FRCR MCQ 5

Question 1

On CT pulmonary angiography (CTPA), which feature is most specific for chronic pulmonary embolism rather than acute PE?

Accepted Answer

Eccentric filling defect forming an obtuse angle with the vessel wall

Answer

Chronic PE shows eccentric mural thrombus forming an obtuse angle with the vessel wall due to organisation and adherence, contrasting with the acute PE 'polo mint' or acute angle sign.

Question 2

Which sequence is most appropriate for evaluating articular cartilage integrity in the knee on MRI?

Accepted Answer

Proton density fat-saturated (PDFS) sequence

Answer

Proton density fat-saturated sequences provide optimal contrast between cartilage and adjacent tissues, making them the sequence of choice for cartilage evaluation.

Question 3

A 60-year-old smoker has a 1.2 cm solid pulmonary nodule on CT. According to Fleischner Society guidelines (2017), what is the recommended follow-up?

Accepted Answer

CT at 3 months, then 18-24 months if stable

Answer

For high-risk patients (smoker) with solid nodules 6–8 mm, Fleischner 2017 recommends initial CT at 3 months, then 18–24 months if stable; for >8 mm nodules, CT at 3 months, PET or biopsy is appropriate.

Question 4

Which of the following is the most common site of metastatic disease in the brain from a primary lung carcinoma?

Accepted Answer

Grey-white matter junction of the cerebral hemispheres

Answer

Haematogenous metastases preferentially lodge at the grey-white matter junction where vessel calibre abruptly decreases, trapping tumour emboli.

Question 5

Which radiological feature best distinguishes a hepatic adenoma from focal nodular hyperplasia (FNH) on MRI?

Accepted Answer

Absence of a central scar and presence of intracellular fat or haemorrhage in adenoma

Answer

Hepatic adenomas may contain intracellular fat or areas of haemorrhage and typically show no hepatobiliary phase uptake, whereas FNH retains gadoxetate on hepatobiliary phase due to functional bile canaliculi.

FRCR - Fellow of the Royal College of Radiologists Practice Test

FRCR - Fellow of the Royal College of Radiologists Practice Test

FRCR MCQ 5