INI-CET 2022 - Radiology PYQs Practice Questions

Q: Which of the following findings are seen in a high-resolution CT scan of fungal pneumonia? 1. Interlobular septations 2. Peripheral wedge-shaped consolidation 3. Pleural effusion 4. Cavitatory lesions with surrounding ground glass opacities

1,2,4. ***1,2,4*** - **Interlobular septations** and **peripheral wedge-shaped consolidations** are common findings due to the **vascular invasion** and **infarction** characteristic of fungal pneumonia. - **Cavitary lesions with surrounding ground-glass opacity**, also known as the **halo sign**, are highly suggestive of invasive fungal infections like aspergillosis. *1,2,3* - While interlobular septations and peripheral wedge-shaped consolidations are seen in fungal pneumonia, **pleural effusion** is less common and not a primary diagnostic feature. - The absence of the characteristic cavitary lesions with ground-glass opacities makes this option incomplete. *2,3,4* - This option correctly includes peripheral wedge-shaped consolidation and cavitary lesions with ground-glass opacity, but the inclusion of **pleural effusion** and exclusion of **interlobular septations** make it less accurate. - Interlobular septations are a significant indicator of **lymphatic involvement** as seen in fungal diseases. *1,3,4* - Although interlobular septations and cavitary lesions with ground-glass opacities are relevant, the presence of **pleural effusion** as a primary finding is less typical for fungal pneumonia. - The absence of **peripheral wedge-shaped consolidation**, which arises from vascular occlusion, makes this option less comprehensive. [Practice more Radiology PYQs on OnCourse]

Q: A child presents with cyanosis. His chest radiograph is shown below. What is the diagnosis?

Tetralogy of Fallot (TOF). ***Tetralogy of Fallot (TOF)*** - The chest radiograph shows a **boot-shaped heart (coeur en sabot)** due to **right ventricular hypertrophy** and a **concave pulmonary artery segment** (absent main pulmonary artery segment), which is characteristic of TOF. - The patient also presents with **cyanosis**, a common symptom of TOF due to right-to-left shunting. *Transposition of great arteries (TGA)* - TGA typically presents with a **"egg-on-a-string" appearance** on chest radiograph, indicating a narrow superior mediastinum and increased pulmonary vascular markings, which is not seen here. - While patients with TGA are cyanotic, the cardiac silhouette on this radiograph is inconsistent with the classic TGA findings. *Ebstein's anomaly* - Ebstein's anomaly is characterized by **apical displacement of the tricuspid valve**, leading to a large right atrium and massive **cardiomegaly** on chest X-ray, often described as a "box-shaped" heart, which is not evident in the provided image. - While it causes cyanosis, the heart size in the image is not markedly enlarged enough to suggest Ebstein's anomaly. *Total anomalous pulmonary venous return (TAPVC)* - TAPVC typically presents with a **"snowman" or "figure-of-8" appearance** on chest X-ray due to a dilated superior vena cava and left brachiocephalic vein, or a small heart with increased pulmonary vascularity, neither of which is present in the image. - Although TAPVC causes cyanosis, the specific radiographic features like the "boot-shaped" heart rule out this diagnosis. [Practice more Radiology PYQs on OnCourse]

Q: Identify the condition based on the non-contrast CT scan of a patient given below.

Hydatid cyst. ***Hydatid cyst*** - The image distinctly shows a **large, well-defined cyst with internal septations**, consistent with the daughter cysts and collapsed membranes within a hydatid cyst (the "**water lily sign**"). - The thick, often calcified wall surrounding the lesion is a characteristic feature often seen in **Echinococcus granulosa** infection. *Hepatocellular carcinoma* - **Hepatocellular carcinoma (HCC)** typically appears as a **solid, enhancing mass** (especially on contrast-enhanced CT) and does not usually present with clearly defined internal septations or "water lily" sign on non-contrast imaging. - While HCC can show necrosis, it does not form the characteristic cystic structure seen here. *Liver abscess* - A **liver abscess** would typically appear as a ill-defined, fluid-filled lesion that may have a rim of enhancement on contrast CT, but it generally lacks the **distinct internal septations** or daughter cysts characteristic of a hydatid cyst. - Abscesses are often associated with signs of infection like fever and elevated inflammatory markers. *Fibronodular hyperplasia* - **Focal nodular hyperplasia (FNH)** is a benign liver lesion characterized by a central scar and is typically **isodense or slightly hypodense** to the liver parenchyma on non-contrast CT. - It does not present as a cystic lesion with internal daughter cysts or calcified walls. [Practice more Radiology PYQs on OnCourse]

Q: A 35-year-old man presented with knee pain. The x-ray of his knee joint is given below. What is the probable diagnosis?

Paget's disease. ***Paget's disease*** - X-rays of Paget's disease show **thickened, sclerotic bone** with coarse trabeculae, often giving a cotton wool appearance, which is consistent with the image. - The disease involves increased bone turnover, leading to **disorganized bone remodeling** and enlarged, weakened bones. *Osteoarthritis* - Osteoarthritis typically presents with **joint space narrowing**, osteophytes, subchondral sclerosis, and cysts, which are not the predominant features in the given image. - It is primarily a degenerative joint disease affecting articular cartilage, rather than the extensive bone remodeling seen here. *Osteosarcoma* - Osteosarcoma is a malignant bone tumor characterized by a **destructive lesion** with associated soft tissue mass, sunburst periosteal reaction, or Codman's triangle. - The image does not show typical osteosarcoma features but rather diffuse bone remodeling. *Multiple myeloma* - Multiple myeloma usually presents with **punched-out lytic lesions** on X-ray, diffuse osteopenia, or generalized osteoporosis. - The image does not show lytic lesions characteristic of multiple myeloma. [Practice more Radiology PYQs on OnCourse]

Question 1

Bleeding as shown in the image is due to which of the following vessels?

Accepted Answer

Bridging veins

Answer

Lenticulostriate artery

Answer

Vertebral artery

Answer

Middle meningeal artery

Question 2

Which of the following findings are seen in a high-resolution CT scan of fungal pneumonia?

1. Interlobular septations
2. Peripheral wedge-shaped consolidation
3. Pleural effusion
4. Cavitatory lesions with surrounding ground glass opacities

Accepted Answer

1,2,4

Answer

1,2,3

Answer

2,3,4

Answer

1,3,4

Question 3

A child presents with cyanosis. His chest radiograph is shown below. What is the diagnosis?

Accepted Answer

Tetralogy of Fallot (TOF)

Answer

Transposition of great arteries (TGA)

Answer

Ebstein's anomaly

Answer

Total anomalous pulmonary venous return (TAPVC)

Question 4

Identify the condition based on the non-contrast CT scan of a patient given below.

Accepted Answer

Hydatid cyst

Answer

Hepatocellular carcinoma

Answer

Liver abscess

Answer

Focal nodular hyperplasia

Question 5

A 35-year-old man presented with knee pain. The x-ray of his knee joint is given below. What is the probable diagnosis?

Accepted Answer

Paget's disease

Answer

Osteoarthritis

Answer

Osteosarcoma

Answer

Multiple myeloma

INI-CET 2022 — Radiology