Written 2000 Questions
1. A patient who has abused analgesics for a long time. IVP show a kidney with a wavy outline and a mass in the renal pelvis. Diagnosis?
a. transitional cell carcinoma
b. intrinsic abnormality in the ureter
c. renal cell carcinoma
d. fungal ball
e. fibrous stricture
2.
A post menopausal woman has a 3.5 cm cyst in the ovary with very fine thin septation. Which of the following is the next most appropriate step?
a. Surgery
b. 3 month follow up
c. Immediate CT scan
3.
A postmenopausal woman has bleeding and 4 mm endometrial stripe. Which of the following is the most likely cause of the bleeding?
a. Endometrial polyp
b. Endometrial hyperplasia
c. Endometrial atrophy
d. Endometrial cancer
4.
At what size is an ovarian follicle most likely to rupture?
a. 20mm
b. 15mm
c. 10mm
d. 25mm
5.
Concerning obstructing ureterolithiasis. Which is true?
a. obliteration of the angle between bladder and the seminal vesicle
b. tissue rim sign
c. comet tail sign
d. perinephric hemorrhage
6.
Congenital lower urinary tract obstruction in a child is at what level:
a. Membranous urethra
b. Prostatic urethra
c. Trigone of the bladder
7.
Cystitis glandularis is associated with?
a. Lymphogranuloma Venereum
b. Pelvic Lipomatosis
c. Retroperitoneal Fibrosis
8.
On contrast enhanced CT there is a mass in the kidney with a 60 HU. What should be the next step:
a. Biopsy
b. Nephrectomy
c. Non contrast CT
9.
Patient with cancer. Contrast CT shows an incidental adrenal mass having 30 HU. Which should be the next step?
a. Biopsy
b. Surgery to remove the mass
c. MRI
d. Delayed scanning to further evaluate it
10.
Patient with pelvic fracture has supra pubic mass with blood at the urethral meatus. What is the next appropriate step?
a. IVP
b. Catheterization of bladder
c. Retrograde urethrogram
d. CT scan
11.
Regarding acquired renal cystic disease:
a. cysts are found in the renal medulla
b. increase in proportion to the duration of dialysis
c. cysts tend to be large
12.
Regarding adenomyosis of the uterus which is true?
a. Ectopic endometrial tissue in the adnexa
b. Appears hypointense on MRI
13.
Regarding urethral diverticulum in females, which is true?
a. They are most often congenital
b. They are located off the posterior wall of the urethra
c. They are treated by marsupialization of the diverticulum
d. Associated with long term catheterization
e. They present with stress incontinence
14.
There is a mass in the kidney, which displaces the bifid collecting system and enhances as much as the surrounding renal tissue. Diagnosis:
a. TCC
b. Normal renal tissue
c. RCC
15.
There were two questions on Conns disease. Which is false?
a. more likely to be due to adenoma than carcinoma of the adrenal gland
b. hypokalemia
c. hypernatremia
d. are associated with increased renin levels
e. easily distinguishable histologically from cortisol secreting tumors
16.
What is a reliable distinguishing feature of AIDS nephropathy from other renal disease?
a. hypoechoic cortex
b. contour of the kidney
c. Doppler wave form
d. Cortical hyperechogenicity with increase or normal size
17.
What is the cause of scarring in reflux nephropathy?
a. pylosinous backflow
b. pylovenous backflow
c. pylolymphatic backflow
d. pylotubular backflow
18.
Which of the following can cause a striated nephrogram?
a. Renal infarction
b. Renal vein thrombosis
c. Renal vascular hypertension
d. Acute bacterial nephritis
e. Obstruction by Tamm-Horsfall protein
19.
Which one of the following is least likely to be ischemic?
a. hepatic flexure
b. rectum
c. splenic flexure
d. cecum
e. sigmoid
20.
A 15mm polyp is found in a colon of an elderly gentleman, what are the chances of malignancy?
a. 1%
b. 50%
c. 35%
d. 10-20%
21.
A 60-year-old female has a mass in the head of pancreas with central stellate scar and calcification. Review of CT scan done 5 years back had the same mass which has not changed. Diagnosis:
a. Islet cell carcinoma
b. Adenocarcinoma
c. Macrocystic adenoma
d. Microcystic adenoma
22.
A female has diarrhea with albumin is 4.5g/dl. GI studies shows dilation of bowel, with transient intussusception, fragmentation and segmentation of barium. Diagnosis?
a. Crohns disease
b. Whipples disease
c. Sprue
d. Mastocytosis
23.
A patient has a non-obstructing, excavating mass in the terminal ileum. Diagnosis:
a. Carcinoid
b. Lymphoma
c. Adenocarcinoma
24.
An elderly man presents with severe abdominal pain, bleeding per rectum and plain film shows thickening of the folds of the transverse colon. The likely diagnosis:
a. granulomatous colitis
b. pseudomembranous colitis
c. ulcerative colitis
d. ischemic colitis
25.
An immunocompromised patient develops multiple spleen hypodense lesions. Which is the most likely diagnosis?
a. disseminated PCP infection
b. fungal microabscesses
c. infarcts
26.
Barretts esophagus:
a. is in response to irritation of the squamous epithelium
b. can revert to normal after therapy
c. causes an increased incidental of squamous cell carcinoma of the esophagus
d. metaplasia of the squamous epithelium
27.
In a patient with AIDS which organism is not found in small bowel?
a. Candida albicans
b. MAI infection
c. Cryptosporidium
28.
Mallory Weiss tear: Which vessel is the bleeding most likely coming from?
a. Inferior phrenic artery
b. Gastric artery
c. Left gastric artery
29.
Regarding adenomyosis of the gallbladder:
a. associated with Rokitansky/Aschoff sinuses
b. rarely associated with the comet tail sign
c. one of the hypercholesteroloses
d. tends to be focal
e. premalignant
30.
Regarding Crohns disease?
a. jejunum frequently involved
b. asymmetric mural involvement
c. colon and small bowel involved equally
31.
Regarding hepatic cirrhosis:
a. hepatic venous wedge injections demonstrate increased opacification of the portal vein
b. hepatofugal flow demonstrated on ultrasound helps to guide treatment
c. the intrahepatic portion of the IVC typically demonstrates decreased pressures
d. the angiographic findings of corkscrew vessels and railroad track calcifications can be used to stage cirrhosis
32.
Regarding islet cell tumor of the pancreas, which is true?
a. Majority of insulinomas are malignant
b. Most nonfunctioning islet cell tumor are not metastatic at the time of presentation
c. Association with von Hippel Lindau disease
33.
Regarding leiomyosarcoma of the stomach which is true?
a. Treated with radiation and chemotherapy
b. With increasing size there is more cystic area and necrosis
34.
Serum gastrin is increased in:
a. Gastric polyps
b. Retained gastric antrum
c. Zollinger-Ellison syndrome
d. Menetriers disease
e. Atrophic gastritis
35.
The following agents can result in cathartic colon:
a. castor oil
b. mineral oil
c. podophyllum
d. senna
e. cascara
36.
The middle hepatic vein divides the:
a. the right and left lobe of liver
b. the left and right segment of the left lobe of liver
c. the anterior and posterior segment of the right lobe of liver
37.
There are multiple liver lesion in a patient. Some of which are pure water attenuation. Some have high attenuation foci, which shows contrast enhancement. What is the diagnosis?
a. Von Meyenburgs complex
b. multiple hepatic abscesses
c. Polycystic disease
d. Carolis disease
38.
What is the most appropriate initial study in a patient with massive hematemesis and hypotension?
a. Upper GI examination
b. Tc-99m RBC study
c. Angiography
d. Endoscopy
39.
Where would you not see peritoneal mets on the colon?
a. Medial surface of the cecum
b. Anterior surface of the rectum
c. Lateral surface of the ascending colon
d. Superior surface of the transverse colon
e. Superior surface of the sigmoid colon
40.
Which is true about Barrets esophagus?
a. Associated with GE reflux
b. Can be evaluated easily with double contrast barium swallow
c. Under endoscopy, area of columnar metaplasia cannot be seen
41.
Which is true about viral esophagitis?
a. More common than candidial esophagitis
b. Seen in immunocompromised patients
42.
Which of the following are true regarding ulcerative colitis?
a. the ileum is involved in 10%
b. the colonic mucosa is hypovascular
c. the rectum is involved in 25%
43.
Which of the following best helps to differentiate typhlitis from other causes of colonic inflammatory disease?
a. Acholic stool
b. Immunosuppressed patient
c. Positive PPD
d. clostridium difficile in the stool
44.
Which of the following disease is most malignant?
a. Cronkite Canada syndrome
b. Juvenile polyposis
c. Peutz Jeghers syndrome
d. Gardners syndrome
45.
Which of the following esophageal strictures is associated with the lowest rate of success with balloon dilatation?
a. lye stricture
b. tracheoesophageal fistula repair
c. chronic granulomatous infection
d. epidermolysis bullosa
e. Nissen fundoplication
46.
Which of the following is a cause of benign ulcer on the greater curvature of the stomach?
a. Aspirin
b. Alcohol
c. H pylori
d. Potassium tablets
47.
Which of the following is H. pylori gastritis not associated with?
a. Gastric ulcer
b. Adenocarcinoma
c. ZE syndrome
d. Lymphoma
48.
Which of the following is least likely to be associated with hypervascular liver metastases?
a. Islet cell tumor
b. Bronchogenic CA
c. Thyroid CA
d. Melanoma
e. Carcinoid
49.
Which of the following spares the rectum?
a. Diverticulitis
b. Lipoma
c. Colitis cystica profunda
50.
With regard to laryngeal papillomatosis, the most common associated neoplasm in the lungs is:
a. adenocarcinoma
b. lymphoma
c. small cell
d. squamous cell
e. carcinoid
51.
50 yo female with fever, increased WBCs, and bilateral pulmonary opacities. Serum analysis is positive for antinuclear cytoplasmic antigen (c-ANCA). What is the most likely etiology?
a. Eosinophilic pneumonia
b. Legionella pneumonia
c. Wegeners
d. Goodpastures disease
e. Rheumatoid necrobiotic nodules
52.
A 60-year-old man has parallel shadows of the perihilar vessel in the left upper lobe. What next?
a. Bronchoscopy
b. Video thoracoscopy
c. Chest tube placement
53.
A child who had recent BMT (bone marrow transplant) develops fever. Chest x-ray shows a pulmonary nodule. Diagnosis:
a. Invasive aspergillosis
b. Lymphoproliferative disorder
c. Bacterial pneumonia
54.
A finding that is diagnostic in differentiating a lung tumor from radiation pneumonitis is:
a. broncho-pleural fistula
b. pleural effusion
c. square margins
d. nodules
e. cavitation
55.
A man presents acutely with flu like symptoms. Chest x-ray reveals massive bilateral hilar lymphadenopahy. Diagnosis:
a. Inhalation anthrax
b. Acute silicoproteinosis
c. Burkitts lymphoma
d. Interstitial pneumonitis
56.
After right upper lobectomy, which of the following is the cause of right middle lobe gangrene?
a. Interruption of the segmental pulmonary artery
b. Torsion
c. Infection
57.
At what CD-4 count is infection with PCP most likely?
a. 200
b. 1000
c. 5000
d. 2000
e. 400
58.
Commonest cause of mediastinal adenopathy and SVC syndrome in a child:
a. TB
b. EG
c. Lymphoma
d. Castlemans disease
e. Histoplasmosis
59.
In heart transplant which native structure is left behind?
a. Coronary cusps
b. Non coronary cusps of valsava
c. Pulmonary valve
d. Coronary sinus
e. Posterior wall of the left atrium
60.
Lymphatics can be found with each except:
a. visceral pleura
b. interlobular septa
c. bronchial
d. pulmonary vein
e. alveoli
61.
Mesothelioma of the pleural looks like which tumor histologically and grossly:
a. Metastatic melanoma
b. Tb
c. Adenocarcinoma
d. Invasive thymoma
e. Urinoma
62.
PCP is not usually seen until the CD4 count falls to what level?
a. 2000
b. 1000
c. 500
d. 200
63.
Regarding RDS:
a. associated with pleural effusion
b. is associated with hypoinflation in the early stage
c. peak lung abnormality/opacity around 6 or 7 days
d. A normal chest X-ray at 6 hours excludes the diagnosis
e. intravenous surfactant is useful
64.
The number of alveoli in the lung reach a maximum at what age?
a. 1 year
b. 5 years
c. 2 months
d. 8 years
65.
What is the acinus in the lung?
a. Distal to the terminal bronchial
b. Distal to the respiratory bronchial
66.
Which cell type regenerates in response to injury:
a. Type 1 pneumatocytes
b. Type 2 pneumatocytes
c. Macrophages
d. Kupffer cells
67.
Which is common about the toxicity of phenytoin and cyclosporine on the lungs?
a. Hypersensitivity pneumonitis
b. Noncardiogenic pulmonary edema
c. Cardiogenic pulmonary edema
d. Pulmonary vasculitis
68.
Which is the commonest mediastinal mass in a child 6 to 12?
a. Neuroblastoma
b. Germ cell tumor
c. Lymphoma
69. Which nerve can be seen at the level of the ap window?
a. Left recurrent laryngeal nerve
b. Vagus nerve
c. Right laryngeal nerve
70.
Which of the following causes increased compliance of the lungs:
a. Scleroderma
b. Alpha 1 anti trypsin deficiency
c. Idiopathic pulmonary fibrosis
d. Pulmonary embolism
71.
Which of the following causes increased lung volumes:
a. EG
b. Pulmonary fibrosis
c. Lymphatic spread of the tumor
72.
Which of the following is least likely with rheumatoid lung disease?
a. bibasilar fibrotic change
b. interstitial lung disease with basal prominence
c. nodules
d. pleural effusion
e. hilar lymphadenopathy
73.
A patient receives 5000 rads to the L3 vertebral body over 4 weeks. Which of the following radionuclide uptake patterns is seen on a bone scan 6 months later?
a. decreased activity at L3
b. increased activity in the entire lumbar spine
c. increased activity at L3
d. decreased activity in the entire lumbar spine
74.
A young woman presents with sore throat, neck pain, restlessness, T4 is elevated and her thyroid uptake is low. The most likely etiology is:
a. sub acute thryroiditis
b. graves disease
c. acute suppurative thyroiditis
d. Hashimoto thyroiditis
e. factitious thyroiditis
75.
For gastric emptying study, which is true?
a. For proper calculation of the half-life. The geometric mean of the anterior and posterior projection is taken
b. Liquids have a linear curve
c. It cannot be used to follow patients with gastroparesis because of poor reproducibility
d. The half time for solids is 30 minutes
76.
For pharmacological augmentation for detection of Meckel's diverticulum. Which drugs act by inhibition of secretion of pertechnetate from the gastric mucosa in the Meckel's?
a. Pentagastrin
b. Viagra
c. Cimetidine
77.
Octreotide scanning is useful for all the listed tumors except:
a. carcinoid
b. renal cell carcinoma
c. gastrinoma
d. Meningioma
e. medullary carcinoma of the thyroid
78.
On renal scintigraphy, what would be the response to Captopril in a patient with right renal artery stenosis?
a. increased initial uptake on the right side
b. no change
c. decreased activity on the left side
d. decreased initial uptake on the right side
79.
One would prefer In 111 WBC to Gallium scanning in:
a. lung fungal infection
b. vertebral osteomyelitis
c. inflammatory bowel disease
80.
Regarding diuretic renal scintigraphy. Which is essential?
a. absence of renal calculi
b. increase creatinine
c. absence of history of previous obstruction
d. normal renal function
81.
Regarding liver scintigraphy?
a. Sulfur Colloid is taken up by hepatocytes
b. bowel transit in HIDA scan can differentiate between neonatal hepatitis and biliary atresia
c. HIDA is taken up by Kupffer cells
82.
Regarding treatment for thyroid cancer post op. which of the following is false:
a. A dose of 200 mCi for lung mass can cause pulmonary fibrosis
b. Two doses of 100 mCi is contraindicated because of leukemia
To minimize the risk for leukemia, a 1 year interval between therapies and a total cumulative dose of administered activity not to exceed 800 mCi is recommended. It is important to note that the mortality from recurrence exceeds that from leukemia by 4 to 40 fold.
83.
There was a question on oriental cholangiohepatitis, advantage of tc99m DTPA as a ventilation agent, how to determine field uniformity in nucs camera, technical question regarding dedicated pet scanner vs. dual head SPECT camera (with coincidence counting software)?
84.
What is the advantage of sulphur colloid nucs scanning over Tc rbc scanning for GI bleed?
a. Better for bleed in the splenic flexure
b. Better for UGI bleeds
c. More sensitive
d. Can be prepared quickly and hence the study can be done quickly
85.
Which is the most common cause of hepatic uptake during Tc99m MDP study:
a. metastatic disease
b. active hepatitis
c. abscess
d. massive hepatic necrosis
86.
Which of the following causes the greatest v/q mismatch?
a. fibrosing mediastinitis
b. radiation changes
c. hilar bronchogenic carcinoma
87.
A baseball pitcher with deltoid weakness, pain and parathesias over the shoulder region. Cause:
a. Brachial plexus injury
b. Entrapment of the axillary nerve in the quadrilateral space
c. DJD of the spine with encroachment of the nerve in the neural foramina
88.
A patient has chronic wrist pain particularly with ulnar deviation. Plain x-ray demonstrates cystic changes in the carpal bones particularly in the lunate with cystic changes also seen in the ulna:
a. RA
b. lunate malacia
c. rupture of the lunato triquetral ligament
d. gout
e. ulnar impaction syndrome
89.
A patient has repeated episodes of GI bleeding and has rash on the skin. Plain x-rays show focal areas of sclerosis and diffuse areas of sclerosis especially in the innominate bones:
a. Mastocytosis
b. Sprue
c. Whipples disease
d. Gardners syndrome
90.
A woman who has diabetes develops pes planus and periosteal reaction over the medial side of the ankle. Which of the following is the likely etiology:
a. Rheumatoid Arthritis
b. Rupture of the Achilles tendon
c. Posterior tibialis tendon rupture
91.
A young woman with a 3.5 cm sclerotic lesion, blends with the adjacent cortex in the proximal end of the humerus...bone scan shows slightly increased activity:
a. Osteoid osteoma
b. Mets
c. Bone island
d. Osteosarcoma
e. Osteoblastoma
92.
All except the following is located in the tarsal tunnel:
a. Sural nerve
b. Tibialis Posterior
c. Posterior tibial nerve
d. Flexor Hallucis Longus
e. Flexor Digitorum Longus
93.
Biciptal tendon dislocation associated with?
a. Supraspinatous tendon rupture
b. Rupture of superior glenohumeral ligament
c. Subscapularis tendon rupture
d. Rupture of the inferior glenohumeral ligament
94.
Ganglion cyst of the shoulder joint associated with?
a. Atrophy of teres major
b. Atrophy of the infraspinatous muscle
c. Tear of labrum lip
d. Atrophy of the supraspinatous muscle
95.
How does phenytoin cause osteomalacia?
a. Impaired metabolism of vitamin D in the kidneys
b. Impaired absorption of calcium from the intestines
c. Inhibition of hydroxylation of vitamin D in the liver
l
96.
In a pediatric patient, C1-2 instability may be caused by all except?
a. trauma
b. juvenile RA
c. hypothyroidism
d. down syndrome
e. spondyloepiphyseal dysplasia
97.
Swelling of the wrist and SLAC deformity associated with?
a. Gout
b. Calcium pyrophostate crystals
c. RhA
d. OA
e. HIAA disease
98.
The most common cause of fracture of the medial patellar lip?
a. lateral patellar dislocation
b. direct trauma
c. medial patellar dislocation
99.
The most common site to develop post traumatic osteolysis:
a. proximal femur
b. tibia
c. rib
d. humerus
e. clavicle
100.
Translocation of the carpals on the ulna:
a. CPPD
b. GOUT
c. RA
d. Psoriasis
101.
Triangular fibro cartilage divides which spaces?
a. Scapholunate and radioulnar
b. Radioulnar and radiocarpal
c. Radiocarpal and scapholunate
102.
Ultrasound of the rotator cuff injury, which is false?
a. complete nonvisualization of the rotator cuff
b. convex appearance of the subdeltoid subacromion bursa
c. fluid in the bicipital tendon and subdeltoid subacromion bursa
d. partial visualization of the rotator cuff
103.
Which is the commonest complication of a fracture of the growth plate of the distal phalanx of the great toe?
a. Infection
b. AVN
c. Growth disturbances
d. Subungal exostosis
104.
Which muscle attaches to the lesser tuberosity?
a. supraspinatous
b. teres minor
c. infraspinatous
d. subscapularis
105.
Which muscle group constitutes the pes anserinus?
a. gracilis, sartorius, and semitendinosis
b. semimembranosus, illiotibial band, and semitendinosis
c. sartorius, gracilis, and semimembranosus
d. popliteus, gracilis, and biceps femoris
106.
Which of the following is least likely to be multifocal:
a. Enchondroma
b. Fibrous dysplasia
c. Chondroblastoma
d. Fibrous cortical defect
107.
Which of the following is the commonest cause of failed hip prosthesis?
a. Loosening
b. Cement disease
c. Infection
108.
Which of the following is the commonest tarsal coalition?
a. Talocalcaneal at middle facet of subtalar joint
b. Calcaneonavicular
c. Talocalcaneal at posterior facet of subtalar joint
d. Talonavicular
109.
Which of the following tumors can cause osteomalacia?
a. Chondroblastoma
b. Hemangioperictyoma
c. Hemangioma
110.
Doppler ultrasound of the portal vein shows no flow. What do you do to image slow flow in it?
a. Quit
b. Scan in such a way as to decrease the Doppler angle
c. Increase pulse repetition frequency
d. Switch to lower transducer
111.
OB-US in patient with Downs syndrome demonstrates all except:
a. cerebral ventriculomegaly
b. pyelectasis
c. echogenic bowel
d. none of the above
e. short femurs and humerus
112.
On OB-US the pulmonary artery and the ascending aorta are seen in parallel. What is the diagnosis?
a. transposition of the great vessels
b. tetralogy of Fallot
c. truncus arteriosus
d. tricuspid atresia
113.
Regarding carotid ultrasound. Which is false?
a. Patient with hypertension would have increased blood velocities across a stenosis
b. Patient with bradycardia have decreased systolic velocity and increase diastolic velocity across a stenosis
c. Patient with AI would have absent or reversal of diastolic flow
d. Patients with occluded ICA would have increased velocity in the contralateral ICA
e. Patient with proximal ICA stenosis would have decreased velocity at the distal tandem stenosis
114.
Regarding the umbilical cord:
a. Arterial blood flow is from the placenta to the fetus
b. A systolic/diastolic ratio of 5 is normal in the third trimester
c. There are two veins and one artery
d. Blood sampling should be done close to the fetal insertion
115.
Sonographic evaluation of an a-v fistula, except:
a. may resolve spontaneously
b. central vein shows pulsatile increased velocity
c. distal artery shows increased velocity
d. proximal artery looses it triphasic waveform
e. speckled echoes in the soft tissue at the level of the fistula
116.
Ultrasound in a 2-week neonate showing hypoechoic regions in the basal ganglia bilaterally, lateral to the thalamus. Most likely cause:
a. anoxic injury
b. intraventricular hemorrhage
c. intraparenchymal hemorrhage
117.
Which are commonly associated with oligohydramnios?
a. Skeletal dysplasia
b. Transplacental infection
c. Amniotic fluid index of 20 or greater
d. IUGR
e. Meningomyelocele
118.
Which lesion is most likely to be hypoechoic within the liver?
a. hemangioma
b. lymphoma
c. adenoma
d. focal nodular hyperplasia
e. regenerating nodule
119.
Which of the following does not affect the Doppler frequency?
a. Angle of incidence
b. Frequency of the transducer
c. Pulse repetition frequency
d. Velocity of the target
e. Velocity of the sound in the medium
120.
Which of the following is not associated with IUGR?
a. Decrease diastolic velocity in the umbilical cord
b. Change in HC/AC ratio
c. Increased diastolic velocity in the carotid arteries
d. An amniotic fluid index of 20
121.
A 2 year old girl develops flank pain, burning micturition, fever, has pyuria. What is the next appropriate study?
a. Contrast enhance ct
b. IVP
c. Ultrasound of kidney and bladder
122.
A child with nursemaids elbow. What are the findings?
a. Dislocation of radial head from the annular ligament
b. Entrapment of the lateral collateral ligament between capitellum and radius
c. Posterior dislocation of the elbow
123.
A child with pustule on the hand, develops axillary and neck lymphadenopathy:
a. Kawasaki's disease
b. Lyme disease
c. Rocky mountain spotted fever
d. Cat scratch disease
124.
Patient with skin rash, cervical lymphadenopathy, cardiomegaly, intestinal pseuodobstructions and gall bladder hydrops:
a. Kawasaki's diseases
b. LGV
c. Lyme disease
d. Henoch Schonlein purpura
125.
The most common cause of precocious puberty in children:
a. hypothalamic hamartoma
b. pituitary microadenoma secreting prolactin
c. Rathke cleft cyst
d. hypothalamic glioma
e. craniopharyngioma
126.
The most common solid renal mass in a child less the 3 month old?
a. Wilms tumor
b. Mesoblastic nephroma
c. Renal Cell Carcinoma
127.
Which of the following has abnormalities of the conal septum:
a. Ebsteins abnormality
b. tricuspid atresia
c. tetralogy of Fallot
128.
Which of the following is the cause of cone shaped epiphysis in a child?
a. leukemia
b. congenital syphilis
c. heavy metal poisoning
d. cleido-cranial dysplasia
129.
What causes loss of signal on t2 weighted images?
a. manganese chelates
b. gadolinium chelates
c. iron oxide chelates
130.
A man sustains a trauma at a nuclear facility and is brought to the ER. What is the first step in the management of the patient:
a. try to decontaminate him
b. attend to his medical needs
c. determine the source of the contamination
131.
A cluster of 4/cc calcification is seen on screening mammogram. Diagnosis:
a. Benign findings
b. Category 0 needs additional imaging
c. Suspicious findings
d. Highly suggestive of malignancy
132.
A diagram of the biopsy needle during stereo tactic biopsy was given. You have to localize the needle point in relation with the lesion:
a. needle to the left of the lesion
b. needle too deep
c. needle too superficial
d. needle to the right of the lesion
133.
A diagram of the MLO and CC view was given with a lesion situated in the lower half on both view. Where is the lesion situated:
a. lower inner
b. lower outer
c. upper inner
d. upper outer
134.
A mammogram shows motion unsharpness. Which of the following is least appropriate step to eliminate it:
a. Increase KVP
b. Increase compression
c. Increase the density setting on the automatic exposure
135.
According to the Mammographic Quality Standards Act (MQSA), as of April 1999, phantom testing should be done at least:
a. Weekly
b. Monthly
c. Annually
d. Daily
136.
After biopsing a cluster of calcification which were seen on specimen radiograph the pathology report comes back no calcification seen. What do you do next?
a. Repeat the biopsy
b. Radiograph the paraffin block
c. Excisional biopsy
137.
At breast biopsy, the diagnosis of atypical ductal hyperplasia comes back. What is the next step?
a. I year follow up
b. 6 months follow up
c. Excisional biopsy
d. Repeat core biopsy
138.
Breast Cancer is most likely to occur in which site?
a. Lobule
b. Terminal Duct Lobular Unit
c. Major breast duct
139.
Breast screening trial is best assessed by:
a. survival rate
b. interval cancer rate
c. number of new cancers picked up each year for every 1000 woman screened
d. mortality rate
140.
During an initial screening mammogram a well circumscribed mass is seen which is not seen on ultrasound. What is the appropriate recommendation?
a. 6 months follow up
b. Benign
c. Stereotatic biopsy
d. Needle localization
141.
If a mass is seen medially only on the CC projection. Which is the next best step?
a. Stereotactic needle localization
b. Reversed CC projection
c. LM view
d. Ultrasound
142.
In 2000, how many new cases of breast cancer and breast cancer deaths were there?
a. 24,000 and 20,000
b. 140,000 and 34,000
c. 182,000 and 41,200
d. 80,000 and 67,000
e. 210,000 and 98,000
143.
In breast biopsy, the diagnosis of radial scar comes back. What should be the next step?
a. 1 year follow up
b. Repeat core biopsy
c. Excisional biopsy
d. 6 months follow up
144.
Patient is status post excisional biopsy of a cluster of microcalcifications. Pathology is positive for adenosis and LCIS. What is the most appropriate management?
a. Unilateral mastectomy
b. Lumpectomy and RT
c. Screening mammogram in 2 years
d. Bilateral mastectomy
e. Screening mammogram in 1 year
145.
The American Cancer Society (ACS), as of 1997, recommends screening mammography:
a. Every other year after 40, and every year after 50
b. Every year after 40
c. Every year after 50
146.
The area least well visualized on an MLO view of the breast is:
a. lower inner
b. lateral quadrant
c. upper inner
d. lower outer
e. upper outer
147.
What are the chances of malignancy in a well-circumscribed mass in breast?
a. 10%
b. 1 to 2 %
c. 50%
d. 5%
148.
Which cancer is most likely to be intra-cystic?
a. DCIS
b. Medullary
c. Mucinous
d. Papillary
e. Tubular
149.
Which carcinoma is most likely to be missed?
a. Ductal carcinoma in situ
b. Lobular carcinoma
c. Tubular carcinoma
150.
Which is most often missed on mammography?
a. Colloid carcinoma
b. Invasive lobular carcinoma
c. Invasive ductal carcinoma
d. Medullary carcinoma
e. Tubular carcinoma
151.
Which is the most important reason for x-raying the surgical specimen?
a. To document the removal of a non palpable lesion
b. To see if the tumor extends to the surgical margin
152.
Which of the following is diagnostic of a lymph node in breast sonography?
a. notched margin
b. lobulated
c. hyperechoic center
d. well circumscribed margin
153.
Which of the following is not an indication for breast cyst aspiration:
a. pain
b. increased size
c. low level echoes within it
d. lobulated margin
e. uncertainty whether the cyst corresponds to the mammogram abnormality
154.
Which of the following is not the cause of ductal calcification:
a. Pagets disease
b. DCIS
c. Adenosis
d. Secretory disease
155.
Which of the following is the most consistent feature of inflammatory carcinoma of the breast?
a. Multicentric and multifocal carcinoma
b. Inflammatory reaction to the carcinoma
c. Invasion of the dermal lymphatics
156.
Which of the following may not be the appropriate step to decrease dose in mammogram?
a. Increase compression
b. Use faster screen film combination
c. Change to tungsten target
d. Decrease kVp
157.
Which of the following should be checked monthly in mammography?
a. View box cleanliness
b. Darkroom cleanliness
c. Film-screen contact
d. Phantom
e. Visual checklist
158.
A patient who has PE and is on heparin at 1000 units/hr and PTT of 80. Now develops a cold, pale and swollen left lower extremity. What should be done?
a. Increase the heparin drip to 1500
b. Do a venogram
c. Do a arteriogram
d. Stop the heparin
159.
A patient who uses crutch comes with blue tinge hands, intact pulses. Bounding axillary pulses and pain, tenderness and indurations in the axillary region:
a. Axillary artery thrombosis with distal microemboli
b. Axillary artery pseudoaneurysm with distal micro emboli
c. Reflex sympathetic dystrophy
160.
Causes of unilateral rib notching except:
a. Blalock Taussig shunt
b. brachial stenosis
c. AVM of the extremity
d. left aortic arch with aberrant right subclavian artery.
e. coarctation between innominate and left common carotid
161.
For catheter induced vasospasm in the popliteal artery. Treated best with intraarterial infusion of:
a. vasopressin
b. papaverine
c. nitroglycerine
d. tolazoline
162.
In the figure of 8 configuration or snowman's heart, what causes the left bulge in the superior mediastinum (Patient with TAPVR) ?
a. Vertical vein
b. SVC
c. Pulmonary artery
163.
One might encounter the highest pulmonary vascular resistance in:
a. Capillary bed
b. Muscular arterioles
c. Main pulmonary artery
d. Segmental pulmonary artery
164.
Patient with pelvic fracture has large hematoma in the pelvis. Angio reveals bleeding from the obturator artery. What do you do next?
a. Peripheral embolization of obturator artery with gel foam and PVA
b. Embolization of the origin of the internal iliac artery by GDC coils
c. Surgical ligation of the internal iliac artery
165.
Regarding coronary artery calcification which is true?
a. It can happen without atherosclerosis if seen in patient over 70 years of age
b. Gated CT is not required if done fast enough
c. More severe the stenosis, more likely the calcification
166.
Regarding effort thrombosis which is false?
a. Common in old woman
b. Occurs after a strenuous arm exercise
c. Thrombolysis of the clot is an acceptable treatment
d. Due to thoracic outlet syndrome
167.
Regarding FMD of the carotid arteries. Which of the following is false:
a. Intracranial saccular aneurysm
b. Unilateral
c. String of beads appearance
d. ICA more common than ECA
168.
Regarding glucophage (Metformin) and contrast what is true?
a. Glucophage causes lactic acidosis in a patient with renal insufficiency
b. You cannot give contrast to someone who has not stopped glucophage 48 hours before the test
c. It causes renal failure if contrast is given
169.
Regarding transvaginal and transrectal abscess drainage which is false?
a. Crohns is a relative contraindication
b. Antibiotic should not be given before obtaining a sample for Culture and Sensitivity
c. Bleeding diathesis is a relative contraindication
170.
The most specific sign for pericardial effusion is:
a. dilated azygous vein
b. non visualization of cardiac pulsation
c. bottle shaped heart
d. cephalization of cardiac vasculature
171.
The reason why post MI pseudoaneurysm is important clinically is because:
a. can cause arrhythmias
b. cause systolic dysfunction
c. cause cardiac emboli
d. they can rupture
172.
Trauma patient with holosystolic murmur and pulmonary edema:
a. Rupture of the papillary muscle
b. Rupture of the AV septum
173.
What is the absolute contraindication for transcatheter thrombolysis?
a. CVA in past 2 months
b. Pregnancy
174.
What is the indication for TIPS:
a. Variceal bleeding which has failed sclerotherapy
b. Hepatic encephalopathy
175.
Which disease causes abnormality of the cardiac valves:
a. Insulinoma
b. Hepatoma
c. Carcinoid tumor
176.
Which does not have effect on the heart size?
a. KVP
b. Phase of respiration
c. Oblique positioning
d. Phase of cardiac cycle
e. Pa vs. ap
177.
Which is likely to cause a symptomatic vascular ring?
a. left aortic arch with aberrant right subclavian
b. right aortic with aberrant left subclavian
c. left pulmonary artery arising from the right pulmonary artery
d. mirror imaging branching
178.
Which is not associated with left atrial enlargement:
a. Atresia of the mitral valve
b. Atrial fibrillation
c. Decreased compliance of the left ventricle
d. Atrial myxoma
179.
Which is not true about post cardiac injury syndrome [Dresslers syndrome]:
a. Fever
b. Transient pulmonary infiltrates
c. Pericardial effusion
d. Pleural effusion
180.
Which is the absolute contraindication for TIPS?
a. Portal vein thrombosis
b. Hepatic encephalopathy
c. Variceal bleeding
d. Ascites
e. None of the above
181.
Which is the best MRI sequence for evaluating the flow dynamics in the heart?
a. T1 weighted spin echo
b. Gradient echo
c. Time of flight
d. ECG gated T2
e. T2 weighted spin echo
182.
Which is the most sensitive sign of left atrial enlargement on frontal radiograph:
a. Double contour
b. Elevation of left main stem bronchus
c. A bump in the left heart border below the left hilum
183.
Which is true about angioplasty of renal artery stenosis?
a. FMD has a 30 % rupture rate
b. Ostial lesion respond better than non ostial lesion
c. Hypertension cure in 90% of the cases
d. Hypotension is a complication
e. Should not be performed if renin levels do not lateralize
184.
Which is true about atrial myxoma?
a. Attached to mitral valve leaflets
b. Presents clinically similar to aortic stenosis
c. It is mobile and attaches to the atrial septum
185.
Which of the following causes abnormal anterior motion of the anterior mitral valve leaflet?
a. mitral valve prolapse
b. mitral valve stenosis
c. IHSS
d. AS
186.
Which of the following does not cause pulmonary arterial hypertension?
a. Chronic PE
b. COPD
c. Pulmonary AVM
d. Eisenmenger complex
187.
Which of the following is true regarding thyroglossal duct cysts?
a. Commonly demonstrate thick rim enhancement
b. Most often superficial to the strap muscles
c. Most often septated
d. Papillary carcinoma is the most common tumor to arise in these cysts
188.
Which tumor is most likely to have drop mets:
a. Medulloblastoma
b. Ependymoma
189.
A 40 year old comes in with seizures. CT shows hypodensity in bilateral temporal lobe and cingulate gyrus without any mass effect. Most likely cause?
a. Low-grade glioma
b. Mesial temporal sclerosis
c. Herpes encephalitis
190.
A hyperdense mass with attenuation of 30-50 with surrounding well defined thin enhancement:
a. abscess
b. Lymphoma
c. high-grade glioma
d. aging hematoma
191.
A right paracentral L4/L5 disc herniation most likely causes which nerve impingement:
a. S-1
b. right L5
c. right L4
d. none
e. right L4 and L5
192.
A young woman comes in with sudden onset of blurred vision. CT shows a pituitary mass with suprasellar extension. This mass has area of high attenuation and fluid level. Cause:
a. pituitary apoplexy
b. craniophyrangioma
c. sarcoidosis
d. germinoma
e. metastatic disease
193.
About posttraumatic vertebral collapse, which is true:
a. Development of large osteophytes
b. Involvement of the adjacent disc space
c. The vertebral body becomes increasingly dense
d. Juxtaarticular erosions
194.
Brain MR reveals multiple bright areas of T2 signal intensity within the cortical and subcortical white matter of the occipital lobes bilaterally in a young woman. There is no evidence of hemorrhage or significant mass effect. Repeat MR imaging in 2 weeks is normal. This is most consistent with which of the following?
a. Superior sagittal sinus thrombosis
b. Eclampsia/Pre-eclampsia
c. Tip of the basilar artery syndrome
d. Herpetic encephalopathy
e. Progressive multifocal leukomalacia
195.
Branchial cleft cyst, which is true?
a. 1st Branchial arch more common
b. Commonest at the angle of mandible
c. Commonly presents in adolescent
d. Commonly multilocular
196.
Child with dehydration and mental status changes. CT showing bilateral thalamic hemorrhage with mass effect. Cause:
a. basilar artery thrombosis
b. hemorrhagic PNET
c. deep vein thrombosis
197.
Infants of diabetic mother can get which congenital abnormality:
a. meningomyelocele
b. caudal regression syndrome
c. renal agenesis
198.
On SPECT imaging (ECD), which pattern does patient with Alzheimer have:
a. decreased activity in the parietal lobe
b. increased activity in the temporal lobe
c. increased activity in frontal lobe
199.
Patient with neurofibromatosis and has pulsatile exophthalmos:
a. Meningioma
b. Sphenoid wing dysplasia
c. CC fistula
d. Enlargement of the optic foramina
200.
Patient with small subcortical shear injury. Which is the best MR sequence for evaluating it:
a. T1, T2 spin echo
b. Flair sequence
c. Gradient echo T2
201.
Patient with Wernickes encephalopathy would have atrophy of which cranial structure:
a. caudate lobe
b. hippocampus
c. mamillary body
d. substantia nigra
202.
Regarding anatomy of the orbit:
a. the trochlea is situated on the lateral side of the orbit
b. annulus of zinn divides the globe into anterior and posterior compartment
c. the ophthalmic artery is situated inferior to the superior opthalmic vein
d. the inferior oblique is supplied by the trochlear nerve
203.
Submental lymph node is classified as what level node:
a. 2
b. 1
c. 3
204.
The anterior longitudinal ligament is disrupted in which fracture?
a. pillar fracture
b. hyperextension strain
c. hyperextension dislocation
205.
The cause of the Wallenberg syndrome is:
a. occlusion of ICA
b. occlusion of ipsilateral PICA
c. occlusion of superior cerebellar artery
d. occlusion of contralateral PICA
206.
The most likely location for an intraventricular Meningioma is:
a. aqueduct of sylvius
b. atria of the lateral ventricle
c. third ventricle
207.
There was a simple question regarding the location of the facial nerve in the IAC:
a. Inferior to crista falciformis
b. Inferior to cochlear nerve
c. Superior to the cochlear nerve
208.
What is true about parotid gland tumors?
a. Warthin tumors are more common in females
b. pleomorphic adenoma usually is located deep to the facial nerve
c. pleomorphic adenoma is the commonest
d. Warthin tumors spread via perineural route
209.
Which is false regarding Dyke Davidoff Mason syndrome or unilateral atrophy:
a. Enlargement of one side ventricles
b. Unilateral thick skull
c. Large paranasal sinuses
d. Underpneumatazition of mastoids
e. Unilateral decrease in size of cranial fossa
210.
Which is most likely to cause acute neurological sequela:
a. Atlanto occipital dislocation
b. Isolate fracture of the posterior arch of C1
c. Hyperextension tear drop
211.
Which is the most benign feature of thyroid mass?
a. Punctate calcification
b. Peripheral eggshell calcification
c. Multinodularity
212.
Which of the following is a contraindication for performing a MRI:
a. Stuart Edwards valve
b. Greenfield filter
c. hip prostheses
d. metallic foreign body within the eye