[Link] [Link].

com

1. Coffee bean sign is seen in?

a) Gastric volvulus

b) Sigmoid volvulus

c) Hypertrophic pyloric stenosis

d) Midgut volvulus

Correct Answer - B
Sigmoid volvulus REF: Wofganag 5th e p. 846/748
Sign Disease
Rat tail appearance Carcinoma esophagus
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Bird beak appearance Achalasia

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Beak sign/double track/ tram track Hypertrophic pyloric stenosis

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Medusa head colonies on CT Round worm

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Pincer/claw/coiled
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Intussception
spring/target/meniscus sign
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Coffee bean sign Sigmoid volvulous

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Lead pipe appearance Ulcerative colitis

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String of kantor/bull's eye Chron's disease

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Thumb printing sign Ischemic colitis

Saw tooth appeance on barium
Diverticulosis
enema
Apple core sign Carcinoma colon
Cork screw appearance Diffuse esophageal spasm
String sign Hypertrophic pyloric stenosis

[Link]
 [Link] [Link]

2. Rat tail appearance in contrast radiography

is seen in?
a) Achalasia cardia

b) Carcinoma esophagus

c) Cork screw esophagus

d) Diffuse esophageal spasms

Correct Answer - B
Carcinoma esophagus REF: sabiston's 18' edition chapter 41 See
om
table in the previous question
"Rat-tail" appearance on barium study is seen in carcinoma
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esophagus.
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3. Which chamber enlargement shows a

double right heart border with a wide
subcarinal angle?
a) Left atrium

b) Left ventricle

c) Right atrium

d) Right ventricle

Correct Answer - A
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Answer- A- Left atrium

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Radiological signs of left atrial enlargement:

A 'double' right heart border
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Elevation of the left main bronchus

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Splaying of the carina

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Enlargement of the left atrial appendage

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The prominence of the portion of the left heart border at the level of
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the left main bronchus

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[Link]
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4. Mercedes Benz sign is seen in:

a) Gall stone

b) Bladder stone

c) Renal stones

d) Foreign body bronchus

Correct Answer - A
Gall stone REF: Sutton's textbook of radiology, Th edition, volume 1
page 713
Mercedes Benz sign/Seagull sign/Crow feet sign:
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Gall bladder stone if radiopaque has a stellate faceted appearance

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with gas containing fissures on the plain radiograph and is called as

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Mercedes Benz sign/Seagull sign or Crow feet sign

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[Link]
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5. Chain of lakes appearance is seen in?

a) Chronic pancreatitis

b) Acute pancreatitis

c) Gall stone ileus

d) Sub-acute intestinal obstruction

Correct Answer - A
Chronic pancreatitis REF: Sutton's Radiology 7th edition volume 1
page 798, Sabiston textbook of surgery 18th ed chapter 5
Chronic pancreatitis is characterized by irregularities of the
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pancreatic ducts, ductal strictures, and areas of duct dilation. The

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major as well as the side-branch ducts may be involved. For

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unexplained reasons, some patients with chronic pancreatitis

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develop dilated main pancreatic ducts (large duct disease), whereas

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others retain ducts of normal or even smaller than normal caliber

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(small duct disease). Some patients with chronic pancreatitis can be

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shown to have major ducts that have the appearance of a "chain of

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lakes" or a "string of pearls" that is the result of segments of dilated

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duct separated by areas of ductal stricture

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[Link]
 [Link] [Link]

6. "Cork screw appearance" is characteristic

of?
a) Carcinoma esophagus

b) Hypertrophic pyloric stenosis

c) Diffuse esophageal spasm

d) Sigmoid volvulous

Correct Answer - C
Diffuse esophageal spasm REF: Wofganag 5th e p. 846/748
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Sign Disease
Rat tail appearance Carcinoma esophagus
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Bird beak appearance Achalasia

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Beak sign/ double track/ tram track Hypertrophic pyloric stenosis

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Medusa head colonies on CT Round worm

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Pincer/claw/coiled spring/target/
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Intussception
meniscus sign
.F
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Coffee bean sign Sigmoid volvulous

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Lead pipe appearance Ulcerative colitis

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String of kantor/bull's eye Chron's disease

Thumb printing sign Ischemic colitis
Saw tooth appeance on barium
Diverticulosis
enema
Apple core sign Carcinoma colon
Cork screw appearance Diffuse esophageal spasm
String sign Hypertrophic pyloric stenosis

[Link]
 [Link] [Link]

7. An absolute contraindication of MRI is:

a) Pacemaker

b) Prosthetic cardiac valves

c) Insulin pump

d) Choclear implants

Correct Answer - A
Pacemaker [Ref: Harrison 17/e p2494; Grainger Diagnostic
Radiology 4/e p122;
various websites-[Link]
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&dbs=Prosthetic%20Heart%20Valves
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[Link] [Link]/PDF/[Link]; http

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://www. mr​tip. com/se ry [Link] ?type = dh 1 &dbs= Prosthetic

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%20Heart %20Valves
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;and journal- _RadioGraphic s 2004 ;24 : 1257- 1267

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MR is considered among the safest imaging modalities for patients,

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even at very high field strengths, more than 3-4 tesla.

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But Ferromagnetic objects under magnetic field can be vulnerable to

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4 adverse effects:
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Movement (causing structural injury),

Current conduction (potentially causing electrical shock),
Heating (possibly causing burn injury), and
Artifact generation
Serious injuries can be caused by attraction of ferromagnetic objects
into the magnet, which would act as missiles if brought too close to
the magnet.
Ferromagnetic implants, such as aneurysm clips, may torque (turn
or twist) due to the magnetic field, causing damage to vessels and
even death.

[Link]
 [Link] [Link]

Metallic foreign bodies in the eye have moved and caused

intraocular hemorrhage.
Pacemakers and pacemaker leads are a contraindication, as the
pacemaker can malfunction and cause arrhythmia or even death.
However with growing expansion of MR, increasing number of
implant medical devices are being MR safe. So newer pacemaker
and aneurysm clips are being made which are MR safe.
Absolute Contraindications for the MRI scan:
Electronically, magnetically, and mechanically activated implants
Ferromagnetic or electronically operated active devices like
automatic cardioverter defibrillators
Cardiac pacemakers
Metallic splinters in the eye
Ferromagnetic haemostatic clips in the central nervous system
(CNS)
Patients with an implanted cardiac pacemaker have been scanned
on rare occasions, but pacemakers are generally considered an
absolute contraindication.
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Relative Contraindications for the MRI scan:

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Cochlear implants
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Other pacemakers, e.g. for the carotid sinus

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Insulin pumps and nerve stimulators

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Lend wires or similar wires (MRI Safety risk)

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Prosthetic heart valves (in high .fields, if dehiscence is suspected)

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Haemostatic clips (body)

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Nonierromagnetic stapedial implants

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Women with [Link]-trimester pregnancy

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Tattoos (only a problem in higher-strength magnetic .field i.e. more

than 3 tesla)
1Reflittp://[Link]/se ry 1 .php?type=dbl &dbs= Prosthetic
%20Heart%20Valvesi

[Link]
 [Link] [Link]

8. Floating water lily sign is seen in

a) Aspergillosis

b) Hamartoma

c) Hydatid cyst

d) Cavitating metastasis

Correct Answer - C
Hydatid cyst [Ref Radiology Review Manual by Dahnert 5/e, p 699;
[Link].00In/Ined/[Link]]
Separated membranes floating with the cyst give the appearance of
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water lily.
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It is pathognomonic of hydatid cyst.

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9. The scan with highest sensitivity to detect adrenal metastasis due to

bronchogenic carcinoma is:

a) Contrast Enhanced CT abdomen with Adrenal protocol

b) PET scan

c) MRI scan

d) Radionuclide scan

Correct Answer - B
Scans to differentiate adrenal adenoma from adrenal metastasis are:
CECT -
Chemical shift MRI
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FDG-PET
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PETscan has almost 100 % sensitivity for detecting adrenal metastasis, so a negative
study excludes the possibility of adrenal mets. But adenomas can give false positive test.
ke
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Ref: Fundamentals of Diagnostic Radiology, Edition - 4, Page - 427.

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10. Which
(GFR)?
of the following agents is used to measure Glomerular Filtration Rate

a) Iodohippurate

b) Tc99m-DTPA

c) Tc99m-MAG3

d) Tc99m-DMSA

Correct Answer - B
Tc99m-Diethylene Triamine Pentothenic Acid (DTPA) is an agent of choice widely used in
measuring GFR.
om
Ref: Renal Disease: Techniques and Protocols By Michael S Goligorsky, Page 87;
Paediatric Uroradiology By Richard Fotter, ALbert L Baert, Page 47
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[Link]
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11. The CT severity index in acute pancreatitis is described by:

a) Balthazar

b) Mengini

c) Chapman

d) Napelon

Correct Answer - A
The CT severity index (CTSI)-described by Balthazar
Balthazar CT Severity Index
CT Grade Score
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A. Normal- 0
B. Enlarged gland -1
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C. Peri-pancreatic inflammation- 2
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D. One fluid collection- 3

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E. Two or more collections- 4

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Necrosis Score
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30%-50%- (4)
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>50% -(6)
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Ref: ACR Appropriateness Criteria,Acute Pancreatitis.

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[Link]
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12. Radiocontrast is contraindicated in all of the following conditions except?

a) Renal failure

b) Patient on metformin

c) Dehydration

d) Obesity

Correct Answer - D
Obesity is not a contra-indication for the administration of radio-contrast agent.

Ref: Radiologic Technology at a Glance By Theresa S. Reid-Paul; pages 66.

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13. A PET scan uses which of the following tracer materials?

a) FDG

b) CDF

c) ADP

d) MIBG

Correct Answer - A
Positron emission tomography (PET) uses positron-emitting
radioisotope (tracer) - 18F-FDG
A PET scan uses a small amount of a radioactive drug, or tracer, to
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show differences between healthy tissue and diseased tissue.

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The most commonly used tracer is called FDG (fluorodeoxyglucose),

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so the test is sometimes called an FDG-PET scan.

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Very expensive.
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Better contrast and spatial resolution

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14. Which one of the following has the maximum ionization potential?
a) Proton

b) Electron

c) Helium ion

d) Gamma (y) – Photon

Correct Answer - C

Helium ion has maximum ionizing potential.

The ionizing potential of atoms ranges from a few eV for alkali elements to 24.6eV for
om
helium which has the maximum ionizing potential.
Ref: Radiation Physics for Medical Physicists By Ervin B. Podgoršak, Page 7
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15. All of the following about MRI are correct

except:
a) MRI is contraindicated in patients with pacemakers

b) MRI is useful for evaluating bone marrow

c) MRI is better for calcified lesions

d) MRI is useful for localizing small lesione in the brain

Correct Answer - C
C i.e. MRI is better for calcified lesions
om
* MRI is very poor in detection of calcification. It is inferior to CT
scan, mammography and x-ray in detecting calcification. That is why
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it lags behind mammography in early detection of noninvasive ductal

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carcinoma in situ (DCIS)Q, which most commonly

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has microcalcification as its only presenting feature. And similarly it

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has a very limited role in detection of renal stones and gall

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stonesQ. However, it is important to note that only upto 60% of gall

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stones have enough calcium density (more than that of bile) to get
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visualized on CT. Becaus of its superior calcification detection

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abilities, MDCT is used in Agatston scoring (Coronary calcium

scoring) of calcified plaques of coronary artery using coronary
calcium as a surrogate marker to detect the presence and measure
the amount of coronary atherosclerosis. Because with exception of
patients with renal failure calcification of arteries occurs exclusively
in context of atherosclerosis.
Similarly nonenhanced helical CT is superior to all other imaging
modalities in diagnosis of urinary tract calculiQ but at the cost of
higher radiation exposure.
Now there is no need to say that MRI is better that CT for evaluation
of bone marrow, small brain lesions, meniscus/ ligament injuries,
soft tissue tumors and meningeal pathology. But MRI is very poor in

[Link]
 [Link] [Link]

soft tissue tumors and meningeal pathology. But MRI is very poor in
detection of calcification.

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[Link]
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16. Tufting of distal phalanx is

characteristically seen in
a) Gout

b) Hyperkalemia

c) Hypoparathyroidism

d) Hyperparathyroidism

Correct Answer - D
Ans. is. D. Hyperparathyroidism
om
Acro-osteolysis is the term used to describe resorption of the distal
phalangeal tufts. Causes are : -
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1. Scleroderma
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2. Trauma & thermal injury

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3. Hyperparathyroidism
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4. Epidermalysis bullosa
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5. Arthropathy (RA, Psoriasis)

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6. Neuropathy (diabetes, syringomyelia

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[Link]
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17. Calcification of Intervertebral Disc is seen

in
a) Gout

b) Rheumatoid

c) Alkaptonuria

d) Psoriasis

Correct Answer - C
C i.e. Alkaptonuria
om
FeaturesDisease
Fish Mouth Vertebrae - Sickel Cell AnemiaQ
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HomocystinuriaQ
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Cod Fish Vertebra - Osteomalacia, Osteoporosis,

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(Biconcave vertebra) Hyperparathyroid

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Rugger jersey spine - CRF induced osteomalaciaQ

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(sclerosis of upper & - Osteopterosis (marbel bone

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lower spine borders) disease)

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Calcification of
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- Alkaptonuria (m.c.)
Intervertebral disc
Picture Frame vertebrae - Paget's disease
Vertebrae plana - Eosinophilic granulomaQ

[Link]
 [Link] [Link]

18. Schober's sign is for :

a) Flexion of lumbar spine

b) Chest expansion

c) Pain with motion of hip

d) Neck pain and stiffness

Correct Answer - A
A i.e. Flexion of lumber spine
Schober's test is measure of flexion on lumber spineQ. This test is
done in ankylosing spondylitisQ
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[Link]
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19. Bone within bone appearance is seen in?

a) CML

b) Osteoporosis

c) Osteopetrosis

d) Bone infarct

Correct Answer - C
C i.e. Osteopetrosis
In osteopetrosis, there is reduced osteoclastic bone resorption
resulting in diffuse symmetrical skeleton sclerosis. Also k/a marble
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bone disease d/t its stone like quality of bones; however the bones
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are abnormally brittle & fracture like a piece of chalk. It can present
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radiologically as?
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Sclerosis of all bones more prominent at base of skullQ.

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Sclerosis of vertebral end plate 1/t characteristic sandwitch or broad

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stripped (rugby jersey spine) Q Bone in bone appearanceQ d/t

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sclerotic foci within the bone.

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[Link]
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20. "Sunray appearance" on X-rays is

suggestive of:
a) A Chondrosarcoma

b) A metastatic tumour in the bone

c) An Osteogenic sarcoma

d) An Ewing's sarcoma

Correct Answer - C
C i.e. Osteogenic Sarcoma
om
Sunray appearance is classically seen in osteosarcoma. It may also
occur in metastases, Ewings sarcoma, Haemang oma, Meningioma
r.c

and tuberculosis.
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21. Inferior rib notching is seen in

a) Coarctation of aorta

b) Rickets

c) ASD

d) Multiple myeloma

Correct Answer - A
A i.e. Coarctation of aorta
Inferior rib notching in coarctation of aorta is d/t pressure erosion of
intercostal arteriesQ It usually takes several years to develop, so is
om

unusual before 10 years of age.

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22. Flask shaped heart is seen in following

except:
a) Ebstein anomaly

b) Pericardial effusion

c) TOF

d) TAPVC

Correct Answer - D
D i.e. TAPVC
om
Due to dilation of SVC (superior vena cava) & left vertical vein,
TAPVC (total anomalous pulmonary venous connection / return) of
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supra diaphragmatic variety shows double contour/ "Figger of 8"/

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Snowman configuration of cardiac silhouetteQ.

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[Link]
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23. Soap Bubble appearance in X-ray is seen

in
a) Multiple cystic Kidney

b) Neuroblastoma

c) Cystic lymphagiectasis

d) Meconium ileus

Correct Answer - D
D i.e. Meconium ileus
om
Soap bubble appearance in X ray is seen in meconium ileus due to
admixture of gas with meconium.
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[Link]
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24. Rim sign in IVP is seen in

a) Polycystic Kidney

b) Hydronephrosis

c) Chronic pyelonephritis

d) Hypernephroma

Correct Answer - B
B i.e. Hydronephrosis
Rim Sign in Nephrogram-
1. Severe hydronephrosis of the kidneys
om

2. Acute complete arterial obstruction

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25. The most accurate investigation for

assessing ventricular function is:
a) Multislice CT

b) Echocardiography

c) Nuclear scan

d) MRI

Correct Answer - B
B i.e. Echocardiography
om
Transthoracic echocardiography is the most commonly used cardiac
imaging examination after the chest X-ray and probably approaches
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the electrocardiogram in its clinical utility. It is harmless and

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relatively comfortable for the patient and is the first-line technique for
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evaluating most abnormalities of the cardiac chambers, valves and

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great vessels.
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Diagnotic Chest Transthoracic Transesophageal Nuclear Multislice

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utility X-ray echocardiogram echocardiogram medicine CT

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technique
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Anatomy
Myocardium+ ++ +++ + ++
Valves + ++ +++ 0 +
Coronaries 0 0 + 0 ++
Pericardium + + + 0 ++
Pulmonary +++ 0 0 0 +++
vessels
Calcification +++ + + 0 +++
Function
Myocardium++ ++ +++ ++ +
Valves + ++ +++ 0 +

[Link]
 [Link] [Link]

Valves + ++ +++ 0 +
Coronaries 0 0 + ++ ++
Limitations
Radiation
- 0 0 --
hazard
Risk/
0 0 -- - -
discomfort
Spatial -- -
resolution
Temporal - -
resolution
Operator
- --- -
skill
Cost --
+++ = Major utility; ++ = moderate utility, + = minor utility; 0 = no
utility/no limitations; - = minor limitation-- - = moderate limitation; - - -
major limitation
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26. In patient with high clinical suspicion of

pulmonary thromboembolism, best
investigation would be?
a) D-dimer

b) CT angiography

c) Catheter angiography

d) Color Doppler

Correct Answer - B
om

B i.e. CT angiography
r.c

Spiral or helical chest CT scan with intravenous contrast (CT

pulmonary angiography) is the principal imaging test for the
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diagnosis of pulmonary embolsmQ. It acquires image with < 1 m

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resolution and visualizes up to 6th order branches and small

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peripheral emboli with a resolution superior to conventional invasive

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contrast pulmonary angiography. It obtains excellent images of right

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& left ventricle and can be used for diagnosis as well as risk
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stratification. In patients with pulmonary embolism, RV enlargement

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indicates 5 times more likelihood of death within next 30 days.

Inadequate breath holding can impair the image quality b/o change
in arterial flow rates and motion artefact during breathing. The
advent of multidetector CT (MDCT) allows examination of whole
lung during single breath -hold. It is noninvasive.
Ventilation - perfusion lung scanning is now second line diagnostic
testa for PE, and mostly used in patients who cannot tolerate
intravenous contrast. Its utility is greatest when accompanied with a
normal chest x-ray implying that a ventilation - perfusion mismatch is
not due to parenchymal disease. High probability (>80%) scan have

[Link]
 [Link] [Link]

2 large segmental V-P mismatches (perfusion defects & normal

ventilation) with a normal chest radiograph. And very low probability
scans have microparticles (10 - 100 1.1 m) of Tc99 micro -
aggregate albumin (MAA) in patients lying supine. Ventilation
scintigraphy is performed by inhalating Krypton - 81, (best), Xenon
133, Tc99 - diethylenetriamine penta acetic acid (DTPA), or
technegas. Last two can't be administered during perfusion scan as
both are labelled with Tc99. Eight images (anterior, posterior,
obtique & lateral on both sides) are aquired.
Conventional pulmonary angiography: Non invasive CT with contrast
have virtually replaced invasive pulmonary angiography as a
diagnostic tool. However, it remains the gold standard testa.

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27. Investigation of choice for studying Renal

Cortical mass
a) 99 Tc DTPA

b) 53 Cr Study

c) 99 Tc DMSA

d) 99 Tc Pyrophosphate

Correct Answer - C
C i.e. 99 - Tc - DMSA
om
DTPA (Renogram) DMSA (Isotope Scanning)
- DTPA is freely filtered at - Tc.99 DMSA is used for renal
r.c

glomerulus with no morphological

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tubular reabsorption or
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(anatomic) imagine
excretion (i.e. GFR =
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- This compound gets fixed in renal

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Excretory function)
tubules & images
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- DTPA is useful for evaluating may be obtained after 1-2 hours of

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perfusion and injection. Lesions

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excretory function of each such as tumors & benign lesions as

kidneyQ cysts show filling
- Indications:defectQ
1. Measurement of relative - Used to assess cortical function of
renal KidneyQ and detect
functionQ in each [Link] scarringQ.
2. Urinary tract obstructionQ
3. Diagnosis of
Renovascular cause of
hypertensionQ

[Link]
 [Link] [Link]

4. Investigation of Renal
transplantQ

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28. Investigation of choice for screening of

proximal internal carotid artery stenosis is
:
a) Doppler flow USG

b) CT substraction angiography

c) MRI

d) Angiography (DSA)

Correct Answer - A
om

Answer is A (Doppler flow USG):

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'Stenosis at the origin of the internal carotid Artery can be identified

and quantified reliably by ultrasonography that combines B mode
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ultrasound image with a Doppler ultrasound assessment of flow

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velocity.'
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29. Roentgen is the unit of:

March 2010
a) Radioactivity

b) Radiation exposure

c) Absorbed dose

d) None of the above

Correct Answer - B
Ans. B: Radiation Exposure
om
The curie, named after scientist Marie Curie, is a unit of
measurement used to measure how radioactive an object is, or how
r.c

much radiation it produces.

ke

This is done by examining how fast its atoms disintegrate and

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measuring their disintegration per second.

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Roentgen, on the other hand, is a radiation unit that indicates

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how much radiation is present in the air of a specific

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environment.
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This is used to show how much radiation may be absorbed by

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standing in a particular place for a certain amount of time. One

roentgen of gamma- or X-ray exposure produces approximately 1
rad (0.01 gray) tissue dose.
More common than these two are the rad and the rem.
These two units can measure any type of ionizing radiation,
including alpha, beta, neutron, gamma and "X," and deal with how
much radiation is absorbed by objects.
Rad stands for "radiation absorbed dose."
One rad equals 100 ergs (an energy unit) absorbed by 1 g of
material.
Rads are used to show how much radiation any object,

[Link]
 [Link] [Link]

especially things like metal and stone, has absorbed. Rem (dose
equivalent)is a strictly biological measurement, and stands for
"roentgen equivalent man," meaning that it is the same essential
measurement as a roentgen, only applied to the human body,
although this works only with gamma and "X" types of radiation.
Rem is used to define limits of exposure for people who work in
nuclear power plants.
Rem is often divided in millirems and assigned a length of time, such
as millirems per hour.
Curie/ becquerel is the unit of radioactivity.

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30. Adder head appearance is seen in:

March 2011
a) Posterior urethral valve

b) Uretrocoele

c) Bladder tumour

d) Horse shoe kidney

Correct Answer - B
Ans. B: Ureterocoele
om
The 'adder head' on excretory urography is typical of ureterocoele
Ureterocele is a cystic dilatation of the distal ureter.
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Cobra head or Adder head appearance is diagnostic of ureterocele.

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Spider leg appearance in polycystic kidney.

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Ref: Bailey & Love, 25th Edition, Page 1290

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31. White line of Frenkel is seen in:

September 2008
a) Osteoporosis

b) Osteomalacia

c) Scurvy

d) Beri-Beri

Correct Answer - C
Ans. C: Scurvy
om
Clinical symptoms and signs of infantile scurvy, in order of frequency
are irritability, tenderness and weakness of lower extremities, a
r.c

scorbutic rosary of the legs, bleeding of the gums (usually where

ke

teeth have erupted), and fever.

an

Radiographic findings of scurvy:

tR

Dense metaphyseal line-This is due to an intensification of the zone

irs

of preparatory calcification, resulting from matrix formation failing, is

.F

has been referred to as the white line of Frenkel, but is non-specific,

w

as it is also seen in healing rickets, and lead or phosphorus

w
w

poisoning.
Ground glass osteoporosis: This appears at the end of the shaft with
blurring or disappearance of trabecular markings.
Halo ossification centre: Also called the Wimberger's ring, it is the
same effect that produces the white line of Frenkel, affecting the
epiphyseal ossification center.
Corner sign-Seen due to subepiphyseal infarction, or separation of
the epiphysis from the metaphysis.
Lateral spurs-These metaphyseal spurs project at right angles to the
axis of the shaft, they may be seen due to mushrooming of epiphysis
on the metaphysis, or may represent earliest calcification of

[Link]
 [Link] [Link]

periosteum elevated by a subperiosteal hemorrhage.

Subperiosteal hematomas-These occur at the end of long bones,
seen after about 2 weeks of onset of clinical symptoms; it is not the
periosteal hemorrhage that calcifies, but the elevated periosteum,
secondary to resumption of bone formation.
Metaphyseal fractures-Subperiosteal comminuted fractures at the
end of long bones, extending only partially through the width of the
bone.
Atrophy scurvy line-A radiolucent zone on the shaft side of Frenkel's
white line, it has been referred to as the Trummerfeld Zone.

om
r.c
ke
an
tR
irs
.F
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[Link]
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32. SI unit of radioactivity is:

March 2013 (c, f)
a) Rem

b) Rad

c) Becuerel

d) Curie

e) None
om

Correct Answer - C
Ans. C i.e. Becquerel
r.c

Old unit of radioactivity is Curie and new unit (SI) is Becquerel.

ke
an
tR
irs
.F
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[Link]
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33. CSF on MRI appears:

a) Hyperintense on T1 weighed image and hypointense on T2
weighed image

b) Hypointense on T1 weighed image and hyperintense on T2

weighed image

c) Hyperintense on T1 and T2 weighed images

d) Hypointense on T1 and T2 weighed images

Correct Answer - B
om

Ans. Hypointense on T1 weighed image and hyperintense on T2

r.c

weighed image
ke

Fluid- Edema, Urine, Bile, CSF- T1 weighted signal low & T2

weighted signal high
an
tR
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[Link]
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34. Best imaging modality in patients with

breast implants is:
a) MRI scan

b) CT scan

c) Mammography

d) Radionuclide scan

Correct Answer - A
Ans. MRI scan
om
It is the best imaging modality for the breasts of women with
implants.
r.c

MRI can be usefirl to distinguish scar from recurrence in women who

ke

have had previous breast conservation therapy for cancer

an
tR
irs
.F
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[Link]
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35. Well defined rounded opacity is the lung

with cause irregular calcification is a
feature of:
a) Hamartoma

b) Hydatid cyst

c) Amoebic abscess

d) Ca lung

Correct Answer - A
om

Ans. Hamartoma
r.c

Irregular central calcification (Popcorn calcification) is characteristic

of hamartoma.
ke
an
tR
irs
.F
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[Link]
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36. Commonly used type of radiation in

radiotherapy is:
a) Alpha rays

b) Beta rays

c) Gamma rays

d) X-rays

Correct Answer - C
Ans. Gamma rays
om
Radioiodine generates both beta and gamma rays but predominantly
beta rays.
r.c
ke
an
tR
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[Link]
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37. Radiation protection shields are made up

of:
a) Copper

b) Silver

c) Lead

d) Tin

Correct Answer - C
Ans. Lead
om
r.c
ke
an
tR
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[Link]
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38. The photosensitive material used in X-

rays films consist of:
a) Cellulose

b) Silver bromide

c) Zinc sulphide

d) Cadmium tungstate

Correct Answer - B
Ans. Silver bromide
om
After the image has been developed, the resultant image is then
fixed by a fixer (Hypo-sodium thiosulphate) which removes unused
r.c

silver halide, which would make the film appear milky or cloudy. X-
ke

ray film should be developed in dark room, otherwise light will spoil
an

the film (x-ray film has photosensitive silver bromide). Blue and
tR

green light are most sensitive whereas yellow and red light are least.
irs
.F
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[Link]
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39. Among the causes of rib notching are:

a) Coarctation of aorta

b) Congenital interruption of aorta

c) Chronic superior venacava obstruction

d) All of the above

Correct Answer - D
Ans. All of the above om
r.c
ke
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40. Thickness of lead apron to prevent

radiation:
a) 1 mm

b) 3 mm

c) 0.5 mm

d) 7 mm

Correct Answer - C
Ans. C. 0.5 mm
om
"It is recommended that for general purpose radiography the minimal
thickness of lead equivalent in the protective apparel should be
r.c

0.5mm."
ke

- Textbook of Radiology Physics p. 39

an

Lead apron of 0.5mm thickness reduce intensity of scattered X-rays

tR

by over 90%.
irs
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[Link]
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41. Hilar dance on fluoroscopy is seen in:

a) ASD

b) TOF

c) VSD

d) TGV

Correct Answer - A
Ans. ASD
Fluoroscopic examination done in a patient with ASD shows hilar
dance sign due to pulsation of central pulmonary artery.
om
r.c

CXR features of ASD:

ke

There is no enlargement of left atrium except in few cases of

an

Lutembacher syndrome.
tR

The heart in ASD is sometimes displaced to the left.

irs

The ascending aorta and its arch tends to appear smaller than
.F

normal, probably due to rotation of the ascending aorta by enlarged

w

right atrium and right ventricle causing sagittal alignment of the

w

aortic arch. Kerley B lines in a patient with ASD should always

w

suggest an associated mitral valve abnormality(Lutembacher

syndrome).
The Goose neck deformity is seen in ASD on cardioangiography.
Ref: Clinical Diagnosis of Congenital Heart Disease By M. Satpathy
page 78, Radiodiagnosis, Nuclear Medicine, Radiotherapy and
Radiation Oncology By Bipin Valchandji Daga page 139.

[Link]
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42. Half life of Technetium 99 is:

a) 2 hours

b) 6 hours

c) 12 hours

d) 24 hours

Correct Answer - B
Ans. 6 hours
Tc-99 - Technitium - 6 hours
Half life (tin) of radium (Ra226)is 1602-1626 years (longest)Q;
om

Cesium (137Cs) is 30 yearsQ; Cobalt (60Co)

r.c

is 5.2 yearsQ; iridium (1921r)is 74.5 daysQ; Iodine (P31)is 8

ke

daysQ; 1123 is 13 hoursQ; technitium (Tc99) is 6 hoursQ; and

an

1132 is 2.3 hoursQ.

tR
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[Link]
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43. Popcorn calcification is seen in:

a) Pulmonary hamartoma

b) Fungal infection

c) Metastasis

d) Tuberculosis

Correct Answer - A
Ans. Pulmonary hamartoma
Popcorn calcification
o Popcorn calcification is a cluster of sharply defined, irregularly
om

lobulated, calcification, usually in a pulmonary nodule.

r.c

o Popcorn calcification is characteristic of hamartoma on chest X-ray

ke

examination.
an

o It may also be seen in mediastinal lymph nodes of acute

tR

histoplasmosis.
irs

Egg-shell calcification
.F

o Egg-shell calcification means peripheral rim calcification of lymph

w

nodes:
w

o It is seen in:
w

N Silicosis (most common cause)

(vi) Histoplasmosis (vii) Tuberculosis
(ii) Coal worker
pneumoconiosis (v) Sarcoidosis (viii)
Coccidiodomycosis
(iii) Lymphoma following radiotherapy (vi) Progressive massive
fibrosis

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44. The principle used in radiotherapy is:

a) Cytoplasmic coagulation

b) Ionising the molecules

c) DNA damage

d) Low dose causes tissue necrosis

Correct Answer - C
Ans. DNA damage
Radiotherapy is the treatment of cancer with ionizing radiation.
It works by damaging the DNA within the tumor cells, making them
om

unable to divide and grow.

r.c

The goal of radiation therapy is to maximize the dose to tumor cells

ke

while minimizing exposure to normal, healthy cells.

an
tR

Ref: Emami B et al. 1991

irs
.F
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[Link]
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45. In a patient with renal cell carcinoma with

a thrombus in IVC renal vein, which is the
best investigation for diagnosis?
a) CT scan

b) Angiography

c) Colour doppler imaging

d) IVP

Correct Answer - A
om

Ans. CT scan
r.c

Investigation of choice in RCC-CT scan.

ke
an
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46. The X-ray view for supra orbital fissure is:

a) Towne's

b) Caldwell

c) AP

d) nasal

Correct Answer - B
Ans. Caldwell
Superior orbital fissure can also be seen on water's view, but best is
caldwell view.
om

"The superior orbital fissure can easily indentified and normally has
r.c

a slightly concave lateral appearacne"

ke

- Text book of oral radiology

an
tR
irs
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47. Which of the following techniques uses

piezoelectric crystals?
a) Ultrasonography

b) NMR imaging

c) X-ray diffraction

d) Xeroradiography

Correct Answer - A
Ans. Ultrasonography
om
Ultrasonography is based on piezoelectric effect.
MRI is based on gyeromagnetic property of proton (IP).
r.c
ke
an
tR
irs
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48. "String of beads" appearance on

horizontal abdominal view X-ray is
suggestive of:
a) Intussusception

b) Sigmoid volvulus

c) Small bowel obstruction

d) Large bowel obstruction

Correct Answer - C
om

Ans. Small bowel obstruction

r.c

String of beads sign is virtually diagnostic of small bowel obstruction

ke
an
tR
irs
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[Link]
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49. Puff of smoke appearance on cerebral

angiography is seen in:
a) ACA aneurysm

b) Cavernous sinus thrombosis

c) Moyamoya disease

d) Vein of Galen malformation

Correct Answer - C
Ans. c. Moyamoya disease
om
Moyamoya disease is an idiopathic, non inflammatory, non
atherosclerotic progressive vasculo-occlusive disease involving the
r.c

circle of Willis, typically the supraclinoid internal carotid arteries.

ke

Small abnormal net-like vessels proliferate giving the

an

characteristic "puff of smoke" appearance on direct

tR

angiography. CTA and MRA is not always able to demonstrate this

irs

appearance on account of lower flow and spatial resolution.

.F
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[Link]
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50. Which of the following is water soluble

contrast?
a) Barium

b) Iodine

c) Bromium

d) Calcium

Correct Answer - B
Answer-B. Iodine
om
Radiocontrast agents are typically iodine, barium-sulphate or
gadolinium based compounds.
r.c
ke
an
tR
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[Link]
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51. Solitary lytic lesions seen in

a) Atherosclerosis

b) Multiple myeloma

c) Mitral stenosis

d) Osteoblast

Correct Answer - B
Answer- B. Multiple myeloma
F: fibrous dysplasia (FD) or fibrous cortical defect (FCD)
O: osteoblastoma
om

G: giant cell tumor (GCT)

r.c

M: metastasis(es)/myeloma
ke

A: aneurysmal bone cyst (ABC)

an

C: chondroblastoma or chondromyxoid fibroma

tR

H: hyperparathyroidism (brown tumor)

irs

I: infection (osteomyelitis)
.F

N: non-ossifying fibroma (NOF)

w

E: enchondroma or eosinophilic granuloma (EG)

w

S: simple (unicameral) bone cyst

w

[Link]
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52. Confusion assessment scale used for

which of the following?
a) Schizophrenia

b) Delirium

c) Dementia

d) Depression

Correct Answer - B
Ans:B. Delirium
om
Confusion Assessment Method (CAM), a widely-used instrument
and diagnostic algorithm for identification of delirium.
r.c

The CAM instrument assesses the presence, severity, and

ke

fluctuation of 9 delirium features:

an

Acute onset
tR

Inattention
irs

Disorganized thinking
.F

Altered level of consciousness

w

Disorientation
w
w

Memory impairment
Perceptual disturbances
Psychomotor agitation or retardation
Altered sleep-wake cycle.
The CAM diagnostic algorithm is based on four cardinal
features of delirium:
Acute onset and fluctuating course
Inattention
Disorganized thinking
Altered level of consciousness.

[Link]
 [Link] [Link]

53. Hummingbird sign in brain MRI is seen in

?
a) Multiple sclerosis

b) Progressive supranuclear palsy

c) Parkinson's disease

d) Alzheimer disease

Correct Answer - B
Ans. is 'b' i.e., Progressive supranuclear palsy
om
[Ref Clinical neurology - 113]
Hummingbird sign on brain MRI is a radiological sign of progressive
r.c

supranuclear palsy.
ke
an
tR
irs
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[Link]
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54. Tigriod pattern on MRI is seen in -

a) Wilson's disease

b) Metachromatic leukodystrophy

c) Parkinsonism

d) GB syndrome

Correct Answer - B
Answer- B. Metachromatic leukodystrophy
It is characteristically seen in -
Metachromatic leukodystrophy
om

Pelizaeus-Merzbacher disease
r.c

Autosomal recessive spastic ataxia of charlevoix.

ke
an
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irs
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55. Which of the following is not a

contraindication of MRI
a) Cardiac pacemaker

b) Cochlear implant

c) Ryle's tube

d) Metallic splinter in eye

Correct Answer - C
Answer- C. Ryle's tube
om
Contraindications for MRI
A) Absolute
r.c

Electronically, magnetically, and mechanically activated implants.

ke

Ferromagnetic or electronically operated active devices like

an

automatic cardioverter defibrillators.

tR

Cardiac pacemaker
irs

Metallic splinters in the eye.

.F

Ferromagnetic haemostatic clips in the CNS.

w

B) Relative contraindications
w
w

Cochlear implants
Prosthetic heart valves
Other pacemakers, e.g., for Carotid sinus
Haemostatic clips
Insulin pumps and nerve stimulators
Non-ferromagentic stapedial implants
Lead wires or similar wires
Women with a first - trimester pregnancy

[Link]
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56. All are done to minimize radiation,

exposure to the patient under fluroscopy,
except
a) Decrease in field of view

b) Increasing the Kv of radiation

c) Decreasing fluroscopic time

d) Using low dose of radiation

Correct Answer - A
om

Answer- A. Decrease in field of view

r.c

Decreasing the field of view during fluroscopy increase the

radiation dose rate :-
ke

1. Field of view diameter 25 cm has dose rate 0.3 mGy/s

an

2. Field of view diameter 17 cm has dose 0.6 mGy/s

tR
irs
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57. Investigation of choice for soft tissue

sarcoma is -
a) CT

b) MRI

c) Ultrasound

d) X-ray

Correct Answer - B
Answer- B. MRI
om
"Any patient with a suspected STS should be referred to a diagnostic
centre for triple assessment with clinical history, imaging and biopsy.
r.c

Whilst the preferred method of imaging is MRI, other options

ke

including computerized tomography (CT) or ultrasound may be

an

appropriate depending on local expertise."

tR
irs
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58. Amount of radiation exposure in 1 CT-

scan of chest is
a) 1 mSv

b) 3 mSv

c) 5 mSv

d) 7 mSv

Correct Answer - D
Answer- D. 7 mSv
om
CT chest causes radiation exposure of 7mSv.
CT abdomen-pelvis causes radiation exposure of 10 mSv.
r.c

CT head causes radiation exposure of 2 mSv.

ke
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59. Which of the following is a late severe

adverse effect of radiation therapy
a) Nausea

b) Erythema

c) Anemia

d) Osteoradionecrosis

Correct Answer - D
Answer- D. Osteoradionecrosis
om
Osteoradionecrosis is a late complication of radiation while nausea,
erythema and anemia are early complications.
r.c
ke
an
tR
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60. Skyline view X-ray is useful in diagnosing

-
a) Patellofemoral problem

b) Radioulnars problem

c) Tibiofibular problem

d) Skull fracture

Correct Answer - A
Answer- A. Patellofemoral problem
om
A 'Skyline' or 'Sunrise' or 'sunset' or 'axial' or 'tangential' or 'mountain
view' gives most information about patellofemoral joint.
r.c
ke
an
tR
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61. Substance used for PET scan is

a) 18FPCT

b) Gadolinium

c) Gastrogarfin

d) Iodine

Correct Answer - A
Answer- A. 18FPCT
Fluorine-18-labeled 2Ali-carbomethoxy-3AY-(4-chloropheny1)-8-(-3-
fluoropropyl) nortropane (FPCT) has been synthesized as a new
om

dopamine transporter imaging agent.

r.c

Other substances used for PET scan are :

ke

1. FDG
an

2. 64Cu-ATSM (4Cu diacetyl-bis(N4-methylthiosemicarbazone)

tR

3. 18F-fluoride
irs

4. FLT (3'-deoxy-3'-[18F]fluorothymidine)
.F

5. FMISO (18F-fluoromisonidazole)
w

6. Gallium
w

7. Technetium-99m
w

8. Thallium

[Link]
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62. Sausage finger appearance is seen in -

a) Psoriatic arthritis

b) Rickets

c) Hyperthyroidism

d) Addison's disease

Correct Answer - A
Answer- A. Psoriatic arthritis
The common causes of sausage digit are :
Psoriatic arthropathy.
om

Ankylosing spondylitis
r.c

Tuberculosis
ke

Osteomyelitis.
an

Sickle cell disease

tR

Leprosy
irs
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63. Which common tracer in PET is usually

administered in the form of a glucose
sugar
a) Oxygen 15

b) Fluorine 18

c) Saccharide - 12

d) Aluminum - 12

Correct Answer - B
om

Answer- B. Fluorine 18
r.c

Fluorine-18 is used in the form of FDG in PET scan.

The most common tracer has a complicated name but is mostly
ke

known as FDG (which stands for 2-[18F]fluoro-2-deoxy-D-glucose).

an

The biologically active molecule most commonly used for PET is 2-

tR

deoxy-2-18F-fluoro-β-D-glucose (18F-FDG), an analogue of

irs

glucose, for early detection of tumors.

.F
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[Link]
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64. Investigation of choice for acute

subarachnoid hemorrhage is -
a) MRI

b) CT scan

c) Enhance MRI

d) Angiography

Correct Answer - B
Answer- B. CT scan
om
Investigation of choice for acute SAH - CT scan
Investigation of choice for chronic SAH - MRI
r.c
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65. Intraoperative radiotherapy is used in

a) Gastric cancer

b) Colon carcinoma

c) Pancreatic carcinoma

d) All of the above

Correct Answer - D
Answer- D. All of the above
Intraoperative radiotherapy can be used In -
1. Pancreatic carcinoma
om

2. Retroperitoneal sarcomas
r.c

3. Gastric carcinoma
ke

4. Genitourinary cancers
an

5. Colorectal carcinoma
tR

6. Brain tumor
irs

7. Head & Neck cancers

.F

8. Some gynecological malignancies

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66. Precisely directed high dose radiation is

used in
a) IMRT

b) EBRT

c) Stereotectic radiosurgery

d) None of the above

Correct Answer - A
Answer- A. IMRT
om
Intensity modulated radiation therapy (IMRT) is an advanced mode
of high precision radiotherapy that utilizes computer controlled X-ray
r.c

accelerators to deliver precise radiation doses to a malignant tumour

ke

or specific areas within the tumour.

an
tR
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67. Epidural hematoma on CT scan shows -

a) Crescent shaped hyperdense lesion

b) Biconvex hyperdense lesion

c) Biconcave hyperdense lesion

d) Crescent shaped hypodense lesion

Correct Answer - B
Answer- B. Biconvex hyperdense lesion
Acute extradural (epidural) hematoma is biconvex hyperdense or
mixed density lesion.
om

Extradural (epidural) hematoma appearance radiolgically :-

r.c

Biconvex (lens shaped or lenticular)

ke

In Acute cases 4 Hyperdense (2/3) or mixed density (1/3).

an

In chronic cases 4 Hypodense

tR
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68. Not used for internal radiotherapy

a) Iodine-125

b) Iodine-131

c) Cobalt-60

d) Iridium-192

Correct Answer - B
Answer- B. Iodine-131
lsotpes used for internal radiotherapy (brachy therapy)
A) Interstitial brachytherapy
om

Permanent implants of interstitial brachytherapy :- Cesium - 131,

r.c

Yttrium, Gold - 198 (Au - 198), 125I, Radon - 222 (Rn - 222),
ke

Pallidum - 103 (Pd - 103).

an

Temporary implants of Interstitial brachytherapy :- Iridium - 192 (Ir -

tR

192), Cesium - 137 (Cs - 137), Cobalt - 60 (Co -60), Californium,

irs

Radium - 226 (Ra - 226), Tantolum.

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[Link]
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69. Radioiodine generates which type of

radiation
a) X-rays

b) Alpha and beta rays

c) Beta and gamma rays

d) Alpha and beta rays

Correct Answer - C
Answer- C. Beta and gamma rays
om
Radioiodine generates both beta and gamma rays but predominantly
beta rays.
r.c
ke
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70. Radioactive iodine is administered

through which route
a) Intravenous

b) Subcutaneous

c) Oral

d) All of the above

Correct Answer - D
Answer- D. All of the above
om
Radioactive iodine is administered orally as well as parentrally i.e.
IV, SC & IM.
r.c
ke
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71. Investigation of choice for acute

intracerebral hemorrhage is -
a) NCCT

b) MRI

c) PET scan

d) None of the above

Correct Answer - A
Answer- A. NCCT
om
"NCCT remains the main stay of emergency imaging of stroke in
order to exclude intracranial hemorrhage".
r.c

"In investigation of stroke with delayed presentation gradient-echo

ke

MRI is the investigation of choice for exclusion of old hemorrhage".

an
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irs
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72. "Tree in bud appearance" on CT is seen

in
a) Pulmonary tuberculosis

b) Silicosis

c) Pulmonary hydatid cyst

d) Small cell carcinoma

Correct Answer - A
Answer- A. Pulmonary tuberculosis
It is usually visible on standard CT, however, it is best seen on HRCT chest.
om

Typically the centrilobular nodules are 2-4 mm in diameter and peripheral, within 5 mm of
r.c

the pleural surface.

ke

The connection to opacified or thickened branching structures extends proximally

an

(representing the dilated and opacified bronchioles or inflamed arterioles)

tR

Associated CT findings of bronchiolitis are seen in about 70% of patients with

irs

bronchiectasis. Small centrilobular nodular and linear branching opacities (tree-in-bud sign)
.F

express inflammatory and infectious bronchiolitis

w

Pathogenesis-
w

The tree-in-bud sign occurs as a result of a number of processes, although often they co-
w

exist in the same condition:

a. bronchioles filled with pus or inflammatory exudate
e.g. pulmonary tuberculosis, aspiration bronchopneumonia

b. bronchiolitis: thickening of bronchiolar walls and bronchovascular bundle

e.g. cytomegalovirus pneumonitis, obliterative bronchiolitis

c. bronchiectasis with mucus plugging

e.g. cystic fibrosis

d. tumor emboli to centrilobular arteries (or carcinomatous endarteritis)

e.g. breast cancer, stomach cancer

[Link]
 [Link] [Link]

e. bronchovascular interstitial infiltration

e.g. sarcoidosis, lymphoma, leukemia

om
r.c
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an
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irs
.F
w
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[Link]
 [Link] [Link]

73. Investigation of choice to evaluate

intracranial hemorrhage of less than 48
hours is -
a) CT scan

b) MRI

c) PET

d) SPECT

Correct Answer - A
om

Answer- A. CT scan
r.c

Primary procedure of choice for evaluating intracranial complications

of acute head injury 4 CT scan.
ke

Best modality for assessing fractures of the skull base, calvarium

an

and facial bone 4 CT scan.

tR

Investigation of choice for demyelinating disorders 4 MRI.

irs
.F
w
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[Link]
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74. Investigation of choice for lung abscess

is
a) Chest X-ray

b) CECT scan

c) MRI

d) Ultrasound

Correct Answer - B
Answer- B. CECT scan
om
Contrast enhanced CT in usually considered to be investigation of
choice for lung abscess, showing a cavity with thick walls and
r.c

central mobile fluid. It helps to differentiate abscess from empyma,

ke

necrotizing pneumonia, sequestration, pneumatocele or underlying

an

congenital abnormalities such as bronchogenic cyst.

tR
irs
.F
w
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[Link]
 [Link] [Link]

75. CT of gastric Volvulus shows -

a) Shortened twisted stomach

b) Enlarged twisted stomach

c) Normal twisted stomach

d) None of the above

Correct Answer - B
Answer- B. Enlarged twisted stomach
CT scan of gastric Volvulus shows enlarged twisted stomach in
thorax with one or more sites of torsion. It is useful in showing the
om

sites of ischemia.
r.c
ke
an
tR
irs
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w
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[Link]
 [Link] [Link]

76. On CT chest 'halo sign' is noted in

a) Pulmonary hydatid cyst

b) Invasive pulmonary aspergilossis

c) Round pneumonia

d) Bronchiectasis

Correct Answer - B
Answer- B. Invasive pulmonary aspergilossis
The halo sign (HS) in chest imaging is a feature seen on lung
window settings (typically HRCT), ground glass opacity surrounding
om

a pulmonary nodule or mass and represents hemorrhage.

r.c

It is typically seen in angioinvasive aspergillosis.

ke
an
tR
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.F
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77.

om
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an
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[Link]
 [Link] [Link]

A 50 year old male presents with fever and

malaise for 4 months& pain in the knees and
ankles. Blood tests are normal apart from a
raised ESR. Chest x-ray shows bilateral hilar
adenopathy and pulmonary infiltrates most
severe in the upper and mid zones. Mantoux
test is negative. What is the most likely
diagnosis
a) Tuberculosis

b) Sarcoidosis

c) Asbestosis
om
r.c

d) Berylliosis
ke
an
tR
irs

Correct Answer - B
.F

Answer- B. Sarcoidosis
w
w

Sarcoidosis is the most likely diagnosis given the presentation with

w

malaise, arthralgia and a chest x-ray showing bilateral hilar

adenopathy.
"The characteristic radiological finding in patients with pulmonary
sarcoidosis is bilateral hilar lymphadenopathy"

[Link]
 [Link] [Link]

78. Ultrasonographic finding of autosomal

recessive polycystic kidney disease
[ARPKD] are all except
a) Cysts more than 2 cm

b) Corticomedullary differentiation is eventually lost

c) Enlarged kidney

d) Oligohydramnios

Correct Answer - A
om

Answer- A. Cysts more than 2 cm

r.c

On antenatal ultrasound associated oligohydramnios may be

identified
ke

Cysts
an

Initially too small to resolve but with time may become discernible
tR

Unlike ADPKD the cysts rarely exceed 1-2 cm in diameter

irs

The kidneys appear enlarged and echogenic but usually retain a

.F

reniform shape
w
w

Medullary pyramids
w

[Link]
 [Link] [Link]

79. 22-year-old women presents to the

emergency department with a chief
complaint of severe left upper quadrant
[LUQ] pain after being punched by her
husband. Her blood pressure is 110/76,
her pulse is 80 bpm, and her respiration
rate is 24 breaths per minute. The best
means to establish a diagnosis is which of
the following ?
a) Four-quadrant tap of the abdomen

b) CT of the abdomen
om

c) Peritoneal lavage
r.c
ke
an

d) Upper gastrointestinal [GI] series

tR
irs
.F
w

Correct Answer - B
w

Answer- B. CT of the abdomen

w

Clinical picture of the patient in above question indicates that patient

is hemodynamically stable. Therefore best mode of evaluation
should be CT scan of abdomen to see the extent of injury.
If the patients is hemodynamically stable and can be shifted - CT
scan

[Link]
 [Link] [Link]

80. A 35 year-old female presented to the

emergency department with the sudden
onset of severe epigastric pain. She had a
history of heart burn and dyspeptic
symptoms for past 10 years. On physical
exam, she had a temperature of 101.4°F, a
pulse of 118 and a blood pressure of
128/72. Abdomen was tender & rigid.
Expected finding on X-ray will be
a) Blood under diaphragm

b) Air under diaphragm

om

c) Hazy lung fields

r.c
ke
an

d) Prominent markings
tR
irs
.F
w

Correct Answer - B
w

Answer- B. Air under diaphragm

w

Above clinical picture is suggestive of perforated peptic ulcer, Which

is the most common cause of pneumoperitoneum (air under
diaphragm).
Perforation results in pneumoperitoneum and the best view to see
pneumoperitoneum is chest x-ray in erect position which detects air
under the domes of diaphragm.

[Link]
 [Link] [Link]

81. Following X-ray finding is associated with

Chilaiditi syndrome -
a) Pseudopneumoperitoneum

b) Pseudopneumothorax

c) Pneumothorax

d) Hydropneumothorax

Correct Answer - A
Answer- A. Pseudopneumoperitoneum
om
Chilaiditi syndrome is the anterior interposition of the colon (usually
tranverse colon) to the liver reaching the under-surface of the right
r.c

hemidiaphragm with associated upper abdominal pain.

ke

It is one ofthe causes ofpseudopneumoperitoneum

an
tR
irs
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w
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[Link]
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82. A 50 year-old chronic alcoholic male

patient, after a large binge of alcohol,
presented to the emergency department in
subconscious state. He vomited several
times, few of them mixed with blood. He
had a history of heart burn and dyspeptic
symptoms for past few tears. On physical
exam, he had a temperature of 102°F, a
pulse of 110, respiratory rate of 20 per
minute and a blood pressure of 90/60. On
physical examination there was
abdominal guarding and tenderness. A
plane erect chest X-ray reveals air under
om

diaphragm. Probable diagnosis is

r.c
ke
an

a) Perforated peptic ulcer

tR
irs

b) Acute MI
.F
w
w

c) Dissected abdominal aorta

w

d) None of the above

Correct Answer - A
Answer- A. Perforated peptic ulcer
History of heart burn and dyspepsia, acute onset of bloody vomiting
after binge alcohol, general and physical examination findings and
air under diaphragm on chest X-ray, all these indicate towards the
perforation of peptic ulcer.

[Link]
 [Link] [Link]

perforation of peptic ulcer.

om
r.c
ke
an
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w
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[Link]
 [Link] [Link]

83. Ring enhancing lesion on CT is a feature

of
a) Toxoplasmsis

b) Intracranial hemorrhage

c) Cysts

d) Hamartoma

Correct Answer - A
Answer- A. Toxoplasmsis
om
Ring enhancing brain lesions
1. Neoplasms :- High grade glioma, meningioma, lymphoma, acoustic
r.c

schwannoma, craniopharyngioma, metastasis.

ke

2. Abscess :- Pyogenic, tuberculoma, toxoplasmosis, cysticercosis,

an

empyema.
tR

3. Hemorrhagic - ischemic lesion :- Resolving infarction, Aging

irs

hematoma, operative bed following resection.

.F

4. Demyelinating disorder
w
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[Link]
 [Link] [Link]

84. About lipoma, radiologically true is -

a) Low attenuation on CT

b) Anechoic on US

c) Hypo-intense on T1 -MRI

d) Hypo-intense on T2-MRI

Correct Answer - A
Answer- A. Low attenuation on CT
Lipomas are benign fat tumors which show
Variable echos on US
om

Hyper-intense shadows on both T1 & T2 MRI

r.c

Low attenuation on CT.

ke
an
tR
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[Link]
 [Link] [Link]

85. USG is done to visualize all except -

a) Fluid

b) Bile

c) Blood flow

d) Bone

Correct Answer - D
Answer- D. Bone
USG is done to visualize soft tissues and fluids. But not for bone.
om
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[Link]
 [Link] [Link]

86. Regarding HRCT, all are true except -

a) Means high reconstruction CT imaging

b) Has narrow beam collimation

c) Investigation of choice for interstitial lung disease

d) Has small field of vision

Correct Answer - A
Answer- A. Means high reconstruction CT imaging
Principles of HRCT (High resolution CT) are :
1. Narrow beam collimation (Thin collimation)
om

2. High frequency reconstruction algorythm, e.g., bone algorithm

r.c

3. Small field of vision

ke
an
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[Link]
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87. All of the following are true about neutron

contrast study except -
a) Provides spatial resolution

b) Hydrogen and boron have high neutron cross section

c) Allows visualization of light elements inside heavy metallic

objects

d) Is an example of destructive testing

Correct Answer - D
om
Answer- D. Is an example of destructive testing
Neutrons interact with matter in a way that is quite complementary to
r.c

X-rays, and so neutron imaging and neutron radiography are

ke

important techniques for non-destructive testing, most suited for

an

visualization of light elements in the interior of (heavy) metallic

tR

objects.
irs

Examples of high absorption cross- section materials include

.F

hydrogen and boron while iron has lower neutron cross-section.

w
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[Link]
 [Link] [Link]

88. In normal X-ray of shoulder which is

superior most structure -
a) Greater tubercle

b) Surgical neck of humerus

c) Coracoid process

d) Head of humerus

Correct Answer - C
Answer- C. Coracoid process
om
From superior to inferior (important structure on X-ray sholder) :-
Clavicle : Acromian : Coracoid : Superior margin of humeral head :
r.c

greater tubercle : anatomical neck : surgical neck.

ke
an
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89. Maximal valve of HU Unit -

a) Water

b) Fat

c) Soft tissue

d) Bone

Correct Answer - D
Answer- D. Bone
Bone has maximum HU → +1000
om
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ke
an
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[Link]
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90. Piezoelectric crystal most widely used in

ultrasonography probes is -
a) Quartz

b) Molybdenum

c) Titanium

d) Lead zircona tetitanate

Correct Answer - D
Answer- D. Lead zircona tetitanate
om
Lead zirconate titanate (PZT) is the most widely used material in the
ultrasound transducers / probes replacing the firstly discovered
r.c

barium titanate.
ke
an
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irs
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w
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[Link]
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91. Most sensitive investigation for minimum

gas in abdomen is -
a) Chest X-ray AP View

b) CT Scan

c) X-ray abdomen in supine position

d) X-ray abdomen in erect position

Correct Answer - B
Answer- B. CT Scan
om
CT Scan is superior to plain radiographs in detection of minute
quatities of pneumoperitoneum
r.c

Thus CT Scan is regarded as the most sensitive investigation for

ke

detection of minute quantities of intraperitoneal gas.

an

Best radiographic view for pneumoperitoneum is Chest x-ray. It is

tR

usually the first investigation of choice.

irs
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[Link]
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92. Cotton wool skull is a radiological feature

of -
a) Pagets disease

b) Eosinophilic granuloma

c) Fibrous dysplasia

d) Fibrous dysplasia

Correct Answer - A
Answer- A. Pagets disease
om
Cotton wool skull-Paget's disease
Groundglass skull- Fibrous dysplasia
r.c

Punched out/Raindrop lesion of skull- Multiple myeloma

ke

Geographic skull- Eosinophilic granuloma

an
tR
irs
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93. The most sensitive imaging modality for

diagnosis of ureteric stone in patient with
acute renal colic is -
a) X ray KUB

b) USG

c) Non contrast CT abdomen

d) Contrast enhanced CT abdomen

Correct Answer - C
om

Answer- C. Non contrast CT abdomen

r.c

Non-contrast spiral CT has now become the investigation of choice

to diagnose renal and ureteric stones.
ke

Investigation of choice for renal and ureteric stones non - contrast

an

spiral CT
tR
irs
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94. Radiological features of coarctation of

aorta is/ are -
a) Reverse figure of 3 sign

b) Dock sign

c) Double aortic knuckle

d) All of the above

Correct Answer - D
Answer- D. All of the above
om
Radiological signs of COA are : i) Reverse figure of 3 sign (double
bulge sign or E sign), ii) Dock's sign; iii) Double aortic knuckle.
r.c

Globular heart with oligemic lung fields

ke

Reverse figure of '3' sign

an

Double aortic knuckle

tR
irs
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[Link]
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95. Eye of tiger appearance is seen in -

a) Halle vorden Spatza

b) Suparanuclear palsy

c) Levodopa-responsive

d) All

Correct Answer - D
Answer- D. All
This appearance can be seen in:
1. Hallervorden-Spatz syndrome: classical but not 100%
om

pathognomonic
r.c

2. Progressive supranuclear palsy

ke

3. Early-onset levodopa-responsive parkinsonism

an

4. Cortical-basal ganglionic degeneration

tR
irs
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[Link]
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96. Following are suggestive of benign lesion

on mammogram -
a) Macrocalcification

b) Floating calcification

c) Tramline calcification

d) All the above

Correct Answer - D
Answer- D. All the above
om
Calcification patterns in benign lesions of breast on
mammography:
r.c

1. Macrocalcification
ke

2. Popcorn (in fibroadenoma)

an

3. Rod like wide-spread

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4. Egg shell curvilinear

irs

5. Tramline / tortous
.F
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[Link]
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97. Anamoly scan done at how many weeks

of gestation -
a) 14

b) 16

c) 18

d) 20

Correct Answer - D
Answer- D. 20
om
Anamoly Scan is done between 18-21 weeks of pregnancy. It is also
called as mid pregnancy or 20-week scan.
r.c
ke
an
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98. Flowing wax appearance on anterior and

posterior borders of vertebrae is seen in -
a) Ankylosing spondylitis

b) DISH

c) Psoriatic arthropathy

d) Rheumatoid arthritis

Correct Answer - B
Answer- B. DISH
om
Diffuse idiopathic skeletal hyperostosis : DISH (hyperostotic
spondylosis, Forestier's disease) is a multifocal entity of older people
r.c

characterized by 'flowing ossifications of the spine" involving four or

ke

more contiguous vertebrae and hyperostosis of some ligamentous

an

attachments.
tR
irs
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99. Radiological view which best shows

maxillary sinus and orbit is -
a) Water's view

b) Caldwell view

c) Lateral view

d) Towne view

Correct Answer - A
Answer- A. Water's view
om
Best view for maxillary sinus → Water's view (occipito-mental view)
Best view for frontal sinus → Caldwell view (occipito-frontal view)
r.c

Best view for sphenoid sinus → Basal view (submentovertical view)

ke
an
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100. Best view for sphenoid sinus is -

a) Water's view

b) Caldwell view

c) Basal view

d) Towne's view

Correct Answer - C
Answer- C. Basal view
Best view for maxillary sinus → Water's view (occipito-mental view)
Best view for frontal sinus → Caldwell view (occipito-frontal view)
om

Best view for sphenoid sinus → Basal view (submentovertical view)

r.c
ke
an
tR
irs
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101. Following are the indications of barium

meal X-ray except -
a) Duodenal ulcer

b) Carcinoma stomach

c) Carcinoma head of pancreas

d) Ischemic Colitis

Correct Answer - D
Answer- D. Ischemic Colitis
om
Indications for Barium meal X-ray
Duodenal ulcer
r.c

Periampulary carcinoma
ke

Psendocyst of pancreas
an

Carcinoma stomach
tR

Chronic duodenal ileus

irs

Carcinoma head of pancreas

.F

Duodenal diverticula
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w
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[Link]
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102. In a children ectopic kidneys can be

diagnosed by -
a) DTPA

b) DMSA

c) MAG 3

d) None of the above

Correct Answer - B
Answer- B. DMSA
om
Indications for static renal scintigraphy (Tc - 99m - DMSA) :
1. Assessment of reflux nephropathy (scars)
r.c

2. Space occupying lesions (cortical mass)

ke

3. Investigation of horse shoe, solitary or ectopic kidney

an
tR
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103. First line investigation for deep venous

thrombosis is -
a) Ultrasonography

b) Venography

c) MRI

d) Nuclear imaging

Correct Answer - A
Answer- A. Ultrasonography
om
Ultrasonography is the current first-line imaging examination for DVT
because of its relative ease of use.
r.c
ke
an
tR
irs
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104. Which of the following is not a chest

radiographic feature of left atrial
enlargement?
a) Double left heart border

b) Elevated left main bronchous

c) Splaying of carina

d) Enlargement of left atrila appendage

Correct Answer - A
om

Answer- A. Double left heart border

r.c

Sings of left atrial enlargement

Straightening of left heart border (due to enlargement of left atrial
ke

appendage).
an

Elevation of left main bronchus with widening (Splaying) of carina.

tR

Double density (atrial) sign.

irs

Posterior displacement of esophagus on barium swallow.

.F
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[Link]
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105. HRCT features of interstitial pneumonia

are all except -
a) Reticular opacities

b) Honeycombing

c) Ground glass opacities

d) No bronchieactatic features

Correct Answer - D
Answer- D. No bronchieactatic features
om
Classical HRCT features of interstitial pneumonia are:
1. Reticular opacities in basal and peripheral distribution.
r.c

2. Traction bronchiestasis.
ke

3. Honeycombing (clustered airspaces 3-10mm diameter/in subpleural

an

location.
tR
irs
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106. Following are the causes of cavity in

lungs except -
a) Staphylococcus

b) Wegeners

c) Hydatid

d) Sarcoidosis

Correct Answer - D
Answer- D. Sarcoidosis
om
Causes of lung cavities are :
1) Necrotizing infections
r.c

2) Vascular : Pulmonary infarction.

ke

3) Neoplastic :
an

1. Carcinoma bronchus :- Especially squamous cell carcinoma.

tR

2. Metastases
irs

3. Lymphoma
.F

4) Granulomas :- Wegener's granulomatosis, Rheumatoid arthritis

w

(also Kaplan's syndrome)

w
w

5) Abnormal lung :- Infected emphysematos bulla, sequestrated

segment, bronchogenic cyst.
6) Traumatic :- Haematoma

[Link]
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107. Beaded lumen with fimbrial fluid is seen

in -
a) TB of fallopian tube

b) TB of endometrium

c) TB of Ovary

d) None

Correct Answer - A
Answer- A. TB of fallopian tube
om
Fallopian tube is the most common site of female genital tract which
is affected in tuberculosis.
r.c

On hysterosalpingography, the fallopian tube often show ragged

ke

outlines with multiple strictures, giving a beaded appearance; in

an

some patients the entire tube appears rigid and may exhibit small
tR

terminal sacculation of the ampullary end.

irs
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108. Following are radiological findings in

rheumatoid arthritis except -
a) Symmetrical involvement

b) Juxta-articiular osteopenia

c) Marginal erosion

d) Subchondral sclerosis

Correct Answer - D
Answer- D. Subchondral sclerosis
om
Rheumatoid arthritis
Bilateral symmetrical involvement
r.c

Marginal erosion
ke

Ankylosis
an

Periarticular soft tissue swelling

tR

Subchondral cysts
irs

Subluxation or dislocation
.F

Juxta - articular osteopenia

w

Narrowing of joint space (Later)

w
w

Arthritis multilans (late)

[Link]
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109. Which of the following is/are radiological

features of fluorosis?
a) Osteosclerosis

b) Cortical thickening

c) Enthesopathy

d) All the above

Correct Answer - D
Answer- D. All the above
om
Radiological features of fluorosis are :
Osteosclerosis - particularly affecting the axial skeleton.
r.c

Cortical thickening with encroachment on medullary cavity.

ke

Enthesopathy with ligamentous ossification.

an

Large spinal osteophytes.

tR
irs
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110. Depth of gastric carcinomas is assessed

by -
a) Abdominal ultrasound

b) Barium meal

c) Endoluminal ultrasound

d) Laproscopy

Correct Answer - C
Answer- C. Endoluminal ultrasound
om
Five layers of the gastric wall can be identified by endoluminal
ultrasound and the depth of invasion of tumor can be assessed by
r.c

exquisite accuracy.
ke
an
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111. Radiological signs of acute pancreatitis

on plain radiography are -
a) Sentinel loop sign

b) Colon cut off sign

c) Renal halo sign

d) All the above

Correct Answer - D
Answer- D. All the above
om
Radiological features of acute pancreatitis :-
1. Air in duodenal C-loop
r.c

2. Colon cut off sign

ke

3. Gasless abdomen
an

4. Sentinal loop sign

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5. Renal Halo sign

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112. Most sensitive investigation for Diffuse

axonal injury is -
a) MRI

b) CT

c) X ray

d) PET scan

Correct Answer - A
Answer- A. MRI
om
MRI is the most sensitive investigation for diffuse axonal injuries.
It shows multiple small faces of increased intensity on T,IAT and
r.c

decreased intensity on Ty.

ke
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113. Most common view used for X-ray chest

-
a) PA view

b) AP view

c) Lateral view

d) Oblique view

Correct Answer - A
Answer- A. PA view
om
Important views for chest x-ray are :
1. Posterior - anterior view (PA view)
r.c

2. Anterior - posterior view (AP view)

ke

3. Lateral view
an

4. Lateral decubitus view

tR
irs
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114. Best investigation for bone metastases

is -
a) MRI

b) CT

c) Bone Scan

d) X Ray

Correct Answer - C
Answer- C. Bone Scan
om
Bone scan (scintigraphy) is the investigation of choice for bone
metastasis.
r.c
ke
an
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115. Double track sign is seen in -

a) Duodenal atresia

b) CHPS

c) Gastric ulcer

d) Achalasia

Correct Answer - B
Answer- B. CHPS
Double/triple track sign is seen in congenital hypertrophic pyloric
stenosis.
om
r.c
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116. Half life of Ra-226 -

a) 8 days

b) 28 years

c) 16-22 years

d) 38 years

Correct Answer - C
Answer- C. 16-22 years
Half life of Ra-226 is 16-22 years.
om
r.c
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117. Which view is taken for aortic window -

a) AP

b) LAO

c) RAO

d) LPO

Correct Answer - B
Answer- B. LAO
`A left anterior oblique (LAO) view is useful to assess thoracic aorta,
aortic window and the chamber of heart".
om

Clinicalradiology
r.c

Aortic window is the space between ascending and descending

ke

thoracic aorta.
an
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irs
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118. The primary diagnostic evaluation for

developmental dyslasia of hip is -
a) Clinical examination

b) X-ray

c) USG

d) CT Scan

Correct Answer - C
Answer- C. USG
om
Ultrasonography is now the primary imaging technique in the
diagnosis and follow up of DDH and has been shown to be more
r.c

accurate than clinical and radiological assessment with a sensitivity

ke

of 100% and specificity of 98%.

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119. Investigation of choice for pancoast

tumor is -
a) MRI

b) HRCT

c) CECT

d) Bronchography

Correct Answer - A
Answer- A. MRI
om
Radiological investigation of choice for pubnonary malignencies is
CT scan excep in superior sulcus (pancoast tumor) where MRI is
r.c

preferred.
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120. Doppler effect results from change in -

a) Amplitude of sound

b) Frequency of sound

c) Direction of sound

d) None of the above

Correct Answer - B
Answer- B. Frequency of sound
The Doppler effect results from an apparent shift in sound frequency
as sound wave are reflected from moving targets, usually blood
om

cells.
r.c

If motion is toward the transducer, the frequency of returning echo is

ke

higher that of the transmitted sound.

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121. X-ray Artifact is -

a) A radiolucent area

b) Any abnormal opacity in the radiograph

c) Produced when patient moves while taking the shoot

d) All the above

Correct Answer - C
Answer- C. Produced when patient moves while taking the
shoot
Artifacts can present in a variety of ways including abnormal shadow
om

noted on a radiograph or degraded image quality and have been

r.c

produced by artificial means from hardware failure, operator error

ke

and software (post-processing) artifacts.

an

Common causes :-
tR

Improper handling of the films

irs

Errors while processing the films

.F

Patient movement while taking the shoot

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[Link]
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122. Frequency of ultrasound waves in USG -

a) 2000 Hz

b) 5000 Hz

c) < 2 MHz

d) >2 MHz

Correct Answer - D
Answer- D. >2 MHz
The ultrasound machine emits high-frequency sound waves, ranging
from 2-15 MHz. Whose frequencies are considerably above the
om

upper limit of human ear's audible range, i.e., greater than 20000
r.c

Hz. Speed of these sound waves in the body is 1540 m/s (in
ke

comparison to air, where velocity of sound wave is 330m/s).

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123. Gyromagnetic property of proton is seen

in -
a) MRI

b) CT

c) PET scan

d) USG

Correct Answer - A
Answer- A. MRI
om
Ultrasonography is based on piezoelectric effect.
MRI is based on gyeromagnetic property of proton W9.
r.c
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124. Enhancement in CT contrast is due to -

a) Iodine

b) Gadolinium

c) Silver

d) Mercury

Correct Answer - A
Answer- A. Iodine
Iodinated contrasts are the most commonly used radiocontrast
media in radiography and CT.
om

Gadolinium is the most commonly used MR contrast agent.

r.c
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125. Which delivers highest dose of radiation

-
a) Cardiac perfusion scan

b) CT chest

c) CT brain

d) Mammogram

Correct Answer - A
Answer- A. Cardiac perfusion scan
om
Medical diagnostic imaging is a major source of radiation exposure
to clinitians and the patients. Following table depicts the radiation
r.c

exposure through the routine medical imaging.

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126. Best view for collapse of middle lobe

lung is -
a) Lateral

b) AP

c) Oblique

d) Lordotic

Correct Answer - D
Answer- D. Lordotic
om
The lordotic view is also useful for recognizing collapse of lingula or
middle lobe when these areas become very thin and cast minimal
r.c

shadow on the PA view.

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127. Double shadow behind right atrium and

straightening of left main bronchus
indicates -
a) Right atrium enlargement

b) Right ventricle enlargement

c) Left atrium enlargement

d) Left ventricle enlargement

Correct Answer - C
om

Answer- C. Left atrium enlargement

r.c

Left atrium enlargement

Ref Sutton 7h/e p. 280-350]
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128. Left atrial enlargement is seen in -

a) Mitral stenosis

b) Tricuspid regurgitation

c) AR

d) None

Correct Answer - A
Answer- A. Mitral stenosis
Due to left atrial enlargement :- Straightening of left heart border,
elevation of left main bronchus with widening of carina, double atrial
om

shadow (Double density sign), posterior displacement of esophagus

r.c

on barium swallow, Prominent posterosuperior part of cardiac

ke

shadow.
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129. Air bronchogram on chest Xray denotes

-
a) Intrapulmonary lesion

b) Extrapulmonary lesion

c) Intrathoracic lesion

d) Extrathoracic lesion

Correct Answer - A
Answer- A. Intrapulmonary lesion
om
Air in bronchi is visualized it is called air bronchogram. Air
bronchogram indicates intrapulmonary pathology, It excludes any
r.c

pleural or mediastinal pathology.

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130. Calcified pulmonary metastasis is seen

in which carcinoma -
a) Pancreatic carcinoma

b) Thyroid carcinoma

c) Endometrial carcinoma

d) None

Correct Answer - B
Answer- B. Thyroid carcinoma
om
Differential diagnosis of calcified pulmonary metastasis :-
1. Osteosarcoma
r.c

2. Colon carcinoma
ke

3. Chondrosarcoma
an

4. Giant cell tumor of bone

tR

5. Thyroid carcinoma
irs

6. Ovarian cancer
.F

7. Synovial sarcoma
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8. Breast carcinoma
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[Link]
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131. Differential diagnosis of solitary

pulmonary nodule are all except -
a) Bronchogenic carcinoma

b) Mycetoma

c) Tuberculoma

d) Hamartoma

Correct Answer - B
Answer- B. Mycetoma
om
Granulomas : - Tuberculoma (most common cause), Histoplasma,
Coccidioidomycosis, cryptococcosis.
r.c

Other infections : - Organizing pneumonia, hydatid cyst.

ke

Benign neoplams : - Hamartoma, Fibroma, Neurofibroma, Carcinoid

an

tumours, Lipoma, Bronchial adenoma

tR

Malignant neoplasm : - Carcinoma bronchus, Alveolar cell

irs

carcinoma, metastasis (from breast, Sarcoma, Renal cell carcinoma,

.F

Seminoma), Pulmonary blastoma, Pulmonary sarcoma.

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Inflammatory - Wegener's granulomatosis, rheumatoid arthritis,

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Sarcoidosis.
Congenital : - Sequestration, Bronchogenic cyst, AV malformation.
Miscellaneous : - Pulmonary infarct, Rounded atelectasis, Mucoid
impaction.

[Link]
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132. The sign with patch of dullness beneath

the angle of left scapula in a patient with
pericardial effusion is named as -
a) Carvallo's sign

b) Ewart's sign

c) Homan's sign

d) Hoffmann's sign

Correct Answer - B
om

Answer- B. Ewart's sign

r.c

Heart sounds become faint -

The apex impulse vanishes; but sometimes it remains palpable,
ke

medial to the left border of cardiac dullness.

an

The base of the left lung may be compressed by pericardial fluid,

tR

producing Ewart's sign, a patch of dullness beneath the angle of the

irs

left scapula.
.F

The chest roentgenogram may show a "water bottle" or "flask

w
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shaped" configuration of the cardiac silhouette

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[Link]
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133. Water bottle heart is seen in -

a) PDA

b) Chronic emphysema

c) Pericardial effusion

d) Constrictive pericarditis

Correct Answer - C
Answer- C. Pericardial effusion
"Water-bottle" or flasked shaped or money bag heart - Pericardial
effusion, hypothyroidism
om
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134. For pericardial calcifications, which is

the best investigation -
a) MRI

b) Transesophageal echocardiography

c) USG

d) CT scan

Correct Answer - D
Answer- D. CT scan
om
CT is the best method for depiction of pericardial calcification, a
finding suggestive of constrictive pericarditis in the appropriate
r.c

clinical setting.
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135. Fluorescin angiography is used to

examine -
a) Ciliary vasculature

b) Retinal vasculature

c) Corneal vasculature

d) Conjuctival vasculature

Correct Answer - B
Answer- B. Retinal vasculature
om
Fluorescein angiography is a radiological examination of retinal
vasculature after the administration of a fluorescein dye.
r.c
ke
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136. Barium swallow is used for -

a) Colon

b) Esophagus

c) Duodenum

d) Jejunum

Correct Answer - B
Answer- B. Esophagus
Barium swallow -Mainly for esophagus
om
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137. Pulled up cecum is seen in -

a) Ileocecal TB

b) Carcinoma cecum

c) Intussuption

d) Carcinoma

Correct Answer - A
Answer- A. Ileocecal TB
Conical cecum or Amputed cecum Cecum is shrunken in size and
pulled out of the iliac fossa due fibrosis and contraction of
om

mesocolon.
r.c

Stierlin sign :- Narrowing of terminal ileum with rapid emptying into a

ke

shortened, rigid or obliterated cecum.

an

String sign
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138. The study using barium for small

intestine is known as -
a) Barium meal follow through

b) Barium swallow

c) Barium enema

d) None of the above

Correct Answer - A
Answer- A. Barium meal follow through
om
In most cases the jejunum and Ileum are examined following the
barium examination of the upper gastrointestinal tract, referred to as
r.c

the "barium meal and follow through" or simply "barium follow

ke

through".
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139. Investigation with least radiation dose in

the diagnosis Meckel's diverticulum is -
a) CT

b) MRI

c) Contrast radiography

d) Technetium -99m scanning

Correct Answer - C
Answer- C. Contrast radiography
om
It is a general rule that the ascending order of the radiation dose is
MRI < X- ray < CT - Scan. Technetium - 99m has the radiation
r.c

exposure more than X - ray but less than CT - Scan. So contrast

ke

radiography will have the minimum radiation exposure as it involves

an

taking a radiograph after small bowel enema for diagnosis of

tR

meckel's diverticulum.
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140. Endoscopic USG criteria for chronic

pancreatitis, when echogenic lesion is -
a) > 1 mm

b) 1.5 mm

c) > 2 mm

d) > 3 mm

Correct Answer - D
Answer- D.�> 3 mm
om
Parenchymal features
Echo-poor lesion
r.c

Echo-rich lesion (> 3 mm in diameter)

ke

Accenuation of lobular pattern

an

Gland size, cyst

tR

Ductal features
irs

Increased duct wall echogenicity

.F

Narrowing, dilatation
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Calculi
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[Link]
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141. Most sensitive test to detect early renal

TB is -
a) Intravenous urography

b) CT

c) MRI

d) USG

Correct Answer - A
Answer- A. Intravenous urography
om
IVP remains the primary modality used to image the patients with
renal, ureteric, and bladder tuberculosis. Early findings are best
r.c

detected on IVP. It is the investigation of choice for urinary TB.

ke
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142. Investigation of choice for focal

neurologic deficit in emergency room is
-
a) CT

b) MRI

c) Lumbar puncture

d) CECT

Correct Answer - A
om

Answer- A. CT
r.c

In Indian set up CT Scan is the investigation of choice in the

emergency room to screen patients of acute focal neurologic deficit.
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143. CT Scan finding in carotid cavernous

sinus fistula is -
a) Enlarged superior ophthalmic vein

b) Enlarged inferior ophthalmic vein

c) Enlarged superior ophthalmic artery

d) Enlarged inferior ophthalmic artery

Correct Answer - A
Answer- A. Enlarged superior ophthalmic vein
om
Contrast-enhanced CT scan and MRI will demonstrate a dilated
superior ophthalmic vein and cavernous sinus.
r.c

Ultrasonography may also demonstrate superior ophthalmic vein

ke

engorgement.
an

Magnetic resonance angiography (MRA) is also very useful in

tR

identifying fistulas as well as particular vessel involvement.

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144. On imagning diffuse axonal injury is

characterized by -
a) Multiple small petechial hemorrhage

b) Patch ill defined low density lesion mixed with small hyperdens
of petechial hemorrhage

c) Crescentic extra-axial hematoma

d) White matter lucencies

Correct Answer - A
om
Answer- A. Multiple small petechial hemorrhage
Multiple small petechial hemorrhage <2cm diameter in cerebral
r.c

hemisphere.
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145. Rhese view is used for -

a) Superior orbital foramen

b) Inferior orbital foramen

c) Optic foramen

d) Sella turcica

Correct Answer - C
Answer- C. Optic foramen
Optic foramen- Rhese view
om
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146. Prevertebral space thickness in adult is -

a) 7mm

b) 14mm

c) 22mm

d) 30mm

Correct Answer - A:C

Answer- A & C. 22mm (A) 7mm
< 7mm at C1 level
< 5mm at C3 - C9level
om

< 22mm at C6 level

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147. Osteolytic metastasis is seen with -

a) Lung

b) Kidney

c) Thyroid

d) All of the above

Correct Answer - D
Answer- D. All of the above
Osteolytic, characterized by destruction of normal bone, present in
multiple myeloma (MM), renal cell carcinoma, melanoma, non-small
om

cell lung cancer, non-hodgkin lymphoma, thyroid cancer or

r.c

langerhans-cell histiocytosis.
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148. Investigation of choice in whole body

imaging in metastasis is -
a) Magnetic Resonance Imaging

b) Angiography

c) Venography

d) CT Scan

Correct Answer - A
Answer- A. Magnetic Resonance Imaging
om
Whole-body MR imaging with use of a rolling table platform in
conjunction with fast T2-weighted turbo spin-echo and 3D gradient-
r.c

echo sequences is a time-saving and accurate alternative to

ke

conventional multimodality evaluation of patients with tumors for

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metastases.
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149. T sign is seen in -

a) Genital TB

b) Membrane in twin pregnancy

c) Molar pregnancy

d) Choriocarcinoma

Correct Answer - B
Answer- B. Membrane in twin pregnancy
'T sign' refers to appearance of the inter-twin membrane in a
monochorionic twin pregnancy.
om
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150. Investigation of choice in congenital

uterine anamoly is -
a) MRI

b) CT

c) HSG

d) Hysteroscopy

Correct Answer - D
Answer- D. Hysteroscopy
om
Hysteroscopy is the gold standard in the diagnosis as well as
therapeutic management.
r.c
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151. Maximum radiation dose tolerable tissue

is -
a) Hemopoietic tissue

b) Testis

c) Ovary

d) Bone

Correct Answer - D
Answer- D. Bone
om
Highly radiosensitive
Lymphoid tissue
r.c

Bone marrow
ke

GIT epithelium
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Gonads (Testis, ovary)

tR

Embryonic tissue
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152. Epidermoid cyst can be differentiated

from arachnoid cyst by -
a) MRI

b) USG

c) Myelography

d) CT scan

Correct Answer - A
Answer- A. MRI
om
Myelography cannot differentiate reliably between an epidermoid
cyst and a noncommunicating arachnoid cyst.
r.c

It has largely been replaced by MRI.

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153. Soap bubble appearance on MRI brain is

characteristic of?
a) Tubercular meningitis

b) Neurocysticercosis

c) Cryptococcal cysts

d) Ependymoma

Correct Answer - C
Answer- C. Cryptococcal cysts
om
Cryptococcomas
T1: low signal
r.c

T2 / FLAIR: high signal

ke

T1 C+ (Gd): variable, ranging from no enhancement to peripheral

an

nodular enhancement.
tR

Gelatinous pseudocysts caused by Cryptococcus tend to give a

irs

"soap bubble" appearance on MRI. MRI findings in neural

.F

cryptococcosis.
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154. T2 image in MRI is -

a) Good to detect pathology

b) Good to detect anatomy

c) Good for both

d) Good for none

Correct Answer - A
Answer- A. Good to detect pathology
Many pulse-sequence techniques are used in MRI, but most classic
are T1 and T2 weighted images. As a general rule, TI-weighted
om

images are good for viewing anatomy, and T2 weighted images are
r.c

good for detecting pathology.

ke

[Ref Fundamentals of diagnostic radiology p. 18]

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155. Keyhole sign on ultrasound is seen in -

a) Polycystic kidney

b) Hydronephrosis

c) Chronic pyelonephritis

d) Posterior urethral valves

Correct Answer - D
Answer- D. Posterior urethral valves
The keyhole sign is an ultrasonographic sign seen in boys with
posterior urethral valves. lt refers to the appearance of the proximal
om

urethra (which is dilated) and associated thick walled distended

r.c

bladder which on ultrasound may resemble a key hole.

ke
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156. MIBG dose is -

a) 40-80MBq

b) 80-100MBq

c) 100-120MBq

d) 120-150MBq

Correct Answer - A
Answer- A. 40-80MBq
MIBG scan is a scintigraphic study that uses
metaiodobenzylguanidine labeled to Iodine- 123 or Iodine- 131.
om

The activity administered to adults should be: for 131I-mIBG: 40-80

r.c

MBq (1.2 - 2.2 mCi); for 123ImIBG: 400 MBq (10.8 mCi).
ke

For minimum and maximum recommended activities in children one

an

should consult the Guidelines for Radioiodinated MIBG

tR

Scintigraphy in Children (minimum activity 20 MBqfor 123I-mIBG

irs

and 35 MBqfor 131I-nIBG; maximum activity 400 MBqfor 123I-mIBG

.F

and 80 MBqfor 131I-mIBG).

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157. Barium meal follow through is helpful in

diagnosing -
a) Colonic stricture

b) Ileal stricture

c) Rectal stricture

d) Esophageal stricture

Correct Answer - B
Answer- B. Ileal stricture
om
Following abnormalities of small intestine can be identified:-
1. Malabsorption
r.c

2. BD (CD & UC)

ke

3. Tumors of small intestine

an

4. Small bowel obstruction

tR

5. Intestinal strtcture
irs
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158. Radiographic sign characteristic of

pulmonary edema is -
a) Westermark's sign

b) Hampton's hump

c) Palla sign

d) Bat wing sign

Correct Answer - D
Answer- D. Bat wing sign
om
Acute pulmonary edema : - Acute pulmonary edema is characterized
by centrally located alveolar sign, with hazy or fluffy increased
r.c

density in perihilar distribution, creating a bat-wing or angel-wing

ke

paftern. There is relative sparing of the more peripheral zones of

an

lung fields. Air bronchogram become evident as edema becomes

tR

more opaque.
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159. Gamma knife utilizes -

a) Strontium 89

b) 1-131

c) Cobalt -60

d) P-32

Correct Answer - C
Answer- C. Cobalt -60
Gamma knife contains Cobalt-60 sources of approximately 30 curis
placed in circular array in a heavily shielded unit. The unit directs the
om

gamma rirys to the target.

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160. Snow storm appearance on chest X-ray

is seen in -
a) Anthracosis

b) Byssinosis

c) Silicosis

d) Bagassosis

Correct Answer - C
Answer- C. Silicosis
om
Simple form z- Multiple small rounded (nodular) opacities in the lung
parenchyna (snow stonn appeoraace).
r.c

These nodules tend to be located predominantly in the middle and

ke

upper lung fields with relative sparing of lower lung fields (Though
an

Iower lung fields can also be involved later in disease process).

tR

There is bilateral hilar lymphadenopathy with characteristic egg shell

irs

calcification.
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161. "Droop lily sign" is seen in -

a) "Droop lily sign" is seen in

b) Duplicated collecting system

c) Chronic pyelonephritis

d) Hypernephroma

Correct Answer - B
Answer- B. Duplicated collecting system
The drooping lily srgl (dropping flower sign) is a urographic sign in
some patients with a duplicated collecting system. It refers to the
om

inferolateral displacement of the opacified lower pole moiety due to

r.c

an obstructed (and unopacified) upper pole moeity.

ke
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162. Sonographic appearance of hydatid cyst

is -
a) Hyperechoic aseptate lesion

b) Hypoechoic aseptate lesion

c) Hyperechoic septate lesion

d) Hypoechoic septate lesion

Correct Answer - D
Answer- D. Hypoechoic septate lesion
om
Type I (Simple cyst):- Single (solitary) hnrcechoic/anechoic aseptate
(without septa) lesion. The diagnosis of hydatid cyst may be
r.c

considered when focal thickening of wall is present or when

ke

hlperechoic spots, due to hydatid sand, appear in the dependent

an

areas.
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163. SI unit of absorbed dose is -

a) Becquerel

b) Columb/cm

c) Gray

d) Sievert [Sv]

Correct Answer - C
Answer- C. Gray
Old unit of absorbed dose is Rad and new unit (SI) is Gray.
om
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164. Stenver's view is used for -

a) Superior orbital foramen

b) Inferior orbital foramen

c) Internal auditory canal

d) Sella turcica

Correct Answer - C
Answer- C. Internal auditory canal
Skull trauma (sella turcica) (pituitary fossa)- Lateral view
Internal auditory view (both side)- Stenver's view
om
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165. Acute myocarditis schintigraphy is done

with -
a) Thallium

b) Technetium

c) Gallium

d) None

Correct Answer - C
Answer- C. Gallium
om
Gallium-67 uptake is increased in inflamed myocardium. Gallium-67
citrate injected intravenously binds to transferrin, and it is
r.c

incorporated into the transferrin receptor of inflammatory cells or

ke

malignant tumor cells.

an

Gallium-67 scintigraphy is useful for examination of heart disease

tR

including cardiac sarcoidosis and acute myocarditis

irs
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166. Radiation used most commonly for pain

management due to bone metastasis is -
a) Co60

b) Iridium 192

c) Tritium

d) Tin-117

Correct Answer - A
Answer- A. Co60
om
Radiopharmaceuticals (radioactive isotopes) used for metastatic
bone pain are strontium (Sr89), Samarium (Sm153), rhenium
r.c

(Re186), Phosphorus-32 and Tin-117 (Sn-177).

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[Link]
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167. Minimum radiation dose which may lead

to oligospermia is -
a) <1 Gy

b) 2-3 Gy

c) 7-10 Gy

d) 15 Gy

Correct Answer - A
Answer- A. <1 Gy
om
Fractionated doses 0.7-0.9 Gy lead to oligospermia/azoospermia but
with frequent recovery at 1-1.5 years. Permanent azoospermia may
r.c

occur after fractionated doses as low as 1.2 Gy, and is likely >2 Gy.
ke
an
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[Link]
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168. Half life of tritium is -

a) 10.2 years

b) 12.3 years

c) 15.5 years

d) 20.7 years

Correct Answer - B
Answer- B. 12.3 years
Tritium (hydrogen-3) is a radioactive isotope of hydrogen. The
nucleus of tritium (sometimes called a triton) contains one proton
om

and two neutrons.

r.c

Whereas the nucleus of protium contains one proton and no

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neutrons.
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Tritium has a half-life of 12.3 years

tR
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[Link]
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169. Safe light in radiographic dark room is

ideally should be of following color -
a) Red

b) Yellow

c) Purple

d) Blue

Correct Answer - A
Answer- A. Red
om
Red- Some blue sensitive materials, most phototypesetting
materials, most blue and most green sensitive medical x-ray films
r.c

(used in darkroom).
ke

Dark amber- Color negative papers and materials, panchromatic

an

black and white papers.

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Amber- Color negative papers, panchromatic black and white papers

irs
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[Link]
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170. Least penetrating power among

following mentioned rays is in -
a) Alpha rays

b) Beta rays

c) Gamma rays

d) X-ray

Correct Answer - A
Answer- A. Alpha rays
om
Penetration power : Gamma rays> X rays > Beta particle > Alpha
particle (or helium ion)
r.c

Ionizing & damaging power : Alpha particle (or helium ion) > Beta
ke

particle > X ray> Gamma ray

an

Alpha particles (Helium nuclei) have highest ionizing power because

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they have a large charge.

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Alpha particles have the highest damaging power as they are

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relatively slow and heavy.

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[Link]
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171. Non - ionizing radiation among the

following is -
a) MRI

b) CT Scan

c) X-ray

d) Position emission scintigraphy

Correct Answer - A
Answer- A. MRI
om
Non- ionizing radiation-
USG
r.c

MRI
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Thermography (infrared rays)

an

UV rays
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Radiofrequency waves
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Microwaves
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[Link]
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172. Mechanism of heat loss in modern X-ray

tube is
a) Radiation

b) Evaporation

c) Conduction

d) Convection

Correct Answer - A
Ans. A. Radiation
om
The mechanism of heat loss in the modern X-ray tube is radiation.
Classical X-ray tube:
r.c

The outer tube is made up of glass.

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Cathode- tungsten filament.

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An anode is the target and is made of tungsten.

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The mechanism of heat loss is conduction.

irs

The atomic number of tungsten is 74.

.F

Modern X-ray tube:

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The outer tube is made up of stainless steel

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Cathode- tungsten + thorium

Anode- tungsten + 10% rhenium. An anode is rotating and the
mechanism of heat loss is radiation.

[Link]
 [Link] [Link]

173. Nonionic dye is

a) Ioxaglate

b) lohexol

c) Iothalamate

d) None

Correct Answer - B
Answer- B. Iohexol
Iohexol is a nonionic monomer contrast agent.
The non-iodine radicals at positions 1, 3 and 5 (including the ionic
om

carboxyl radical) were replaced by long amino hydrocarbons that

r.c

provide adequate solubility without ionizing.

ke

Examples of this type of compound are iopromide, iohexol,

an

iopamidol, ioversol, iopentol, iobitridol, and iomeprol.

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irs
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[Link]
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174. HU is measure of
a) CT

b) MRI

c) PET

d) USG

Correct Answer - A
Answer- A. CT
Hounsfield's contribution is memorialized in the Hounsfield scale,
which is used to measure the x-ray attenuation in CT scanning.
om

Water is arbitrarily assigned a value of 0 Hounsfield units (HU).

r.c

[Ref Essential radiology p. 86]

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[Link]
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175. Which looks same on Ti & T2 on MRI

a) Gall bladder

b) Fat

c) Kidney

d) CSF

Correct Answer - B
Answer- B. Fat
Fat (adipose tissue) has high signal intensity on both T1 & T2
images.
om

Other three options have low signal intesity on T1 and high signal
r.c

intensity on T2 images.
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[Link]
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176. Hypertranslucent chest X-ray is seen in

all except
a) Mcleod syndrome

b) Emphysema

c) Pneumonectomy

d) Poland syndrome

Correct Answer - C
Answer- C. Pneumonectomy
om
Causes of opaque hemithorax
Technical : - Rotation, Scoliosis.
r.c

Pleural : - Pleural effusion, Pleural thickening, Mesothelioma.

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Surgical : - Pneumonectomy, Thoracoplasty.

an

Congenital : - Pulmonary agenesis.

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Mediastinal : - Gross cardiomegaly, tumors.

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Pulmonary : - Collapse, Consolidation, fibrosis, Foreign body.

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Diaphragmatic hernia
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[Link]
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177. What is not seen on chest X-ray in

pulmonary artery hypertension
a) Enlargement of central arteries

b) Peripheral prunning

c) Narrowing of central arteries

d) None

Correct Answer - C
Answer- C. Narrowing of central arteries
om
Characteristic radiological feature of pulmonary hypertension is
enlargement of central arteries with peripheral prunning.
r.c

Increased pulmonary artery pressure and pulmonary vascular

ke

resistance characterize pulmonary hypertension. PAH is defined as

an

systolic pressure in the pulmonary artery exceeding 30 mm Hg.

tR
irs
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[Link]
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178. Colon is identified on X-ray

a) Haustra

b) Valvulae conniventes

c) String of beads sign

d) More number of loops

Correct Answer - A
Answer- A. Haustra
Haustra (incomplete band across the bowel gas shadow) are seen in
colon.
om
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ke
an
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[Link]
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179. Double track sign is seen in

a) Duodenal atresia

b) CHPS

c) Gastric ulcer

d) Achalasia

Correct Answer - B
Answer- B. CHPS
Double/triple track sign is seen in congenital hypertrophic pyloric
stenosis.
om
r.c
ke
an
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[Link]
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180. Investigation of choice for multiple

sclerosis
a) CT

b) MRI

c) USG

d) PET

Correct Answer - B
Answer- B. MRI
om
MRI is the investigation of choice for demyelinating disorder, e.g.
multiple sclerosis.
r.c
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an
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[Link]
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181. Investigation of choice for intramedullary

SOL is -
a) MRI

b) USG

c) CT

d) X-ray

Correct Answer - A
Answer- A. MRI
om
Investigation of choice for intramedullary space occupy lesion is
MRI.
r.c
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an
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[Link]
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182. Von Rosen's view is for

a) CDH

b) Perthe's disease

c) CTEV

d) None

Correct Answer - A
Answer- A. CDH
In Von Rosen's view is used in DDH/CDH.
om
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ke
an
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[Link]
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183. Nuchal translucency is used in

a) Head scan

b) MRI neck

c) ANC USG

d) Anthropometry

Correct Answer - C
Answer- C. ANC USG
Nuchal translucency is used for screening of down syndrome in
antenatal USG.
om
r.c
ke
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[Link]
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184. Half-life of Iodine 131 is

a) 8 hours

b) 8 days

c) 8 weeks

d) 8 months

Correct Answer - B
Answer- B. 8 days
Iodine - 131 Half life 8 days
Iodine - 123 -3 Half life 13 hours
om

Iodine - 132 Half life 2.3 hours

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[Link]
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185. Dye used in diagnosis of esophageal

perforation:
a) Iohexol

b) Barium sulphate

c) Gadolinium

d) Iodine dye

Correct Answer - B
Answer-B. Barium sulphate
om
Barium sulfate in suspension is frequently used medically as a
radiocontrast agent for X-ray imaging and other diagnostic
r.c

procedures.
ke

It is most often used in imaging of the GI tract during what is

an

colloquially known as a "barium meal".

tR

Fluoroscopy
irs

most sensitive within the first 24 hours.

.F

patient examined semi-supine (~20 degrees) on fluoroscopy table

w

a water-soluble agent should be used initially as barium can cause

w
w

mediastinitis
esophageal perforation may be represented as mucosal irregularity
or gross extraluminal contrast extravasation
some authors suggest the use of small amounts of low or high
concentrations of barium if no leak is evident on initial screening with
water soluble contrast
Iohexol, trade names Omnipaque among others, is a contrast
agent used during [Link] includes when visualizing arteries,
veins, ventricles of the brain, the urinary system, and joints, as well
as during computer tomography. It is given by mouth, injection into a
vein, or into a body cavity.

[Link]
 [Link] [Link]

om
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[Link]
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186. Bragg peak effect pronounced in:

a) X ray

b) Proton

c) Neutron

d) Electron

Correct Answer - B
Answer- B. Proton
Nowadays proton therapy (PT) represents an established alternative
to photon radiotherapy for the treatment of specific types of cancer.
om

The therapeutic use of proton beams (and of charged particles in

r.c

general) is motivated primarily by their inverted depth-dose profile

ke

compared to photons, being characterized by the so-called Bragg

an

peak.
tR

Several beams of different energy can then be combined in order to

irs

achieve the prescribed dose in a region as large as the target

.F

volume, resulting in the production of what is defined as the Spread-

w

Out Bragg Peak (SOBP).

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[Link]
 [Link] [Link]

187. Salt and Pepper pot appearance of skull

seen in:
a) Hyperparathyroidism

b) Multiple myeloma

c) Hyperthyroidism

d) Pseudo hyperparathyroidism

Correct Answer - A
Answer- A. Hyperparathyroidism
om
Pepperpot skull is occasionally used in place of salt and pepper
skull to describe the typical radiographic appearance of multiple
r.c

small radiolucent lesions of the skull vault.

ke

In primary hyperparathyroidism, extensive resorption bone in the

an

skull in combination with cystic areas of osteopenia are

tR

termed pepper pot skull.

irs

Classically seen in hyperparathyroidism, and is occasionally used

.F

(inaccurately) to describe the raindrop skull of multiple myeloma.

w
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: Sull X-ray with a typical "pepper-pot" appearance

[Link]
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188. Imaging techniques used in Uterus

anomalies EXCEPT:
a) HSG

b) MRI guided HSG

c) CT guided HSG

d) USG

Correct Answer - C
Answer C. CT guided HSG
om
Imaging studies, such as a hysterosalpingogram
(HSG) and ultrasound, or an MRI are required to visualise the
r.c

uterus and confirm that a congenital uterine anomaly is present.

ke

A hysterosalpingogram is not considered as useful due to the

an

inability of the technique to evaluate the exterior contour of the

tR

uterus and distinguish between a bicornuate and septate uterus.

irs

In addition,laparoscopy and/orhysteroscopy may be indicated.

.F
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[Link]
 [Link] [Link]

189. Which is the treatment of choice for

irradiation in Chordoma?
a) Protons

b) Electrons

c) Gamma radiation

d) 3D - CRT

Correct Answer - A
Answer: A - Proton Therapy
om
Chordoma:
Slow-growing neoplasm
r.c

Arising from cellular remnants of notochord.

ke

Arise from bone in skull base and along spinal cord.

an

Most common locations -

tR

Cranially at clivus
irs

In sacrum at bottom of spine

.F

Radiation therapy:
w

Are relatively radioresistant

w
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High doses of radiation required to control.

Hence, high focus radiation like proton therapy and carbon ion
therapy are preferred than conventional radiation methods.
Close proximity to vital structures like brain stem, requires high
precision and accuracy for any planned surgical resection.
Radiation with high accuracy and minimal damage with maximal
safety is delivered.

[Link]
 [Link] [Link]

190. Cancer patient undergoes radiotherapy,

pick the true statement for
radiosensitivity of tissues?
a) Rapidly dividing cells are resistant to radiation

b) GI mucosa is one of the most radioresistant tissues in the body

c) The intensity of radiation is inversely proportional to the square

of distance from the source

d) Small blood vessels are least resistant to radiation

om

Correct Answer - C
r.c

Answer- C- The intensity of radiation is inversely proportional

to the square of distance from the source
ke

The inverse square law describes the principle of dose reduction

an

as the distance from the source increases.

tR

The dose is proportional to the inverse of the square of the radius.

irs

Thus if you double the distance you reduce the dose by a factor of
.F

four.
w
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Ref- 1. Shafiei SA, Hasanzadeh H, Shafiei SA. A simple

w

calculation method for determination of equivalent square field.

J Med Phys. 2012;37 (2): 107-11. DOI:10.4103/0971-
6203.94746 - Free text at PubMed - Pubmed citation

[Link]