NEET-PG 2018 - Radiology PYQs Practice Questions

Q: What does the following radiograph from a double contrast esophagram represent?

Feline esophagus. **Feline esophagus (Correct)** - The image displays a characteristic transverse striation pattern along the esophageal mucosa, resembling the rings seen in the esophagus of a cat (hence "feline esophagus") - This finding is often associated with gastroesophageal reflux disease (GERD) or eosinophilic esophagitis, representing mucosal edema and inflammation - Also known as "ringed esophagus" or "corrugated esophagus" *Esophageal atresia (Incorrect)* - This is a congenital condition where the esophagus ends in a blind pouch, making it impossible for food to reach the stomach - The radiograph clearly shows a patent esophagus with contrast flowing through it, which rules out atresia *Esophageal stenosis (Incorrect)* - Esophageal stenosis refers to a narrowing of the esophagus, which would appear as a constricted segment on a barium swallow - While there is some irregularity, the primary pattern seen is transverse rings, not a focal, sustained narrowing typical of stenosis *Tracheoesophageal fistula (Incorrect)* - A tracheoesophageal fistula is an abnormal connection between the esophagus and the trachea - This would typically present with aspiration of contrast into the trachea or lungs, which is not evident in the provided image [Practice more Radiology PYQs on OnCourse]

Q: Water’s view is used to obtain diagnostic information of:

Maxillary sinus. ***Maxillary sinus*** - **Water's view** (occipitomental projection) is specifically designed to visualize the **maxillary sinuses** and highlight any **fluid levels** or **mucosal thickening** within them. - In this view, the **petrous ridges are projected below the floors of the maxillary sinuses**, allowing for clear assessment and optimal visualization. *Ethmoidal sinuses* - While partially visible on Water's view, the **ethmoidal sinuses** are best visualized with a **Caldwell view** (occipitofrontal projection) or a **CT scan**. - The complex bony structures surrounding them make detailed assessment difficult with Water's view alone. *Frontal sinus* - The **frontal sinuses** are best evaluated with a **Caldwell view** (occipitofrontal projection), which projects the petrous ridges at the lower third of the orbits. - Water's view offers a suboptimal projection for comprehensive assessment of the frontal sinuses. *Sphenoid sinus* - The **sphenoid sinus** is centrally located and often obscured by other structures on plain radiographs like Water's view. - It is best visualized with a **lateral skull view** or, more comprehensively, with a **CT scan**. [Practice more Radiology PYQs on OnCourse]

Q: What type of lesions in the skull bones can be identified on this X-ray?

Paget's disease. ***Paget's disease*** - An X-ray of the skull in Paget's disease typically shows **thickening of the skull vault** and areas of both **osteolysis** and **osteosclerosis**, leading to a characteristic "cotton wool" appearance. - The disease involves abnormal bone remodeling, leading to enlarged and weakened bones susceptible to deformity and fracture. *Multiple myeloma* - On a skull X-ray, multiple myeloma usually presents as multiple, sharply-defined, **"punched-out" lytic lesions** without a sclerotic border. - These lesions reflect areas where malignant plasma cells have destroyed bone, which is distinct from the mixed lytic and sclerotic changes of Paget's disease. *Osteosarcoma* - Osteosarcoma is a **primary bone malignancy** that typically presents as a solitary lesion with a mixture of lytic and sclerotic areas, often with a **sunburst or Codman's triangle** periosteal reaction. - It most commonly affects long bones in younger individuals and is a much less common presentation in the skull compared to other bone conditions. *Osteomyelitis* - Osteomyelitis is an **infection of the bone** that would appear on an X-ray as areas of bone destruction (lysis) and new bone formation (sclerosis), often with **sequestrum** (dead bone) and **involucrum** (new bone formation around the infection). - While it can affect the skull, its imaging features would typically be localized signs of infection rather than the widespread, generalized changes seen in Paget's disease. [Practice more Radiology PYQs on OnCourse]

Q: Which of the following abnormalities is most commonly detected as a vascular malformation on skull MRI?

Vein of Galen abnormalities. ***Vein of Galen abnormalities*** - **Vein of Galen malformations (VOGM)** are the **most common symptomatic cerebral vascular malformations in neonates and infants**, accounting for approximately **30% of pediatric cerebral vascular malformations**. - They often present with **high-output cardiac failure**, hydrocephalus, or seizures in early life. - On **MRI**, they appear as a large, abnormal midline venous pouch in the quadrigeminal cistern with characteristic **flow voids** on T2-weighted images. - VOGM represents an **arteriovenous shunt** to a persistent embryonic vein (median prosencephalic vein of Markowski). *Dandy Walker malformation* - This is a **congenital brain malformation** involving the cerebellum and fourth ventricle, characterized by hypoplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle, and an enlarged posterior fossa. - While readily seen on MRI, it is a **structural developmental anomaly**, not a vascular malformation. *Pneumocephalus presence* - **Pneumocephalus** refers to the presence of **air within the intracranial cavity**, usually resulting from trauma, neurosurgery, or skull base fractures. - It is an **acquired condition**, not a congenital vascular malformation, and appears as dark signal (air) on all MRI sequences. *Crouzon syndrome features* - **Crouzon syndrome** is a genetic disorder (FGFR2 mutation) characterized by **craniosynostosis** with premature fusion of coronal and sagittal sutures, leading to brachycephaly and midface hypoplasia. - It is a **craniofacial skeletal disorder**, not a vascular malformation. [Practice more Radiology PYQs on OnCourse]

Q: What is the structure seen in the X-ray?

Stent. ***Stent*** - The image clearly shows **bilateral coiled structures** (pigtails) at the proximal and distal ends within the renal pelvis and bladder, which are characteristic features of **double J stents (ureteral stents)**. - These devices are used to maintain patency in the **ureters**, often to bypass obstructions or facilitate urine drainage. *Surgical clips* - **Surgical clips** are typically small, dense, metallic objects used to ligate vessels or tissue, appearing as tiny, bright specks on X-rays. - The structures seen in the image are long, tubular, and coiled, which is inconsistent with the appearance of surgical clips. *Foley catheter* - A **Foley catheter** is a flexible tube inserted into the bladder to drain urine, sometimes with a balloon tip. - It would typically be seen entirely within the **bladder**, and its path would not extend bilaterally into the renal pelvis as shown. *Intravesical wire* - An **intravesical wire** (a wire entirely within the bladder) would appear as a coiled or linear structure confined to the bladder itself. - The structures in the image extend from the renal region down into the bladder, traversing the **ureters**, which is not typical for an intravesical wire. [Practice more Radiology PYQs on OnCourse]

Question 1

What does the following radiograph from a double contrast esophagram represent?

Accepted Answer

Feline esophagus

Answer

Esophageal atresia

Answer

Esophageal stenosis

Answer

Tracheoesophageal fistula

Question 2

Water’s view is used to obtain diagnostic information of:

Accepted Answer

Maxillary sinus

Answer

Ethmoidal sinuses

Answer

Frontal sinus

Answer

Sphenoid sinus

Question 3

What type of lesions in the skull bones can be identified on this X-ray?

Accepted Answer

Paget's disease

Answer

Multiple myeloma

Answer

Osteosarcoma

Answer

Osteomyelitis

Question 4

Which of the following abnormalities is most commonly detected as a vascular malformation on skull MRI?

Accepted Answer

Vein of Galen abnormalities

Answer

Dandy Walker malformation

Answer

Pneumocephalus presence

Answer

Crouzon syndrome features

Question 5

What is the structure seen in the X-ray?

Accepted Answer

Stent

Answer

Surgical clips

Answer

Foley catheter

Answer

Intravesical wire

Question 6

Identify the condition shown in the CT scan image.

Accepted Answer

Dandy-Walker malformation

Answer

None of the options

Answer

Cerebellar vermis hypoplasia

Answer

Mega cisterna magna

Question 7

What does the fallen fragment sign indicate in radiology?

Accepted Answer

Indicates a simple bone cyst

Answer

Indicates osteosarcoma

Answer

Indicates an aneurysmal bone cyst

Answer

Indicates adamantinoma

Question 8

What condition is shown in the MR angiogram of the skull?

Accepted Answer

Vein of Galen malformation

Answer

Dandy-Walker malformation

Answer

Pneumocephalus

Answer

Crouzon syndrome

Question 9

What type of lesions in the skull calvarium can be identified on this X-ray?

Accepted Answer

Brain metastases

Answer

Multiple myeloma

Answer

Osteosarcoma

Answer

Osteomyelitis

Question 10

What is the diagnosis based on the following X-ray?

Accepted Answer

Renal Tuberculosis

Answer

Bladder Stone

Answer

Uterine Fibroid

Answer

Bladder Carcinoma

NEET-PG 2018 — Radiology