Past-papers Flashcards
Which imaging technique is useful to demonstrate the ascites in the abdominal cavity? (you have to choose the FALSE answer):
A/ Abdominal Ultrasound
B/ Abdominal CT examination
C/ Abdominal CT and US examination
D/ Scintigrapy
D/ Scintigrapy
Subdural hematoma appears on CT examination usually with:
A/ Amorf contours
B/ Ring shape
C/ Crescent shape
D/ Lense shape
C/ Crescent shape
Ultrasound sign of the intussusception:
A/ „target” sign
B/ „whirplpool” sign
C/ „pseudokidney”
D/ „comet” sign
A/ „target” sign
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 in this case?
A/ MR
B/ Skull X-ray, two view
C/ Native CT of the brain
D/ Color-duplex Carotid Ultrasound
C/ Native CT of the brain
In case of a huge left sided pleural fluid collection the mediastinal complex will move:
A/ moderately to the right side
B/ the medastinal complex will stay in unchanged position
C/ moderately to the left side
D/ extensively to the left side
A/ moderately to the right side
For the mediastinal and retroperitoneal lymph nodes the most acceptable imaging method is:
A/ Ultrasound
B/ CT examination
C/ Scintigraphy
D/ Chest X-ray (two views)
B/ CT examination
The following transducer is used generally for adult’s abdominal US examination:
A/ 7,5-10 MHz convex
B/ 6-9 MHz phased-array
C/ 3,5-5 MHz convex
D/ 7,5-10 MHz linear
C/ 3,5-5 MHz convex
Appendicitis can be visualised with the following imaging methods (there is only one false statement, you have to find this FALSE answer):
A/ with native and contrast enhanced CT examination
B/ with Ultrasound examination
C/ with P-A abdominal X-ray examination
D/ with US and abdominal CT examination
C/ with P-A abdominal X-ray examination
In case of a polytraumatised patient which is the fastest imaging method to get useful informations about cranial, chest and abdominal condition?
A/ Skull, Chest and abdominal X-ray
B/ Carotid and Abdominal Utrasound examination
C/ native and contrast enhanced Multidetector CT examination
D/ PET-CT
C/ native and contrast enhanced Multidetector CT examination
The following pathological conditions can generate small bowel ileus (Only one answer is false, you have to choose this FALSE answer):
A/ Crohn’s disease
B/ Coecum tumor
C/ Strangulated hernia
D/ Thrombosis of the splenic vein
D/ Thrombosis of the splenic vein
During the CT examinations in the Hounsfield scale the density of the ………… is fixed to Zero.
A/ fresh blood
B/ water
C/ fat
D/ bone
B/ water
In case of a suspected nephro-ureterolithiasis the best method for the localisation of the nephro-ureterolithiasis is:
A/ Abdominal Ultrasound examination
B/ Intravenous Urography
C/ Low-dose CT
D/ PET-CT
C/ Low-dose CT
Which guidence technique is mainly useful for the biopsy of thyroid nodule?
A/ X-ray guided biopsy
B/ US-guided biopsy
C/ CT-guided biopsy
D/ MR-guided biopsy
B/ US-guided biopsy
In case of a simple liver cyst (with 25 mm diameter, without irregular wall and without septations), how could we characterize the inner content of the cyst?
A/ hypoechoic
B/ anechoic
C/ hyperechoic
D/ hyperdense
B/ anechoic
In case of widening of the mediastinum what pathological process could be the cause of this alteration? (Only ONE answer is FALSE, you have to sign this statement):
A/ Lymphoma
B/ Aneurysm of the descending aorta
C/ Calcified pleural callus
D/ Hilar pulmonary neoplasia
C/ Calcified pleural callus
Which method is used for the detection of abdominal aortic aneurysm rupture?
A/ Barium enema
B/ PA Chest and native abdominal X-ray
C/ Contrast enhanced abdomino-pelvic CT – CT angiography
D/ PET-CT
C/ Contrast enhanced abdomino-pelvic CT – CT angiography
Pulmonary abscess usually appears on the chest X-ray with:
A/ lower transparency crescent shape
B/ lower transparency ring shape with inner fluid level
C/ lower transparency lense shape
D/ lower transparency wedge shape
B/ lower transparency ring shape with inner fluid level
Duplex ultrasonography
- Combination of two transducers to see blood vessesl both in superficial and deep locations
- Simultaneous doppler analysis of bilateral limbs by two sonographs
- 2D US examination, then doppler analysis by ”pencil” probe
- Simultaneous 2D US with doppler sampling from the vessels specified on the 2D image
- Simultaneous 2D US with doppler sampling from the vessels specified on the 2D image
Duplex ultrasonography is used in vascular studies; refers to the simultaneous use of both grayscale or color Doppler to visualize the structure of, and flow within, a vessel and sprectral (waveform) doppler to quantitate flow.
For what does a radiologist look for when performing a FAST-exam?
- Free abdominal fluid
- Gall bladder inflammation
- Kidney stones
- Cysts
a. Free abdominal fluid
FAST is a rapid bedside US examination performed by surgeons, emergency physicians and certain paramedics as a screening test for blood around the heart or abdominal organs after trauma.
What is the first modality choice in symptomatic bone tumors?
- PET-CT
- Scintigraphy
- Conventional x-ray
- CT
c. Conventional x-ray
US sign of intussuception:
- ”target” sign
- ”whirlpool” sign
- ”psudokidney”
- ”comet” sign
a. ”target” sign
the target sign of intestinal intussusception, also known as the doughnut sign, or bulls eye sign. The appearance is generated by concentric alternating echogenic and hypoechogenic bands. The echogenic bancs are formed by mucosa and muscularis, whereas submucosal is responsible for the hypoechogenic bands.
MR spectroscopy is a useful method in diagnosis of
- Renal cell cancer
- Ovarian cancer
- Testicular cancer
- Prostate cancer
d. Prostate cancer
MRS is currently used to investigate a number of diseases in the human body, most notably cancer (brain, breast and prostate), epilepsy, alzheimers, parkinsons and huntingtons. MRS has been used to diagnose pituitary tuberculosis. Prostate cancer: combined with MRI and given equal results, then the #D MRS can predict the prevalence of a malignant degeneration if prostate tissue by approx. 90%. The combination of both metods may be helpful in the planning of biopsies and therapies of the prostate, as well as to monitor the success of a therapy.
Choose the correct statement regarding hyperacute cerebral infarcts
- Hyperdense media sign is always visible
- Hyperdense media sign is visible in 25-50% of the cases
- Hyperdense media sign is never visible
- Hyperdense media sign is visible in 10-15% of the cases
b. Hyperdense media sign is visible in 25-50% of the cases
What is the diagnostic strategy in extracranial carotid disease?
- Primary examination is DSA which is complemented by CTA or MRA, US is only for kids
- Primary examination is duplex US for screening and follow-up: probless solving advanced imaging for selected cases is CTA or MRA – catheter angiography (DSA) is mainly for therapeutic interventions
- US-guided puncture of the CCA and then directed angiography of the affected side
- Primary examination is CTA; MRA is only for iodine-sensitive patients; DSA for all patients preceding surgery and duplex US for post-surgical complications
b. Primary examination is duplex US for screening and follow-up: probless solving advanced imaging for selected cases is CTA or MRA – catheter angiography (DSA) is mainly for therapeutic interventions
- Carotid artery stenosis is usually diagnosed by color flow duplex US scan of the carotid arteries in the neck. This involves no radiation, no needles, and no contrast agents that may cause allergic reactions. This test has good sensitivity and specificity.
- CTA or MRA may be useful. With contrast: contraindicated in patients with renal insuffieicency, catheter angiography has a 0.5-1% risk of stroke, MI arterial injury or retroperitoneal bleeding. The investigation chosen will depend on the clinical question and the imaging expertice, experience and equipment available.
In case of a huge left-sided pleural fluid collection the mediastinal complex will move:
- Moderately to the right side
- The mediastinal complex will stay in unchanged position
- Moderately to the left side
- Extensively to the left side
- Moderately to the right side
- A large pleural effusion may cause treacheal deviation away from the effusion
For the mediastinal and retroperitoneal lymph nodes the most acceptable imaging method is
- US
- CT examination
- Scinitigraphy
- Chest x-ray (two views)
- CT examination
- CT scans of the chest are more accurate in determining the location and nature of a mediastinal mass than conventional radiographs.
The following transducer is used generally for superficial soft tissue US examinations
- 7,5-10 MHz convex
- 6-9 MHz phased-array
- 3,5-5 MHz convex
- 7,5-10 MHz linear
7,5-10 MHz linear
Linear; 8-10 (or more)MHz, superficial penetration, better resolution
How do you call the complex that should be evaluated in case of chronic sinusitis?
- Osteomeatal complex
- Ostiomeatal complex
- Ethmoidal complex
- Nasomeatal complex
b. Ostiomeatal complex
In case of a polytraumatic patient, which is the fastest imaging method to get useful information about cranial, chest and abdominal complications?
- Skull, chest and abdominal x-ray
- Carotid and abdominal US examination
- Non contrast and contrast enhanced multidetector
- CT examination
c. Non contrast and contrast enhanced multidetector CT examination
- It is also quite common in severe trauma for patients to be sendt directly to CT or a surgery theater, if they require emergency treatment
The following pathological conditions can generate small bowel ileus (only one answer is false, you have to choose the FALSE answer):
- Crohn´s disease
- Coecum tumor
- Strangulated hernia
- Thrombosis of the splenic vein
d. Thrombosis of the splenic vein
In neuroradiology
- MR has a superior ability in the imaging of the cranial bones
- MR images lack bone artifacts
- MR has the ability to distinguish calcifications
- MR cannot visualize white matter lesions
b. MR images lack bone artifacts
(Bone-artefact O on lecture slide..)
Interstitial shadows are
- Web-like
- Of vascular origin
- Patchy
- Common CT terminology for mesenteric fat
a. Web-like
-
Choose the correct statement
- Fresh hemorrhage in CT is hypodense
- Chronic subdural hematoma in CT is hyperdense
- MR is capable to determine the approximate age of hemorrhage
- MR is not useful in identifying hemorrhage
c. MR is capable to determine the approximate age of hemorrhage
- Chonic >14 days, T1=dark, T2=dark
- Late subacute 7-14 days, T1=bright, T2=bright
- Early subacute 3-7 days, T1= bright, T2= dark
- Acute 1-3 days, T1=isointense, T2=dark
- Hyperacute <24h, T1=isointense, T2=bright
- Changes in the appearance of blood over time on MRI
-
Which of the following is an absolute contraindicated for enema reduction of an intussusception?
- Small amount of free fluid on utrasonography
- Signs of perforation (pneumoperitoneum, peritonitis)
- Small bowel obstruction
- Iodine allergy
b. Signs of perforation (pneumoperitoneum, peritonitis)
1. Contraindications: signs of peritonitis and perforations according to: https://radiopaedia.org/articles/intussusception-reduction
Choose the correct statement
- On T1 weighted images white mater has a higher signal intensity than grey matter
- On T1 weighted images white matter has a lower signal intensity than grey matter
- On T2 weighted images CSF has intermediate signal
- On T2 weighted images bones have the highest signal intensity
a. On T1 weighted images white mater has a higher signal intensity than grey matter
- Different tissues have different T1 and T2 values, which is why fat, muscle, and bone, for example, will appear differently not only from each other but also within different pulse sequences.
- Tissues that have a short T1 will be bright.
- Tissues with a long T2 will be bright
- Bright translates into whiter or having increased signal intensity on MRI scans. Dark translates into blacker or having decreased signal on MRI.
- A key point is that water will be dark on T1-weighted images and bright on T2-weighted images. Water is T1-dark and T2-bright.
- If the fluid is dark (e.g., CSF, urine, etc) = T1 weighted image.
If the fluid is bright (e.g., CSF, urine, etc) = T2 weighted image. - Tissues and structures that are typicallt bright on T1: fat, hemorrhage, proteinaceous fluid, melanin, gandolinium abd other paramagnetic substances.
- Tissues and structure typically bright on T2: fat, water, edema, inflammation, infection, cysts, hemorrhage.
-
The vertebral column injuries are classified according to the “model” below
- David 3 column theory
- Denis spinal canal theory
- Davis spinal canal theory
- Denis 3 column theory
d. Denis 3 column theory
Denis divided the vertebral column into 3 vertical parallel columns beased in biomechanical studies related to stability following traumatic injury. Instability occurs when injuries affect 2 contiguous columns (i.e., anterior and middle column, or middle and posterior column). Obvious a 3 column injury is unstable.
What is NOT typical for a malignant bone tumor?
- Ill-defined
- Periosteal reaction
- Destructions
- Well circumscribed
d. Well circumscribed
The …….. classification system divides renal cyctic masses into five categories based on imaging characteristics on contrast-enhanced CT
- Bi-rads
- Ren-Rads
- Li-Rads
- Bosniak
d. Bosniak
The bosniak classification system of renal cystic masses divides renal systic masses into five catergories based on imaging characteristics on contrast enhanced CT. it is helpful in predicting a risk of malignancy and suggesting either follow up or treatment.
MR spectroscopy is a useful method in the diagnosis of
- Renal cell cancer
- Ovarian cancer
- Testicular cancer
- Prostate cancer
d. Prostate cancer
What is the central (“fatty”) compartment of the suprahyoid neck?
- Anterior cervical space
- Pharyngeal mucosal space
- Masticator space
- Parapharyngeal space
d. Parapharyngeal space
What is the diagnostic strategy in extracranial carotid disease?
- Primary examination is DSA which is complemented by CTA or MRA, US is only for kids
- Primary examination is duplex US for screening and follow-up: problem-solving advanced imaging for selected cases is CTA or MRA; catheter angiography (DSA) is mainly for therapeutic interventions
- US-guided puncture of the CCA and then directed angiography of the affected side
- Primary examination is CTA: MRA is only for iodine-sensitive patients; DSA for all patient preceding surgery and duplex US for post-surgical complications.
b. Primary examination is duplex US for screening and follow-up: problem-solving advanced imaging for selected cases is CTA or MRA; catheter angiography (DSA) is mainly for therapeutic interventions
- Carotid artery stenosis is usually diagnosed by color flow duplex US scan of the carotid arteries in the neck. This involves no radiation, no needles, and no contrast agents that may cause allergic reactions. This test has good sensitivity and specificity.
- CTA or MRA may be useful. With contrast: contraindicated in patients with renal insuffieicency, catheter angiography has a 0.5-1% risk of stroke, MI arterial injury or retroperitoneal bleeding. The investigation chosen will depend on the clinical question and the imaging expertice, experience and equipment available.
In case of ileus in newborns
- We can make the diagnosis based only on abdominal x-ray
- Meconium ileus is caused by impacted thick meconium in children suffering from CF.
- Hirschsprung´s disease never causes ileus in newborn.
- Ileum atresia never occurs with non-used colon, because it is a disease of the small bowel, not the colon.
a. We can make the diagnosis based only on abdominal x-ray
Diagnosis of meconium ileus is suspected in a neonate with signs of intestinal obstruction, particularly if a family history of CF exists. Patients should undergo abdominal x-ray which show dilated intestinal loops; however, fluid levels may be absent.
-
In case of a moderate amount of right sided pleural fluid collection the mediastinal complex will move
- Moderately to the right side
- Stay in unchanged position
- Moderately to the left side
- Extensively to the left side
c. Moderately to the left side
Very large pleural effusions may act like a mass and produce a shift of the mobile mediastinal structures AWAY from the side of the effusion.
For the mediastinal and retroperitoneal lymph nodes the most acceptable imaging method is:
- US
- CT examination
- Scintigraphy
- Chest x-ray (two views)
b. CT examination
CT scans of the chest are more accurate in determining the location and nature of a mediastinal mass than conventional radiographs.
Acute pulmonary embolism
- Negative chest radiography and lower extremity venous US can rule out confidently.
- Pulmonary angiography (DSA) is the best modality to assess the vasculature and this is the only modality, which is feasible in patients with dyspnea.
- CTA provides only indirect evidence of PE while MRA can visualize even the smallest branches (the only problem is restricted availability)
- CTA can directly prove the presence of emboli and additionally other possible causes of chest symptoms are often disclosed.
d. CTA can directly prove the presence of emboli and additionally other possible causes of chest symptoms are often disclosed.
- Over 90% of PE develop from thrombi in the deep veins of the leg, especially above the level of the popliteal veins. They are usually a complication of surgery or prolonged bedrest or cancer. Because of the dual circulation of the lungs most PE do not result in infarction.
- Chest radiographs infrequently manifest one of the “classic” findings for PE which can include:
- Wedge-shaped peripheral air-space disease (Hampton hump)
- Focal oligemia (westermark sign)
- A prominent central pulmonary artery (knuckle sign)
- If the chest radiograph is normal, a nuclear medicine ventilation-perfusion scan may be diagnostic. If however, the chest radiograph is abnormal, a CT is usually performed.
- CT-PA is made possible by the fast data acquisition of spiral CT scanners (one breath hold) combined with thin slices and rapid bolus IV injections of iodineated contrast that produce maximal opacification of the pulmonary arteries with little or no motion artifacts.
