NEET-PG 2013 - Radiology PYQs Practice Questions

Q: Inferior rib notching is seen in which of the following conditions?

Coarctation of the aorta. ***Coarctation of the aorta*** - **Inferior rib notching** is a classic radiographic sign caused by the **enlarged, tortuous intercostal arteries** eroding the inferior margins of the ribs. - This collateral circulation develops to bypass the narrowed aortic segment, increasing blood flow through the intercostal arteries. *Rickets* - Rickets can cause **bowing of long bones**, widened epiphyseal plates, and a **rachitic rosary** (enlargement of costochondral junctions). - It does not typically lead to rib notching; rather, it affects bone mineralization and growth patterns. *ASD* - An **atrial septal defect (ASD)** is a congenital heart defect causing a left-to-right shunt, leading to pulmonary overload and right heart enlargement. - While it can manifest with cardiomegaly and increased pulmonary vascular markings, it does not cause rib notching. *Multiple myeloma* - Multiple myeloma is a plasma cell malignancy that causes **punched-out lytic lesions** in bones, leading to bone pain and pathological fractures. - While it affects bone, the lesions are typically osteolytic and diffuse, not specifically causing inferior rib notching. [Practice more Radiology PYQs on OnCourse]

Q: Hose pipe appearance of intestine is a feature of

Ulcerative colitis. ***Crohns disease*** - The **hose pipe appearance** of the intestine on imaging is due to **transmural inflammation** and **strictures**, characteristic of Crohn's disease [1]. - This feature indicates a **narrowed lumen** due to fibrosis, often affecting the small intestine or colon [1]. *Malabsorption syndrome* - This condition is primarily associated with **nutrient absorption issues**, not structural changes in the intestine. - It typically presents with **diarrhea**, **weight loss**, and **malnutrition**, lacking the characteristic imaging findings. *Ulcerative colitis* - Usually presents with **continuous lesions** confined to the colonic mucosa, leading to ulcers and inflammation but not a **hose pipe appearance**. - Symptoms include **bloody diarrhea** and **abdominal pain**, distinctly different from Crohn's disease. *Hirsprung disease* - A congenital condition causing **intestinal obstruction** due to the absence of ganglion cells, leading to **dilated proximal bowel** rather than a hose pipe appearance. - Typically presents in infants with **severe constipation** and **abdominal distension**, unrelated to imaging features seen in Crohn's disease. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 366-367. [Practice more Radiology PYQs on OnCourse]

Q: Retrocardiac lucency with air fluid level is seen in

Hiatus hernia. ***Hiatus hernia*** - A **hiatus hernia** occurs when part of the stomach protrudes into the chest through the **esophageal hiatus** of the diaphragm. - This can lead to a **retrocardiac lucency** (gas-filled stomach) with an **air-fluid level** visible on chest X-rays due to gastric contents. - The herniated gastric fundus appears as a characteristic gas bubble behind the heart, particularly well-seen on lateral chest radiographs. *Distal esophageal obstruction* - While distal esophageal obstruction can cause esophageal dilation and sometimes an **air-fluid level** within the esophagus, it generally presents as a tubular structure *behind* the heart rather than a distinct retrocardiac lucency representing a portion of the stomach. - The appearance would be more suggestive of a dilated esophagus filled with contents, not a herniated stomach. *Diaphragmatic eventration* - **Diaphragmatic eventration** is an abnormal elevation of a portion of the diaphragm, often due to congenital weakness or phrenic nerve paralysis. - It does not typically cause a **retrocardiac lucency** with an **air-fluid level**, as it involves the diaphragm itself rather than the herniation of an abdominal organ. - It may show elevation of the hemidiaphragm but without the characteristic gas-filled viscus appearance. *None of the options* - Hiatus hernia is a well-established radiological diagnosis for retrocardiac lucency with an **air-fluid level**, making this option clearly incorrect. [Practice more Radiology PYQs on OnCourse]

Q: What are the X-ray findings associated with chronic otitis media?

Sclerosis with cavity in mastoid. ***Sclerosis with cavity in mastoid*** - Chronic otitis media leads to **long-standing inflammation** and **destruction** of the mastoid air cells, resulting in dense, **sclerotic bone** with cavity formation due to bone erosion. - This is the **characteristic X-ray finding** in chronic otitis media, indicating osseous remodeling and bone destruction from persistent infection. - The sclerosis represents reactive bone formation, while cavities form from **coalescence** of destroyed air cells. *Honeycombing of mastoid* - Honeycombing describes a **normal, well-pneumatized mastoid** with numerous small, distinct air cells visible on X-ray. - This appearance indicates a healthy mastoid bone with good aeration and is **inconsistent** with chronic inflammation. - Chronic otitis media causes bone remodeling and sclerosis, **not** preserved pneumatization. *Clear-cut distinct bony partition between cells* - This describes **normal mastoid anatomy** where air cells are well-defined and separated by thin, intact bony septa. - In chronic otitis media, these septa are typically **eroded or thickened** by inflammation, leading to loss of distinctness. - The inflammatory process causes destruction and sclerosis, **not** preservation of normal architecture. *Increased pneumatization of mastoid cells* - Increased pneumatization indicates **excessive air cell development**, which is opposite to the changes seen in chronic infection. - Chronic otitis media causes **destruction and sclerosis** of air cells, not increased pneumatization. - This would be seen in normal developmental variants, not chronic inflammatory disease. [Practice more Radiology PYQs on OnCourse]

Q: All the following are true of craniopharyngioma except:

Present in sella or infra-sellar location. ***Present in sella or infra-sellar location*** - Craniopharyngiomas are typically located in the **suprasellar region**, above the **sella turcica**, where they can compress the optic chiasm. - While they can extend into the sella, their primary location is rarely exclusively intrasellar or infrasellar. *Derived from Rathke's pouch* - This statement is true; craniopharyngiomas arise from remnants of **Rathke's pouch**, the embryonic precursor of the anterior pituitary gland. - This origin explains their characteristic location near the pituitary stalk and third ventricle. *Contains epithelial cells* - This statement is true as **craniopharyngiomas** are benign **epithelial tumors**, specifically adamantinomatous or papillary types. - They are composed of stratified squamous epithelium, often with calcifications and cystic components. *Causes visual disturbances* - This statement is true because the **suprasellar location** of a craniopharyngioma often leads to compression of the **optic chiasm**, resulting in characteristic visual field deficits like bitemporal hemianopsia. - Visual disturbances are a common presenting symptom due to their proximity to the visual pathways. [Practice more Radiology PYQs on OnCourse]

Question 1

Inferior rib notching is seen in which of the following conditions?

Accepted Answer

Coarctation of the aorta

Answer

Rickets

Answer

ASD

Answer

Multiple myeloma

Question 2

Hose pipe appearance of intestine is a feature of

Accepted Answer

Ulcerative colitis

Answer

Malabsorption syndrome

Answer

Crohn's disease

Answer

Hirschsprung disease

Question 3

Retrocardiac lucency with air fluid level is seen in

Accepted Answer

Hiatus hernia

Answer

Distal esophageal obstruction

Answer

Diaphragmatic eventration

Answer

None of the options

Question 4

What are the X-ray findings associated with chronic otitis media?

Accepted Answer

Sclerosis with cavity in mastoid

Answer

Honeycombing of mastoid

Answer

Clear-cut distinct bony partition between cells

Answer

Increased pneumatization of mastoid cells

Question 5

All the following are true of craniopharyngioma except:

Accepted Answer

Present in sella or infra-sellar location

Answer

Derived from Rathke's pouch

Answer

Contains epithelial cells

Answer

Causes visual disturbances

Question 6

What is the primary use of the Balthazar scoring system?

Accepted Answer

Acute Pancreatitis

Answer

Acute Appendicitis

Answer

Acute Cholecystitis

Answer

Cholangitis

Question 7

Which condition is characterized by a specific radiological appearance resembling a sunburst pattern?

Accepted Answer

Osteosarcoma

Answer

Chondrosarcoma

Answer

Fibrosarcoma

Answer

Ewing's sarcoma

Question 8

The procedure of choice for the evaluation of aortic aneurysms is -

Accepted Answer

Computed tomography

Answer

Magnetic resonance imaging

Answer

Arteriography

Answer

Ultrasonography

Question 9

The CT severity index in acute pancreatitis is described by:

Accepted Answer

Balthazar score

Answer

Mengini score

Answer

Chapman score

Answer

Napelon score

Question 10

Which CT view is best for visualizing paranasal polyps?

Accepted Answer

Coronal view

Answer

Axial view

Answer

Sagittal view

Answer

3D view

NEET-PG 2013 — Radiology