NEET-PG 2018 - Radiology PYQs Practice Questions

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 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: 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 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: Identify the condition shown in the CT scan image.

Dandy-Walker malformation. ***Dandy-Walker malformation*** - The image shows an enlarged posterior fossa with **cystic dilation of the fourth ventricle** and **absence/hypoplasia of the cerebellar vermis**, which are classic features of Dandy-Walker malformation. - The elevated tentorium and upward displacement of the transverse sinuses are also characteristic, contributing to the distinct appearance. *Cerebellar vermis hypoplasia* - While cerebellar vermis hypoplasia is a component of Dandy-Walker malformation, it is not the sole, defining feature. - Dandy-Walker also includes cystic dilation of the fourth ventricle and an enlarged posterior fossa, which are evident in the image and go beyond isolated vermis hypoplasia. *Mega cisterna magna* - A **mega cisterna magna** is a benign enlargement of the cisterna magna, which is the space between the cerebellum and the medulla oblongata. - Unlike in Dandy-Walker malformation, a mega cisterna magna usually does not involve displacement of the tentorium or hypoplasia of the cerebellar vermis, and the fourth ventricle is typically normal in shape and size. *None of the options* - The image clearly displays the diagnostic hallmarks of Dandy-Walker malformation, making this option incorrect. [Practice more Radiology PYQs on OnCourse]

Question 1

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

Accepted Answer

Maxillary sinus

Answer

Ethmoidal sinuses

Answer

Frontal sinus

Answer

Sphenoid sinus

Question 2

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 3

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 4

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 5

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 6

What is the structure seen in the X-ray?

Accepted Answer

Stent

Answer

Surgical clips

Answer

Foley catheter

Answer

Intravesical wire

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

Identify the condition represented in the chest radiograph.

Accepted Answer

Miliary tuberculosis

Answer

Bronchiectasis

Answer

COPD

Answer

Lung cancer

NEET-PG 2018 — Radiology