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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%
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
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
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
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
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
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
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