MCQs High Yield

1. Compression band during IVU

a. Done after 5 mins film is taken
b. Contraindicated in hematuria
c. Contraindicated in children
d. Contraindicated in aortic aneurysm
e. Causes a dense nephrogram

2. Which of the following is true regarding the kidney?

a. The presence of cyst calcification in patients with ADPKD confers a high risk
of malignancy
b. The ipsilateral adrenal gland is involved in 10% of patients with renal cell
carcinoma
c. In RCC, the demonstration of stranding in the perinephric space on CT
indicates tumour extension beyond the kidney
d. Gradient echo sequences have greater accuracy in the detection of IVC tumour
thrombosis than spin echo sequences
e. Lymphangioleiomyomatosis of the kidney is associated with tuberous
sclerosis

3. Which of the following liver lesions may demonstrate signal loss on out-of-phase
(opposed phase) MRI
a. Hepatocellular carcinoma
b. Cholangiocarcinoma
c. Lymphoma
d. Hepatocellular adenoma
e. Haemangioma

4. Hirschprung’s disease in the neonate

a. Is commoner in pre-term babies
b. 80% occurs in the rectosigmoid
c. In 90% a transition zone can be seen on barium enema
d. 5-15% are associated with meconium ileus
e. Always involve the rectum

5. Causes of biliary-enteric fistula

a. Acute pancreatitis
b. Diverticulitis
c. Cholecystitis
d. Caroli’s disease
e. Crohn disease

6. Endoanal Ultrasound
 a. Better at defining T1 tumour than MRI
b. Internal sphincter is hyperechoic
c. External sphincter is hyperechoic
d. Rectal mucosa is echogenic
e. Is accurate in the assessment of anal sphincter function or tear

7. The following would be in the differential diagnosis of an isolated solitary 4cm lesion
which was hypo-attenuating in unenhanced CT, hyper-attenuating in the hepatic
arterial phase, and iso-attenuating in the portal venous phase.
a. FNH
b. Hepatoma
c. Focal fatty change
d. Adenoma
e. Cystic metastasis

8. Concerning the ventricular system

a. The cerebral aqueducts connects the posterior end of the 3rd ventricle with the
superior end of the 4th ventricle
b. The Aqueduct of Sylvius passes through the brain stem with the tectum,
tegmentum and cerebral peduncles posterior to it.
c. The 4th ventricle tend to be symmetrical in anatomy
d. The choroid plexus of the 4th ventricle invaginates the lowest part of its floor
e. The lateral ventricles are often indicated on plain skull radiographs as lucent
shadows over the occipital and parietal bones

9. Regarding orbital blow-out fractures

a. Non-contrast CT is the modality of choice for diagnosis
b. Orbital fat prolapse may be demonstrated
c. Muscle entrapment may involve the inferior rectus muscle
d. There may be associated globe rupture/injury
e. Associated clinical features include enophthalmos, diplopia, orbital
emphysema, malar region numbness due to injury to the inferior orbital nerve

10. Hepatic calcification is seen in

a. Hydatid disease
b. Brucellosis
c. Portal vein thrombosis
d. Chronic granulomatosis disease
e. Hepatic abscesses

11. Cystic liver metastasis is seen in

a. Colonic tumour
b. Pancreatic tumour
c. Melanoma
 d. Osteosarcoma
e. Carcinoid tumour

12. Crossed fused renal ectopia

a. There is a recognized male predilection
b. Forms up to 90% of cases of crossed
c. Right to left ectopy is commoner
d. Ultrasonography may demonstrate a characteristic anterior and posterior
“notch” between two fused kidneys
e. Superiorly crossed fused renal ectopia is the commonest type

13. FAST ultrasound visualizes 4 cardinal areas

a. Hepatorenal and perihepatic space
b. Peripancreatic space
c. Perisplenic space
d. Pelvis

14. The following radiographic features may be seen in osteogenesis imperfecta

a. hyperplastic callus formation
b. wormian bones
c. pectus excavatum
d. “Zebra stripe sign" in the long bones

15. Pulmonary hypoplasia may be seen information

a. Poland syndrome
b. Scimitar syndrome
c. Osteogenesis imperfecta
d. Congenital diaphragmantic hernia
e. Tetralogy of Fallot

16. Concerning ankylosing spondylitis

a. The hallmark of the disease is cervical spine involvement
b. Spinal involvement is usually asymmetrical
c. It is characterized by “bamboo spine” appearance on antero-posterior view of
the spine
d. It is associated with ulcerative colitis
e. Hand involvement is very rare

17. Which of these statements is/are true?

a. The calcaneum is the most commonly fractured tarsal bone
b. Bilateral calcaneal fractures are often associated with spinal injury
c. Bohler’s angle is increased in calcaneal fracture
d. Extra-articular type of calcaneal fractures is commoner than the intra-articular
type
 e. Lover’s fracture only implies the extra-articular type of calcaneal fracture

18. A classic Dandy-Walker malformation is characterized by

a. Hypertrophy of the vermis
b. Cystic dilatation of the fourth ventricle
c. Inferior displacement of the vermis
d. Elevation of the tentorium
e. A trapezoid-shaped gap between the cerebellar hemispheres on antenatal
ultrasound.

19. Concerning the lentiform nucleus

a. It is also referred as the corpus striatum
b. It is made up of a larger medial Putamen and a smaller lateral Globus pallidus
c. Medially, it is separated from the head of the caudate nucleus anteriorly
d. It is separated from the claustrum by a thin layer of grey matter called external
capsule
e. Its head is usually more radiodense than the caudate nucleus in elderly
subjects

20. Regarding bronchogenic cysts

a. They are most common in the middle mediastinum
b. fThey may be associated with spinal abnormalities
c. The parenchymal type is usually localized in the upper lobes
d. The mediastinal type usually presents with haemoptysis
e. They may contain air when infected

21. Myositis ossificans progressive

a. Is characterized by calcification of involuntary muscles
b. May resemble calcinosis universalis
c. Often begins with linear or rounded calcifications on the lower thoracic spine
d. May progress over the abdomen and chest
e. May be seen as subcutaneous masses in the neck

22. Regarding arachnoid cyst

a. Most commonly localized in the anterior cranial fossa
b. May mimic the appearance of porencephalic cyst
c. MRI usually demonstrates its walls
d. CT cisternography can demonstrate its communication with the subarachnoid
space
e. Is not seen in the suprasellar region of the brain

23. On plain film, infantile autosomal recessive osteopetrosis is characterized by

a. The paranasal sinuses are hyperpneumatised
b. Hair-on-end appearance in the skull bone
 c. Hypertelorism
d. Defective dentition
e. A broad high attenuation diploic space

24. The following statements are true concerning cerebellopontine angle masses
a. Acoustic schwannomas are of CSF density
b. Meningiomas are the commonest
c. Ependymomas are seen as enhancing masses
d. Neurenteric cysts may demonstrate high T1 signal on MRI
e. Metastatic lesions are commonly non-enhancing

25. Concerning congenital trachea-oesophageal fistula

a. Diagnosis is usually made in the neonatal period
b. Maternal polyhydramnios is seen antenatally in less than 50% of cases
c. Oesophageal atresia is also present in the H-type
d. Clinical presentation is similar in all types
e. Areas of consolidation are often demonstrated in the lungs

26. Oesophageal varices may result from the following

a. Portal vein thrombosis
b. Inferior Vena Cava obstruction below the hepatic veins
c. Obstruction to the superior vena cava
d. Mediastinal fibrosis
e. Retrosternal goiter

27. Which of these statements is/are correct in Gastroschisis

a. There is an increased incidence with younger maternal age
b. It does not have a surrounding membrane
c. On antenatal ultrasound, the fetal abdominal circumference is usually bigger
than expected for gestational age
d. The herniated content is most commonly on the left side of the umbilical cord
e. It may be accompanied by necrotizing enterocolitis

28. Regarding medullary sponge kidney

a. Medullary nephrocalcinosis occurs in the majority of cases
b. It demonstrates the “drooping lily” appearance of IVP
c. Echogenic medullary pyramids are demonstrated sonographically in the
absence of medullary nephrocalcinosis
d. It may be associated with Caroli disease
e. It may mimic medullary cystic disease

29. The following are findings that may be appreciated on barium studies in Crohn’s
disease
a. Cobblestoning
 b. Luminal narrowing
c. Involvement of the colon
d. Lymphadenopathy
e. Aphthous ulcers

30. The following are true regarding penile Doppler ultrasound

a. It is useful in evaluation of Peyronie’s disease
b. The most common indication for it is penile cancer
c. It may help in distinguishing psychogenic from arteriogenic form of erectile
dysfunction
d. The dorsal veins of the penis are the main vessels which are studied
e. B-mode ultrasound may also give additional information in combination with
it.

31. The following disease entities have been documented to cause an increase in renal
arterial resistivity index
a. Diabetes Mellitus
b. Sickle cell disease
c. AIDS
d. Malaria
e. Crohn's disease

32. The following features are highly suggestive of malignancy in solitary pulmonary
nodules
a. Ground glass density
b. Upper lobe location
c. Doubling time of less than 1 month
d. Homogeneous pattern of calcification
e. Size greater than 10mm

33. Which of the following statements are correct

a. Multinodular goiter has greater preponderance in males
b. Primary retrosternal goiters are usually located in the mediastinum
c. Secondary retrosternal goiters receive their blood supply from cervical vessels
d. Intrathoracic goiters are not usually complicated by malignant transformation
e. Oedema of the head and neck may complicate intrathoracic goiter

34. The following statements are correct

a. Ameloblastoma is commonly associated with extraosseous extension
b. Unilocular ameloblastoma may resemble dentigerous cyst
c. Ultrasonography may demonstrate bilateral extraocular muscle enlargement in
thyroid ophthalmopathy
d. Endometriosis may mimic hydatiform mole on ultrasound
 e. “Double density sign” is demonstrated in osteoid osteoma on bone
scintigraphy

35. Concerning Neurofibromatosis type 1 (NF1)

a. Extracranial manifestations may include internal carotid artery stenosis and
Moya-Moya
b. It can be differentiated from schwannomas
c. It may mimic lymphatic malformation
d. It frequently demonstrates low attenuation pre and post-contrast CT images
e. It is an autosomal dominantly-inherited syndrome with multiple
schwannomas, meningiomas and ependymomas

36. Cherubism
a. Is genetically identical to fibrous dysplasia
b. Has been reported in patients with Neurofibromatosis type 1 (NF1)
c. Is of autosomal recessive inheritance
d. Usually begins in early childhood and may regress in adulthood
e. More commonly affects the maxilla bilaterally

37. These statements are true about sinonasal mucoceles

a. They are located in the maxillary sinuses in 60 to 65% of cases
b. They may be associated with cystic fibrosis in children
c. Ethmoidal mucoceles have greatest potential for intracranial extension
d. They can be differentiated from allergic fungal sinusitis by CT
e. MRI is not recommended for evaluating sinonasal mucoceles

38. In pancreatic investigations the following statements are true

a. An ERCP must be done under general anaesthesia
b. There is an increased uptake of selenomethionine Se
c. ERCP accurately defines the operability of pancreatitic carcinoma
d. Real time ultrasonography demonstrates a mass in the pancreatic tail better
than CT
e. Acute pancreatitis may be a complication of ERCP

39. Regarding Achalasia of the oesophagus

a. It is usually associated with Hirschprung's disease
b. It may be complicated by carcinoma
c. An air-fluid level may be seen in the oesophagus
d. It is characterized by absence of gastric bubble in long-standing cases
e. Calcification of the mucosal lining is usually demonstrated on CT

40. Concerning hepatoblastoma

a. It is typically found in children above 5 years of age
b. It is the commonest abdominal malignancy in children
 c. On MRI, it is hypointense on both T1 and T2
d. Hemorrhages and necrosis are common findings even in small lesions
e. Hepatoblastomas are more common in children with familial adenomatous
polyposis

41. Regarding Paget’s disease

a. Sarcomatous transformation most commonly arises from facial bone
involvement
b. It is commonest in Caucasians
c. Tibia is the commonest site of diaphyseal involvement in long bones
d. Pathological fractures are commonly seen on the convex side of long bones
e. It can be complicated by paraplegia

42. The following may be seen in Chronic renal failure

a. Delay in bone age
b. Septic arthritis
c. Brown tumors
d. Osteomalacia
e. Spontaneous tendon rupture

43. Common features of psoriatic arthritis include

a. Osteoporosis
b. Periostitis
c. Bilateral sacroilitis
d. Marked soft tissue calcification
e. Distal interphalangeal joint involvement

44. The following features contribute to spinal stenosis

a. Shape of the spinal canal
b. Dentate ligament hypertrophy
c. Osteophytes
d. Disc bulge
e. Facet joint degenerative disease

45. In the hepatobiliary system

a. Pneumobilia is most likely due to biliary-enteric fistula
b. Choledochoduodenal fistula is the commonest cause of biliary-enteric fistula
c. Majority of the cases of choledochoduodenal fistula result from duodenal ulcer
d. Choledochocele may be complicated by pancreatitis
e. Xanthogranulomatous cholecytitis does not usually exend to the liver

46. Regarding thyroid nodules

a. Follicular adenomas are commoner than adenomatous nodules
b. Higher risk of malignancy is seen in patients below 20 years of age
 c. Ultrasonography is the best imaging modality for determining the volume of
nodule
d. Nodules that are taller than wide on ultrasound often suggest malignancy
e. Over 50% of the hypervascular nodules on ultrasound are benign

47. Regarding posterior cranial fossa tumours

a. Cerebellar astrocytoma is the most frequent tumour in children
b. Medulloblastoma is the most frequently calcified
c. Ependymoma is usually associated with hydrocephalus
d. They are hyperdense on non-enhanced CT
e. Ependymomas demonstrate homogenous Gd-DTPA enhancement on MRI

48. Enlargement of the azygos vein may result from

a. Inferior vena cava obstruction
b. Superior vena cava obstruction
c. Constrictive pericarditis
d. Pregnancy
e. Tricuspid insufficiency

49. Regarding breast masses

a. Lipoma of the breast is usually associated with calcification
b. Juvenile papillomatosis may undergo malignant transformation
c. Fibroadenoma may have echogenic halo with lateral shadowing on ultrasound
d. Gynecomastia is a risk factor for breast carcinoma in males
e. Metastasis may originate from hypernephroma

50. Concerning torsion of the ovary

a. It may occur prenatally
b. Normal arterial waveform on Doppler ultrasound rules out torsion
c. High signal intensity on fat suppressed T1WI suggests haemorrhage or
vascular congestion
d. Thickening of the fat planes is seen around torsed ovary on CT
e. It is commonly associated with large amounts of haemorrhagic ascites
 A B C D E

1 T F T T F

2 F T F T T

3 T F F T F

4 F T F F F

5 T T T F T

6 T F F T T

7 T T F T F

8 T F T F F

9 T T T T T

1 T T T T T

1 T T T F T

1 T T F T F

1 T F T T The four
classic areas
examined are
the
perihepatic
3 space
(including
Morison's
pouch or the
hepatorenal
recess),
perisplenic
space,
pericardium,
and the
pelvis.
1 T T T T

4
Question 4F: Seen in 50% in first week of life

Question 10: Causes of hepatic calcifications are as follows:

 Infections
o Tuberculosis, histoplasmosis, coccidioidomycosis, brucellosis
o Echinococcal cyst
o Schistosomiasis, cysticercosis, filariasis, paragonimiasis, armillifer, guinea worm
o Cytomegalovirus, toxoplasma, Pneumocystis carinii
o Chronic granulomatous disease of childhood
o Chronic amebic and pyogenic abscess
 Vascular
o Hepatic artery aneurysm
o Portal vein thrombosis
o Hematoma
 Benign tumor
o Hemangioma
o Hepatocellular adenoma
o Infantile hemangioendothelioma
o Regenerating nodule (capsule)
o Cyst
 Primary malignant tumor
o Fibrolamellar carcinoma
o Hepatocellular carcinoma
o Choloangiocarcinoma
o Epithelioid hemangioendothelioma
o Hepatoblastoma
 Metastatic tumor
o Mucinous carcinoma of colon, breast, stomach, ovary
o Others: melanoma, thyroid, osteosarcoma, malignant teratoma, chondrosarcoma,
carcinoid, leiomyosarcoma, neuroblastoma
 Biliary
o Calculus
o Ascariasis, chlonorchis

Question 11: A cystic hepatic metastasis may arise from any source, but consideration of
primary lesions should include:

 colon cancer
 ovarian cystadenocarcinoma
 squamous cell lung cancer
 sarcomas
 melanoma
 gastrointestinal stromal tumour (GIST)
 pancreatic mucinous cystadenocarcinoma
 pancreatic neuroendocrine tumour: a metastasis with a fluid-fluid level on MRI is
characteristic of a neuroendocrine tumour metastasis 4
 a large metastasis from any origin that has outgrown its blood supply
Cystic hepatic metastases may arise from any number of primary tumours, but classically
hepatic metastases arise from organs that have the opportunity of seeding the liver with
metastases via the portal vein, including the gastrointestinal tract (stomach, small bowel,
colon) and the pancreas.

Question 12: C = Left-to-right ectopy is thought to be three times more common. D = While
the inferior CFRE is the most frequent type observed, the superior CFRE is reported
to be the least common.

Question 19: corpus striatum = lentiform nucleus plus caudate nucleus

Question 36: Cherubism is inherited in an autosomal dominant fashion and is caused by

mutations in the SH3BP2 gene. Fibrous dysplasia is due to developmental dysplasia and focal
arrest in normal osteoblastic activity secondary to a non-hereditary mutation which results in
the presence of all of the components of normal bone with a lack of normal differentiation
into their mature structures.

Mandible>Maxilla