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Chest and Vascular Radiology

FRCR Part 2a, Module 1: Chest and Cardiovascular


1 Histiocytosis X of the lungs
a) causes thin-walled cysts ?t thick & thin
b) ground glass attenuation is characteristic f
c) affects the lower lobes f
d) lymphangioleiomyomatosis can look the same on a plain radiograph t
e) causes pneumothorax t
2 An elderly patient presents with a several weeks history of cough. A plain radiograph shows patchy infiltrates. On
CT there are multiple areas of consolidation but no lymphadenopathy. The differential diagnosis includes
a) heart failure t
b) cryptogenic organizing pneumonia t Effusion 30%, lym.pathy 30%
c) eosinophilic pneumonia T
d) alveolar cell carcinoma t
e) pulmonary haemorrhage t
3 Pulmonary AVMs
a) are associated with TIAs t
b) are present in 80% patients with hereditary haemorrhagic telangiectasia f (5-15%) 6% of pAvm patients have HHT
c) plain radiographs may show only pulmonary hypervascularity t
d) 90% are calcified on helical CT f
4 Azygous continuation of the IVC is associated with
a) a normal intrahepatic IVC f
b) bilateral bilobed lungs t
c) polysplenia t
d) total anomalous pulmonary venous drainage f
5 Kaposis sarcoma
a) is an early finding in AIDS f
b) is associated with a pleural effusion in the majority of cases f (30%, lym 15-25% late feature)
6 Angiography
a) the testicular vein is easier to catheterise on the left than the right using a femoral approach t
b) a non-covered stent in the iliac arteries is contraindicated at the bifurcation f
c) iliac artery stent has double the patency rate of angioplasty at one year t
d) iliac artery stent has a 2% infection rate at 2 years
e) iliac artery stents prevent neointimal hyperplasia f
f) following iliac artery stenting the patient should be heparinised for 24 hours t
7 Regarding embolisation
a) polyvinyl alcohol causes intimal sloughing T
b) platinum coils are thrombogenic f
c) the hepatic artery can only be embolised if the portal vein is patent t
d) unintentional embolisation of the distal systemic arteries is more common at the beginning of the procedure than
the end
8 Intrapulmonary bronchogenic cysts
a) 10% calcify ( occasional calcification)
b) are of water attenuation on CT T (50%)
c) typically occur in the lower lobes T
d) commonly present with infection T (76%)

9 The following are recognised findings in cystic fibrosis


a) an association with situs inversus t
b) gallstones t
c) splenic artery aneurysm
d) cirrhosis of the liver t
10 Popliteal artery entrapment syndrome
a) displaces the popliteal artery laterally f
b) occurs over the age of 50 years f <35yrs M:F=9:1, Bil 66%
c) post-stenotic dilatation of the artery is seen t
d) can cause distal embolisation t
e) the artery lies posterior to the medial head of gastrocnemius f (with in)
11 Fat embolism is associated with
a) pleural effusion f
b) pneumothorax f
c) multiple pulmonary opacities t
d) petechiae t
e) arterial hypoxia t
12 Regarding congenital abnormalities in the chest
a) usually only a single lobe is involved in cystic adenomatoid malformation t
b) intralobar sequestration is commonly associated with other congenital anomalies f (6-12%), (Extra 14-25%)
c) 25% of scimitar syndromes occur on the left f
13 Causes of endobronchial metastases include
a) breast carcinoma t
b) melanoma f
c) thymoma f
d) bronchial carcinoma t
e) mesothelioma f
Others are Lymphoma, RCC, Colon
14 Diffuse pleural thickening (17% of pleural disease, Bil. 20%)
a) is associated with asbestosis in 5-15% F
b) spares the interlobular fissures F
c) occurs on the parietal pleura t
d) is usually preceded by benign pleural effusions t
CP angles obliterated in minority
15 Aortic dissection
a) is associated with a bicuspid aortic valve t
b) is associated with Marfans syndrome t
c) is most commonly type A t
d) type A requires surgery t (60-70%)
e) type B does not involve the descending aorta f
16 IVC filters
a) are indicated in pregnant women who have had a previous DVT f
b) are used prophylactically following pulmonary thrombectomy f
c) are used in those who have a contraindication to anticoagulation t
d) are used for thrombus of the suprarenal IVC t ( rarely)
17 The following are a cause of narrowing of the bronchus
a) histiocytosis X f
b) systemic sclerosis f
c) aortic aneurysm t
d) amyloid t
e) sarcoidosis t

18 The following are recognised associations


a) hydrallazine and SLE t
b) doxorubicin and pulmonary fibrosis f
c) prostaglandins and arthropathy
d) busulphan and cardiomyopathy f
e) lead intoxication and punctate basophilia t
19 Thymomas are associated with
a) Hyperparathyroidism t
b) Anaemia t
c) polyarteritis nodosa f
d) SLE f
e) Cushings syndrome t
20 Pleural effusion due to rheumatoid disease
a) is usually painless F (pleurisy 21%, effusion3 %)
b) is usually bilateral f
c) nodules are perihilar f ( peripheral)
d) has a low glucose t
e) is associated with bronchopleural fistula t
21 The following may simulate enlargement of the left atrial appendage
a) partial pericardial defect t
b) pulmonary stenosis t
c) persistence of the left SVC f
d) corrected transposition of the great arteries t
e) coronary artery fistula
22 Visible bronchial arteries on a frontal chest radiograph are seen in
a) Fallots tetralogy t
b) tricuspid atresia t
c) mitral atresia f
d) primary pulmonary hypertension ?t
e) corrected transposition of the great arteries f
23 The following investigations are appropriate
a) thallium-201 scintigraphy in left-to-right shunt f
b) left atrial myxoma and echocardiography t
c) left ventricular aneurysm and fluoroscopy t
d) CT with contrast enhancement in dissecting aneurysm of the descening aorta t
e) cinefluorography in mechanical dysfunction of a prosthetic cardiac valve t
24 Mediastinal bronchogenic cyst
a) usually occurs in the superior mediastinum f
b) is a recognised cause of respiratory distress in the neonate t ( usually asymptomatic)
c) has an attenuation of 0 to 25 HU at CT t
d) commonly calcifies f
e) is commoner on the left f
25 In hypertrophic obstructive cardiomyopathy
a) the inverventricular septum is involved t
b) systolic anterior movement of the mitral valve is seen t
c) diastolic left ventricular size is greater than 6 cm f
d) mitral valve prolapse may occur f
e) pericardial effusions are a feature f

26 The following are features of Hodgkins disease


a) alcohol induced flushing t
b) haemolytic anaemia f ( anaemia of chronic disease)
c) prolonged fever F ( pel ebstein fever)
d) a disorder of T-cell immunity t
27 The following is true of primary pulmonary hypertension
a) males are more commonly affected f
b) a history of breathlessness extending over some years t
c) ventilation-perfusion scans can distinguish the condition from multiple pulmonary emboli T
28 The following are features of 1-antitrypsin deficiency
a) wash-in of xenon-133
b) upper lobe involvement f
c) atopy f
d) usually presents in childhood f
29 Fat embolism
a) can be due to arterial hypoxia f
b) presents as petechiae t
c) hypothermia is a cause f
d) causes pulmonary shadowing t
e) causes a pleural effusion f
30 Features of chronic alcohol abuse include
a) hypertrophic cardiomyopathy f
b) malabsorption t
c) fetal cerebellar syndrome
d) avascular necrosis t
e) tuberculosis t
31 Ring shadows are seen in the lungs in
a) tuberous sclerosis t
b) closed chest trauma t
c) sequestrated lung segment t
d) primary pulmonary haemosiderosis f
e) alveolar proteinosis f
32 Features of crytogenic fibrosing alveolitis include
a) lung shrinkage t
b) pleural effusion t (4-6%)
c) carcinoma of the bronchus t
33 Calcified hilar lymph nodes are seen in
a) Sarcoidosis t
b) beryllium exposure t
c) systemic sclerosis f
d) Treated Hodgkins disease t
e) Histoplasmosis t
34 The following are true of farmers lung
a) precipitating antibodies are present in less than 50% of cases T (20-40%)
b) fibrosis is predominantly lower zone f
c) an insidious onset is recognised t

35 The following are complications of myocardial infarction


a) bacterial endocarditis T
b) mitral regurgitation t
c) pericardial effusion t
d) ventricular septal defect t
e) ruptured sinus of Valsalva f
36 Left atrial enlargement is a feature of
a) Atrial septal defect f
b) Mitral stenosis t
c) Ventricular septal defect t
d) Mitral regurgitation t
e) Patent ductus arteriosus t
37 Recognised features of AIDS include
a) CNS involvement t
b) Thymoma f
c) Lymphadenopathy t
d) cytomegalovirus infection t
e) oral candidiasis t
38 Central cyanosis and pulmonary plethora occur in
a) truncus arteriosus t
b) Fallots tetralogy f
c) total anomalous pulmonary venous drainage t
d) hypoplastic left heart syndrome f
e) Ebsteins syndrome f
39 Regarding pleural effusions
a) 5-10 ml of fluid can be detected on a lateral decubitus chest radiograph
b) they are a feature of fibrosing alveolitis
c) in Meigs syndrome, the effusion is most commonly right-sided
d) effusions are frequently left-sided in acute pancreatitis
40 Traumatic aortic dissection
a) displacement of the right paraspinal line is a recognised feature
b) sudden onset acute hypertension may be a feature
c) fewer than 30% arise at the isthmus
41 Regarding the trachea
a) normal tracheal diameter varies with respiration
b) the upper limit of normal tracheal sagittal diameter on HRCT in men is 27mm at 2cm above the arch of the aorta
c) men and women have similar normal tracheal diameters
d) tracheal diameter decreases with age in normal patients
e) normal tracheal diameter is directly related to patient height
42 Regarding Bronchiectasis
a) tracheomegaly is usually associated with cystic type bronchiectasis
b) Kartagener's syndrome is associated with tracheomegaly in the majority of cases
c) the majority of patients with tracheomegaly have no respiratory symptoms
d) tracheal diameter greater than one standard deviation above the normal range is found in 15-20% of patients
with bronchiectasis
e) bronchography remains a useful test in the diagnosis of tracheobronchomegaly in patients with bronchiectasis
43 Regarding the airways
a) in tracheobronchomegaly the conducting airways dilate on inspiration and collapse on expiration

b) airway calcification is seen prematurely in patients with bronchiectasis


c) relapsing polychondritis involving the airways usually results in increased airway diameter
d) dilatation of the airways may be observed in Ehlers - Danlos syndrome
e) inspiratory stridor is a well recognized clinical finding in tracheomegaly
44 Tracheal narrowing occurs in
a) Wegeners granulomatosis
b) replasing polychondritis
c) amyloidosis
d) sarcoidosis
e) Marfans syndrome
45 The following drug associations are true
a) bleomycin and pleuroparenchymal fibrosis
b) atenolol and hilar lymphadenopathy
c) gold and pulmonary interstitial fibrosis
d) methotrexate and Pneumocystis carinii pneumonia
e) BSNU & CCNU and pneumothorax
46 Concerning Doppler ultrasound of blood vessels
a) a triphasic waveform is normal in the popliteal artery
b) the external and internal carotid arteries can be distinguished by their waveforms
c) stenosis causes spectral broadening
d) distal to a high grade iliac stenosis, a triphasic waveform can be seen
e) a significant stenosis causes at least a doubling of velocity
47 Concerning ventilation-perfusion scintigraphy
a) the optimal perfusion particle size is 80-100 m
b) 20% of the pulmonary capillary bed is occluded
c) a known right-to-left shunt is a relative contraindication
d) pulmonary embolus characteristically results in a segmental defect
e) upper zone shunting with mitral stenosis is a recognized pattern
48 Regarding the thymus
a) hyperplasia occurs in response to steroid therapy
b) enlargement occurs in hyperthyroidism
c) it is mobile with respiration on changes of posture
d) it is detectable on CT in less than 50% of patients aged under 30 years
e) detection of thymoma is incidental in 50% of cases
49 Systemic arterial aneurysms are recognised associations of
a) phaeochromocytoma
b) intravenous drug abuse
c) polyarteritis nodosa
d) coarctation of the aorta
e) polycystic renal disease
50 Concerning atheromatous dissection of the aorta
a) hypertension is the main risk factor
b) in the descending aorta, transoesophageal US is better than CT
c) On CT, the left brachiocephalic vein may mimic a dissection
d) aortic regurgitation occurs in 60%
e) dissections originating at the aortic isthmus require surgical treatment
51 Causes of pulmonary arterial hypertension include
a) schistosomiasis

b) sarcoidosis
c) carcinoid syndrome
d) 1-antitrypsin deficiency
52 The following are recognised features of scleroderma
a) pneumothorax
b) malignant hypertension
c) alveolar cell carcinoma
d) oesophageal stricture
e) pulmonary hypertension
53 Arterial aneurysms are associated with
a) Ehlers-Danlos syndrome
b) intravenous drug abuse
c) temporal arteritis
d) aortic coarctation
e) polyarteritis nodosa
54 Primary tuberculosis is more likely than post-primary disease if
a) there is pleural calcification
b) there is lobar consolidation
c) there are military deposits
d) there is hilar lymphadenopathy
55 Recognised causes of superior vena cava obstruction include
a) a Hickman line
b) histoplasmosis
c) aortic aneurysm
d) constrictive pericarditis
56 Aortic dissection is associated with
a) Marfans syndrome
b) SLE
c) rheumatoid arthritis
d) hypertension
e) Takayasus arteritis
57 Vascular calcification is a feature of
a) hyperlipidaemia
b) chronic renal failure
c) haemochromatosis
d) hyperparathyroidism
e) scleroderma
58 The following fungal infections are endemic in the United Kingdom
a) blastomycosis
b) histoplasmosis
c) torulopsis
d) aspergillosis
e) actinomycosis
59 Wegeners granulomatosis
a) May cause bilateral consolidation
b) Renal involvement is seen in 25%

60 Bilateral pulmonary calcific nodules may be seen in


a) Goodpastures syndrome
b) mitral stenosis
c) histoplasmosis
d) varicella pneumonia
e) SLE
61 Typical features of Pneumocystis carinii pneumonia include
a) a normal chest radiograph
b) pleural effusion
c) bilateral perihilar consolidation
d) increased uptake on 67Ga scintigraphy
e) pneumomediastinum
62 Bilateral hilar lymphadenopathy occurs in
a) sarcoidosis
b) histoplasmosis
c) silicosis
d) primary tuberculosis
e) bronchogenic carcinoma
63 The following statements regarding fat embolism are true
a) it typically occurs within 12 hours of injury
b) it occurs in 20% of femoral neck fractures
c) the commonest cause is fracture of a lower limb long bone
64 Causes of pulmonary hypertension include
a) carcinoid syndrome
b) schistosomiasis
c) alpha-1 antitrypsin deficiency
65 Concerning non-small cell carcinoma of the lung
a) rib invasion is a contraindication to surgery
b) malignant effusion contraindicates curative resection
66 Regarding CT of a pulmonary nodule
a) no follow-up is required if there is no change after one year
b) attenuation of 60 HU is consistent with a benign lesion
c) attenuation of 180 HU indicates malignancy
d) percutaneous biopsy may be safely performed if the FEV1 is greater than 1.5 L s-1
67 Enlargement of the left atrial appendage is simulated by
a) pulmonary stenosis
b) left-sided superior vena cava
c) partial pericardial defect
d) corrected transposition of the great arteries
68 Regarding inflammatory aortic aneurysm
a) there is an association with increased blood viscosity
b) fever is absent
c) characteristically, no aortic calcification is seen on CT
d) rupture occurs less frequently than in atheromatous abdominal aortic aneurysm
e) most occur above the level of the renal arteries
69 Systemic arterio-venous shunts occur in
a) hereditary haemorrhagic telangiectasia

b) Mafuccis syndrome
c) patent ductus arteriosus
d) Turners syndrome
e) Downs syndrome
70 Features of systemic sclerosis include
a) pneumothorax
b) pleural effusion
c) oesophageal stricture
d) pulmonary fibrosis
e) alveolar cell carcinoma
71 Concerning hypertrophic cardiomyopathy
a) there is an association with mitral valve prolapse
b) systolic anterior motion of the mitral valve occurs
c) the interventricular septum is affected characteristically
d) the left ventricular diameter is greater than 6 cm
e) pericardial effusion is a feature
72 Regarding acute respiratory distress syndrome
a) pleural effusion is characteristic
b) fleeting lung opacification is a recognised early finding
c) pulmonary artery diameter is increased
d) pulmonary fibrosis is a recognised sequel
e) there is an association with pneumothorax
73 Primary tuberculosis is more likely than post-primary disease when the following are seen
a) extrapulmonary focus of tuberculosis
b) miliary pattern of pulmonary opacification
c) lobar consolidation
d) hilar lymphadenopathy
e) pleural calcification
74 Concerning 201Tl cardiac scintigraphy
a) atrial fibrillation prevents the acquisition of diagnostic images
b) left anterior oblique is the most reliable view for the diagnosis of septal infarction
c) the right ventricle can be reliably imaged
d) reversible defects at rest compared to stress indicate ischaemia
e) left bundle branch block precludes the diagnosis of infarction
75 Following pneumonectomy, the following findings are abnormal
a) contrast enhancement of the chest wall on the side of surgery at CT
b) an increasing air-fluid level in the first post-operative month
c) the presence of air on the side of surgery when it was previously absent
d) air remaining after one post-operative month
e) shift of the mediastinum towards the side of surgery on consecutive days
76 Concerning farmers lung
a) blood eosinophilia is characteristic
b) rigors are a recognised presentation
c) an insidious onset is recognised
d) pulmonary fibrosis is a recognised sequel
77 Cryptogenic organising pneumonia is seen in association with
a) ulcerative colitis
b) gout

c) amiodarone therapy
d) sulphasalazine therapy
e) acebutolol therapy
78 Regarding pulmonary embolism
a) there is a 30% chance of fatal recurrence if untreated
b) there is a 5% chance of recurrence if treated with an IVC filter
c) the sensitivity of lung perfusion scintigraphy equals pulmonary arteriography
d) there is a 90% chance of a correct diagnosis using perfusion scintigraphy alone
79 Concerning asbestos-related lung disease
a) there is an association with benign pleural effusion
b) thickening of the visceral pleura is a good prognostic sign
c) there is an association with pleural plaques on the parietal pleura
d) fibrotic lung disease is associated with carcinoma
e) mesothelioma arises from calcified pleural plaques
80 The following statements concerning Doppler ultrasound are true
a) diastolic flow reversal is seen in a normal internal carotid artery
b) diagnostic features are seen in the subclavian steal syndrome
c) decreased velocity is seen with arterial stenosis
d) absence of colour flow in the portal vein is diagnostic of obstruction
81 Thymoma is associated with
a) anaemia
b) Cushings syndrome
c) hyperparathyroidism
d) SLE
e) Hypogammaglobulinaemia
82 The following are recognised causes of bronchiectasis
a) bronchial atresia
b) Kartageners syndrome
c) cystic fibrosis
d) hypogammaglobulinaemia
e) alpha-1 antitrypsin deficiency
83 Regarding a bilateral aortic arch
a) bilateral common carotid arteries may occur
b) the trachea may be indented
c) MRI may be diagnostic
d) stridor may occur
84 Pseudocoarctation of the aorta
a) may cause an oesophageal impression on a barium swallow
b) is associated with rib notching
c) does not produce a focal pressure gradient
d) causes systemic emboli
85 Pulmonary fibrosis may be caused by the following drugs
a) carmustine (BCNU)
b) cyclophosphamide
c) methotrexate
d) busulphan
e) amiodarone

86 Concerning dissection of the thoracic aorta


a) 90% occur within 4 cm of the aortic root
b) the false lumen is associated with thrombus in 40%
c) the dissection flap is best seen if there is equal flow in the true and false lumens
87 Regarding lung contusion
a) changes are evident on the chest radiograph with 12 hours
b) haematoma resolves by 7 days
c) hypoxia is related to the amount of contused lung
d) the distribution is usually segmental
e) sternal fractures are usually associated with thoracic spine injuries
88 Right ventricular enlargement is seen in
a) mitral stenosis
b) Ebsteins anomaly
c) carcinoid syndrome
d) chorioepithelioma
e) schistosomiasis
89 Pulmonary hamartoma
a) are multiple in tuberous sclerosis
b) calcify in 70%
c) are premalignant in 15%
d) are excuded from the differential if serial radiographs show an increase in size
e) occur mainly in patients under 40 years of age
90 Squamous cell carcinoma of the lung
a) rarely cavitates
b) occurs peripherally in 40%
c) has a greater association with extra-thoracic metastases than does small cell lung carcinoma
d) may secrete anti-diuretic hormone
e) is the commonest histological type of Pancoast tumour
91 Bronchiectasis may be caused by
a) scimitar syndrome
b) SLE
c) Wegeners granulomatosis
d) sarcoidosis
e) hypogammaglobulinaemia
92 Calcified mediastinal lymph nodes are a recognised feature of
a) amyloidosis
b) untreated lymphoma
c) silicosis
d) tuberculosis
e) phaeochromocytoma
93 Causes of multiple calcified pulmonary lesions include
a) varicella pneumonia
b) systemic lupus erythematosus
c) mitral stenosis
d) haemosiderosis
e) histoplasmosis
94 Prior to treatment, the following pulmonary metastases may be calcified
a) Papillary thyroid carcinoma

b) Osteosarcoma
c) Renal cell carcinoma
d) Small bowel carcinoid
95 Cardiac valvular abnormalities are associated with
a) aortic coarctation
b) neurofibromatosis
c) Reiters syndrome
d) Behets disease
e) decceleration injuries
96 Causes of pneumothorax include
a) oesophageal rupture
b) osteosarcoma metastases
c) tuberculosis
97 Traumatic rupture of the bronchi
a) most often occurs with 2.5 cm of the carina
b) when complete, the collapsed lung falls towards the mediastinum
c) is associated with fractures of the first three ribs
d) is usually associated with external evidence of major trauma
e) may cause bronchiectasis
98 Concerning pulmonary scintigraphy
a) the xenon ventilation scan must be performed before the perfusion scan
b) pulmonary embolus cannot be diagnosed in the presence of COPD
c) pleural effusion is a cause of a reverse mismatched defect
d) in the presence of heart failure, the injection should be made with the patient sitting up
e) a low probability of pulmonary embolus indicates a less than 5% probability
99 Areas of increased attenuation in the basal lung peripheries at CT are seen with
a) bleomycin therapy
b) asbestosis
c) scleroderma
d) ankylosing spondylitis
e) tuberculosis
f) cryptogenic fibrosing alveolitis
100 Recognised pulmonary features of Wegeners granulomatosis include
a) cavitation
b) calcification
c) pleural effusion
d) lymphadenopathy
e) pulmonary involvement occurs in 95% of cases
101 Regarding Doppler ultrasound of the deep leg veins
a) the demonstration of flow excludes deep vein thrombosis
b) phasic flow excludes DVT
c) compressibility of the popliteal vein reliably excludes the presence of thrombus
d) incompressibility of the adductor segment is a reliable sign of DVT
e) acute thrombus is of increased reflectivity
102 Concerning Doppler ultrasound of the internal carotid artery
a) reversed flow is seen in normal individuals in the proximal segment
b) flow aliasing is normal
c) subclavian steal syndrome produces characteristic appearances

d) stenosis are associated with low flow


e) low peak systolic velocities are associated with stenosis
103 Thoracic aortic injury
a) commonly affects the ascending aorta
b) is most commonly heralded on a chest radiograph by pleural effusion
c) is reliably excluded by a normal CT examination
d) is universally fatal within 48 hours if untreated
e) affects the aortic valve in 50%
104 Folded lung
a) causes crowding of vessels and bronchi entering the lesion
b) causes an enhancing mass on CT
c) is associated with extensive pleural disease
d) is completely surrounded by aerated lung
105 Left atrial enlargement is associated with
a) atrial myxoma
b) pulmonary arteriovenous malformations
c) ventricular septal defect
d) Ebsteins anomaly
e) mitral stenosis
106 Pulmonary arteriovenous malformations
a) are associated with cerebral abscesses
b) present with haemoptysis
c) are associated with Osler-Weber Rendu syndrome
d) can present with a rounded mass on a chest radiograph
e) cause left atrial enlargement
f) may be treated by bronchial artery embolisation
107 The following are poor prognostic factors in sarcoid
a) erythema nodusum
b) bone lesions
c) interstitial pulmonary disease not resolving after one year
d) presentation at under 40 years old
108 Regarding blunt chest trauma
a) segmental contusion may be recognised radiographically
b) lung contusion appears radiographically within 12 hours
c) pulmonary haematomas resolve within three weeks
d) sternal fractures are associated with fractures of the thoracic spine
109 Concerning pleural effusions
a) cryptogenic fibrosing alveolitis is a recognised cause
b) 5-10 ml of pleural fluid can be recognised on a lateral decubitus radiograph
c) superior vena cava syndrome is a recognised cause
d) Meigs syndrome is characteristically associated with a right-sided effusion
e) in acute pancreatitis, the effusion characteristically occurs on the left
110 Squamous cell carcinoma of the lung
a) is the characterstic histological type in Pancoasts tumour
b) is peripheral in 30-40% of cases
c) rarely cavitates
d) is associated with the syndrome of inappropriate ADH secretion
e) produces radiologically detectable metastases more often than does small cell carcinoma

111 Recognised features of histiocytosis X include


a) lymphadenopathy
b) pleural effusion
c) pneumothorax
d) pulmonary fibrosis
e) inferior rib notching
112 Causes of aortic aneurysms include
a) Marfans syndrome
b) Ehlers Danlos syndrome
c) polyarteritis nodosa
d) Takayasus disease
e) Turners syndrome
113 Dissection of the thoracic aorta
a) is more reliably detected on transoesophageal ultrasound than on CT
b) may be mimicked by the left brachiocephalic vein
c) is most commonly due to hypertension
d) when arising distal to the left subclavian artery, requires surgical treatment
e) is associated with aortic regurgitation in 60% of cases
114 Superior vena cava obstruction may occur due to
a) histoplasmosis
b) sarcoid
c) aortic aneurysm
115 Coarctation of the aorta
a) is associated with notching of the first seven ribs
b) an aberrant right subclavian artery is associated with right-sided rib notching
c) there is a recognised association with gonadal dysgenesis
d) aortic valve regurgitation is a recognised association
116 Cytomegalovirus infection may cause
a) air space shadowing
b) lymphadenopathy
c) thickening of the colonic wall
117 Pneumocystis carinii infection
a) can be reliably differentiated from pulmonary Kaposis sarcoma by radiology
b) shows a predominantly upper lobe distribution
118 Mediastinal lymph node calcification occurs in
a) histoplasmosis
b) silicosis
c) amyloid
d) untreated lymphoma
119 Regarding the solitary pulmonary nodule
a) no growth over one year guarantees benignity
b) size less than 2 cm is good evidence of benignity
c) size greater than 3 cm is good evidence of malignancy
d) punctate calcification is reliable evidence of benignity
e) a smooth outline implies benignity
120 The following pulmonary metastases show cavitation
a) cutaneous squamous cell carcinoma

b) teratomas
c) seminoma
d) osteosarcomas
e) glioma
121 Following pneumonectomy, the following are abnormal
a) air in the ipsilateral hemithorax one month post surgery
b) a rising air-fluid level
c) movement of the mediastinum towards the pneumonectomy side
d) new air in a previously fluid-filled space
e) enhancement of the pleura on CT
122 Regarding the thymus
a) more than 50% of myaesthenics have thymoma
b) in children, the normal thymus may occupy 50% of the cross sectional area of the chest on a frontal chest
radiograph
c) fat is seen as a normal component on CT
d) in myasthaenia, there are circulating antibodies to acetylcholine receptors
123 Post-primary TB is more likely than primary disease if there is
a) lobar consolidation
b) hilar lymphadenopathy
124 Regarding chronic radiation pneumonitis
a) the onset occurs within two weeks of exposure
b) fibrosis occurs without a previous pneumonitis
c) it is potentiated by cytotoxic agents
d) steroids produce some improvement in appearances
e) fibrosis is related to the amount of lung irradiated
125 Embolisation via an arterial approach is appropriate treatment for
a) epistaxis
b) cavernous haemangioma
c) oesophageal varices
126 Regarding the positioning of central venous catheters
a) a line seen lateral to the aorta is outside the vein
b) a line overlying the lung should be presumed to have punctured the vein
c) position within the jugular vein is acceptable for infusion
d) position within the coronary sinus is associated with arrhythmia
e) a lateral film is necessary to ascertain true position of a catheter
127 The azygos vein is enlarged in
a) inspiration
b) superior vena cava obstruction
c) inferior vena cava obstruction
d) portal hypertension
128 Digital ischaemia is seen in
a) carpal tunnel syndrome
b) rheumatoid arthritis
c) SLE
d) workers exposed to polyvinyl chloride
129 Tracheal narrowing is a feature of
a) tracheomalacia

b) sarcoid
c) Wegeners granulomatosis
d) amyloid
e) croup
130 Concerning pulmonary perfusion scintigraphy
a) defects are segmental in pulmonary embolic disease
b) the particle size is 80-100 m
c) a right-to-left shunt is a relative contraindication
131 Patients presenting with inflammatory aortic aneurysms
a) commonly have aortic calcification
b) are usually pyrexial
c) usually have an elevated ESR
d) rupture occurs less commonly than with atheromatous aneurysms
e) the aneurysm commonly extends above the renal arteries
132 The interlobular septae are thickened in
a) pneumoconiosis
b) sarcoid
c) primary pulmonary haemosiderosis
d) alveolar proteinosis
133 Thymic enlargement is a feature of
a) adrenal insufficiency
b) thyrotoxicosis
c) lymphoma
134 Recognised features of ARDS include
a) pleural effusion
b) early radiological changes relative to symptoms
c) perihilar changes
d) rapidly changing appeatances
e) fibrosis
135 Chylothorax may be secondary to
a) tuberculosis
b) filariasis
c) repair of tracheo-oesophageal fistula
136 Regarding asbestos-related pleural abnormalities
a) plaques are associated with a prolonged period of asbestos exposure
b) mesothelioma is associated with early bone destruction
c) chest pain is associated with rib destruction
137 The following commonly present with wheeze
a) alveolar cell carcinoma
b) amyloid
138 Constrictive pericarditis is associated with
a) rheumatoid arthritis
b) coxsackie B myocarditis
c) histoplasmosis
d) lymphoma

139 Wegeners granulomatosis


a) is commoner in women
b) is associated with endobronchial masses
c) is associated with acute tubular necrosis
140 Histiocytosis X is associated with
a) diabetes mellitus
b) proptosis
c) lung fibrosis
141 The following associations are recognised
a) closure of the aortic valve in mid-systole and hypertrophic cardiomyopathy
b) systolic motion of the posterior mitral valve cusp into the left atrium and mitral prolapse
c) anterior movement of the posterior mitral valve cusp in systole and mitral stenosis
d) calcification of the atrioventricular groove and hypertrophic cardiomyopathy
142 Regarding aortic stenosis
a) a peak aortic blood flow of 1.5 m s-1 indicates significant stenosis
143 Pneumocystis carinii pneumonia in immunocompromised patients
a) causes bilateral, symmetrical pulmonary shadowing in most cases
b) can cause pulmonary fibrosis
c) is associated with increased risk of pneumothorax
144 Allergic bronchopulmonary aspergillosis
a) is the most common cause of pulmonary infection and eosinophilia in the UK
b) causes lung cavitation
c) is associated witth mucous plugging in subsegmental bronchi
d) is more common in lower lobes
145 Causes of ground glass appearance on HRCT
a) silicosis
b) sarcoidosis
c) acute EAA
d) chronic organising pneumonia
e) alveolar proteinosis
146 An adult presents with cough for 2 weeks. CXR shows alveolar opacity and CT shows patchy consolidation. No
lymphadenopathy. The differential diagnosis includes
a) LVF
b) alveolar cell Ca
c) COP
d) EAA
147 Colour Doppler in abdominal vessels
a) lack of colour flow in a well seen portal vein means occlusion
b) post-prandial decrease in the SMA diastolic flow is normal
c) normal renal artery flow is low resistance
148 On sonovenogram
a) the patient is examined in the trendelenberg position
b) without pulsed doppler is unreliable
c) anechoic thrombus means no thrombus
d) sensitivity is < 90% for above knee DVT

149 TIPSS
a) femoral route is commonly employed
b) encephalopathy is a contraindication
c) hepatic transplantation is a contraindication
150 Lymphoma
a) three groups of lymph nodes on the same side of the diaphragm suggest stage III disease
b) fatty centre in the centre of the LN is recognised
151 Pulmonary AVMs
a) are acquired in adulthood
b) usually seen in upper lobes
c) are associated with clubbing
d) associated with cerebral abcesses
e) only 5-15% of HHT patients have pulmonary AVMs
f) haemoptysis is the most common presentation
152 Pulmonary artery hypoplasia
a) is usually on the side opposite to the aortic arch
b) can be left sided in tetralogy of Fallot
c) is distinguished from McLeods syndrome by absence of air trapping
d) enlarged bronchial arteries are seen
e) the aortic arch may be on the right if the left is interrupted, especially in congenital heart disease
153 Thrombolysis is contraindicated in
a) aortic aneurysm
b) major surgery in the last 10 days
c) streptokinase sensitivity
d) longstanding graft
154 IVC filters are used for
a) recurrent PE despite adequate anticoagulation
b) pregnant women with past history of PE
c) IVC thrombus above renal veins
d) prophylacically after pulmonary embolectomy
155 Regarding stents
a) a self-expandable stent should not be used in the biliary system
b) an expandable stent should not be balloon dilated
c) a 16 F stent is too big for the SVC
d) covered vascular stents are able to prevent neointimal hyperplasia
e) a double J ureteric stent placement needs cytoscopic access
156 Malignant mesothelioma
a) is associated with pleural plaques
b) rarely involves mediastinal pleura
c) characterisically shows rib erosions
157 A pericardial sac defect
a) is usually left sided
b) associated with other cardiac defects in 30-40%
c) pericardial cysts commonly calcify
d) pericardial cysts are hyperintense on both T1 and T2
e) intrapericardial bronchogenic cyst contains layering calcium

158 Regarding bronchopulmonary sequestration


a) the intralobar sequestration is more common on the left
b) recurrent haemoptysis is a feature
c) extrapulmonary sequestration can be seen below the diaphragm
d) are hyperintense on both T1 and T2
159 Upper lobe fibrosis with volume loss is seen in
a) EAA
b) sarcoid
c) alveloar proteinosis
d) ankylosing spondylosis
160 In venous US of legs
a) in acute thrombosis there are linear high echoes within the lumen
b) vein is incompressible if fillled with thrombus
c) acute thrombus distends the vein
d) loss of phasic flow in posterior tibial vein
e) non-occlusive thrombus cannot be seen
161 Endoluminal repair of infrarenal AAA
a) majority of infrarenal AAA are suitable for endoluminal repair
b) endoluminal leaks are usually due to lumbar arteries
c) late endoluminal leaks rae best diagnosed with arteriography
d) is more expensive than conventional surgical repair
162 Hydatid cyst
a) lung cyst usually calcify
b) are usually solitary
c) have similar HU to water
d) can cross joints
e) cats are the domestic vector
163 A man in his 50s with cough and acute SOB; CXR shows ill defined pulmonary opacities, basal septal lines and
normal heart size. The following should be considered in the differential:
a) acute MI
b) PE
c) viral pericarditis
d) EAA
e) left atrial myxoma
164 Concerning carotid dissection
a) ipsilateral headache occurs in approx 75%
b) intracranial extension occurs in 70-80%
c) associated with caroticocavernous fistula
d) Most common cause of strokes in <30yrs
e) fibromuscular dysplasia is the cause in 10-20%
165 Thrombolysis is used in the treatment of
a) 7 day old thrombosis of prosthetic dialysis fistula
b) 7 day history of thrombosis of femoral graft with critical ischaemia
c) Budd-Chiari syndrome
d) priapism
e) acute MI
166 Histiocytosis X of the chest
a) thin walled cysts with septations in the upper lobes on HRCT

b) predominantly lower zone


c) ground glass opacity on HRCT
d) similar appearances to lymphangiomyomatosis on CXR
e) is associated with increased lung volume
167 Thoracic aneurysms are associated with
a) vertebral body scalloping
b) Behets syndrome
c) Takayasus arteritis
d) dysphagia
e) if before left subclavial artery is likely to be secondary to trauma
168 In HIV
a) Kaposis sarcoma is associated with pleural effusion
b) Kaposis sarcoma appears early
c) cryptococcus more likely to infect CNS
d) bacterial pneumonia is more likely than PCP
e) If CD4 is lower TB tend to cavitate
169 Pulmonary sequestration
a) angiography can confidently diagnose
b) bronchial connection occurs in extra-lobar type
c) commonly occurs in lower lobe on the right
d) infection is more common with intralobar type
170 Concerning interventional angiography
a) PVA causes irritation to endothelium amd causes sloughing
b) tungsten coils are thromogenic
c) the hepatic artery shoud only be embolised if the portal vein is patent
d) the left rather than the right gonadal vein is easier to cannulate with a right femoral puncture
e) distal embolisation to tissue other than the target organ is more likely at the beginning than at the end of injection
of particles
171 Time of flight MRI of peripheral arteries
a) overestimates stenosis length
b) relies on in flow
c) cardiac gating is useful
172 Causes of endobronchial metastases
a) breast
b) carcinoma of the bronchus
c) melanoma
d) carcinoma of the colon
e) mesothelioma
173 The following are suitable for access for angiography
a) radial artery
b) brachial artery
c) ulnar artery
d) anterior tibial artery
e) popliteal artery
174 Thrombolysis
a) can cause acute renal failure
b) can cause hepatic failure

175 Concerning the thoracic aorta


a) there is a 30% chance of rupture in an aneurysm measuring 6cm or greater
b) majority of post-traumatic thoracic aneurysms are at the level of the ligamentum arteriosum
c) intramural haematoma of the ascending aorta should be managed in the same way as dissection
d) conventional MR is more sensitive that MRA in the assessment of intra-mural thrombus
e) Stanford type B is associated with dissection of the ascending aorta
176 In a patient with pulmonary abnormalities and a peripheral blood eosinophilia, the following must be considered
a) Wegeners granulomatosis
b) round worm infection
c) silicosis
d) Behets syndrome
177 Marfan syndrome is associated with
a) typically, calcified aortic aneurysm
b) mitral valve prolapse
c) pulmonary aneurysm
d) spinal stenosis
178 Fat embolism
a) CXR changes precede symptoms
b) occurs within 12 hrs of injury
c) results in multiple areas of low attenuation in the brain on CT
d) recognised cause of severe hypoxia
179 Mesothelioma
a) causes pleural effusions
b) can cause contralateral lymphadenopathy
c) rib erosion is a recignised feature
d) pericardial erosion is a recognised feature
180 Regarding IVC filters
a) ideally placed above the level of the renal arteries
b) in patients with bilateral iliac vein thrombosis a jugular approach is appropriate
c) thrombolysis is contraindicated post filter placement
181 Concerning angiographic intervention
a) intra arterial nitrates may be injected to overcome muscle spasm
b) arterial rupture following CIA angioplasty is more likely that EIA angioplasty
c) choosing angioplasty balloon sizes 20% larger than vessel diameter for SFA angioplasty is recommended
d) boluses of less than 50 IU heparin should be injected once, ideally
e) angioplasty of endoprostheses is contraindicated
182 Renal artery intervention
a) injection of intra-arterial vasodilators directly into renal arteries is contraindicated
b) rupture of renal artery following renal artery angio in 5-10% is recognised
c) improvement on the blood pressure of a patient with fibromuscular hyperplasia in the majority
d) 8 mm balloon is suitable
183 Renal artery aneurysms
a) are more likely to rupture in pregnancy
b) multiple in polyarteritis nodosa
c) concentric muscle wall thickening is characteristic of Takayasus arteritis
d) most atherosclerotic stenoses are within 2 cm of the ostium
e) extra renal aneurysms can be treated with coil thrombosis

184 Concerning bronchial carcinoid


a) presents as a solitary nodule in 50%
b) characteristically calcifies
c) characteristically causes carcinoid syndrome
d) is a recognised cause of Cushings syndrome
e) radiolabelled octreotide is sensitive in its diagnosis
185 The following features are recognised on HRCT in bronchiolitis obliterans
a) mosaic like pattern
b) air trapping in expiration
c) an area of focal increased transradiancy amongst the consolidation
d) ground glass change in the majority
186 The following conditions cause bronchiectasis
a) silicosis
b) sarcoidosis
c) congenital IgG deficiency
d) ABPA
e) fume inhalation
187 The following cause Kerley B lines
a) Mycoplasma pneumonia
b) viral pneumonia
c) TB
d) silicosis
e) sarcoidosis
188 The following conditions may cause a focal bulge in the left heart border
a) Ebsteins anomaly of the tricuspid valve
b) focal pericardial defect
c) Tetralogy of Fallot
d) pulmonary artery stenosis
e) pulmonary valve stenosis
189 Concerning CT pulmonary angiogram
a) contraindicated in severe RHF
b) contraindicated in pulmonary fibrosis
c) contraindicated in hypotension
d) if patients are very dyspnoeic better results are obtained by MR angiogram
e) can detect emboli down to segmental level
190 Regarding US of the carotid arteries
a) velocity in the ICA falls to less than that in the CCA when there is significant stenosis
b) stenosis is only surgically significant when the patient is symptomatic and vessel diameter is decreased by 85%
c) power dopppler is helpful in distinguishing critical stenosis from occlusion
d) calcium plaques can limit use of US
e) US can reliably interrogate the origin of the great vessels
f) MR tends to overestimate the length of stenosis
191 Congenital heart disease causing pulmonary plethora and cyanosis
a) truncus arteriosus
b) total anomalous pulmonary venous drainage
c) patent ductus arteriosus
d) tetralogy of Fallot
e) transposition of the great arteries

192 Regarding carotid doppler US


a) the external carotid artery arises anteromedial to the internal carotid
b) a peak systolic flow of 150cm/s equates to a stenosis of 50%
c) a doppler angle of 70-90 deg is required to minimise error
d) spectral broadening alone signifies significant stenosis
e) surgical treatment is beneficial in symptomatic patients with 50% stenosis
193 Regarding MRA
a) can be used in the screening for 3-4mm intracerebral aneurysms
b) saturation techniques cancel out the signal in time of flight imaging
c) phase contrast imaging is better at quantitative measurement of flow than TOF
d) phase contrast imaging can detect flow in all directions
194 Ground glass change in HRCT is seen in:
a) bronchiectasis
b) left ventricular failure
c) pulmonary haemorrhage
d) alveolar proteinosis
e) hypersensitivity pneumonitis
f) COP
195 In HRCT septal lines are seen in:
a) lymphangiomyomatosis
b) pericardial effusion
c) allergic alveolitis
d) sarcoidosis
e) bleomycin lung toxicity
196 Non Hodgkins lymphoma of the chest:
a) is more common than Hodgkins
b) opacities developing over 3 days is a feature
c) may cavitate
d) associated lymphadenopathy is more common than in Hodgkins
197 Concerning myocardial imaging with thallium:
a) reduced uptake in infarct
b) reduced uptake in reversible ischaemia
c) reduced radiation dose compared with MIBG
d) thallium is injected at peak stress
e) lung uptake with bronchogenic carcinoma and lung lymphoma
198 Increased size of pulmonary arteries seen in
a) normal children
b) ASD in patients over 40
c) PE in the majority
d) COPD
e) Majority of Fallots tetralogy
199 V/Q lung scanning:
a) mismatched defects in infarct
b) cannot diagnose PE in COPD
c) relative contraindication is right to left shunt
d) renal uptake is seen in left to right shunt
e) defects characteristically change over a period of weeks with emboli

200 Primary stenting


a) for renal artery ostial lesions give better results
b) results with SFA angioplasty and stent much better than plasty alone ?F
c) nitinol possesses thermal energy
d) all patients need warfarin for 3 months
e) angioplasty prior to stenting reduces the risk of emboli ?
201 concerning deep vein thrombosis:
a) non compressibility is associated with acute thrombus
b) acute thrombus has hyperechoic strands on US
c) acute clot distends the vein
d) US can not detect non occlusive thrombus
e) non phasic flow through the PT vein confirms the diagnosis
202 Fat embolism :
a) occurs within 12 hours of trauma
b) CXR abnormality is seen prior to symptoms
c) associated with pericardial effusion F
d) apical opacities are seen ?f
e) pleural effusions are seen
203 Ascaris infection:
a) causes haematuria F
b) causes fleeting pulmonary infiltrates
c) can be seen on plain abdominal film f
d) causes biliary obstruction
e) causes calcified cerebral lesions f
204 Concerning the pericardium:
a) defects commoner on the right f
b) associated with congenital heart disease in 20% f (30% for all anamolies)
c) calcification is seen in constrictive pericarditis t
d) radiation is a cause of constrictive pericarditis t
205 Good indicators for aortic injury on CXR are:
a) tracheal deviation to the right
b) thickening of the right para tracheal stripe
c) left apical cap
d) fractures of first three ribs
e) normal contour of the aortic arch
206 Ground glass change on HRCT:
a) simulated by bronchiolitis obliterans
b) may assess areas of low attenuation by comparing to air in the trachea
c) confers 50% higher radiation dose than standard CT slice for slice
207 CTPA:
a) not diagnostic >4th generation artery branches
b) false positive in SVC obstruction f
c) false positive in L-R shunt f
208 Drug causes of pulmonary interstitial infiltrates include:
a) Aspirin T ( pul oedema)
b) busulphan t
c) prolonged oxygen therapy t

209 thoracic AIDS imaging:


a) the lesions of Kaposis sarcoma enhance t
b) the commonest cause of lymph node enlargement is TB f
c) lymphoma is likely to be extranodal t
d) a normal HRCT excludes PCP
e) atypical mycobacterium infection is more likely to be extranodal f
210 Intra arterial thrombolysis may be used to treat:
a) a popliteal aneurysm with occluded run off
b) intermittent claudication
c) cholesterol emboli
d) following SFA angioplasty with loss of pulses 24 hours later
211 The following are features of BOOP
a) dry cough
b) poor response to steroids
c) cavitation t (rare)
d) pleural effusion t (30% on HRCT, lymphadenopathy 25% HRCT)
e) peripheral subpleural opacities t
212 Decreased perfusion and ventilation of a lung may be seen on isotope scanning with
a) bronchogenic carcinoma
b) TB
c) aortic dissection
d) mediastinal fibrosis
e) pulmonary hypoplasia
213 Regarding non small cell carcinoma of the lung
a) squamous cell is less likely to have positive nodes than adenocarcinoma
b) MRI is better than CT at demonstrating superior sulcal tumours
c) CT can accurately separate tumour from adjacent atelectasis
214 The following are causes of thickened interlobar septa on HRCT:
a) LVF
b) Pericarditis f
c) alveolar proteinosis t (late stages)
d) lymphangitis carcinomatosis.
e) silicosis
215 The following are presenting features of mesotheliomas:
a) pericardial involvement. t
b) parietal pleura involvement. t
c) rib involvement f ( advanced cases)
d) associated pleural effusion t
e) interlobar fissure extension t
216 Concerning fibromuscular hyperplasia: 2/3 bil, R:L =4:1
a) is more common in males f (M:L= 1:3)
b) may involve the carotid arteries. t
c) intracranial involvement is recognised t
d) good result with angioplasty t
e) is more common as a cause of hypertension in patients below 40 years of age f ( renovascular HTN only)
217 Concerning the ischaemic limb:
a) limb claudication is likely to be due to a thrombotic process.
b) thrombolysis can be helpful.

c) thrombolysis is contraindicated folowing a recent CVA.


d) early angiography is contraindicated after thrombolysis.
218 Concerning thrombolysis:
a) ipsilateral antegrade approach to a femoral-popliteal graft is contraindicated.
b) compartment syndrome may be a complication of successful angioplasty.
c) intravenous therapy is as effective as local treatment.
219 Double aortic arch:
a) causes dysphagia. t
b) causes tracheal narrowing. t
c) carotid artery commonly originates from each aortic arch. t
d) associated with total anomalous pulmonary venous drainage. f
220 Concerning HIV infections:
a) commonest pneumonia organism is pneumocystis carinii.
b) commonest fungal infection of the GI tract is cryptococcus. t
c) in Kaposis sarcoma, lung lesions occur before skin lesions. F ( follow skin and visceral lesions)
d) cerebral lymphoma occurs in 6% f (2%, pulmonary 9-31%)
221 Digital artery ischaemia is seen in:
a) carpal tunnel syndrome
b) PVC workers
c) Systemic sclerosis
d) HPOA
e) RA
222 The following are features of AIDS related lymphoma in the thorax
a) Lymphadenopathy t
b) multiple pulmonary nodules t
c) pleural effusions t
d) single pulmonary nodule t
e) pericardial effusion t
223 Regarding thallium201 myocardial imaging
a) the optimal view to demonstrate septal infarcts is the LAO
b) a defect present on exercise but not at rest is indicative of reversible ischaemia
c) adequate imaging can be obtained in the presence of uncontrolled atrial fibrillation
d) diagnosis of ischaemia is unreliable in the presence of left bundle branch block
224 Regarding angioplasty of the superficial femoral artery
a) a popliteal approach is contraindicated
b) a balloon diameter of 8mm is appropriate
c) a stenosis length of 15cm is a contraindication
d) 50,000 IU heparin is normally given during the procedure
e) 90% of successfully treated stenoses will remain patent at 1 year
225 Reagrding peripheral thrombolysis
a) is most commonly carried out for embolic disease
b) a history of stroke within the previous 3 months is a contraindication
c) acute renal failure is a recognised complication
226 Concerning sequestrated lung segments
a) aortography is diagnostic in most cases
b) communication with bowel is not recognised
c) the presence of gas filled structure on CT excludes the diagnosis

227 Recognised associations of bilateral pulmonary agenesis include


a) diaphragmatic hernia t
b) gastroschisis f
c) anencephaly f
228 The following are features of Behets syndrome
a) SVC obstruction
b) pulmonary infarction
c) oesophageal stricture
d) bowel perforation
e) meningoencephalitis
229 In HRCT of the chest, the following are associated with predominantly subpleural changes
a) histiocytosis X f
b) cryptogenic fibrosing alveolitis t
c) scleroderma t
d) ankylosing spondylitis t
e) lymphangiomyomatosis t
230 Features more suggestive of a benign lesion in a lung mass seen on CT include
a) cavitation
b) calcification
c) fat density
231 Concerning ultrasound assessment of leg veins
a) in chronic DVT the vein diameter increases
b) a false negative result may be obtained in the presence of a bifid femoral vein
c) damping of amplitude on calf compression is indicative of distal calf vein thrombosis
d) normal femoral vein Doppler signal shows respiratory variation
232 Regarding total anomalous pulmonary venous drainage
a) the 4 chamber view on the antenatal scan may appear normal t
b) pulmonary plenaemia is a feature t
c) angiography is mandatory before corrective surgery f
d) an atrial septostomy may improve symptoms in the immediate postnatal period f
233 In HRCT of the lungs
a) ground glass change is associated with a favourable response to steroid treatment
b) cryptogenic fibrosing alveolitis is a recognised cause of ground glass change
234 the following are causes of bilateral hilar adenopathy
a) histoplasmosis t
b) primary pulmonary TB
c) silicosis t
d) sarcoidosis t
235 Concerning Abdominal Aortic Aneurysms
a) 90% arise below the renal arteries t
b) the normal aortic diameter is 3cm
c) calcification occurs in intraluminal thrombus in 90% T(75-86%)
d) a third have renal artery stenosis t (22-30%)
e) 80% have an occluded IMA t
236 The following have positive predictive value in blunt trauma to the thoracic aorta
a) tracheal shift to the right
b) apical pleural cap on the left

c) fracture of superior ribs


d) double aortic shadow f
e) pleural effusion
237 In pseudocoarctation
a) the aortic abnormality is sited proximally to the origin of the left subclavian artery f
b) rib notching is associated f
c) a narrowing of the aorta is seen on aortography ?f (notch)
d) peripheral embolisation is a complication f
e) there is anterior displacement of the aorta f (oesophagus)
238 In HRCT of the lungs the following cause nodular abnormalities
a) Asbestosis f
b) Silicosis t
c) fibrosing alveolitis f
d) histiocytosis t
e) sarcoidosis t
239 Possible causes of pleural thickening and a loculated pleural effusion include
a) rheumatoid arthritis t
b) tuberculosis t
c) mesothelioma t
240 Coarctation of the aorta is associated with
a) tracheoesophageal fistula f
b) bicuspid aortic valve t
c) turners syndrome t
d) horseshoe kidney t
e) Marfans syndrome t
241 Heart failiure
a) is associated with a dilated IVC t
b) is associated with a thickened gallbladder wall t
c) may cause dilated portal veins t
d) may cause reverse flow in portal veins t
e) is associated with ascites t
242 Rheumatoid arthritis is associated with
a) egg shell calcification in the lymph nodes f
b) longstanding pleural effusion t
c) upper zone fibrosis f
d) cavitation of nodules t
243 Concerning deep vein thrombosis
a) acute clot is hyperechoic
b) the vein gets larger with time
c) a duplex vein can cause a false negative examination
d) distal clot can cause loss of phasicity
244 In vascular ultrasound
a) doubling of the velocity indicates a significant stenosis t
b) normal popliteal artery demonstrates triphasic flow t
c) distal to an ileal stenosis there is triphasic flow f
d) stenosis is associated with spectral broadening t

245 Concerning oat cell carcinomas


a) they are most commonly located in the first and second order bronchi t
b) they are associated with hypertrophic pulmonary osteoarthropathy t
c) may be associated with metastases in 50% at presentation t
246 A bulge on the left lateral heart border may be seen in
a) Ebsteins anomaly f
b) total anomalous pulmonary venous drainage t
c) mitral stenosis t
d) a pericardial defect t
247 Tetralogy of Fallot may be associated with
a) left ventricular hypertrophy f
b) right ventricular hypertrophy t
c) ASD f
d) aortic stenosis f
e) VSD t
248 In Extrinsic Allergic Alveolitis
a) bird fanciers lung characteristically affects the bases f
b) non caseating granulomas are frequently found on transbronchial biopsy ? t
c) air trapping occurs t
249 Enlarged left atrium is typical in
a) ASD f
b) VSD t
c) TAPVD f
d) pulmonary AVM f
e) mitral stenosis t
250 AAA
a) prognosis is related to size t
b) most commonly presents with rupture. F (25%)
c) most involve the renals f
d) is a recognised cause of ureteric obstruction. t
e) is a recognised cause of consumptive coagulopathy. f
251 Asbestos related disease
a) typically 20 years delay before changes are seen f
b) pleural plaques are on visceral pleura f
c) commonest to see plaques on diaphragmatic pleura t
d) over 80% have visible plaques on CXR f
e) HPOA is common f
252 AIDS related PCP characteristically causes
a) Hilar lymphadenopathy f
b) Pleural effusions f
c) Multiple pneumatoceles t
d) Patchy pulmonary infliltrates after pentamidine nebulisers t
e) Ground glass opacities on CT t
253 BOOP
a) rapidly respondes to steroids t
b) causes focal consolidation t
c) is caused by rheumatoid arthritis t

d) is caused by acebutalol ?
e) associated with increased WCC ?
254 Causes of cavitating pulmonary metastases
a) squamous cell carcinoma of the skin t
b) osteosarcoma t
c) teratoma f
d) seminoma f
e) glioma f
SCC, sarcoma, colon, melanoma,TCC, cervix on chemo
255 Doppler US
a) aliasing is common due to a too high PRF f
b) cannot measure flow in a vessel < 1 mm f
c) PRF decreases with the depth of tissue t
d) an angle <65 degrees is necessary to avoid error t
e) colour flow helps to determine the angle of incidence t
256 Cystic fibrosis is associated with
a) generalised hyperinflation t
b) upper lobe bronchiectasis t
c) oesophageal varices t
d) hilar lymphadenopathy t
e) the majority have normal sinuses. f
257 Histiocytosis is associated with
a) diabetes mellitus f
b) exophthalmos t
c) pneumothorax f
d) females (m:f= 4:1)
e) lung fibrosis f
258 Contrast nephrotoxicity
a) Prophylatic haemodalysis for precention
b) 4 hourly 1L saline prior
c) CCF- more likely to occur
d) Occurs after 3 days
259 Digital ischaemia occurs in:
a) Bechets
b) Takayasu
c) Beurgers
d) Scleroderma
e) Ehlers-Danlos
260 Tuberculosis
a) 10-15% false negative chest xrays in AIDS patients
b) 1-5% chest xray false negative in normal population
c) Homogenous contrast enhancement of involved lymph node
d) Post primary occurs in the upper lobe in 80%
e) Post primary occurs in endobronchial in 10-15%
261 Drug trolley for adverse reaction to contrast should have:
a) 1:100 000 adrenaline
b) Beta 2 agonist inhaler
c) H2 anatgonist

d) Atropine
e) Diazepam
262 Fleeting opacification occurs in
a) EAA
b) Asbestosis
c) Aspergillosis
d) UIO
e) Alveolar cell Ca
263 In HRCT, air trapping is seen in
a) Bronchiolitis obliterans
b) EAA
c) Asbestosis
d) Emphysema
e) Lymphangitis Carcinomata
264 Egg shell calcification
a) Treated lymphoma
b) Sarcoid
c) Blastomycosis
d) Amyloid
265 Acute EAA
a) More than 50% chest xrays show lymphadenopathy
b) Ground glass is characteristic
c) Apices effected
d) Focal air trapping
266 Eosinophilia and chest xray changes occur in
a) Methoteraxate
b) Wegners
c) Round worm
267 Aortic dissection
a) Stanford A does not include descending aorta
b) Marfans more commonly involves ascending aorta
c) True lumen usually smaller than false
d) MTI more sensitive than TOE
268 Acute partial dissection
a) Angio contraindicated
b) Acute angle with aorta
c) Acute haematoma in sac is hight signal on T1W
269 CT Cardiac
a) Cardiac Images acquired during systole (early)
b) Left coronary gives off circumflex
c) Left coronary gives off marginal obtuse
d) Right coronary comes off anterior sinus
e) Radiation doses are comparable to coronary angiograms
270 Embolization of Fibroid
a) Pain post embolisation is commonest complaint
b) Vaginal discharge for weeks indicated infection

c) Women over age of 40 are at risk of early menopause


d) Subserosal fibroid can fall transvaginally
271 Intervention
a) In colonic embolization, ischaemia is a significant risk (>1%)
b) Polyvinal alcohol is used as an embolic agent
c) Abcolute alcohol is associated with pulmonary hypertension
d) The embolization catheter should be bigger than the vessel
e) Post embolic syndrome occurs with solid organs
272 Asbestose related
a) Asbestose related disease is on the rise
b) Nodular pleural thickening is benign
c) In mesothelioma marked enhacement is seen with Gadolinium on MR
d) PET used for tumour staging
273 Contrast in MRI
a) Gadolinium prolongs T1
b) Aortic enhacement is seen
c) Shortens T2*
274 Sedation in angio
a) The person performing angio should give drug and monitor sats
b) Midazolam is longer lasting than dizapam
c) Pre-sedation O2 is required
275 Increased acculmulation of FDG in lung is seen in
a) Pneumonia
b) PE
c) Pulmonary oedema
276 Ultrasound
a) The RPF is twice the frequency of the probe
b) There is a maximal doppler frequency that can be measured
c) PRF is low in deep vessels
277 Perfusions scanning
a) Left lung is more perfused than the right
b) Pulmonary oedema has perfusion defects that are non segmental
278 Lymphangitis carcinomata
a) Unilateral involvement is common
b) Is considered stage IV disease
279 Pulmonary AVM
a) 10-15% malignant transformation rate
b) Rim calcification is characteristic
c) In presence of fat, another diagnosis should be Considered
d) Most lesions are peripheral.
280 In pregnancy
a) CTPA has same dose as scintography
b) Thyroid check for fetus post partum is needed is mum had pulmonary angio
c) Majority of normal chest xrays have positive PE exam
d) D-Dimer raised in pregnancy
e) 60% of perfusion scans are indeterminate of PE

281 Histocyotosis
a) Charactiscally cavitates
b) Typically occurs in smoker
c) Form regular cysts
d) Volume is preserved
282 Regarding Takayasus
a) Normally occurs in patients > 40years
b) causes constitutional symptoms
c) pulmonary arterial involvement occurs in <20%
d) associated with DVT
e) is associated with arterial stenoses
283 Regarding coarctation
a) in neonates, the majority have rib notching
b) if the patients survive childhood, they do not need treatment
c) associated with bicuspid valve
d) associated with Turners
e) associated with ASD in 50-60%
284 Regarding stents in intervention
a) self-expandable stents should not be used in biliary system
b) expandable stents should not be balloon dilated
c) a 16mm stent is too large for the IVC
d) cause neointimal neoplasia
e) double J ureteric stents need cystoscopic access
285 Pulse oximetry
a) is unreliable in severe anaemia
b) is impeded with jaundice
c) bright ambient light causes oximetry error
d) measures ventilatory function
e) measures arterial oxygenation
286 Acute ischaemic limb
a) in 80-90%, are caused by an embolic event
b) caused by angiogram
c) shouldnt be treated by thrombolysis
d) usually caused by SFA occlusion
e) caused by venous thrombosis
287 Carotid Doppler
a) a 4m/s velocity equates to stenosis of > 90%
b) in diastole, ECA flow is lower than ICA
c) vertebral arteries are successfully interrogated in 80%
d) if there is vertebral artery dominance then L is dominant in 80%
e) there is reversal of flow in vertebral arteries in 5-10% of normal population
288 Regarding Pulsed Doppler USS
a) aliasing is common at 30cm/s
b) electronic gating is inefficient at 5cm depth
c) Doppler shift is proportional to transducer frequeny
d) cant measure directional flow
e) increasing the PRF causes range ambiguity

289 Structures in front of the Left main Bronchus


a) Left upper lobe artery
b) Superior pulmonary vein
c) Vagus
d) Phrenic vein
e) Left recurrent laryngeal nerve
290 Signs of malignancy in pleural disease
a) >1cm thickness
b) Nodularity
c) Mediastinal involvement
291 Concerning MRI artifacts
a) Chemical shift not observed on gradient echo sequences
b) Motion artifact in phase encoding direction
c) TR influences motion artefact
d) Susceptibility artifact reduced in T2* compared to T2
e) Turbulence in vessels increases signal
292 Pulmonary fibrosis
a) Methotrexate
b) Amiodarone
c) Captopril
d) High dose oxygen
e) Gold
293 The abdominal aorta
a) shouldnt measure more than 3cm is normal in people <50yrs
b) calcification occurs within the thrombus of a dissected aorta
c) 90% are below the renal arteries
d) US is useful to rule out rupture
e) multiple renal arteries occur in 15-25%
294 Renal artery aneurysms
a) occur in Takayasus arteritis
b) pregnancy increases the risk of rupture
c) associated with neurofibromatosis
d) in PAN are multiple
e) usually treated by embolisation if extrarenal
295 In asbestos-related lung disease
a) there can be unilateral involvement
b) there can be mediastinal involvement
c) in diffuse involvement the upper thorax is more involved than the lower thorax
d) pleural changes appear 3 5 years after asbestos exposure
e) in the diffuse form, nodular thickening is a feature
296 There is a greater perfusion defect than a ventilatory effect in
a) Bronchial carcinoma
b) Tumour embolus
c) COAD
d) Pulmonary hypertension
e) Pneumonia
297 Regarding features of rheumatoid disease
a) Splenomegaly

b) Lymphadenopathy
c) Subarachnoid haemorrhage
d) pulmonary fibrosis
e) pleural effusion
298 In the HIV positive patient
a) Kaposi's sarcoma occurs early in AIDS
b) Cryptococcal infection most commonly affects the CNS
c) Bacterial pneumonia is more frequent than PCP
d) Cavitation in TB occurs most commonly at a low CD4 count
e) Pleural effusion is characteristic of Kaposi's sarcoma
299 Regarding vascular anatomy
a) The portal vein formed by the splenic vein and IMV
b) L gastric artery comes off the coeliac artery
c) The uterine artery arises from the anterior branch of the internal iliac artery
d) the middle colic comes off the SMA
e) The R hepatic artery arises from the SMA in 20-30%
300
The following are associated with sarcoidosis
a) focal boney sclerosis
b) upper lobe fibrosis
c) cardiac arrhthymias
d) facial palsy
e) oesophageal dysmotility
301 The following are correct
a) In intralobar sequestration the majority are associated with congenital anomalies
b) CCAM usually affects a single lobe
c) Morgagni hernia are usually left sided
d) Scimitar syndrome affects the left lobe in 10-20%
e) Bronchogenic cysts are calcified in less than 10%
302 Regarding congenital cardiovascular defects
a) There is always a R to L ASD in tricuspid atresia
b) VSD is the most common congenital heart disease
c) Double aortic arch causes posterior indentation of the oesophagus
d) Coarctation is associated with rib notching of the upper 6 ribs
303 Abdominal doppler US
a) Post prandial end diastolic volume in SMA is decreased
b) Renal A waveform is low resistance
c) The hepatic V adjacent to the IVC is pulsatile with bidirectional flow
d) Resistive index increases in acute ureteric obstruction
e) Resistive index is used to differentiate between acute rejection and ATN in a transplanted kidney
304 Cysts are seen in the following
a) Lymphangiomyomatosis
b) histiocystosis X
c) emphysematous bullae
d) tuberous sclerosis
e) pneumocystis carinii

305 Regarding lymph nodes


a) in sarcoid egg-shell calcification is seen
b) calcification is seen in silicosis
c) 8mm in short axis is abnormal for mediastinal lymph nodes
d) usually measure longitudinal axis
e) in TB shows necrotic cavity and enhancing rim
306 Contraindications in intraarterial thombolysis include;
a) Pregnancy.
b) Muscle necrosis.
c) Vein graft thrombosis.
d) Calf arterial thombosis.
e) Recent stent insertion.
307 Concerning FMD
a) Over 25% have coronary involement.
b) 70-80% re stenosis post angioplasty in RAS
c) Can be distingusished fromatheromatous disease post captopril renogram
d) Alternating dilatation and stenosis in carotids.
e) Found at the renal artery ostium id suggestive of diagnosis.
308 Concerning visceral blood supply:
a) The portal vein is formed by the confluence of the splenic and inferior mesenteric veins
b) The left gastric artery usually arises from the coeliac axis
c) The uterine artery is usually a branch of the anterior division of the internal iliac artery
d) The right hepatic artery arises from the superior mesenteric artery in 20-30%
e) The middle colic artery is usually a branch of the superior mesenteric artery
309 In Aorto-arteritis (Takayasus disease)
a) Most patients are over the age of 40 years at presentation
b) Generalised constitutional symptoms are seen in the majority of patients
c) The pulmonary artery is affected in less than 20% of patients
d) Arterial stenoses are a feature
e) Deep vein thrombosis has an association
310 Regarding abdominal aorta
a) Normal diameter should be 3cm or less
b) Calcification can be seen in intramural thrombus
c) 90% aneurysms are infrarenal
d) US can be useful in excluding rupture
e) More than one renal artery in 15-25%
311 Regarding renal artery aneurysm
a) Is a recognised feature in Takayasus arteritis
b) There is increased risk of rupture in pregnancy
c) Is a recognised association in neurofibromatosis
d) Usually multiple in polyarteritis nodosum
e) Extrarenal renal artery aneurysms are treated by embolisation in the majority of cases

312 Causes of a Pericardial effusion


a) ASD
b) Aortic Stenosis
c) Anticoagulants
d) Rheumatoid Arthritis
313 Ionic contrast
a) risk of death is 1/20000 30000
b) increased complications occur with pre-hydration
c) is antigenic
d) increased complications occur with cardiac failure
314 The following are true
a) With a double aortic arch you get oesphageal compression
b) The hepatic vein is pulsatile at the IVC.
c) Tricuspid Atresia always has an ASD
d) Rib notching occurs in the first 6 ribs

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