SPEX SPEX Radiology and Imaging 2

Question 1

Which finding on ultrasound is most consistent with acute cholecystitis?

Accepted Answer

Gallbladder wall thickening with a positive Murphy's sign on US

Answer

Sonographic Murphy's sign (probe tenderness over the gallbladder) combined with wall thickening >4 mm is highly specific for acute cholecystitis.

Question 2

What is the most appropriate imaging for a pregnant woman with suspected appendicitis when ultrasound is inconclusive?

Accepted Answer

MRI abdomen without contrast

Answer

MRI without contrast is preferred in pregnancy for inconclusive ultrasound findings because it avoids ionizing radiation while providing excellent soft tissue detail.

Question 3

A bone scan shows a 'cold' lesion in a patient with known multiple myeloma. What does this indicate?

Accepted Answer

Aggressive lesion with poor blood flow

Answer

Cold lesions on bone scan represent areas of poor vascularity; in myeloma, purely lytic lesions may not take up the tracer, making plain X-rays or PET-CT superior.

Question 4

Which finding on echocardiography is most consistent with cardiac tamponade?

Accepted Answer

Right ventricular diastolic collapse

Answer

Right ventricular diastolic collapse on echo is a hallmark of cardiac tamponade, indicating elevated pericardial pressure compressing the right heart.

Question 5

Which imaging modality best characterizes liver lesions detected incidentally on CT?

Accepted Answer

MRI with hepatobiliary contrast agent

Answer

MRI with hepatobiliary contrast agents (e.g., gadoxetate disodium) provides excellent characterization of focal liver lesions including hemangiomas, HCC, and metastases.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX SPEX Radiology and Imaging 2