,MCQ --Pulmonary artery

17.All are true regarding pulmonary artery except

a.The main PA measures upto 20mm in diameter in normal subjects

b.measurement made near the level of its bifurcation at right angles to the long axis of the PA

c.the PA is usually smaller than the adjacent aorta

d.the right and left pulmonary arteries size is  approx. of equal size

e.the diameter of a small PA and its neighboring bronchus is of  approx. equal size within the lung

17.---a

The main PA measures upto 30mm in diameter in normal subjects.(Webb)

FEEDING VESSEL SIGN --MCQ FRCR AND PG

16.Feeding vessel sign is noted on CT scan of chest in

a.hematogenous metastases

b.septic emboli

c.multiple pulmonary infarcts

d.Wegener’s granulomatosis

e.all

16.---e

The feeding vessel sign consists of a nodule or focal opacity that demonstrates a vessel leading to it .The presence of a feeding veseel indicates either that the lesion occurs in close proximity to small pulmonary vessels or the lesion has a hematogenous origin.(Hagga)

MCQ FOR FRCR AND PG---Atypical nontuberculous mycobacterial infection

Q.A middle aged immunocompetent female patient  was suffering from chronic cough and hemoptysis but no fever  All features are found in atypical nontuberculous  mycobacterial infections except

a.bronchiectasis

b.small nodules

c.tree-in-bud

d.lower lobe predominance

e.consolidation

ANS.-------d

Lingula and middle lobe predominance of lesion is noted in atypical nontuberculous mycobacterial infections.(Webb)

MCQ---SOLITARY PULMONARY NODULE

5.60 yrs old was subjected to chest x ray hemoptysis and a solitary pulmonary nodule is noted in left mid lung field.Features on CT/PET favouring  the diagnosis of malignancy are all except

a.irregular /speculated margin

b.laminated calcification

c.volume doubling time 30-400 days

d.enhancement more than 20HU

e.increased uptake of FDG

5.---b

Calcification occurs in upto 14% of lung cancer.The calcification is amorphous while diffuse solid ,central punctuate,laminated or popcorn-like calcification are noted in benign lesions.

Lung cancers typically double in volume (an increase of diameter of 26% in diameter) between 30-400days  (average 240 days).An absence of growth over a 2-year period is usually a reliable feature of benign nodule.

Cavitation in malignant nodule shows thick irregular wall (thin and smooth wall in benign nodule)

MCQ FRCR PG-----ALVEOLAR PROTEINOSIS

2.30 year old male patients presented with exertional dyspnoea 

 and non-productive cough and showed evidence of digital clubbing

 and inspiratory crackes.X ray showed bilateral  airspace

  opcification pronounced in central area.The  broncho-alveolar 

lavage revealed periodic acid-Schiff-positive lipoproteinaceous

 material .What is the expected chararacheristic HRCT finding is 

this case?

a. miliary lesions

 b.honeycombing

c. crazy-paving pattern

d.diffuse emphysema

e.multiple holes

mcq frcr and pg---

1.A 10 year old child suffering from parasitic infection with 

minimal symptoms  shows peripheral blood eosinophilia .X ray 

shows transient bilateral airspace opacification which resolves 

within a week.Which of following is the most likely diagnosis

a. Simple pulmonary eosinophilia (Löffler's syndrome)

b. Acute eosinophilic pneumonia

c. Chronic eosinophilic pneumonia

d. Wegener's granulomatosis

e. Hypereosinophilic syndrome

1.----a

The airspace opacification in Löffler's syndrome is fleeting and

 may be either uni- or bi-lateral. Resolution of opacities within a 

period of days and, by definition, within a month is the rule

Although spontaneous resolution of acute eosinophilic pneumonia 

occur without therapy,patients with Acute eosinophilic pneumonia

 has more fulminant clinical course . The clinical improvement 

with corticosteroids is often dramatic, fever and radiographic 

changes resolve within days and with very little risk of relapse on 

withdrawal of therapyThe plain radiographic abnormalities in 

chronic eosinophilic pneumonia reveals  patchy, nonsegmental 

areas of consolidation  typically  in the mid and upper zones. A

 distinctive feature in x ray is that the opacities are peripheral and 

seem to parallel the chest wall (the ‘photographic negative of 

pulmonary oedema’)

IMAGING FOR SWINE FLU

IMAGING FOR SWINE FLU

CXR is usually the first imaging test performed for the assessment of acute respiratory symptoms.
The predominant findings are bilateral consolidation and reticular opacities .

INDICATION OF CHEST CT -----

1. high clinical suspicion of pneumonia in the presence of normal or questionable radiological findings. 

2.Chest CT is also helpful in assessing complication or evidence of mixed infection.

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The predominant CT findings at presentation of illness are unilateral or more often bilateral multi-focal asymmetric ground-glass opacities, either alone or associated with areas of consolidation.

The abnormalities have a predominantly peripheral and subpleural distribution:

Patients who exhibit consolidation on chest CT have a more severe clinical course compared with those who present with ground-glass opacities.

The crazy-paving pattern is a common finding on chest CT of the lungs: Some authors presume that crazy-paving pattern is also closely related to an adverse course,

Multifocal bilateral distribution and Opravil CXR score are directly correlated with the severity of the illness:

MCQ Congenital diaphragmatic hernia

702.All are true regarding Congenital diaphragmatic hernia except

a. occurs in 1 in 2500 live births.

b. The most common site ----posterolateral (Bochdalek hernia)

c. Bochdalek hernia involve the left diaphragm in 70% of cases

d. an opacity  ,then radiolucencies in affected hemithorax  in

 postnatal period

e. The presence of the stomach in the thorax is usually associated 

with later herniation and less severe pulmonary hypoplasia

702.----e

The presence of the stomach in the thorax is usually associated with earlier herniation and mpr severe pulmonary hypoplasia. 

(CHAPTER 64 – The Neonatal and Paediatric Chest  ,Adam: Grainger & Allison's Diagnostic Radiology, 5th ed)

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mcq frcr and pg

687.All are true regarding radiological evaluation of tubes and lines except

a. Optimal positioning for an endotracheal tube (ETT) is approximately 1–1.5 cm above the carina

b. The umbilical arterial line  lies just lateral to the right  side of the spine.

c.The tip of umbilical arterial line should ideally lie between T6 and T10 to avoid the spinal artery

d. The tip of umbilical arterial line should ideally lie at L3–L5 below the level of the bowel and renal arteries

e. The umbilical vein catheter  tip lies above the liver 

687.-----b

The umbilical arterial line initially courses caudally through the internal and common iliac arteries to enter the aorta, and lies just lateral to the left side of the spine. The umbilical vein catheter courses directly cephalad on the right side of the abdomen and enters the left portal vein, at which point it may enter the ductus venosus and then the inferior vena cava. Radiographs should confirm that the tip lies above the liver and has not passed into a tributary vein (CHAPTER 64 – The Neonatal and Paediatric Chest  ,Adam: Grainger & Allison's Diagnostic Radiology, 5th ed)

689. Surfactant is produced

a.within the endoplasmic reticulum of type 2 pneumocytes

b.  within the golgi body  of type 2 pneumocytes

c. within the endoplasmic reticulum of type 1 pneumocytes

d. within the golgi body  of type 1 pneumocytes

e. within the mitochondria  of type 2 pneumocytes

689.----a

Westermark's sign,Hampton's hump

516. Radiographic signs of pulmonary embolus (not causing infarction) are all except
a. Localized peripheral oligaemia (Westermark's sign)
b. Peripheral airspace opacification due to haemorrhage
c. Hampton's hump
d. Linear atelectasis due to surfactant deficiency
e. prominent central pulmonary artery 
516.---c




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(CHAPTER 6 – Pulmonary Circulation and Pulmonary Thromboembolism,Adam: Grainger & Allison's Diagnostic Radiology, 5th ed)

MCQ on V/Q SCAN

520.All are used in ventilation scintigraphy of lung except
a. ^99mTc micro-aggregate albumin (MAA
b. krypton-81m
c. xenon-133
d.^99mTc-diethylenetriamine penta-acetic acid (DTPA)
 e. ‘technegas’


520.---a
Perfusion (Q) scintigraphy (to assess the distribution of pulmonary blood flow) is performed using injection of microparticles (10–100μm) of ^99mTc micro-aggregate albumin (MAA)


523.V/Q ‘mismatches’means

a.defects on perfusion imaging in regions that are normal on the ventilation study
b.defects on ventilation imaging in regions that are normal on the perfusion study
c.normal on perfusion imaging in regions that are also normal on the ventilation study
d.seen in pulmonary embolism with infarct
e. seen in obstructive airways disease


523.---a

Pulmonary artery hypertension

506. Pulmonary arterial size is said to be enlarged  if the transverse diameter of the right descending  artery at its midpoint is
a.greater than 16 mm.
b. greater than 17 mm
c. greater than 18 mm
d. greater than 15 mm
e. greater than 19 mm


506.---b
(CHAPTER 6 – Pulmonary Circulation and Pulmonary Thromboembolism,Adam: Grainger & Allison's Diagnostic Radiology, 5th ed)

KERLEY LINES

KERKEY LINES

496. All are true regarding Kerley B lines except

a.  1 cm or less in length
b. found predominantly in the mid  zones
c.peripheral location  and parallel to each other but
d.at right angles to the pleural surface
e. as a result of fluid accumulation in interlobular septa
496.----b            


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Kerley B lines are shorter (1 cm or less) interlobular septal lines, found predominantly in the lower zones peripherally, and parallel to each other but at right angles to the pleural surface. ( CHAPTER 26 – Pulmonary Circulation and Pulmonary Thromboembolism,Adam: Grainger & Allison's Diagnostic Radiology, 5th ed)


497. All are true regarding Kerley A lines except
a. approximately 4 cm in length
b.most conspicuous in the upper and mid portions of the lung.
c.deep septal lines (lymphatic channels) that radiate from the hila into the central portions of the lungs
d. do not reach the pleura.
e. normally indicates a less acute or less degree of oedema.
497.----e
Presence of Kerley A normally indicates a more acute or severe degree of oedema. ( CHAPTER 26 – Pulmonary Circulation and Pulmonary Thromboembolism,Adam: Grainger & Allison's Diagnostic Radiology, 5th ed)