Radiology MasterClass quizzes 1-4

E. The image is normal

Athletic 24-year-old female non-smoker with palpitations. Which statement is true? A. The lungs are hyperexpanded B. The heart is enlarged C. Multiple rib fractures are visible D. Breast asymmetry indicates a previous mastectomy E. The image is normal

D. Left mid and lower zone consolidation

Chest pain in patient with permanent pacemaker inserted 2 months previously. Which radiological finding is present? A. Normal image B. Pacemaker incorrectly positioned C. Pacemaker insertion complicated by large pneumothorax D. Left mid and lower zone consolidation E. Enlarged heart

D. The lungs are hyperexpanded

Cough, weight loss and finger clubbing. Which statement is true? A. The image is diagnostic of lung cancer B. The image is diagnostic of pneumonia C. Blunting of the costophrenic angles is due to pleural effusions D. The lungs are hyperexpanded E. The heart is enlarged

C. Trauma

What is the most likely cause of chest pain seen in this close-up chest X-ray image? A. Infection B. Cancer C. Trauma D. Fibrosis E. Sarcoidosis

A. Oesophageal stent

Which artifact is seen on this chest X-ray detail image? A. Oesophageal stent B. Aortic stent C. Inhaled foreign body D. Sternotomy wires E. Tracheal stent

B. Septal lines (Kerley B lines)

Which finding is present in this close up chest x-ray image? A. Bronchietasias B. Septal lines (Kerley B lines) C. Accessory fissures D. Lung fibrosis E. Normal chest X-ray

D. Calcified pleural plaques

Which finding is present on this detail image of the left lung? A. Mesothelioma B. Asbestosis C. Pleural Effusion D. Calcified pleural plaques E. Normal x-ray image

C. Meniscus sign

Which finding is present on this image? A. Normal x-ray image B. Sail sign C. Meniscus sign D. Pneumothorax E. Air bronchogram

C. Pectus excavatum

Which finding is present? A. Normal B. Dextrocardia C. Pectus Excavatum D. Right middle lobe pneumonia E. Cardiomegaly

A. Normal chest x-ray

Which finding is present? A. Normal chest x-ray B. Cardiomegaly C. Pectus excavatum D. Azygos fissure E. Free gas under the diaphragm

C. The previous image is irrelevant to interpretation of this image

2 images (First one in picture). Rapid onset shortness of breath and chest pain. A previous chest x-ray is shown for reference (not included). Regarding the image, which statement is FALSE? A. The costophrenic angles are blunt B. The upper zone vessels are enlarged C. The previous image is irrelevant to interpretation of this image D. The image is of adequate quality E. The diagnosis is consistent with heart failure

B. Phrenic nerve palsy

2 images on original quiz. Image 2 uploaded. Patient with lung cancer. Image 1 shows a right hilar mass. What complication has occurred at the time of image 2 which was acquired 4 months after image 1? A. Lung metastases B. Phrenic nerve palsy C. Right lower zone pneumonia D. Right pleural effusion E. Left pneumothorax

E. The areas of consolidation have improved

2 images. (Image 2 = 6 weeks later) 69-year-old male smoker with a productive cough, fever, and raised white cell count and C-reactive protein. He was started on antibiotics at the time of image 1. Which image is TRUE regarding image 2? A. Metastatic renal cell carcinoma is the most likely cause of the X-ray appearances B. Multi-focal consolidation of the lungs is invariably due to pneumonia C. Comparison with previous chest X-rays would not be helpful in this setting D. The radiological features alone are diagnostic of lobar pneumonia E. The areas of consolidation have improved

A. Chest x-rays are not required routinely in the setting of clinically suspected uncomplicated rib fractures

2 images. Image 2 - detail image here. Patient with chest pain. Which statement is true? A. Chest x-rays are not required routinely in the setting of clinically suspected uncomplicated rib fractures B. There is no cause of chest pain demonstrated on these images C. A normal chest X-ray excludes rib fractures D. This image shows blunting of the left costophrenic angle indicating a haemothorax E. The patient is rotated and so the image is non-diagnostic

E. Consolidation

20 year old female with high temperature and cough. Which answer best describes the appearance? A. Normal B. Image inadequate due to patient rotation C. Pleural Effusion D. Lung cancer E. Consolidation

E. Normal appearances

29-year-old male - presented with cough and pleuritic chest pain. What is the rediological diagnosis? A. Metastatic disease B. Pulmonary fibrosis C. Sarcoidosis D. Surgical emphysema E. Normal appearances

B. The patient has smoked heavily for many years

55-year-old male. Which is the most likely clinical scenario? A. Clinically suspected bowel perforation B. The patient has smoked heavily for many years C. Unilateral hyper-resonance to percussion D. Long history of cardiomegaly E. Multiple previous exposures to asbestos

C. Aspiration pneumonia

A 78-year-old woman remains in hospital 4 weeks after a stroke with residual poor swallow. She becomes short of breath with a cough, high temperature, and raised inflammatory markers; none of these clinical features were present at the time of admission. The X-ray appearances are most likely caused by which complication? A. Lung fibrosis B. Community acquired pneumonia C. Aspiration pneumonia D. Surgical emphysema E. Heart failure

C. The chest drain is adequately positioned

A chest X-ray taken one hour earlier showed a large right pneumothorax. A chest drain was inserted, and a repeat X-ray was obtained. Which statement is true? A. The pneumothorax is now small and so the chest drain can be removed B. The chest drain is incorrectly placed and should be removed C. The chest drain is adequately positioned D. The chest drain has pierced the right lung and should be removed E. The chest drain should be replaced by a larger chest drain regardless of the clinical response

D. Surgical emphysema

A chest drain has been inserted to treat a large pneumothorax and a chest X-ray was requested to check its position. Which feature does the X-ray show? A. Normal appearances B. Correctly placed chest drain C. Cardiomegaly D. Surgical emphysema E. Inadequate image - the X-ray should be repeated

A. The lungs are hyperexpanded

Longstanding heavy smoker with a dry cough. Which statement is true? A. The lungs are hyperexpanded B. Blunting of the costophrenic angles is due to pleural effusions C. The heart is enlarged D. The patient is rotated to their right E. The smoking history is irrelevant to interpretation of this image

B. Right lower zone

Middle-aged male with cough, high temperature, and chest pain. Where is the acute abnormality? A. Right upper zone B. Right lower zone C. Left upper zone D. Left lower zone E. Below the diaphragm

E. Right lung

Nasogastric tube insertion with failure of attempted aspiration of gastric fluid. What is the location of the nasogastric tube? A. Stomach B. Within a hiatus hernia C. Right upper quadrant of abdomen D. Right side of the mediastinum E. Right lung

A. Immediately return to reassess the patient and alert your team of the X-ray findings

On seeing this chest X-ray, which of the following actions is most appropriate? A. Immediately return to reassess the patient and alert your team of the X-ray findings B. Request a CT of the chest with intravenous contrast C. Request an ultrasound of the abdomen D. No action is necessary - the image is normal E. Request a repeat X-ray - it is under-penetrated

B. Left internal jugular catheter

PA image. Which of the following is not present? A. Cardiomegaly B. Left internal jugular catheter C. Prosthetic heart valves D. Pacemaker device E. Sternotomy wires

E. Left lower zone

Patient with cough and fever. Which area is abnormal? A. Right upper zone B. Left upper zone C. Both middle lobes D. Right lower zone E. Left lower zone

E. Primary bronchogenic lung carcinoma

Regarding this X-ray - the most likely diagnosis is.... A. Sarcoidosis B. Mesothelioma C. Pulmonary fibrosis D. Thymoma E. Primary bronchogenic lung carcinoma

C. Primary bronchogenic carcinoma

Smoker with weight loss, haemoptysis, and finger clubbing. The most likely diagnosis is...? A. Sarcoidosis B. Glioblastoma metastasis C. Primary bronchogenic carcinoma D. Pneumonia E. Normal X-ray

E. A sign of interstitial pulmonary oedama

The radiological feature shown is... A. Diagnostic of sarcoidosis B. Not a significant finding in the context of suspected heart failure C. Diagnostic of lymphangitis carcinomatosa D. A normal variant E. A sign of interstitial pulmonary oedama

C. Tuberculosis infection

What are the chest X-ray appearances most likely due to in this patient with a cough? A. Pulmonary oedema B. Lung metastases C. Tuberculosis infection D. Previous spontaneous pneumothorax E. Sarcoidosis

E. Dextrocardia with normal situs (situs solitus)

What congenital abnormality is visible in the chest X-ray of a patient with no respiratory symptoms? A. Right-sided aortic arch B. Tetralogy of Fallot C. Dextrocardia with bronchietasias related to Kartagener's syndrome D. Dextrocardia with situs inversus E. Dextrocardia with normal situs (situs solitus)

D. The azygo-oesophageal line

What does the anatomical line marked on the image represent? A. The anterior junctional line B. The right heart border C. The right paratracheal stripe D. The azygo-oesophageal line E. The descending thoracic aorta

B. Pleural effusion

What is the abnormality demonstrated radiological? A. Breast asymmetry due to previous mastectomy B. Pleural effusion C. Air bronchogram D. Bilateral hilar enlargement E. Phrenic nerve palsy

D. Hiatus hernia

Which of the following features is present? A. Dextrocardia B. Bilateral pleural effusions C. Pericardial effusion D. Hiatus hernia E. Normal chest X-ray

D. Any of the above

Which one statement is true? On the grounds of imaging appearances alone, the diagnosis is... A. Pneumonia B. Lung cancer C. Pulmonary contusion D. Any of the above E. Normal chest X-ray

C. Right side of chest hyper-resonant to percussion

Which physical examination sign would you expect to be present at that time of taking this X-ray? A. Left sided bronchial breathing B. Tracheal deviation C. Right side of chest hyper-resonant to percussion D. Normal examination finsings E. Finger clubbing

A. The image shows a finding which could be explained by recent laparoscopic surgery

Which statement is TRUE? A. The image shows a finding which could be explained by recent laparoscopic surgery B. Urgent CT scanning is required regardless of the clinical context C. The abnormality is obvious and so a systematic approach is not required D. The image is of poor quality and should be discarded and repeated E. The heart is enlarged

D. The nasogastric tube should be removed

Which statement is correct? A. The x-ray is of poor quality and should be repeated B. The endotracheal tube should be advanced C. The internal jugular catheter should be removed D. The nasogastric tube should be removed E. The lungs are normal

E. None of the above (normal x-ray)

Which structure is abnormal? A. Heart B. Right hilum C. Aortic knuckle D. Trachea E. None of the above (normal x-ray)

D. Right paratracheal stripe

Which structure is visibly normal in this patient with lung cancer? A. Left upper zone B. Left hilum C. Left lower zone D. Right paratracheal stripe E. Right hilum