for embolisation? a. polyvinyl alcohol molecule b. microbubble c. absolute alcohol d. coil

Answer 35

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

Question 36

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

Answer 36

- 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)

Question 37

For acute sinusitis, do you need X-Ray scan

Answer 37

acute sinusitis you need X-Ray scan (FALSE)

Question 38

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

Answer 38

Contrast enhanced multiphasic abdominal CT examination

Question 39

For double contrast bowel examination? Distent the lumen with gas, which is a positive contrast media, because of decreasing transparency. TRUE or FALSE

Answer 39

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

Question 40

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

Answer 40

Broncho-alveolar subtype of lung cancer

Question 41

appendicitis can be visualized with the following imaging methods:

Answer 41

with native and contrast enhanced CT examination **US examination** P-A abdominal X ray *_US and abdominal CT exam_*

Question 42

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

Answer 42

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

Question 43

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

Answer 43

rib surgery

Question 44

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

Answer 44

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

Question 45

what is the first modality choice in symptomatic bone tumors PET-CT Scintigraphy X-ray CT

Answer 45

PET-CT ***Scintigraphy*** X-ray CT

Question 46

Negative abdominal X-ray rules out the following: - Ileus - Tumor - Perforation of luminal organ - none of the others

Answer 46

- ***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!

Question 47

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

Answer 47

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

Question 48

Which structures are typically echodense? Please choose the **wrong answer.** a) gallstone b) kidney stone c) sclerotic vascular plaque d) liver cyst

Answer 48

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

Question 49

True for imaging of acute appendicitis:

Answer 49

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

Question 50

Gold standards for differentiation between kidney cyst and cystic kidney tumor: contrast CT contrast MR US or CT guided biopsy angiography

Answer 50

***contrast CT*** contrast MR US or CT guided biopsy angiography

Question 51

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

Answer 51

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

Question 52

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

Answer 52

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

Question 53

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)

Answer 53

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)***

Question 54

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

Answer 54

With angiography ***with abdominal US examination*** native abdominal CT examinations P-A abdominal X ray

Question 55

for the mediastinal Lymph nodes the most acceptable imaging method is; US CT scintigraphy chest x ray

Answer 55

US ***CT*** scintigraphy chest x ray

Question 56

Does CT apply to radiation?

Answer 56

yes

Question 57

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

Answer 57

the presence of mycoplasma or klebsiella supraglottic cancer of larynx ***broncho-alveolar subtype of lung cancer*** broeck sarcoidosis

Question 58

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

Answer 58

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***

Question 59

Which of the following modalities is NOT a functional imaging method? A. Scintigraphy C B. PET C. Mammography D. SPECT

Answer 59

A. Scintigraphy C B. PET C. ***Mammography*** D. SPECT

Question 60

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.

Answer 60

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.

Question 61

NOT true for gadolinium-based contrast agent:

Answer 61

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

Question 62

When is it normal to see retroperitoneal fluid?

Answer 62

Post- surgery 1 week

Question 63

which modality do you use in the assessment of the bony structures of the skull US CT MRI Native XR 2 Directions

Answer 63

US CT MRI ***Native XR 2 Directions***

Question 64

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

Answer 64

- 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

Question 65

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

Answer 65

lower transparency and crescent shape ***lower transparency ring shape with inner fluid level*** lower transparency lense shape lower transparency wedge shape

Question 66

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

Answer 66

- staging of abdominal region in oncologic patients - ***assessment of kidney stones*** - following up of pulmonary embolism - assessment of focal liver lesion of unknown dignity

Question 67

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

Answer 67

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

Question 68

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

Answer 68

- 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***

Question 69

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

Answer 69

parallel rows of detectors

Question 70

What is the ultrasound terminology of pure fluid?

Answer 70

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

Question 71

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

Answer 71

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

Question 72

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

Answer 72

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

Question 73

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

Answer 73

Hardbeam technique (120-140keV)

Question 74

Which PET-radiopharmaceuticals is most often used in oncology?

Answer 74

18F-Fludeoxyglucose (18F-FDG)

Question 75

why is CT helpful in acute pancreatitis? Cheap avaliable everywhere no contrast needed helps with morphologic assessment and the reactive changes surrounding it

Answer 75

Cheap avaliable everywhere no contrast needed ***helps with morphologic assessment and the reactive changes surrounding it***

Question 76

Most sensitive organ from radiation?

Answer 76

Gonads

Question 77

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

Answer 77

Abdominal plain film Abdominal US ***CT native and contrast enhanced*** barium meal

Question 78

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

Answer 78

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***

Question 79

Lower electron-density regions (such as air) stop very few x-rays, therefore, lower electron-density regions are rendered as dark on film

Answer 79

Both statements are correct and there is a connection between them

Question 80

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

Answer 80

lymphoma aneurysm of descending aorta ***calcified pleural callus*** hilar pulmonary neoplasia

Question 81

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

Answer 81

- bones - muscles - aorta - ***water***

Question 82

# 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

Answer 82

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

Question 83

What is the most common indication for thyroid scintigraphy?

Answer 83

Diagnosis of hyperthyroidism

Question 84

Put the following into one row according to radiation dose:

Answer 84

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

Question 85

In which anatomical structure can we register Doppler signal typically? a) biliary duct b) common carotid artery c) wirsung duct d) ureter

Answer 85

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

Question 86

the head and neck compartments are separated into parts on the basis of the following structures epiglottis hyoid bone cricoid cartilage uvula

Answer 86

epiglottis ***hyoid bone*** cricoid cartilage uvula

Question 87

true or false Nuclear medicine has higher spatial resolution than radiology

Answer 87

Nuclear medicine has higher spatial resolution than radiology FALSE

Question 88

Which shape is generally characteristic in case of epidural bleeding...

Answer 88

lentiform

Question 89

Biopsy with CT?

Answer 89

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

Question 90

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

Answer 90

CT

Question 91

Bi-rad scaling?

Answer 91

Mammography scaling

Question 92

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

Answer 92

water

Question 93

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

Answer 93

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

Question 94

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?

Answer 94

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?

Question 95

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

Answer 95

- 3-5 MHz liner - 7-12 MHz convex - ***3-5 MHz convex (more commonly used)*** - 7-12 MHz liner

Question 96

interstitial shadows: web-like of vascular origin patchy common CT terminology for mesenteric fat

Answer 96

***web-like*** of vascular origin patchy common CT terminology for mesenteric fat

Question 97

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

Answer 97

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

Question 98

Which of the following imaging methods DO NOT use ionizing radiation? - Ultrasound and MRI - CT and MRI - X-rays and Ultrasound - Fluoroscopy and Ultrasound

Answer 98

- ***Ultrasound and MRI*** - CT and MRI - X-rays and Ultrasound - Fluoroscopy and Ultrasound

Question 99

MR spectroscopy is a useful method in the diagnosis of: renal cell cancer ovarian cancer testicular cancer prostate cancer

Answer 99

renal cell cancer ovarian cancer testicular cancer ***prostate cancer***

Question 100

which technique is useful to demonstrate the ascites in the abdominal cavity? Abdominal US abdominal CT examination abdominal CT and US examination Scintigrapy

Answer 100

Abdominal US abdominal CT examination ***abdominal CT and US examination*** Scintigrapy

Question 101

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

Answer 101

GFR \> 30 ml/min/1.73m2

Question 102

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

Answer 102

Can be used for the diagnosis of renal tumors

Question 103

What is not true about gadolinium?

Answer 103

Have the same effect/side effect as iodine

Question 104

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

Answer 104

Anteroposterior (AP)

Question 105

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

Answer 105

Hyoid Bone

Question 106

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.

Answer 106

- 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.

Question 107

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

Answer 107

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

Question 108

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

Answer 108

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

Question 109

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

Answer 109

***moderately to the right side*** the mediastinal complex will stay in an unchanged moderately to the left side expressely to the left

Question 110

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

Answer 110

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

Question 111

Acoustic enhancement on ultrasonography is seen in case of:

Answer 111

Splenic Cyst

Question 112

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

Answer 112

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

Question 113

True for clinical radiography:

Answer 113

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

Question 114

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

Answer 114

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***

Question 115

Interstitial shadows

Answer 115

web-like

Question 116

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

Answer 116

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

Question 117

First chosen imaging method in case of a neck nodule

Answer 117

US

Question 118

X-ray using technique?

Answer 118

CT (DSA)

Question 119

whats FALSE about air in abdomen:

Answer 119

X-ray is more sensitive than CT

Question 120

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

Answer 120

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

Question 121

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

Answer 121

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

Question 122

In which imaging study is radiation protection mandatory?

Answer 122

Barium Swallowing

Question 123

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

Answer 123

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

Question 124

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

Answer 124

abdominal US intravenous urography ***low dose CT*** PET CT

Question 125

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

Answer 125

Ultrasound guided

Question 126

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

Answer 126

Subpulmonal fluid. Lateral decubitus position

Question 127

main component of tissue with -70 HU fat bone water air

Answer 127

***fat*** bone water air

Question 128

Which is NOT an indication for bile duct interventional radiological procedure? - cholangitis - bile duct stenosis caused by malignant tumor - bile stone - portal hypertension

Answer 128

- cholangitis - bile duct stenosis caused by malignant tumor - bile stone - ***portal hypertension***

Question 129

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

Answer 129

MR skull X ray ***CT of the brain*** color duplex carotid US

Question 130

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

Answer 130

Anechoic

Question 131

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

Answer 131

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

Question 132

Epidural hematoma appears on CT examination usually with: \* Subdural hematoma = crescent shape Amorphic contours ring shape lens shape - crescent shape

Answer 132

Amorphic contours ring shape ***lens shape - (lentiform)*** crescent shape

Question 133

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

Answer 133

Liver

Question 134

Which material of the followings is NOT used for embolisation?

Answer 134

microbubble

Question 135

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

Answer 135

- 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**

Question 136

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

Answer 136

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

Question 137

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

Answer 137

WL = 60 HU // WW = 360 HU \*WL = windowing level, WW = windowing width

Question 138

Which imaging method is applied for screening of hip dysplasia for neonates between 4-5 months X-ray US MRI None

Answer 138

X-ray ***US*** MRI None

Question 139

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

Answer 139

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

Question 140

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

Answer 140

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

Question 141

Iodinated contrast agent is applied in which radiological study?

Answer 141

DSA

Question 142

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

Answer 142

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

Question 143

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

Answer 143

Bosniak

Question 144

What is the typical ultrasound terminology of gallstone? a) echogenic b) hypoechoic c) anechoic d) echodense

Answer 144

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

Question 145

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

Answer 145

- 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

Question 146

Galactography is indicated:

Answer 146

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

Question 147

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

Answer 147

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***

Question 148

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

Answer 148

Hypoechoic ***anechoic*** hyperchoic hyperdens

Question 149

What is the half-life of Technetium 99?

Answer 149

6 hours

Question 150

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

Answer 150

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

Question 151

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?

Answer 151

CT /unenhanced and contrast-enhanced study

Question 152

Which imaging modality is capable to differentiate between solid and cystic breast masses? a. galactography b. ultrasonography c. PET-CT d. mammography

Answer 152

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

Question 153

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

Answer 153

- 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

Question 154

In which imaging study is radiation protection mandatory? a. contrast-enhanced ultrasonography b. sonoelastography c. barium swallowing d. MR angiography

Answer 154

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

Question 155

Which investigation is strongly recommended before doing a barium enema? a) Pelvic US b) Cystoscopy c) Rectoscopy d) Urography

Answer 155

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

Question 156

What can we investigate with myocardial scintigraphy?

Answer 156

Rate of Perfusion

Question 157

for pneumothorax in x-ray

Answer 157

Outline of lungs will disappear

Question 158

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

Answer 158

weakly echogeneic, irregular structure with lobulated contour

Question 159

the 18 F- FDG its tumorspecific gives information about the glucose uptake of the tumor cells emits only characteristic XR useful for tumor therapy

Answer 159

its tumorspecific ***gives information about the glucose uptake of the tumor cells*** emits only characteristic XR useful for tumor therapy

Question 160

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.

Answer 160

- 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.***

Question 161

Which of the following statements about isotope studies is true?

Answer 161

Most of the isotope investigations have high sensitivity.

Question 162

if you have lung cancer what kind of imaging?

Answer 162

Chest CT

Question 163

Ultrasound sign of volvulus

Answer 163

“Whirlpool sign”

Question 164

What is the shape of subarachnoid bleeding?

Answer 164

Bleeding follows the sulci and space of the subarachnoid space.

Question 165

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

Answer 165

A. Abdominal plain film B. Abdominal US C. ***CT native and contrast enhanced*** D. Barium meal

Question 166

Indications for chest x-ray:

Answer 166

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

Question 167

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

Answer 167

**- 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

Question 168

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.

Answer 168

- 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.

Question 169

What is the frequency and probe used in abdominal ultrasound?

Answer 169

3,5-5 mHz convex probe

Question 170

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

Answer 170

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

Question 171

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

Answer 171

Contrast enhanced abdomino-pelvic CT – CT angiography

Question 172

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

Answer 172

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

Question 173

contrast material in small intestine

Answer 173

nasojejunal tube needs to stay close

Question 174

Which of the followings has a negative CT density value? ## Footnote ***a.*** mesenterial fat b. chronic hematoma c. cerebrospinal fluid d. grey matter of the brain

Answer 174

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

Question 175

Which modality DOES NOT apply ionizing radiation?

Answer 175

Contrast enhanced US

Question 176

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

Answer 176

Non contrast and contrast enhanced multidetector CT exam

Question 177

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

Answer 177

**Water-soluble contrast material should be used.** Note: BA containing CM can cause mediastinitis

Question 178

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

Answer 178

only gamma radiation is used only beta radiation is used only positron emission is used ***gamma and positron emision are used***

Question 179

Which color indicates the flow towards the transducer conventionally in color Doppler? a) black b) red c) blue d) white

Answer 179

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

Question 180

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

Answer 180

Presence of hemorrhage

Question 181

Which modality can be used in radiofrequency ablation?

Answer 181

US, MRI, X-ray, CT

Question 182

What is detected by PET camera?

Answer 182

Gamma Photons

Question 183

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

Answer 183

Radiopharrnacon

Question 184

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

Answer 184

- 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***

Question 185

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

Answer 185

- **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

Question 186

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

Answer 186

***Osteomeatal complex*** osteomata complex ethimoidal complex nasomeatal complex

Question 187

Iodinated contrast agent is applied in which radiological study? a. ultrasonography b. scintigraphy c. magnetic resonace imaging d. digital subtraction angiography

Answer 187

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

Question 188

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

Answer 188

US

Question 189

Which structures are typically anechoic? Please choose the **wrong answer** a) full bladder b) cyst c) the lumen of greater vessels d) acute hematoma

Answer 189

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

Question 190

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

Answer 190

2

Question 191

Acoustic shadowing on US is seen in case of - liver abscess - hyperechoic kidney tumor - gallstone - liver cyst

Answer 191

- liver abscess - hyperechoic kidney tumor - ***gallstone*** (Cholelithiasis = hyperechoic (bright)) - liver cyst

Question 192

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

Answer 192

Ultrasonography

Question 193

Gall stone on ultrasound is?

Answer 193

Hyperechoic

Question 194

What is the resolution of ultrasound in soft tissue?

Answer 194

1540 m/s

Question 195

True for normal gallbladder fluid appearance on imaging modalities:

Answer 195

a. CT density is approximately -50 HU ***b. no Doppler signal*** C. hyperintense on T1 d. hyperechoic

Question 196

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

Answer 196

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***

Question 197

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

Answer 197

- 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

Question 198

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

Answer 198

- hybrid operation - open surgery **- endovascular recanalization** (minimum invasive, lower risk of amputation) - conservative management

Question 199

Which of the following is true?

Answer 199

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

Question 200

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

Answer 200

Ostiomeatal complex