NEET-PG 2020 - Radiology PYQs Practice Questions

Q: What is the most likely diagnosis of a child with the following chest X-ray finding (image required)?

Tetralogy of Fallot (TOF). ***TOF*** - The classic chest X-ray finding in **Tetralogy of Fallot** is a **boot-shaped heart** ("coeur en sabot") due to right ventricular hypertrophy and a concave pulmonary artery segment. The image provided would show this characteristic configuration. - This morphology is a result of the four defects: **ventricular septal defect (VSD)**, **pulmonary stenosis**, **overriding aorta**, and **right ventricular hypertrophy**. *Transposition of Great Arteries (TGA)* - TGA typically presents with a **"egg-on-a-string"** or **"egg-on-side" appearance** on chest X-ray, characterized by a narrow upper mediastinum (due to parallel great arteries) and cardiomegaly. - This is due to the **aorta arising from the right ventricle** and the **pulmonary artery from the left ventricle**, leading to two separate circulations. *Total Anomalous Pulmonary Venous Connection (TAPVC)* - TAPVC, particularly the supracardiac type, often presents with a **"snowman" or "figure-of-8" heart** on chest X-ray, caused by the dilated vertical vein and superior vena cava draining into the right atrium. - This anomaly involves all **four pulmonary veins draining abnormally**, typically into the systemic circulation. *Ebstein's Anomaly* - Ebstein's anomaly is characterized by a **massively enlarged right atrium** and **cardiomegaly** on chest X-ray, often described as a **"box-shaped" heart**, due to the apical displacement of the tricuspid valve. - This condition involves the **tricuspid valve being displaced into the right ventricle**, leading to atrialization of a portion of the right ventricle. [Practice more Radiology PYQs on OnCourse]

Q: Identify the condition in the X-ray given below:

TOF. ***TOF*** - The chest X-ray shows a **boot-shaped heart (coeur en sabot)**, which is highly characteristic of **Tetralogy of Fallot** due to right ventricular hypertrophy and pulmonary artery hypoplasia. - There is also **reduced pulmonary vascular markings** (oligemia), indicating decreased blood flow to the lungs, a typical finding in TOF. *TGA* - Transposition of the Great Arteries (TGA) typically presents with a **"egg-on-a-string" appearance** on chest X-ray, characterized by a narrow mediastinum and cardiomegaly, which is not seen here. - Pulmonary vascularity can be increased or normal in TGA, unlike the decreased vascularity observed in the image. *TAPVC* - Total Anomalous Pulmonary Venous Connection (TAPVC) usually shows a **"snowman" or "figure-of-8" heart** shadow on chest X-ray, due to enlarged SVC and innominate vein. - This condition is also associated with **increased pulmonary vascular markings** and often cardiomegaly, which are absent in the provided image. *Ebstein's anomaly* - Ebstein's anomaly is characterized by a **massively enlarged heart** on chest X-ray due to right atrial enlargement and tricuspid regurgitation. - It often shows **reduced pulmonary vascular markings** due to functional pulmonary stenosis, but the characteristic "boot shape" is not typically present. [Practice more Radiology PYQs on OnCourse]

Q: Which radiological finding is shown in the image?

Intussusception. ***Intussusception*** - The image clearly displays the classic "coiled spring" appearance, which is pathognomonic for **intussusception** on a barium enema study. This pattern is created by barium trapped between the intussusceptum and intussuscipiens. - The arrow specifically points to the leading edge of the intussusception, where the bowel telescopes into an adjacent segment. *Colon carcinoma* - Colon carcinoma typically presents as an **irregular narrowing** or an **apple-core lesion** on barium studies, a sign of luminal stricture due to a mass. - The radiological appearance for carcinoma would not show the distinct layered or coiled pattern seen in the provided image. *Sigmoid volvulus* - Sigmoid volvulus is characterized by a **"coffee bean" sign** on plain radiographs due to the massively dilated, inverted U-shaped loop of colon, or a **"bird's beak" appearance** on contrast studies at the twisted obstruction point. - This contrasts significantly with the concentric rings and linear striations indicative of intussusception. *Ileus* - Ileus, or paralytic ileus, involves generalized **bowel dilation** without a clear point of mechanical obstruction, often with gas present throughout the large and small bowel. - The image shows a very specific, localized abnormality with a characteristic pattern, not generalized bowel distension associated with ileus. [Practice more Radiology PYQs on OnCourse]

Q: The chest radiograph shown below is from a 25-year-old male patient presenting with hypertension. The image demonstrates bilateral inferior rib notching. What is the most likely diagnosis?

Coarctation of Aorta. ***Coarctation of Aorta*** - The chest radiograph shows findings consistent with **rib notching**, which is a classic sign of coarctation of the aorta due to increased collateral circulation through intercostal arteries. - The history of **hypertension** in a male patient, especially if presenting at a younger age or with differential blood pressures between upper and lower extremities, strongly suggests coarctation of the aorta. *Tetralogy of Fallot* - Characterized by a **boot-shaped heart** due to right ventricular hypertrophy and pulmonary outflow obstruction. - Would typically present with **cyanosis** and decreased pulmonary vascular markings, not rib notching or isolated hypertension. *Ebstein's Anomaly* - Involves apical displacement of the **tricuspid valve**, leading to atrialization of the right ventricle and severe tricuspid regurgitation. - Chest X-rays often show **severe cardiomegaly** (huge heart due to right atrial enlargement) and decreased pulmonary vascularity, which are not depicted here. *TAPVC* - Total anomalous pulmonary venous connection (TAPVC) involves all pulmonary veins draining into the systemic circulation. - The classic chest X-ray finding for supracardiac TAPVC is a **"snowman" or "figure of 8" sign** due to dilated anomalous vessels and superior vena cava, which is absent in this image. [Practice more Radiology PYQs on OnCourse]

Q: Identify the imaging modality and the location of pathology shown in the image.

MCU with Bulbar urethral stricture. ***MCU with Bulbar urethral stricture*** - The image shown is a **Micturating Cystourethrogram (MCU)** because the bladder is filled with contrast and the urethra is being visualized during urination. - There is a clear **narrowing (stricture)** in the **bulbar portion of the urethra**, appearing as a segment with reduced caliber, consistent with a bulbar urethral stricture. *MCU with penile stricture* - While it is an MCU, the stricture is located in the **bulbar urethra**, which is proximal to the penile (pendulous) urethra. - A penile stricture would be seen further distally in the urethra. *RGU with membranous stricture* - This is an **MCU**, not a Retrograde Urethrogram (RGU), which is performed by inserting contrast from the urethral meatus. In an MCU, the contrast flows antegrade from the bladder. - A **membranous stricture** would be located more proximally, within the deep perineal pouch, between the bulbar urethra and the prostatic urethra. *RGU with prostatic stricture* - As mentioned, this is an **MCU**, not an RGU. - A prostatic stricture would be located within the **prostatic urethra**, which is much more proximal than the stricture seen in this image. [Practice more Radiology PYQs on OnCourse]

Question 1

What is the most likely diagnosis of a child with the following chest X-ray finding (image required)?

Accepted Answer

Tetralogy of Fallot (TOF)

Answer

Transposition of Great Arteries (TGA)

Answer

Total Anomalous Pulmonary Venous Connection (TAPVC)

Answer

Ebstein's Anomaly

Question 2

Identify the condition in the X-ray given below:

Accepted Answer

TOF

Answer

TGA

Answer

TAPVC

Answer

Ebstein's anomaly

Question 3

Which radiological finding is shown in the image?

Accepted Answer

Intussusception

Answer

Colon carcinoma

Answer

Sigmoid volvulus

Answer

Ileus

Question 4

The chest radiograph shown below is from a 25-year-old male patient presenting with hypertension. The image demonstrates bilateral inferior rib notching. What is the most likely diagnosis?

Accepted Answer

Coarctation of Aorta

Answer

Tetralogy of Fallot

Answer

Ebstein's Anomaly

Answer

TAPVC

Question 5

Identify the imaging modality and the location of pathology shown in the image.

Accepted Answer

MCU with Bulbar urethral stricture

Answer

MCU with penile stricture

Answer

RGU with membranous stricture

Answer

RGU with prostatic stricture

Question 6

Steeple sign is seen in which of the following conditions?

Accepted Answer

Acute laryngotracheobronchitis

Answer

Acute epiglottitis

Answer

Laryngeal papillomatosis

Answer

Bilateral abductor paralysis

Question 7

Identify the radiological sign of Ischemic colitis from the image provided.

Accepted Answer

Thumbprinting sign of Ischemic colitis

Answer

Diverticulitis

Answer

Appendicitis

Answer

None of the options

Question 8

The Barium Swallow examination shows a filling defect in the esophagus. What is the most probable diagnosis?

Accepted Answer

Esophageal Carcinoma

Answer

Esophageal Ring

Answer

Esophageal Tear

Answer

Achalasia Cardia

Question 9

What does the sign depicted in the image represent?

Accepted Answer

Mickey Mouse sign

Answer

String sign

Answer

Tillaux sign

Answer

Stemmer's sign

Question 10

Chest radiograph obtained from a male patient with hypertension. What could be the probable diagnosis?

Accepted Answer

Coarctation of Aorta

Answer

Mitral Stenosis

Answer

Transposition of Great Arteries

Answer

Aortic Stenosis

NEET-PG 2020 — Radiology