Beruflich Dokumente
Kultur Dokumente
1/97
Test Information
Test Name
Total Questions
100
Test Type
Examination
Difficulty Level
Difficult
Total Marks
300
Duration
90minutes
2/97
(1).
a. Pseudomembranous colitis
b. Crohns disease
c. Ulcerative colitis
d. Intussussception
Solution. 1)A
The accordion sign is seen on CT examinations of the abdomen and refers to the similarity between the thickened oedematous wall of
pseudomembranous colitisto that of an accordion.The appearance arises as a result of oral contrast being trapped between oedematous
haustral folds and pseudomembranes formed on the surface of the colon.
See the image of the actual accordion below:
3/97
(2).
The Xray given below is likely to be that of a child suffering from which congenital heart disease?
a. TAPVC
b. TGA
c. TOF
d. PDA
Solution. 2)C
Boot shaped heart is a radiological feature of Tetralogy of Fallot.
Also know that:
i)Snowman appearance,Figure of 8 appearance,Cottage loaf heart-TAPVC
ii)Egg on side appearance-D-TGA
iii)Square root sign,Egg in cup appearance-Constrictive pericarditis
iv)Jug Handle appearance-Primary Pulmonary Hypertension
v)Water bottle/Flask shaped heart-Pericardial effusion
vi)Sitting duck shaped heart-Persistent TruncusArteriosus
EXTRA EDGE(Ref:Nelson 19th edition)
The aortic arch is right sided in 20% cases of Tetralogy of Fallot.
Your Answer. c
Correct Answer. c
4/97
(3).
a. HallervordenSpatz disease
b. Multiple System Atrophy-c
c. Multiple System Atrophy-p
d. Wilsons disease
Solution. 3)HOT CROSS BUN sign in MRI is seen in Multiple System Atrophy-c.
Multiple System Atrophy-c means cerebellar features predominate
Multiple System Atrophy-p means extrapyramidal features predominate
The hot cross bun sign is seen on transverse T2-weighted magnetic resonance images of the brain as a cruciform hyperintensity in the
pons . The sign is due to a selective loss of myelinated transverse pontocerebellarfibers and neurons in the pontine raphe with
preservation of the pontinetegmentum and corticospinal tracts.
Tiger eye appearance in MRI is seen in-HallervordenSpatz disease
Face of Giant Panda sign in MRI is seen in-Wilsons disease
EXTRA EDGE(Ref:Harrison 18th edition page 3356)
The most common form of MSA is MSA-p
Your Answer. c
Correct Answer. b
5/97
(4).
A 23 year old has been complaining of recurrent episodes of bloody diarrhea and crampy abdominal pain for the past 2 weeks.Barium
enema finding is shown below..What is your diagnosis?
a. Diverticulosis
b. Crohns disease
c. Ulcerative colitis
d. Irritable Bowel Syndrome
Solution. 4)C
The Barium enema finding shown in image is the lead pipe appearance seen in Ulcerative Colitis.
EXTRA EDGE(Ref:Sabiston 18th edition)
Perianal disease is an uncommon finding in patients with Ulcerative colitis, whereas it may be the only presenting symptom of Crohn's
disease. It is an interesting and seemingly paradoxical fact that rectal involvement is present in virtually 100% of patients with
Ulcerative Colitis, whereas anal involvement is very rare. In contrast, patients with Crohn's disease may have normal rectal mucosa (socalled rectal sparing), although anal disease (fissures, fistulas, abscesses) is common
Your Answer. c
Correct Answer. c
6/97
(5).
The Xray findings shown below are most consistent with a diagnosis of?
7/97
a. Rickets
b. Scurvy
c. Lead poisoning
d. Achondroplasia
Solution. 5)B
The important radiological findings in Scurvy are illustrated below
Wimberger's ring sign: Circular, opaque radiologic shadow surrounding epiphyseal centers of ossification, which may result from
bleeding
Frankel's line: Dense zone of provisional calcification
Trummerfeld zone: Lucent metaphyseal band underlying Frankel's line
Pelken spur: Metaphyseal spurs which result in cupping of the metaphysis
EXTRA EDGE(Nelson 19th edition)
Scurvy cannot be diagnosed with certainty from the radiograph until a zone of rarefaction under the white line at the metaphysis
becomes apparent.
Subperiostealhemorrhages are not visible radiographically during the active phase of scurvy. During healing, however, the elevated
periosteum becomes calcified and the affected bone assumes a dumbbell or club shape.
Your Answer. a
Correct Answer. b
8/97
(6).
a. Acute Cholecystitis
b. Chronic cholecystitis
c. Adenomyomatosis of gall bladder
d. Porcelain Gall bladder
Solution. 6)C
Comet tail sign/artifact on USG is seen in Adenomyomatosis of Gall bladder.
Adenomyomatosis of Gall bladder
It is a benign hyperplastic cholesterolosis of gall bladder
Cholesterol crystals accumulating within the Rokitansky- Aschoff sinuses of gall bladderproduce the characteristic comet tailor ringdown artifact.
EXTRA EDGE
Other Strawberries.
Strawberry skull-Edward syndrome
Strawberry skin and nasal mucosa -Sarcoidosis
Strawberry nasal mass - Rhinosporidiosis
Strawberry gingiva- Wegeners granulomatosis
Strawberry tongue- Kawasaki, Toxic Shock Syndrome, Scarlet fever
Strawberry lesion of rectosigmoid- caused by spirochetavincentiand Bacillusfusiformis
Strawberry vagina- Trichomoniasis
Your Answer. c
Correct Answer. c
9/97
(7).
A two year old child presents with difficulty in breathing and an inspiratory stridor,following an episode of upper respiratory tract
infection.X-ray taken is shown below.Whats your diagnosis?
a. Acute Epiglottitis
b. Acute Laryngo-tracheo-bronchitis
c. TB larynx
d. Laryngomalacia
Solution. 7)B
The Xray shows the Steeple sign seen in Acute Laryngo-tracheo-bronchitis (Croup) .It is seen due to the characteristic narrowing in the
subglottic region.
EXTRA EDGE
The most common organism responsible for croup is Parainfluenza virus type 1
Your Answer. b
Correct Answer. b
10/97
(8).
A 12 year old boy presents with seizures to the casualty.On history taking,mother reveals several previous episodes of hospitalisation for
seizures which were difficult to control with medication.CT scan was taken.What is the diagnosis?
11/97
(9).
a. Sialolithiasis
b. SLE
c. Scleroderma
d. Sarcoidosis
Solution. 9)D
The image shows Panda sign in Sarcoidosis,which occurs due to Gallium scan uptake in Lacrimal and Parotid glands.(Ref:Review of
Radiology by Dr Sumer K Sethi 6th edition page 28)
EXTRA EDGE (Harrison 18th edition)
Increased Gallium scan uptake in the right paratracheal and left hilar area in Sarcoidosis is known as Lambda sign
Your Answer. d
Correct Answer. d
12/97
(10).
13/97
(11).
The power Doppler finding shown below in a 25 year old female is suggestive of ?
a. Endometriosis
b. Ectopic pregnancy
c. Hydatidiform mole
d. Choriocarcinoma
Solution. 11)B
The Power Doppler shows Ring of fire sign seen in Ectopic pregnancy.
EXTRA EDGE(Ref:Review of Radiology by Dr Sumer K Sethi 6th edition page 158)
Double decidual sac sign is a sensitive and specific indicator of intrauterine pregnancy.
Your Answer. b
Correct Answer. b
14/97
(12).
A 24 year old male complaints of dull pain in the lower lumbar region of two months duration.Initially,the pain improved with activity and
returned following inactivity. Now,the pain has become persistent.X-ray taken is shown below.What is the most probable diagnosis?
15/97
(13).
a. Rheumatoid arthritis
b. Psoriatic arthritis
c. Scapholunate dislocation
d. Skiers thumb
Solution. 13)C
The X-ray demonstrates the Terry Thomas sign which is seen in Scapholunate dislocation.
Terry-Thomas(born Thomas Terry Hoar Stevens; 10 July 1911 8 January 1990) was an English comedian and character actor who
became known to a worldwide audience through his many films during the 1950s and '60s. His striking dress sense was set off by a 13inch (8.5 mm) gap between his two upper front teeth.
Note the gap between Scaphoid and Lunate in the X-ray.
EXTRA EDGE
The most common nerve involved in perilunate dislocation is median nerve
Your Answer. c
Correct Answer. c
16/97
(14).
What is the most common cause of the USG appearance shown below?
a. Acute hepatitis
b. Chronic hepatitis
c. Hepatocellular carcinoma
d. Fatty liver
Solution. 14)A
The USG shows a starry sky pattern,most commonly seen with acute hepatitis
Ultrasound of the liver shows centrilobular or starry sky pattern characterized by increased brightness portal venules and diminished
parenchymal echogenicity accentuating the portal venule walls. Acute hepatitis is the most common cause of starry sky appearance. This
sonographic appearance is due to the intralobularedematous swelling of the hepatocytes and a change in acoustic properties between
the portal venous radicals and hepatic lobules
EXTRA EDGE(Ref:Robbins 8th edition)
Ballooning degenerationis a morphological feature of acute hepatitis
Your Answer. d
Correct Answer. a
17/97
(15).
A child with history of tonic-clonic seizures on the right side of the body,which is refractory to anticonvulsants is brought to the
ophthalmology OPD with decreased vision in left eye.On detailed ophthalmological examination, a diagnosis of glaucoma was made.The
imaging findings of brain are given below.What is the most probable diagnosis?
a. Neurofibromatosis
b. Tuberous Sclerosis
c. Sturge Weber syndrome
d. Von HippelLindau syndrome
Solution. 15)C
The clinical history as well as the tram-track calcification on imaging points towards a diagnosis of Sturge Weber Syndrome.
EXTRA EDGE
Sturge Weber syndrome results from anomalous development of the primordial vascular bed during the early stages of cerebral
vascularization.
It is also known as Encephalo-trigeminal-angiomatosis
Glaucoma occurs in the same side of the nevus,but focal tonic-clonic seizures occur contralateral to the nevus.
Your Answer. d
Correct Answer. c
18/97
(16).
The characteristic radiographic appearance of the vertebra shown below is seen in?
a. Eosininophilic Granuloma
b. Vertebral hemangioma
c. Pagets disease
d. Sickle cell anemia
Solution. 16)C
Picture frame vertebral body is a radiologic appearance in which the cortex of the vertebral body is thickened.It is seen
characteristically in Pagets diseaseof bone.This is a result of disorganized new cortical bone formation after excessive osteoclastic
activity causes the resorption of normal bone.
EXTRA EDGE
Theblade of grass sign (also called the flame sign) refers to the lucent leading edge in a long bone seen during the lytic phase of
Paget's disease of bone. Please see the image below
Your Answer. d
Correct Answer. c
19/97
(17).
a. Perthes disease
b. Congenital dislocation of hip
c. Downs syndrome
d. Achondroplasia
Solution. 17)D
Champagne glass type pelvic inlet is seen in Achondroplasia
EXTRA EDGE (Nelson 19th edition)
The most common nonlethal chondrodysplasia is Achondroplasia
The most common lethal chondrodysplasia is Thanatophoric dysplasia
Your Answer. a
Correct Answer. d
20/97
(18).
Which of the following conditions produce the X-ray appearance shown below?
21/97
a. Coarctation of aorta
b. Rheumatoid arthritis
c. Rickets
d. Osteogenesisimperfect
Solution. 18)A
Causes of rib notching:
Superior rib notching
Polio
Connective tissue diseases (Rheumatoid arthritis)
Osteogenesisimperfecta
Hyperparathyroidism
Inferior rib notching
Thrombosis of aorta
Coarctation of aorta
Blalock Taussig shunt
Occlusion of subclavian artery
Pulmonary AV malformation
EXTRA EDGE(Harrison 18th edition)
Pathognomonicfinding in Coarctation of aorta is the indentation of aorta at the site of coarctation and pre- and post stenotic dilatation
along the left paramediastinal shadow.( 3 sign).Please see the image below
Your Answer. a
Correct Answer. a
22/97
(19).
a. Ureterocoele
b. Horse-shoe shaped kidney
c. Renal agenesis
d. Polycystic kidney disease
Solution. 19)D
B/L spider leg appearance on IVP is seen in Polycystic kidney disease.
EXTRA EDGE(Harrison 18th edition)
Cardiac valvularabnormalties occur in 25% of patients with Autosomal dominant polycystic kidney disease, most commonly Mitral
valve prolapse and Aortic Regurgitation.
Your Answer. d
Correct Answer. d
23/97
(20).
a. Achondroplasia
b. Rickets
c. Rheumatoid arthritis
d. Turners syndrome
Solution. 20)D
Short fourth metacarpal (Metacarpal sign) is seen in;
i)Turners syndrome
ii)Pseudohypoparathyroidism (Ref:Review of Radiology by Dr Sumer K Sethi 6th edition page 95)
EXTRA EDGE(Harrison 18th edition)
Most common congenital heart defect associated with Turners syndrome is Bicuspid aortic valve.Second most common is Coarctation
of aorta
Your Answer. d
Correct Answer. d
24/97
(21).
a. Duodenal atresia
b. Jejunal atresia
c. Pyloric stenosis
d. Hirschsprung disease
Solution. 21)A
Double bubble sign can be seen in Duodenal atresia and Annular pancreas (Ref:Review of Radiology by Dr Sumer K Sethi 6th edition
page 118)
EXTRA EDGE (Ref:Sabiston 18th edition)
There are several anatomical variants of Duodenal atresia.One of them is a duodenal mucosal web with intact muscular wall producing
the classical windsock deformity
Your Answer. a
Correct Answer. a
25/97
(22).
26/97
(23).
A 30 year old alcoholic was admitted with complaints of fever and cough of 5 days duration.X-ray taken is shown below.What is the most
probable etiological agent?
a. Pneumococcus
b. Staphylococcus aureus
c. Klebsiellapneumoniae
d. Mycobacterium tuberculosis
Solution. 23)C
The Chest X-ray shows the bulging fissure sign,classically seen with Klebsiellapneumonia,where the minor fissure which is usually
horizontal,bulgesdown.It can also be seen with Lung abscess and Ca Bronchus.(Ref: Review of Radiology by Dr Sumer K Sethi 6th edition
page 57).
Also remember that Klebsiella pneumonia usually affects the upper lobe and is more common in alcoholics.
EXTRA EDGE
Classical pneumonia patterns:
1. Lobar distribution: Streptococcus pneumoniae
2. Bulging fissure: Klebsiella
3. Pulmonary edema: Viral/Pneumocystis pneumonia
4. Pneumatocele: Staphylococcus
5. Alveolar nodules: Varicella, bronchogenic spread of TB
Your Answer. a
Correct Answer. c
27/97
(24).
a. Spondylolysis
b. Spondylolisthesis
c. Lumbar canal stenosis
d. Slipped disc
Solution. 24)A
The X-ray shows Scotty dog sign seen in Spondylosis(defect in pars interarticularis without slipping of vertebrae).
EXTRA EDGE
Beheaded Scotty dog sign is seen in Spondylolisthesis(defect with slip of vertebrae).
Your Answer. b
Correct Answer. a
28/97
29/97
(25).
30/97
a. Vertebral chordoma
b. Osteopetrosis
c. Eosinophilic granuloma
d. Vertebral hemangioma
Solution. 25)D
On CT,Vertebralhemangiomas show polka dot appearance.(Ref: Review of Radiology by Dr Sumer K Sethi 6th edition page 109)
EXTRA EDGE
On plain X-ray,vertebralhemangiomas show vertical striations orCoduroy Cloth appearance.Vertebralhemangiomas are most common
in lumbar vertebra.
Your Answer. d
Correct Answer. d
31/97
(26).
a. Perthes disease
b. Avascular necrosis of femur
c. Fibrous dysplasia
d. Osteopetrosis
Solution. 26)C
Shepherd crook deformity of femur is seen in Fibrous dysplasia.(Ref Review of Radiology by Dr Sumer K Sethi 6th edition page 108)
EXTRA EDGE
Fibrous dysplasia can be monostotic or polystotic.Monostotic form is more common
The association of polystotic form with caf au lait spots and pseudo-precocious puberty of ovarian origin is known as McCuneAlbright syndrome.
McCune-Albright syndrome patients may have caf au lait spots which are flat,hyperpigmented skin lesions that have rough borders
(coast of Maine) ,in contrast to the caf au lait lesions of neurofibromatosis that have smooth borders (coast of California)
Your Answer. c
Correct Answer. c
(27).
a. Osteochondroma
b. Osteoclastoma
c. Osteosarcoma
d. Ewings Sarcoma
Solution. 27)C
Sunray appearance in X-ray is seen in Osteosarcoma.(Ref Review of Radiology by Dr Sumer K Sethi 6th edition page 106)
EXTRA EDGE(Robbins 8th edition)
Conditions predisposing to Osteosarcoma are Paget disease, bone infarcts, and prior irradiation
Your Answer. c
Correct Answer. c
32/97
(28).
a. Spondylolisthesis
b. Ankylosing spondylitis
c. Spinal metastasis
d. Multiple myeloma
Solution. 28)A
Inverted Napoleon hat sign on AP view is seen in Spondylolisthesis.(Ref Review of Radiology by Dr Sumer K Sethi 6th edition page
112)
Your Answer. b
Correct Answer. a
33/97
(29).
a. Vertebral hemangioma
b. Vertebral chordoma
c. Pagets disease
d. Osteopetrosis
Solution. 29)D
Bone within bone appearance is produced by Osteopetrosis,Sickle cell disease.
EXTRA EDGE(Harrison 18th edition)
Carbonic anhydrase type II deficiency produces osteopetrosis associated with renal tubular acidosis and cerebral calcification
Your Answer. c
Correct Answer. d
34/97
(30).
The barium swallow finding shown below most closely correlates with a diagnosis of?
a. Achalasia cardia
b. Hiatus hernia
c. Diffuse esophageal spasm
d. Nut cracker esophagus
Solution. 30)C
Diffuse esophageal spasm shows Cork screw appearance on barium swallow.
EXTRA EDGE (Sabiston 18th edition)
Investigation of choice for Diffuse Esophageal Spasm is Prolonged ambulatory oesophageal manometry (Specificity is 100%).The
classic manometry findings in DES are simultaneous, multipeaked contractions of high amplitude (>120 mm Hg) or long duration (>2.5
sec)
Your Answer. c
Correct Answer. c
(31).
Geographic lytic lesions in the vault of skull with bevelled edges are seen in?
a. Multiple myeloma
b. Hyperparathyroidism
c. Pagets disease
d. Eosinophilic granuloma
Solution. 31)D
Classical geographic skull appearance is seen in Eosinophilic granuloma.
EXTRA EDGE(Robbins 8th edition)
Involvement of the posterior pituitary stalk of the hypothalamus leads to diabetes insipidus in about 50% of patients.The combination
of calvarial bone defects, diabetes insipidus, and exophthalmos is referred to as the Hand-Schuller-Christian triad.
Your Answer. d
Correct Answer. d
35/97
(32).
Which of the following conditions can produce the radiological appearance as shown below?
a. Chronic hydrocephalus
b. Hurler syndrome
c. Optic chiasm glioma
d. all of these
Solution. 32) J shaped sella can be seen in the following conditions;(Mnemonic:CONMAN)
Chronic hydrocephalus
Optic chiasm glioma,Osteogenesisimperfecta
Neurofibromatosis
Mucopolysaccharidosis
Achondroplasia
Normal variant
Your Answer. d
Correct Answer. d
(33).
Which of the following conditions produces the characteristic angiographic appearance shown below?
a. Atherosclerosis
b. Buergers disease
c. Fibromuscular dysplasia
d. Polyarteritis nodosa
Solution. 33) C
String of beads appearance in angiography is seen in Fibromuscular dysplasia. It refers to the appearance arising from the stenoses
resulting from the disease alternating with aneurysmal dilatation.
EXTRA EDGE
Most common cause of renovascular hypertension:
a)in adults-atherosclerosis
b)in young individuals-Fibromuscular dysplasia(Worldwide),Takayasu arteritis(India)
Your Answer. b
Correct Answer. c
36/97
(34).
a. Thimble bladder
b. Neurogenic bladder
c. Carcinoma urinary bladder
d. Schistosomiasis of bladder
Solution. 34)B
A pine cone bladder or christmas tree bladder is a cystogramappearance in which the bladder is elongated and pointed with
thickened trabeculated wall. It is typically seen in severe neurogenic bladderwith increased sphincter tone (detrusor sphincter
dyssynergia) due to suprasacral lesions (above S2-S4) or epiconal lesions (in and around S2-S4)
EXTRA EDGE
Exceedingly contracted bladder seen in Tuberculous cystitis is called Thimble bladder
Your Answer. b
Correct Answer. b
(35).
a. Ureterocoele
b. Renal agenesis
c. Renal tuberculosis
d. Hydronephrosis
Solution. 35)C
IVP shows calcified right kidney and upper ureter.Such a pattern of calcification(also known as Putty kidney) is associated with
renal tuberculosis.
EXTRA EDGE
Earliest symptom of renal tuberculosis is urinary frequency.
Your Answer. c
Correct Answer. c
37/97
(36).
38/97
(37).
a. Corticosteroids
b. Erythromycin
c. Tetracycline
d. Isotretinoin
Solution. 37)D
Drug of choice for nodulocystic acne is Isotretinoin
EXTRA EDGE(Katzung 12th edition)
Teratogenicity is a significant risk in patients taking isotretinoin; therefore, women of childbearing potential must use an effective
form of contraception for at least 1 month before, throughout isotretinoin therapy, and for one or more menstrual cycles following
discontinuance of treatment
Your Answer. d
Correct Answer. d
(38).
a. Keloid
b. Mucous gland hypertrophy
c. Sweat gland hypertrophy
d. Sebaceous gland hypertrophy
Solution. 38)D
Rhinophyma(potato nose) occurs due to sebaceous gland hypertrophy.It is a glandular form of acne rosacea.
EXTRA EDGE
Enlarged hilar and mediastinal nodes in sarcoidosis are called potato nodes
Your Answer. d
Correct Answer. d
39/97
(39).
A 50 year old man complaints of painful nodule on the upper surface of ear which is very tender.What is the most probable diagnosis?
a. Keratoacanthoma
b. Pseudocyst of auricle
c. Chondrodermatitis nodularis helicis
d. Basal cell carcinoma
Solution. 39)C
In Chondrodermatitisnodularishelicis,small painful nodules appear in the free border of helix in men about the age of 50 years.
Your Answer. c
Correct Answer. c
(40).
a. Alopecia mucinosa
b. Androgenic alopecia
c. Alopecia areata
d. Traumatic alopecia
Solution. 40)C
Exclamation mark hairs are seen in Alopecia areata
Your Answer. c
Correct Answer. c
40/97
(41).
A 25 year old male presents with erythematous raised lesions in the body.Examination finding of his hand is also shown below.What is
your diagnosis?
a. Psoriasis
b. Lichen planus
c. Pemphigus vulgaris
d. Pityriasis rosea
Solution. 41)A
Psoriasis is grouped under papulosquamousdisorders.It presents with well demarcated erythematous raised papules and plaques,covered
by silvery micaceousscales.The lesions preferentially affect extensor aspects of trunk(back and lumbosacral area) and limbs
(elbow,knee).Nail changes that occur in psoriasis are shown in image below:
41/97
(42).
a. Psoriasis
b. Leprosy
c. Dermatitis Herpetiformis
d. Lichen planus
Solution. 42)D
In 10-20% of patients with Lichen planus,longitudinalridging,grooving and scarring leads to dorsal pterygium formation
EXTRA EDGE(Harrison 18th edition)
Lichen planus may be associated with Hepatitis C infection
Your Answer. d
Correct Answer. d
(43).
A 24 year old male developed an annular skin lesion on the trunk.One week later,he developed many small such lesions on the trunk,as
shown in image below.What is your diagnosis?
42/97
(44).
a. Nikolsky sign
b. Asboe Hansen sign
c. Auspitz sign
d. Koebner sign
Solution. 44)B
Asboe Hansen signor Bulla spread signmeans when you apply gentle pressure on an intact bulla,the fluid spreads away under
the skin away from the site of pressure.This spread occurs because of loss of desmosomes(acantholysis).This sign is positive in all
varieties of pemphigus and many cases of subepidermal blisters, including bullous pemphigoid, dermatitis herpetiformis,
epidermolysisbullosaacquisita, cicatricialpemphigoid, dystrophic epidermolysisbullosa, Stevens-Johnson syndrome and toxic epidermal
necrolysis.
EXTRA EDGE
Skin biopsy of Pemphigus vulgaris on Direct Immunofluorescence shows Fish net pattern
Your Answer. d
Correct Answer. b
(45).
A 30 year old female presentswith well defined,irregular brown red plaques on both shins(Image shown below).What could be the
possible underlying systemic disorder she may have?
a. Diabetes
b. Hypertension
c. Hypothyroidism
d. Hyperthyroidism
Solution. 45)A
The diagnosis is Necrobiosislipoidicadiabeticorumwhich is seen in young female diabetics.Treatment is with steroids,but often
unsatisfactory.Chronic stage of this condition may present as ulcers.
Your Answer. a
Correct Answer. a
43/97
(46).
A patient with which of the following dermatological conditions can have X-ray findings as shown below?
a. Psoriasis
b. Leprosy
c. Pemphigus
d. Lichen planus
Solution. 46)A
The X-ray shows the characteristic pencil in cup deformity seen in psoriatic arthritis.
EXTRA EDGE(Harrison 18th edition)
Wright and Moll classification is for Psoriatic arthropathy
Your Answer. a
Correct Answer. a
(47).
a. Pityriasisversicolor
b. Tineacapitis
c. Vitiligo
d. all of these
Solution. 47)D
The instrument shown in the image is the Woods lamp.It can aid the diagnosis of all the three conditions based on fluorescence
pattern.
EXTRA EDGE
Fluorescence patterns in Woods lamp is various conditions;
Tineacapitis-Yellowish fluorescence
Pityriasisversicolor-Golden yellow fluorescence
Erythrasma-Coral red fluorescence
Vitiligo-Total white
Your Answer. d
Correct Answer. d
44/97
(48).
The findings in the image below is most likely to be associated with which nutritional dermatoses?
a. Beri-beri
b. Scurvy
c. Pellagra
d. Riboflavin deficiency
Solution. 48)B
The image shows perifollicularhemorrhagestypical of Scurvy.The follicles are often plugged by keratin(perifollicular
hyperkeratosis).
EXTRA EDGE
Infantile scurvy is also known as Barlows disease.
Your Answer. c
Correct Answer. b
(49).
A 2 year old child presents with patches and crusted plaques in face,neck and extensor surfaces of the body.Additional finding is shown
in the image.What is the diagnosis?
a. Urticaria
b. Seborrheic dermatitis
c. Scabies
d. Atopic dermatitis
Solution. 49)D
The clinical history as well as the finding of Denny-Morgan fold(extrafold of skin beneath the lower eyelid) is suggestive of Atopic
dermatitis.
Your Answer. d
Correct Answer. d
45/97
(50).
A 27 year old female presents with tender subcutaneous nodules on lower legs.Which of the following is least likely to be the etiology?
(51).
A 6 year old boy presented with recurrent scaly lesions on face as shown in image.What is the most probable diagnosis?
a. Tinea versicolor
b. Indeterminate leprosy
c. Pityriasis rosea
d. Pityriasis alba
Solution. 51)D
Pityriasis alba presents as multiple ill-defined scaly hypopigmanted patches on face, neck upper trunk.
Tineaversicolor though can present with scaly hypopigmented patches, is seen more in young adults.
Your Answer. d
Correct Answer. d
46/97
(52).
a. Type 1
b. Type 2
c. Type 3
d. Type 4
Solution. 52)D
Patch test is the gold standard for the diagnosis of allergic dermatitis.It is based on delayed(type IV)hypersensitivity.
Your Answer. d
Correct Answer. d
(53).
Spot diagnosis?
a. Seborrheic dermatitis
b. Nummular dermatitis
c. Contact dermatitis
d. Atopic dermatitis
Solution. 53)B
Intenslyitchy,erythematous scaly coin shaped lesions are a feature of nummular eczema/dermatitis
Your Answer. b
Correct Answer. b
47/97
(54).
a. Pemphigus vulgaris
b. Pemphigus foliaceus
c. Psoriasis
d. Lichen planus
Solution. 54)D
The characterisitic histological changes seen in Lichen planus are;
i)Basal epidermal cell degeneration causing saw tooth appearance of rete pegs and eosinophiliccytoid bodies(Civatte bodies)
ii)Epidermal thickening,especially of granular cell layer
iii)Sub-epidermal lichenoid band due to deposition of lymphocytes and histiocytes.
iv)Max Joseph spacesor small areas of artifactual separation between the epidermis and the dermis
Your Answer. d
Correct Answer. d
(55).
a. Pemphigus vulgaris
b. Paraneoplastic pemphigus
c. Bullous pemphigoid
d. Dermatitis herpetiformis
Solution. 55)A
The histopathology shows suprabasalacantholysis with row of tombstone appearance
Your Answer. a
Correct Answer. a
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(56).
A 6 year old boy presents with lesions on dorsal aspect of hands and genitals as shown in image.What is the diagnosis?
a. Molluscum contagiosum
b. Scabies
c. Lichen nitidus
d. Lichen planus
Solution. 56)C
Lichen nitidus presents as multiple grouped pinhead sized shiny papules mainly in children. Cause unknown. Sites-genitals, arms. Biopsy
has a claw clutching a ball appearance. Usually self limiting. Topical steroids and tacrolimus may be used.
Your Answer. c
Correct Answer. c
(57).
A 35 year old male presents with intensly pruritic papulovesicular lesions in hus buttocks.Biopsy was taken and HPE slide is shown
below.What is the diagnosis?
a. Erythema multiforme
b. Dermatitis herpetiformis
c. Psoriasis
d. Lichen planus
Solution. 57)B
Dermatitis herpetiformis is an intensely pruritic,papulovesicular skin disease characterised by lesions symmetrically distributed over
extensor surfaces.(ie:elbows,knees,buttocks,back,scalp).
Biopsy reveals neutrophil rich infiltrates within dermal papillae.
EXTRA EDGE
Direct immunofluorescence in Dermatitis herpetiformis reveals granular IgA deposition in the epidermal basement membrane zone
Your Answer. b
Correct Answer. b
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(58).
A 25 year old male developed sudden onset rapidly spreading lesions on hand as shown in image.What is the diagnosis?
a. Molluscum contagiosum
b. Epidermolysis bullosa
c. Erythema multiforme
d. Linear IgA disease
Solution. 58)C
The image shows Target lesions/Iris lesions/Bulls eye lesions/Annular lesions seen in Erythema multiforme.The lesions are
symmetric,develop abruptly and rapidly spreading.
EXTRA EDGE
The most common cause of Erythema multiforme is Herpes Simplex virus-1(HSV-1)
Your Answer. c
Correct Answer. c
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(59).
A 2 year old child with high fever developed toxic look,eruptions as shown in image along with fissuring and cracking of lips.What is the
most probable diagnosis?
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(60).
The patient is most likely to be suffering from which sexually transmitted disease?
a. Gonorrhea
b. Lymphogranuloma venereum
c. Donovanosis
d. Chancroid
Solution. 60)B
The image shows Groove sign seen in Lymphogranulomavenereum.This sign is due to involvement of inguinal nodes above and
below the inguinal ligament.
Your Answer. b
Correct Answer. b
(61).
a. Indeterminate leprosy
b. Borderline borderline
c. Borderline tuberculoid
d. Borderline lepromatous
Solution. 61)C
The image shows satellite lesionsseen in Borderline tuberculoid type of leprosy.
Your Answer. c
Correct Answer. c
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(62).
A 24 year old male who is a diagnosed case of tuberculosis develops lesions on trunk as shown below.What is the most probable
diagnosis?
a. Lichen scrofulosorum
b. Papulonecrotic tuberculid
c. Erythema nodosum
d. Erythema induratum
Solution. 62)A
Lichen scrofulosorum is a type of tuberculid occurring in young patients with underlying tuberculosis.There is lichenoid eruption of
papules involving perifollicular distribution on abdomen,chest,back and proximal limbs.
Your Answer. b
Correct Answer. a
(63).
A 28 yea old rugby player comes to the OPD with skin lesion shown in image.What is the most probable diagnosis?
a. Tinea corporis
b. Lupus vulgaris
c. Cutaneous leishmaniasis
d. Erythema migrans
Solution. 63)A
The history of contact sports(rugby) along with skin lesion showing central clearing is seen in Tineacorporis.
EXTRA EDGE
Central scarringis seen in Lupus vulgaris
Central crustingis seen in Cutaneous Leishmaniasis
Your Answer. a
Correct Answer. a
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(64).
A 18 year old girl living in hostel complaints of itching in scalp.Section of hair shaft is shown in image.What is the most probable
diagnosis?
a. Tinea capitis
b. Pediculosis
c. Seborrhoeic dermatitis
d. Lichen planopilaris
Solution. 64)B
The hair shaft shows pediculosiscapitis egg.
Your Answer. b
Correct Answer. b
54/97
(65).
A 60 year old male presented with lesion in the face.Biopsy was taken and HPE slide is shown in image.What is the diagnosis?
a. Malignant melanoma
b. Dermoid cyst
c. Squamous cell carcinoma
d. Basal cell carcinoma
Solution. 65)D
The histopathology shows the characteristic peripheral palisading seen in basal cell carcinoma.
Your Answer. d
Correct Answer. d
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(66).
a. Adenocarcinoma stomach
b. Obesity
c. Blooms syndrome
d. all of these
Solution. 66)D
The image shows Acanthosisnigricans which may be seen in all these conditions.
Your Answer. d
Correct Answer. d
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(67).
a. Candidiasis
b. Pityriasis versicolor
c. Tinea corporis
d. Tinea capitis
Solution. 67)B
The KOH mount shows spaghetti-and-meatballappearance seen in Pityriasisversicolor
Your Answer. b
Correct Answer. b
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58/97
(68).
A 55 year old male patient has been having skin lesions over elbow (shown in image) for the past 4 years.He has seen many
dermatologists,but no diagnosis could not be made.His doctor now ordered for a biopsy and HPE slide image is shown below.What is the
most probable diagnosis?
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a. Actinic keratosis
b. Squamous cell carcinoma
c. Mycosis fungoides
d. Keratoacanthoma
Solution. 68)C
Mycosis fungoides is an indolent lymphoma with patients often having several years of eczematous or dermatitis skin lesions before the
diagnosis is finally established.The skin lesions progress from patch stage to plaque stage to cutaneous tumorstage.Histologically, the
epidermis and upper dermis are infiltrated by neoplastic T cells(epidermotropism) either as single cells and small clusters
(Pautriermicroabscesses).
Your Answer. c
Correct Answer. c
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(69).
A pregnant female presents with lesions in genitilia as shown in image.Which of the treatment modalities is not recommended?
a. Cryosugery
b. Trichloroacetic acid
c. Imiquimod
d. Podophyllin
Solution. 69)D
Podophyllin is contraindicated in the treatment of Condylomaacuminata (venereal warts) in pregnancy as it is teratogenic
Your Answer. c
Correct Answer. d
61/97
(70).
A 40 year old farmer presents with lesions on his forearm(shown in image).Colony of the organism on special stain is also shown
below.What is the diagnosis ?
a. Candidiasis
b. Chromoblastomycosis
c. Paracoccidiodomycosis
d. Sporotrichosis
Solution. 70)D
Sporotrichosis is seen in farmers following penetrating injury by plant product(thorn).It is also known as Rose Gardeners disease.It
presents as subcutaneous nodules which may break down to form ulcers.Cigar shaped yeasts of Sporothrix is shown in the image in
question
Your Answer. d
Correct Answer. d
62/97
(71).
a. Median nerve
b. Radial nerve
c. Ulnar nerve
d. Musculocutaneous nerve
Solution. 71)A
Ape thumb deformity is caused by ulnar nerve palsy.
Your Answer. a
Correct Answer. a
(72).
a. Finkelstein test
b. Tinels test
c. Phalens test
d. Adsons test
Solution. 72)C
Phalens test aids in the diagnosis of carpal tunnel syndrome. Patients wrist is completely flexed (as shown in image). This position is
held for 60 seconds or until symptoms are reproduced. A positive test occurs with numbness and tingling on the palmar aspect of the 1st,
2nd, 3rd, and radial half of the 4th digit within 60 seconds of assuming the position.
Your Answer. c
Correct Answer. c
Copyright 2014 Delhi Academy of Medical Sciences, All Rights Reserved.
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64/97
(73).
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a. Lanes forceps
b. Fergussons forceps
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d. Lowmans clamp
Solution. 73)A
The instrument shown is Lanes bone holding forceps.
Other options
Fergussons bone holding forceps
Your Answer. c
Correct Answer. a
68/97
(74).
Diagnosis?
a. Jones fracture
b. Essex-Lopresti fracture
c. Pilon fracture
d. Aviators fracture
Solution. 74)C
Pilon fracture is a comminuted intra-articular fracture of distal end of tibia.
EXTRA EDGE
Ruediand Algower classification of Pilon fractures.
a) Type I : articular fracture with minimal or no displacement
b)Type II : displacement of the articular surface but with minimal or no comminution.
c)TypeIII : marked comminution as well as articular impaction
Your Answer. c
Correct Answer. c
69/97
(75).
70/97
(76).
71/97
(77).
In a 28 year old male with recurrent shoulder dislocation,which of the following lesion is seen on the X-ray shown below ?
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a. Bankart lesion
b. Hill-Sach lesion
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d. Stener lesion
Solution. 77)A
Bankart lesion results from the detachment of the anterior inferior glenoid labrum from the underlying glenoid.
Hill-Sach lesion is posterolateral humeral head compression fracture as the humeral head comes to rest against the anteroinferior part of
the glenoid. X-ray is shown below
Your Answer. a
Correct Answer. a
75/97
(78).
a. Olliers disease
b. Maffuci syndrome
c. Hyperparathyroidism
d. Rheumatoid arthritis
Solution. 78)B
Multiple enchondromas in the X-ray as well as multiple cavernous hemangiomas on the foot suggest the diagnosis of Maffuci syndrome.
Your Answer. b
Correct Answer. b
76/97
(79).
Your Answer. c
Correct Answer. c
77/97
(80).
Identify ?
a. Cock-up splint
b. Knuckle-bender splint
c. Volkmanns splint
d. Crammer-wire splint
Solution. 80)B
The image shows Knuckle-bender splint used in Ulnar nerve palsy
Your Answer. b
Correct Answer. b
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(81).
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(82).
a. Periosteal elevator
b. Bone lever
c. Bone nibbler
d. Osteotome
Solution. 82)A
The image shows Langenbeck periosteal elevator.
Your Answer. a
Correct Answer. a
80/97
(83).
A 10 year old child weighing 65 kg presents with limitation of abduction and internal rotation.There is tenderness in Scarapas triangle in
the left side.The X-ray taken is shown below.What is the diagnosis ?
a. Perthes disease
b. Slipped capital femoral epiphysis
c. Observation hip
d. Tuberculosis of hip
Solution. 83)B
The clinical history as well as the X-ray finding points towards a diagnosis of Left sided Slipped Capital Femoral Epiphysis.
Your Answer. b
Correct Answer. b
81/97
(84).
a. Monteggia fracture
b. Galeazzi fracture
c. Chauffer fracture
d. Colles fracture
Solution. 84)B
Galeazzi fracture-Fracture of distal third of radius with dislocation of distal radio-ulnar joint.
Your Answer. b
Correct Answer. b
82/97
(85).
a. Ulnar nerve
b. Radial nerve
c. Median nerve
d. Musculocutaneous nerve
Solution. 85)A
Froments sign is positive in Ulnar nerve palsy.If the ulnar nerve is injured,the adductor pollicis will be paralysed and the patient will
hold the book by using the flexor pollicislongus(supplied by median nerve)
Your Answer. a
Correct Answer. a
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(86).
84/97
(87).
a. Nelatons line
b. Perkins line
c. Shentons line
d. Perkins line
Solution. 87)C
Shentons line is an imaginary line joining the medial cortex of femoral neck to the lower border of superior pubic ramus.It is breeched
in fracture neck of femur,head of femur,superior pubic rami and dislocation of hip.
Your Answer. c
Correct Answer. c
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(88).
86/97
(89).
What sign is being shown positive in the image in a 3 year old child with limitation in hip abduction ?
a. Ortolanis sign
b. Barlows sign
c. Galeazzi sign
d. Cateralls sign
Solution. 89)C
Galeazzi sign The level of knees are compared in a child lying with hip flexed to 70 degrees and knees flexed.There is lowering of knee
on the affected side in Developmental Dysplasia of Hip (Congenital Dislocation of Hip)
Your Answer. c
Correct Answer. c
(90).
a. Scoliosis
b. Developmental dysplasia of Hip
c. Brachial plexus injury
d. Fracture shaft of femur
Solution. 90)B
The image shows Von Rosen splint used in the management of Dvevelopment Dysplasia of Hip
Your Answer. b
Correct Answer. b
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(91).
A 10 year old child presents with pain in right hip and limping.On examination,there is restriction in abduction and internal rotation.Xray is shown below.What is the most probable diagnosis ?
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(92).
89/97
(93).
The fracture shown in X-ray falls under which type in Salter Harris classification ?
a. Type 1
b. Type 2
c. Type 3
d. Type 4
Solution. 93)B
Your Answer. b
Correct Answer. b
90/97
(94).
a. Obers test
b. Simmondss test
c. Charnleys test
d. Apleys test
Solution. 94)A
Obers test is for evaluating the tightness of iliotibial band. The subject is placed on their side, healthy side down. The knee is flexed 90
degrees and the hip extended to neutral (no flexion).The doctor holds the leg up by the foot. Normally, the knee falls down to the exam
table. If the iliotibial band is very tight, the leg hangs up in the air (very impressive). If it's moderately tight, the knee falls halfway to the
table.
Your Answer. c
Correct Answer. a
91/97
(95).
A 40 year old patient who is a known case of psoriasis,on regular treatment for past 5 years now presents with pain in the right hip.X-ray
is shown below.What should be the next diagnostic modality for confirmation of diagnosis?
a. Ultrasonography of hip
b. CT scan
c. MRI
d. Isotope bone scan
Solution. 95)C
The patient is on long term treatment for psoriasis (most probably with steroids).Long term steroid treatment predisposes to
avascular necrosis.The X-ray finding also suggest Avascular necrosis of right side of femur.
Your Answer. c
Correct Answer. c
92/97
(96).
a. Rheumatoid arthritis
b. Scuvy
c. Osteomalacia
d. Hyperparathyroidism
Solution. 96)D
Subperiostealresorption of phalanges is the hallmark of Hyperparathyroidism.Thesubperiostealresorption is best seen on radial aspect of
middle phalanx of second and third fingers.(Ref:Review of Radiology by Dr Sumer.K.Sethi 6th edition page 95)
Your Answer. b
Correct Answer. d
93/97
(97).
A 15 year old boy presents with deep boring pain in the right knee which becomes worse at night.On history taking,mother reveals that
he was hospitalised with fever along with pain and swelling of right knee two years back.Identify the area marked by arrow in the X-ray
taken now.
a. Brodies abscess
b. Sequestrum
c. Involucrum
d. Pannus
Solution. 97)A
Brodies abscess is a well subscribed area of destruction with surrounding sclerosis.Basically,itrefers to an abscess related to focus of
chronic osteomyelitis in a bone.
Your Answer. a
Correct Answer. a
94/97
(98).
What is the most probable diagnosis from the X-ray shown below ?
a. Tuberculosis of spine
b. Multiple myeloma
c. Eosinophilic granuloma
d. Ankylosing spondylitis
Solution. 98)A
The X-ray shows involvement of adjacent vertebra along with reduction of intervertebral space.Most probably due to T.B spine
Your Answer. a
Correct Answer. a
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(99).
A 12 year old male presents with swelling in left index finger along with a lesion in his neck as shown in image.Correlate and give your
diagnosis ?
a. Hyperparathyroidism
b. Spina ventosa
c. Rheumatoid arthritis
d. Psoriatic arthritis
Solution. 99)B
Tuberculousdactylitis involves the short tubular bones of the hands and feet in children. It often follows a benign course without pyrexia
and acute inflammatory signs as opposed to acute osteomyelitis.The skin lesion shown in image is most probably a scrofuloderma,which
supports the diagnosis.
Your Answer. d
Correct Answer. b
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(100).
A 30 year male who is a diagnosed case of Rheumatoid arthritis,now complaints that his ring finger clicks as he bends it.The finger
remains bent even when the hand is unclenched.But with further effort,it suddenly straightens with a snap.What is the level of tendon
sheath constriction found in this patient?
a. Middle phalanx
b. Proximal phalanx
c. Proximal interphalangeal joint
d. Metacarpophalangeal joint
Solution. 100)D
Trigger finger is a type of stenosingtenosynovitis.It is caused by thickening of fibrous tendon sheath or constriction of mouth of the
fibrous digital sheath at the level of metacarpophalangealjoint.A tender nodule can be felt in front of the metacarpophalangeal joint.
Your Answer. d
Correct Answer. d
Test Answer
1.(a)
2.(c)
3.(b)
4.(c)
5.(b)
6.(c)
7.(b)
8.(c)
9.(d)
10.(a)
11.(b)
12.(b)
13.(c)
14.(a)
15.(c)
16.(c)
17.(d)
18.(a)
19.(d)
20.(d)
21.(a)
22.(b)
23.(c)
24.(a)
25.(d)
26.(c)
27.(c)
28.(a)
29.(d)
30.(c)
31.(d)
32.(d)
33.(c)
34.(b)
35.(c)
36.(b)
37.(d)
38.(d)
39.(c)
40.(c)
41.(a)
42.(d)
43.(c)
44.(b)
45.(a)
46.(a)
47.(d)
48.(b)
49.(d)
50.(d)
51.(d)
52.(d)
53.(b)
54.(d)
55.(a)
56.(c)
57.(b)
58.(c)
59.(c)
60.(b)
61.(c)
62.(a)
63.(a)
64.(b)
65.(d)
66.(d)
67.(b)
68.(c)
69.(d)
70.(d)
71.(a)
72.(c)
73.(a)
74.(c)
75.(c)
76.(b)
77.(a)
78.(b)
79.(c)
80.(b)
81.(d)
82.(a)
83.(b)
84.(b)
85.(a)
86.(d)
87.(c)
88.(a)
89.(c)
90.(b)
91.(d)
92.(c)
93.(b)
94.(a)
95.(c)
96.(d)
97.(a)
98.(a)
99.(b)
100.(d)
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