SPEX SPEX Radiology and Imaging 1 — Questions and Answers
Question 1: Which imaging modality is the first-line choice for evaluating a suspected acute ischemic stroke?
- MRI with diffusion-weighted imaging
- Non-contrast CT of the head (Correct answer)
- CT angiography of the brain
- Cerebral arteriography
Correct answer: Non-contrast CT of the head
Non-contrast CT of the head is the first-line test to rapidly exclude hemorrhage before thrombolytic therapy in acute stroke.
Question 2: A chest X-ray shows a 'Hampton's hump' sign. Which diagnosis does this suggest?
- Pneumonia
- Pulmonary embolism with infarction (Correct answer)
- Pleural effusion
- Pneumothorax
Correct answer: Pulmonary embolism with infarction
Hampton's hump is a wedge-shaped pleural-based opacity representing pulmonary infarction due to pulmonary embolism.
Question 3: Which sign on chest X-ray indicates tension pneumothorax requiring immediate intervention?
- Blunting of the costophrenic angle
- Tracheal deviation away from the affected side (Correct answer)
- Increased opacity of the affected lung
- Bilateral hilar enlargement
Correct answer: Tracheal deviation away from the affected side
Tracheal deviation away from the affected side indicates mediastinal shift due to tension pneumothorax, requiring emergent needle decompression.
Question 4: What does the 'double bubble' sign on abdominal X-ray in a neonate indicate?
- Meconium ileus
- Duodenal atresia (Correct answer)
- Malrotation with midgut volvulus
- Hirschsprung disease
Correct answer: Duodenal atresia
The double bubble sign represents air in the stomach and dilated proximal duodenum, characteristic of duodenal atresia.
Question 5: Which imaging study is preferred to evaluate renal colic and suspected urolithiasis in adults?
- IVP (intravenous pyelogram)
- Non-contrast CT of the abdomen and pelvis (Correct answer)
- Ultrasound of the kidneys
- MRI of the abdomen
Correct answer: Non-contrast CT of the abdomen and pelvis
Non-contrast CT of the abdomen and pelvis has the highest sensitivity and specificity for detecting urinary calculi and is the preferred modality.
Question 6: On a lateral cervical spine X-ray, what is the normal prevertebral soft tissue width at C3?
- Less than 7 mm (Correct answer)
- Less than 3 mm
- Less than 10 mm
- Less than 15 mm
Correct answer: Less than 7 mm
The prevertebral soft tissue at C3 should be less than 7 mm; widening suggests retropharyngeal abscess or hematoma from injury.
SPEX SPEX Radiology and Imaging 1
Which imaging modality is the first-line choice for evaluating a suspected acute ischemic stroke?