Past-papers COPY Flashcards
(114 cards)
1
Q
-
Which image technique is useful to demonstrate ascites in the abdominal cavity? (choose the false)
- Abdominal US
- Abdominal CT
- Abdominal CT and US examinatio
- Scintigraphy
A
d. Scintigraphy
2
Q
Appendicitis can be visualized with the following imaging methods, except:
- With native and contract enhanced CT
- With US examination
- With P-A abdominal x-ray
- With US and abdominal CT examination
A
c. With P-A abdominal x-ray
3
Q
-
In case of suspected nephron-ureterolithiasis the best method for the localization of the nephron-ureterolithiasis is:
- Abdominal US examination
- Intravenous urography
- Low dose CT
- PET-CT
A
c. Low dose CT
4
Q
1.Tumors within the spinal canal may be classified as
Intramedullary
Extradural
Intradural-extramedullary
Extradural-intramedullary
A
1.Tumors within the spinal canal may be classified as
Intramedullary
Extradural
Intradural-extramedullary
Extradural-intramedullary
5
Q
US sign of intussusception?
- “Target” sign
- “Whirpool” sign
- “Pseudokidney”
- “Comet” sign
A
a. “Target” sign
6
Q
For the mediastinal and retroperitoneal lymph nodes the most acceptable imaging method is:
- US
- CT examination
- Scintigraphy
- Chest x-ray (two views)
A
b. CT examination
CT scans of the chest are more accurate in determining the location and nature of a mediastinal mass than conventional radiographs.
7
Q
In case of a huge left-sided pleural fluid collection the mediastinal complex will move:
- Moderately to the right side
- The mediastinal complex will stay in unchanged position
- Moderately to the left side
- Extensively to the left side
A
- Moderately to the right side
- A large pleural effusion may cause treacheal deviation away from the effusion
8
Q
MR spectroscopy is a useful method in the diagnosis of
- Renal cell cancer
- Ovarian cancer
- Testicular cancer
- Prostate cancer
A
d. Prostate cancer
9
Q
-
a young 30 year old female was admitted for the emergency department with a strong “beating-like” occipital headache. What is the first imaging method in this case?
- MR
- Skull x-ray, two view
- Native CT of the brain
- Color-duplex carotid US
A
c. Native CT of the brain
10
Q
In case of a moderate amount of right sided pleural fluid collection the mediastinal complex will move
- Moderately to the right side
- Stay in unchanged position
- Moderately to the left side
- Extensively to the left side
A
b. Stay in unchanged position
11
Q
MR spectroscopy is a useful method in diagnosis of
- Renal cell cancer
- Ovarian cancer
- Testicular cancer
- Prostate cancer
A
d. Prostate cancer
MRS is currently used to investigate a number of diseases in the human body, most notably cancer (brain, breast and prostate), epilepsy, alzheimers, parkinsons and huntingtons. MRS has been used to diagnose pituitary tuberculosis. Prostate cancer: combined with MRI and given equal results, then the #D MRS can predict the prevalence of a malignant degeneration if prostate tissue by approx. 90%. The combination of both metods may be helpful in the planning of biopsies and therapies of the prostate, as well as to monitor the success of a therapy.
12
Q
1.Which are the guiding principles when it comes to choosing a modality to diagnose a disease?
Modality having a high specificity
Least invasive modality
Available modality
Most cost-effective modality
A
1.Which are the guiding principles when it comes to choosing a modality to diagnose a disease?
Modality having a high specificity
Least invasive modality
Available modality
Most cost-effective modality
13
Q
Which imaging technique is useful to demonstrate the ascites in the abdominal cavity (choose the wrong one)
- Abdominal US
- Abdominal CT
- Abdominal CT and US
- Scintigraphy
A
d. Scintigraphy
14
Q
In case of a huge left sided pleural fluid collection the mediastinal complex will move:
A/ moderately to the right side
B/ the medastinal complex will stay in unchanged position
C/ moderately to the left side
D/ extensively to the left side
A
A/ moderately to the right side
15
Q
1.In case of stroke, treatment strategy is primarily based on the following findings:
Localization of the lesion (infra- or supratentorial)
Unilateral or bilateral lesion
Presence of oedema
Presence of hemorrhage
A
1.In case of stroke, treatment strategy is primarily based on the following findings:
Localization of the lesion (infra- or supratentorial)
Unilateral or bilateral lesion
Presence of oedema
Presence of hemorrhage
16
Q
Which imaging technique is useful to demonstrate the ascites in the abdominal cavity? (you have to choose the FALSE answer):
A/ Abdominal Ultrasound
B/ Abdominal CT examination
C/ Abdominal CT and US examination
D/ Scintigrapy
A
D/ Scintigrapy
17
Q
For the mediastinal and retroperitoneal lymph nodes, the most acceptable imaging method is:
- US
- CT examination
- Scintigraphy
- Chest X-ray (two views)
A
b. CT examination
18
Q
1.In case of which of the following conditions would you make a frimann-dahl image?
Infiltrate of the lung
Abdominal free gas
Fracture of the femoral head
Subpulmonal fluid
A
1.In case of which of the following conditions would you make a frimann-dahl image?
Infiltrate of the lung
Abdominal free gas
Fracture of the femoral head
Subpulmonal fluid
19
Q
In case of a suspected nephro-ureterolithiasis the best method for the localisation of the nephro-ureterolithiasis is:
A/ Abdominal Ultrasound examination
B/ Intravenous Urography
C/ Low-dose CT
D/ PET-CT
A
C/ Low-dose CT
20
Q
Choose the correct statement regarding hyperacute cerebral infarcts
- Hyperdense media sign is always visible
- Hyperdense media sign is visible in 25-50% of the cases
- Hyperdense media sign is never visible
- Hyperdense media sign is visible in 10-15% of the cases
A
b. Hyperdense media sign is visible in 25-50% of the cases
21
Q
1.Which X-ray technique is applied by conventional chest x-ray?
Heardbeam technique (25-35keV)
Softbeam technique (25-35 keV)
Heardbeam technique (120-140 keV)
Mammography uses soft beams
Softbeam technique (120-140 keV)
A
1.Which X-ray technique is applied by conventional chest x-ray?
Heardbeam technique (25-35keV)
Softbeam technique (25-35 keV)
Heardbeam technique (120-140 keV)
Mammography uses soft beams
Softbeam technique (120-140 keV)
22
Q
1.Which is not a functional x-ray examination
Swallow examination
Fistulography of the liver
Bedside A-P view chest x-ray
Barium enema study (irrigoscopy)
A
1.Which is not a functional x-ray examination
Swallow examination
Fistulography of the liver (???)
Bedside A-P view chest x-ray
Barium enema study (irrigoscopy)
23
Q
In case of widening of the mediastinum, what pathological process could be the case of this alteration: (except)
- Lymphoma
- Aneurysm of the descending aorta
- Calcified pleural callus
- Hilar pulmonary neoplasia
A
c. Calcified pleural callus
24
Q
These devices are mandatory during angiography. Mark the FALSE one
- Ballon catheter
- 4F catheter
- seldinger needle
- Guide wire
A
a. Ballon catheter – used in angioplasty, but not needed in angiography?!
25
**What is NOT typical for a malignant bone tumor?**
1. Ill-defined
2. Periosteal reaction
3. Destructions
4. Well circumscribed
d. Well circumscribed
26
1.What is the first chosen imaging method in case of neck nodule?
Swallow x-ray examination
US
MR
CT
1.What is the first chosen imaging method in case of neck nodule?
Swallow x-ray examination
**US**
MR
CT
27
**What is the diagnostic strategy in extracranial carotid disease?**
1. Primary examination is DSA which is complemented by CTA or MRA, US is only for kids
2. Primary examination is duplex US for screening and follow-up: probless solving advanced imaging for selected cases is CTA or MRA – catheter angiography (DSA) is mainly for therapeutic interventions
3. US-guided puncture of the CCA and then directed angiography of the affected side
4. Primary examination is CTA; MRA is only for iodine-sensitive patients; DSA for all patients preceding surgery and duplex US for post-surgical complications
b. Primary examination is duplex US for screening and follow-up: probless solving advanced imaging for selected cases is CTA or MRA – catheter angiography (DSA) is mainly for therapeutic interventions
1. Carotid artery stenosis is usually diagnosed by color flow duplex US scan of the carotid arteries in the neck. This involves no radiation, no needles, and no contrast agents that may cause allergic reactions. This test has good sensitivity and specificity.
2. CTA or MRA may be useful. With contrast: contraindicated in patients with renal insuffieicency, catheter angiography has a 0.5-1% risk of stroke, MI arterial injury or retroperitoneal bleeding. The investigation chosen will depend on the clinical question and the imaging expertice, experience and equipment available.
28
The following transducer is used generally for adult’s **abdominal US** examination:
A/ 7,5-10 MHz convex
B/ 6-9 MHz phased-array
C/ 3,5-5 MHz convex
D/ 7,5-10 MHz linear
C/ 3,5-5 MHz convex
29
In case of widening of the mediastinum what pathological process could be the cause of this alteration? (Only ONE answer is **FALSE**, you have to sign this statement):
A/ Lymphoma
B/ Aneurysm of the descending aorta
C/ Calcified pleural callus
D/ Hilar pulmonary neoplasia
C/ Calcified pleural callus
30
1.IV contrast material should be avoided at CT examinations when the patient suffers from:
Manifest hypothyroidism
Severe lower extremity atherosclerotic disease
Manifest hyperthyroidism
Multinodular goiter
1.IV contrast material should be avoided at CT examinations when the patient suffers from:
Manifest hypothyroidism
Severe lower extremity atherosclerotic disease
Manifest hyperthyroidism
**Multinodular goiter**
31
Which method is used for the detection of abdominal aortic aneurysm rupture?
A/ Barium enema
B/ PA Chest and native abdominal X-ray
C/ Contrast enhanced abdomino-pelvic CT – CT angiography
D/ PET-CT
C/ Contrast enhanced abdomino-pelvic CT – CT angiography
32
Which is **NOT** an indication of chest x-ray
High fever
Search for primary tumor
Elevated liver enzymes
Chest screening
Which is NOT an indication of chest x-ray
High fever
Search for primary tumor
**Elevated liver enzymes**
Chest screening
33
**During the CT examination in the Houndfield scale, the density of the ……. Is fixed to zero:**
1. Fresh blood
2. Water
3. Fat
4. Bone
b. Water
34
**US sign of intussuception:**
1. ”target” sign
2. ”whirlpool” sign
3. ”psudokidney”
4. ”comet” sign
a. ”target” sign
the target sign of intestinal intussusception, also known as the doughnut sign, or bulls eye sign. The appearance is generated by concentric alternating echogenic and hypoechogenic bands. The echogenic bancs are formed by mucosa and muscularis, whereas submucosal is responsible for the hypoechogenic bands.
35
2.What kind of material is administered to the patient during an isotope examination?
Contrast media
Isopharmacon
Gadolinium
Radiopharmacon
2.What kind of material is administered to the patient during an isotope examination?
Contrast media
Isopharmacon
Gadolinium
**Radiopharmacon**
36
For the **mediastinal** and **retroperitoneal** lymph nodes the most acceptable imaging method is:
A/ Ultrasound
B/ CT examination
C/ Scintigraphy
D/ Chest X-ray (two views)
B/ CT examination
37
1. **How do you call the complex that should be evaluated in case of chronic sinusitis?**
1. Osteomeatal complex
2. Ostimeatal complex
3. Ethmoidal complex
4. Nasomeatal complex
b. Ostimeatal complex
38
**The following transducer is used generally for adults abdominal US examination**:
1. 7,5-10 MHz convex
2. 6-9 MHz phased-array
3. 3,5-5 MHz convex
4. 7,5-10 MHz linear
c. 3,5-5 MHz convex
39
In case of a simple liver cyst (with 25 mm diameter, without irregular wall and without septations), how could we characterize the inner content of the cyst?
A/ hypoechoic
B/ anechoic
C/ hyperechoic
D/ hyperdense
B/ anechoic
40
**What is the method of choice in case of a head and neck cancer in order to evaluate the perineural tumor spread?**
1. fMRI
2. CT
3. Scintigraphy
4. MRI
d. MRI
Perineural spread of tumor is a form of local invasion in which primary tumor cells spread along the tissues of the nerve sheats. It is a well-recognized phenomenon in head and neck cancers. Signs on MRI suggesting perineural tumor spread are:
1. Nerve thickening
2. Widening of the neuronal foramen
3. Loss of fat surrounding the nerve
4. Abnormal perineural contrast enhancement
41
1.In case of recurring right subcostal pain, the first imaging method is:
Abdominal CT
MR
Abdominal US
Scintigraphy
1.In case of recurring right subcostal pain, the first imaging method is:
Abdominal CT
MR
**Abdominal US**
Scintigraphy
42
1.Which imaging technique is useful to demonstrate the vascularity of a splenic tumor?
Color-duplex abdominal US
Multiphasic contrast enhanced abdominal CT
A-P abdominal x-ray
Contrast enhanced abdominal MR
1.Which imaging technique is useful to demonstrate the vascularity of a splenic tumor?
Color-duplex abdominal US
**Multiphasic contrast enhanced abdominal CT**
A-P abdominal x-ray
Contrast enhanced abdominal MR
43
**Which imaging method is applied for screening of hip dysplasia for neonates between 4-5 months of age?**
1. X-ray
2. Ultrasonography
3. MRI
4. Non of the above
b. Ultrasonography
44
Pulmonary abscess usually appears on the chest X-ray with:
A/ lower transparency crescent shape
B/ lower transparency ring shape with inner fluid level
C/ lower transparency lense shape
D/ lower transparency wedge shape
B/ lower transparency ring shape with inner fluid level
45
1. **Which modality does not apply ionizing radiation**
1. Contrast enhanced US
2. Positron emission tomography (PET)
3. Fluoroscopy
4. Digital subtractional angiography (DSA)
a. Contrast enhanced US
46
1.In case of a left sided PTX the mediastinal complex will move:
Moderately to the left side
The mediastinal complex will stay in unchanged position
Extensively to the right side
Extensively to the left side
1.In case of a left sided PTX the mediastinal complex will move:
Moderately to the left side
**The mediastinal complex will stay in unchanged position**
Extensively to the right side
Extensively to the left side
47
**In case of a polytraumatic patient, which is the fastest imaging method to get useful information about cranial, chest and abdominal complications?**
1. Skull, chest and abdominal x-ray
2. Carotid and abdominal US examination
3. Non contrast and contrast enhanced multidetector
4. CT examination
c. Non contrast and contrast enhanced multidetector CT examination
1. It is also quite common in severe trauma for patients to be sendt directly to CT or a surgery theater, if they require emergency treatment
48
1.If a pulmonary infiltrate DOES NOT resolve over time despite treatment with antimicrobial agents, think of….
Broncho-alveolar subtype of lung cancer
Supraglottic cancer of larynx
Boeck sarcoidosis
Presence of mycoplasma or klebsiella
Pleural adhesions
1.If a pulmonary infiltrate DOES NOT resolve over time despite treatment with antimicrobial agents, think of….
**Broncho-alveolar subtype of lung cancer**
Supraglottic cancer of larynx
Boeck sarcoidosis
Presence of mycoplasma or klebsiella
Pleural adhesions
49
1.To evaluate an abdominal CT, the optimal windowing setting is…./on the HU-scale? (WL=window level, WW=window width)
WL=-600 HU, WW=1600 HU
WL=800 HU, WW=2000 HU
WL=60 HU, WW=360 HU
WL= 0 HU, WW=200 HU
1.To evaluate an abdominal CT, the optimal windowing setting is…./on the HU-scale? (WL=window level, WW=window width)
WL=-600 HU, WW=1600 HU
WL=800 HU, WW=2000 HU
**WL=60 HU, WW=360 HU**
WL= 0 HU, WW=200 HU
50
1. **Interstitial shadows are**
1. Patchy
2. Of vascular origin
3. Web like
4. Common CT terminology for mestenteric fat
c. Web like
51
1.Which condition can cause paralytic ileus?
Cramp caused by kidney stone
Acute pancreatitis
Mesenterial thrombo-embolism
Side-effect of medication
1.Which condition can cause paralytic ileus?
## Footnote
**Cramp caused by kidney stone**
**Acute pancreatitis**
**Mesenterial thrombo-embolism**
**Side-effect of medication**
52
**Pulmonary abscess usually appears on the chest x-ray with**
1. Lower transparency crescent shape
2. Lower transparency ring shaped with inner fluid level
3. Lower transparency lense shaped
4. Lower transparency wedge shape
b. Lower transparency ring shaped with inner fluid level
53
**_Tension ptx_ is present, which requires emergent treatment if cxr shows**
1. Mediastinal shift to the pathological side
2. Mediastinal shift to the normal side
3. Superiors displacement of the diaphragm on the normal side
4. Inferior displacement of the diaphragm on the pathological side
**Tension ptx is present, which requires emergent treatment if cxr shows**
1. Mediastinal shift to the pathological side
2. **Mediastinal shift to the normal side**
3. Superiors displacement of the diaphragm on the normal side
4. **Inferior displacement of the diaphragm on the pathological side**
54
**For the _mediastinal_ and _retroperitoneal_ lymph nodes the most acceptable imaging method is**
1. US
2. CT examination
3. Scinitigraphy
4. Chest x-ray (two views)
1. CT examination
1. CT scans of the chest are more accurate in determining the location and nature of a mediastinal mass than conventional radiographs.
55
**Patognomic sign of GI tract perforation in an erect plain abdominal radiograph:**
1. Oral contrast material depicted in the duodenum
2. Colon cut-of sign
3. Broad air-fluid level in the transverse colon
4. Crescent translucency under the dome of the hemidiaphragm
d. Crescent translucency under the dome of the hemidiaphragm
56
1.The following transducer is usually used for adult thyroid US
9-12.5 MHz convex
6-9 MHz phased-array
2. 5-5 MHz convex
7. 5-10 MHz linear
1.The following transducer is usually used for adult thyroid US
9-12.5 MHz convex
6-9 MHz phased-array
2.5-5 MHz convex
**7.5-10 MHz linear**
57
1.Which renal lesion contains typically fat?
Renal cell carcinoma
Septated renal cyst
Renal cortical infarction
Angiomyolipoma
1.Which renal lesion contains typically fat?
Renal cell carcinoma
Septated renal cyst
Renal cortical infarction
**Angiomyolipoma**
58
1.What is the difference between the origin of an epidural and subdural hematoma (usually)?
Subdural hemorrhage: arterial
Subdural hemorrhage: vein
Epidural hemorrhage: vein
Epidural hemorrhage: arterial
1.What is the difference between the origin of an epidural and subdural hematoma (usually)?
Subdural hemorrhage: arterial
**Subdural hemorrhage: vein**
Epidural hemorrhage: vein
**Epidural hemorrhage: arterial**
59
1. **The vertebral column injuries are classified according to the “model” below**
1. David 3 column theory
2. Denis spinal canal theory
3. Davis spinal canal theory
4. Denis 3 column theory
d. Denis 3 column theory
Denis divided the vertebral column into 3 vertical parallel columns beased in biomechanical studies related to stability following traumatic injury. Instability occurs when injuries affect 2 contiguous columns (i.e., anterior and middle column, or middle and posterior column). Obvious a 3 column injury is unstable.
60
1.In case of a simple renal cyst (with 25 mm diameter, without irregular wall and without septations), how could we characterize the inner content of the cyst?
Hypoechoic
Anechoic
Hyperechoic
Hyperdense
1.In case of a simple renal cyst (with 25 mm diameter, without irregular wall and without septations), how could we characterize the inner content of the cyst?
Hypoechoic
**Anechoic**
Hyperechoic
Hyperdense
61
The following pathological conditions can generate small bowel ileus (Only one answer is false, you have to choose this FALSE answer):
A/ Crohn’s disease
B/ Coecum tumor
C/ Strangulated hernia
D/ Thrombosis of the splenic vein
D/ Thrombosis of the splenic vein
62
**For what does a radiologist look for when performing a FAST-exam?**
1. Free abdominal fluid
2. Gall bladder inflammation
3. Kidney stones
4. Cysts
a. Free abdominal fluid
FAST is a rapid bedside US examination performed by surgeons, emergency physicians and certain paramedics as a screening test for blood around the heart or abdominal organs after trauma.
63
Ultrasound sign of the intussusception:
A/ „target” sign
B/ „whirplpool” sign
C/ „pseudokidney”
D/ „comet” sign
A/ „target” sign
64
**Which is NOT true regarding the multidetector/multislice CT**
1. Parallel rows of detectors
2. During one rotation 4,16, 32… slices are measured
3. Fractional (discontinuous) data collection = loss of information
4. During one inspiration only, the whole body is scanned
5. Reconstructions are made in any preferable plane
c. Fractional (discontinuous) data collection = loss of information
65
1. **In case of which organ can you apply ultrasonography as the first imaging modality for adults:**
1. Lung
2. Colon
3. Spine
4. Liver
5. Brain
d. Liver
66
**Based on the physical investigation and laboratory parameters, there is a suspicion of acute pancreatitis. Which of the following imaging methods is able to detect the complications most efficiently?**
1. Abdominal plain film
2. Transabdominal ultrasonography
3. CT/unenhanced and contrast-enhanced study
4. Barium meal
c. CT/unenhanced and contrast-enhanced study
67
In case of typical liver hemangiomas, how can we characterize the mass?
Well rounded, hypoechoic
Well rounded, anechoic
Well rounded, hyperechoic
Well rounded, hyperdense
Well rounded, hypoechoic
Well rounded, anechoic
**Well rounded, hyperechoic**
Well rounded, hyperdense
68
Appendicitis can be visualised with the following imaging methods (there is only one false statement, you have to find this **FALSE** answer):
A/ with native and contrast enhanced CT examination
B/ with Ultrasound examination
C/ with P-A abdominal X-ray examination
D/ with US and abdominal CT examination
C/ with P-A abdominal X-ray examination
69
**What is the central (“fatty”) compartment of the suprahyoid neck?**
1. Anterior cervical space
2. Pharyngeal mucosal space
3. Masticator space
4. Parapharyngeal space
d. Parapharyngeal space
70
**The following transducer is used generally for _superficial soft tissue_ US examinations**
1. 7,5-10 MHz convex
2. 6-9 MHz phased-array
3. 3,5-5 MHz convex
4. 7,5-10 MHz linear
7,5-10 MHz linear
Linear; 8-10 (or more)MHz, superficial penetration, better resolution
71
**Which statement is false on double contrast bowel examination**
1. Smear mucosa with barium-containing contrast agent.
2. Distend the lumen with gas, which is a positive contrast media, because of decreasing transparency.
3. Relax bowel walls with smooth muscle relaxant
4. Depiction: luminal contour, mucosal relief
c. Relax bowel walls with smooth muscle relaxant
(not sure)
72
**The following pathological conditions can generate small bowel ileus (only one answer is false, you have to choose the FALSE answer):**
1. Crohn´s disease
2. Coecum tumor
3. Strangulated hernia
4. Thrombosis of the splenic vein
d. Thrombosis of the splenic vein
73
1.Which of the following modalities is not a functional imaging method:
Scinitgarphy
PET
Mammography
SPECT
1.Which of the following modalities is not a functional imaging method:
Scinitgarphy
PET
**Mammography**
SPECT
74
1.Which of the following fracture type is considered as "pathological fracture"?
Fatigue fractures of athletes
Facture of bones weakened by a tumor, inflammation or cyct
All type of vertebral facture
Fractures due to osteoporosis
1.Which of the following fracture type is considered as "pathological fracture"?
Fatigue fractures of athletes
Facture of bones weakened by a tumor, inflammation or cyct
All type of vertebral facture
Fractures due to osteoporosis
75
1.Which method is used for the detection of testicular cancer?
PET-CT
Angiography
CT
US
1.Which method is used for the detection of testicular cancer?
PET-CT
Angiography
CT
**US**
76
**Acute pulmonary embolism**
1. Negative chest radiography and lower extremity venous US can rule out confidently.
2. Pulmonary angiography (DSA) is the best modality to assess the vasculature and this is the only modality, which is feasible in patients with dyspnea.
3. CTA provides only indirect evidence of PE while MRA can visualize even the smallest branches (the only problem is restricted availability)
4. CTA can directly prove the presence of emboli and additionally other possible causes of chest symptoms are often disclosed.
d. CTA can directly prove the presence of emboli and additionally other possible causes of chest symptoms are often disclosed.
1. Over 90% of PE develop from thrombi in the deep veins of the leg, especially above the level of the popliteal veins. They are usually a complication of surgery or prolonged bedrest or cancer. Because of the dual circulation of the lungs most PE do not result in infarction.
2. Chest radiographs infrequently manifest one of the “classic” findings for PE which can include:
1. Wedge-shaped peripheral air-space disease (Hampton hump)
2. Focal oligemia (westermark sign)
3. A prominent central pulmonary artery (knuckle sign)
3. If the chest radiograph is normal, a nuclear medicine ventilation-perfusion scan may be diagnostic. If however, the chest radiograph is abnormal, a CT is usually performed.
4. CT-PA is made possible by the fast data acquisition of spiral CT scanners (one breath hold) combined with thin slices and rapid bolus IV injections of iodineated contrast that produce maximal opacification of the pulmonary arteries with little or no motion artifacts.
77
1.Which is reliable imaging method in a suspicion of pulmonary embolism?
Transesophageal US
P-A chest x-ray
Pulmonary CT-angiography
Fluoroscopy of the chest
1.Which is reliable imaging method in a suspicion of pulmonary embolism?
Transesophageal US
P-A chest x-ray
**Pulmonary CT-angiography**
Fluoroscopy of the chest
78
**In case of ileus in newborns**
1. We can make the diagnosis based only on abdominal x-ray
2. Meconium ileus is caused by impacted thick meconium in children suffering from CF.
3. Hirschsprung´s disease never causes ileus in newborn.
4. Ileum atresia never occurs with non-used colon, because it is a disease of the small bowel, not the colon.
a. We can make the diagnosis based only on abdominal x-ray
Diagnosis of meconium ileus is suspected in a neonate with signs of intestinal obstruction, particularly if a family history of CF exists. Patients should undergo abdominal x-ray which show dilated intestinal loops; however, fluid levels may be absent.
79
**The head and neck compartments are separated into parts on the basis of the following structure:**
1. Epiglottis
2. Hyoid bone
3. Cricoid cartilage
4. Uvula
5. Hard palate
b. Hyoid bone
80
1.The following inflammatory conditions can cause small bowel ileus:
Chron´s disease
Diverticulitis
Bowel tuberculosis
All of the above
1.The following inflammatory conditions can cause small bowel ileus:
Chron´s disease
Diverticulitis
Bowel tuberculosis
**All of the above**
81
**Which type of renal stone is radiolucent (non opaque) on abdominal plain radiography?**
1. Urine acid
2. Sturvite
3. Calcium phosphate
4. Calcium oxalate
a. Urine acid
Uric acid?! = Radiolucent
82
1.In case of enlarged axillary and supraclavicular lymph nodes the first imaging method is:
CT
MR
US
Scintigraphy
1.In case of enlarged axillary and supraclavicular lymph nodes the first imaging method is:
CT
MR
**US**
Scintigraphy
83
**Which method is used for the detection of abdominal aortic aneurysm rupture?**
1. Barium enema
2. PA chest and native abdominal x-ray
3. Contrast enhanced abdomino-pelvic CT – CT angiography
4. PET-CT
c. Contrast enhanced abdomino-pelvic CT – CT angiography
84
1.Which of the following indications is inadequate planning an MRI in head and neck region?
Evaluation of perineural tumor spread
Bony skullbase evaluation in suspicion of bony fracture owing to an injury
Cartilage infiltration of the larynx
Proving soft tissue involvement of suprahyoid compartments
Posttherapeutic differentiation between recidive tumor and scar tissue
1.Which of the following indications is inadequate planning an MRI in head and neck region?
Evaluation of perineural tumor spread
**Bony skullbase evaluation in suspicion of bony fracture owing to an injury**
Cartilage infiltration of the larynx
Proving soft tissue involvement of suprahyoid compartments
Posttherapeutic differentiation between recidive tumor and scar tissue
85
**Which shape is generally characteristic in case of epidural bleeding**
1. Crescent
2. Amorph
3. Lentiform
4. Not detectable
c. Lentiform
86
1.Which of the following statement is the absolute contraindication for enema reduction of an intussusception (in case of a 4 month old baby):
Small amount of free fluid on the abdominal US
Signs of perforation
Subicterus
Small bowel obstruction
1.Which of the following statement is the absolute contraindication for enema reduction of an intussusception (in case of a 4 month old baby):
Small amount of free fluid on the abdominal US
**Signs of perforation**
Subicterus
Small bowel obstruction
87
1.To differentiate a T1 and T2 weighted image in MRI, look for:
Bones
Muscles
Aorta
Water
1.To differentiate a T1 and T2 weighted image in MRI, look for:
Bones
Muscles
Aorta
**Water**
88
**Subdural hematoma appears on CT examination usually with**:
1. Amorf contours
2. Ring shaped
3. Crescent shaped
4. Lense shaped
c. Crescent shaped
89
**Which guidance technique is mainly useful for the biopsy of thyroid nodule?**
1. X-ray guided biopsy
2. US-guided biopsy
3. CT-guided biopsy
4. MR-guided biopsy
b. US-guided biopsy
90
Subdural hematoma appears on CT examination usually with:
A/ Amorf contours
B/ Ring shape
C/ Crescent shape
D/ Lense shape
C/ Crescent shape
91
# Choose the correct statement
1. On T1 weighted images white mater has a higher signal intensity than grey matter
2. On T1 weighted images white matter has a lower signal intensity than grey matter
3. On T2 weighted images CSF has intermediate signal
4. On T2 weighted images bones have the highest signal intensity
a. On T1 weighted images white mater has a higher signal intensity than grey matter
1. Different tissues have different T1 and T2 values, which is why fat, muscle, and bone, for example, will appear differently not only from each other but also within different pulse sequences.
2. Tissues that have a short T1 will be bright.
3. Tissues with a long T2 will be bright
4. Bright translates into whiter or having increased signal intensity on MRI scans. Dark translates into blacker or having decreased signal on MRI.
5. A key point is that water will be dark on T1-weighted images and bright on T2-weighted images. Water is T1-dark and T2-bright.
6. If the fluid is dark (e.g., CSF, urine, etc) = T1 weighted image.
If the fluid is bright (e.g., CSF, urine, etc) = T2 weighted image.
7. Tissues and structures that are typicallt bright on T1: fat, hemorrhage, proteinaceous fluid, melanin, gandolinium abd other paramagnetic substances.
8. Tissues and structure typically bright on T2: fat, water, edema, inflammation, infection, cysts, hemorrhage.
92
1.Gold standard" method currently in the diagnosis of renal cell cancer
HRCT
Transabdominal US
Unenhanced abdominal CT examination
IV urography
Contrast enhanced multiphasic abdominal CT
1.Gold standard" method currently in the diagnosis of renal cell cancer
HRCT
Transabdominal US
Unenhanced abdominal CT examination
IV urography
**Contrast enhanced multiphasic abdominal CT**
93
During the CT examinations in the Hounsfield scale the density of the ………… is fixed to Zero.
A/ fresh blood
B/ water
C/ fat
D/ bone
B/ water
94
1. **Choose the correct statement**
1. Fresh hemorrhage in CT is hypodense
2. Chronic subdural hematoma in CT is hyperdense
3. MR is capable to determine the approximate age of hemorrhage
4. MR is not useful in identifying hemorrhage
c. MR is capable to determine the approximate age of hemorrhage
* Chonic \>14 days, T1=dark, T2=dark
* Late subacute 7-14 days, T1=bright, T2=bright
* Early subacute 3-7 days, T1= bright, T2= dark
* Acute 1-3 days, T1=isointense, T2=dark
* Hyperacute \<24h, T1=isointense, T2=bright
* Changes in the appearance of blood over time on MRI
95
1.How could we demonstrate a calcified stone in the gallbladder, with 30 mm in diameter (choose the false statement)
Angiography
US
Native abdominal CT
With P-A abdominal x-ray
1.How could we demonstrate a calcified stone in the gallbladder, with 30 mm in diameter (choose the false statement)
**Angiography**
US
Native abdominal CT
With P-A abdominal x-ray
96
1.Which investigation is stongly recommended before doing a barium enema?
Pelvic US???
Cystoscopy
Rectoscopy????
Barium follow-through
Urography
1.Which investigation is stongly recommended before doing a barium enema?
Pelvic US???
Cystoscopy
Rectoscopy????
Barium follow-through
Urography
97
1. **Which of the following is an absolute contraindicated for enema reduction of an intussusception?**
1. Small amount of free fluid on utrasonography
2. Signs of perforation (pneumoperitoneum, peritonitis)
3. Small bowel obstruction
4. Iodine allergy
b. Signs of perforation (pneumoperitoneum, peritonitis)
1. Contraindications: signs of peritonitis and perforations according to: https://radiopaedia.org/articles/intussusception-reduction
98
In case of a polytraumatised patient which is the fastest imaging method to get useful informations about cranial, chest and abdominal condition?
A/ Skull, Chest and abdominal X-ray
B/ Carotid and Abdominal Utrasound examination
C/ native and contrast enhanced Multidetector CT examination
D/ PET-CT
C/ native and contrast enhanced Multidetector CT examination
99
**In case of a simple liver cyst (with 25 mm diameter, without irregular wall and without septations), how would we characterize the inner content of the cyst?**
1. Hypoechoic
2. Anechoic
3. Hyperechoic
4. Hyperdense
b. Anechoic
100
**In neuroradiology**
1. MR has a superior ability in the imaging of the cranial bones
2. MR images lack bone artifacts
3. MR has the ability to distinguish calcifications
4. MR cannot visualize white matter lesions
b. MR images lack bone artifacts
(Bone-artefact O on lecture slide..)
101
A young 30 years old female was admitted for the emergency department with a strong, „beating-like” occipital headache.
What is the first imaging method in this case?
A/ MR
B/ Skull X-ray, two view
C/ Native CT of the brain
D/ Color-duplex Carotid Ultrasound
C/ Native CT of the brain
102
**How do you call the complex that should be evaluated in case of chronic sinusitis?**
1. Osteomeatal complex
2. Ostiomeatal complex
3. Ethmoidal complex
4. Nasomeatal complex
b. Ostiomeatal complex
103
**Interstitial shadows are**
1. Web-like
2. Of vascular origin
3. Patchy
4. Common CT terminology for mesenteric fat
a. Web-like
104
1.Young female patient previously underwent appendectomy. Now she is having pain n the ileocecal region. Which of the following disorders would you be suspicions of?
Sigma diverticulitis
Crohns disease
Peptic ulcer
Extrauterine gravidity
1.Young female patient previously underwent appendectomy. Now she is having pain n the ileocecal region. Which of the following disorders would you be suspicions of?
Sigma diverticulitis
**Crohns disease**
Peptic ulcer
**Extrauterine gravidity**
105
**What is the first modality choice in symptomatic bone tumors?**
1. PET-CT
2. Scintigraphy
3. Conventional x-ray
4. CT
c. Conventional x-ray
106
**The …….. classification system divides renal cyctic masses into five categories based on imaging characteristics on contrast-enhanced CT**
1. Bi-rads
2. Ren-Rads
3. Li-Rads
4. Bosniak
d. Bosniak
The bosniak classification system of renal cystic masses divides renal systic masses into five catergories based on imaging characteristics on contrast enhanced CT. it is helpful in predicting a risk of malignancy and suggesting either follow up or treatment.
107
**What is the diagnostic strategy in extracranial carotid disease?**
1. Primary examination is DSA which is complemented by CTA or MRA, US is only for kids
2. Primary examination is duplex US for screening and follow-up: problem-solving advanced imaging for selected cases is CTA or MRA; catheter angiography (DSA) is mainly for therapeutic interventions
3. US-guided puncture of the CCA and then directed angiography of the affected side
4. Primary examination is CTA: MRA is only for iodine-sensitive patients; DSA for all patient preceding surgery and duplex US for post-surgical complications.
b. Primary examination is duplex US for screening and follow-up: problem-solving advanced imaging for selected cases is CTA or MRA; catheter angiography (DSA) is mainly for therapeutic interventions
1. Carotid artery stenosis is usually diagnosed by color flow duplex US scan of the carotid arteries in the neck. This involves no radiation, no needles, and no contrast agents that may cause allergic reactions. This test has good sensitivity and specificity.
2. CTA or MRA may be useful. With contrast: contraindicated in patients with renal insuffieicency, catheter angiography has a 0.5-1% risk of stroke, MI arterial injury or retroperitoneal bleeding. The investigation chosen will depend on the clinical question and the imaging expertice, experience and equipment available.
108
**Duplex ultrasonography**
1. Combination of two transducers to see blood vessesl both in superficial and deep locations
2. Simultaneous doppler analysis of bilateral limbs by two sonographs
3. 2D US examination, then doppler analysis by ”pencil” probe
4. Simultaneous 2D US with doppler sampling from the vessels specified on the 2D image
4. Simultaneous 2D US with doppler sampling from the vessels specified on the 2D image
Duplex ultrasonography is used in vascular studies; refers to the simultaneous use of both grayscale or color Doppler to visualize the structure of, and flow within, a vessel and sprectral (waveform) doppler to quantitate flow.
109
Which guidence technique is mainly useful for the biopsy of thyroid nodule?
A/ X-ray guided biopsy
B/ US-guided biopsy
C/ CT-guided biopsy
D/ MR-guided biopsy
B/ US-guided biopsy
110
**In case of a huge left-sided pleural fluid collection, the mediastinal complex will move:**
1. Moderately to the right
2. The mediastinal complex will stay in unchanged position
3. Moderately to the left
4. Extensively to the left
a. Moderately to the right
111
1.Which organ would you put in this sentence: the …… body is the most common portion of this organ to be injured in blunt trauma because they are compressed against the spine in blunt traumatic injuries to the abdomen
Gall-bladder
Bladder
Pancreas
Liver
Aorta
1.Which organ would you put in this sentence: the …… body is the most common portion of this organ to be injured in blunt trauma because they are compressed against the spine in blunt traumatic injuries to the abdomen
Gall-bladder
Bladder
**Pancreas**
Liver
Aorta
112
**Which correlation is the most correct to the application of ultrasonography**
1. High frequency probe – deep penetration – low spatial resolution
2. High frequency probe – poor penetration – good spatial resolution
3. Low frequency probe – deep penetration – good spatial resolution
4. Low frequency probe – poor penetration – good spatial resolution
b. High frequency probe – poor penetration – good spatial resolution
113
**In case of the following GFR value the patient DOES NOT need hydration prior to an IV contrast enhanced CT examination:**
1. GFR is below 30 ml/min/1.73m2
2. GFR is above 40 ml/min/1.73m2
3. GFR is below 60 ml/min/1.73m2
4. GFR is above 60 ml/min/1.73 m2
d. GFR is above 60 ml/min/1.73 m2
114
1.Which of the followings can be complications after an operation
Ileus caused by adhesions
Abscess
Stress ulcus
Insufficiency of the suture
1.Which of the followings can be complications after an operation
## Footnote
**Ileus caused by adhesions**
**Abscess**
**Stress ulcus**
**Insufficiency of the suture**
