UPSC-CMS 2025 - Radiology PYQs Practice Questions

Q: The first imaging modality of choice for a 35-year-old lady, presenting to surgical emergency with complaints of colicky pain in right lower quadrant of abdomen and vomiting since last 2 days is:

Ultrasound abdomen. ***Ultrasound abdomen*** - Ultrasound is the **first-line imaging modality** for evaluating acute right lower quadrant pain in women of reproductive age due to its **safety (no ionizing radiation)**, availability, and cost-effectiveness. - It effectively visualizes the **appendix**, ovaries, uterus, and can detect **appendicitis**, ovarian pathology (e.g., cysts, torsion, ectopic pregnancy), and other causes of acute abdominal pain. - Follows the **ALARA principle** (As Low As Reasonably Achievable) for radiation exposure in young women. *Plain X-ray abdomen erect view* - Plain X-ray has **limited utility** for acute right lower quadrant pain as it cannot visualize soft tissue structures like the appendix or ovaries. - Primarily useful for detecting **bowel obstruction** (air-fluid levels) or **pneumoperitoneum** (free air under diaphragm), which are not suggested by this clinical presentation. *Contrast CT abdomen* - While highly sensitive for appendicitis and intra-abdominal pathologies, contrast CT involves **ionizing radiation** and **IV contrast administration**. - Should be **minimized in women of reproductive age** due to radiation risks (including potential pregnancy). - Reserved for cases where ultrasound is **inconclusive** or when detailed anatomical assessment is required. *Non-contrast CT abdomen* - Non-contrast CT exposes the patient to **ionizing radiation** without the diagnostic advantage of contrast enhancement. - **Less effective** than contrast-enhanced CT for detecting inflammatory processes and appendiceal pathology. - Not preferred as first-line imaging when ultrasound is available and appropriate. [Practice more Radiology PYQs on OnCourse]

Q: On a chest radiograph, which of the following occupational diseases is most likely to be mistaken as a case of tuberculosis of lungs?

Silicosis. ***Silicosis*** - **Silicosis** manifests with radiographic findings such as **nodular opacities**, often in the upper lobes, and can progress to **progressive massive fibrosis**. These can be visually similar to granulomatous lesions seen in **tuberculosis**. - Additionally, patients with silicosis have an **increased susceptibility to tuberculosis** (silico-tuberculosis), making differentiation solely based on chest radiographs challenging. *Anthracosis* - **Anthracosis** (coal worker's pneumoconiosis) primarily causes diffuse, small, rounded opacities, which are generally less organized and prominent than the nodules seen in silicosis or tuberculosis. - While it can lead to **progressive massive fibrosis** in severe cases, the initial presentation is usually less likely to be confused with tuberculosis compared to silicosis. *Siderosis* - **Siderosis** is caused by the inhalation of iron dust and typically results in fine, diffuse, and irregular opacities on chest radiographs. - These opacities are generally benign and rarely lead to significant pulmonary fibrosis or mimic the discrete, nodular pattern of tuberculosis. *Byssinosis* - **Byssinosis** is an occupational lung disease associated with exposure to cotton dust. It is primarily characterized by **bronchial hyperreactivity** and **asthma-like symptoms**, particularly "Monday chest tightness." - It does not typically produce significant or distinctive radiographic changes that could be confused with tuberculosis, as it is a disease of the airways rather than parenchymal infiltrates. [Practice more Radiology PYQs on OnCourse]

Question 1

The first imaging modality of choice for a 35-year-old lady, presenting to surgical emergency with complaints of colicky pain in right lower quadrant of abdomen and vomiting since last 2 days is:

Accepted Answer

Ultrasound abdomen

Answer

Plain X-ray abdomen erect view

Answer

Contrast CT abdomen

Answer

Non-contrast CT abdomen

Question 2

On a chest radiograph, which of the following occupational diseases is most likely to be mistaken as a case of tuberculosis of lungs?

Accepted Answer

Silicosis

Answer

Anthracosis

Answer

Siderosis

Answer

Byssinosis

UPSC-CMS 2025 — Radiology