Diagnostic Radiology

The following are examples of items that you

would find in a multiple-choice question (MCQ)
exam. Model answers are included for your
information.

[Date]

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 Diagnostic Radiology

Instructions
Answer sheets

1. Please ensure that your name and identification number are correctly recorded at the top
of your answer sheet.
2. Use only the pencil provided to mark the answer sheet. Do not use ink.
3. To indicate a correct answer, blacken the appropriate oval with your pencil. Please note
that the mark you make must be definite and black; if not, the optical scanner may not
sense it.

Please note that these answer sheets are marked by optical scanner.

Do NOT cross out an incorrect answer, it must be erased.

Do NOT mark the answer sheet anywhere except in the answer ovals.

All pencil marks on the answer sheet are picked up by the scanner, which rejects sheets
with extra or improperly placed markings. Any question having more than one oval
blackened is rejected.

NOTE: It is to your advantage to answer every question even if you are not satisfied that you know the
correct answer. You are advised not to mark your answers in the examination booklet with the intention
of transferring them later to the answer sheet. Only answers recorded on the answer sheet will be
scored. You will not be given extra time to record or transfer answers from the examination booklet to
the answer sheet. It is also suggested that you start to answer the questions at once rather than try to
read through the paper first and then start recording your answers; otherwise you may run out of time.

i
 Diagnostic Radiology

Example

All questions have a stem and four options, only one of which is considered to be the CORRECT answer.

Question

This is a stem.

1.

2.

3.

4.

The correct answer is number 3, and should be marked on your answer sheet as follows:
 Diagnostic Radiology

MARK ONLY ONE OVAL FOR EACH QUESTION

Question 1
Which of the following statements BEST describes the Professional Role of physicians according to the
2005 CanMEDS Physician Competency Framework?
1. As Professionals, physicians effectively facilitate the doctor-patient relationship and the dynamic
exchanges that occur before, during, and after the medical encounter.
2. As Professionals, physicians are committed to the health and well-being of individuals and society
through ethical practice, profession-led regulation, and high personal standards of behaviour.
3. As Professionals, physicians are integral participants in health care organizations through organizing
sustainable practices, making decisions about allocating resources, and contributing to the
effectiveness of the health care system.
4. As Professionals, physicians responsibly use expertise and influence to advance the health and well-
being of individual patients, communities and populations.

Answer: As Professionals, physicians are committed to the health and well-being of individuals and
society through ethical practice, profession-led regulation, and high personal standards of behaviour.

Reference: CanMEDS 2005 Framework can be found on line at www.royalcollege.ca

http://www.royalcollege.ca/portal/page/portal/rc/common/documents/canmeds/framework/the_7_canm
eds_roles_e.pdf
 Diagnostic Radiology

Question 2
A 64-year-old man undergoes a chest CT scan while in hospital for persistent pneumonia. A 3-cm
adrenal nodule is incidentally noted, and a subsequent adrenal washout study is ordered. On the non-
contrast imaging series, region of interest (ROI) measurement of the nodule provides a reading of
27 HU. On the contrast-enhanced series that follows, this measurement rises to 88 HU. Delayed images
through the adrenal glands at 15 minutes show a reading of 45 HU. What is the absolute washout for
this lesion?
1. 31%
2. 49%
3. 59%
4. 70%

Answer: 70%

References :
Taffel M, et al. Adrenal Imaging: a comprehensive review. Radiol Clin North Am 2012; 50:219-243.
Caoili EM, et al. Delayed enhanced CT of lipid-poor adrenal adenomas. AJR Am J Roentgenol
2000;175(5):1411-5.
 Diagnostic Radiology

Question 3
A 45-year-old man sustained a hyperextension injury to the wrist and subsequent carpal dislocation.
Which of the following statements about carpal dislocations is TRUE?
1. The most common carpal dislocation is a lunate dislocation.
2. A greater arc injury is a perilunate dislocation with associated fracture of one or more bones.
3. Anterior dislocation of the capitate head along with the rest of the hand, relative to the lunate, is
characteristic of a perilunate dislocation.
4. A lesser arc injury is a lunate dislocation with associated fracture of one or more bones.

Answer: A greater arc injury is a perilunate dislocation with associated fracture of one or more bones.

Reference:
Kaewalai R, et al. Multidetector CT of carpal injuries: anatomy, fractures, and fracture-dislocations.
Radiographics 2008;28:1771-1784.

Question 4
In order to minimize radiation dose to patients undergoing CT, you are reviewing the imaging
parameters used in your CT department. Which of the following steps will decrease radiation dose?
1. decreasing anatomic coverage, reducing the number of contrast series, iterative reconstruction, and
decreasing peak kilovoltage (kVp) in small patients
2. decreasing anatomic coverage, reducing the number of contrast series, tube current modulation, and
increasing kVp in small patients
3. tube current modulation, decreasing kVp in small patients, increasing the x-ray tube rotation time,
and decreasing pitch
4. iterative reconstruction, increasing kVp in small patients, decreasing x-ray tube current, and
decreasing the x-ray tube rotation time

Answer: decreasing anatomic coverage, reducing the number of contrast series, iterative
reconstruction, and decreasing peak kilovoltage (kVp) in small patients

Reference:
Goldman AR, et al. Reducing radiation dose in body CT: a practical approach to optimizing CT protocols.
AJR Am J Roentgenol 2013;200:748-754.
 Diagnostic Radiology

Question 5
Which of the following statements about infections involving the neck is TRUE?
1. Since the introduction of the Haemophilus influenzae vaccine, epiglottitis is no longer considered to
be a life-threatening disease in children.
2. Descending necrotizing mediastinitis most commonly spreads from the oral cavity/oropharynx to the
mediastinum via the carotid space.
3. Ludwig angina is a type of focal abscess.
4. Peritonsillar cellulitis is treated with antibiotics, whereas peritonsillar abscess requires needle
aspiration or surgical drainage.

Answer: Peritonsillar cellulitis is treated with antibiotics, whereas peritonsillar abscess requires needle
aspiration or surgical drainage.

Reference:
Capps EF, et al. Emergency imaging assessment of acute, nontraumatic conditions of the head and neck.
Radiographics Sept 2010;30(5):1335-1352.