This presentation was basically a test for IMM candidates who were appearing in the IMM exam Dec. This test in the form of PPT contain the format of CPSP. Very helpfull for candidates.

1. Mock Test for IMM Radiology
Dr. Muhammad Bin Zulfiqar
Dr. Tayyaba Niazi
PGR Services Hospital Lahore / Services Institute
of Medical Sciences

2. 1
2
3
4
5

3. • Study
• Findings
• Diagnosis
• Most Common cause
• What Next

4. • Which modality?
• What happened?
• Solution.
• Name two other
examples?

5. • Study
• Findings
• Diagnosis
• Radiological suggestion

6. (1). Modality and View
2
3
4 5

7. • Study
• Findings
• Diagnosis
• What Next

8. Label 2
Labelfsdkhsjfkfz
zhfjzhj 2
Label 3
Label 5
Label 4
Label 4Label 4
Label 4Name the Machine

9. • Study and View.
• Findings
• Diagnosis
• Differntial Diagnosis.
• Name the Sign on IVU
H/O Left Flank Pain

10. Fill the missing
• The smaller the anode angle, the larger the
heel effect.
• The usual shape of a focal spot is the double
• Banana???
• K X Ray energy of Molybdenum is Kev.
• Atomic No of Tungsten is ????
• Pair production has role in radiology.

11. • Name the study.
• Findings
• Diagnosis.
• Conventional radiographic approach regarding
posttraumatic posterior urethral stricture
Poor stream from 2 years

12. • Label
• Name other types
• Benefit in single line

13. • Study
• Findings
• Diagnosis
• Differntial Diagnosis
• What Next

14. • Fill the missing

15. • Study
• Findings
• Diagnosis
• Differntial Diagnosis
• What Next
18 years F H/ O trichotilomania

16. 4
3
2
1
5

17. • Study
• Findings
• Diagnosis
• Differntial Diagnosis
• What Next

18. • Name above mentioned subject.
• Label from A-D

19. • Studies
• Findings
• Diagnosis

20. 5
4
1
2
3

21. • Study
• Findings
• Diagnosis
• Differntial Diagnosis
• What Next
CT done for an incidental finding on chest
radiograph in otherwise healthy young adult.

22. 1
2 5
4
3

23. • Study
• Findings
• Diagnosis
• Differntial Diagnosis
• What Next

24. • Name only 1-5

25. • Study
• Findings
• Diagnosis
• What Next

26. • Name the View.
• Describe Centering.
• Indications

27. • Study
• Findings
• Diagnosis
• Differntial Diagnosis

28. 1
2
5
4
3

29. 1
• WHAT STUDY?
• FINGDINGS?
• DIAGNOSIS?

30. • Name the View?
• Detailed Centering?
• Indications?

31. • WHAT STUDY’?
• FINDINGS?
• DIAGNOSIS?
• WHAT NEXT LL U
SUGGEST?

32. • Identify the Subject.
• Describe its types?
• Name the most commonly used grid in
Radiology?

33. • WHAT STUDY?
• FINDINGS?
• DIAGNOSIS?
• DIFFERENTIAL
DIAGNOSIS?
• WHAT NEXT?

34. Fill the missing

35. • WHAT STUDY??
• FINDINGS?
• DIAGNOSIS?
• DIFFERENTIAL?
• WHAT NEXT?

36. 1
2
3
4
5

37. • Study
• Findings
• Diagnosis
• Differntial Diagnosis
• What Next

38. Label 1
Label 1
Label 2
Label 5
Label 1
Label 1
Label 3
Label 4

39. • WHAT STUDY?WHICH
VIEW?
• FINDINGS?
• DIAGNOSIS?

40. • Name Lines, curve and Angle.
1
5
2
3
4

41. • What study?
• Findings?
• Diagnosis and types of
it?
• What further
investigation can b
done?

42. • Study
• Which Radiopharmaceutical is
used?
• What is half life
• Indications

43. • H/ O TB
• What study
• Findings
• Diagnosis

44. 1. Superior Cerebellar Vermis
2. Midbrain
3. Orbits
4. Posterior Cerebral Artery
5. Middle Cerebral Artery

45. • Gray Scale and Doppler abdominal
Ultrasound.
• Portal Vein is Distended by echogenic
thrombus. On color doppler no flow is seen.
Liver echotexture is coarse.
• Portal Vein thrombus.
• Hepatitis C, B
• Biphasic CT.

46. • MR Imaging.
• Phase encoded motion artifact / Ghosting.
• Council, immobilize or sedate patient / swap
phase and frequency.
• Any two Artifact.

47. • Contrast Enhanced Axial CT abdomen
Portovenous Phase
• Heterogeneously contrast enhancing lesion in
the body of pancreas which is completely
encircling the celiac trunk and its branches.
Conglomerate lymph nodes also seen.
• Pancreatic Body Malignant Mass.
• Tumor is irresectable irresectable.

48. (1). Coronal Cranial Ultrasound
(2). Cavum septum pellucidum
(3). Frontal Horne of Lateral Ventricle
(4). Cingulate gyrus
(5). Falx Cerebri

49. • Radiograph Chest PA and Lateral View.
• Radiograph demonstrates complete opacification
of the left hemithorax with abrupt cutoff of left
main bronchus with ipsilateral tracheal and
mediastinal shift. Associated marked
displacement of right lung anteriorly and
posteriorly across midline. Note the marked
anterior hyperlucency of the thorax on the lateral
view (B).
• Lung Mass (Bronchogenic Carcinoma).
• CT Chest with IV Contrast.

50. • Xray tube
• Spinning anode
• Anode heal effect
• Filament cathode
• Electron beam

51. • Ultrasound Pelvis Transverse and Longitudinal.
• Well defined cystic lesion is seen in the
urinary bladder at vesico-ureteric junction. No
definitive wall defect is seen.
• Ureterocele.
• Bladder diverticulum and Pseudoureterocele.
• Cobra Head Sign.

52. • Larger
• Double banana
• 19
• 69
• No

53. • Retrograde Urethrogram.
• Strictural narrowing of the bulbous urethra is
seen, however transit of contrast is seen into
posterior urethra.
• Stricture Bulbous urethra.
• simultaneous antegrade cystourethrography
and retrograde urethrography are often
required to determine the length of the
urethral defect.

54. • radiographic rating charts for a given x-ray
tube.
• Anode Cooling Chart, Housing cooling chart.
• Tube rating charts aid the radiographer in
using acceptable exposure levels to maximize
x-ray tube life.

55. • MD CT Sagittal Reconstructed MIP image.
• A homogeneously contrast enhancing lesion in
at the carotid bifurcation with splaying of ECA
and ICA. No vascular erosion or luminal
narrowing is seen. No definitive
Lymphadenopathy seen.
• Carotid Body Tumors.
• Neurilemomma,

57. • Ultrasound Abdomen Through Stomach
transverse View.
• An echogenic focus with shadowing seen
occupying and distending the stomach.
• Trichobezoar.
• Phytobezoar, foreign body, mass.
• Ct Abdomen Plain and with IV contrast

58. • Psoas Muscle
• Spinous Process
• Rectum
• Gluteus medius
• Gluteus maximus

59. • IVU
• Right kidney is visualized in the lower
abdomen and pelvis in front of right side of L5
vertebra and is relatively smaller with
prominent pelvicalyceal system.
• Right Ectopic Kidney— lower abdomen and
pelvis.
• Transplanted Kidney.
• DTPA, MR IVU, CT IVU

60. • A, Trough filter.
• B, Wedge filter.
• C, “Bow-tie” filter for use in computed
tomography.
• D, Conic filters for use in digital fluoroscopy.

61. • Radiograph Chest PA view. One of spot film of
barium swallow.
• Radiograph demonstrate mediastinal widening
with a tube like structure extending from neck to
the abdomen with air fluid levels.
• A smooth, tapered, beaklike narrowing of the
distal esophagus adjacent to the
gastroesophageal junction with hold up of
contrast in retrograde dilated esophagus.
• Cardiac Achlasia.

62. • IVC
• Right crus of diaphragm
• Aorta
• Main Portal vein
• Fissure / Ligamentum Teres

63. • CT Chest Axial Slice.
• A well defined smooth oval lobulated nodule
seen in posterior basal segment with popcorn
calcification. No tail sign and no spiculations.
• Hemartoma.
• Granuloma, AVM.
• Follow up radiograph 6 months. If no interval
change then yearly and then 2 yearly.

64. (1). Intercruciate recess
(2). Posterior cruciate ligament
(3). Body medial meniscus
(4). Anterior cruciate ligament
(5). Lateral meniscus

65. • Radiograph Chest PA view of Skeletally immature
subject.
• Cardiac size is enlarged with boat shape configuration
and cardiac apex pointing upward.
• Tetrology of fallot
• Other congenital Cyanotic Heart diseases. e.g. total
anomalous pulmonary venous return (TAPVR) ,
transposition of the great arteries (TGA) truncus
arteriosus and large AVSD
• Cardiac MRI / Cardiac CT
•

66. • Ascending Aorta
• Descending Aorta
• Brachiocephalic Trunk
• Right Subclavian Artery
• Right CCA

67. • Radiograph Right Hip and Radiograph right
Knee Joint.
• Radiograph demonstrates displaced fracture
of the intracapsular portion of the neck of
femur at level of its junction with femoral
head. Overlying caste is also seen. Foleys
catheter is also seen.
• Subcapital Femoral Neck Fracture.
• 3 D CT and MRI for pelvic pathologies

68. • Chest Radiograph PA View
• Radiograph demonstrates extensive bilateral
hilar lymphadenopathy with thickened right
paratracheal stripe. No definitve lung
pathology is seen.
• Sarcoidosis
• Lymphoma, T.B.
• HRCT Chest / CT Chest with IV Contrast

69. • Posterior oblique – both hands (ball catcher’s
or Norgaard projection)
• The vertical central ray is centred to a point
midway between the hands at the level of the
fifth metacarpo-phalangeal joints.
• This projection may be used in the diagnosis
of rheumatoid arthritis. It can also be used to
demonstrate a fracture of the base of the fifth
metacarpal.

70. • CT Skull Scout View and Axial CT Scan with
Bone Window.
• Numerous well defined lytic lesions of variable
size and shape are seen diffusely scattered in
the calvarium.
• Multiple Myeloma
• Metastasis, Lymphoma.
• Skeletal Survey, Whole body low dose CT, MRI,
PET CT.

71. (1). Scaphoid
(2). Capitate
(3). Triquetral
(4). Pisiform
(5). Hook of Hamate

72. • Ct BRAIN (PLAIN) Axial slice
• Hyperdense cresentric shaped lesion in right
parietal region,effacement of ipsilateral lateral
ventricle and adjacent sulci. Fracture of
underlying bone with associated scalp
hematoma .no midline shift,no subarachnoid
extension.
• Subdural hematoma.

73. • Tunnel View.
• Centre immediately below the apex of the
patella, with the following angulations to
demonstrate either the anterior or posterior
aspects of the notch:
– 110 degrees angulation along long axis of tibia to look
for Anterior aspect of the notch.
– 90 degrees angulation along long axis of tibia to look
for Posterior aspect of the notch.
• Loose bodies and Fracture of tibial Spine.

74. • CT brain(plain) axial slice
• Hypodense lesion involving the right MCA
territory, loss of grey and white matter
differentiation, effacement of sulci…vanishing
basal ganglia sign.mass effect causing effacement
of ipsilateral lateral ventricle.no midline shift
• Acute Infacrt in Right MCA territory
• Carotid Doppler and echocardiography

75. • Crossed Grid.
• Parallel grid, Crossed Grid, Focused Grid,
Moving grid.
• Moving Grid.

76. • X Ray chest PLAIN PA view
• lobulated soft tissue opacities in both hilar
regions , lung fields are normal and cp angles
are clear,
• Sarcoidosis
• Dd Lymphoma , Tuberculosis , histoplasmosis
• Blood ACE levels

78. • X ray wrist frontal projection
• Expansile Lytic lesion located at the distal end
of radius with multiple trabeculations/sepate
, no fracture of bone noted. No intra articular
extention.
• Giant cell tumor
• Dd aneurysmal bone cyst, simple bone cyst,
fibrous dysplasia, metastasis
• CT or MRI (show fluid fluid levels)

79. (1). Cervical Portion of ICA
(2). Supraclinoid portion of ICA
(3). Ophthalmic Artery
(4). ACA
(5). MCA

80. • HRCT
• Axial CT at the level of the lower part of the
chest shows bilateral bronchiectasis in the right
middle lobe and the left lower lobe with some
mucoid impactions. Note the presence of
bronchial wall thickening and multiple foci of
‘tree-in-bud’ sign, reflecting infectious
bronchiolitis.
• Situs inversus (Kartagener’s syndrome).
• Cystic Fibrosis.

81. (1). Subscapularis
(2). Supraspinatus
(3). Tendon of long head of bicep
(4). Acromioclavicular Joint
(5). Glenoid

82. • Mamography MLO view
• A large thin walled well defined encapsulated
lesion with heterogeneous density in retroareolar
region of right breast. It consists of both fat and
soft tissue density. No intralesional calcification
is noted. No skin thickening or nipple retraction is
noted.
• Possibility of benign hamartomatous lesion
(fibroadenolipoma). Also called as BREAST
WITHIN BREAST appearance

83. (1). Perkin's line
(2). Hilgenreiner's line
(3). Shenton's curve
(4). Acetabular angle
(5). Acetabular Line

84. • Plain X ray Chest PA view
• Multiple gas locules within the lower left
chest, the majority of the rest of the left lung
opacified. The left hemidiaphragm can not be
seen. The mediastinum and the heart are
deviated to the contralateral right side.
• congenital Diaphragmatic hernia. Two types
bochdAalek and morgagni
• Barium study(follow through) and ct scan

85. • Thyroid Scan
• 99m TC
• 6hours
• Thyroid nodule, Thyroiditis

86. • Plain x ray chest frontal projection
• A cavity in the left upper zone with the
formation of intra-cavitary bodies and
surrounding fibrosis, suggestive of mycetoma
formation. The left lower zone reveals
bronchiectatic changes.
• Mycetoma formation on background of
tuberculosis.

87. THANK YOU