FRCR 2A QUESTIONS

1.As part of an investigation for altered bowel habit, a 32 year old female has a double
contrast barium enema performed. Findings include deep and superficial aphthous
ulceration from the caecum proximally to the sigmoid colon and the presence of
pseudodiverticula. Which one of the following is most likely?
a. Crohns disease
b. Ulcerative colitis
c. Tuberculosis
d. Yersinia
e. Lymphoma

2. A 37-year-old male presents to accident and emergency following smoke

inhalation in a fire. He feels well and a chest radiograph is normal. The following day
he re-presents feeling short of breath and unwell. What are the most likely findings
on the chest radiograph now?
Please select ONE of the following options:
a)pulmonary oedema
B)pleural effusions
C)upper-zone consolidation
D)diffuse reticular change
E)Pneumothorax
3. A 14-year-old boy slides off his saddle while cycling, injuring his testicles. On
ultrasound scan, one testicle has a paratesticular complex cystic mass, loss of
testicular outline and several avascular planes within the testicle. Which of the
following is the most appropriate management?
Please select ONE of the following options:
a)discharge with analgesia
b)admission for analgesia
c)admission for elective surgery
d)admission for surgery the following day
E)immediate surgical interventio

4. Following a deceleration injury in a road traffic accident, a young man presents to

the A&E department with shock, chest wall contusion and severe chest pain. An
aortic injury is suspected. Which of the following is least likely?
a. A normal chest radiograph has high negative predictive value
b. Aortic injury is the usual cause of mediastinal haematoma
c. The aorta just beyond the left subclavian artery is the most common site of injury

d. Aortic rupture is usually circumferential

e. A non-contrast CT scan has a high negative predictive value in the absence of
demonstrable mediastinal haematoma
5. An elderly man undergoes CT for gradual onset of confusion and memory loss. A
pattern of generalized global brain atrophy showing marked temporal lobe
predominance with an increase in size of the hippocampalchoroidal fissure is seen.
Coronal T2W images show atrophy of the hippocampus bilaterally. Which condition
is most likely to result in such a pattern of volume loss?
Please select ONE of the following options:
1.Pick's disease
2.Alzheimer's disease
3.Parkinson's disease
4.Lewy body dementia
5.multi-infarct dementia
6. A 23-year-old woman is found on a 10-week dating ultrasound scan to have a
twin pregnancy. A repeat examination prompted by blood spotting per vaginum,
later attributed to a cervical erosion, shows a singleton pregnancy and no evidence
of the twin. What should this be termed?
Please select ONE of the following options:
1.foetus papyraceus
2.vanishing twin
3fetal death in utero

4.immune fetal hydrops

5.non-immune fetal hydrops
7. Following major trauma, which of the following fractures of the thoracic skeleton
is most likely to indicate a significant injury to the underlying intrathoracic viscera?
Please select ONE of the following options:
1.glenoid
2.scapular blade
3.clavicle
4.first rib
5.sternum
8. A 65-year-old male presents with a 2-month history of cough and dyspnoea and
has had swelling of the face, neck and arms for 1 week. He has had tuberculosis in
the past. CT shows an irregular right paratracheal mass with calcification that is
compressing the superior vena cava and right main bronchus, with patchy
consolidation in the right lung. What is the most likely diagnosis?
Please select ONE of the following options:
a)small-cell carcinoma
b)lymphoma
c)malignant teratoma
d)fibrosing mediastinitis
e)bronchogenic cyst
9. A 42-year-old female patient presents with a swollen calf, and deep venous
thrombosis is suspected clinically. The D-dimer is elevated. Doppler ultrasound scan
shows no thrombus in the thigh or calf veins. Spectral Doppler shows continuous
signal with no respiratory variation. Which further investigation may be of value?
Please select ONE of the following options:
1.no further investigation normal findings
2.pelvic ultrasound

3.CT pulmonary angiogram

4.chest radiograph
5.echocardiogram
10. A homeless adult male is admitted with a change in mental state and a
metabolic
abnormality. CT shows a focus of reduced attenuation in the pons. On MRI the focus
is hypointense on T1 and hyperintense on T2. There is restricted diffusion on
diffusionweighted imaging and there is no enhancement post-contrast. What is the
most likely diagnosis?
a. Brainstem glioma
b. Metastasis
c. Infarction
d. Tuberculosis
e. Osmotic myelinolysis
11. What is the initial imaging modality for evaluation of suspected Mullerian duct
anomaly?
1. MRI
2. CT scanning
3. Ultrasonography
4. Cystography
5. IVP
12. 20 yrs young male presents with trichoptysis .His chest x ray shows an anterior
madiastinal mass.CT of thorax is most likely to show
a.cystic lesion with presence of fat,fluid, teeth and calcification of wall
b.homogenous mass with uniform enhancement
c.mass with low density centre and rim enhancement
d.hyperdense soft tissue mass
e.enhancing cystic lesion on dynamic CT
13. You are given a chest x ray by medicine resident to evaluate for situs inverse for
wrong x ray marker Which of the following determines cardiac situs
1.atria
2.ventricle
3.great vessels
4.position of the cardiac apex
13. A 42 year old man with a diagnosed malignancy presents with pericardial
metastases andChest x ray shows enlarged delta shaped heart with pencil sharp
border. The metastatic deposits are high signal on T1-weighted imaging.Which is

the likely primary diagnosis?

1. Lung cancer
2. Lymphoma
3. Melanoma
4. Colorectal cancer
5. Fibrosarcoma
14. A 22yr old female with raised total leukocyte count and unexplained fever, CT
chest, abdo, pelvis were normal, FDG-PET shows increase uptake in aorta, carotid
and subclavian arteries, what is most likely cause?
1. SLE
2. Polyarteritis nodosa
3. Takayasus arteritis
4.Churg-Strauss syndrome
5 Kawasaki disease
15. A 45-year-old woman presents with submental adenopathy and pruritus, initial
chest x-ray shows a middle mediastinal mass, Which of the following would be most
likely to manifest with this finding?
1 Lymphoma
2 Foregut duplication cyst
3 Schwannoma
4 trache esophageal fistula
5 Thyroid goiter
16. A 68-year-old patient presents with cough and dyspnoea. A chest radiograph is
performed. Which feature would suggest sarcoidosis as a more likely diagnosis than
tuberculosis? Please select ONE of the following options:
1. pleural effusion
2. cavitating upper lobe lesion
3. consolidation
4. symmetrical hilar lymphadenopathy
5. calcified lung lesion
17. A young male with pul kochs presents with massive recurrent hemoptysis, for
angiographic treatment, which vascular structure should be evaluated first.
1. Pulmonary artery
2. Bronchial artery
3. Pulmonary vein
4. Intercostals arteries
5. Sup vena cava.
18. A 58 yr old man, who has been bed rest for the past 10 days, complain of
breathlessness and chest pain. The chest x ray is normal. the next step in
investigation should be.

1.lung ventilation perfusion scan

2.pulmonary arteriography
3. pulmonary venous wedge angiography
4. echocardiography
19. A 29 YR OLD MAN COMPLAINS OF PAIN IN RIGHT THIGH NOT RELIVED BY
NSAID.X RAY SHOWS A 3TO 4 CM EXPANSILE LYTIC LESION IN THE MID SHAFT OF
THE FEMUR WITH REACTIVE SCLEROSIS AND PERIOSTEAL REACTION WITH INTENSE
TRACER UPTAKE..THE DIAGNOSIS WOULD BE...
1. OSTEOID OSTEOMA
2. OSTEOSARCOMA
3. OSTEOMYELITIS
4. OSTEOBLASTOMA
5. ABC
20. A 42 yr old man presents with lump in the right groin 3 months after a
laparoscopic inguinal hernia repair.USG shows a well defined homogenous ,hyper
echoic, Avascular soft tissue mass lateral to inferior epigastric vessels. It has no
change on pressure or with valsalva.diagnosis would be
1. recurrent direct inguinal hernia
2. recurrent indirect inguinal hernia
3. Lymphnode
4. Lipoma
5. seroma
21. A 60-year-old man with chest pain.ECG-gated CT angiography (CTA) of the chest
was performed. A 7-mm saccular aneurysm involving the proximal left anterior
descending (LAD) coronary artery is noted . Which source of image artifact cannot
be corrected for with image data reconstruction methods?
1.Cardiac motion
2.Beam hardening
3.Ectopy
4.Respiratory motion
22. A 39 yr old male comes to A& E department with chst pain and shortness of
breath ,initial chest x-ray shows large right-sided pneumothorax. X-ray after chest
tube placement shows near complete resolution of pneumothorax with re-expansion
of the right lung. Four hours after chest tube placement, repeat chest x-ray shows
development of multifocal right-sided air space opacities. What is the most likely
etiology given the finding chronology?
1Pulmonary contusion
2Pneumonia
3 Re-expansion edema
4Congestive heart failure
5 Diffuse alveolar hemorrhage

23. which of the following is unlikely Regarding tuberculosis,

1. Radiographic evidence of hilar lymphadenopathy is more common in adults than
in children
2. Cavitation is hallmark of post-primary TB
3. In TB meningitis, abnormal meningeal enhancement is more often seen in the
basal cisterns
4. In spinal TB, calcification of abscess is characteristic
5. Calcification is seen more than 50% of renal TB
24. A 45-year-old man presents with dysphagia and undergoes a double-contrast
barium swallow. This demonstrates a smooth oblique indentation on the posterior
wall of the oesophagus. What is the most likely cause of these appearances?
Please select ONE of the following options:
1.enlarged left atrium
2.aberrant right subclavian artery
3.aberrant left pulmonary artery
4.right-sided aortic arch
5.coarctation of the aorta
25. In a case of Left ventricular failure which of the following is not found on frontal
chest x ray:
a) Kerley B lines
b) Oligaemic lung fields
c) Increased vascularity in upper lobes
d) Increase pulmonary capillary wedge pressure
26. A 16 year old girl presents with mild left arm pain. X rays AP show High-riding
humeral head and Axillary view shows Posterior subluxation Which of the following
regarding her injury is incorrect?
1. 2% to 4% of shoulder dislocations are posterior.
2. Often missed or misdiagnosed as frozen shoulder.
3. Caused by axial loading of internally rotated and adducted arm.
4. Often causes reverse Hill-Sachs or reverse Bankhart.
5. Completely torn rotator cuff is usually seen
27. A 23 year old man sustains a Jefferson fracture to his cervical spine following an
injury in which he dived into a shallow swimming pool, hitting his head on the
bottom.
Which of the following regarding his injury is incorrect?

a. Displacement of the lateral masses of C1 relative to the dens on an odontoid view

indicates a transverse ligament rupture
b. Associated C2 fracture will be present in up to 30% of cases
c. Jefferson fractures are usually associated with a neurological deficit
d. Up to 50% are associated with a further cervical spine injury
e. There may be associated vertebral artery injury
28. A 16 year old girl presents with pain in the distal forearm which has worsened
over the last six to seven weeks. X rays show an eccentric lytic radiolucency in the
distal radius with a soap-bubble appearance. The most likely pathology is:
a. Enchondroma
b. Aneurysmal bone cyst
c. Simple bone cyst
d. Fibrous dysplasia
e. Chondroblastoma