UPSC-CMS 2010 - Radiology PYQs Practice Questions

Q: 'Double duct' sign is diagnostic of

periampullary carcinoma. ***periampullary carcinoma*** - The **"double duct sign"** refers to the simultaneous dilation of both the **common bile duct** and the **pancreatic duct**. - This sign is highly suggestive of an obstruction at the **ampulla of Vater**, most commonly caused by **periampullary carcinoma**. *hepatocellular carcinoma* - **Hepatocellular carcinoma** primarily affects the liver parenchyma and typically does not cause simultaneous dilation of both the common bile and pancreatic ducts. - It more commonly presents with symptoms related to **liver dysfunction** or a palpable **liver mass**. *gallbladder carcinoma* - **Gallbladder carcinoma** can lead to bile duct obstruction, but it generally causes dilation of the **biliary tree** proximal to the obstruction, not simultaneous dilation of both the bile and pancreatic ducts. - The obstruction is usually located at the **cystic duct** or **common hepatic duct** due to direct tumor extension or nodal involvement. *Klatskin's carcinoma* - **Klatskin's tumor** is a type of **cholangiocarcinoma** located at the **bifurcation of the common hepatic duct**. - While it causes **biliary obstruction** and dilation of the intrahepatic ducts, it does not typically cause dilation of the pancreatic duct. [Practice more Radiology PYQs on OnCourse]

Q: Consider the following radiological signs : 1. Claw sign in barium enema 2. Apple core sign in barium enema 3. Multiple fluid levels with absent caecal gas in plain skiagram of abdomen 4. Single large fluid and air level in plain skiagram of abdomen Which of the above signs is/are suggestive of ileocolic intussusception?

1 only. ***1 only*** - The **claw sign** in a barium enema is a classic radiological finding in **ileocolic intussusception**, where the intussusceptum indents the barium column, forming a characteristic claw-like appearance - This sign indicates the presence of the invaginated bowel segment within the larger bowel, as the barium passes around it - It is the most specific radiological sign for intussusception on contrast studies *3 only* - **Multiple fluid levels** with absent caecal gas on plain skiagram are indicative of **small bowel obstruction**, which can be caused by intussusception but is **not specific** to it - This finding does not pinpoint intussusception specifically and can occur with adhesions, hernias, or other causes of obstruction - Alone, this does not diagnose ileocolic intussusception *1 and 2 only* - While the **claw sign** (1) is specific to intussusception, the **apple core sign** (2) is characteristic of a **constricting colonic malignancy**, not intussusception - The apple core sign represents irregular narrowing of the bowel lumen due to an annular carcinoma - Including sign 2 makes this option incorrect for intussusception *1, 2, 3 and 4* - Only the **claw sign** (1) is specifically suggestive of intussusception - The **apple core sign** (2) indicates colonic carcinoma, not intussusception - **Multiple fluid levels with absent caecal gas** (3) indicate bowel obstruction but lack specificity - A **single large fluid and air level** (4) suggests gastric outlet obstruction or closed loop obstruction, not specifically intussusception [Practice more Radiology PYQs on OnCourse]

Q: A middle-aged man presents with a lower jaw swelling. Clinically, there is expansion of the left ramus and the X-ray mandible shows soap bubble appearance. What is the clinical diagnosis?

Ameloblastoma. ***Ameloblastoma*** - Ameloblastoma is the most common odontogenic tumor, often presenting as a **slow-growing, expansile swelling** in the posterior mandible, as seen in this patient. - The classic **"soap bubble" or "honeycomb" radiographic appearance** is highly characteristic of ameloblastoma, reflecting its multilocular nature. *Aneurysmal bone cyst* - While an aneurysmal bone cyst can cause bony expansion, it typically presents with a **blood-filled lesion** and may not consistently show a "soap bubble" appearance unless it's very large and destructive. - Radiographically, it often appears as a **lytic lesion** rather than strictly multilocular. *Odontogenic myxoma* - Odontogenic myxoma can also cause jaw swelling and has a multilocular appearance, but it's often described as having a **"tennis racket" or "stepped ladder" trabeculation** pattern rather than clear "soap bubbles." - Its incidence is lower than ameloblastoma, making it less likely given the classic presentation. *Keratocyst* - An odontogenic keratocyst (OKC), now often referred to as a **keratocystic odontogenic tumor (KCOT)**, is primarily a cyst that can grow extensively and cause expansion. - Radiographically, it typically appears as a **well-defined, unilocular or multilocular radiolucency** but rarely has the classic "soap bubble" appearance as consistently as ameloblastoma. [Practice more Radiology PYQs on OnCourse]

Question 1

'Double duct' sign is diagnostic of

Accepted Answer

periampullary carcinoma

Answer

hepatocellular carcinoma

Answer

gallbladder carcinoma

Answer

Klatskin's carcinoma

Question 2

Consider the following radiological signs :

1. Claw sign in barium enema

2. Apple core sign in barium enema

3. Multiple fluid levels with absent caecal gas in plain skiagram of abdomen

4. Single large fluid and air level in plain skiagram of abdomen
Which of the above signs is/are suggestive of ileocolic intussusception?

Accepted Answer

1 only

Answer

3 only

Answer

1 and 2 only

Answer

1, 2, 3 and 4

Question 3

A middle-aged man presents with a lower jaw swelling. Clinically, there is expansion of the left ramus and the X-ray mandible shows soap bubble appearance. What is the clinical diagnosis?

Accepted Answer

Ameloblastoma

Answer

Aneurysmal bone cyst

Answer

Odontogenic myxoma

Answer

Keratocyst

UPSC-CMS 2010 — Radiology