1.

A 60 years gentle man who was smoker is diagnosed as case of lung carcinoma on bronchial
brushings. On CT chest collapse of right lower lobe collapse is reported but the pulmonologist is
convinced that right lower lobe is not collapsed but is invaded by tumour. You are the
radiologist in that hospital. The physician consults you and MRI chest is planned by mutual
consenses.

To distinguish between collapsed lung from tumour the most important MR sequence is:
a) ADC mapping
b) DW sequence
c) FLAIR sequence
d) T1W sequence
e) T2 sequence

David Sutton 7th edition page 125

2. A 60 years gentle man who was smoker is diagnosed as case of lung carcinoma has severe chest
wall pain on right side. His treating physician suspects that the tumour has infiltrated the chest
wall. You are the radiologist in that hospital. The physician consults you and want to discuss with
you the most helpful examination to determine earlierst chest wall invasion.

Earliest chest wall invasion by tumour is best delineated on:

a) CT
b) Fluroscopy
c) MRI
d) Ultrasound
e) X-ray chest

David Sutton 7th edition page 125

3. A 60 years gentle man who was smoker is diagnosed as case of lung carcinoma has severe chest
wall pain on right side. His treating physician suspects that the tumour has infiltrated the chest
wall. You are the radiologist in that hospital. MRI of chest was performed which revealed T2
hyperintense signals in chest wall muscles. This is suggestive of chest wall invasion.

The other condition in which T2 hyper intense signal seen in chest wall muscles would be:
a) Congenital disease
b) Inflammatory disease
c) Metabolic disease
d) Vascular disease
e) Post traumatic sequelae

David Sutton 7th edition page 125

 4. A 60 years gentle man who was smoker is diagnosed as case of lung carcinoma has severe
ischemia of right hand with excruciating pain. His treating physician suspects that the tumour
has infiltrated the vessel. You are the radiologist in that hospital.. The physician consults you and
want to discuss with you the most helpful examination to determine earlierst vascular invasion.

Earliest vascular invasion by tumour is best delineated on:

a. CT
b. Fluroscopy
c. MRI
d. Ultrasound
e. X-ray chest

David Sutton 7th edition page 126

5. A 50 years white gentle man, complains of persistent cough, wheezing, hemoptysis, flushing,
diarrhea and vomiting for the last 3 years. On chest X- ray he has recurrent unifocal
pneumonitis. On laboratory investigations his urinary 5-HIAA levels are very high.

The most common location of this tumour is:

a. Bronchial wall
b. Central Lobar
c. Endobronchial
d. exobronchial
e. Submucosal
David Sutton 7th edition page 122

6. A 50 years white gentle man, complains of persistent cough, wheezing, hemoptysis, flushing,
diarrhea and vomiting for the last 3 years. On chest X- ray he has recurrent unifocal
pneumonitis. On laboratory investigations his urinary 5-HIAA levels are very high.
His CT chest is performed which reveals mass lesion in main segmental bronchus.

This diagnostic finding on CT is:

a. Calcification on CT
b. Cystic spaces
c. No enhacement on CT
d. Non circumscribed mass
e. Pulmonary embolism
David Sutton 7th edition page 123
 7. A 65 years gentle man was asymptomatic through out life now had a single episode of
hemoptysis, and since last 6 months has vauge chest pain and cough. On CT chest there is a
lobulated smooth mass lesion with pop corn calcifications and fat density.

The differentials of this lesion would not include:

a. Amyloidoma
b. Granulomatous disease
c. Lipid pneumonia
d. Metastatic mucinous adenocarcinoma
e. Wegners granulomatosis

Danhert 6th edition page 497

8. A 65 years gentle man was asymptomatic through out life now had a single episode of
hemoptysis, and since last 6 months has vauge chest pain and cough. On CT chest there is a
lobulated smooth mass lesion with pop corn calcifications and fat density.

The common location of this lesion is:

a. Central
b. Chest wall
c. CP angle
d. Endobronchial
e. Peripheral

Danhert 6th edition page 497

9. A 30years gentle man has painless lymphadenopathy , unexplained fever, night sweats and
weightloss. CT guided biopsy of the mediastinal lymphnodes revealed Reed-Sternberg cells.

The frequency of involvement of lung prachyma by this disease is:

a. 10%
b. 20%
c. 30%
d. 40%
e. 50%

David Sutton 7th edition page 118

10. A 30years gentle man has painless lymphadenopathy , unexplained fever, night sweats and
weightloss. CT guided biopsy of the mediastinal lymphnodes revealed Reed-Sternberg cells.
 Most likely cause of pleural effusion is:

a. Inflammatory response of pleura

b. Involvement of pleura
c. Loss of renal functions
d. Lymphatic obstruction
e. Protein loss / hypoproteinemia

David Sutton 7th edition page 118

11. A 30years gentle man has painless lymphadenopathy , unexplained fever, night sweats and
weightloss. CT guided biopsy of the mediastinal lymphnodes revealed Reed-Sternberg cells.

Involvement of bronchial wall by this disease process may lead to:

a. Collapse/Consolidation
b. Pleural effusion
c. Pulmonary arterial hypertension
d. COPD
e. Cystic spaces in lung parenchyma

David Sutton 7th edition page 118

12. A 30years gentle man has painless lymphadenopathy , unexplained fever, night sweats and
weightloss. CT guided biopsy of the mediastinal lymphnodes revealed Reed-Sternberg cells.

According to Ann Arbor Staging Classifcation

a. Stage I- greater than 2 anatomic regions
b. Stage II- greater than 2 anatomic regions
c. Stage III- orgran involvement (such as kidney, liver, GI tract)
d. Stage IV E- splenic involvement
e. Stage IV S- extralymphatic site

Danhert 6th edition, page 499

13. A 30years gentle man has painless lymphadenopathy , unexplained fever, night sweats and
weightloss. CT guided biopsy of the mediastinal lymphnodes revealed Reed-Sternberg cells.

The most common extranodal site of this disease involvement is

a. Bone
b. Chest wall
c. CNS
 d. Head and neck
e. Thymus
Danhert 6th edition, page 500

14. 60 years lady, smoker is diagnosed as carcinoma lung. She consults most renowned
cardiothoracic surgeon of the town who order CT chest. You are the radiologist to report the CT
scan of the patient.

Sign which represent non- operability is:

a. Tumour invading the visceral pleura
b. Tumour involve main bronchus >2cm distal to carina
c. Tumour involving carina
d. Tumour size is less than 2 cm
e. Tumour involving segmental bronchioles
David Sutton 7th edition page 117

15. 60 years lady, smoker is diagnosed as carcinoma lung. She consults most renowned
cardiothoracic surgeon of the town who order CT chest. You are the radiologist to report the CT
scan of the patient. You find a cavitating lesion on CT scan.

The most likely type of lung cancer would be:

a. Adeno carcinomas
b. Mixed cell carcinomas
c. Oat cell carcinomas
d. Small cell carcinomas
e. Squamous cell cancers
David Sutton 7th edition page 108

16. A 50 year gentle man, smoker and worker of nickel industry compains of fever and weight loss.
He has a patch of consolidation in left lower lobe. He was prescribed antibiotics for 7 days and
after that follow up X-ray did not reveal any improvement. He was admitted and IV antibiotics
were given for another week which also did not reveal any improvement.

The next step in management would be:

a. CT guided biopsy
b. CT scan chest with contrast
c. Follow up X-ray after 1 week without treatment.
d. Prescribe antibiotics for another week
e. Ultrasound chest
David Sutton 7th edition page 108
17. A 50 year gentle man, smoker and worker of nickel industry compains of fever and weight loss.
On examination he has ptosis of right eye with miosis, along with anhydrosis of right side of
face.

Most likely finding on chest X ray would be:

a. Collapse of right lung
b. Erosion of 1st rib on right side
c. Hilar lymph node on right side
d. Pleural effusion on right side
e. Pneumothorax on right side
David Sutton 7th edition page 110

18. A 60 years old male, worker of asbestos industry presented with finger clubbing and joint pains
and hypoglycemias. The chest X-ray showed well defined lobulated mass adjacent to chest wall.

The latent period of asbestos exposure and development of this condition is:
a. 1-5 years
b. 5-10 years
c. 10-20 years
d. 20-40 years
e. 40-60 years
David Sutton 7th edition page 102

19. A 60 years old male, worker of asbestos industry presented with finger clubbing and joint pains
and hypoglycemias. The chest X-ray showed well defined lobulated mass adjacent to chest wall.
CT guided biopsy of this lesion was done which shows that this disease is malignant.

The occasional complication of this biopsy would be:

a. Development of ipsilateral pleural effusion
b. Massive bleeding at puncture site
c. Seedling of tumour along biopsy tract
d. Severe pain at puncture site
e. Tension pneumothorax with mediastinal shif
David Sutton 7th edition page 103

20. A 40 years old lady underwent laprotomy for small bowel obstruction. On post op day 7 she
developed high grade fever with chills and right upper quadrant abdominal pain. She is
suspected to have developed subphrenic abscess.
The plain film finding would not include:
a. Abnormal gas shadow between right hemidiaphragm
b. Elevated right hemidiaphragm
c. Erosion of right sided lower ribs
d. Right sided basal atelactasis
e. Right sided pleural effusion
David Sutton 7th edition page 53