20 Random Clinical Radiology Questions

Which of the following statements regarding contrast media viscosity is FALSE?

Contrast medium viscosity is not directly proportional to the concentration of iodine
Contrast medium viscosity and angiocatheter size are important factors in determining maximum injection rates
Viscosity of contrast media is affected by temperature
As viscosity increases, the pressure associated with an intravascular contrast medium injection decreases
If a rapid injection rate is delivered through a small gauge angiocatheter and contrast medium viscosity is high, the desired injection flow rate may not be achieved and the high pressure may cause catheter failure and/or vessel injury.

Which of the following statements regarding contrast media osmolality is FALSE?

Neonatal and paediatric patients are especially susceptible to fluid shifts and have a lower tolerance for intravascular osmotic loads when compared to adults.
In paediatric patients, the intravascular administration of hyperosmolar contrast medium may result in migration of fluid from extravascular soft tissues into blood vessels, consequently expanding blood volume
Large fluid shifts can cause cardiac failure and pulmonary oedema
Children with significant preexisting cardiac dysfunction may be at particular risk to large fluid shifts caused by hyperosomolar contrast media administration
The iodine concentration of contrast media has a linear relation to osmolality

Which of the following statements regarding Gadolinium-based IV contrast agents in paediatrics is FALSE?

The risk for fluid shift, vessel injury and extravasation would be the same as iodinated contrast media.
Allergic-like reactions to IV gadolinium-based contrast media in children do occur.
Paediatric allergic-like reactions to gadolinium-based contrast media are treated similarly to those reactions to iodinated contrast agents,
Severe reactions like nephrogenic systemic fibrosis (NSF) can occur in children.
As with iodinated contrast media, there is a significant range in osmolality and viscosity of gadolinium-based MR contrast agents

Which of the following statements regarding gastrointestinal contrast media use in children is FALSE?

Barium-based contrast agents are contraindicated in patients with suspected or known gastrointestinal tract perforation.
Low-osmolality contrast agents should be avoided in gastrointestinal tract perforation.
High-osmolality iodinated contrast agents should be avoided in children who are at risk for aspiration.
Aspiration of large volumes of barium-based contrast agent can be fatal.
Aspiration of large volumes of iodinate oral contrast agent can be fatal.

Which of the following statements regarding adverse reactions to IV contrast media is FALSE?

Patients who have had a prior allergic-like reaction to contrast medium have an approximately 5-fold increased risk of developing a future allergic-like reaction if exposed to the same class of contrast medium again.
Patients with unrelated allergies are at a 2- to 3-fold increased risk of an allergic-like contrast reaction and therefore restriction of contrast medium or premedication is generally recommended.
Patients with shellfish or povidone-iodine (e.g., Betadine®) allergies are at no greater risk from iodinated contrast medium than are patients with other allergies.
Patients allergic to gadolinium-based contrast medium are not usually allergic to iodinated contrast medium (and vice versa).
A history of asthma increases the likelihood of an allergic-like contrast reaction.

Which of the following statements regarding use of premedication for IV contrast media is FALSE?

A potential risk of premedication is transient leukocytosis.
The largest risk of premedication is indirect and related to the delay in diagnosis imparted by the multi-hour duration of premedication
In patients who are pre-medicated due to a prior allergic-like reaction to a known contrast medium, changing from one iodinated medium to another will not further reduce the likelihood of a subsequent contrast reaction,
Breakthrough reactions are reactions which occur despite premedication.
Oral premedication is preferred over IV premedication in most settings due to lower cost, more convenience, and greater supporting evidence in the literature

Which of the following statements regarding air embolism caused by IV contrast media injection is FALSE?

Patients with right-to-left intracardiac shunts or pulmonary arteriovenous malformations are at a higher risk of having a stroke develop from small volumes of air embolism.
Treatment of venous air embolism includes administration of 100% oxygen and placing the patient in the right lateral decubitus position (i.e., right side down)
Hyperbaric oxygen may reduce the size of air bubbles.
Air hunger can result from large amounts of air in the venous system.
A large-volume venous air embolism may be fatal.

Which of the following statements regarding extravasation of IV contrast media is FALSE?

Extravasation is more common in patients injected with contrast material of lower viscosity.
Extravasation occurs more frequently in patients who are non-communicative.
The risk of extravasation is minimised by using a plastic venous cannula rather than butterfly metal needles.
Extravasation risk is increased when contrast is injected into the hand, foot or ankle, when compared to the antecubital fossa.
Compared to iodinated contrast media, extravasation injuries are less likely during gadolinium-based contrast media injection, due to the lower toxicity and lower total volumes of the agent used.

Which of the following statements regarding seeking surgical consultation for a IV contrast media extravasation event is FALSE?

Surgical consultation should be sought if there is severe pain or progressive swelling.
Surgical consultation should be sought if there is altered tissue perfusion (decrease capillary refill time).
Surgical consultation should be sought if there is a change in sensation of the affected limb.
Surgical consultation should be sought if the extravsation volume exceeds 50 mL.
Surgical consultation should be sought despite the potential prolongation of length of stay if a radiologist determines a severe injury has occured.

A young boy undergoes an MCUG, which shows unilateral reflux of contrast into his ureter and pelvicalyceal system. There is no hydrouretonephrosis. According to the International Reflux Study Committee, what grade is this?

Grade I
Grade II
Grade III
Grade IV
Grade V

Which of the following statements regarding metformin is FALSE?

Patients taking metformin are not at higher risk than other patients for post-contrast acute kidney injury
If acute kidney injury were to be caused by the iodinated contrast media, an accumulation of metformin could occur, with resultant lactate accumulation
Metformin is a biguanide oral anti-hyperglycemic agent generally used to treat non-insulin dependent diabetes mellitus.
In patients taking metformin who are undergoing arterial catheter studies that might result in emboli (atheromatous or other) to the renal arteries, metformin should be temporarily discontinued at the time of or prior to the procedure
In patients taking metformin who are known to have acute kidney injury or severe chronic kidney disease (stage IV or stage V; i.e., eGFR< 30) metformin should be withheld for 48 hours subsequent to the procedure. It can be recommenced only after renal function has been re-evaluated and found to be normal.

Which of the following is NOT a finding diagnostic of pregnancy failure?

Crown-rump length (CRL) of ≥7 mm and no heartbeat on a transvaginal scan
Mean sac diameter (MSD) of ≥25 mm and no embryo on a transvaginal scan
Absence of embryo with heartbeat ≥2 weeks after a scan that showed a gestational sac without a yolk sac
Absence of embryo when amnion seen adjacent to yolk sac
Absence of embryo with heartbeat ≥11 days after a scan that showed a gestational sac with a yolk sac

Practice MCQ Clinical Radiology: An abdominopelvic CT acquired in the portal venous phase demonstrates a bear paw sign of the right kidney. Which condition does this sign indicate?

Xanthogranulomatous pyelonephritis
Emphysematous pyelonephritis
Lobar nephronia
Renal infarction
Renal papillary necrosis

A 35-year-old male patient presents to the emergency department after a fall from a ladder. A lateral radiograph of the ankle shows a decreased Böhler angle. What is the most likely diagnosis?

Calcaneal fracture
Talar fracture
Ankle dislocation
Lisfranc injury
Tibial plafond fracture

Which radiological sign is most commonly associated with congenital hip dysplasia on an infant’s hip ultrasound?

Femoral head subluxation
Shenton's line disruption
Perkins line abnormality
Acetabular angle increased
Positive Ortolani sign

According to the Todani classification cystym, which type of choledochal cyst is most commonly associated with cystic dilation of the distal common bile duct that protrudes into the duodenum?

Type I
Type II
Type III
Type IV
Type V

Which radiological finding corresponds to stage T3b in urothelial bladder cancer?

Tumour confined to the bladder mucosa
Tumour invading the bladder muscle
Tumour extending into perivesical fat
Tumour invading adjacent organs
Tumour metastasised to regional lymph nodes

A 58-year-old woman with deep vein thrombosis undergoes an interventional radiology procedure for catheter-directed thrombolysis. During the procedure, unfractionated heparin is administered to prevent clot formation. After the procedure, the patient complains of pain at the access site in the groin. Ultrasound reveals a hypoechoic collection with turbulent colour Doppler flow. Which of the following agents should be administered?

Fresh frozen plasma
Protamine
Cryoprecipitate
Vitamin K
Platelets

20 Random Clinical Radiology Questions

20 Random Clinical Radiology Questions

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