Question: Frequency of sound waves used for transabdominal ultrasonography is


Question: Spinnaker Sail sign is seen in

Pneumo mediastinium

Ring around the artery sign
Spinnaker sail sign
Continuous diaphragm sign


Question: NMR is based on the principle of

The phenomenon of 'nuclear induction', later to be termed 'nuclear magnetic resonance' (NMR), was described by Bloch and Purcell and their colleagues in 1946. NMR has been used extensively for studying the propeies of matter at the molecular level (NMR spectroscopy). In applications to medicine, the term 'nuclear' has been dropped, leaving it as magnetic resonance or MR(Ref: Grainger&;s diagnostic radiology, 6th ed; page 90)


Question: Isotope used in RAIU


Question: For teletherapy, isotopes commonly used are


Question: Phantom Tumor is name given to

*Fissural Interlobar effusion is called as Phantom Tumor *It appears biconvex sharply marginated along the fissural lines viewed on a Lateral view


Question: Deep sulcus sign is seen in

Deep Sulcus sign is seen On Supine chest x-ray in Expiration phase in a case of Pneumothorax where the lucency of air in the costophrenic angle gives the appearance of a deep sulcus. Other Findings of Pneumothorax on CXR: Absent Bronchoalveolar markings Visceral Pleural Reflection


Question: Spot the diagnosis in the following IVU

Note the ectopic kidney seen in the pelvis on left side above the urinary bladder. This patient had solitary right kidney, which was normal in position. Ectopic kidneys are found in one in 1000 people, usually on the left near the pelvic brim. The other kidney is generally normal. A diseased ectopic kidney may present diagnostic problems and may be mistakenly excised as an unexplained pelvic mass.


Question: Artifical radioisotopsa) Radiumb) Uraniumc) Plutoniumd) Iridiume) Cobalt

Important artificial radionuclides :- Tritium - 1, Carbon - 14, Cobalt - 60, Strontium 89, Strontium - 90, Iodine 131, Cesium 134, Cesium 137, Plutonium - 239, Iridium, Tc - 99.


Question: Investigation of choice in obstructive jaundice is


Question: SI unit of radiation absorbed dose is

Absorbed dose - Gray (SI)
Exposure dose - C/kg (SI)
Dose equivalent - Sievert


Question: Remote after loading is used in


Question: Best view for visualizing Cl and C2 veebrae is


Question: Paint brush appearance is a feature of

Paint brush appearance - Medullary sponge kidney.
Egg in CUP appearance  - Papillary necrosis.


Question: Beheaded Scottish terrier sign is seen in

Optimal view for visualizing (spondylolysis) defect is=X-ray spine oblique view: - Scotty dog with "broken collar or neck" = Spondylolysis. - Beheaded Scotty dog = Spondylolisthesis. Oblique radiograph of lumbar spine is best view for radiographic diagnosis of spondylosis. Note the description of Scottish dog appearance as seen on oblique LS spine view and classical spondylolysis:

Fracture transverse process of lumbar veebra


Question: Most common intracranial neoplasm

M/c intracranial neoplasm - Metastasis.
M/c primary intracranial neoplasm - Gliomas.
M/c extra - axial intracranial neoplasm - Meningioma.


Question: Stereotactic radiosurgery is a form of

Stereotactic radiosurgery means delivery of precise high dose radiation in a single fraction to intracranial targetsReference: Eric J Hall Textbook of Radiobiology for Radiologist; 5th edition

Embolisation and radiofrequency ablation


Question: Onion peel appearance on radiograph is not seen in

Fibrous dysplasia-
The normal radiolucent maxillary sinus may be partially or totally replaced by the increased radiopacity of  this lesion. The degree of radiopacity depends on its stage of development and the relative amounts of bone and fibrous tissue present. Usually the radiopaque areas have a uniform characteristic ground-glass appearance on extraoral images or an orange-peel appearance on intraoral views. Onion-peel appearance is not seen in this condition.
White and Pharoah, 7th ed, pg- 485


Question: Renal coical imaging is done by

(Ref: Grainger&;s diagnostic radiology, 6th ed; page 133)


Question: Initial investigation for an amoebic liver abscess is September 2009

Ans. A: USG Ultrasonography is the preferable initial diagnostic test. It is rapid, inexpensive, and is only slightly less sensitive than CT scan (75-80% sensitivity vs 88-95% for CT scan). Ultrasonography simultaneously evaluates the gallbladder and avoids radiation exposure. As opposed to scanning with technetium-99m, sonography often can distinguish an abscess from a tumor or other solid focal lesion. The lesions tend to be round or oval, with well-defined margins, and hypoechoic. CT scan is sensitive but the findings are not specific. The abscess typically appears low density with smooth margins and a contrast-enhancing peripheral rim. The use of injected contrast may differentiate hepatic abscesses from vascular tumors. MRI is sensitive, but the findings are not specific. This test provides information comparable with less expensive imaging procedures. Technetium-99m liver scanning is useful for differentiating an amebic liver abscess from a pyogenic abscess; however, it is not used as a first-line test. Because amebic liver abscesses do not contain leukocytes, they appear as cold lesions on hepatic nuclear scanning, with a typical hot halo or a rim of radioactivity surrounding the abscess. In contrast, pyogenic liver abscesses contain leukocytes and, therefore, typically appear as hot lesions on nuclear scanning. Gallium scanning is helpful in differentiating pyogenic abscess (similar to technetium-99m nuclear hepatic scanning) but requires delayed images, which makes the test less helpful. Hepatic angiography is only useful to differentiate liver abscesses from vascular lesions. Plain chest or abdominal films may show elevation and limitation of motion of the right diaphragm, basilar atelectasis, and right pleural effusion or gas within the abscess cavity. None of the imaging tests can definitely differentiate a pyogenic liver abscess, an amebic abscess, or malignant disease. Clinical, epidemiological, and serological correlation is needed for diagnosis.


Question: Preferred method for obtaining dense nephrograms

Rapid (bolus) injection of contrast is preferred method.


Question: "Egg shell" calcification in hilar nodes suggest


Question: An exaggerated smile line seen in OPG is due to


Question: Inveed Moustache Sign is seen in

Suggestive Of Congestive Hea Failure Reverse Moustache Sign, Stag Antler Sign, Hands Up sign Indicate prominence of Upper Lobe Vessels(cephalization) TAPVC -Figure of 8 Constrictive pericarditis -Egg in Cup PAPVC- Scimitar Sign


Question: Father of Radioactivity is

Henry Becquerel was the first person to discover evidence of radioactivity, received the 1903 Nobel Prize in Physics. The SI unit for radioactivity, the becquerel (Bq), is named after him. W.C. Roentgen was a German mechanical engineer and physicist, who, on 8 November 1895, produced and detected electromagnetic radiation in a wavelength range known as X-rays or Rontgen rays, an achievement that earned him the first Nobel Prize in Physics in 1901. Godfrey Hounsfield was an English electrical engineer who shared the 1979 Nobel Prize for Physiology or Medicine with Allan McLeod Cormack for his pa in developing the diagnostic technique of X-ray computed tomography(CT). Henri Becquerel


Question: Following is used in PET scan

Explanation:
"Fluorine-18 Fluorodeoxyglucose (FDG) is the most common positron-labeled radiotracer in positron emission tomography fPET), in most tissues,
including cancer, there is little phosphatase activity. The intracellular metabolite, FDG-6-phosphate cannot undergo further conversions and is therefore trapped inside the cell.
FDG is useful in staging and metastasis of Renal cell cancer by PET. " (Ref: Wolfgang) Positron Emission Tomography (PET)
● It is a nuclear medicine imaging technique that produces a three-dimensional image or picture of functional processes in the body.
The system detects pairs of gamma rays emitted indirectly by a positron-emitting radionuclide (tracer), which is introduced into the body on a biologically active molecule.
Three-dimensional images of tracer concentration within the body are then constructed by computer analysis.
In modern scanners, three-dimensional imaging is often accomplished with the aid of a CT X-ray scan performed on the patient during the same session, in the same machine.
If the biologically active molecule chosen for PET is FDG, an analogue of glucose, the concentrations of tracer imaged then give tissue metabolic activity, in terms of regional glucose uptake.
The electron-positron decays result in two 511 keV gamma photons being emitted at almost 180 degrees to each other; hence, it is possible to localize their source along a straight line of coincidence (also called the line of response, or LOR). A collimator is a device that narrows a beam of particles or waves.
Lead collimators are used in X-rays and linear accelerators.


Question: Earliest & characteristic radiological finding of leukemia

All the above are the findings of leukemia. But Earliest & characteristic finding is option A.

Translucent transverse metaphyseal bands


Question: "Spongy appearance" with central sunburst calcification is seen in

Serous cyst adenoma (Ref: Sutton Radiology, 7/e, p 793] "The serous cyst adenoma, or inicrocystic adenoma, is a benign tumor of elderly women, presenting with vague abdominal symptoms. A large calcified mass is often seen, with the calcification having a characteristic sunburst pattern within a central fibrotic scar". - Sutton Splenocolic ligament Small and large bowel mesentry Left broad ligament in women Left spermatic cord in men


Question: The most radiosensitive cells in the body are


Question: Egg shell calcification in hilar lymph nodes is seen ina) Sarcoidosisb) Histoplasmosisc) Tuberculosisd) Carcinoma lunge) Silicosis


Question: CTDI represents

CT Dose Index (CTDI): It is a standardized measure of radiation dose output of a CT scanner which allows the user to compare the radiation output of different CT scanners. In CT the computed tomography dose index (CTDI), and the dose-length product (DLP) are used. These operational dose qualities are often stored together with patient information in the digital archives like PACS and thus the radiation exposure of individual patients may be retrieved afterward.


Question: The gold standard for diagnosis of echinococcal cyst is

USG is the cornerstone for diagnosis and staging of cystic echinococcus (especially liver).MRI is capable of reproducing ultrasound features of cystic echinococcal and is preferred over CT where USG cannot be used because of a difficult location.Serological tests are commonly employed to supplement the radiological data in the diagnosis of hydatid cyst. The current gold standard serology test for echinococcosis detects IgG antibodies to hydatid cyst fluid-derived native or recombinant antigen B subunits. This is performed using ELISA or immunoblot formats Classification of hydatid cyst:GharbiWHOUS characteristicsType 1CE 1Unilocular cyst + wall + internal echogenicitiesType 2CE 3Detached membraneType 3CE 2Multivesicular, multiseptated cyst, daughter cystsType 4CE 4Heterogeneous cyst, no daughter vesiclesType 5CE 5Cyst with a wall calcification(Ref: Grainger and Allison&;s diagnostic radiology 6th edition, 770)


Question: Most common cause of osteoblastic bone metastais


Question: Floating water lily sign is seen in

Ans. is 'c' i.e. Hydatid cyst Separated membranes floating with the cyst give the appearance of water lily.It is pathognomonic of hydatid cyst.


Question: "Lemon sign" & "Banana sign" on Antenatal USG is seen in

*The Anterior bossing of frontal bone is called as Lemon sign *Wrapping of cerebellum around brain stem is called as Banana sign *Lemon sign and Banana sign are features of Chiari -II Malformation and also seen with spina bifida.


Question: Investigation of choice for a pregnant lady with upper abdominal mass


Question: Molten wax appearance is seen in

Motten wax or Flowing candle wax appearance feature of Melorheostosis.


Question: Short 4th metacarpal is a feature of

Seen in pseudohypoparathyroidism and Pseudo pseudo hypoparathyroidism.


Question: Alpha particle is similar to

Ans: d (Helium nucleus) Ref: Vasudevan 4th ed/p 464.Alpha particle consists of 2 protons and 2 neutrons bound together into a particle identical to Helium nucleus He2+.Beta particles are high energy, high speed electrons or positrons emitted by radioactive nuclei. Gamma rays are electromagnetic radiation of high frequency.X-rays are low energy photons.Penetration powen-Gamma ray > X ray. Beta particle > alpha particleIonising and damaging power: -Alpha particle> Beta particle > X ray> Gamma ray


Question: Months or years following radiotherapy, the irradiated oral mucosa


Question: Radiation exposure is least in

MCU : 1 - 2 (msv) - 60 chest x - ray.
Cystography : 1- 8 (msievert) - 90cxr.
IVP : 2 - 4 - 120cxr.
CT pelvis : 10 - 500cxr.


Question: Maximum radiopaque shadow in ovary is seen in

Teratoma is most radio-opaque because of its calcifications (Ref: Radiology Review Manual by Wolfgang Dahne 6thEtd, 1010)


Question: A developer at high temperature will cause


Question: IOC for pyonephrosis


Question: IOC for acoustic neuroma

IOC for acoustic neuroma - Gadolinium enhanced MRI.


Question: Claw sign or pincer sign is seen in

Other signs in intusucception: Target sign pseudokidney sign coiled spring sign solar eclipse sign


Question: The best method to reduce radiation caries is application of viscous


Question: Substance with same atomic number but different mass number

Ans. a (Isotope). (Ref. Radioactive isotope in medicine and biology by Quimby, 2nd ed., 26)TermDefinitionIsotopesAtoms having same atomic numbers, different mass numbers (hence different neutron number) e.g., 17CI35, 17CI37 (same no.of protons and electrons)IsobarsAtoms having same mass numbers, different atomic number (hence different neutron number) e.g., 28Ni64, 30Zn64IsotonesAtoms have same neutron number, different atomic mass number e.g., 18A40IsomersAtoms having same atomic and mass numbers but different energy states in nucleus.


Question: Air bronchogram on chest Xray denotes

A solitary pulmonary nodule (SPN) or coin lesion is a mass in the lung smaller than 3 centimeters in diameter.
It can be an incidental finding found in up to 0.2% of chest X-rays and around 1% of CT scans.


Question: Investigation of choice for diagnosis of spleenic rupture


Question: Radioprotector among the following is

Amifostine is an organic thiophosphate cytoprotective agent indicated to reduce the cumulative renal toxicity associated with repeated administration of cisplatin in patients with advanced ovarian cancer or non-small cell lung cancer and also to reduce the incidence of moderate to severe xerostomia in patients undergoing post-operative radiation treatment for head and neck cancer. Amifostine is a prodrug that is dephosphorylated by alkaline phosphatase in tissues to a pharmacologically active free thiol metabolite, believed to be responsible for the reduction of the cumulative renal toxicity of cisplatin and for the reduction of the toxic effects of radiation on normal oral tissues. Healthy cells are preferentially protected because amifostine and metabolites are present in healthy cells at 100-fold greater concentrations than in tumour cells.Reference: Eric J Hall Textbook of Radiobiology for Radiologist; 5th edition


Question: SPECT Stands for

SPECT stands for Single Photon Emission Computed Tomography, It uses a 360 degree revolving Gamma Camera and Acquires 3D images using Tc99m labelled radioisotopes like HMPAO (Hexamethylpropyleneamine oxime).

Single Proton Emission Computed Tomography

Single Positron Emission Computed Tomography

Single Positive Emission Computed Tomography


Question: IOC for cardiac tamponede

IOC for cardiac tamponade - 2D Echo.
IOC for cardiomyopathy  - 2D Echo.


Question: Shepherd's crook deformity is a characteristic radiological feature of

Shepherd's crook deformity - Fibrous dysplasia
Coat - hanger appearance - Osteochondroma.


Question: On MRI the differential diagnosis of spinal cord edema is

Both cord edema and myelomalacia appear hypointense on T1 and hyperintense on T2 image.


Question: Main advantage of transoesophageal echocardiography (TEE) is

Ans. a (Site of origin of thrombus can be detected). (Ref. Grainger, Diagnostic Radiology, 4th ed., 697, 977)Advantages of TRANSESOPHAGEAL ECHO (TEE)# Widely available, noninvasive (relatively)# Can be performed at the bedside within 10-15 minutes.# Can be performed on an unstable patient.# TEE is useful in patients in whom adequate echo images cannot be obtained by the standard echo techniques (most often because their chest walls are particularly thick, or because they have emphysema.)# Best for detecting perioperative ischemia and is a cardiovascular monitoring.# Provides additional useful information:- AI,- Pericardial effusion,- Coronary ostia visualization,# TEE can be performed in the operating room during open heart surgery (Intraoperative TEE is especially useful during valve reconstruction surgery).# Posterior structures (pulmonary veins, the atria & their appendages & atrioventricular valves) are especially well imaged & hence the thrombi that are common in atria and their appendages (especially the left atrial thrombus) can be easily detected.# Best for detecting vegetations on the valves in IE.Disadvantages of TEE# Contraindicated in patients with: esophageal varices, tumours and strictures.# Potential complications:- Bradycardia, hypotension, bronchospasm.- The most common problem with the TEE is certain amount of gagging and throat discomfort during the procedure.- Patients often have sore throats for a few days after the procedure.- Rarely, perforation of the esophagus or bleeding can occur.


Question: IOC for stroke is

IOC FOR STROKE is NCCT as it differentiates hemorrhagic stroke from ischemic stroke The initial investigation in all cases of Cerebrovascular accidents should be NCCT IOC FOR ISCHEMIC STROKE/ACUTE INFARCT is DWI-MRI IOC for Head trauma is NCCT IOC For Acute SAH IS NCCT


Question: Renal GFR is best measured by

C i.e. Tc99 DTPA 99mTcDMSA (gold standard) and 99mTc- GFIA are morphologic agents. Dimercaptosuccinic acid (DMSA) labelled with technetium-99m is most satisfactory tracer for imaging renal anatomyQ (e.g. in renal ectopia and anomalies like horseshoe kidney), differentiating functional renal masses (with radiotracer uptake) from pseudomassesQ (abscess, cysts or tumors which show no uptake of DMSA and appear photon deficient on renal images) and detecting infection and scarringQ. 99Tc-DMSA scan is most accurate (non invasive) method for estimating distribution of function between two kidneysQ. It is used to locate functional renal tissue, to find out scar or non-functioning areas of renal parenchymaQ (or to differentiate renal coex form soft tissue masses in or near kidney) and to estimate the functional contribution of each abnormal kidney. Dimercaptosuccinic acid (DMSA) labelled with technetium-99m is most satisfactory tracer for imaging renal anatomyQ (e.g. in renal ectopia and anomalies like horseshoe kidney), differentiating renal masses (with radiotracer uptake) from pseudomassesQ abscess, cysts or tumors which show no uptake of DMSA and appear photon deficient on renal images) and detecting infection and scarringQ. 99mTc-MAG3 (preferred), 99mTc-DTPA (preferred in emergency) and 1311OIH, (ohoiodohippurate) are functional agents. Functional agents are used for assessment of renal perfusion, renal plasma flow, glomerular filtration and tubular secretion and are applied in dynamic radionuclide studies of urinary tract obstruction. (obstructive uropathy), vesico-ureteral reflux, renovascular hypeension, and acute renal failure. (anuria/oliguria). Radionucleide that are excreted almost entirely by glomerular filtration can be used to estimate GFR and these are - Tc99 in- labelled DTPA (diethylenetriaminepenta acetic acid)Q and Chromium 51- labelled - EDTAQ


Question: Obliteration of Costophrenic angle is seen in

A Small Amount of free fluid may be undetectable on an erect PA chest radiograph as it tends initially to collect under the lower lobes. As the amount of effusion increases, the posterior and then the lateral costophrenic angles become blunted, by which time a 200 to 500-mL effusion is present


Question: In pantamograph, if patient chin is placed anterior to the focal trough, the structures appears to be


Question: Most sensitive tissue to Radiaton is


Question: Dye used for myelography is

Myelography uses a real-time form of x-ray called fluoroscopy and an injection of contrast material in subarachnoid space to evaluate the spinal cord, nerve roots and meninges. Iofendylate (Myodil) is a radiocontrast agent, typically used for performing myelography studies.It is paicularly useful for assessing the spine following surgery and for assessing disc abnormalities in patients who cannot undergo MRI.


Question: A 35 year old female presented with history of multiple transient ischemic attacks. The Given Carotid angiogram is suggestive of

Beaded or toous appearance of internal carotid aery Fibromuscular dysplasia Characterised by an idiopathic, non-inflammatory,non-atherosclerotic angiopathy of small and medium-sized aeries. More common in young women, typically diagnosed between the ages of 30 and 50 DSA is the gold standard. The characteristic findings alternating stenosis and dilatations, causing a String of beads appearance.


Question: Best radiographic view for fracture C1, C2 veebra is

(Ref: Radiology Review ManualBy Wolfgang Dahne 6thEtd, Page no:183)


Question: Egg shell calcifications can be seen in Sarcoidosis Silicosis Aspergillosis Pulmonary aery hypeension Amyloidosis scleroderma

Egg shell calcification is peripheral rim like calcifications seen in cases of Sarcoidosis, Silicosis,Pneumoconiosis.


Question: In pulmonary embolism, findings in perfusion scan isa) Perfusion segmental defectb) Perfusion defect with normal lung scan & radiographyc) Tenting of diaphragmd) Normal chest scan

At least 2% of patients with PE have normal V/Q scan and 4% of patients with normal V/Q scan have pulmonary embolism.
41% of patients with PE have high probability scan which includes 2 or more segmental perfusion defects with normal chest radiograph and normal lung ventilation scan.


Question: Posterior acoustic enhancement is seen with

Posterior acoustic enhancement is seen with cystic lesions, gall bladder and urinary bladder. Posterior acoustic shadowing is seen with air, bone, calcification. Acoustic shadowing on an ultrasound image is characterized by a signal void behind structures that strongly absorb or reflect ultrasonic waves. This happens most frequently with solid structures, as sound conducts most rapidly in areas where molecules are closely packed such as in bone and stone.


Question: Maximum radiation dose tolerable tissue is

Tissue-specific radiation riskHigh riskGonadsStomachColonlungBone marrowBreastModerate riskBladderOesophagusLiverThyroidLow riskBrainBoneSkinSalivary glands(Ref: Farr&;s Physics for Medical Imaging, 2nd Edition, chapter 2)


Question: Accordian sign is seen in

The 'Accordion sign' (also known as 'conceina sign') is seen on CT examinations of the abdomen Refers to the similarity between the thickened oedematous wall of Pseudomembranous colitis and the folds of an accordion. This appearance is the result of hyperaemic enhancing mucosa stretched over markedly thickened submucosal folds. Also seen when contrast is trapped between oedematous haustral folds and pseudomembranes formed on the luminal surface of the colon.


Question: Wavelength of light is

Ans: a (400-700nm) Ref: Vasudevan 4th ed p. 479Wavelength of visible light is 400-700nm.Violet- 420 nmBlue- 470 nmGreen- 520 nmYellow- 580 nmRed- 680 nm


Question: Compared with calcium tungstate screens, rare earth screens decrease patient exposure by about


Question: Ground glass appearance is not seen in

B i.e. Left to Right Shunt Ground Glass Appearance It is radiological marker of pathology in air space or interstitiumQ. Presents with increased lung density which on chest X Ray obscures broncho vesicular markings (but present on CT ; if bronchial & vascular markings are absent both in X Ray & CT then k/a consolidation) Total Anomalous Pulmonary Venous Drainage (TAPVD) Due to Interstial & alveolar edema caused by pulmonary venous hypeension Obstructed TAPVD usually presents in neonatal period with cynosis and severe respiratory distress and it is difficult to differentiate it from pulmonary hypeension & severe pulmonary disease.


Question: Spongy appearance with sunburst calcification is seen in

Serous cystadenoma-Serous cystadenomas (microcystic adenomas) are the second most common cystic tumours of the pancreas. The clinical presentation of serous cystadenomas is similar to that of mucinous cystic pancreatic tumours.- An association with VHL disease has been described.-Most patients present with nonspecific symptoms of vague abdominal pain or discomfo, but many have a palpable mass.- These tumours can be large, with a size of 1-25 cm. Because of increasing use of cross-sectional imaging, many of these tumours are detected as an incidental, asymptomatic finding.- On CT scans, sunburst central calcification in a spongy mass is pathognomonic of this tumour, but this finding occurs only in 10% of patients.- Endoscopic Ultrasonography (EUS) allows better resolution of the honeycomb structure than CT. At times, the cysts may be large, a feature that makes it difficult to differentiate these cysts from MCNs.g. Hypervascularity may be demonstrated on angiograms, and some tumours occur with intra-abdominal haemorrhage.-Analysis of the cyst fluid characteristically reveals low viscosity and low levels of CEA, with negative cytologic results for malignant cells, as the vast majority of serous cystadenomas are benign.-Surgical resection is the treatment of choice for symptomatic tumours and tumours that show continuous growth.-Many of these tumours may require a Whipple procedure or distal pancreatectomy, depending on the anatomic location. Distal pancreatectomy may be performed and the spleen can be preserved, given the absence of malignant potential.Mucinous cystic neoplasmsa. Nonenhanced CT scans show a well-defined, unilocular or multilocular, externally smooth, round-to-ovoid mass with fluid attenuation.b. The attenuation values of the multilocular cysts vary according to the degree of haemorrhage or protein in the mucoidc. Visualization of nodular or papillary excrescences with irregular borders of the septae is possible. If present, calcification is curvilinear or punctate and confined to the cyst wall or septa. Contrast-enhancedd. CT scans show enhancement of the cyst wall, internal septations, mural nodules, and other intracavitary projections. CT more clearly demonstrates the enhancement of cystic walls and septa than do other studies.e. Compared with serous cystic tumours, the cysts in MCNs are larger (>20 mm in diameter) and less numerous (usually <6).f. CT guided aspiration of the cyst can provide fuher diagnostic clues and enable their differentiation from other pancreatic cystic masses (eg, pseudocyst, serous cystadenoma, and solid and pseudopapillary neoplasm).g. MCN cyst fluid typically has a high viscosity, low amylase levels, and high CEA and carbohydrate antigen (CA) 72-4 levels, and they may show malignant cytology in patients with mucinous cystadenocarcinomas.h. Periodic acid Schiff (PAS) and May Grunwald/Giemsa (MGG) stains are usually positive for extracellular as well as intracellular mucin.i. Treatment is the same as that of serous cystadenoma.(REF. SCHWAZ SURGERY 8TH EDITION PG 1572; David Sutton; Textbook of radiology and imaging, 7th edition, page no.793 )


Question: Luftsichel sign on chest radiograph is indicative of


Question: IOC for aortic dissection in unstable patient

Stable patient - MRI.
Unstable patient - TEE (Trans esophageal Echo).


Question: Measurement used to estimate gestational age in first trimester.

Crown - rump length - 1st trimeter.
FL - 2nd and 4rd trimeter.
AC and HC  - 3rd trimester.


Question: Balthazar grading is used for acute pancreatitis based on findings on

CT grading of acute pancreatitis - Balthazar grading.


Question: Transrectal ultrasonography in carcinoma prostate is most useful for

A i.e. Guided prostatic biopsy The major role of transrectal USG is to guide prostatic biopsiesQ.


Question: Radiopharmaceutical used for the liver scan is

Tc-99m sulphur colloid is used in liver scan.Tc-99m DTPA measurement of GFR.Tc99m-sestamibi is taken up by cells with a high concentration of mitochondria i.e. highly cellular/metabolically active tissues such as the hea but also abnormal tissues such as oxyphil cell parathyroid adenomas, myeloma and breast cancer.


Question: Tissue weighing factor for gonads is


Question: One gray equals

SI unit of radiation absorbed dose is GRAY (1 Gy= 1J/Kg)Absorbed dose is the energy absorbed as ionization or excitation per unit mass of the material irradiated.The concept of absorbed dose applies to all kinds of ionizing radiation (direct and indirect) and to any material.Before 1980 the international dose of absorbed dose is RAD1 Gy=100 rad (1rad=1cGy=10 mGy)(Ref: Farr&;s Physics for Medical Imaging, 2nd Edition, Page No 17)


Question: For the treatment of deep seated tumors, the following rays are used.

Ans. is 'a' i.e. X-rays and Gamma-rays X-rays and gamma rays are electromagnetic waves with highest penetrating power.For deep seated tumours rays with maximum penetrating power is required so x-rays and gamma rays are used.Harrison 141h/e states - "Megavoltage X-rays are used to irradiate internal deep seated lesions since high energy penetrating beams deliver a less intense superficial dose and spares the skin".


Question: Cystic lesion in suprasellar region with calcification


Question: Pruned tree appearance of pulmonary circulation is a feature of

Prunel tree appearance of pulmonary circulation in X-ray - Pulmonary artery hypertenion.
Prunel tree appearance of pulmonary circulation in ERCP or MRCP - Primary scleroing cholangitis.


Question: Dawson Fingers are feature of

Multiple sclerosis :- - is m/c immune mediated inflammatory demyelinating disease of CNS - autoimmune destruction of myelin formed - Dawson fingers - are radiological feature of Multiple sclerosis - are periventricular white matter hyperintensities perpendicular to ventricles - involvement of calloso-septal interface - open ring/ horseshoe enhancement is suggestive of demyelination


Question: Earliest sign of fetal life is best detected by

D i.e. Doppler Doppler is an interpretation of audible signals of USG By listening fetal hea sounds and seeing blood flow, we can detect fetal life at earliest.


Question: Location of the indicated arrow in internal capsule is

(A) Rubrospinal tract# Rubrospinal tract is a part of the nervous system. It is a part of the lateral indirect extra-pyramidal tract.> Path: In the midbrain, it originates in the magnocellular red nucleus, crosses to the other side of the midbrain, and descends in the lateral part of the brainstem tegmentum. In the spinal cord, it travels through the lateral funiculus of the spinal cord in the company of the lateral corticospinal tract.> Function: It is a major motor control pathways for the mediation of voluntary movement. Responsible for large muscle movement as well as fine motor control, and it terminates primarily in the cervical spinal cord, suggesting that it functions in upper limb but not in lower limb control. It primarily facilitates flexion in the upper extremities. It is small and rudimentary in humans.


Question: Sieve is a unit of

Ans. is'd'i.e., Dose equivalentRef: A Textbook of Sciencefor the Health Professions p. 132Sieve is new (Sl) unit of dose equivalent replacing Rem


Question: Best test to determine etiology of SAH

C i.e. Intra aerial digital Substraction Once dx is done by CT Scan; digital substraction angiography (DSA) is done to determine etiology. DSA is most sensitive & best inv. for determining etiologyQ. Now DSA is being replaced by noninvasive methods as MRA (MRI - angiography) & CTA (CT - Angiography).

Intra aerial digital Substraction Angiography


Question: B/L spider leg sign on IVP suggests


Question: Radon exposure is known to cause

ETIOLOGY OF CANCERS OF LUNG
■ Chromium,
■ Nickel, other metals
■ Tobacco smoking,
■ Ionising radiation (uranium)
■ Radon.
■ Asbestosis (May predispose to Bronchogenic carcinoma, mesothelioma, gastrointestinal cancer). Suspected Carcinogens


Question: Late Complication of radiotherapy

Mucositis (Inflammation of mucosa) is a late complication.


Question: Zygoma fractures can be best viewed by

The occipitomental (Waters view) radiograph provides an image of the whole zygoma and maxillary sinus.


Question: T sign is seen in

T sign - membrane in a monochoronic twin pregnancy.


Question: Base of hea is formed by

D i.e. RA + LA The base of hea forms its posterior surface. It is formed mainly by the left atriumQ and by small pa of right atriumQ.


Question: The best radiographic view for TMJ is

The panoramic image is a useful tool for providing a broad overview of the TMJ and surrounding structures. It serves the purpose of allowing the clinician to rule out gross disease, and for some patients, it is the only imaging required before conservative therapy is initiated. Gross osseous changes in the condyles may be identified, such as asymmetries,  extensive erosions, large osteophytes, tumors, or fractures. The panoramic projection also provides a means of comparing left and right sides of the mandible and can reveal odontogenic diseases and other disorders that may be the source of TMJ symptoms.


Question: Multiloculated cystic lesion in liver is a CT feature of

Ans: a) Hydatid cyst On CT scans hepatic echinococcal cysts (hydatid cyst) appear as well defined round or oval cystic masses with a density near that of water.Daughter cysts, indicating viability, give the lesion a multilocular appearance. Extensive calcification usually indicates that the lesion is no longer viable.Liver is the commonest site of hydatid disease. Most cysts are in the right lobe and are clinically silent.Calcification is seen in 20-30% of cases and although calcification doesn't necessarily indicate death of the parasite, extensive calcification favours an inactive cyst.Hydatid cyst in kidneyCyst is usually polar and calcification is curvilinear or heterogenous.Hydatid cyst in lungsMost common in right lower lobes.Various Chest x-rav signsi) Meniscus / Moon signCyst communication with bronchial tree.ii) Crescent signThin radioluscent crescent in uppermost part of the cyst due to rupture of pericyst with air dissecting between pericyst and laminated membrane.iii) Cumbo sign:Air fluid level inside endocystiv) Serpent sign:Collapsed membrane inside cyst outlined by air.v) Water lilly sign/ Sign of CamalotteCompletely collapsed crumpled cyst membrane floating on the cyst fluid.Regarding option d -metastases: they are uniloculated purely cystic lesions in liver - seen with adenocarcinomas such as mucinous carcinoma of the colon and cystadenocarcinoma of the ovary.Option c - Hepatocallular carcinomaAppear as a hypodense mass with attenuation values more than that of water. It is usually unilocular but may appear multifocal.


Question: Point B in treatment of Ca cervix corresponds to


Question: Onion peel appearance is more characteristic of

Onion peel appearance is a periosteal reaction more characteristic of Ewing's sarcoma.


Question: Penny test is the quality assurance test to detect


Question: Interpret the following chest Xray


Question: Yolk sac is visible on USG first at

yolk sac should be seen on transabdominal scanning when the mean sac diameter (MSD) is 20 mm or at a gestational age of 7 weeks and is usually seen endovaginally with an MSD of 8-10 mm or gestational age of 5.5 weeks.The gestational sac (GS) is the first sign of early pregnancy on ultrasound The threshold level identifies the earliest one can expect to see a sac (4 weeks, 3 days), and the discriminatory level identifies when one should always see the sac (5 weeks, 2 days).(Ref: Diagnostic Ultrasound by Carol M. Rumack, Stephanie R. Wilson, J. William Charboneau, and Deborah Levine,4thed, page 1079,1080)


Question: The ultrasonic sound waves employed in ultrasound machine for medical sonography have the frequency of

Frequency refers to a characteristic of the sound that is, the number of times that conduction paicles vibrate back and foh per second. Frequency of sound waves is usually between 1 and 20 MHz in medical sonography. Hence the best answer for this question would be A. 2-20 MHz Christensen's Physics of Diagnostic Radiology, 4/E,Pg no 347


Question: Calcification in basal ganglia is seen in


Question: Chain of lakes appearance in ERCP is seen is


Question: The characteristic finding in USG of ectopic pregnancy is

<img alt="" src=" />An ectopic pregnancy occurs when a feilized egg implants and grows outside the main cavity of the uterus


Question: Arrange the radiographic findings of Congestive Hea Failure in sequential order with earlier changes first and advanced findings later. 1. Kerley Lines 2. Cephalisation 3. Equalisation of Upper Lobe and Lower lobe vessels 4. Batwing appearence

Equalisation of Upper Lobe and Lower lobe vessels | Cephalisation | Kerley Lines | Batwing appearance


Question: Key hole sign is seen in

Key hole sign - Posterior urethral valve.
Crescent sign - Hydronephrosis.


Question: Half life of I131 is


Question: Earliest CXR feature of left atrial enlargement is

A i.e. Elevation of the left main bronchus Left atrial enlargment presents radiologically with elevation of left main bronchus (earliest feature)Q, splaying or widening of carinaQ (to right or obtused angle), indentation & displacement of oesophagus posteriorly, double contour/shadow/density or double right hea borderQ, and prominent left atrial appendage. Left Atrial Enlargement LA does not form any pa of cardiac border in normal subjects (on PA view) because it lies in midline & posteriorly. It usually, enlarges postriorly & to the right causing indentation & displacement of oesophagus posteriorly (on barium swallow) . Elevation of left main bronchusQ is the earliest evidence (feature) of left atrial enlargmentQ. Subequently there is splaying of carina (i.e. carinal angle widens and become right or obtused angled as compared to normal 51-71 degree). The right border of an enlarged left atrium is visible as double contour (shadow/density) adjacent to the right hea border usually within the main cardiac shadow. Double right hea border is formed d/t bulging of left atrium into right lung & eventually forming right hea border. The borders of left & right atria are differentiated by the fact that left atrial border passes medially towards spine & border of right atrium is limited below by entry of IVC (inf. venacava). With massive enlargment LA can form the most pa of right cardiac border - Left border of LA is rarely visible, although left atrial appendage, when dilated, is seen as a bulge below the main pulmonary aery. - On lateral view postero-superior pa of cardiac shadow becomes prominent. Right Atrium Enlargement - In early stage, only RA appendage fills the space b/w front of heat & back of sternum (prominent anterosuperior pa on lateral view). - It causes an increase in the curvature of right hea border, which becomes more convex, prominent and also protudes to the right away from midline (>3cm beyond right lateral veebral border). It is often accompanied by enlargment of superior venacava and increase in RA height (most reliable sign). In normal individuals, the distance b/w top of aoic arch and the junction of SVC & RA is more than the distance between the later & right cardiophrenic angle. When the reverse happens (i.e. SVC/RA to RCPA distance >AA to SVC/RA distance), the RA is said to be enlarged. Left Ventricle Enlargment On PA view, there is prominent left hea border with rounding. Hyperophy produces rounding of cardiac apex whereas dilatation causes elongation/displacement of cardiac apex to the left or to the left & downwards Lateral view shows prominent postero-inferior pa of cardiac shadow Right Ventricle Enlargement RV enlarges mainly to the left & anteriorly, so there is prominence of left hea border on PA view and prominence of anterior pa of cardiac shadow with encroachment of retrosternal space in upper pa on lateral view. Pulmonary conus (outflow tract) becomes prominent. It may form left cardiac border and can rotate LV to the left with elevation of cardiac apex. This rotation tends to swing the aoa to right, so that aoic knukle becomes less prominent.


Question: Dural tail sign is high suggestive of

Dural tail sign - highly s/o meningioma.
Other lesions are metastasis, glioma, acoustic neuroma, sarcoidosis.


Question: Diamond sign is seen in

"Diamond"sign is a transient triangular tent-like cleft/niche in the middle of the pyloric canal, Seen in case of Congenital Hyperophic Pyloric Stenosis . Congenital hyperophic pyloric stenosis :- - usually presents around 3-12 weeks of age; as non bilious vomiting in a 1st born male - IXOC - USG - On USG appears as - target sign /cervix sign/antral nipple sign Other signs seen in CHPS :- - string sign - diamond sign - mushroom sign


Question: Intracranial Irradiation most commonly leads to deficiency of

*Growth Hormone is most radiosensitive pituitary hormone and intracranial irradiation leads to hypopituitarism mainly due to hypothalamic damage rather than pituitary damage *Least radiosensitive pituitary hormone is TSH


Question: The four points of probe placement in focused abdominal sonogram for trauma (FAST) in thoracoabdominal trauma are

FAST - Focused assessment with sonography for trauma (FAST) examination is a bedside screening tool to identify free intraperitoneal, pleural and pericardial fluid. It is limited ultrasound examination with 6 views. - The average time to perform a complete FAST examination is 2-4 minutes. The four points of probe placement in focused abdominal sonogram for trauma (FAST) in thoracoabdominal trauma: 1) Subxiphoid To look for pericardial fluid & 4 chamber view of the hea 2) Right intercostal oblique view To look for right pleural effusion 3) Right coronal view To look for free fluid in Morrison's pouch and paracolic gutter 4) Left intercostal oblique view To look for left pleural effusion, free view fluid in subphrenic space 5) Left coronal view For left paracolic gutter 6) Pelvic (longitudinal/ transverse) views To detect free fluid in cul-de-sac

subxiphoid, (R) upper quadrant, (L) upper quadrant , suprapubic

Epigastrium, (R) and (L) hypochondria, (R) iliac fossa

Epigastrium, (R) and (L) lumbar region, (R) Lower Chest

Hypogastrium, (R) and (L) lumbar region, (R) lower chest


Question: Punch drunk syndrome is associated with

Punch drunk syndrome is neurological defects seen associated with boxers and usually associated with subdural hematoma due to chronic head trauma in boxers.


Question: Maximum radiation exposure

X-ray abdomen- Single spot film, therefore comparatively less radiation exposure. Chest X ray- Single spot film, therefore comparatively less radiation exposure. IV pyelography- Sequential/ multiple imaging but covers less area,* therefore, comparatively less radiation exposure. Barium Enema- Sequential/ multiple imaging, covers larger area. therefore comparatively maximum radiation exposure. PET CT - Has highest radiation exposure. Diagnostic Procedure Typical Effective Dose Chest Radiograph(PA) 0.02msv Extremities /limbs 0.01msv Skull 0.07msv pelvis 0.7msv Abdomen 1.0msv Mammography (bilateral in 2 planes) 0.5msv Intravenous pyelography 2.5msv Head Ct 2.3msv Chest CT 8 Abdominal CT 10 PET 7.2msv Barium Enema 7-8msv


Question: Parathyroid adenoma best diagnosed by

Ans d Tc99m-Th201 scan. (Ref. Grainger, Diagnostic Radiology 4th ed., 1380)PARATHYROID SCINTIGRAPHY# Tc-99m -thallium substraction scan has 70-92% sensitivity & 43% specificity# Tc-99m sestamibi has 88-100% sensitivity & 91-98% specificity best scan.# Radionuclide scintigraphy with 201 (Technetium-thallium) or "m Tc- MIBI (Technetium-99m sestamibi), using a subtraction technique whereby the image of thyroid gland as shown by "m Tc or 123 I is removed, is thus a noninvasive & other best technique for tumor & other lesions localization of parathyroid gland.Educational points:# Presently, Tc-99m sestambi is the best available agent for parathyroid scanning.# Parathyroid adenoma is the most common cause of primary hyperparathyroidism.# Subperiosteal resorption of bones including erosion of lamina dura, "Pepper-pot" skull, phalangeal erosions, platyspondyly, osteitis fibrosa cystica, Brown's tumors are few typical X-ray findings of hyperparathyroidism.# "Superscan" appearance on Tc99m-MDP bone scan is a prominent feature of hyperparathyroidism.# A notable point - in primary hyperparathyroidism osteoporosis is common feature while in secondray hyperparathy- roidism osteosclerosis ("Rugger-Jersey spine") is a important feature.


Question: Multiple rain drop osteolytic lesions are seen in

Multiple lytic lesions are seen in Acute disseminated langerhans cell histiocytosis (aka Letterer-Siwe disease)


Question: Intraoperative Radiotherapy for treating pancreatic carcinoma mainly uses

Electron Beam is preferred for intraoperative Radiotherapy. The Intraoperative radiotherapy (IO) appears to be an ideal therapeutic strategy for pancreatic cancer, Having the advantage of enabling the delivery of high doses of radiation to areas that are at risk for microscopic disease, saving critical organs and reducing the possibility of inducing radiotoxicity.


Question: Bulging fissures in lung is seen in


Question: Arthroscopy of TMJ is useful in

Soft tissues of the joint (articular disk) can be imagined with MRI or Arthrography. MRI produces superb images of the soft tissues in internal derangement of the disk. Arthrography is invasive and has the risk of infection and allergic reaction due to the contrast agent.


Question: Most sensitive investigation for air embolism is


Question: Preveebral space thickness in adult is

The preveebral component is measured on sagittal imaging as the distance between the anterior border of the veebral body and the air within the pharynx/tracheaNear-normal distribution of thickness in normal patients depending on body build and expected variationPlain radiographs:C2/3: <7 mm and C6/7: <21 mmCT:C1: 8.5 mmC2: 6 mmC3: 7 mmC4/C5: variable due to variable height for cricoid/oesophagusC6: 18 mmC7: 18 mmAccording to age:C20-2 years of age: 7.6 mm3-6 years of age: 8.4 mm7-10 years of age: 6.8 mm11-15 years of age: 6.8 mmC60-2 years of age: 9.0 mm3-6 years of age: 9.8 mm7-10 years of age: 12.1 mm11-15 years of age: 14.5 mm(Ref: Radiology Review ManualBy Wolfgang Dahne 6thEtd, chapter 2)


Question: Not a Epiphyseal tumors

Simple bone cyst (Unicameral bone cyst) is a Metaphyseal tumor.


Question: Best method for detecting minimal Bronchiectasis

B i.e. CT Scan High Resolution CT ScanQ with sensitivity 97% & specificity almost 100% has become the investigation of choiceQ. Investigation of IInd choice is BronchographyQ which is now occasionally used in recurrent hemoptysis when all other investigations are negativeQ, to demonstrate bronchopleural fistulas and congenital lesions such as sequestration & agenesis. It is C/I in massive hemoptysisQ, active infections (TB, pneumonia) & impaired pulmonary function.


Question: Most important screening test in pulmonary thromboembolism is

(D-dimer) (266-70-CMDT-10) (1653-H17th)D-dimer serves as an excllant screening test with a sensitivity of 96.4% and negative predictive value of 99.6% but only for out patient or emergency department patients, not for hospitalized patients (1562-H16th)PULMONARY VENOUS THROMBOEMBOLISM (PE)Laboratory findings* ECG - Most common abnormality are sinus tachycardia*** Arterial blood gases - reveal acute respiratory alkalosis due to hyperventilation* Plasma level of D-dimer - using a D- dimmer threashold between 300 and 500 ng/ml, a rapid quantitative ELISA has shown a sensitivity for venous thromboembolism of 95-97% and a specificity of 45%. Therefore a D-dimer >500 ng/ml using the rapid ELISA provides strong evidence against venous thrmboembolism with a likehood ratio of 0.11 -0.13* Serum troponin I, troponin T, and beta natriuretic peptide (BNP) levels are increased* CT - helical CT pulmonary angiography has essentially supplanted V/Q scanning as the initial diagnostic study in North America for suspected PE (Proximal pulmonary variety)* Pulmonary angiography - remains the reference gold standard for the diagnosis of PE**** Best investigation when there is clinical suspicion of pulmonary embolism in a patient is - Multi detector CT angiogrphy**1. Increased D-dimer values are associated with(a) DIC (secondary fibrinolysis)(b) Arterial or venous thrombosis (Deep vein thrombosis)(c) Renal or liver failure(d) Pulmonary embolism(e) Late in pregnancy preclampsia(f) Myocardial infarction(g) Malignancy inflammation and severe infection2. D- dimmer values are increased with tPA anticoagulant therapy3. D- dimmer assay is not specific* CT of the chest with intravenous contrast is the principal imaging test for diagnosis of pulmonary empolism (1654-H17th)* Lung scanning is now second-line diagnostic test for PE {Mostly used for patients who cannot tolerate intravenous contrast)


Question: Most common hormone deficiency that occurs after intracranial irradiation is

The development of hypopituitarism occurs after 5-15 years and usually reflects hypothalamic damage rather than the absolute destruction of pituitary cells.Though the pattern of hormone loss is variable, Growth hormone deficiency is most common, followed by gonadotropins and ACTH deficiency.(Ref: Harrison's principals of Internal medicine, 16th Ed page 2078)


Question: Wimberger sign is seen in

Radiological features of scurvy: Palkan spur : metaphyseal spurs projecting at right angles to the shaft. White line of Frankel : calcified cailage in the metaphysis Trumefeld zone : zone of rarefraction below the white line of Frankel Wimburger sign : ring surrounding the ephiphyseal centres of ossification Pencil thin coex Subperiosteal hemorrhages Generalised osteoporosis


Question: Triangular shaped heart is a radiological finding of

Triangular shaped heart - Constrictive Pericarditis.
Pentagon shaped heart - Mitral incompetence.


Question: Best investigation for acute cholecystitis is

C i.e. HIDA Scan HIDA Scan & PIPIDA are best test to rule out acute cholecystitisQ with.--400% negative predictive value. It can be pseudo positive in chronic malnutrition, & Parenteral nutrition & alcoholic liver disease.


Question: Most accurate method to diagnose Hemangioma of liver

Most accurate method - MRI > hepatic scintigraphy.


Question: USG velocity

Answer: d) Is lower in tissues with a higher fat or water contentUltrasound velocity:It is a product of the frequency and wavelengthIt is inversely proportional to the square root of the material densityUltrasound travels faster in stiff, non-compressible mediaVelocity in a given medium is virtually independent of the frequency. With velocity being constant, an increase in the frequency causes a proportional decrease in wavelengthThe velocity of ultrasound in fat and water is lower than in an average soft tissue.


Question: A radiolucency in bone without periosteal bone reaction is seen in

Any lesion of bone destruction that has ill-defined borders and a lack of peripheral bone response (sclerosis) should be viewed with suspicion.
Squamous cell carcinoma originating in bone
The internal structure is wholly radiolucent with no evidence of bone production and very little residual bone left within the center of the lesion.
Periapical image reveals bone destruction similar to periodontal disease around the lateral incisor from a squamous cell carcinoma originating in the soft tissues of the alveolar process. In image A note the lack of a sclerotic bone reaction at the periphery.


Question: Linear accelerator produces

X-rays - Linear accelerator.
γ-rays - emitted by radioactive materials.


Question: IOC for pericardial calcification

Pericardial calcification - CT scan.
Pericardial effusion - 2D echo.


Question: Scan used to estimate collecting system dilatation is

(Ref: Grainger&;s diagnostic radiology, 6th ed; page 134)


Question: Most radiosensitive tumor among the following is

A dysgerminoma is a type of germ cell tumor; it usually is malignant and usually occurs in the ovary.
A tumor of the identical histology but not occurring in the ovary may be described by an alternate name: seminoma in the testis or germinoma in the central nervous system or other parts of the body.


Question: Tear drop heart is seen in

Tear drop heart - Chronic emphysema.
Pentagon shaped heart - Mitral incompetence.


Question: Apple core lesion is seen in

The Radiological hallmarks of the classic colonic Apple core lesion are sho, sharply defined regions of annular colonic narrowing with overhanging margins; ulcerated mucosa; and eccentric, irregular lumen. An apple core lesion can have a number of causes, the most serious being malignant neoplasm.


Question: Submentovertex view is best useful for

SUBMENTOVERTEX PROJECTION
Structures Shown:
A full axial view of the base of the cranium showing a symmetrical projection of the petrosa, the mastoid process, foramen ovale, spinosum canals, carotid canals, sphenoidal sinuses, mandible, maxillary sinus, nasal septum, odontoid process of the atlas and the entire atlas, axial inclination of the mandibular condyles. Helps to study destructive/expansile lesions affecting the palate, pterygoid region or base of the skull, sphenoidal sinus.


Question: Investigation of choice for SAH is

Ans: a) Non enhanced CT SAH is caused by damage to blood vessels on the pia- arachnoid.Non contrast CT scanning of the brain is the first step in the evolution of SAH. If the scan is performed within 12- 24 hrs after hemorrhage, 92 - 100 % cases can be detected. After 1 day and upto 1 week CT scans performed will appear normal.On CT scans, SAH present as hyperdensity representing acute hemorrhage visualized in the sulci overlying the cerebral convexities, within the sylvian fissurs, basal cisterns and interhemispheric fissure.Non enhanced CT is the modality of choice in the evaluation of SAH because of the hyperdensity clotted blood.It is difficult to visualize SAH with MRI because the high O, concentration in CSF prevents the degradation of oxyHb to deoxyHb.


Question: Keyhole Appearence on ultrasound is seen in

*Key hole appearance on antenatal scan is a feature of posterior urethral valve *Key hole appearance/linguine sign on breast MRI is a feature of intracapsular Breast implant rupture.


Question: Bilateral pleural thickening in lower and middle lung zone is radiological feature of

Bilateral pleural thicking (Pleural plaques) in lower & middle lung is seen in Asbestosis.


Question: Bone with a bone appearance is seen in

Bone within bone appearance is seen in : Osteopetrosis Acromegaly Bisphophonate therapy sickle cell anemia Healed phase of rickets and scurvy. Normal neonate.


Question: Water lily sign is seen in

Classical signs of pulmonary hydatid cyst on chest X-rayUncomplicated hydatid cystComplicated hydatid cystWell circumscribed round radio-opacity (resembling canon ball on AP and rugby ball on lateral projection)Crescent signPolycyclic and bilobed appearanceCumbo or double arch signSlot sign (impending rupture)Waterlily or camelotte signRising sun signDry cyst sign(Ref: Chapman and Nakielny's Aids to Radiological Differential Diagnosis 6thEtd, page no.82)


Question: Investigation of choice for diagnosis and staging of renal cell carcinoma

IOC - CECT.
IOC if renal vein or IVC involved  - MRI.


Question: The thresholds for permanent sterility in women for prepubeal exposure and premenopausal exposure conditions are

In women, radiation is highly effective at inducing permanent ovarian failure, but there is a marked age dependence insensitivity. The dose required to induce permanent sterility varies from 12 Gy (1,200 rad) prepubeal to 2 Gy (200 rad) premenopausal. Pronounced hormonal changes, comparable to those associated with the natural menopause, accompany radiation-induced sterilization in females.Reference: Eric J Hall Textbook of Radiobiology for Radiologist; 5th edition


Question: The facial aspect of an intraoral film is determined by the


Question: Bowler hat sign is seen in

BOWLER HAT SIGN: Cup shaped filled defect seen on air contrast barium enema that represents POLYP if it points towards lumen. The "bowler-hat sign" represents the appearance of a sessile colonic polyp observed at an oblique angle on a double contrast barium enema. The bowler-hat sign is formed by a ring of barium adjacent to the base of the polyp surrounding a domed layer of barium coating the surface of the polyp.


Question: A 16 film radiographic survey consists of the 12 film survey and the addition

4 film survey requires 2 anterior occlusal and 2 bitewing radiographs.
8 film survey requires 4 posterior, 2 anterior occlusal and 2 bitewing radiographs.
12 film survey requires 4 IOPAs for posterior teeth, 4 canine IOPAs, 2 incisor IOPAs and 2 bitewing radiographs.
16 film survey requires 4 permanent molar radiographs additional to the 12 film survey.

Ref: Principles and practice of Pedodontics by Arathi Rao

2 posterior bitewing, 1 OPG and 1 Lateral cephalogram


Question: Most sensitive and specific investigation for screening of Renovascular hypeension

C i.e. Spiral CT Scan (CTA) - The presence of aerial collaterals indicates that renal aery stenosis is hemodynamically significantQ. The diameter of stenotic segment may also give an indication of hemodynamic significance, but is only reliable if the stenosis is either very severe or minimal. Conventional contrast renal aeriography (or digital substraction angiography or intraaerial catheter angiography) is the gold standard for diagnosis of renal aery stenosisQ against which all other modalities are compared. On angiography, the presence of collateral vessels to the ischemic kidneyQ suggest a functionally significant lesion (i.e. a lesion that occludes >70% of lumen of affected renal aery). A lateralizing renal vein renin ratio (>1.5 of affected side/contralateral side) has a 90% predictive value for a lesion that would respond to vascular repair and result in BP control. After percutaneous aeriography, the next most sensitive and specific screening test for diagnosis of RAS is CT angiographyQ (using spiral and more recently multidetector CT) almost equvalent to DSA. However, it requires use of large amount of iodinated contrast medium (like IVP) precluding its use in renal insufficiency and also exposes to ionizing radiation. - Captopril enahanced radionuclide renal scintigraphy, is most widely performed screening test for diagnosis of renovascular hypeension, (neither most sensitive nor most specific). 99mTcMAG 3 is slightly preferred over 99mTc-DTPA; 131IOIH is not used now. It can be used as screening test to establish hemodynamic significance of RAS, to predict the outcome of revascularizaation and in the follow up after successful revascularization. Disadvantages include low sensitivity in patients with azotemia or underlying renal dysfunction & with bilateral RAS. Branch aery stenosis cannot be diagnosed and provides functional not anatomical data. Summary: The decreasing order of sensitivity & specificity for diagnosis of renal aery stenosis (related renovascular hypeension) is conventional contrast / intraaerial-catheter angiography >CT angiography (using spiral/MDCT) > CE-MRA (dynamic) > SSFP non contrast. enhanced MRA > captopril enhanced radionuclide renal scintigraphy (99mTcMAG3 and 99mTcLLEC preferred over 99mTcDTPA). All have their pros & cons.


Question: 'Adder head' appearance on voiding cystourethrogram in bladder is feature of

Ans. c (Ureterocele) (Ref: Diagnostic Radiology by Grainger, 4th/pg. 1620, 1739)URETEROCELE# Ureterocele is cystic dilatation of intramural (subepithelial) segment of intravesical part of ureter.# IVU shows early filling of bulbous terminal ureter ("cobra head" appearance) and a radiolucent halo (ureteral wall + adjacent bladder urothelium) giving "spring onion" appearance. Thus, ureterocele leads to repeated infection of renal system and has above explained radiological features.Types# Simple Ureterocele - congenital prolapse of dilated ureter and orifice into the bladder lumen at usual location of trigone and typically is seen with single ureter (orthotopic Ureterocele). 30% cases are bilateral.M:F = 2:3.# Ectopic Ureterocele -usually seen in upper moiety ureter of duplex PC system with 80% incidence.# Pseudoureterocele - no protrusion of ureter into bladder lumen; however, thick irregular halo seen in urinary bladder as e.g., in impacted ureteral calculus (edema in the ureteric wall at the UV junction due to impacted ureteral calculus shows EDLING SIGN, i.e., filling defect surrounded by radiolucent halo of edema).# Caecoureterocele - Ureterocele going into bladder outlet and causing outlet obstruction.# Imaging:# Rx: SurgeryEducational points:X-ray AppearanceDiagnosis"Egg-in-cup" appearance, Ring shadows & HornsPapillary necrosis'Cobra head or adder head' appearanceUreterocele'Flower-vase' ureterHorse-shoe kidney'Cork-screw' ureterTubercular ureteritisFish-hooked/Reverse 'J' ureterBPHNotching of ureterRAS with collaterals'Cow-horn' deformity of ureterSchistosomiasis'Drooping-Lilly' signDuplication of ureter with ectopic ureterFetal head calcification of bladderSchistosomiasis


Question: Notching of the ribs is seen in man


Question: Most radiosensitive cells are


Question: Trifoliate appearance is seen in

Trifoliate appearance is due to secondary duodenal diverticula which occurs as a result of scarring of peptic ulcer.


Question: Oreo cookie sign is a radiological finding of

Oreo - cookie sign - radioopaque pericardial fluid is borderd on either side by echo - dense pericardial fat.


Question: Investigation of choice for pericardial effusion is

Transthoracic echocardiography (TTE) is usually the initial investigation of suspected pericardial disease. It is cheap and widely available and has high accuracy for detecting pericardial effusions and signs of tamponade. TTE is also helpful for guiding diagnostic or therapeutic pericardiocentesis. Restricted acoustic windows limit its evaluation of the entire pericardium; loculated collections, intrapericardial blood clot, and pericardial thickening may be difficult to assess.CT and MR are indicated when TTE is inconclusive or when loculated or hemorrhagic effusion or pericardial thickening is suspectedIOC for aoic dissection-- MRI IOC for pericardial effusion= M- mode ECHOIOC for valvular disease = 2 D - ECHO IOC FOR RADIOTHERAPY CAUSED FIBROSIS= BIOPSY(Grainger and Allison&;s diagnostic radiology 6th edition, page 240)


Question: Sensitivity of mammography is low in young females because

Young females have dense brest tissue,thus sensitivity of mammo is low.


Question: Intra cavitary Radiotherapy is used for the treatment of

Ans. is 'b' i.e.Ca Cervix Intracavitary radiotherapy is a form of brachytherapy in which radiation source is placed inside the body cavity e.g. Vagina, cervical canal or uterine cavity.


Question: Expansile lytic lesion of sacrum with specks of calcification is suggestive of

Chordoma: This is a locally malignant, sometimes actually malignant tumour supposedly originating from the remnants of notochord. Sacrum and cervical spine are common sites. It presents with a persistent pain and swelling, sometimes with a neurological deficit. Bone destruction is the only hallmark feature of this tumour. Treatment, wherever possible, is complete excision. If complete excision is not possible, radiotherapy is done. Chordoma 1 It is a destructive bone tumor believed to arise from ectopic remnants of notochord/notochord cell rest. 2 Its maximum incidenceis between 50-70 years. 3 It is locally malignant with strong tendency to recur after excision. n Predilection for sacral (50%) and cranial (40%) regions (the extreme ends of the axial skeleton). 4 In sacrum at S4and S5and in cranium basisphenoid (clivus and dorsal aspect of sella) 5 Above sacrum and below C2, chordomas are rare. 6 Radiologically appears as a oval or lobulated well-defined purely lytic mass in midline, which may contain calcification and a soft tissue component. 7 Recurrence rate is high but its metastasis occurs late. 8 Chordoma at the base of skull carries best prognosis


Question: Acoustic shadow in USG is due to


Question: "Bone within a Bone" appearance is


Question: Segment IV of liver corresponds to

Segment 1 - Caudate Lobe.
Segment IV - Quadrate Lobe.


Question: Radioactive emissions used in radiotherapy are


Question: Best radiographic view for fracture of C1, C2 veebrae is

B i.e. Odontoid View Open mouth odontoid (peg) view is the best radiographic view to visualize upper cerical C1, C2 veebraeQ. Atlanto-axial (C1-C2) aiculation and integrity of dens & body of C2 are best seen on the odontoid viewQ.


Question: Atomic number of tungsten


Question: Longest half life is seen in


Question: Luftsichel sign is seen in

Luftsichel sign is a sickle shaped lucency of air seen On Chest Radiographs, Seen in Left Upper lobe collapse with Compensatory Left Lower lobe hyperinflation.


Question: Radiation dose safe in pregnancy is

(Ref: Farr&;s physics for medical imaging 2e,39)


Question: "Time of Flight" technique is used in


Question: Frequency for trans vaginal USG for obstetric purpose

Transabdominal USG - 3 - 5 MHz.
Trans vaginal USG - 5 - 7.5 MHz.


Question: Not a radiological feature of sickle cell anemia

Chondrocalcinosis is a feature of Pseudogout.


Question: Optium phase for cardiac and coronary vessel imaging are

Optimum phase for cardiac and coronary vessel image is

Mid-diastole at low or intermediate heart rates.
Late-systole - at high heart rates.


Question:
A low kilovoltage technique is most advantageous in
demonstrating


Question: Most common cause of Air bronchogram

All the above are causes of AIr bronchogram.
M/C cause is consolidation.


Question: Radiation tolerance of liver is

Liver injury tends to be more common in those patients with radiation doses greater than 30 Gy or when the whole-liver is irradiated .It is usually seen as a result of therapy to adjacent organs, such as pancreatic carcinoma, gallbladder carcinoma, retroperitoneal lymphoma, pleural mesothelioma, distal esophageal and other lower thoracic malignancies.


Question: C Xylose test diagnostic of


Question: Investigation of choice for choledocolithiasis is

(Ref: Grainger and Allison&;s diagnostic radiology 6th edition, chapter 32)


Question: A young man with tuberculosis presents with massive recurrent hemoptysis. Most probable cause would be.

B i.e. Broncheal aery In great majority of patients hemoptysis originates from systemic rather than pulmonary aeries and the bronchial vessels are almost universally involved. (Grainger) Massive hemoptysis in a patient of T.B. is usually d/ t erosion of bronchial aery which bleeds at systemic pressure.


Question: In MRI the field used is

MR scans are obtained by placing the patient in a static magnetic field of 0.02 to 4 tesla (T) strength.


Question: Large discrete ulcers in esophagus are seen in

Oesophagitis including HIV and CMV oesophagitis usually manifest as one or more large ovoid or diamond-shaped ulcers.


Question: Xeroradiography is used in... cancer detection.


Question: Calcification is best detected by


Question: Radiological feature of Pneumothorax on USG

Lung sliding sign & Sea shore sign - Normal lung.
B lines - Comet tail artefact below the pleura.


Question: Most radiosensitive bone tumor is

Ans. a (Ewing's sarcoma). (Ref. Essential Orthopedics by Maheshwari, 2nd ed., 220; Harrison 18th/ch. 98)Osteosarcoma is relatively radioresistant and wide surgical resection and chemotherapy is the RX. There is no role of RT in Rx of Aneurysmal bone cyst and Chondroblastoma.EWING'S SARCOMA# Ill-defined osteolytic medullary lesion involving diaphysis.# Small round cell PNET tumor.# Age group 5-15 years with 75% patients being under the age of 20 years and having male predilection.# Extension along the length of the marrow with permeative bone destruction.# Cortical saucerization.# Classical multilaminar periosteal reaction giving 'onion-peel' appearance.# Codmann's triangles with elevated periosteum.# Soft tissue mass disproportionately large compared to the extent of osseous involvement, resembling osteomyelitis.# Bone tumor metastasizing to bone.# Ewing's sarcoma is the highly malignant primary bone neoplasm having specific cytogenetic analysis i.e. t( 11,22), is a PNET.# CD99 is important marker# It is thought to be radiosensitive bone tumor, and supposed to melt with radiotherapy. However, Chemotherapy is the mainstay of treatment for Ewing's primitive neuroectodermal tumors (PNET) and rhabdomyosarcomas.External beam radiation therapy is an adjuvant to limb-sparing surgery for improved local control. Preoperative radiation therapy allows the use of smaller fields and smaller doses but results in a higher rate of wound complications. Postoperative radiation therapy must be given to larger fields, as the entire surgical bed must be encompassed, and in higher doses to compensate for hypoxia in the operated field. This results in a higher rate of late complications. Brachytherapy or interstitial therapy, in which the radiation source is inserted into the tumor bed, is comparable in efficacy (except in low- grade lesions), less time-consuming, and less expensive. Although Ewing's sarcoma is radiosensitive, systemic chemotherapy is the mainstay of therapy, often being used before surgery. Doxorubicin, cyclophosphamide or ifosfamide, etoposide, vincristine, and dactinomycin are active drugs. Topotecan or irinotecan in combination with an alkylating agent are often used in relapsed patients. Targeted therapy with an anti IGF 1 alpha antibody appears to have promising activity in refractory cases. Local treatment for the primary tumor includes surgical resection, usually with limb salvage or radiation therapy.


Question: Odontoid view is

(C) Open mouth view# AP open mouth projection of the odontoid peg can be troublesome. The main difficulty arises from the fine line between successful positioning and unsuccessful positioning.> There are a number of objectives when performing the AP open mouth odontoid peg view superimpose the outer table of the occiput of the skull with the patient's central incisors position the patient's head in a true AP position ensure the patient's mouth is open as wide as possible cone to include the anatomy of interest don't injure the patient in the process.> Anteroposterior: From front to back. When a chest x-ray is taken with the back against the film plate and the x-ray machine in front of the patient it is called an anteroposterior (AP) view. As opposed to from back to front (which is called posteroanterior).> Posteroanterior: From back to front. A chest x-ray taken with the chest against the film plate and the x-ray machine behind the patient is a posteroanterior(PA) view. As opposed to anteroposterior (AP).


Question: Cause of Opaque hemithorax

A, b, c are causes of U/L hypertranslucent hemithorax.


Question: MARTEL'S sign is seen in

Ans. A. GoutCystic changes, well-defined erosions with sclerotic margins (often with overhanging bony edges), and soft tissue masses are characteristic radiographic features of advanced chronic tophaceous gout. Martel sign sharply marginated bony erosions from a long standing soft tissue tophus in patient with gout.


Question: A newborn baby has not passed meconium for 48 hours since bih. She has vomiting and distension of abdomen. The most appropriate investigation for evaluation would be

C i.e. Lower GI contrast study Lower GI contrast study confirms the diagnosis & indicate the type of involvement, in cases of lower intestinal obstruction causing failure to pass meconium timelyQ.


Question: Cobra head  deformity is characterstic of

A ureterocele is a congenital abnormality found in the ureter. In this condition the distal ureter balloons at its opening into the bladder,
forming a sac-like pouch. It is most often associated with a duplicated collection system, where two ureters drain their respective kidney instead of one.


Question: Extradural hematoma CT scan finding is


Question: Bear paw sign is seen in

Xanthogranulomatous pyelonephritis (XGP): Rare form of chronic pyelonephritis and represents a chronic granulomatous disease resulting in a non-functioning kidney. Radiographic features are usually specific. CT findings are most helpful in reaching the correct diagnosis. The normal renal outline is lost and enlarged with a paradoxical contracted renal pelvis. The calyces, in contrast, are dilated giving a multiloculated appearance that has been likened to the Paw print of a bear (bear's paw sign). Sometimes there is a perinephric extension with thickening of Gerota's fascia. Calcification can be better delineated on CT scan. Bear paw sign in xanthogranulomatous pyelonepritis. Bear claw sign is seen in liver trauma on CECT.


Question: Earliest sign of increased intracranial tension is

Adults - Erosion of dorsum sella.
Children - Suture diastasis.


Question: Most commonly used method of display of ultrasound is

Applications- A-Mode- Commonly used for orbital biometry,Axial Length of eyeball. B-Mode (Brightness) : Most commonly used mode. M-mode (motion): Used for valvular morphology and motion,Echocardiography and Fetal Hear Rate monitoring.


Question: Cardiotoxicity caused by radiotherapy & chemotherapy is best detected by

D i.e. Endomyocardial Biopsy and CT cause fibrosis; which can be best diagnosed by seeing the tissue under microscope Endomyocardial Biopsy.Q IInd best answer is Radionucleotide scanQ.


Question: The disadvantage of standard cephalometric radiograph is that it

Has cumbersome developing and fixing procedure

Produces two dimensional representation of a three dimensional structure


Question: "Onion peel" appearance is seen in

Ans. a (Ewing's sarcoma) (Ref. RRM Radiology, 6th ed., p.)The four main types of rosettes in pathology :1. Homer Wright rosette: typically seen in neuroblastomas, medulloblastomas, and primitive neuroectodermal tumors (PNETs). It consists of a halo of tumor cells surrounding a central region containing neuropil.2. Flexner-Wintersteiner Rosette: characteristic of retinoblastomas. It consists of tumor cells surrounding a central lumen that contains cytoplasmic extensions from the tumor cells.3. True Ependymal Rosette: consists of tumor cells surrounding an empty lumen. Are characteristic of ependymoma, but not seen in all cases.4. Perivascular Pseudorosette: consists of tumor cells collected around a blood vessel. It's called a pseudorosette because the central structure isn't part of the tumor. These rosettes are common in ependymomas, but you also see them in medulloblastoma, PNET, central neurocytomas, and glioblastomas.EWING'S SARCOMA# Incidence: Constitutes ~10 to 15% of all bone sarcomas.# Age: Peak incidence in the second decade of life.# Origin: Arises in the medullary cavity of the bones.# Location:involves the diaphyseal region of long bones (especially femur) & flat bones (especially pelvis).# X-ray: permeative destructive lytic lesion with "onion peel" periosteal reaction with soft tissue mass.# Histopathology:- It is composed of sheets of monotonous, small, round, blue cells and can be confused with lymphoma, embryonal rhabdomyosarcoma, and small-cell carcinoma.- The cells are rich in glycogen (PAS positive cells).6- The presence of "Homer-Wright rosettes" is indicative of neural differentiation.- Most PNETs arise in soft tissues; they include:* Peripheral neuroepithelioma,* Askin's tumor (chest wall), and* Esthesioneuroblastoma.- The presence of p30/32, the product of the mic-2 gene (which maps to the pseudoautosomal region of the X and Y chromosomes) is a cell-surface marker for Ewing's sarcoma (PNETs).- The classic cytogenetic abnormality associated with this disease (and other PNETs) is t(11;22).- CD99 +.# It is very aggressive tumor and considered a systemic disease and mimics acute osteomyelitis.# Common sites of metastases are lung, bones (bone to bone metastases/), and bone marrow.# Rx:# Systemic chemotherapy is the mainstay of therapy, often being used before surgery.# Local treatment for the primary tumor includes surgical resection, usually with limb salvage or radiation.# Ewing's is a curable tumor, even in the presence of obvious metastasis, especially in children <11 years old.Also Know:TranslocationTtimor# (22q11)Chronic myelogenous leukemia# (12;22)(q 13 ;q 12)Malignant melanoma of soft parts (MMSP)# (11;14)(q13;q32)Mantle cell lymphoma# (14; 18)(q32;q21)Follicular lymphoma# (1;22)(q24;q12)Ewing's sarcoma# (1;7)(p34;q35)T cell acute lymphocytic leukemia (ALL)# (8;14)(q24;q32)Burkitt's lymphoma, B cell ALL# (11;22)(pl3;q12)Desmoplastic small round cell tumor (DSRCT)# (2;13)(q35;ql4)Alveolar rhabdomyosarcoma# (1; 13)(p36;q 14)Alveolar rhabdomyosarcoma# (10; 17)(q 11.2;q23)Papillary thyroid carcinomas# (x, 18)Synovial cell sarcoma


Question: Bone within a Bone appearance is not seen in

Bone within a Bone appearance is seen in Hypothyroidism & Hypoparathyroidism.


Question: Radioresistant tumor is

List of highly radioresistant tumors : Osteosarcoma Melanoma Pancreatic cancer Hepatocellular carcinoma


Question: Ideal imaging method for diagnosis of hydrocephalous in infant is


Question: Investigation of choice for juvenile nasoangiofibroma

Contrast CT is the investigation of choice as extent of the tumor can be seen.


Question: Investigation of choice in aoic dissection is

C i.e. MRI Aoic dissection - Most patients are in 50-70 years age group present with very sudden onset pain, often accompanied by tearing sensation. It is usually felt in the precordium & substernal region but may be in back between scapula. These patients are usually misdiagnosed as having cardiac ischemia, which increases risk of complications. - Dialation & dissection in Morphan SyndromeQ are probably caused by a failure to resist shearing stress in media. In Ehlers-DanlosQ collagen molecule abnormalities predispose to dialation & saccular aneurysms but not to dissection these patients have normal resistance to shearing stress. - Stanford classifies it into two types as Type A (involving ascending aoa) - which is more common & carry high probability of complications & moality; and Type B (not involving ascending aoa). * Aoography is the gold standardQ


Question: Thimble bladder is seen in

Tuberculous urinary infection is secondary to renal tuberculosis.Early tuberculosis of the bladder stas around the ureteric orifice or trigone, the earliest evidence being pallor of the mucosa due to submucous oedema. Subsequently, tubercles may be seen and, in longstanding cases, there is marked fibrosis and the capacity of the bladder is greatly reducedA contracted bladder ('thimble' bladder) with ureteric orifices that are in-drawn ('golf-hole' ureter) may be seen; these changes are due to fibrosis.Bailey and love 27e pg 1442


Question: Suprasellar calcification with growth retardation is seen in


Question: Doppler effect results from the change in

An ultrasound beam insonating a blood vessel is paially reflected by red blood cells. If these are moving, there is a change in the frequency of the reflected pulse: an increase in frequency if the flow is towards the probe and a decrease if it is away from it. This is the Doppler effect and the changes in frequency referred to as the Doppler shift. (Ref: Grainger and Allison&;s diagnostic radiology 6th edition, page 63)


Question: Ideal position for dentist to stand while taking radiographs

At an angle of 90-135 degrees and six feet away from patient


Question: To obtain better information of a cyst eroding the surface of cortex


Question: Windswept deformity is seen in

Valgus deformity of one knee in association of varus deformity of other knee is known as windswept deformity. Seen in Rickets, Rheumatoid arthritis etc.


Question: Shiny Corner Sign is seen in

*Shiny corner sign is a finding in ankylosing spondylitis, representing reactive sclerosis at the superior and inferior endplates of the veebral bodies. Eventually, the veebral bodies become squared in Ankylosing Spondylitis. *Note- Corner Sign Of Park is metaphyseal Clefts Seen In Scurvy


Question: Field carcinogenesis theory is commonly seen in

Smoking causes diffuse epithelial injury in the oral cavity, neck, esophagus and lung. Patients cured of squamous cell cancers of the lung and esophagus, oral cavity and neck are at risk (as high as 5% per year) of developing second cancers of the upper aerodigestive tract. Cessation of cigarette smoking does not markedly decrease the cured cancer patient&;s risk of second malignancy, even though it does lower the cancer risk in those who have never developed a malignancy. Smoking cessation may halt the early stages of the carcinogenic process (such as metaplasia) but it may have no effect on late stages of carcinogenesis. This "field carcinogenesis" hypothesis for upper aerodigestive tract cancer has made "cured" patients an impoant population for chemoprevention of second malignancies.Reference: Harrison; 19th edition


Question: Fleishner sign is characteristic of

Fleshner sign - Wide gaping of ileocecal value with narrowing of terminal ileum characteristic of Ileocecal tb.


Question: Commonly used collimating device

The collimating device often used is a lead diaphragm with a circular aperture for circular PIDs or a rectangular aperture for rectangular PIDs and the lead-lined PID.
Frommer’s Radiology for Dental Professional, pg-22


Question: Intraoperative is given in

C i.e. Carcinoma Pancreas Intraoperative radiotherapy is used in carcinoma pancreasQ. Because of poor local control achieved with postoperative EB & chemotherapy, the use of intraoperative in pancreatic cancers in rational. The cpmbination of EB plus IOE in locally advanced/ unresectable pancreatic adenocarcinoma result in improvement in local control and survival.


Question: Air bronchogram on a CXR denotes

Air bronchogram Air bronchograms appear on a CXR whensomething other than air is present in the alveoli adjacent to a bronchus or bronchiole, making the air-filled bronchus more conspicuous than normal. That something is usually fluid, and this is most commonly due to pneumoniaalthough pulmonary oedema and haemorrhage can also cause air bronchograms. The presence of an air bronchogram indicates that the airway proximal to it is patent, which can be a helpful sign. In the magnified example here, the air bronchograms were caused by extensive pneumonia in this patient's lingula and left lower lobe. The image on the right has been manipulated to fuher increase the conspicuity of the air bronchograms for illustrative purposes. Note the left internal jugular venous line. Six causes of Air bronchogram are: 1. Lung consolidation 2. Pulmonary edema 3. Non-obstructive pulmonary atelectasis 4. Severe interstitial disease 5. Neoplasm 6. Normal expiration 7. ARDS/ Hyaline membrane disease


Question: IOC for mesial temporal sclerosis is

MRI is the IOC.
Feature :

Hippocampal atrophy.
Atrophy of ipsilateral mammillary body, fornix.


Question: Fir tree  appearance of bladder is seen in

Neurogenic bladder is bladder dysfunction (flaccid or spastic) caused by neurologic damage. Symptoms can include overflow incontinence, frequency, urgency, urge incontinence, and retention.
Risk of serious complications (eg, recurrent infection, vesicoureteral reflux, autonomic dysreflexia) is high.


Question: An example of a isotope that is predominantly a beta emitter is


Question: Most common cause for subdural hematoma

Injury to MMA or MMV - Epidural.
Rupture of berry aneurysm - SAH.


Question: Increased Radioisotope uptake is seen in A/E


Question: Drug used as pharmacological stress in stress echo

Pharmacological stress : Dobutamine.
Physiological stress : Ttreadmill or bicycle exercise.


Question: Gamma camera is used for

(Ref: Grainger&;s diagnostic radiology, 6th ed; page 120)


Question: Effective dose in radiation at 2 m, is 1 gray ; At 1 m, it will be


Question: Ultrasonogrsphy of umbilical aery is done to know about

A i.e. Hea beat USG of umbilical aery is done to know about hea beatQ.


Question: The ground glass ventricular septum is seen in

Four bump heaMS/MR Due to left atrial appendage enlargementGlassy hea on ECHOAmyloidosisDouble Cardiac shadow, Double density sign, Bedford signLeft Atrial EnlargementDock&;s sign, E-Sign, Figure of 3 sign, Reversed E sign, Inveed 3 signCoarctation of the aoaDouble aoic knuckleAoic dissectionJughandle appearancePrimary pulmonary hypeensionMaladie de Roger effectsmall VSDHilar dance (Pulmonary plethora)ASDBox-shaped heaTricuspid atresiaWater bottle / Flask shaped hea / Leather bottle / Pear shaped / money bag hea/Purse like hea/Epicardial fat pad signPericardial effusionCoeur en Sabot ie., Boot shaped heaTetrology of heaSpade-like deformity on ECHOAtypical HOCMEgg in Cup appearance, Square root signConstrictive PericarditisInveed moustache signMitral stenosisEgg on side appearance, Egg shaped hea, Egg in StringD-Transposition of great aeries (D-TGA)Convex left hea borderL-TGAGround glass ventricular septumHyperophic Obstructive Cardiomyopathy (HOCM)Straight left upper cardiac borderEbstein&;s anomalyConcave main pulmonary segment and right aoic archPersistent TruncusAeriosusSnowman sign, Figure of 8 sign, Cottage loaf signTotal Anomalous Pulmonary Venous Connection (TAPVC)Gooseneck signAtrio-ventricular septal defectTubular heaEmphysemaStag antler / Hands up signCCFSchimitar sign / Turkish sword appearanceCongenital venolobar syndromeSitting duck signpersistent TruncusAeriosusYin Yang SignPseudoaneurysmSmall hea signTension PneumopericardiumHigh attenuating Crescent signImpending rupture of an abdominal aoic aneurysmDraped Aoa signContained rupture of an abdominal aoic aneurysm(Ref: Problem Solving in Radiology: Cardiovascular Imaging by SuhnyAbbara and SanjeevaKalva)


Question: High brachytherapy is

According to ICRU repo 38, treatment dose rates fall into three categories * Low Dose Rate (LDR) brachytherapy ranges between 0.4 and 2 Gy/h. However, in routine clinical practice, LDR brachytherapy is usually delivered at dose rates between 0.3 and 1 Gy/h. This is compatible with conventional manual or automatic afterloading techniques. * Medium Dose Rate (MDR) brachytherapy ranges between 2 Gy/h and 12 Gy/h. MDR can also be delivered by manual or automatic afterloading, although the latter is far more frequent. * High Dose Rate (HDR) brachytherapy delivers the dose at 12 Gy/h or more, and only automatic afterloading can be used because of the high source activity.(Ref: Radiobiology of Brachytherapy and the Dose-Rate Effect by JJ Mazeron et al, 95)


Question: Craniospinal irradiation is used in the Treatment of


Question: Most common site of Metastasis of Lung carcinoma

Brain is m/c site of metastasis of lung carcinoma.
Adrenal is m/c endocrinal site to be involved.


Question: Most common cancer worldwide is

Lung cancer is the most common cancer and the most common cause of cancer death in the world.Reference: Harrison; 19th edition


Question: Investigation of choice for studying Renal Coical mass

C i.e. 99 - Tc - DMSA DTPA (Renogram) DMSA (Isotope Scanning) - DTPA is freely filtered at glomerulus with no - Tc.99 DMSA is used for renal morphological tubular reabsorption or excretion (i.e. GFR = (anatomic) imagine Excretory function) - This compound gets fixed in renal tubules & images - DTPA is useful for evaluating perfusion and may be obtained after 1-2 hours of injection. Lesions excretory function of each kidneyQ such as tumors & benign lesions as cysts show filling - Indications: defectQ 1. Measurement of relative renal - Used to assess coical function of KidneyQ and detect functionQ in each kidney. renal scarringQ. 2. Urinary tract obstructionQ 3. Diagnosis of Renovascular cause of hypeensionQ 4. Investigation of Renal transplantQ


Question: IoC for chronic pancreatitis

ERCP (Endoscopic retrograde cholangio pancreatography) is IoC for Chronic Pancreatitis.


Question: Battered baby syndrome is associated with

Battered child syndrome, shaken baby syndrome, and non-accidental trauma are all terms to describe the complex of non-accidental injuries in infants and young children as a result of abuse. Subdural hematoma can occur as a result of severe angular acceleration, deceleration and direct impact as the head is shaken voilently and due to rupture of bridging veins.


Question: Fat halo sign is associated with

The 'Fat halo sign' refers to a feature seen on CT examination of the abdomen, and represents infiltration of the submucosa with fat, between the muscularis propria and the mucosa. It is characterized by an inner (mucosa) and outer (muscularis propria and serosa) ring of enhancing bowel wall along with a non-enhancing middle layer (submucosa).


Question: Atomic number of Tungsten is


Question: "Chain of lakes appearance" On ERCP is seen in

Beaded appearance due to alternating dilatation and stenosis → Chain of lakes appearance or string of pearl appearance seen in chronic pancreatitis.


Question: Most radiosensitive tissue of body among the following is

Ans. a (Bone marrow). (Ref. Harrison, Medicine, 15th ed., 2588)The minimal tolerance dose (Rads) for (TD 5/5):Bone marrow250 (radiosensitive)Spleen1000Kidney1500Brain5000 (radioresistant)Liver2500Intestine4500Heart3000Lung3000Testis600-1000 (radiosensitive)


Question: Characteristic of subdural hematoma is


Question: Not a Radiological sign of Crohn's disease

Thumb printing - mucosal edema seen in ischaemic colitis > Ulcerative colitis.


Question: Medusa head appearance on MRI is seen in

Veins are small at periphery and gradually enlarge as they approach a central draining vein - caput medusa or medua head.
serpentine apperance of the curvilinear peripheral draining veins seen in venous malformation (venous angioma).


Question: Egg in cup appearance is seen in

Egg in cup - Constrictive pericarditis
Egg on side - Uncorrected TGA


Question: Investigation of choice in diffuse esophageal spasm is

Investigation of choice for motor disorders (including diffuse esophageal spasm) is esophageal manometry.

Barium examination showing tertiary contractions


Question: On DSA, typical "STRING OF BEADS" appearance of arteries is seen in

Ans. c (Fibromuscular dysplasia) (Ref. Harrison's medicine 17th/ 1554; 1569)FMD is identified angiographically by a "string of beads" appearance/ "Pile of plates" appearance/ "Beaded" appearance caused by thickened fibromuscular ridges contiguous with thin, less-involved portions of the arterial wall.FIBROMUSCULAR DYSPLASIA# This is a hyperplastic disorder affecting medium-sized and small arteries.# Usually involves renal and carotid arteries but can affect extremity vessels, such as the iliac and subclavian arteries.# Although fibromuscular dysplasia may occur at any age, it has a strong predilection for young Caucasian women.# F>M.# There are several histologic variants- medial fibroplasia,- perimedial fibroplasia,- medial hyperplasia, and- intimal fibroplasia.# Medial dysplasia is subdivided into- medial fibroplasia,- perimedial fibroplasia, and- medial hyperplasia.# Medial fibroplasia is the most common type and is characterized by alternating areas of thinned media and fibromuscular ridges.# Medial fibroplasia is the most common variant and accounts for approximately two-thirds of patients.0# The lesions of fibromuscular dysplasia are frequently bilateral, and in contrast to atherosclerotic renovascular disease, tend to affect more distal portions of the renal artery.# Patients with FMD have more favourable outcome than atherosclerosis.# The internal elastic lamina is usually preserved. The iliac arteries are the limb arteries most likely to be affected by fibromuscular dysplasia.Few important angiographic appearance.DiseaseAngiographic findings1FMD"String of beads" appearance/ "Pile of plates" appearance/ "Beaded" appearance2Thromboangiitis obliterans (Buerger's disease)Smooth, tapering segmental lesions in the distal vessels are characteristic, as are collateral vessels at sites of vascular occlusion.3Takayasu's arteritisIrregular vessel walls, stenosis, poststenotic dilatation, aneurysm formation, occlusion, and evidence of increased collateral circulation.4MeningiomaSpoke-wheel appearance"Mother-in-law" sign5Moyamoya disease (bilateral supraclinoid ICA block; a cause of paediatric stroke)"Puff of smoke appearance"6Carotid body tumorLyre's sign (splaying of ECA from ICA) JIPMER20127RCC, AngiofibromaTumor blush (Suitable tumors for Pre-Op embolization)8Budd-Chiari syndrome"Spider-web" collaterals

Peripheral and Visceral Vascular Imaging


Question: Pleural effusion without evident lung infiltration is most often due to


Question: Tc labelled RBC's are used for

D i.e. Splenic disease Tc99 - labelled RBCs provides information about red cell pooling, so it is used in : Haerningioma detection Gastrointestinal bleedingQ Spleenic diseaseQ Cardiac ventriculography


Question: In medical radiotherapy linear particle accelerator emits


Question: Radiation necrosis from recurrence Of brain malignancy can be best differentiated by

Radiation necrosis from recurrence Of brain malignancy can be best differentiated by PET Scan. Radiation necrosis is a phenomenon seen in high grade gliomas after radiotherapy and may mimic tumour recurrence, thus challenging in clinician's decision for treatment of the same. Conventional MRI sequences are not able to differentiate between these two entities. On PET scan, radiation necrosis may show (not always) decreased uptake in comparison to tumour recurrence. Thus, ideally the best way to differentiate between two entities is brain biopsy.


Question: Chondrocalcinosis is seen with

C i.e. Pseudogout Chondrocalcinosis term is used for finding of radiopaque crystals in hyaline or fibrocailage. It is seen in calcium pyrophosphate dihydrate crystal deposition disease (CPPD)Q, of which pseudogoutQ is a manifestation.


Question: IOC for radiotherapy / Chemotherapy induced myocardial damage

IOC for radio / chemo induced myocardial damage - Endomyocardial biopsy.


Question: Wide diploic space of skull with brush border (hair on end) appearance is characteristic of


Question: Investigation of choice for a pregnant lady with upper abdominal mass is

Ultrasound is the most commonly used imaging exam during pregnancy. It usually focuses on the baby in the womb. When ultrasound does not provide a clear answer, or if other pas of your body need to be imaged, an MRI is usually performed. MRI does not use x-rays.


Question: High resolution CT of the lung is a specialized CT technique for greater detail of lung parenchyma and it utilizes

Ans. is 'c' i.e., Bone algorithm for image reconstruction HRCT gives detailed images of the lung parenchyma (which is comparable to gross tissue inspection) and thus allows detection of diseases at an earlier stage than conventional CT scans.HRCT utilizes thin collimation (i.e., thin slices of 1 or 2 mm.) as compared to thick slices of conventional CT scan (of 5 to 7 mm.)The field of view is reduced to increase the resolution of the image.HRCT utilizes High spatial frequency algorithms, such as bone algorithms, rather than traditional soft-tissue algorithms (as used in conventional CT scan) for image reconstruction. It smoothens the image data and gives more sharp images and finer lung details.


Question: Ghost like shadow is seen in

Structures located between the X-ray source and moving center of rotation (orange zone) cast ghost images.
On the panoramic image, ghost images appear on the image on the opposite side of its true anatomic location and at a higher level, because of the upward inclination of the X-ray beam. Because the object is located outside of the focal plane and close to the X-ray source, the ghost image is blurred and significantly magnified. Several anatomic structures cast ghost images.