UPSC-CMS 2020 - Radiology PYQs Practice Questions

Q: 'Chain of Lakes' appearance due to sacculation with intervening short strictures of pancreatic duct is seen on:

ERCP. ***ERCP*** - **Endoscopic Retrograde Cholangiopancreatography (ERCP)** is an invasive imaging technique that directly visualizes the bile and pancreatic ducts by injecting contrast, allowing for the classic "chain of lakes" appearance (dilatation and stricturing) seen in chronic pancreatitis. - This characteristic appearance on ERCP is a definitive sign of advanced **chronic pancreatitis**, indicating ductal irregularity, strictures, and dilations. *Ultrasonography* - While ultrasonography can show features of chronic pancreatitis like **pancreatic calcifications** and **ductal dilation**, it typically does not provide the detailed luminal view necessary to appreciate the "chain of lakes" pattern. - Its utility in visualizing the pancreatic duct can be limited by **bowel gas** and patient body habitus, making it less sensitive for intricate ductal changes. *CECT abdomen* - **Contrast-Enhanced Computed Tomography (CECT) of the abdomen** can identify pancreatic calcifications, **atrophy**, and **ductal dilation** in chronic pancreatitis but is generally not as precise as ERCP in delineating the intricate "chain of lakes" pattern within the duct itself. - CECT is more effective for assessing parenchymal changes and complications like **pseudocysts** rather than the fine ductal morphology. *Plain X-ray abdomen* - A plain X-ray of the abdomen primarily visualizes **calcifications** within the pancreas, which are a common feature of chronic pancreatitis. - However, it does not provide any information about the **ductal anatomy** or the "chain of lakes" appearance, as it is a 2D image without contrast in the ducts. [Practice more Radiology PYQs on OnCourse]

Q: The term mid-line shift is associated with:

Head injury. **Head injury** - **Mid-line shift** refers to the displacement of the brain's central structures, such as the septum pellucidum or pineal gland, from their normal position due to a **mass effect** from a lesion like a hematoma or edema following a head injury. - This displacement is a critical sign of increased **intracranial pressure** and can lead to herniation syndromes, indicating a severe and life-threatening condition. *Chest injury* - Chest injuries typically involve structures within the thorax, such as the lungs, heart, or rib cage. - While a tension pneumothorax can cause a **mediastinal shift** (displacement of the trachea and heart), this is distinct from a "mid-line shift" which specifically describes brain structures. *Abdominal injury* - Abdominal injuries usually affect organs like the liver, spleen, or intestines. - These injuries can cause significant internal bleeding or organ damage but do not directly lead to a "mid-line shift" of brain structures. *Limb injury* - Limb injuries involve damage to bones, muscles, ligaments, or blood vessels in the extremities. - These injuries are localized to the limbs and are not associated with any form of intracranial shift or increased intracranial pressure. [Practice more Radiology PYQs on OnCourse]

Q: Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

Short learning curve. ***Short learning curve*** - While ultrasound is widely used, developing proficiency requires **extensive training** and **experience**, especially for complex evaluations. - The interpretation of ultrasound images is highly **operator-dependent**, and mastering proper technique and recognizing subtle findings demands a significant learning investment. *No radiation* - Ultrasound uses **sound waves** to generate images, meaning it does not expose patients to **ionizing radiation**. - This makes it a safer option for repeated studies, pregnant patients, and pediatric populations compared to modalities like X-rays or CT scans. *Inexpensive* - Ultrasound machines are generally **less expensive** to purchase and maintain compared to MRI or CT scanners. - The procedure itself is also typically **less costly** than other advanced imaging techniques, making it more accessible. *Allows dynamic studies to be done* - Ultrasound can capture images in **real-time**, allowing clinicians to observe organ movement, blood flow, and tissue changes during various maneuvers. - This capability is crucial for assessing joint stability, vascular patency, and the mobility of masses or fluid collections. [Practice more Radiology PYQs on OnCourse]

Question 1

'Chain of Lakes' appearance due to sacculation with intervening short strictures of pancreatic duct is seen on:

Accepted Answer

ERCP

Answer

Ultrasonography

Answer

CECT abdomen

Answer

Plain X-ray abdomen

Question 2

The term mid-line shift is associated with:

Accepted Answer

Head injury

Answer

Chest injury

Answer

Abdominal injury

Answer

Limb injury

Question 3

Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

Accepted Answer

Short learning curve

Answer

No radiation

Answer

Inexpensive

Answer

Allows dynamic studies to be done

UPSC-CMS 2020 — Radiology