Question: Multiple cystic lesions seen in muscle and brain of 16 year old boy died of Status epilepticus. The diagnosis is

(D) Neurocysticercosis# Neurocysticercosis (NCC) is caused by CNS infection with the pork tapeworm Taenia solium.> Demographics & clinical presentation: The disease is endemic in Central and South America, Asia and Africa. There is a variable time interval between point of infection and the onset of symptoms (ranging from 1-30 years).> Clinical presentation includes: Seizures: most common cause of seizures in young adults in endemic areas; headaches; hydrocephalus; altered mental status and neurological deficits> CSF serology may be helpful with the initial diagnosis especially in cases of intraventricular/subarachnoid infection.> Pathology: Infection which leads to extra-intestinal disease (including neurocysticercosis) usually occurs as a result of eating food or drinking water contaminated by human feces containing T. solium eggs. This is distinct from the 'normal' life cycle in which the undercooked pork is eaten and the larval cysts contained within mature into adult intestinal tape worm.> Extra-intestinal infection undergoes specific clinical and imaging changes at it progresses through four stages of infection.> Stages: There are four main stages (also known as Escobar's pathological stages):1. Vesicular: viable parasite with intact membrane and therefore no host reaction.2. Colloidal vesicular: parasite dies within 4-5 years 1 untreated, or earlier with treatment and the cyst fluid becomes turbid. As the membrane becomes leaky oedema surrounds the cyst. This is the most symptomatic stage.3. Granular nodular: oedema decreases as the cyst retracts further; enhancement persists.4. Nodular calcified: end-stage quiescent calcified cyst remnant; no oedema.# Location: Infection can be both intra and extra axial. Commonest location is the subarachnoid space over the cerebral hemispheres.> Other locations in order of decreasing frequency are: subarachnoid space over the cerebral hemispheres - may be large basal cisterns - may be "grape like" (racemose): most lack an indentifiable scolex; parenchyma ventricles - usually solitary cysts; 4th ventricle most frequent> Typically the parenchymal cysts are small (1cm) whereas the subarachnoid ones can be much bigger (up to 9cm): differential therefore being arachnoid cyst. It is the most common cause of epilepsy in endemic areas (South-east Asia, South America) with progression through the 4 stages taking anywhere between 1 to 9 years.> Radiographic features: Imaging findings depend on location and stage of infection.> Subarachnoid-intraventricular: When in the subarachnoid space/intraventricular, the the cysts typically do not have a visible scolex. In the basal cisterns they can be grape-like (racemose). The cysts are typically 1-2 cm in diameter 2. Usually the cysts are similar in signal intensity to CSF, although occasionally cyst fluid may somewhat differ.> In the ventricles there is often (79%) 2 associated ventriculitis often leading to aqueductal stenosis and hydrocephalus.> Parenchymal: Parenchymal cysts usually involve the grey white matter junction.> Vesicular: cyst with dot sign; CSF density/intensity; hyperintense scolex on T1 can sometimes be seen; no enhancement is typical, although very faint enhancement of the wall and enhancement of the scolex may be seen> Colloidal vesicular: cyst fluid becomes turbid CT: hyperdense to CSF; MRI T1: hyperintense to CSF; surrounding oedema; cyst and the wall becomes thickened and brightly enhances scolex can often still be seen as an eccentric focus of enhancement> Granular nodular: oedema decreases; cyst retracts; enhancement persists but is less marked>Nodular calcified: Endstage quiescent calcified cyst remnant, no oedema; no enhancement on CT; signal drop out on T2 and T2* sequences; some intrinsic high T1 signal may be present; long term enhancement may be evident on MRI, and may predict ongoing seizures.


Question: Contrast material used in the diagnosis of esophageal atresia is


Question: The best X Ray view for minimal pleural effusion


Question: Point A in radiotherapy for carcinoma cervix corresponds to


Question: Most common investigation done for obstructive jaundice

B i.e. Ultrasonography - USG is most sensitive in detecting gall stone & is the first screening method and investigation of choice for gall stone (obstructive jaundice)Q. - Most common cause of obstructive jaundice is stone in gall bladder or CBD. And the stones are best visualized by USG. Other advantage of USG is that it's a noninvasive & cheap procedure, easily available every where. - If asked obstructive jaundice d/t tumours condition, then investigation of choice will be CT Scan. Though CT Scan may yield similar information, is more expensive and is not good as ultrasound when the stones are concerned.


Question: Radioresistant tumour is

Highly resistantHighly sensitiveMaligant melanomaOsteosarcomaSeminomaMultiple myelomaEwings sarcomaWilms tumourLymphoma(Ref: Harrison's principals of Internal medicine, 17th Ed page 612)


Question: Mammography uses

Answer: b.There are two types of x-radiation produced when electrons hit the x-ray tube anode.Bremsstrahlung is the most common and is in the form of a broad continuous photon energy spectrum with a maximum energy determined by the selected KV value.Characteristic radiation is produced under certain conditions and is confined to just a few photon energies.The molybdenum filter attenuates and blocks much of the bremsstrahlung spectrum above the energy of 20 keV.This results in the spectrum that is most often used in mammography, produced with the "moly/moly" anode/filter combination.


Question: Dysphagia lusoria is best diagnosed by

Ans. is'c'i.e., CT AngiographyRef: Human Malformations and Related Anomalies p. 130Dysphagia lusoria is an impairment of swallowing due to compression from an aberrant right subclan aery (aeria lusoria)CT angiography and MRI thorax are the best diagnostic modalities that could identify the aeria lusoria.


Question: Swirl sign is associated with

Swirl sign is a hypodense area noted within a hyperdense Epidural hematoma suggestive of active bleeding, a hyperacute unclotted blood.


Question: William's syndrome is associated with

A i.e. Congenital Supravalvular Aoic stenosis William's Syndrome or Idiopathic Hypercalcemia of Infancy It is characterized by: Hypercalcemia d/ t abnormal sensitivity to vitamin D Supravalvular aoic stenosisQ & other congenital defects Mental retardation Elfin facies (Round face with full cheeks & lips)


Question: Agenesis of cerebellar vermis,large posterior fossa with megacisterna magna is a feature of

Dandy-Walker Malformation is associated with agenesis of the cerebellar vermis, with the fouh ventricle communicating with cisterna manga producing Mega Cisterna Magna and a large Posterior Fossa. The Dandy-Walker continuum (DWC) is a spectrum of anomalies that includes Dandy-Walker malformation (DWM), vermian hypoplasia (VH),Blake pouch cyst (BPC), and mega cisterna magna (MCM).


Question: Nuchal translucency is used in

Fetuses with trisomy 21 and other chromosomal anomalies often have excess fluid in the subcutaneous tissue behind the fetalSonographically, this appears as an echolucent fluid collection between the soft tissue over the cervical spine and an echogenic line representing the skin edge. This fluid space is called the nuchal translucency (NT).The lucency is thought to represent mesenchymal edema and is often associated with distended jugular lymphatics.The prevailing theory suggests an alteration in lymphangiogenesis and delayed lymphatic development. Other possible etiologies include cardiac failure and abnormal extracellular matrix, but these do not explain the localized and transient nature of the NT. Most likely, the etiology is a complex interaction of factors.NT normally increases with advancing gestational age, and therefore the measurement is compared to crown-rump length (CRL). A thin NT is seen in most normal fetuses.An NT greater than 95% for CRL is considered thickened. An NT greater than 99% does not change significantly with CRL and is approximately 3.5 mm(Ref: Diagnostic Ultrasound by Carol M. Rumack, Stephanie R. Wilson, J. William Charboneau, and Deborah Levine,4thed, page 1190)


Question: Spoked wheel appearance is seen in

Spoked wheel appearance - Oncocytoma.
B/L spider leg deformity - PCKD.


Question: Epiphyseal enlargement is seen in


Question: Calcification of Interveebral Disc is seen in

C i.e. Alkaptonuria Features Disease Fish Mouth Veebrae - Sickel Cell AnemiaQ HomocystinuriaQ Cod Fish Veebra (Biconcave veebra) - Osteomalacia, Osteoporosis, Hyperparathyroid Rugger jersey spine (sclerosis of upper & lower spine borders) - CRF induced osteomalaciaQ - Osteopterosis (marbel bone disease) Calcification of Interveebral disc - Alkaptonuria (m.c.) Picture Frame veebrae - Paget's disease Veebrae plana - Eosinophilic granulomaQ


Question: Maximum penetrating radiation among the below is

The penetrating power of alpha rays, beta rays, and gamma rays varies greatly. Alpha paicles can be blocked by a few pieces of paper. Beta paicles pass through paper but are stopped by aluminium foil. Gamma rays are the most difficult to stop and require concrete, lead, or other heavy shielding to block them.Reference: Eric J Hall Textbook of Radiobiology for Radiologist; 5th edition


Question: Phosphorous 32 emitts

A beta particle also called beta ray or beta radiation is a high-energy,
high-speed electron or positron emitted by the radioactive decay of an atomic nucleus during the process of beta decay.


Question: NMR principle is based on

NMR/MRI principle is based on ability of protons in the body to absorb and emit radio waves when the body is placed in strong magnetic field


Question: CT number of water and bones respectively

Answer: c) 0, + 1000CT- scan or CAT scanInvented by God Frey Hounsfield in 1963, awarded Nobel Prize.Basic principle of CT is linear attenuation of x-rays.Incident x-rays are linearly attenuated by their interaction with orbital electrons of tissues.Measurement of attenuation of emerging / detected beam - gives density of intervening tissues and this density forms basis of signal intensity variation obtained in x-ray tomograms.Two type of contrast agents are usedIonic - water soluble iodide dyes (e.g. Na- diatrizoate, megliumine, conray, urograffin, angiografin) - may cause anaphylaxisNon ionic- Safer but expensive e.g. iohexol (Omnipaque), lopamiroElectron density of tissues in numbered as Hounsfield number (H.N.) or Hounsfield units.Air have a value of -1000 HUFat:-120 to-200 HUWater-0 HUSoft tissue: 20-60 HUBlood: 50-60 HUBone:+1000 HU


Question: Earliest feature of pulmonary venous hypeension

B i.e., Upper lobar diversion of vessels Upper lobe venous diversion is the first radiological sign of pulmonary venous hypeensonQ.


Question: Amniocentesis is done at

Amniocentesis normally done at 14 - 16 weeks.
Early Amniocentesis 12 - 14 week.


Question: Atelectasis with reverse S sign is seen in

The Golden S-sign is seen on both PA chest radiographs and on CT scans. It is named because this sign resembles a reverse S shape, and is therefore sometimes referred to as the reverse S-sign of Golden. Although typically seen with right upper lobe collapse, the S-sign can also be seen with the collapse of other lobes. It is created by a central mass obstructing the upper lobe bronchus and should raise suspicion of a primary bronchogenic carcinoma. It can also be caused by other central masses, such as metastasis, primary mediastinal tumour, or enlarged lymph nodes(Grainger&;s diagnostic radiology, 6th ed, 328)


Question: Dense middle cerebral aery (MCA) Sign in brain is seen in

The hyperdense MCA sign refers to the focally increased density of the middle cerebral aery on CT and is a direct visualization of thromboembolic material within the lumen. It is thus the earliest visible sign of MCA infarction as it is seen within 90 minutes after the event - acute infarct. It is the longitudinal equivalent of the MCA dot sign and hyperdense basilar tip sign.


Question: Earliest radiological finding of chron's disease

Earliest change are aphthous lesions or erosions.


Question: Excretory urography should be cautiously performed in


Question: Spoke wheel calcification in an osteolytic lesion is seen in

Radiological findings in intraosseous hemangioma are : Prominent trabecular pattern Better visualization of thickened veical trabeculation: polka-dot appearance on axial images and corduroy sign on coronal and sagittal images. Lytic calvarial lesions with spoke-wheel appearance Irregular and lytic in long bones, with a honeycomb appearance


Question: Rim sign in IVP is seen in


Question: Commonly used criteria for response evaluation during cancer treatment

A complete response is defined as disappearance of all evidence of disease and a paial response as >50% reduction in the sum of the products of the perpendicular diameters of all measurable lesions. The determination of paial response may also be based on a 30% decrease in the sums of the longest diameters of lesions (Response Evaluation Criteria in Solid Tumors ). Progressive disease is defined as the appearance of any new lesion or an increase of >25% in the sum of the products of the perpendicular diameters of all measurable lesions (or an increase of 20% in the sums of the longest diameters by RECIST). Tumor shrinkage or growth that does not meet any of these criteria is considered a stable disease. Some sites of involvement (e.g. bone) or patterns of involvement (e.g.lymphangitic lung or diffuse pulmonarg infiltrates) are considered unmeasurable.Reference: Harrison; 19th edition


Question: Least useful for diagnosing spondylolisthesis

D i.e. X ray spine AP view Spondylolisthesis is a forward slip of one veebrae upon another; so it is best viewed (or seen earliest) in sagittal images of spine i.e. lateral and oblique X rays of spine and saggital & axial views of CT & MRIQ. AP views of X ray can only be used to demonstrate indirect evidences (eg. inveed Napoleon's hat sign) of late/ severe spondylolisthesis. Oblique view of spine display the lamina and aicular processes more clearly than the classical anteroposterior & lateral views. The shadow of neural arch resembles that of Scottish terrier dogQ. Spondylothesis is forward slip of one veebrae upon another. Majority of cases are due to stress fracture of pars interaicularis leading to broken neck or presence of collar on the Scottie doe. More displacement will lead to Beheaded (without head) Scottie terrier sign(2. Spondylolisthesis : ventral slipping or gliding of all or pa of one veebrae on a stationary veebra beneath it. Most common is between L5 - S1 and between L4 -- L5. "Inveed Napoleon's HatQ" sign: A severe degree of spondylolisthesis at L5 - Si can be identified on A-P view by ventrocaudal displacement of L5 over sacrum and creates curvilinear densities.


Question: Subdural haematoma most commonly results from


Question: Premature filling of veins on cerebral angiography is a feature of


Question: Most accurate assessment of gestational age by USG is done by


Question: Inferior rib notching is seen in

A i.e. Coarctation of aoa Inferior rib notching in coarctation of aoa is d/t pressure erosion of intercostal aeriesQ It usually takes several years to develop, so is unusual before 10 years of age.


Question: Best investigation to detect rupture of breast implant is

Linguine sign is seen in ruptured breast implant.


Question: Assymetric growth on ultrasound imaging is seen in


Question: Distribution of functional renal tissue is seen by


Question: Hydrocephalus in infant is best diagnosed by

Ans. a (USG cranium). (Ref. Grainger, Diagnostic Radiology, 4th ed., 2469)Cranial ultrasound of Infants# USG cranium is best method to diagnose hydrocephalus through the anterior and posterior fontanalles.# Progression of hydrocephalus can be estimated by comparison with previous studies.# USG is also helpful in following ventricular decompression in patients treated for hydrocephalus.# Neonatal hydrocephalus can also be evaluated by Doppler to assess indirectly intracranial pressure and help to determine the need for shunt placement.Cranial CT# CT enable us to evaluate the brain structure and ventricular size by noninvasive highly reliable technique.# But due to the ionizing radiations hazard, CT as a screening investigation is less preferable.Qhstretk. (Fetal) Cranial ultrasound# Obstretic ultrasound study is one of the best methods for antenatal diagnosis of hydrocephalus as it is noninvasive & hazard free not only to fetus as well as to mother. However assessment prior to GA of 20 weeks may be difficult, as ventricles constitute a large portion of cranial vault.# Signs suggestive of fetal hydrocephalus on obstretic USG study are:- Atrial size > 10 mm- Dangling "Choroid plexus" sign- BPD > 95th percentile- +- PolyhydramniosEducational points:# Lemon sign:- Concave/linear frontal contour abnormality located at coronal suture strongly associated with spina bifida.# Banana sign:- Cerebellum wrapped around posterior brainstem + obliteration of cisterna magna secondary to small posterior fossa + downward traction of spinal cord in Chiari II malformation.# Key points about Obstetric color Doppler study:- Assessment of flow in MCA is important parameter to diagnose fetal anemia.- Assessment of flow in umbilical vessels is important parameter to diagnose fetoplacental insufficiency.- Reduced diastolic flow in umbilical artery is the earliest sign of fetoplacental insufficiency.- Reversal of flow in umbilical artery (as well as pulsatile flow in umbilical vein) is the most ominous sign and may indicate impending fetal death.


Question: Following is not a differential diagnosis for middle mediastinal mass

Neuroenteric cyst - Posterior mediastinum.


Question: Sunburst appearance on the radiograph is seen in


Question: Radiation dose monitoring in occupational personal is done by


Question: The most radiosensitive cells are

The most sensitive cells are those that are undifferentiated, well nourished, dividing quickly and highly active metabolically. Amongst the body cells, the most sensitive are spermatogonia and erythroblasts, epidermal stem cells, gastrointestinal stem cells. The least sensitive are nerve cells and muscle fibres.Very sensitive cells are also oocytes and lymphocytes, although they are resting cells and do not meet the criteria described above. The reasons for their sensitivity are not clear.Reference: Eric J Hall Textbook of Radiobiology for Radiologist; 5th edition


Question: S.I Unit of radioactivity is

UNITS OF RADIATION Physical quantity S.I. Unit Non S.I. Unit Conversion Radioactivity Becqueral (Bq) Curie (Ci) 1 Ci = 3.7 X 1010 Bq Absorbed dose Gray (Gy) Rad 1 Gy = 100 rads 1 rad = 0.01 gy Dose equivalent Sieve (SV) Rem 1 SV = 100 rem 1 Rem = 0.01 Sv Exposure coulomb/kg Roentgen 1R= 2.58 x 10-4coulomb/kg of air


Question: A 5 year old child diagnosed with cystic lesion with a enhancing mural nodule seen in cerebellar hemisphere on Brain MRI has

Cystic lesion with an enhancing mural module in a child is suggestive of Pilocytic astrocytoma In a adult above finding is suggestive of Hemangioblastoma Figure: Large posterior fossa cystic lesion with enhancing mural nodule.


Question: Golden S is seen in

Golden "S" sign is a Reverse "S" sign seen on Frontal Chest Radiograph In patients with Bronchogenic Ca with Right Upper lobe collapse Lower convexity of the Reverse S is due to the mass Upper concavity of the "S" is due to Right UPPER LOBE atelectasis with the upward shifting of the horizontal fissure.


Question: Most common hormone deficiency seen after intracranial radiation therapy

Growth hormone Harrison writes ? "Cranial irradiation may result in long-term hypothalmic and pituitary dysfunction, especially in children and adolescents. The development of hormonal abnormalities correlates strongly with irradiation dosage and the time interval after completion of radiotherapy. The development of hypopituitarism occurs after 5 to 15 years and usually reflects hypothahnic damage rather than absolute destruction of pituitary cells Though the pattern of hormone loss is variable, GH deficiency is most common, followed by gonadotropin and ACTH deficiency"


Question: CBCT stands for

Cone-beam computed tomographic (CBCT) imaging is the most significant technologic advance in maxillofacial imaging since the introduction of panoramic radiography. CBCT imaging was initially developed commercially for angiography in the early 1980s. It uses a divergent cone-shaped or pyramid-shaped  source of ionizing radiation and a two-dimensional area detector fixed on a rotating gantry to provide multiple sequential transmission images that are integrated directly, forming volumetric  information.


Question: Best investigation for cardiac temponade is

A i.e. 2 D Echocardiography M- Mode Echo is also k/a One dimensional echo, it uses stationary beam so informations are updated very rapidly. It is often more conventient for assessing distance & motion of selected cardiac structure. 2-Dimensional echo has replaced it for most diagnostic purposes. It is expected that 3D imaging will replace most 2D imaging in future. 2-D-Echocardiography is investigation of choice for: Pericardial effusionQ Cardiac TemponadeQ Valvular hea ds Cardiomyopathy


Question:
In bitewing radiographs, occlusal pit caries of enamel
appears as a

Triangular radiolucent area with its base towards the dentino-enamel junction

Triangular radiolucent area with its base towards the surface


Question: Radiation Dose Monitoring in Occupational Workers is done by

TLD Batch (Thermoluminescent Dosimeter) It is used to evaluate occupational radiation exposure It is made up of lithium flouride (LiF) or Calcium suphate Dysprosium It is worn under lead apron


Question: Not a Stochastic side effect of radiation

Stochastic - Dose independent.
Ex: Cancer, Genetic S/E, Teratogenicity.


Question: Contrast used for MRI

MRI Contrast Agents : Are contrast agents used to improve the visibility of internal body structures in magnetic resonance imaging(MRI). The most commonly used compounds for contrast enhancement are Gadolinium-based.


Question: Polka dot sign on CT is a feature of

Polka dot sign/ Corduroy/vertical striations – Vertebral hemangioma.


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


Question: | energy linear acceleration used in


Question: IOC for Acute Aoic Dissection

IOC for acute Aoic Dissection is CT-Angio In Unstable patients- Transesophageal Echocardiography MRI is NOT used in Acute conditions but is helpful in chronic dissections to better delineate the true and false lumen - Dissection of aerial wall forming shreds within false lumen - COB WEB SIGN - False lumen form an acute angle giving BEAK SIGN in aoic dissection COB WEB SIGN BEAK SIGN


Question: Half life of Iridium 192

Answer: c) 73.8 daysISOTOPES USED IN MEDICINEReactor Radioisotopes (half-life indicated in brackets):Molybdenum-99 (66 h): Used as the 'parent' in a generator to produce technetium-99m.Technetium-99m (6 h): Used in to image the skeleton and heart muscle in particular, but also for brain, thyroid, lungs (perfusion and ventilation), liver, spleen, kidney (structure and filtration rate), gall bladder, bone marrow, salivary and lacrimal glands, heart blood pool, infection and numerous specialized medical studies.Uses of Technetium 99 tagged RBC's:Commonly indicated in Acute Lower Gastrointestinal Bleeding.Relatively sensitive & very specific imaging method for noninvasive diagnosis of liver hemangioma.Measurement of left ventricular ejection fraction. Assessment of regional wall motion (left and right ventricles).Chromium-51 (28 d): Used to label RBC's and quantify gastro-intestinal protein loss.Cobalt-60 (10.5 months): Formerly used for external beam radiotherapy.Copper-64 (13 h): To study genetic diseases affecting copper metabolism. Eg: Wilson's and Menke's diseases.Dysprosium-165 (2 h): Used as an aggregated hydroxide for synovectomy treatment of arthritis.Erbium-169 (9.4 d): Use for relieving arthritis pain in synovial joints.Holmium-166 (26 h): Being developed for diagnosis and treatment of liver tumours.Iodine-125 (60 d): Used in brachytherapy (prostate and brain), to evaluate the filtration rate of kidneys and to diagnose DVT in the leg. It is also used in radioimmuno-assays to show the presence of hormones in tiny quantities.Iodine-131 (8 d): Used in treating thyroid cancer, imaging the thyroid; in diagnosis of abnormal liver function, renal (kidney) blood flow and urinary tract obstruction. A strong gamma emitter, but used for beta therapy.Iridium-192 (74 d): Supplied in wire form for use as an internal radiotherapy source for cancer treatmentIron-59 (46 d): Used in studies of iron metabolism in the spleen.Lutetium-177 (6.7 d): emits just enough gammas for imaging while the beta radiation does the therapy on small (eg endocrine) tumours. Its half-life is long enough to allow sophisticated preparation for use.Palladium-103 (17 d): Used to make brachytherapy permanent implant seeds for early stage prostate cancer.Phosphorus-32 (14 d): Used in the treatment of polycythemia vera (excess red blood cells). Beta emitter.Potassium-42 (12 h): Used for the determination of exchangeable potassium in coronary blood flow.Rhenium-186 (3.8 d): Used for pain relief in bone cancer. Beta emitter with weak gamma for imaging.Rhenium-188 (17 h): Used to beta irradiate coronary arteries from an angioplasty balloon.Samarium-153 (47 h): Sm-153 is very effective in relieving the pain of secondary cancers lodged in the bone, sold as Quadramet. Also very effective for prostate and breast cancer. Beta emitter.Selenium-75 (120 d): Used as seleno-methionine to study the production of digestive enzymes.Sodium-24 (15 h): For studies of electrolytes within the body.Strontium-89 (50 d): Very effective in reducing the pain of prostate & bone cancer. Beta emitter.Xenon-133 (5 d): Used for pulmonary (lung) ventilation studies.Ytterbium-169 (32 d): Used for cerebrospinal fluid studies in the brain.Ytterbium-177 (1.9 h): Progenitor of Lu-177.Yttrium-90 (64 h): for brachytherapy and as silicate colloid for relieving pain of arthritis. Pure beta emitter.Radioisotopes of caesium, gold and ruthenium are also used in brachytherapy.


Question: A patient presented with minimal Rt. sided pleural effusion. The best method to detect this would be

D i.e. Right lateral decubitus Ipsilateral decubitus is investigation of choice for minimal pleural effusionQ


Question: Film exposed to light during development will be


Question: Filarial Dance sign is seen on

The Filarial dance sign refers to a twirling motion of microfilariae (e.g.W. bancrofti) noted in dilated lymphatic channels. It is identified as a characteristic sign and indicator of scrotal filariasis. The dilated channels are identified with absence of color flow on Color Doppler study (CDS) and the microfilariae as curvilinear echogenic undulating structures within it. Generally 5-6 microfilariae are seen per channel. GIF image: Filarial dance sign on USG


Question: Punctuated lesion and floating teeth are seen in

Skullsolitary or multiple punched-out lytic lesions without sclerotic rimdouble contour/beveled edge appearance /hole within a hole signbutton sequestrum representing residual bonegeographic skull/ raindrop skullMandibleirregular radiolucent areas involving superficial alveolar bonefloating tooth: loss of lamina duraSpineveebra plana: most common cause of veebra plana in childrenLong bonespermeative and aggressive appearing lesionmainly involves diaphysis or metadiaphysis endosteal scalloping, periosteal reaction, coical thinning, intracoical tunneling, and associated soft tissue mass (Ref: Radiology Review ManualBy Wolfgang Dahne 7thEtd, Page no:115,116)


Question: Half life of Technetium is

A i.e. 6 hours Half life (tin) of radium (Ra226)is 1602-1626 years (longest)Q; Cesium (137Cs) is 30 yearsQ; Cobalt (60Co) is 5.2 yearsQ; iridium (1921r)is 74.5 daysQ; Iodine (P31)is 8 daysQ; 1123 is 13 hoursQ; technitium (Tc99) is 6 hoursQ; and 1132 is 2.3 hoursQ.


Question: Investigation of choice in bronchiectasis

Ans: b (HRCT)Second investigation of choice (earlier): Bronchography (not Bronchoscopy)HRCT signs:Honeycomb patternTram-track patternGrape cluster patternTooth paste patternSignet ring patternVery importantSome Investigations of choice:Bronchiectasis :HRCTRenal TB (early) :IVPRenal TB (advanced) :CT>IVPRenal calculus :Non contrast Helical CT scanDental pathology andTM joint pathology :pantamogramPregnant lady with upper abdominal mass :MRIPosterior urethral valve and VUR :MCU (Micturating cystourethrogram)Osteoporosis :DEXA


Question: Defenitive test to diagnose pulmonary embolism

CTPA is defenitive test or gold standard test.


Question: Contrast media of choice for myelogram is

C i.e. lohexol - Dianosil is used in oesophageal atresiaQ, as in most cases it is frequently associated with tracheooesophageal fistula; so on instillation of contrast media, there is risk of flooding in the lungs. Water soluble-nonionic LOCM are licenced for intrathecal use eg Iohexol (omnipaque) and Iopamidol (neopam)Q and are contrast agents of choice for myelographyQ. These are non neurotoxic, donot cause epileptic fits, can be used without withdrawing other drugs & are devoid of arachioid toxicity and anticonvulsant cover is unnecessary. Whereas ionic contrast media (both HOCM & LOCM) are very very toxic & often fatal when injected into subarachnoid space.


Question: MRI finding in cavernous angioma

MRI finding of cavernous malformation (cavernous angioma or covernoma) demonstrate typical 'Popcorn like' smoothly circumscribed, well - delineated complex lesion.


Question: HIFU stands for

HIFU stands for High-Intensity Focused Ultrasound. HIFU uses High Intensity Focused Ultrasound beam in the treatment of uterine fibroids and other lesions. it acts due to the thermal, mechanical and cavitational effects of the high-intensity Ultrasound beam in tissues.


Question: Upstream and downstream hydrocephalus is seen in

Most Brain tumors usually produce only upstream hydrocephalus. Choroid plexus papilloma is a CSF producing tumor located in occipital horns of lateral ventricle and produces both upstream and downstream hydrocephalus. CECT axial image showing intensely enhancing lesion in occipital horn of left lateral ventricle s/o Choroid plexus papilloma.


Question:
The fastest dental film currently available has the speed
rating of


Question: Penetration power is more for


Question: Puff of smoke appearance in cerebral angiography is a feature of

Lenticulostriate arteries form a rich collateral network around occlusive lesion - puff of smoke.
Anterior circulation > posterior.


Question: Most important cause of bulging fissure

All the above are causes of bulging fissure.
Most important cause is Klebsiella pneumonia.


Question: Salt and Pepper pot appearance of skull is seen in

(A) HyperparathyroidismHYPERPARATHYROIDISM:Uncontrolled production of parathyroid hormone causes | bone mass secondary to | number of osteoclasts, | osteoid volume (defect in mineralization), slightly | number of osteoblasts.Loss of lamina dura of tooth, Pepper pot appearance in skull, "Rotting fence post' appearance of proximal femur in childrenBone Resorption: Subperiosteal (most constant & specific finding; virtually Pathognomonic of Hyperparathyroidism).Lacelike irregularity of cortical margin; may progress to scalloping/spiculation (pseudoperiostitis), involves phalangeal tufts (earliest involvement), radial aspect of middle phalanx of 2nd & 3rd finger beginning in proximal metaphyseal region (early involvement)Subchondral collapse of cortical bone & overlying cartilage with development of erosion, cyst, joint narrowing.Cortical resorption, trabecular resorption, subligamentous bone resorption.Bone Softening: Basilar impression of skull, Wedged vertebrae, kyphoscoliosis, biconcave vertebral deformities, bowing of long bones, Slipped capital femoral epiphysis.Brown Tumor: Eccentric, cortical frequently solitary expansile lytic wellmarginated cystlike lesion, endosteal scalloping, seen in jaw, pelvis, rib, metaphyses of long bones (femur), facial bones, axial skeleton (DDx--GCT).Osteosclerosis - 'Rugger jersey spine' - sclerosis of vertebral endplates with intervening normal osseous densitySoft-Tissue Calcification: Metastatic calcification cornea, viscera (lung, stomach, kidney), periarticular in hip, knee, shoulder, wrist & chondrocalcinosis in menisci, wrist, shoulder, hip, elbow.Erosive Arthropathy, Periosteal New-Bone Formation.Sequele Hyperparathyroidism 1. Renal stones & nephrocalcinosis 2. osteoblastic activity--osteitis fibrosa Cystica, brown tumours (primary Hyperparathyroidism) bone softening (fractures), 3. Peptic ulcer disease, 4. Calcific pancreatitis, 5. Soft-tissue calcifications (Secondary Hyperparathyroidism).Primary Hyperparathyroidism: Hypercalcemia due to uncontrolled secretion of parathormone by one or more hyperfunctioning parathyroid glands featuring brown tumor & chondrocalcinosisSecondary Hyperparathyroidism: Diffuse adenomatous hyperplasia of all four parathyroid glands as a compensatory mechanism in any state of hypocalcemia featuring soft-tissue calcifications & osteosclerosis.Tertiary Hyperparathyroidism: Development of autonomous PTH adenoma in patients with chronically overstimulated hyperplastic parathyroid glands (renal insufficiency).Pseudo hyperparathyroidism: Ectopic parathormone production in paraneoplastic syndrome in bronchogenic carcinoma and renal cell carcinoma.CHARACTERISTIC X-RAY APPEARANCES'Sun-ray1 appearance... Osteogenic sarcoma'Soap bubble' appearance... Osteoclastoma'Moth-eaten' appearance around epiphysis... Rickets'Rain drop' osteolytic lesions in skull ... Letterer-Siwe disease, Multiple myeloma'Saw tooth' appearance of metaphysis... Congenital syphilis'Cup and Pencil' joint appearance ... Rheumatoid arthritis'Ground glass' appearance... Fibrous dysplasia'Honeycomb' appearance ... Chronic osteomyelitis, Paget's disease, Osteoclastoma, Adamantinoma'Cricket bat* shaped ribs... Morquio disease'Ribbon ribs'... Neurofibromatosis'Shepperd crook' deformity of femur... Fibrous dysplasia'Flask shaped' femur... Thalassemia'Bag of bones' appearance... Charcot's joints'Moth eaten' appearance of skull... Pyogenic osteomyelitis'Onion peel' appearance... Ewing's sarcoma'Bossing' of calvarium & 'Cupping' of distal... Rickets end of radius & ulna'Bone within a bone' appearance ... Osteopetrosis, Periostitis, Scurvy, Gaucher's disease & congenital syphilis'Swiss cheese' appearance... Plasmacytoma'Floating teeth' appearance... Histiocytosis'Celery stick' of long bones in infants... Congenital rubellaBilateral iliac horns ... Nephrotic syndrome'Pencil in cup' appearance... Arthritis mutilans type of Psoriatic arthritis'Trident hand' is seen in... Achondroplasia'Spina ventosa' (air within a small bone)... Tuberculous dactylitis'Sabre tibia'... Congenital syphilis'Hot cross bun' appearance of skull... Congenital syphilis'Bucket handle' Epiphyseal cartilage... Battered Baby'Lace-work' periostitis... Tertiary syphilis'Bayonet-like' wrist... Madelung's deformity'Candle wax' appearance... Meliorheostosis'Marble bone'... Osteopetrosis'Wormian bones'... Fibrous dysplasiaBanana fracture... Paget's diseaseEnlarged sclerotic ivory vertebra ... Paget's diseaseIvory dense vertebra ... Hodgkin's lymphoma'Cod-fish' vertebra... Hyperparathyroidism, Osteomalacia'Spoke wheel' calcification within osteolytic ... Haemangioma lesion of bone'Squaring' of vertebral bodies ... Ankylosing spondylitis'Bamboo-spine' appearance... Ankylosing spondylitis'Hair brush' appearance of skull... Hyperparathyroidism'Geographical' appearance of skull... Hand-Schuller Christian