Download الاشعة التشخيصية - Palestine Medical Council

Palestine Medical Council Examination
Diagnostic Radiology
Answer each item in each of the following questions using false or true (Qs 1-60)
1. In the normal radiograph of the chest :
A. There are three lobes in each lung.
B. The accessory fissure is seen in up to 1% of the population.
C. A superior accessory fissure may be seen separating the anterior segment of the
upper lobe from the apical segment of the lower lobe.
D. Tracheal cartilage calcification commonly appears between 20 and 30 years of
age.
E. The inferior pulmonary ligaments are pleural reflections.
2. Concerning pleural tumors :
A. Hypertrophic osteoarthropathy is a well-recognized complication of localized
mesothelioma.
B. Pleural tumors usually make an acute angle with the chest wall on the chest
radiograph.
C. The commonest pleural neoplasms are metastases from adenocarcinomas.
D. Liposarcomas exhibit homogeneous soft-tissue attenution on CT.
E. Malignant pleural fibromas are typically of low signal intesity on T1-and T2weighted images.
3. Regarding mediastinal masses :
A.
B.
C.
D.
E.
More than 50% of thymomas are malignant.
Calcification seen in a thymic tumour signifies a benign lesion.
On MRI, thymomas are isointense to muscle on T1- weighted images.
Thyrotoxicosis is a recognized association of thymic hyperphasia
Within a mediastinal mass, the presence of fat, either as a focal collection or
fluid fat, favors a diagnosis of benign cystic teratoma over other diagnosis.
4. Regarding pneumonia :
A. Lobar expansion is commonly a feature of klebsiella pneumonia infection.
B. Pneumocystis carinii pneumonia (PCP) is a cause of pneumatocele.
C. Cavitation and abscess formation are seen in 20-30% of mycoplasma
pneumonias.
D. Empyemas are commonly associated with streptococcus pneumonia infection.
E. The apperance of a large irregular cavity containing an irregular intracvitary
body is a recognized complication of klebsiella pneumonia infection.
5. Regarding pulmonary tuberculosis :
1
A. Normal chest radiographs are seen in 5% of patients with pulmonary
tuberculosis.
B. Bilateral pleural effusions are commonly seen in primary pulmonary
tuberculosis.
C. In post primary tuberculosis, the initial lesion arises in the anterior segments of
the upper lobe in 95% of patients.
D. Cavitary tunerculosis is associated with Rasmussen aneurysm.
E. In patients with miliary tuberculosis, calcification of the nodules is seen in
approximately 10% of cases.
6. Concerning emphysema :
A. Centrilobular emphysema is associated with α1-antitrypsin deficiency.
B. Panlobular emphysema is most severe in the lower lobes.
C. Paraseptal emphysema predominantly involves the air spaces located in the
distal part of the secondary pulmonary lobule.
D. Paracicatricial emphysema occurs in patient with pulomonary fibrosis.
E. Focal areas of emphysema usually have distinct walls on CT images.
7. Regarding pulmonary neoplasms:
A.
B.
C.
D.
E.
8.
Squamous cell carcinomas compromise 15-20% of cases.
A” corona radiate” appearance of a mass strongly suggests the presence of a
bronchial carcinoma.
Calcification is seen in 10% of bronchogenic carcinomas on conventional chest
radiographs.
The demonstration of a peripheral line shadow or tail is pathognomomic of
malignancy.
In bronchial carcinoma, 40-60% of patients are asymptomatic at time of
diagnosis.
Pulmonary metastases :
A. Nodules with an irregular edge are suggestive of metastases form an
adenocarinoma.
B. Calcification is common when the primary tumor demonstrates calcific deposits.
C. Is a rare cause of an asymptomatic solitary pulmonary nodule in patients without
a known extrathoracic primary neoplasm.
D. CT is the most cost-effective method of finding pulmonary metastases.
E. MRI is more sensitive in detecting metastases than CT.
9.
Regarding sarcoidosis :
2
A. Eighty per cent of patients with enlarged lymph nodes on the chest radiograph
develop parenchyma opacities within 1 year.
B. Less than 20% of patients with the disorder have an abnormal chest radiograph.
C. Broncho vascular nodular beading is a highly specific feature of sarcoidosis on
high resolution CT.
D. Twenty per cent of patients have concomitant pleural effusions
E. In 20% of patients, lymphadenopathy presists indefinitely and can be confused
with other subsequent incidental chest pathology.
10. Regarding the imaging of pulmomary thromboembolism :
A.
B.
C.
D.
E.
Emboli confined to the sub-segmental pulmonary arteries can result in a false –
negative diagnosis on spiral CT.
The optimum concentration of contrast medium is 350 mg/ml of iodine for a CT
pulmonary angiogram.
Hampton’s hump describes a typical plain – film appearance of a pulmonary
infarct.
Sterile cavitation of pulmonary infarcts occurs in 10% of cases.
Consolidation involving an entire lobe is unlikely and should suggest an
infective aetiology.
11. Regarding fractures to the spine :
A. The “swimmers view “is necessary to see the upper 3 thoracic vertebra
B. Compression fractures are the commonest injury to the thoracic spine.
C. Fracture dislocation most commonly occurs in the upper thoracic spine and lower lumbar
spine.
D. The chance fracture is associated with significant vertebral body compression.
E. Isolated fractures of the posterior elements are common isolated injuries.
12.
The follwoing are recognized features of benign bone lesions
A.
B.
C.
D.
E.
Less than 10 years old.
Solitary lesions.
Giant cell tumors and chondroblastomas metastasize.
A lodwick type III pattern.
A thick well – defined periosteal reaction.
13. Concerning chondroblastoma :
A.
B.
C.
D.
E.
The lesion typically occurs in the diaphysis.
Most tumors affect the immature skeleton.
Pain is the predominant presenting feature.
The main differential diagnosis is a giant cell tumor.
There is a high recurrence rate after curettage.
14. Regarding spinal injuries :
A. Image reconstruction is usually required when CT has been preformed
3
B. There is a direct correlation between the MR signal characteristics and the
histopathology of spinal cord trauma.
C. Isolated fractures of the vertebral body or posterior elements are usually stable.
D. Unstable fractures arise from multilevel injury.
E. Lumbar spine haematomas are easily demonstrated on AP radiographs.
15. Concerning osteosarcoma :
A.
B.
C.
D.
E.
16.
The radiological changes of sickle cell disease are :
A.
B.
C.
D.
E.
17.
Osteosarcoma is the commonest primary malignant tumor of bone after myeloma.
Eighty per cent of patients are older than 25 years.
There is a second peak incidence towards middle age.
The tumor typically elevated the serum acid phosphates.
Regional lymph nodes are not usually involved early in the disease.
Early skeletal maturation.
Marrow hyperplasia.
Bone infarction.
Soft – tissue calcification.
Secondary osteomyelitis.
Concerning multiple myeloma :
A. This is the commonest primary malignancy of bone.
B. Widespread skeletal involvement is demonstrated in 40% of patients at presentation.
C. Bence Jones protein is present in the urine in over half the patients presenting with
myeloma.
D. Bonly lesions appear typically well defined.
E. A typical radiological finding includes generalized osteopeina.
18.
The following are associated with a general loss of bone density :
A.
B.
C.
D.
E.
F.
19.
Concerning rheumatoid arthritis :
A.
B.
C.
D.
E.
20.
Osteogeneses imperfecta.
Addison’s disease.
Hyperpituitarism.
Sickle cell anaemia.
Hyperphosphatasia.
Symmetrical soft – tissue swelling is typical.
Marginal erosions occurring in the ‘bare area ‘of bones.
Subchondral cysts and bone erosions are typical.
Joint malalignment without evidence of bony erosions.
Generalized osteopenia.
Concerning anterior cruciate ligament disruption :
A.
B.
Posterior tibial disruption may be seen.
An over – straightened patella ligament.
4
C.
D.
E.
A’ bunched up ‘posterior cruciate ligament.
The accuracy of MRI is approximately 70%.
The second fracture is present in over 95% of patients with ACL disruption.
21. The followings are used in the X-ray tube :
A.
B.
C.
D.
Tungsten filament.
Focusing cup.
Gas vapour.
Lead anode.
E. Aluminum filtration.
22.
In radiation protection, the followings should be considered :
A.
B.
C.
D.
E.
23.
The following can be radiation risks :
A.
B.
C.
D.
E.
24.
Leukemia.
Cataract.
Skin epilation.
Decrease sperm count.
Decrease white cell count.
The followings are used for the examination of the sinuses :
A.
B.
C.
D.
E.
25.
The dose should not exceed a limit to the workers.
The dose should not exceed a limit to the patient.
The dose should be kept as low as reasonably as possible.
Any examination should be clinically justified.
The radiologist should wear a lead glass all the time.
Water’s view.
Lateral skull X-ray.
Postero-anterior skull X-ray.
Panoramic view.
CT scan of the facial bones.
In CT scan, the CT values or numbers mean:
A. Zero for fat.
B. + 1000 for bone.
C. – 100 for air
D. Related to the linear attenuation coefficient.
E. +100 for water.
26.
The following radio isotopes are used for these scans :
A.
B.
Tc 99m DTPa for renal scan.
Tc 99m DMSA for bone scan.
5
Tc 99m HIDA for the heart.
Thallium 201 for the liver.
Galium for bone infection.
C.
D.
E.
27.
The technitium 99m is considerd the ideal isotope because :
A.
B.
C.
D.
E.
28.
In utrasound scan :
A.
B.
C.
D.
E.
29.
Magnetic field is used.
Can be used in brain tumors.
Is contraindicated in patients with heart pace maker.
Is contraindicated in patients with previous aneurismal clipping
T1 and T2 weighted images are basically the same.
In obstetrics , the ultrasound scan can show the followings :
A.
B.
C.
D.
E.
31.
Placenta previa.
Spina bifida.
Ovarian cyst.
The kidney of the fetus can be seen at 10 weeks gestation.
The heart of the foetus can be seen at 3 weeks gestation.
Regarding chest radiography :
A.
E.
32.
Magnetic field is used.
2 MH2 transducer is used for the heart scan.
7 MH2 transducer is used for abdomen scan.
Is not used in early pregnancy.
Is not used to scan neonatal hip.
Magnetic resonance imaging :
A.
B.
C.
D.
E.
30.
It has 6 hours half life time.
Widely available.
Photon energy is optimum for the gamma camera.
Cheap.
Can be supplied by generators.
Lateral decubitus radiography can detect pleural effusions of less than 20 ml.
B. Expiratory films are mandatory in a patient with a history of foreign body
inhalation.
C. Conventional tomography has better spatial resolution than computed
tomography (CT).
D. Reasonable high – resolution CT windows for parenchyma imaging would
be: centre + 500 and width 1500 HU.
CT adrenal imaging is recommended in most patients undergoing CT scanning
of a solitary pulmonary nodule.
Regarding the thymus :
6
A. Prior to puberty the thymus occupies most of the mediastinum in front of the
great vessels as seen on the CXR.
B. The CT density (HU) of the thymus tends to decrease with age.
C. Thymomas tend to occur in-patient less than 20 years of age.
D. ACTH is the commonest ectopic hormone to be produced by thymic carcinoid
tumour.
E.
Eighty to ninety percent of patients with thymomas have myasthenia gravis.
33.
Calcifications in the kidney can occur in the followings:
A.
B.
C.
D.
E.
.
Tuberculosis.
Hydatid disease.
Carcinoma
Simple cyst.
Nephrocalcinisis
34. The following should be considered as normal findings in chest imaging :
A. Tracheal cartilage calcification at 20 year of age.
B. On the erect CXR the upper-lobe anterior segmental artery and bronchus should
have the same diameter.
C. Discrete hilar nodes on CT scanning of the chest.
D. The right main bronchus and the bronchus intermedius are outlined by air .
E. A vascular structure seen between the middle-lobe bronchus and the right lowerlobe bronchus of the lateral CXR.
35.
Concerning pulmonary consolidation :
A. The consolidation associated with pulmonary sarcoidosis is due to granulomata
within the alveoli.
B. A segmental distribution is characteristic.
C. Desquamative interstitial pneumonuia interstitial process producing alveolar
compression.
D. There is usually associated loss of volume.
E. Early changes include acinar nodules / shadows 1-4 mm in diameter.
36.
Cerebral abscesses:
A.
B.
C.
D.
E.
37.
Are most commonly caused by streptococci.
25%arise from haematogenous spread of infection.
25% arise from spread of infection from adjecent structure.
Often contain gas.
Tend to be loculated.
Acromegaly causes:
A. Kyphosis.
7
B.
C.
D.
E.
Anterior scalloping of the vertebral bodies.
Chondrocalcinosis.
Calcification of the pinna of the ears.
An enlarged sella turcica.
38. Concerning liver anatomy:
A. The middle hepatic vein drains both lobes of the liver.
B. The right hepatic vein divides the right lobe of liver into a superior sector and an
inferior sector.
C. The left lobe of liver is divided into an anterior and a posterior sector by the left
portal vein.
D. The caudate lobe receives branches from both left and right portal veins.
E. Calcification of liver parenchyma may be a normal finding in the eldery.
39.Concerning focal liver lesions:
A. Daughter cysts develop within a larger mother cyst in hydatid disease.
B. A prominent air-fluid level in an intrahepatic mass implies that it is an abscess.
C. “ Filling in “ of a lesion on delayed contrast _enhanced CT means it is almost
certainly a haemangioma.
D. A central, hyper reflective “punctum “surrounded by echo-poor foci is a feature
of fungal abscess.
E. High _ attenuation abdominal deposits may ocur in angiosarcoma.
40. Regarding the ultrasound imaging of liver disease:
A. Regenerating nodules are usually very small and cannot be demostrated by
imaging techniques.
B. Acute hepatitis and diffuse tuberculosis are causes of a “bright “liver.
C. A fasting protal venous velocity of more than 12 cm per second does not occur
in portal hypertension.
D. High – velocity spectral traces are seen in relation to most hepatomas.
E. Daughter cysts are present in 80-90% of liver hydatid cysts.
41. Regarding the radiology of hepatomas:
A.
B.
C.
D.
Thorotrast exposure predisposes to the development of hepatomas.
Calcification is seen in 30-40% of hepatomas.
Angioraphy plays a significant role in the initial diagnosis of hepatomas.
Complete non-enhancerment of a liver lobe on CT after intravenous contrast
administration yields the “straight – line sign “that is diagnostic of portal venous
occlusion.
E. The presence of portal vein thrombosis makes the diagnosis of hepatoma virtually
certain.
42. Pheochromocytoma:
A. Are usually less than 5 mm in size.
8
B.
C.
D.
E.
10% are malignant.
95% are intrabdominal.
Are associated with neurotibromarosis in 15%.
Are associated with multiple endocrine neoplasia type I.
43. Intracranial aneurysms:
A.
B.
C.
D.
E.
Are giant if larger than 10mm.
10% arise from the anterior communicating artery.
Bleeding is uncommon.
Calcification is uncommon.
Are multiple in 20% of cases.
44. Regarding the plain abdominal radiograph:
A.
B.
C.
D.
The presence of more than two air-fluid levels in dilated small bowel is abnormal.
A caecal fluid level is an abnormal finding.
It is unusual for the bowel caliber to be less than 5cm in severe large lowel obstruction.
Normal fluid levels are usually shorter than 205cm in length.
E. A (string of beads) sign caused by bubbles of gas trapped between valvulae conniventes
is seen after cleansing enema administration.
45. Intrahepatic calcification is caused by:
A.
B.
C.
D.
E.
Chronic granulomatous disease of chilhood.
Cavernous haemangioma.
Portal vein thrombosis.
Armillifer armillatus infestation.
Hepatic adenoma.
46. Causes of adrenal calcification in adults, include:
A.
B.
C.
D.
E.
Adrenal adenoma.
Adrenal hyperplasia.
Wolman disease
Sarcoidosis.
Addison’s disease
47. Small bowel air-fluid levels are caused by :
A.
B.
C.
D.
Large bowel obstruction.
Hyperkalaemia.
Peritoneal metastases.
Gastroenteritis.
E. Mesenteric thrombosis.
48. Regarding uncorrected transposition of the arteries (UTGA)
9
A. UTGA is the commonest type of congenital heart disease causing central cyanosis at or
shortly after birth.
B. Isolated UTGA has a better prognosis than one complicated by a VSD.
C. The heart size is usually normal at birht.
D. Is associated with pulmonary plethora and prominent main pulmonary artery.
E. Indomethacin is given at birth to maintain ductal patency.
49. Regarding transposition of the great arteries:
A.
B.
C.
D.
E.
UTGA is usually associated with right – sided aortic arch.
Angiocardiography is mandatory to decide UTGA treatment.
Corrected TGA is less common than UTGA treatment.
The cardiac contour of CTGA is suggestive of an “egg on its side”.
MRI is useful for post-operative follow –up.
50. Meningiomas:
A.
B.
C.
D.
E.
Form 25% of primary intracranial tumors.
Calcification is seen on plain films in 50%.
Hyperostosis is seen in 90% of basal tumours.
May enlarge the internal auditory meati.
Are homogenous on MRI.
51. Gall stones:
A.
B.
C.
D.
Occur in 10-15% of adults.
Are 5 times in women.
Cholesterol stones are associated with cirrhosis.
Are found in two thirds of patients with pancreatitis.
E. 50% of pigmented stones are radio-opaque.
52. Calcification in the liver:
A.
B.
C.
D.
In hepatocellular carcinoma.
In haemangioma.
Is curvilinear in hydatid disease.
Is nodular in tuberculus granulomata.
E. Is seen in 20% of cases of cholangio carcinoma.
53. Gas in the liver:
A.
B.
C.
D.
E.
In the portal vein in narcotizing enterocolitis.
May be seen post ERCP examination .
In the biliary tree is a life threatening condition .
Is seen in the portal vein after bowel infarction.
Is seen in the portal vein with acute pancreatits.
54. Arnold Chiari malformation:
A. Type I is seen in 10% of normal population.
10
B.
C.
D.
E.
Type I is involving the medulla oblongata.
Type I is involving the cerebellar tonsils only.
Type II shows myelomeningocele in 50%
50% of symptomatic type I will have syringomyelia.
55. The follwoing may mimic an acute abdomen:
A.
B.
C.
D.
E.
Basal pneumonia.
Myocardial infarction.
Primary tuberculosis.
Post-primary tuberculosis.
Dissecting aortic aneurysm.
56. Dilated ureters can be due to:
A.
B.
C.
D.
E.
Vesico-ureteric reflux.
Diabetes insipidus.
Diabetes mellitus.
Enlarged prostate.
Bladder stones.
57. Esophageal varices can occur secondary to :
A.
B.
C.
D.
Liver cirrhosis.
Superior vena cava obstruction.
Inferior vena cava obstruction.
Superior mesenteric artery thrombosis.
E. Inferior mesenteric artery thrombosis.
58. Increased transradiancy of the left haemithorax can be due to
A.
Left sided pneumothorax.
B.
Right-sided-pneumothorax.
C. Left-sided pleural effusion.
D. Right-sided pleural effusion.
E. Absent left pectoralis major
59. Bilateral symmetrical enlarged hilar hymph nodes are seen in:
A.
B.
C.
D.
E.
Miliary tuberculosis.
Lymphoma.
Sarcoidosis.
Leukemia.
Cryptogenic fibrosing alveolitis.
60. Breast cancer :
A.
B.
C.
D.
E.
Usually occurs mostly between 20 and 30 years of age.
Ultrasound is the examination of choice.
Ultrasound is accurate in detecting micro-calcification.
Mammography is the examination of choice.
MRI can distinguish recurrent tumour from surgical scar.
11
Choose the most appropriate single answer
(Qs 61- 120):
61. Solitary sclerotic bone lesion can be seen in EXCEPT:
A.
B.
C.
D.
E.
Bone island.
Metastases.
Primary bone sarcoma.
Bone infarct.
Bone lesion in hyperparathyroidism.
62. Lytic skeletal metastases can be seen in EXCEPT:
A.
B.
C.
D.
Lung carcinoma.
Wilm’s tumor.
Prostatic tumor.
Ovarian tumor.
E. Adrenal carcinoma.
63. All the following pediatric tumors metastasize to bone EXCEPT
A.
B.
C.
D.
Neuroblastoma.
Lymphoma.
Retinoblastoma.
Medulloblastoma.
E. Rhabdomyosarcoma.
64. Moth-eaten bone can be present in EXCEPT:
A.
B.
C.
D.
Multiple myeloma.
Ewing’s sarcoma.
Chondrosarcoma.
Osteomyelitis.
E. Regional osteopenia.
65. Rib-notching inferior surface can be seen in all the following, EXCEPT:
A. Coarctation of the aorta.
B. Sclerodermia.
C. Aortic thrombosis.
D. Subclavian obstruction.
E. Sperior vena cava obstruction.
66. Ivory vertebral body can be seen in, EXCEPT:
A. Metastases.
B. Paget’s disease.
C. Sclerodermia.
D. Lymphoma.
12
E. Hemangioma.
67. Sacroilitis can be seen in, except:
A.
B.
C.
D.
Ankylosing spondylitis.
Crohn’s disease.
Ulcerative colitis.
Reiter’s syndrome.
E. Osteochondritis dissicans.
68. Intraspinal extradural masses can be due to, except:
A.
B.
C.
D.
E.
Prolapsed intervertebral disc.
Metastases.
Astrocytoma.
Neurofibroma.
Haematoma.
69. An ill-defined lucent bone lesion in the medulla can be due to, EXCEPT:
A.
B.
C.
D.
Metastases.
Ewing’s sarcoma.
Osteomyelitis.
Lymphoma of the bone.
E. Chondromyxoid fibroma.
70. Solitary pulmonary nodule of the bronchus can have the following
radiologic features, EXCEPT:
A.
B.
C.
D.
E.
Calcification is common.
Rapid growth.
Size greater than 4 Cm.
The lesion crosses a fissure.
Ill-defined margins with speculation.
71. Unilateral hypertransradiant Hemithorax can be due to all the
followings, EXCEPT:
A.
B.
C.
D.
E.
Scoliosis.
Pneumothrax.
Poliomyelitis.
Compensatory emphysema.
Adult respiratory distress.
13
72. Bronchial stenosis or occlusions can be caused by the following except:
A.
B.
C.
D.
E.
Foreign body.
Mucous plug.
Lymph nodes.
Bronchial adenoma.
Prolonged tracheal intubations.
73. Increased opacification of a hemithorax could be due to the followings
EXCEPT:
A.
B.
C.
D.
E.
Acute bronchitis.
Pneumonia.
Radiation pneumonitis.
Diaphragmatic hernia.
Post-pneumonectomy.
74. Bronchiectasis radiologic findings include the followings, EXCEPT:
A.
B.
C.
D.
E.
Peribronchial thickening.
Crowded vessels.
Labor consolidation.
Coarse honeycomb pattern in very severe diseases.
Could be normal in 70%.
75. Radiologic signs of wide spread air space (acinar) disease includes the
followings, EXCEPT:
A.
B.
C.
D.
E.
Well defined margins.
Acinar nodules 4-10 mm diameter.
Mostly non segmental.
Air bronchogram.
Air bronchogram and alveologram.
76. Regarding Kerly B lines, the following are true, EXCEPT:
A.
B.
C.
D.
E.
They are 1-3 cm. long extending perpendicular to the pleural surface.
Best seen in the costo-phrenic angles.
Seen in aortic stenosis.
Seen in left ventricular failure.
Present in lymphangitis carcinomatosa.
77. The X-ray tube is made of:
A.
B.
C.
D.
E.
Tungsten.
Lead.
Pyrex.
Concrete.
Barium.
14
78. Barium is the best gastro intestinal tract contrast medium because:
A.
B.
C.
D.
E.
It is of low atomic number.
It is safe.
Can be used in perforated viscus.
Can be used in tracheo- oescphageal fistula.
Can be used immediately post-operative.
79. The following contrast medium is used in tracheo- esophageal fistula:
A. Barium.
B. Gastrograffin.
C. Ionic- water sdoluble contrast.
D. Non- ionic water soluble contrast.
E. Air.
80. Scatter radialion means:
A. X- rays not reaching the patient.
B. X- rays not reaching the film.
C. High energy X- ray photons resulting from Compton effect.
D. High energy X- rays resulting from photo-electric effect.
E. High energy X-rays resulting from complete absorption by the nucleus.
81. The Followings are views used for skull, except:
A.
B.
C.
D.
E.
Postero anterior.
Antero postenior.
Lateral.
Water’s view.
Submentovertical.
82. Chest X-ray is done with the focus film distance is:
A.
B.
C.
D.
60 cm.
90 cm.
120 cm.
150 cm
E. 180 cm.
83. The following chambers are seen on standard chest X-ray, EXCEPT :
A.
B.
C.
D.
E.
The left atrium.
The right atrium.
The left ventricle.
The right venticle.
The aortic arch.
15
84. At 18 weeks gestation the following are seen EXCEPT:
A. The fetal femur.
B. The lateral ventricles in the fetus head.
C. The fetal heart.
D. The fetal kidney.
E. The fetal spine
85. The following is a contraindication for Ba enema:
A.
B.
C.
D.
E.
Ulcerative colitis
Crohn’s disease.
Sigmoidoscopy without biopsy.
Sigmoidoscopy with biobsy.
Ca colon.
86. The followings are indications for the use of gastrograffin, EXCEPT:
A.
B.
C.
D.
E.
Perforated peptic ulcer.
Toxic megacolon.
Tracheo-oesphageal fistula.
24 hours post partial gastrectomy.
24 hours post hemi colectomy.
87. The oesophagus is the site for secondary tumours from, EXCEPT:
A. The stomach.
B. The lung.
C. The breast.
D. The kidneys
88. Oesophageal varices:
A.
B.
C.
D.
Arteriovenous connection at the lower oesophagus.
Venous anastomotic collateral veins.
Rarely develop as a result of liver cirrhosis.
Varices are difficult to see on Ba meal.
89. Ingested foreign body:
A.
B.
C.
D.
Rarely causes complete obstruction.
Plain X-ray may show the metalic foreign body.
Ba meal is needed in all cases.
Difficult to see on endoscopy.
90. Oesphageal achalasia, the followings are true, EXCEPT:
A. It is a functional disorder of oesophageal motility.
B. The lower eosophageal sphineter fails to relax.
C. Can cause gross oesophageal dilatation.
D. The dilated oesophagus is not seen on chest X-ray.
16
E. On fluoroscopy there is poor peristaltic activity.
91. Benign oesophageal stricture:
A.
B.
C.
D.
E.
Most commonly in the middle third.
It is circumferential.
Does not cause dysphagea, in.
The oesophagus is rigid and tube like.
All of the above are true.
92. Oesophagitis due to infection is caused by:
A.
B.
C.
D.
Malignant tumor.
Benign tumour.
Candida albicans.
E-coli.
93. The followings are complications of hiatus hernia, EXCEPT:
A. Oesophagitis.
B. Stricture.
C. Anaemia.
D. Intussusception.
94. Ba-meal, the followings can be seen in reflux oesophagitis EXCEPT:
A. Barium reflux in the oesophagus in 90% of cases.
B. Oesophageal ulcers.
C. Mucosal granularity.
D. Motility disturbances.
95. In primary oesophageal carcinoma, the followings are true, EXCEPT:
A.
B.
C.
D.
Dysphagia.
Heart burn.
Coughing of blood.
Bleching.
96. In primary oesophageal carcinoma the followings are true, EXCEPT:
A.
B.
C.
D.
90% are squamous cell carcinoma.
More in middle aged men (40-50 years).
Progressive dysphasia is the most common symptom.
Occasionally can cause constant substernal pain.
97. Gastric carcinoma:
A.
B.
C.
D.
Can be predisposed by adenomatus polyp.
Can be predisposed by previous partial gastrectomy.
Can be predisposed by hiatus hernia.
Can be predisposed by haemolytic anaemia.
17
98. The followings are features of gastric carcinoma on Ba meal, EXCEPT:
A.
B.
C.
D.
Polypoid type.
Deep ulcer.
Shallow ulcer.
Linitis plastica.
99. The followings are causes of gastric outlet obstruction, EXCEPT:
A.
B.
C.
D.
Gastric carcinoma.
Pancreatic carcinoma.
Duodenal perforation.
Duodenal ulcer.
100. All of the followings regarding the duodenum are true, EXCEPT:
A. 20-30 cm in length.
B. Forms a complete circle surrownding the head of pancreas.
C. The first part in the duodenal cap.
D. The ampulla of Vater opens in the upper part of the second part.
101. The duodenal ulcer, the followings are true EXCEPT:
A.
B.
C.
D.
More common than gastric ulcer.
Mostly in the second part.
Can be complicated by perforation.
May cause gastic outlet obstruction.
102. The followings are features of gastric ulcer on Ba meal EXCEPT:
A.
B.
C.
D.
Oval or round collection of barium.
Halo around the ulcer.
Polypoid appearance.
Barium filling the ulcer crater.
103. The followings are complications of duodenal ulcer EXCEPT
A.
B.
C.
D.
Perforation.
Malignancy.
Bleeding.
Gastric outlet obstruction.
104. The small bowel:
A.
B.
C.
D.
30-50 cm in length.
Jejunum is the proximal one third.
Ileum is the distal two thirds.
Jejunum is less than 4 cm in diameter.
105. Crohn’s disease:
18
A.
B.
C.
D.
Usually limited to the terminal ileum.
May present with abdominal pain and diarrhea.
Does not present as acute abdomen.
May present with weight loss.
106. The followings are features of Crohn’s disease EXCEPT:
A. Discrete ulcer.
B. Cobblestone appearance.
C. Thick valvulae conniventis.
D. The rectum is usually affected.
107. The followings are complications of Crohn’s disease, EXCEPT
A.
B.
C.
D.
Abscess formation
Subacute obstruction.
Gallstones.
Malignant change.
108. The followings are causes of small bowel obstruction, EXCEPT
A.
B.
C.
D.
Strangulated hernia.
Post surgical adhesions.
Intussusception.
Duodenal ulcer.
109. The following is a sign of small bowel obstruction:
A. Collapsed small bowel loops.
B. No gas in the stomach fundus.
C. No gas in the large bowel.
D. Ba enema is needed to confirm the diagnosis.
110. Meckel’s diverticulum:
A.
B.
C.
D.
It occurs in 20% of individuals.
It lies 2 feet from the pylorus.
5 cm in length.
Usually diagnosed by Ba follow through.
111. The followings are causes of large bowel obstruction, EXCEPT
A.
B.
C.
D.
Foecal impaction.
Carcinoma.
Diverticular disease.
Oesophageal atresia.
19
112. Communicating hydrocephalus can be due to:
A.
B.
C.
D.
E.
Aqueduct stenosis.
Tuberous sclerosis.
Choroid plexus papilloma.
Medulloblastoma.
Third ventricle colloid cyst.
113. Esophageal stricture can be caused by the followings, EXCEPT
A.
B.
C.
D.
E.
Lye ingestion (corrosive).
Myxoedema.
Epidermolysis.
Chalasia of the cardia.
Ca oesophagus.
114. Renal vein thrombosis is associated with the following EXCEPT:
A. Dehydration in children.
B. Scleroderma.
C. Amyloidosis.
D. Nephrotic syndrome.
115. The followings are features of rheumatoid arthritis on a chest X-ray,
EXCEPT:
A.
B.
C.
D.
E.
Localized apical emphysematous bullae.
Persistent pleural effusions.
Erosions of the acromio-clavicular joint.
Cavitating nodules of 2cm in diameter.
Periarticular osteopenia at the acromio-clavicular joint.
116. Complications of Crohn’s include the followings EXCEPT:
A.
B.
C.
D.
E.
Pericholangitis.
Carcinoma.
Renal stones in patinets with iliostomy.
Renal stones in patients without iliostomy.
Stricture of the transverse colon.
117. The recongnized features of renal artery stenosis on an IVU:
A.
B.
C.
D.
E.
Blunting of the calyces.
Quicker appearance of contrast medium in the collecting system.
Ureteric notching.
Low position of the kidney.
Dilated pelvicalyceal system.
20
118. Renal artery stenosis is found in the followings, EXCEPT:
A.
B.
C.
D.
E.
Cystine.
Uric acid.
Oxalate.
Phosphate.
Cholesterol.
119. The following types of renal calculi are radiolucent:
A.Cystine.
B. Uric acid.
C. Oxalate.
D. Phosphate.
E. Cholesterol.
120. Osteoporosis may occur with:
A.
B.
C.
D.
Thyrotoxicosis.
Vitamin A excess.
Pheochromocytoma.
Osteoporosis.
‫انتهى‬
21