RADIOLOGY CRASH COURSE

DR. ZAINAB VORA

MD RADIOLOGY (AIIMS)
BASICS
BASICS OF IMAGING MODALITIES
THUMB RULES-XRAY

EMERGENCIES- MSK LINES AND

AIR TUBES
THUMB RULES-CT

CALCIUM BONE FOREIGN ACUTE AIR

BODY HEMORRHAGE
MRI SEQUENCES
MRI SEQUENCES
THUMB RULES-MRI

CNS SPINE PNS BM EDEMA

THUMB RULES-USG

GALL FLUID CYST PREGNANCY

BLADDER
USG PROBES
DOPPLER USG
DOPPLER WAVEFORMS
 NORMAL VEIN DVT

COMPRESSIBILITY

FLOW
Radiosensitivity of Tumors

● RADIOSENSITIVE ● RADIORESISTANT
TypeRadiosensitivity Most sensitive Least sensitive

Cell Type

Organ

Blood cell

Cell cycle phase

Tissue

Structure of eye
Q. Identify the modality shown here

a) CT
b) Dye study
c) Angiography
d) X-ray
Q. Identify the MRI sequence

a) SWI
b) Proton density
c) ADC
d) Gradient echo
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
Q. Name the investigation shown

a. PET-CT
b. Technetium scan
c. Cerebral flow study
d. Tc sestamibi scan
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
● C) Oral Antibiotics x 7days
● D) Needle biopsy
Q. All of these are signs of normal vein on USG except:

a) Anechoic lumen
b) Compressible
c) Monophasic flow on spectral doppler
d) Decreased flow on augmentation
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
Q. IOC for localization of PTH adenoma

a) CT scan
b) Sestamibi scan
c) MRI
d) FDG-PET
Q. FDG-PET negative tumor is:

● A) Atypical carcinoid
● B) Typical carcinoid
● C) Small cell carcinoma
● D) Large cell neuroendocrine tumor
Q. True about acute radiation syndrome is:

a) At lower doses, more GI symptoms than bone marrow suppression

b) CNS is more sensitive than GI to radiation
c) Hematopoeitic syndrome occurs at 2-8Gy
d) Symptoms occur in the shortest duration with hematopoietic syndrome
Q. Most radiosensitive bone tumor

● A) Enchondroma
● B) Osteosarcoma
● C) Ewing sarcoma
● D) Osteochondroma
Q. A 26 year old female underwent a CXR and later found out
that she was 6weeks pregnant. Next step?

● a) MTP
● b) Consult ethics board
● c) Reassurance
● d) Invasive genetic testing at 9 weeks
GI/HPB RADIOLOGY
IMPORTANT BARIUM SIGNS
• DIAGNOSIS:

• TYPES:

• C/F:

• MOST IMPORTANT PROGNOSTIC

FACTOR:

• INITIAL MX:

• CI:
• DIAGNOSIS:

• AGE:

• C/F:

• MC TYPE:

• INITIAL:

• IOC/GOLD STANDARD:
Pain abdomen + Obstipation + Abdominal distension + Vomiting
eFAST

● Full form:

● Sensitivity:

● Limitations:
Blunt trauma abdomen

Unstable Stable
GB PATHOLOGIES
APPROACH TO OBSTRUCTIVE JAUNDICE

C/F:

INITIAL:

IOC:

GOLD STANDARD:
APPROACH TO SUSPECTED BILE LEAK

C/F:

INITIAL:

BEST:

MOST SENSITIVE:
Q. 35 year old male with progressive dysphagia to both solids and
liquids. He has a BMI of 18.5 Which of the following investigations are
indicated:

● a) UGIE + Manometry
● b) UGIE + CECT
● c) UGIE + PET
● d) UGIE + 24 hour ph monitoring
Q. Feature of large bowel obstruction on Xray:

A) Dilated bowel loops with haustrations

B) Dilated bowel loops with valvulae conniventes
C) Central dilated bowel loops
D) String of pearls sign
Q. 35-year-old male with severe pain abdomen since 2 hrs. He
has a history of peptic ulcer disease. CXR is shown here. What is
the next step?

a. IV fluids
b. USG
c. Exploratory laparotomy
d. CECT abdomen
Q. Identify the sign shown in the image

● A) Saw tooth sign

● B) Apple core sign
● C) Corkscrew appearance
● D) String sign
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 transferase 5times increased,
alkaline phosphatase was high also 400IU. Other parameters are
normal.
What is the next step ?

a) 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
● b) ERCP
● c) PET scan
● d) MRCP
Q. A 35 year old female presents with pain abdomen on post-op day 5
following laparoscopic cholecystectomy. USG shows a collection in
the RUQ. What is the next step?

a) ERCP
b) MRCP
c) USG guided pigtail catheter
d) Re-explore and T-tube insertion
 Q. A 35 year old female presents with pain abdomen on post-op
day 5 following laparoscopic cholecystectomy. USG shows a
collection in the RUQ. What is the most sensitive investigation to
rule out biliary leak?

● a) ERCP
● b) MRCP
● c) HIDA
● d) CECT
Patient with blunt trauma
abdomen came to ER. What is
the result of eFAST in the
following image:

● a) Positive
● b) Negative
● c) Equivocal
● d) Cannot comment
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. 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. eFAST is least useful for:

A) Pericardial effusion
B) Pneumothorax
C)Retroperitoneal hematoma
D)Renal injury
Q. A. 11-month-old child presented with recurrent abdominal
pain. On examination a mass can be felt in lumbar region. A
barium enema study was done. What is the likely diagnosis?

a. Duodenal atresia
b. Intussusception
c. Malrotation
d. Volvulus
Q. A 50 year old female came to the OPD with complaints of
dysphagia and chest pain. The patient was further evaluated
with barium swallow which is shown below. What is the most
probable diagnosis:

a) Carcinoma esophagus
b) Diffuse esophageal spasm
c) Achalasia cardia
d) Oesophageal web
Q. What is the imaging modality given below?

a) CT enterography
b) MRI
c) Barium enema
d) X ray
Q. 45 year old male with dysphagia. Barium swallow is shown
here. Likely diagnosis?

● a) Candida esophagitis
● b) Achalasia
● c) Peptic stricture
● d) Carcinoma esophagus
 Q. 39 year old male with recurrent episodes of pain abdomen
and jaundice. MRCP is shown here. Likely diagnosis?

● a) Primary biliary cirrhosis

● b) Primary sclerosing cholangitis
● c) Oriental cholangitis
● d) Caroli disease
Q7. A patient diagnosed with spinal TB, he has a swelling in the
left groin limb attitude is in flexion. Identify what caused it?

A
B
C
A
D
B

C
D
Q. A newborn baby presents with respiratory distress. Diagnosis based
on image

● A) Congenital diaphragmatic hernia

● B) Hiatal hernia
● C) RDS
● D) TTNB
THORACIC RADIOLOGY
• DIAGNOSIS:

• SIGN:

• EARLIEST FINDING:

• MEDIASTINAL SHIFT:

• MOST SENSITIVE IX:

• MOST SENSITIVE XRAY:

• DIAGNOSIS:

• MEDIASTINAL SHIFT:

• MOST SENSITIVE IX:

• MOST SENSITIVE XRAY:

• MX:
UNSTABLE STABLE
HRCT PATHOLOGIES-APPROACH
• DIAGNOSIS:

• SPREAD:
 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
PEDIATRIC INFECTIONS
CONGENITAL HEART DISEASES
• DIAGNOSIS:

• MC R/F:

• C/F:

• IOC STABLE:

• IOC UNSTABLE:

• MANAGEMENT:
• DIAGNOSIS:

• MC R/F:

• C/F:

• INITIAL IX:

• IOC :

• INDICATIONS OF MX:
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
A 34-year-old male patient presented with productive cough. He is
a chronic smoker and alcoholic. CXR is shown below. What is the
best management?

● a) Gemcitabine and carboplatin-based chemotherapy

● b) Radiotherapy
● c) Clindamycin and iv fluids
● d) Antitubercular therapy
 A patient presented with fever and cough with expectoration.
The chest X-ray has been shown below. What is the likely
causative organism?
● a) Hemophilus influenze
● b) Parainfluenza virus
● c) Pneumococcus
● d) S.aureus
Q. 40 year old male with productive cough underwent HRCT.
What is the likely diagnosis?

● a) CF
● b) Sarcoidosis
● c) Hydatidosis
● d) Bronchiectasis
Q. What does the following X ray depict?

a. Pleural effusion
b. Tension pneumothorax
c. Emphysema
d. Bronchiectasis
 Q. A 30 year old male presents to the trauma centre after RTA.
He’s unable to speak in complete sentences. On auscultation,
resonant note is seen on the right side. What is the appropriate
management?

● a) Thoracotomy
● b) Needle thoracostomy
● c) Needle thoracostomy with large bore needle
in 5th ICS followed by ICD in 5th ICS
● d) ICD insertion in 5th ICS with water-seal
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 would be contraindicated?
A. NG tube
B. Log roll
C. ICD tube drainage
D. Epidural anaesthesia
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. A 30-year-old patient presented to the causality after a motor
vehicle accident. He has bruises on the chest. His pulse is 100
bpm. BP is 125/85 and RR is 28. A chest Xray was performed and
show below. What is the next most appropriate step in the
management of this patient?

a. Immediate thoracotomy
b. Pleurodesis
c. Pericardiocentesis
d. Chest tube placement and drainage
Q. A 25 year old patient presented with fever dry cough,
breathlessness and night sweats. On chest X-Ray, bilateral hilar
lymphadenopathy was seen. What is the most likely cause?

a. Hypersensitive pneumonitis
b. Sarcoidosis
c. Lymphoma
d. Tuberculosis
Q. The following appearance as shown below is present in:

a. Metastasis
b. TB
c. Bronchogenic Ca
d. Hamartoma
Q.What is the likely diagnosis?

● A) Hamartoma
● B) Carcinoid
● C) Ca lung
● D) TB
Q. A 19 year old male with high grade fever and productive cough.
What is the likely diagnosis?

● a) RML consolidation
● b) RLL consolidation
● c) RUL consolidation
● d) Pericardial effusion
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?

● a) HRCT chest
● b) 2D ECHO
● c) PFT
● d) MRI Chest
 Q. Identify the tip of
pacemaker
● A) RV
● B) LV
● C) SVC
● D) LA
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
D) Asthma
Q. Pulmonary plethora is seen in:

● a) TOF
● b) Coarctation of aorta
● c) TAPVC
● d) Tricuspid atresia
Q. 55-year-old hypertensive male with acute chest pain, loss
of consciousness, diaphoresis with unequal pulses in bilateral
upper limbs. What is the best investigation in the emergency
setting to reach the diagnosis?

a) TEE
b) MRI
c) Cardiac enzymes
d) Xray
Q. Which of the following is not seen in heart failure?

● a) Kerley B lines
● b) Cardiomegaly
● c) Interlobular septal thickening
● d) Pulmonary Plethora