RADIOLOGY RAPID REVISION

Dr. Zainab Vora

Annotated Dr. Levina
by
 GENERAL RADIOLOGY
"
Ray su MRI

Black lucent
- - hypo ->

opaque-
white ryper-
X-RAY ~Ionizing
radiation ~2D

⑫ ⑰
obli= Anterio I
I
C 2

2
3

4
3
5

Y
6

5 H2
7
↓ S

posterior
6
2 I -

Rif -

Radio
Air-Black ->
lucent

Bone - white-opaque
soft tissue-grey Air-Pueumothorax
~Demergencies
-

mediast
ms Rule - Sintral ->②
orthopedics 19
peritoneum
↳8 lines & tases IOC
X-RAY- LINES AND TUBES to confine position &
Integrity
- 100 exe for Ex tube

->
↑
SVC
Ring
below -> M

RA Ring abv-> A
trium
-

RA
↓ X RV
↳

44
2 small

central line
I L
leads.
ET tube NG tube & Cardio
phrenice
10c ETw,-Caprography.
=

Ip & SVC-RAjx ① Pacemaller

1

1
e I lead -> RY

rad
(m/9 -> RV + RA

RV+RA + 2X
3 lead -

I
"In RHD - MIC value in - Mitral
↑
If u don't
rent, mark this
 "slices" High
CT computed Tomography.
- Radiation Resolution 44 (3D)

air air
↳ I
Black Black

jodinated HRCT other than

Bone: White -
NCCT contrast
CECT
->
Any thing k

white
↓ long
is

(compare vessel
IOC
I
muscle)
1.
lung parenchyma:
-

Pneumonia
COVID-19
-

Bronchiectasis
-

ILD

PNS bone
2.
. Temporal
 10C NCCT

CT +
=

10c = c7
Hyperdense Hypodense
x st- I
CALCIFICATION CALCULI BONE -CORTEX ACUTE AIR
HEMORRHAGE I
Intracranial

se
IOC for All Calculi
Anyt10C icchhead Pneumothorax
· ·

is
trauma
Catt
except "mediast
a

to
Gall stones
10C MRI
=
peritoneum
-
(for marrow
edumal
10C NCCT
=

Tumor
only
·
Osteoid osteoma
10C NCCT
=

⑫ ⑫ ⑭ ⑫
⑫ ④

y
I SDU P. two sax
B
⑭
t cresent

Periventricular: cm1 HRCT

Parenchymal: Toxoplasmosis. I ureteric
-

(diffuse) stone
 APPROACH TO FOREIGN BODY metal
whiterre
I
a

Streak E
artefact
d/t
Metal

esphagus Trachea Intraocular FB

INITIAL- X Ray
IOC- NCCT
&CI- MRI A
 Magnetic Resonance
MRI by
akoNuclear
1.37/39 n+
Magnetic Resonance
Imaging
-Scalp
WWI- T2 Far !

white
/
white
water

->

· Bone= Black ->

E
·
No Radiation

Best Resolution -
Black
was costly, time Bone
consuming
Fluid attenuated IR
(for BM)
SEQUENCE - STIR
Ti T2 Tzw i est TCW: fatsuppressed
suppressed

FLUID ⑭ ⑭ Hyperintense CSD Edema Edema ↑

FAT ↑ ↑ Hyper ↑It ⑭

IX white ↑ ↑
GRAY MATTER Grey
-

↑ ↓ ↓
-

WHITE MATTER White Grey

MRI SEQUENCES
DTI

Diffusion E

Tensor
to
Imaging
for white
matter
tract
IS "
3D
tractography

&
SWI: susceptivility DWI wit
Diffusion
Imaging Imaging
Ease
not

-
-
Catt
-or
0

8
->
s8 1. Tumor
unde
en
↑
stroke
Hige+ DAI - 2.
Cytotoxic edema-Ischemic
Brownian diffusion restriction
3. Auscess
stroke
mostin sequence motion
for ge 4.
Epidermoid cyst
THUMB RULES-MRI

S
CNS SPINE NERVES BM EDEMA LIGAMENTS
- # 10C MRI
=

MRI
CARTILAGE
Tumole

SOFT TISSUE

I
102 MRI
=
o stress #
10C MR I
sacroititis
=

MR1 (STIR)
Neurogenic tumor Acute
=

o Om

Calung=HRC/T
Pancoast tumor MR/GO
=

(Involves nerves)
 Radiation Greg/children
USG 2-20 v
MHz x

-11 d

Fluid

x
-> ↓bbbb
->

Posterior acoustic
Anything in GB

Asession)10c/most
=> 10C
USG
=

enhancement
I e
posterior Acouste shadow
FLUID/Cyst
awe.I air=
Eigty
"Anechoic"

Bone lair is
enemy
d usa)
USG PROBES Requency
audio ra
Rib

mem
I C
ter

phased away/
curvilinear linear Endocaritory sectoral

FREQUENCY 2-5 mm2 D 10-15

MU2 * 5-10 MHz (4) 1-5 MHz -

RESOLUTION A ↑ ↑ ↳

⑭
00
DEPTH ↑ ↓ to

ivs- ut,
USE
Abdomen USG Thyroid, scrotal, ovary ECHO 9)
Pelvic USG Testis, Breast TRUS -

prostate (TTE)
Doppler

!-Red (t)
->
Blue
-
(-3

colour

B mode Doppler USG

velocity.
L
nu -

Spectral dopplers

3
-
Blood Towards (t):Red

(-): Blue
alla
DuplexUSG (Triple doppler)
Blood Away
uses: Blood dirn -
DOPPLER WAVEFORMS

dindkessel
effect
↑

Triphasic Biphasic Monophasic

0

Neur
extremity artery visceral
artery

InPAD: triph monophasic

to

(periph.
a.ds)
↓ tote b compression
t

FA
FA
-

FV

NORMAL VEIN DVT IOC:Doppler

->

COMPRESSIBILITY ⑰ Now
compressible

FLOW monophasic absent

flow
 THUMB RULES-USG

GALL BLADDER FLUID PREGNANCY DVT ARTERIAL

USG-1OC CYST -Initial Fux) VARICOSE VEINS DISEASES

-
Gallstone
~effusion 10C =
Doppler Initial
complex fetal *
·

~ ascites
anomaly Doppler
to
MRI
-
PAD (periph. ads
-
RAS (Renala.st)
⑳

pulsatile
swelling
"Mickey Mouse Sign"
 CONTRAST MEDIA

Contrast Modality Route Pre- Complication

media requisite
IODINATED induced
nephropathy
CONTRAST
XRay/CT Any RFT
CIN-contrast

↑V [AK1 in 48 les of contrast

inj)

GADOLINIUM MRI iV RFT

NSF -

Nephrogenic Systemic fibrosis

SONOVUE
-
USG iv Rule out
safe in Renal failure ->
Pulmonary
Sulfa excretion
allergy
BARIUM ⑪ iv Rule out

XRay oral-perforation
-

-O
TEF - do CXR-PA
enema ve obstruction
· al post op.
PYQs
Q. Identify the MRI sequence

a) SWI
b) Proton density
c) ADC
d) Gradient echo
Identify the structure marked by the arrow?
I

• A) Right 3rd anterior Rib 3

Y

• B) Right 3rd Posterior Rib

• C) Right 4th anterior Rib

• D) Right 4th Posterior Rib

Q. A patient is brought to casualty and a whole-body CT scan has to be
done. This CT scan will include the following except?

• A) CT Head

• B) CT Limbs

• C) CT Abdomen

• D) CT Cervical spine
Q. Identify the tip of pacemaker

A) RV

B) LV

C) SVC

D) LA =RA
RV
b
Q. Identify the modality shown here

a) CT

b) Dye/Contrast study(contrast+ X
Ray)
c) Angiography

d) X-ray
Q. A 35-year-old male working with hammer and
chisel had an accident and a foreign body enters the
eye. Which of these investigations will be detrimental?
E
Initial
->
a) Xray

b) CT IOC NCCT
- >
=

c) USG

d) MRI
Q. In which of the following is MRI better than CT

a) Adenocarcinoma lung

b) Squamous cell carcinoma lung

c) Mesothelioma

d) Pancoast tumor
*
Q. What is the imaging modality given below?
drink mannitol
a) CT enterography b

↳
b) MRI Bowel distends.

c) Barium enema IOC for small Bowel

d) X ray Himor/structure
Q. Identify the prosthetic device

a) Pacemaker

b) Aortic valve

c) Mitral valve

d) Pulmonary valve

Below
Q. A person at the airport with symptoms shouting agitations
showed following x- ray findings. He was carrying enema
apparatus and laxatives. Which of the following is a wrong
statement?

A) Abdominal CT imaging is required -> IOC CT

=

B) He is malingering

C) He is body packer -
Body
-
packer Sx

D) He is at risk of poisoning N
Q. A middle aged male patient presented with acute onset
pain in right limb. An investigation was performed. What is
the name of the investigation ?

a) Digital subtraction angiography

b) Ultrasound doppler

c) Plethysmography

d) MR Angiography
Spectral doppler-Triphasic
to

Periph. a
Q. A 25-year-old male presented with a pulsatile --

supraclavicular neck mass.

-

What is the most appropriate next investigation?

a) Doppler USG

&
b) CT angio + Percutaneous intervention
IOC - -
-
-> C1I

c) Oral Antibiotics x 7days

d) Needle biopsy cI
->
Q. A 35-year-old smoker male presents with a painful ulcer in
the tip of great toe surrounded by blackish discolouration.
Best initial investigation of choice is:

a) DSA

b) CTA

c) MRA

d) Doppler USG
GI and HBP RADIOLOGY
 Tube
-
-
↓

sin um
mu

St
R
Duod

-Heum
↑
Ba swallow Ba meal Ba meal
"featureless" Jejunum
m
Ba
me
enema

to I b
esople
follow through
stomach/ Ba-Enteroclysis
prox duodenum
(BMET) -

Tube used
-

33incomplete
-folds"
b

Jejun
Haustration
Better distension ↑
valvular
colon
conniventis
"Valve of Kerckring"
·
complete fold
 IOC
Ba Swallow
T/N stage
↳
FUS

M DET-CT
stage +

ESquat
q4

Irregular
the

taper
smooth
Is
Rat tail
Bird beak
sign sign.
Achlasia Ca-esophagus
10C8 10C: UGIE +BX
Manometry
Chicago classification
 Feline
Esophagus H10 HIV+
odynophagia work screw

↓ to

veosinophilic esophag its DES

shaggy eso

atopy, astuma
~

~GERD Candida
esophagitis
IOC:
Manometry
~
Reflux esophagits (Any Motility disorder)
 Hernia
• DIAGNOSIS: Congenital diaph ↑
CDH

=Etube
• TYPES:
L -
pleuroperitoneal
en
age
L Bochdalek membrane

ze
(BPL) absence
side] posterior in
Adult
I
diaple.
left tube
NG
-
• C/F: Neonatal Resp distress +
Scaphoid ald.
I
• MOST IMPORTANT PROGNOSTIC FACTOR: Pul. hypoplasi a

↳
WVC.
umblical
• INITIAL MX:①ET tube Cathe.
vein

② NG tube

• CI: & mask

Bag
• DIAGNOSIS: Intessusception *
(C)
• AGE: 6-8 month
insQ
team
• C/F: Pain +
cry4+Red currant ⑧
jelly stools.
Donut
• MC TYPE: 9100 -
Colc
~

sign
Sandwich
sign
- ~

law
sign
• INITIAL: USG Targetsign
~

Pseudokiancy sign
coiled
I
spring sign
• IOC/GOLD STANDARD: Ba
->

enemal
meet
↳ Air enemal
while
reducing
diagnosis
t
water enema

TH
• C/F: Pain Abd +
Guarding/Rigidity / Tenderness

• DIAGNOSIS: Pneumoperitoneums/perforation
peritonits
• MOST SENSITIVE XRAY: CXR-PA erect

I soluble
->
• MOST SENSITIVE IX: CECT + oral contrast
contrast
I Stomach
↳ ⑫
to know site only
• NEXT STEP: Exploratory
lape myto
-teallage "Air
under
T

1st
step- is 42
im
I
n
↳ in diaph"
fluid "Sy
to stabilize
emergency"
Pt
APPROACH TO INTESTINAL OBSTRUCTION
Pain abdomen + Obstipation + Abdominal distension + Vomiting
3- 6 -
9
in fluid + NPO + NG tube / I ga
>30 I
>6cm
site Cae
quital: Abd CEC
XRay IOC: SBO IBO nm
cause
I
t
SBO (MIC) LBO

MC Cause Adhesion
Carcinoma
O (prior 410 Sx)
Distribution
peripheral
- -

-
Central
-

Diameter >3u - Ga

Valvulae conniventes
Jejunum ⑦
>3 Airfluid
level -> As String of pearls sign
sBo ⑦
Stepladder sign
Haustra
⑰ ⑬
⑬
-

Mx conservative for zuhrs

As SX
AdheSIOLYSIS
SIGMOID VS CECAL VOLVULUS
↳
I
-
1 -9am
2

/ RIF Ei
&
RIF
elderly
Anticlockwise*
Pregnancy
Chr.
constipation
Coffee Beau
sign 'C'sign Pelvic Sx

Haustra -> ⑦ ⑰ =u clockwise

No. A loops - ⑳ ②
Mx+
Endoscopic detoision Mx -> SX
IMPORTANT BARIUM SIGNS

Jeju

Fleu

string sign lead

pipe colou Apple core
Sign Sigmoid Diverticulosis
t painless
Terminal ileum stricture ulcerative colites Car Color saw tooth
sign
-

L ↳ (UC)

entere
Grown as TB

E
(Kantor) 21F
E
Fever
+ Paw
↑

Ald
 eFAST
I
extended
-
focussed Assessment
Sonography in Trauma

Add thorax

1.
Subxiphoid ③ Spleeno Renal
pouch

⑳
Echo
probe
lineal ⑰
Pneumo
⑤ probe
Hemo ⑫
pericard thorax
"Mmode"
&motion

④
pelvis Hemothesax
② HR pouch
CPL
linear ⑦ efast=
lineal -
-

~ 100wl
limitation 8
Retroperitoneal
o efast hemato ma

(notseen)
Blunt trauma abdomen

Unstable Stable
↓ I
efast efast
1 H-
of
exploratory (aprotomy SECT observe

IOC to localize

injury
 Hydatid cyst

&
Awaterlilysign
Honeycomb sign calcified liver
in

~ E
granulosus
Endocyst
Mic: Liver>
lang W
--

Ectocyst
-

pericyst-connective
tissue
 Asbestosis Round telectasis
GB PATHOLOGIES
-
10C
a
USG
=

Comettail
on CT

C
A

thick GB
polyp
Cholelithias is
wall comet tail
Sign Phrygian ⑪
>3mul
~ No shadow
Asis Adeno-
Cap
Acute
Cholecystitis -

M,- myopatosis
Rx: Re-

6
assure

a
Lantive
Murphy sign cholestrol
m
-

No fever/local Tender Reassure 0 deposit

strawberry
&

in his wall
news
Chole.

mostaccurate=> HIDA
scan
GB
(non visualization
of GB)
 direct Bili=1.3

APPROACH TO OBSTRUCTIVE JAUNDICE ALP 4

I
Not
filling
"double barrel
defect->
contrast
as no
it
sign" L

Se
CBD 1
↑
6
-
PY

t
17

E
stone
Endoscopet
back
To not
X
Ray,
Initial:USG
↓ NexE/IOC (Cholangio- ERCP (endoscopic
MRCP std:
-

dilation Baucreatico
Retrograde
CBD
dx
> 6mm
graphy) R
+

Pros:No contrast CPS

contrast v
:No Radiation
X
:Non Invasive Rayv
Invasive v
 sderosing cholangits)
-

Beaded

a/w IBD

↑ Ro
Cholangiola
-

PANCA
PYQs
Q. A 30-year man post-RTA with flank ecchymoses with
stable vitals. Which of the following investigations is
the best to localize the site of bleed?
- -

A) Xray
b) CECT
c) USG
d) RGU
Q. A 35 year old male with RTA with BP 90/60mm Hg.
What is the next appropriate investigation?

a) eFAST
b) CECT
c) MRI
d) DPL
 Q. 39 year old male with recurrent episodes of
pain abdomen and jaundice. MRCP is shown
here. Likely diagnosis?
• a) Primary biliary cirrhosis
A*
• b) Primary sclerosing cholangitis
• c) Oriental cholangitis
• d) Caroli disease Neonatal Jamdice
-
-

-
dilational of Sutratp.
-Central dot
sign
(portal radicle)
Q. A 48-year-old lady presents with right upper quadrant
abdominal pain. USG reveal multiple GB calculi but no
-

wall thickening, CBD diameter 12mm, gamma glutamyl

e -

transferase 5times increased, alkaline phosphatase was

high also 400IU. Other parameters are normal.
What is the next step ?

A. MRCP obst.
jaundice
CBD stone FOC MRCP
=

B. ERCP

C. Semi-urgent cholecystectomy

D. EUS
Q. 40 year old female presents with jaundice and pain
abdomen. LFT reveals raised bilirubin and GGT. USG reveals
scleroatrophic GB with dilated CDB with impacted calculi.

--
What is the next step of management?

A. Cholecystectomy stones seen in CBD

notneed
B. ERCP So

to do MRCA
C. PET scan

D. MRCP
Q. A 56yrs old male with obstructive jaundice reveals
dilated CBD and intrahepatic biliary radicles on USG.
No stone was identified. CT confirmed the findings.
Which of the following investigation would be most
useful to localize the cause?

A. Endoscopic USG
B. Percutaneous transhepatic cholangiogram
C. MRI
D. PET scan
AA
Q. A 60yr old female with increased bowel sounds.
Xray reveals dilated small bowel loops and air in the
biliary tree. She has a history of hysterectomy 2yrs
ago. What is the likely diagnosis?

A. Gallstone ileus Rigler's triad-Bo

air in
biliary tree
-

I
B. Small bowel obstruction stone & 1-Cjx

C. Mesenteric ischemia

D. Large bowel obstruction

 Q. 35 year old male with severe pain abdomen since 2
hrs. He recently had a radius fracture for which he’s
been taking lot of painkillers. CXR is shown here. What
is the next step?
• a) Advise him to stop painkillers
• b) eFAST
• c) Barium meal
• d) Exploratory laparotomy

Pucumoperitons
 Q. A 8 month old child after vaccination presents to
the emergency with incessant crying and legs
drawn up. X-ray abdomen is normal with no signs
of free air. USG is done next which shows the
following. What will you do next?
a) Plan for urgent surgical exploration
b) Air enema Gold sta
c) CT scan
d) MRI
Q. What is the least useful investigation to confirm
the diagnosis of the patient with following
condition?
a) Timed barium swallow
b) UGIE
c) Manometry
d) 24-hr pH monitoring
Q. Identify the marked segment of liver.

• A) V

• B) VII

• C) III

• D) IVa
Cross-sectional anatomy LIVER

Tissum LUV

ind
33
-498 a

5
46

7 6

I
spleen
I
per Game
What is the likely diagnosis?

A. Duodenal atresia

B. Subcutaneous emphysema

C. Pneumatosis intestinalis

D. Pneumoperitoneum
-
football sign
 Q. A 45 year old male presents with sudden onset
colicky pain abdomen with vomiting. Supine AXR
is shown here. Diagnosis?

(3) -
A. Proximal SBO

(5 i) B. Distal SBO
+
& Jeju. Il
C. LBO
x7
X

D. Pseudo-SBO
Q. A 35 year old male with fever, weight loss since
6 months. Diagnosis based on image?

A. GI TB pulled up
Caecuns
B. Diverticulosis carcum

C. Carcinoma colon

D. Ulcerative colitis
⑧
GU RADIOLOGY
IVP SIGNS

I
HDN

J-shapel Fish
Cobra/ Adder Head Maiden waist
L Hook weter
ureteroce
RPF-RP fibrosis I

Retrocaval
-
Orm and -
de Brugs 44RD
writer

ADDER HEAD SIGN

disease
Methy serigide
-
 CECT

%oI
IMA
0 IMA

istums

Horse shoe kidney

IMA- istmus
I
than O
1
Lower 23

Weshaking
a
de

flower
calyes
Vase sign
-- ->
-
AbXray IVP: delayed IVP

⑭
S pyramid
last

stghorn
calculus

Proteus
sterile pyria B/2 medullary
struvite CtripleP0u] PUSO
pully kidney Nephrocalcinosis
-

or s obstruct
coffin lid
↑Cath/Roxalurial
IGUTB Ri -

Pyeloplasty
↑PTH
RENAL CYSTS
09
up
↑
⑧
wwI

0
X ~fluid
W
said
⑰

CECT
-> iter
Bosniak
cyst-classificat Spider leg sign
L MRI
ADPKD
0%w/o malig. 45yu-BIC cyst
simple cyst ADPKD
-> 1/spleen/paue.
->

Berry anerensm
RENAL MASSES 2 Air Hat
Black
-> -
& UV

⑧ fair
W

e
O
fat

↓
0

Heterogenous Angio Myolipoma cellate scar

I
onco
RCC
-
Tuberous sclerosis cytome
-
clear cell RCC
·subependymal Birt Hogg Dube Sx
modules
I I
-

P+x
Hemangioblastoma adenoma I
Grebellum selsacium
follicular
-

lesion
VHL 3
p
 ⑳
⑨
5
↑
Keyno le sign
oligohydram.
mar-micturating 10 C ·

Potter
cysto wiethography L ->

PWY Lung Hypoplasia

contrast VUR
foley'sinjected
L
well al
post
-

death
↓ mac of value

oiding
-

recurr. UTI -
mec
of olst.
child wopatty
3 lever
- in

in child
URETHRAL TRAUMA
to void wine
C/F: inability
+ blood at meatus
R/F-
Anterior: straddle ing
Posterior: pelvic # (RTA)
prostate contrast
roct
(memb↳ Pende
d
↓ Foley's:C/2 mar-C12 /
S
Bulbar)
Penile
Bulbar
IOC:RGU

d
I
RGW UB not R4U: Bulbar
suprapubic palpable wellral
-

Retrograde -cography
well
cystostomy injury
↓ 4-brok & ↓
wait 2
watch
Delayed
methroplasty
Q. A 13-year-old boy presents to trauma center after
skid injury, and he is unable to pass urine with blood at
meatus. What is the next step?

A) SPC
-
-

B) Foley’s catheterization
C) MCU
D) Wait and watch
Q. A 13-year-old boy presents to trauma center after
skid injury, and he is unable to pass urine with blood at
meatus. What is the next step?

A) SPC
B) Foley’s catheterization
C) Wait and watch
D) RGU
-
Q. A 13-year-old boy presents to trauma center after
skid injury, with lower abdominal pain and blood at
meatus. The bladder is not palpable. What is the next

=
step?

A) SPC
B) Foley’s catheterization
C) Wait and watch
D) CECT
Q. A 13-year-old boy presents to trauma center after
skid injury, with lower abdominal pain and blood at
meatus. The bladder is not palpable. What is the next
step?

A) SPC
B) Foley’s catheterization
C) Wait and watch
D) RGU`
*
IOC FOR BLADDER TRAUMA: CT
Cystography

~morar to oth

Flame
foley's
↓
in UB
contrast
sign I
- CI

peri/pre resical

Intraperitoneal (20%)
↑

TYPE: Extraperitonical TYPE:

100%)
MX: conservative MX: Sx

dome- ruptures
 I
CT
~

Bladder wall cath/

Christmas tree Tear
drop UBI skull
Fetal sign
↓ pear shape
UB ↓ schistosoming is
Neurogenic extrinsic compression SCC
Hematobiun
Hematoma
- -
terminal
->
Felic Tx/LN/ Lipomatosis Spine
earliest-G.Sa Yolk sac ->
embryo -> Double Bleb
-
->
+w1 pole
fetal
sign
TVS:n.5-50K
5.5-6wK 6.5-7wK Amniotic sas
TAS:5.5-6wK t
FHR I Y01k SaC
intradecidual
·
sign ↓
7.5-BcK
-
eccentric sac
wall
swrest sign of
well
defined Bestfor GA
-capsularis viability I
·
Double decidual-CP-parietalis CRL
 TWINS USG

ir
S
-

SIGN: Lambda / peak SIGN:

Twin -sign
INTERTWIN MEMBRANE: >2mm INTERTWIN MEMBRANE: <2mm

TYPE: DCDA TYPE: MCDA

 Acrania -
Exercephaly -

• DIAGNOSIS: Anencephaly
so
• SIGN:
frog eye sign 0

• EARLIEST ANOMALY TO BE DETECTED: 10-11 WK

• PREVENTION: Folic acid

L ->
·

5mg /ONTD
I
3 mm before
Sig
contracept
B/L ENLARGED OVARIES-APPROACH

W
P
E
0 ->stromal large
0 roll follicles
0
echogenicity 4

210mm in size
string of pearls follicles 4
>10 - 720
BUCh**
PCOD L
IOIVF -lo molar
irreg mne/amenorrheal
H
No hirsutism
I preg.
DOC I
DOC L OHSS
Theca
Letrozole> Clomiphene
infertility: COCP+ Leutin
metformin cyst
• DIAGNOSIS: IH mole
• SIGN: snowstorm/cluster of
grapes
• MX: S&E
↓
BHCC follow up
12 k amenorhee
I

UPTO + pain

bleeding
PYQs
Q. While doing USG of a neonate who has
difficulty in urinating, this appearance is
noted in the lower abdomen. What is the
gold standard investigation to confirm the
diagnosis?
• a) IVP
• b) RGU
•↓c) MCU
• d) RGP
 Q. A 35 year old female presents to you with history of nausea and
vomiting. She is undergoing IVF treatment. What is the likely
diagnosis?

a) PCOD
b) Theca-Lutein cyst
c) OHSS
-
d) Mucinous cystadenoma
Q. A 30 year old female presenting with sterile
pyuria. Radiograph is shown identify the
diagnosis?

A) Nephrocalcinosis
B) Putty kidney
#

C) Staghorn calculus
D) Psoas Calcification
 Q. A delayed intravenous urogram of the patient is
shown. What is the most likely diagnosis?

A. Staghorn calculus

B. Putty Kidney

C. Pelviuretric junction obstruction

*

D. Renal Cyst
Q. A 37 year old banker presents with flank pain
and a renal lesion is detected on CT. What is the
likely diagnosis?

A. RCC

B. AML
-

C. Renal cyst

D. Oncocytoma
Q. Sequential arrangement of order of appearance
1-Yolk sac 2-Embryo 3-Double decidual sign 4 Cardiac activity

• a) 1-2-3-4
-
• b) 3-1-2-4
• c) 3-1-4-2
• d) 3-2-1-4
Q. A 30 year old with motor vehicle accident presented
to the causality with pelvic fracture. His vitals are stable

I
but he is unable to pass urine. He has blood at the
urethral meatus. An RGU was performed as shown
below. What is the most likely site of urethral injury?

A. Penile urethra
Ipost.
B. Membranous
e urethra
C. Spongy urethra
D. Bulbar urethra
Q. What is the likely diagnosis?

A. CT- AD PCKD

B. MR-AD PCKD
e

C. CT-AR PCKD

Can
D. MR-AR PCKD

uscopic cyst
 Q. A 35 year old patient comes to emergency
room with vomiting and colicky abdominal pain,
on investigation following image is obtained,
likely diagnosis is?

A. Pancake kidney

B. Ectopic kidney

C. Horseshoe
e kidney

D. Crossed fused ectopia

Q14. A 45 year old female presents with abnormal
uterine bleeding. USG is shown here. What is the
likely diagnosis?

A. Ovarian dermoid

B. Endometrial hyperplasia

C. Endometrial carcinoma

D. Endometrial polyp
e
 Q. 34 years old lady using OCP since 5 months presents with
amenorrhea since 6 weeks. Which of the following is best to
calculate gestational age in this case?

A. 280 days from LMP

B. 256 days from LMP

C. CRL by USG
e

D. Abdominal girth
 Q. What is the likely diagnosis based on the
image shown here?

A. B/L cornual block

B. Normal

C. B/l hydrosalpinx
I

D. Asherman syndrome
Q. What is the likely diagnosis?

A. Bicornuate uterus
D
B. T shaped uterus bicornste
ys septate
C. Unicornuate uterus
- I

MR1/3DUSG
D. Diadelphys uterus

& ⑬ ③
septate Bi
Q. Which of the following modalities are used for
the diagnosis of placenta accreta?
↳ adherent
1. USG morbidly
placenta
-

2. MRI
3. Angiography
4. Radiography

A. Only 1
B. 1 and 2 are true
-
C. 2 and 3 are true
D. 1,2,3 4 are true
 CXR-PA

AP -
bigger ↓small
rat

THORACIC RADIOLOGY
• DIAGNOSIS: P
effusion
Lt

• SIGN: Ellis carve/meniscus sign

• EARLIEST FINDING: Blunting of CPL
C
• MEDIASTINAL SHIFT: a/2
• MOST SENSITIVE IX: USG (5-10me)
F1
• MOST SENSITIVE XRAY: 2) I lat decubitus
250m
250me)
 ⑪
• DIAGNOSIS: Rt PHX

• MEDIASTINAL SHIFT: 2/2 Hyper

went

• MOST SENSITIVE IX: CF

(102)
• MOST SENSITIVE XRAY: exp. view E
• MX: UNSTABLE STABLE
tension PAX
ED obstructive
shock.
↓
weedle thoracostomy child
adult:5t ICS MAL I

·Let
and ICS
L inG McL
ICD
exp
 ↑ motion
M-mode
US4

seashore sign barcode/

↓
stratosphere
⑪ I

X
HRCT APPROACH-FEVER + PRODUCTIVE COUGH
↓
everything
Whil......
·

is
eus ex
or
wengs -
↑

↳
⑧

⑭
⑧Artery
⑧Brondung

consolidate air
Tree in bud sign ⑧
I signet
bronchogram
dilate
bronchus
of ring
I sign
bronchus (black)
panpucumonia
1 TB -endobronchial Bronchi

⑭I alredli
filled
L active TB
-
ectasis

white TB bacilliin the

I
pus
-> ·
bronchus
 fever- Immuno compromised

Halo Reverse Halo

sign ④@⑧.·
Invasive Aspergillosis organising
solid Pneumonia
⑧ Doc: Voriconazole

1440 -> mucos

HRCT
of fungal Pneumonia: -

-> interlobular septat

consolid
-> pecip, wedge shape
-> pleural effusion
-> nodule 440

-
carity inBureus

crescent
Aspergilloma-
· air

sign
 consolidat" -

poora white
240
nazy
-

chronic
e dry
ough
-

I
multiple Nodules UIP
miliary
peripheral 440-CORADS5
0000
0000

mcc:TB

Honeycombing
-

COVID-19 ·
Histo
varicella
O-incomp
.

CORADS
Sx
0 -
6 ·

TPE
Lefflers
=

]Atypical
Typical ·
of cosinophilia)
Since
silicosis
6- RIPCR proven
 [

0 vingula S
Mr

1
in

RML

silhouette Pneumatocele
sign
S. aureus
middle
pneumonia
opacely
-

lobe -

I
merging
&
margin
Q. 28-year-old male with HIV and CD4 count of 120
cells/mm3 and non-productive cough. Diagnosis?

A. TB

B. Pneumococcus

C. Invasive aspergillosis

D. Pneumocystis carinii
E
B/2 440 cysts
+

diffuse bassiness ↑440 +t

 Popcorn sign T2 -MRI

Fibroadenoma Hamaratoma Cavernoma

PEDIATRIC INFECTIONS
Neck

I
↳

estrat
also

Thumb
sign
-strep
Steeple sign whee ze +

B/2 markings M4
Acute apiglotitis -rib Croup/ATLB tever t

fever not
-

potato
voice barking
cough Bronchiolitis
Lmcc: RSV
A poss mc-Parainfluenza
+
 CONGENITAL HEART DISEASES

=
Suc
②
for
L

W RA LA

RVH d L
predominant
I marking-oligenia plethora
markings -

DIAGNOSIS
·TOF Ebstei TGA TAPVC
SIGN cer-er
Boot sabot
BOX egg
on
string snownanl
COMPONENTS
1. RVH H0 Li-mother r 1:
Sup so
2. USD 11 Il 2:B
atrialist" RV
3.
overriding
Aorta of AO PA
3: ingra
RA
2. Pul. Stenosis ↳ ⑪
War
OLIGEMIA/
I 11

PLETHORA oligemia oligemia Plethora piethoxa

Neonatal respiratory distress B/2 out
white
I
lungs/Preterm
HMD

marking
multiple lung
Hyperinflat
.

fluid
in

fissure
·

S
H/o sibling death
SP-B

Term
crazy paring
·

Post
term
·

LSCS CDH
MSL
↓ PAP
TTNB
MAS
 -
p.nein
A
CARDIOGENIC PULMONARY EDEMA
↓
W wengs

8-12:
PCWP FINDINGS
-UL veinsbecome prominent
reverse mustache
13-15mi
cephalisht" stag-
anther
sign) righ
15 - 25 Kerley B>A
>25 Batwing sign-BI consolid" -
perihilar

M
A
Keeley

CS
(eilum)
-

B
~

Karley
~ Bage
 rise

the t
in

LA dilat"(ms) water/lather calcific

↳postmost chamber bo the
/money bag constrictive
I Pericarditis
Double RMB pericardial off
LUB-straightened
My
2.
C.
Tamponade egg
in
up
3.
splaying of cornea
sign
• DIAGNOSIS: Aortic Dissect imtimal 29Ct
for - as
worten

⑧
↳

• MC R/F: HTN F Th
↑

R main

• C/F: acute clust

• IOC STABLE: 27
pain-radiate

angio
to
back SAM
SVC

↓
⑳

-g
Branches
3 A
R
sterg

⑧ - Dese

• IOC UNSTABLE: TEE Aorta

Tu -
75

• MANAGEMENT:
/
⑰ -
↓ ↓
Sx Medical Mx
B
esmold
- O
• DIAGNOSIS: Aortic Anewysm
-
• MC R/F: Atherosclerosis er
&To

-
-
-
-
• C/F: asym/pulsatile swelling - in a
Yang
• INITIAL IX: Doppler US4 sign

• IOC : CT
angio
• INDICATIONS OF MX: -

symptomatic
ruptured
<5.52m
 Gorte
• DIAGNOSIS: Pul embolism
Asc. -
-
PA
main

• C/F: DVT -> acute

dyspnea SUC
hombre
->

• IOC : CTPA
PYQs
 *
I
Q. A 45-year-old male presents to the trauma centre post-RTA.
HE is conscious, talking and vitals are stable. CXR is shown.
Which of the following procedures is contraindicated?

A. NG tube
B. Log roll diaphragm
-C. ICD tube drainage injury -diaphragm
is
raised
D. Epidural anaesthesia
stomach
air
deoP+X
My
fid
Q. A child presents with cyanosis. Xray of the
patient is given below identify the diagnosis?

A) Cottage loaf, truncus arteriosus

B) Snowman sign, Supracardiac TAPVC
-
C) Egg on side, TGA
D) Boot shaped heart, TOF
 Q. What does the following X ray depict?

a. Pleural effusion
X
b. Tension pneumothorax R L

c. Emphysema
d. Bronchiectasis
-
 Q. A 35 year old female presented with fever, expectoration and difficulty
breathing. HRCT of chest was performed and shown. What is the likely diagnosis?

a. Mediastinal mass
b. Pleural effusion
c. Diaphragmatic hernia
d. Consolidation with air bronchogram
↳

I
*
Q. Identify the correct pair
Arteriosus
• a) Sitting duck-Tricuspid atresia
-
T
Persistent runcus

• b) Goose neck deformity-VSD-

As cushion defect
•-c) Hilar dance-ASD
• d) Egg on string-PTA T4A
-
Q. A 6-year-old child presents with hypertension. On
examination lower limb pulsation was feeble, upper
limb pulse were normal. On chest Xray notching of
the ribs were noted? intercostalA. prominent

A. Atrial septal defect -

N

L
B. Bicuspid aortic valve

↳
·

C. Patent ductus arteriosus ↓

e
D. Coarctation of Aorta
Q. 45 year old male had RTA. Patient is stable but
complaining of mild chest pain and dyspnea. CXR
is shown below. What is the diagnosis?
a) Hemothorax
b) Pneumothorax
e I

c) Lung contusion
d) Diaphragm tear
Q. After a delivery via Caesarean
section, a term neonate presents with
respiratory distress. CXR is shown.
Likely diagnosis?

a) Hyaline membrane disease

b) Transient tachypnea of newborn
-
c) Diaphragmatic hernia
d) Meconium aspiration
 Q. Identify the true statement

R L

a) Left heart border silhouette sign negative X

b) Location in Left lower lobeX

c)
*Location in Lingula W

d) Location cannot be commented without CT

merging
&
*
Q. A cattle handler from a village with cough, hemoptysis
and chest pain underwent a chest radiograph and is shown
below, what is the probable diagnosis?

A. Abscess

I
B. Hydatid cyst

C. Byssinosis
air
D. Anthrax
e
water
lily
sign
Q. A 35 year old female with Raynaud’s phenomenon and
tightening of skin of face and extremities presents with
dyspnea and bilateral basal rales. What is the next best step?
d
Scleroderma-ILD
er
A. HRCT chest

B. 2D ECHO

C. PFT

D. MRI Chest
Q. A 54 year old male with dyspnea and elevated
eosinophil count of 5000. CXR shows military mottling.
What is the likely diagnosis?

A. Tropical
- pulmonary eosinophilia

B. Chronic HSP

C. Tuberculosis XX

D. Asthma
Q. Which of the following statement is true
regarding CORADS

A. CORADS 0- Normal lung incomplete

440
-
B. CORADS 5- Typical of COVID-19 BI multiple
C. Pleural thickening- Typical feature of COVID-19 X

D. Lobar consolidation-Typical of COVID-1 X

NEURORADIOLOGY
HEAD TRAUMA

• INITIAL INVESTIGATION: NCCT

• IOC: DAI: 10C +MRI

NCCT--except

Acute EDH - Acute SDH

-
·

HORTA rivial traum a

arterial bridging veins

· ·

me -MMA
• DIAGNOSIS:

~Y
SAH
Acute

rupture
• MCC: Trauma) Anewhysm
3
• C/F: headache
worst of life - Thunderclap

• MC SITE OF BERRY ANEURYSM: ACA-ACOM june

• INITIAL IX: WCCT

• IOC: CT Angio O CA
->
mat
subtract
• GOLD STANDARD: DSA- digital
"

endovascular
Dx Rx
+

angiography Loiling - 12 A

e 33
Q. A 34-year-old woman landed up in AIIMS emergency after
a road traffic accident with GCS of 3. She was intubated and
sent for NCCT which was found to be normal. What is the
most likely diagnosis?

A. SAH

B. EDH

C. Cerebral contusion

D. DAI
e
• DIAGNOSIS: DAI

• C/F: ↓GCs/coma
• NCCT: ⑭ /petechiel H'ge
• IOC : MRI:SWI

l bleed
 STROKE Acute
FND

• INITIAL INVESTIGATION OF CHOICE: WCCT

• MOST SENSITIVE INVESTIGATION FOR INFARCT: MRI -

DWI

• ALGORITHM:
stroke
acute
L
NCCT
L ↳>
ischemic
NoH'gia
4.5hea
↓
i) thrombolysis
• DIAGNOSIS: - T
Intra Granial Hige
• MC SITE: Putamen

• MC R/F: HTN ⑥O
g
P P
MCA
• VESSEL: of
Art Charcot -

·
CIL Hemiplegia
 Empty

⑳
als
ab ⑱
-
4
O &
⑧
delta
Empty sella sign thecal empty
Empty sign
4/0PPH -> lactatex
BP 1
sac
sign SSS
lethargy
Thrombosis
Shechen-ischemic
Arachnoiditis
SX
Necrosis
BRAIN TUMORS IN ADULTS-PATTERN APPROACH
IOC
↓

⑧
MRI

cross &
midline

me
benign me
malig. (hr-IV) me CPC Tx

dural tail sign Glioblastoma Acoustic schwamoma

psSammma bodies me:

Ing. Vest N.

·butterfly
glioma Ice cream cone
pseudo pallisading
Meningioma ......
- Antoni A
-verrocay
Necrosis
serpentine O- bodies
·

antoni B
BRAIN TUMORS IN CHILDREN
CT

sypra

ne
seller
P ai C
O - >
optic

⑧
chima
de
⑧
M

Biterp
Hemianopia
mc
Benign me
malig. (IV) Cath child cyst

Pilocytic Astrocytoma Medulloblastoma

CranioPharyngiona
·

resenthal
fibers
Homer
wright wetkeratin

Pseudo R machine oil

...Neuro pil
=>
CNS INFECTIONS

Cerebral abscess NCC *conglomerating child

REL
behaviour
7. solium
·

diffusion restrict" eggs als ⑱

0
scolex 7B I
enhancement
ring
·

starry sky nsv

encep.
CNS INFECTIONS-HIV/AIDS

O B/2
BG
00
affect
white
matter

bubble
Target ⑧ soap JC virus
↓ ↓
↓
PML
ToxO crypto
-prog, multifocal
leukoencephalo
pally
-
SKULL XRAYS-PATTERN APPROACH

· ⑧

08

salt & pepper punched out child I

geograp
drop bevelled
rain
hytic I
Hyper PTH
MM margins

say
Birbeck
SKULL XRAYS-PATTERN APPROACH

O Ill
D
0
men

colton wool skull Hair on end Tram track

paget's An e Sturge weber

/
Hemolytic
blastic lyticXix /
-CA portwine stain
Thallesemia Waucoma
cong.
PNS X-RAY VIEWS

R
-
*
8
&
mouth
Mod, Water's-open Caldwell view

Pierre's
best for frontal
best for max-sinus sinns
PYQs
Q. A 34-year-old woman landed up in AIIMS
emergency after a road traffic accident with GCS
of 3. She was intubated and sent for NCCT which
was found to be normal. What is the most likely
diagnosis?
• A. SAH
• B. EDH
• C. Cerebral contusion
• D. DAI
-
Q. Identify the view given in the X-ray?

a. Towne view
b.
- Water’s view
c. Coldwell view
d. Basal view

-
 Q. Which of the following is most likely to be seen due to rupture of saccular
aneurysm in brain?

a. Subdural Haemorrhage
b. Subarachnoid Haemorrhage
e
c. Hydrocephalous
d. Intracerebral Haemorrhage
*
Q. A 10-year-old boy
presented with seizure and
then fell unconscious. Imaging 0
was done which is shown here.
What is the likely diagnosis?
• a) Glioblastoma multiforme
• b) Abscess
• c) TB
•Ed) NCC
Q. 36 year old male underwent a road traffic
accident. NCCT was performed. What is the likely
diagnosis?

a) EDH
I
b) SDH
c) SAH
d) Cerebral contusion
Q. Identify the technique

in
IMyelography
a) contrast
b) MCU X E
c) Vertebroplasty
Spinal
anal
⑭
d) Vesseloplasty
 Q. A 2-month-old infant is brought to the OPD with a parietal swelling
present since birth. An X-ray was ordered and is shown below. What is
the likely diagnosis?

-
⑧
z
A) Cephalhematoma
B) Subgaleal hematoma -> within
parency ma

C) Encephalocele -> Brain herniat

D) Caput Succedaneum -> resolve
quickly
Identify the marked structure.

• A) Putamen

• B) Thalamus

• C) Internal capsule
- jat
• D) External capsule
Q. 35 year old female with thunderclap headache.
What is the likely diagnosis based on image?

A. SDH

B. EDH

C. SAH
Z
D. IVH
 Q. A 56 year old male presents with sudden onset
right hemiplegia. What is the likely diagnosis?

A. Hypertensive hemorrhage
-

B. Berry aneurysm rupture -

SAH
C. Pontine hemorrhage X

D. Intraventricular hemorrhage X
**
Q. What is the likely diagnosis?
O
A. ICH X

B. Lacunar stroke
e - small val stroke
in Basal
C. MCA embolic stroke Thalamus

D. MCA thrombotic stroke

Langlich 0
Q. Which arterial territory is involved on this
CT scan image of a patient with infarct?

A. ACA

St
ACA
B. MCA
e -> ischemic

C. PCA MCA

D. VERTEBRAL ARTERY

PCA
Q. A patient presents to emergency department with
chronic ear discharge and head ache with ear pain. CT
revealed the following findings. What is the most
probable diagnosis?

*
A. Temporal abscess

B. Extradural abscess

C. Cerebellar abscess

D. Subdural abscess Ring

enhancry
-

lesion
Q. A 10-year-old child presents to the emergency with
sudden onset of vision loss in the bilateral temporal
fields. NCCT head was done. What is the likely
diagnosis?

A.Pituitary adenoma

B.Craniopharyngioma
e

C.Rathke cleft cyst ⑧

D.Meningioma
 Q. A 15yr old male patient presenting with epistaxis
underwent CECT. What is the sign demonstrated in the
given image? JNA- Juvenile Nasal
Angiofibroma
1
A. Homan-Miller sign
↳ 10C - CECF

B. Dodd sign polyp vIS JNA

i
->

C. Phelp sign -> womus:erosion of SPF

I
D. Griesinger sign spine
↓
lat simes thrombosis
behind
erythemamastoid
-
MSK RADIOLOGY
 I
Ank
i spond

HLAB27

earliest (most in Bambo

Dagger sign spine
sacroi litis B/2 Tram track
syndesmophytes
-

MRI (STIR) sign

v/L sacroilitis
↳ TB
• DIAGNOSIS: Osteoporosis
• SIGN: codfish mouth

• BIOCHEMICAL: Ca

• IOC: DEXA
POy
PTH
ALP
I ⑬

I I
• SCORE:
dual
energy X-ray
absorptimetry
WHO:T score
young
-

adult
compression #

<-2.5SD:
osteoporosis
 sandwich V.
SPINE XRAYS-APPROACH ostopetogis ->
Bone [inbone)

Rugger Jersey Picture

frame vertebrae Vertebra
spine Ivory
- plana
HL
paget's
·

2
PT/CKD/ ·
Blastic mets - Lu
Renal
oster
dystrophy Prostate Breast
 Cobb's L
-
Scoliosis
 Chronic OM

sclerotic- sequestrum
I
(white) dead bone

involucrum- gramat

⑧
tissue

cloace
 111
-Trimmer
field zone
(121,
..
- ~Pelkan
spur
B

winberger
-

sign

1975 -
healing Survey
rickets
white
line of Frenkel
white line
(smooth)
M cupping/splaying
widened
fraying -

metaphysis
PYQs
Q. A 26 year old male with back ache, morning
stiffness and reddening of eyes. X- ray of the
patient is given below, Identify the diagnosis of
this patient?

A) Rheumatoid arthritis
B) Psoriatic arthritis
C) Ankylosing spondylitis
*
D) Paget’s disease
Identify the structure marked with the arrow

• a) Sequestrum
-
• b) Involucrum
• c) Cloaca
• d) Osteoid osteoma
Q. A 5 year old boy with inability to pronate
and supinate. What is the likely diagnosis?
• a) Radial head dislocation
• b) Monteggia fracture
• c) Galleazi fracture
• d) Radioulnar synostosis
e

↑
 *Identify the correct pair
Q.

A-Coronoid fossa
B-Trochlea
A alchawan
C-Olecranon process A. is
12
D-Lateral epicondyle
~↑
sifellum
B.
trochbe D.

C.
↳ radial
Poronoid R head

upda
Q. A 35 year old male presented with pain and
swelling around wrist joint. There is no history of
injury. X ray is shown below:

A. Osteosarcoma

B. Rickets

C. Colle’s fracture

D. Giant cell tumor

-
Q. 50yr old male presenting with diffuse back
pain; Cervical spine Xray shown. Dx?

A. Ankylosing spondylitis

B. DISH All
*
C. Klippel-Feil syndrome

D. Sprengel deformity
Q. A patient presents with persistent back pain. He has
past h/o pulmonary TB. What is the likely diagnosis?

A. Inguinal hernia

B. Psoas abscess
-

O
C. Perthes disease

D. Ureterocele
Q. Identify the diagnosis?

A. Multiple enchondromas
* I dier's
B. Multiple exostosis I

C. Brown tumors
Hemangioma
↓

Maffuci
D. Polyostotic fibrous dysplasia
*
Q. All of the following are useful in osteoporosis:

1. DEXA W
2. Quantitative CT e
3. Bone scanX
4. Chemical analysis ~ - but still do it

a) 1,2
b) 1,2,3
c) 1,2,4
e
d) 1 only
Q. A 40-year-old male with progressive forward
bending with increasing stiffness of the spine. A
CT-spine was performed and shown below. What is
the most Likely Diagnosis ?

A. RA - atlanto axial dislocate

B. Fluorosis -
I density/interosseous
memb
C. Ankylosing spondylitis
-

D. Reiter syndrome
see
can't

can't pee
can't climb tree
Q. A 70-year-old male presents with a history of
painful limp. There is no history of drug intake or
trauma. What is the most likely diagnosis based on
the given image?
-
A. AVN
- crescent
sign, no steroids
-

⑪
B. TB hip -matter a pestle
C. Ankylosing spondylitis
⑧

D. RA
7,99m DMSA
+
7,99*- 799
↓
wrays
S-e rays
Ways.
~ ~
rad"
NUCLEAR MEDICINE and
RADIOTHERAPY
Scan Use

Tc99m-DMSA static renal scar

morpho-IOC
+
to

Tc99m-DTPA
Tc99m-MAG3 I dynamic:obstruct

Diuretic renography
obstruct
Captopril
-

renography Renal
Artery Stenosis

0
Radioisotope Test notspots

mets +1OC:Naf
Tx PET 7
Tc99m-MDP
·

Bone scan
#
IOFDG
(methylene PET
Pagets
·

diphosphonate) ·cold spot

↳ MM
Tc99m-HIDA Biliary Atresia -
best rule out
to

accurate
most -
acute cholecystitis ALP
i n-Bile
most leaks
Tc99m Sestamibi ⑤ IOC -
PTH Adenoma
Tc99m Sulphur colloid
scan Hot spot -FNH
Tc99m pertechnate O
red currant
Painless jelly stool
I
&Meckel's Diverticulum (IOC) FNH PTH Meckel
Tc99m labelled RBC adeord
sn-L4IB
most
Tc99m tetrofosmin,
Sestamibi, Th-201 in perfusion
MP
I
Tc99m pyrophosphate
-
infarct-
-
Hot spot
 PET-CT
physio IOc:mets
O ->

I8FD4 -
PET

187 position
deoxygle
-

I
emitor

AD4
⑧ d1L FD4 -
000P
000 ↓
O e
Warburg er+

effect ↓

Typical
carcinoid Ways x 2 (5T1kev)
↳ on PET
MOA of Ionizing Radiation

1) DNA as DNA
breaks
damage --

2) free radical
damage
MAXIMUM PERMISSIBLE DOSE

Occupational Exposure Public Exposure

20
• mSv/ year averaged over 5-year I mSv/y
Overall ->

consecutive

•
30 mSv in any single year

Lens 150 mSv/y 15 mSv/y

500 mSv/y 50 mSv/y

Skin, Extremities

& Pregnant female ② mSv/y I mSv/y

mSv/y
Fetus I 005 mSv/y
 ↑LD
↑

Thermo
Luminiscent
Dosimeter

-
3mon
-

below Pb apron
level
at chest

CaSOn> lif ron

mc:0.5mm

min:a 25mm
 Types of Radiotherapy

Teletherapy Brachytherapy systemic RT

I-131

d mold
Interstitial
Endocaritary
eyelid

Q
ca

d
·CaCX
Lip Ca

lad
->

- rctur
 Dose-Depth curve

⑰↳ - Cut. I cell fungoides

lymphoma:mycosis

I
into RT
op
Bragg'speak Proton

-
-

2
T
seated x
deep
clival Chordoma
Dose
eg.

-
Tay/rrays
Depth
Remote

afterloading
L

Brachy Therapy
 Knife
ma
↑
Leksell frame (n,y,z)
RT
·Vrays-focussed
Brain
TX

mets
solitary
·

vest. Schwar.

adenoma
Pit C0-60 -V
rays
Trigeminal Neuralgia
·

refractory I
DOC:carbama
apine
Fractionated RT – 5Rs
60 by
• Repopulation Normal cells
- DDDDD -
-

• Reoxygenation
e -- 4 radio Sn

• Repair potent
02-most
= ⑱ alls

• Redistribution 42 -
M -
S

• Radiosensitivity
- S-resistant
Inverse Square Law
2
ayd2

⑧ i
I
2/4
Element HALF LIFE
18-FDG 110 min

Tc 99
-
6 Gr

I-123 13hr - RAI scan

-
I-124 4d
I-125 12x5
60d
I-131 113+ 1 3
+

Pd RT Rx: U+ B
rays
-

Co-60 (Q) 5.2 ye

Cs-137
*
30
=> ye
I wrgs
Radium-226 1622
-
-

yar
 Important one-liners

• Most common side effect of RT-

eythema
• MC RT-induced malignancy- Leukemia (AML)

• MC brain tumor after cranio-spinal RT- meningioma

&• MC RT-induced thyroid carcinoma- Pap. Ca

• MC bone cancer after RT- osteosarcoma

Type Most sensitive Least sensitive
Cell Type Bergorie
law
rapidly I Quiscent

Organ Gonads vagina

Blood cell ⑫ Plt > RBC

Cell cycle phase 42 -

M ⑤
Tissue Hematopoietic CNS

Structure of eye Lens schere

Tumors o WE LMS HOM

·wilms ·

Ma HCCIRCC Pan Ca
.
-

Ewing Seminoma osteo Sa

·

Leukemia ·
Melanoma

Acute radiation Hemato -> 42 ->CVs-CNS

syndrome WIS 10-20
my
death s month -zay days
was 20-150
by
PYQs
Q. Most radiosensitive bone tumor
• A) Enchondroma
• B) Osteosarcoma Rardio resistant
-

•-C) Ewing sarcoma

• D) Osteochondroma
A woman has been diagnosed with endometrial carcinoma is
undergoing radiotherapy. Choose the correct statement?

•2A) Intensity is inversely proportional to the square of the distance from

the source
• B) Small blood vessels are most radioresistant X sensitive
• C) Rapidly proliferating cells are most radioresistant xsemitive
• D) Small intestinal mucosa is most radio-resistant x sensitive
 A patient diagnosed with cancer is undergoing radiotherapy. She is given a
dose of 1.8 to 2 Gy daily for five days a week, for a total treatment duration
of 6 to 8 weeks. What among the following explains this type of
radiotherapy?

-
• A) Conventional Fractionation radiotherapy
-
• B) Hypofractionation radiotherapy ↓ fractions

• C) Accelerated Fractionation radiotherapy no break

• D) Hyperfractionation radiotherapy
Thank you