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With negative marking your current score is 43 %
Combination. 3895 Question number 1
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Delayed visual evoked potentials with little or no change in their amplitude would be evidence in favour
of
a) multiple sclerosis
b) Friedreich's ataxia
c) an occipital glioma
d) hypothyroidism
e) hypocalcaemia
Your answer is T T F F F
The correct answer is T T F F F
Explanation
NO EXP
Combination. 1358 Question number 2
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the following are true of pleomorphic adenoma of the parotid gland
a) they are characteristically of high signal on T2
b) contain epithelial cells
c) usually presents with paralysis in the distribution of the facial nerve
d) compose less than 50% of all benign parotid tumours
e) commonly affect young adults
Your answer is T F F F T
The correct answer is T T F F F
Explanation
due to the and cellular component mucoid matrix B. pleomorphic adenoma of the parotid gland contains
a mixture of epithelial and myoepithelial cells C. the usual presentation is as a painless lump D. they
compose more than 80% of all parotid tumours E. they affect the elderly
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Combination. 3295 Question number 3
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the following show increased uptake of pertechnetate on the scan of a parotid gland
a) Wharton's tumour(papillary cystadenomalymphomatosum)
b) oncocytoma (oxyphillic adenoma)
c) mixed tumour
d) parotid simple cyst
e) normal lymph node
Your answer is T T T F F
The correct answer is T T F F F
Explanation
A. 6% of all parotid tumours characteristically start in the lower pole of the superficial lobe B. this
constitutes less than 1% of all parotid tumours C/D/ E NO EXP
Combination. 4107 Question number 4
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causes of peri-ventricular T2-weighted hyperintense lesions
a) hemochromatosis
b) HIV encephalitis
c) lymphoma
d) normal invaginations of subarachnoid space
e) SLE
Your answer is F T T T T
The correct answer is F T T T T
Explanation
A. Migraine: in 41% with classic migraine, in 57% with complicated migraine; presumed to represent
vasculitis-induced small infarcts B/C. NO EXP D. Virchow-Robin space = small invaginations of
subarachnoid space following pia mater along perforating nutrient end vessels into brain substance
Location: inferior third of putamen; usually bilateral E. Vasculitic disorder: SLE, Behcet disease, sickle
cell disease triad of deep white matter lesions + cortical infarcts + hemorrhage
Combination. 4140 Question number 5
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basal ganglia calcification
a) normal variant
b) hyperparathyroidism
c) hemochromatosis
d) Parkinson's syndrome
e) Cockayne syndrome
Your answer is T T F F T
The correct answer is T T F F T
Explanation
A. in 50% B. hyper AND hypo parathyroidism C/D. NO EXP E. type of dysmyelinating disease
autosomal recessive onset usually within 2nd year CT findings: microcephaly basal ganglion
calcification cerebral atrophy
Combination. 3668 Question number 6
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recognised features of Herpes simplex type 1 encephalitis
a) it is less common than Herpes simplex type 2 in neonates
b) tends to involve the limbic system
c) the mortality is over 50%
d) gyral enhancement on CT
e) high signal intensity on T2 MRI
Your answer is T T F T T
The correct answer is T T T T T
Explanation
A. herpes simplex type 2 affects neonates B. tends to involve the limbic system ; it includes several
lobes- cingulate gyrus ,insular cortex and subfrontal regions C/D/E NO EXP
Combination. 2106 Question number 7
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features of CNS lymphoma
a) Increased incidence in renal transplant patients
b) poor response to steroids
c) multicentric involvement
d) characteristic low attenuation on CT
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e) pronounced mass effect
Your answer is T T T F F
The correct answer is T F T F F
Explanation
A. Increased incidence in immunosuppressed patients (transplant, AIDS) B. steroid response is a
feature C. multicentric involvement of deep hemispheres. LOCATION : paramedian structures
preferentially affected; basal ganglia (50%), leptomeninges (30%), posterior fossa / brainstem (10 -
20%), thalamus, corpus callosum, periventricular white matter, vermis cerebelli, parenchymal mass
(<5%); multicentricity not uncommon D. usually mildly hyperdense (33%) / occasionally isodense /
low-density area (least common) E. little mass effect with significant peritumoral edema
Combination. 4146 Question number 8
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associations of an encephalocele
a) agenesis of the corpus callosum
b) skull fracture
c) holoprosencephaly
d) infective meningitis
e) heterotopic gray matter
Your answer is T T T F T
The correct answer is T T T F T
Explanation
A/D/E . NO EXP B. skull fx with leptomeningeal cyst C. fused frontal horns (holoprosencephaly?)
Combination. 3725 Question number 9
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Which of the following are true of arteriovenous malformation of the spinal cord?
a) they most commonly present in adults with subarachnoid haemorrhage
b) myelography is usually normal
c) intramedullary lesions may be supplied by the artery of Adamkiewicz
d) arteriography may demonstrate an associated intraspinal aneurysm
e) a 'glomus' type lesion is typically supplied by a single artery
Your answer is T T T T T
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The correct answer is F F T T T
Explanation
A. Spinal AVMs account for approximately 5% of all spinal 'tumours'. Most patients are in the fourth to
sixth decades and usually present with progressive myelopathy. Rarely presentation may be with an
acute neurological deficit'or subarachnoid haemorrhage. These forms of presentation are commoner in
children B.Myelography may demonstrate characteristic serpiginous intradural filling defects in at least
50-70% of cases. Lesions are predominantly retromedullary and commonest in the thoracic,or
thororacolumbar regions.The malformation consists of large 'arterialized' veins that drain a relatively
small nidus which is usually supplied by posterior retromedullary arteries or dural vessels. The venous
component may commonly appear as a single coiled vessel C. intramedullary AVMs are supplied by
multiple radiculomedullary arteries,including the artery of Adamkiewicz. These are usually high flow
lesions that produce symtoms due to a 'steal' phenomenon or due to actual cord he angiomatous
tissue.They are most commonly located in the cervical cord, especially in children D. In
adults,presentation with subarachnoid haemorrhage occurs in less than 30% of cases and almost
always indicates an associated spinal aneurysm. Spinal AVMs may be associated with port wine
stains, Weber-Osler-Rendu disease, vertebral haemangiomas and the Klippel-Trenaunay-Weber
sydrome(cutaneous angioma of the extremity with hypertrophy of the limb E. A 'glomus' type lesion is
another type of spinal AVM that appears as a small plexus or tuft of vessels that is usually supplied by
a single artery and does not have predominant draining veins. Less commonly, AVMs can be entirely
extradural and may present with radiculopathy
Combination. 2936 Question number 10
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in the spin echo pulse sequence
a) the Larmor equation is not obeyed
b) dephasing does not occur
c) two consecutive 90 degree radiofruequency pulses are applied
d) when used to produce a T1 weighted image a long TE should be used
e) in the dual echo pulse sequence performed for T2 weighted images both the spin echoes should be
generated at long TE times
Your answer is F T F F F
The correct answer is F F F F F
Explanation
NO EXPLANATION
Combination. 1593 Question number 11
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the following are true of radionuclide cisternography
a) is typically performed with free technetate
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b) is useful for investigating suspected normal pressure hydrocephalus
c) the first images are typically taken after about 2 hours after injection
d) activity at the vertex is normally seen after about 4 hours
e) Technetium-99m DTPA tends to have faster flow rate than CSF
Your answer is T T T T F
The correct answer is F T F F T
Explanation
A. ideal agents include Indium-111 DTPA which has a Physical half-life: 2.8 days; Technetium-99m
DTPA which is not entirely suitable for imaging up to 48 - 72 hours; Iodine-131 serum albumin
(RISA)which is no longer used secondary to pyrogenic reactions, and Ytterbium-169 DTPA which has a
Physical half-life of 32 days C. image lumbar region should be imaged immediately after injection to
assure subarachnoid injection D. activity at the vertex is not usually seen before 24 - 48 hours E.
Technetium-99m DTPA tends to have faster flow rate than CSF; used for shunt evaluation + CSF leak
study since leak increases CSF flow
Combination. 2289 Question number 12
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regarding the radiological features of the subarachnoid cisterns
a) the quadrigeminal cistern is seperated from the superior vermian cistern by the tentorium cerebelli
b) the pericallosal cistern cannot usually be distinguished on CT
c) in cervical myelography the needle is normally inserted to a depth of about 5cm before it penetrates
the atlanto-occipital membrane
d) cervical myelography may lead to injuiry to the posterior inferior cerebellar artery
e) the pericallosal cistern can be seen on CT to lie between the falx and the genu of the corpus
callosum
Your answer is T T T T T
The correct answer is F F F T T
Explanation
no explanation
Combination. 1475 Question number 13
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the following intraconal lesions typically have optic nerve involvement
a) Cavernous hemangioma
b) arterio-venous malformation
c) Optic nerve sheath meningioma
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d) Intraorbital lymphoma
e) Neurilemoma
Your answer is F F T T T
The correct answer is F F T T F
Explanation
A. does NOT involve the optic nerve B. this may be congenital, idiopathic or traumatic and is
associated with a dilated superior or inferior ophthalmic vein C. Optic nerve sheath meningioma
comprises 10% of orbital neoplasms and typically involves the optic nerve D. Intraorbital lymphoma
typically involves the optic nerve but may surround the optic nerve in an older patient E. Neurilemoma
commonly lies adjacent to the superior orbital fissure and inferior to the optic nerve and causes local
bone erosion
Combination. 2061 Question number 14
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the following are expected to be hypointense on T1-weighted MR
a) colloid cyst
b) early subacute phase of a cerebral hematoma
c) epidermoid of the CNS
d) rhabdomyosarcoma
e) meningioma
Your answer is T T T T T
The correct answer is F F T F T
Explanation
A. lesion hyperintense on T1WI + hyperintense on T2WI in 60% (related to large protein molecules /
paramagnetic effect of magnesium, copper, iron in cyst) B. very hyperintense on T1WI (= oxidation of
deoxyhemoglobin to methemoglobin results in marked shortening of T1) C. signal intensity similar to
CSF: heterogeneously hypointense lesion on T1WI + hyperintense on T2WI rarely hyperintense on
T1WI due to presence of triglycerides + polyunsaturated fatty acids D.signal intensity intermediate
between muscle and fat on T1WI + hyperintense on T2WI E.hypointense on T1WI + iso- to
hyperintense on T2WI (intensity depends on amount of cellularity versus collagen elements)
Combination. 3498 Question number 15
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recognised features of inflammatory cholesteatomas
a) cannot usually be detected by otoscopy
b) marked enhancement with Gd-DTPA on MR
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c) a high signal on T1 weighted MR
d) extension into the mastoid antrum is usually through the 'foramen of Prusack'
e) a recognised association with Alport syndrome
Your answer is T F F F F
The correct answer is F F F F F
Explanation
A. whitish pearly mass behind intact tympanic membrane (invasion of middle ear cavity and mastoid)
diagnosed otoscopically in 95% B. no enhancement with Gd-DTPA (enhancement is related to
granulation tissue) C. iso- / hypointense relative to cortex on T1WI D. extension posteriorly through
aditus ad antrum into mastoid antrum E. no association
Combination. 3839 Question number 16
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the following are true of hypopharyngeal carcinomas
a) when post-cricoid have a relatively poor prognosis
b) of the piriform sinus are likely to show early invasion of posterior ala of thyroid cartilage
c) most frequently present with hemoptysis
d) cervical adenopathy is present in about 10% at presentation
e) associated with sideropenic anemia
Your answer is T T F T F
The correct answer is T T F F T
Explanation
A. Prognosis: 25% 5-year survival (worst prognosis) B. NO EXP C. sore throat, intolerance to hot / cold
liquids (early signs) D. cervical adenopathy (in 50% at presentation) E. May be associated with:
Plummer-Vinson syndrome (= atrophic mucosa, achlorhydria, sideropenic anemia) affecting women in
90%
Combination. 1594 Question number 17
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the following are true of radionuclide cisternography
a) is typically performed with Iodine-131 serum albumin (RISA)
b) is useful for investigating suspected leptomeningeal cyst
c) the first images are typically taken immediately after injection
d) activity at the vertex is not normally seen before 12 hours
e) Technetium-99m DTPA is useful for CSF leak study
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Your answer is D N F D T
The correct answer is F T T T T
Explanation
A. ideal agents include Indium-111 DTPA which has a Physical half-life: 2.8 days; Technetium-99m
DTPA which is not entirely suitable for imaging up to 48 - 72 hours; Iodine-131 serum albumin
(RISA)which is no longer used secondary to pyrogenic reactions, and Ytterbium-169 DTPA which has a
Physical half-life of 32 days B. leptomeningeal cysts comprise about 1% of all pediatric skull fractures.
Pathogenesis: skull fracture with dural tear leads to arachnoid herniation into dural defect; CSF
pulsations produce fracture diastasis + erosion of bone margins (apparent 2 - 3 months after injury C.
image lumbar region should be imaged immediately after injection to assure subarachnoid injection D.
activity at the vertex is not usually seen before 24 - 48 hours E. Technetium-99m DTPA tends to have
faster flow rate than CSF; used for shunt evaluation + CSF leak study since leak increases CSF flow
Combination. 3842 Question number 18
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recognised features of capillary hemangioma of the orbit
a) commoner in adults
b) chemosis of the eyelid
c) well marginated on CT
d) spontaneous involution within 1 - 2 years
e) expansion of bony orbit
Your answer is F T T T F
The correct answer is F T F T T
Explanation
A. Age: first 2 weeks of life; 95% in <6 months of age B. chemosis (= edema) of eyelid + conjunctiva
exaggerated by crying C. poorly marginated (suggesting malignant cause) D.Prognosis: often increase
in size for 6 - 10 months followed by spontaneous involution within 1 - 2 years E. NO EXP
Combination. 3664 Question number 19
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agenesis of the corpus callosum is associated with
a) Arnold-Chiari II malformation
b) Dandy-Walker cyst
c) maternal diabetes
d) trisomy 13
e) hydrocephalus in about a third
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Your answer is T T F T T
The correct answer is T T F T T
Explanation
A. Arnold-Chiari II malformation (7%) B. Dandy-Walker cyst (11%) C/D/E NO EXP
Combination. 2271 Question number 20
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regarding the radiological features of the ventricular system
a) calcification of the choroid plexus of the lateral ventricle is usually bilateral
b) on axial CT the third ventricle and the temporal horns of the lateral ventricle can usually be seen on
the same axial slice
c) the body of the caudate nucleus is of relatively low attenuation on CT as compared to the gray
matter
d) MRI is useful for viewing the recesses of the third ventricle
e) the mean width of the body of the lateral ventricle of a full-term infant should not exceed 1cm
Your answer is T T F T T
The correct answer is T F F T F
Explanation
no explanation
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