QUESTIONS POUR CONCOURS D’ENTRER D E S Radiologie 2016-2017
A 5-month-old child presents to Emergency Department with a reduced conscious level. No history of trauma, but he appears neglected. No physical injury is identified on clinical examination. A CT head is performed. Which one of the following is the most common intracranial finding in non-accidental injury?
Hydrocephalus
Intra-cerebral hemorrhage
Loss of gray-white matter differentiation
Subdural hematoma
2. A 7-year-old boy has fallen on an outstretched hand and complains of a painful right elbow. When reviewing the radiographs for evidence of bony injury, which one of the following statements is true?
Posterior fat pad may be a normal finding on flexed lateral view
An anterior fat pad is always abnormal
The line from the anterior cortex of the humerus should pass through the anterior third of the capitellum
The radiocapitellar line should intersect on all views
A newborn delivered by cesarean section shows signs of respiratory distress soon after birth. A chest radiograph is performed. Which one of the following features favors the diagnosis of transient tachypnea of the newborn (TTN)?
A ground glass opacities throughout both lungs
Hyper inflated lung
Loss of lung volume
The presence of a pleural effusion
A 4-week-old male neonate presents with milky vomiting and a hypochloraemic alkalosis. Hypertrophic pyloric stenosis is suspected and ultrasound is performed. Which one of the following ultrasound findings would confirm the diagnosis?
A pylorus that does not open
Pyloric canal length of greater than 11mm
pyloric muscle wall thickness of 1mm
Transverse pyloric diameter of greater than 11mm
A 4-year-old child presents with upper back pain. Hepatomegaly and blood tests show iron deficiency anemia. Chest radiograph demonstrates an abnormal mediastinal contour, and CT confirms an 8-cm posterior mediastinal mass which contains calcifications. The lungs are clear. Which one of the followings is most likely the diagnosis?
Extramedullary hematopoiesis
Lymphoma
Neuroblastoma
Teratoma
A 6-month-old child with palpable abdominal mass. Ultrasound is revealing a mixed echogenic mass in the left kidney. CT demonstrates a large mass within the left kidney which has a moderate enhancing component. Which one of the following would be the most likely diagnosis?
Angiomyolipoma
Lymphoma
Neuroblastoma
Wilm’s tumor
A 3-month-old infant with failure to thrive and tachypnea. No evidence of central or peripheral cyanosis. A chest radiograph shows enlarged central and peripheral pulmonary vessels throughout both lungs. Which one of the following is a potential diagnosis?
Pulmonary stenosis
Tetralogy of Fallot
Tricuspid atresia
Ventricular septal defect (VSD)
Interstitial lung disease is suspected in a 3-year-old child who has a long history of breathlessness on exertion. A chest radiograph reveals interstitial change at the lung base. The clinical symptoms are more severe that the radiographic changes appear to suggest and a diagnosis is yet to be established. Which one of the following would be the next appropriate investigation?
Bronchoscopy
Contrast-enhanced CT of the chest
HRCT (high resolution CT)
MRI
A 2-week-old baby presents with poor feeding and bilious vomiting. Malrotation is suspected and an upper GI contrast study (TOGD) is requested. What specific radiological finding would confirm the diagnosis?
Corkscrewing’ appearance of the duodenum and jejunum
On the supine radiograph the D-J flexure lies to the left of the midline
On lateral view the D-J flexure is posterior
D. On the supine radiograph the D-J flexure lies above the duodenal bulb
A 5-year-old child presented 1 week ago with bacterial meningitis and is now persistently pyrexial with new onset seizures. A CT head with contrast injection shows frontal leptomeningeal enhancement, with hypodense material within the subdural space, but hyperdense to CSF. What is the most likely diagnosis?
Cerebral abscess
Cerebritis
Ubdural empyema
Ntriculitis
A 3-month-old infant with Tetralogy of Fallot is waiting surgery. A pre-operative chest radiograph is performed when the child has no current illness. Which one of the following features are you most likely to see?
Boot-shape heart
Enlarged hila
Pulmonary plethora
Splaying of hila
A 2 week-old septic neonate shows worsening renal function and proteinuria. Seven days after his initial illness, an ultrasound is performed which reveals a unilateral enlarged kidney, with loss of corticomedullary differentiation and reversal of end-diastolic arterial flow. Associated adrenal hemorrhage is noted. What is the most likely diagnosis?
Acute glomerulonephritis
Acute tubular necrosis
Renal vein thrombosis
Renal artery stenosis
A 12-year-old child with CF (cystic fibrosis) had been followed up with annual chest radiographs. Which of the following features is a late radiographic change associated with the disease?
A. Cavitation
B. Diffuse interstitial patters
C. Hilar enlargement
D. Consolidation
A neonate with a history of worsening cyanosis and respiratory distress has a series of chest radiographs taken. The initial chest radiograph reveals a solid left upper lobe mass and over the course of 3 weeks, this becomes aerated. The progressive mediastinal shift is seen as the mass enlarges. Which one of the following is the most likely diagnosis?
Congenital lobar emphysema
Congenital cystic adenomatoid malformation (CCAM)
Bronchopulmonary sequestration
Congenital diaphragmatic hernia
A 3-year-old boy presents with a short history of shortness of breath. Clinical examination is unremarkable, but on the chest radiograph there are multiple pulmonary nodules suggestive of metastases. Which one of the following tumors would be the most likely source of pulmonary metastasis?
Neuroblastoma
Meduloblastoma
Nephroblastoma (Wilm’s tumor)
Lymphoma
A 4-year-old child presents with shortness of breath and fever. The chest radiograph shows a round opacity within the right lower lobe. No previous chest radiographs are available for comparison. Which one of the following statements is true when trying to distinguish pneumonia from a tumor in a child?
Sharp margins are associated with pneumonia
The absence of an air bronchogram makes tumor lore likely
Ill-defined margins make pneumonia more likely
An MRI would be the next investigation of choice
A newborn baby is hypoxic immediately following delivery. There is evidence of meconium-stained amniotic fluid. Which one of the following statements is true regarding meconium aspiration syndrome?
The chest radiograph typically shows patchy consolidation with areas of hyperinflation
The chest radiograph typically shows a fine ground glass appearance
Pneumothorax and pneumomedianum are uncommon complications
Radiological resolution is usually seen within 48-72hours
A 5-year-old boy is involved in traffic accident and is complaining of neck pain. Which of the following statements is true regarding the cervical spine radiograph?
Subluxation of up to 7mm of C2 anteriorly on C3 is normal
Subluxation of up to 3mm of C2 posteriorly 0n C3 is normal
He soft tissues anterior to C2 must be no wider than 1/4 of the width of the C2 vertebral body
The distance between the anterior arch of C1 and the dens can be up to 5mm
A neonate presents at 24 hours old with vomiting, abdominal distension and failure to pass meconium. A series of investigations are performed. Which of the following would be in keeping with a diagnosis of meconium ileus?
A contrast enema showing pellets of meconium within the terminal ileum
A contrast study showing narrow loops of proximal ileum
A contrast enema showing a dilated terminal ileum
A plain abdominal radiograph (ASP) showing a soap bubble appearance within the left iliac fossa
Following a recent viral illness, a 5-year-old girl presents with a fluctuating conscious level, seizures and left leg weakness. She is apyrexial and does not have a rash. An MRI is performed. This shows bilateral areas of increased T2 signal in the subcortical white matter and cerebellum and deep grey matter. Which one of the following is the most likely diagnosis?
Bacterial meningitis
Viral encephalitis
Multiple sclerosis
Acute disseminated encephalomyelitis (ADEM)
3-day-old neonate demonstrates signs of respiratory distress. A chest radiograph demonstrates a right pleural effusion. Which one of the following is the commonest cause?
Hydrops fetalis
Meconium aspiration syndrome
Pulmonary hemorrhage
Chylothorax
An 8-month-old child who was previously well presents with vomiting and altered conscious level. A CT head reveals significant hydrocephalus with a hyperdense mass. An MRI is arranged and reveals a lobulated mass adjacent to the trigone of lateral ventricles. The lesion yields low signal on both T1w and T2w sequences with avid enhancement postcontrast. Which one of the following is likely the most likely diagnosis?
Craniopharyngioma
Meningioma
Ependymoma
Choroid plexus tumor
A 6-year-old boy presents with a right-side limp of a few week’s duration. He is apyrexial. Which one of the following is the earliest radiographic sign that would support a diagnosis of Perthes’disease of the hip?
Fragmentation of the femoral head
Hip effusion
A subchondral lucency
Sclerosis of the femoral head
A 5-year-old child presents with vomiting, lethargy and a persistent headache. A CT head is performed and shows a hyperdense midline posterior fossa mass, abuting the fourth ventricle with associated hydrocephalus. There is significant peritumoral oedema but no calcification, and avid homogenous enhancement is seen postcontrast. Which one of the following posterior fossa tumors is the most likely diagnosis?
Meduloblastoma
Ependymoma
Pilicystic astrocytoma
Cerebellar heamangioma
A 3-year-old girl presents with a purpuric rash, abdominal pain and blood-stained stools. Henoch-Schönlein purpura (HSP) is the clinical diagnosis. Which one of the following statements is true when investigating this girl?
An ultrasound is of little diagnostic use
If an intussusception is seen it is likely to be difficult to reduce
An ultrasound finding of hypoechoic, thickened bowel wall would be supportive the clinical diagnosis
Involvement of the GI tract is seen in 10% of patients with HSP
26. An 11-year-old boy presents with right hip pain. He is apyrexial and the clinicians are concerned that he has a slipped femoral epiphysis (epiphysiolyse aseptique). Which one of the following would be appropriate first-line imaging?
AP and frogleg lateral radiographs of the pelvis
PA and frogleg lateral radiographs of the pelvis
Ultrasound of the hip
CT with 3D reconstruction of the affected hip joint
A 10-year-old child presented 5 weeks ago with prolonged fever and headache with new onset seizures. A CT head pre-and post-contrast injection shows frontal isodense mass with peripheral enhancement centered by a calcification. What is the most likely diagnosis?
Cerebral abscess
Neurocysticercosis
Brain Tuberculoma
Brain tumor
A 9-year-old child presents with headache and vomiting. Lumbar puncture tab shows a changed pathological CSF with 120 cells, 1.5g/l of protein and 1.5mmol/l of glucose. A CT head with contrast injection shows basilar meningeal enhancement, with hypodense erea of basal ganglia and associated hydrocephalus. What is the most likely diagnosis?
A. Tuberculous meningitis
B. Toxoplasmosis
C. Saccoïdosis
D. Bacterial meningitis
( NOTE: NO ANSWER IN FILE GIVEN)
A 7-year-old girl presents with a fluctuating conscious level, seizures and contractures. Lumbar tab is consistent with viral encephalitis. An MRI is performed. This shows bilateral areas of increased T2 signal in the thalami. Which one of the following is the most likely diagnosis?
JEV encephalitis
HSV encephalitis
Bacterial encephalitis
HIV encephalitis
A 6-year-old boy is involved in traffic accident and is complaining of headache and subsequently developed altered conscious level. Which one of the following investigations is appropriate in this condition?
CT head with contrast injection
CT head without contrast injection
MRI head
AP and Lateral view radiographs of the head
Signe appartient au syndrome alvéolaire:
Opacité en anneau
Opacité hilifuge
Opacité réticulo-micronodulaire
Opacité linéaire en rail
Opacité systématisée
Signe appartient au syndrome bronchique:
Opacité en verre dépoli
Pacité en rayon de miel
Opacité en doigt de gant
Micronodules
Opacité réticulaire
Signe appartient au syndrome interstitiel:
Opacité hilifuge
Opacité en aile de papillon
Brochocèle
Opacité nodullaire à contours flous
Opacité confluente
Signe appartient au syndrome de condensation
Opacité en verre dépoli
Opacité systématisée
DDB
Abcès du poumon
Emphysème
Signe indirect du syndrome bronchique:
A) Ligne septale
B) Bronchectasie
C) Opacité linéaire en rail
D) Atélectasie
E) Bronchogramme aérien
Image de thymus normal sur le cliché du thorax de face:
Opacité de densité hydrique au médiastin moyen
Masse hétérogène et calcifiée au médiastin antérieur
Masse hypodense comme la graisse
Opacité de densité hydrique au médiastin postérieur
Masse de densité hydrique au médiastin antérieur
Le signe de la shilouette est appliqué dans:
TDM
IRM
Echographie
Radiographie du thorax de face
Radiographie du thoax de profil
La radiographie du thorax de face chez une primo-infection tuberculeuse montre un foyer de condensation pulmonaire au lobe moyen droit, quelle lésion associée la plus fréquente?
Cavitation
Pleurésie
Adénopathie hilaire
Pneumothorax
Lignes septales
Pour l’enfant plus de 3 ans, on fait la radiographie du thorax de face comme technique:
Couché, rayon en AP
Debout, rayon en AP
Couché, rayon en PA
Debout, rayon en PA
Chacune des positions en haut
Dans le syndrome vasculaire, quelle cardiopathie congénitale qui peut donner une hypovascularisation pulmonaire généralisée?
CIA
CIV
PCA
ToF
CAV
41. Masse la plus fréquente au médiastin moyen chez l’enfant:
Lymphome
Hymus
Adénopathie
Malformations
Malformations
Masse la plus fréquente au médiastin moyen chez l’enfant:
Lymphome
Thymus
Adénopathie
Malformations
Neuroblastome
Cause d’hydronéphrose unilateral chez un nouveau-né:
Calcul renal
Reflux vésico-rénal
Valve urètrale postérieure
Syndrome de jonction pyélo-urétérale
Vessie neurologique
En cas d’occlusion haute néonatale, sur le cliché d’ASP en couché, montre:
A) Hyperaération intestinale généralisée
B) Estomac dilaté
C) Image” double bulle”
D) ASP comme normal
E) Côlon dilaté
Dans la méningite bactérienne non compliquée, sur l’échographie transfontanellaire, on peut voir:
Le résultat de l’examen est comme normal
L’espace péricérébrale est élargi
Le systéme ventriculaire est dilaté
Signe de ventriculite
Signe de vascularite
La pleurésie de petite abondance, la radiographie du thorax de face en couché, montre:
Effacement de coupole diaphragmatique
Ligne bordante pleurale
Courbe de damoiseau
Hémithorax atteint est opaque
Thorax normal
Diagnostic en imagerie de sténose hypertrophique du pylore de nourrisson se fait par:
TDM
IRM
TOGD
ASP
Echographie
Signe “ Iceberg” appliqué dans:
Masse thoraco-abdominale
Masse cervico-thoracique
Masse médiastinale antérieure
Masse médiastinale postérieure
Masse hilaire
Un prematuré avec maladie de membrane hyaline, sur le cliché du thorax on peut voir:
A) Thorax comme normal
Opacités non homogènes aux deux poumons
Poumons blancs avec volume augmenté
Poumons blancs avec volume diminué
Poumons hyperclartés
Hyperclarté pulmonaire se voit dans:
Syndrome alvéolaire
Syndrome pleural
Syndrome brochique
Syndrome médiastinal
Syndrome vasculaire
Image “double bulle” vu à l’ASP d’un nouveau-né, montre:
Hernie hyatale
Sténose hypertrophique du pylore
Volvulus gastrique
Occlusion haute duodénale
Occlusion basse.
Cochez la proposition fausse :
Une partie du corps est proximale lorsqu’elle est plus proche de la racine du membre. Elle est dite distale dans le cas contraire.
Un élément est médial lorsqu’il est situe plus près du plan sagittal médiane. Il est dit latéral dans le cas contraire.
Le squelette appendiculaire représente l’ensemble des os présentant un appendice, par exemple le sternum qui comporte l’appendice xiphoïde.
Les os longs sont des os dont la longueur est prédominante par rapport aux autres dimensions.
Un os long est compose d’une diaphyse et de deux épiphyse.
Choisissez la proposition fausse à propos squelette :
L’humérus appartient au squelette appendiculaire.
La clavicule appartient au squelette zonal.
Le rachis cervical appartient au squelette axial.
La scapula est un os plat.
Le sphénoïde est un os court.
Choisissez la proposition vraie. L’articulation entre la crête sphénoïdale inferieure et la rainure du bord supérieur du vomer est une :
Synfibrose.
Yndesmose.
Schindylese.
Synchondrose.
Gomphose.
Quelle structure contient des cellules musculaires lisses ?
Muscle de l’iris.
Muscle diaphragme.
Muscle deltoïde.
Muscle grand fessier.
Muscle quadriceps.
Indiquez, parmi les os suivants, celui qui ne s’articule pas directement avec le frontal chez l’adulte :
L’os temporal.
Le sphénoïde.
L’ethmoïde.
L’os zygomatique.
L’os maxillaire.
A propos du système nerveux :
Les nerfs vagues accélèrent la fréquence cardiaque.
Les nerfs sympathiques innervant le cœur sont issus des chaines sympathiques thoraciques.
La moelle épinière est une partie du système nerveux périphérique.
Un nerf spinal est par définition un nerf mixte
Un nerf crânien comporte toujours des fibres sensitives et des fibres motrices.
Cochez les nerfs moteurs de l’œil :
I
II
III
IV
V
Choisissez la proposition exacte parmi les suivantes. L’axe de la tête cartilagineuse de l’humérus est oriente :
En haut, en arrière, en dedans.
En haut, en avant, en dehors.
En bas, en avant, en dehors.
En haut, en avant, en dedans.
En bas, en avant, en dedans.
Quel muscle appartient a la coiffe des rotateurs ?
Le deltoïde.
Le triceps brachial.
Le grand rond.
L’infra-épineux.
Le trapèze.
Concernant le tarse, cochez la proposition vraie :
Le tarse est constitué de 6 os.
Le métatarsien V est médial.
Le tarse postérieur comprend le talus et le calcanéus.
Tous les doigts du pied ont 3 phalanges.
Les métatarses et les phalanges ne sont pas tous constitués d’un corps, d’une base, et d’une tête.
Le talus n’articule pas avec :
Le tibia.
La fibula.
Le calcanéum.
L’os naviculaire.
Le cuboïde.
Concernant l’articulation de la hanche, cochez la proposition fausse :
A) Le col fémoral est orienté en avant, en dedans, en haut.
L’ acetabulum (= cotyle) est orienté en avant, en bas, en dehors.
L’angle cervico-diaphysaire est de l’ordre de 90 degré.
L’échancrure ischio-pubienne est située entre les deux cornes de l’acetabulum.
L’arrière-fond de l’acetabulum n’est pas recouvert de cartilage articulaire.
Concernant les poumons :
Les poumons droit et gauche ont en commun une face costale et une face médiatisnale concave.
Le cul de sac pleural se projette en regard de la 7e côte.
Sur la face médiatisnale du poumon gauche, l’œsophage laisse son empreinte en arrière du hile pulmonaire
Le ligament pulmonaire unit le poumon au muscle diaphragmatique.
L’empreinte de l’artère subclavière gauche est clairement visible sur la face médiatisnale du poumon droit.
Le bol alimentaire passe successivement par :
La bouche, le rhinopharynx, l’œsophage, l’estomac, l’iléum, le duodénum.
L’estomac, le duodénum, le jéjunum, l’iléum, le colon descendant, le colon transverse.
L’œsophage, l’estomac, le jéjunum, l’iléum, le duodénum.
L’œsophage, l’estomac, le duodénum, le jéjunum, l’iléon, le colon ascendant, le colon transverse, le colon pelvien (sigmoïde), le colon descendant, le rectum.
E) Toutes les propositions précédentes sont fausses.
Concernant le colon :
A) Il forme un carde étendu du jéjunum à l’anus.
L’appendice vermiculaire se situe au niveau du caecum.
Le rectum débute au niveau de la vertèbre L3.
Le colon est vascularisé par des branches du tronc coeliaque.
Le colon intra-péritonéal se draine dans la veine cave.
66. La vascularisation du sein n’est pas assurée par :
A) Des branches de l’artère thoracique interne.
B) Des branches de l’artère thoracique latérale.
C) Des branches de l’artère pulmonaire.
D) Des branches de l’artère sub-scapulaire.
A propos du rachis :
Le rachis cervical présente une cyphose.
Le sommet de la cyphose thoracique est normalement au niveau de T3-T4.
Le rachis lombaire comprend le plus souvent 6 vertèbres lombaires.
La crête iliaque se projette horizontalement au niveau de L4.
Le disque L5-S1 est oblique en bas et en arrière.
Parmi les propositions suivantes concernant les os du pied, lequel se n’articule pas avec le cuboïde ?
L’os cunéiforme latéral.
B) L’os calcanéus.
L’os talus.
D) Le quatrième métatarsien.
Le cinquième métatarsien.
A propos des voies aériennes et des poumons :
A) Les voies aériennes inferieures commencent en regard de C2.
La bronche souche droite est plus verticale que la bronche souche gauche.
Le pédicule fonctionnel du poumon droit comprend la bronche souche droite, l’artère pulmonaire droite et les veines bronchiques droites supérieure et inférieure.
Le parenchyme pulmonaire est divisé en 3 segments à droit et 2 segments a gauche.
Le hile pulmonaire est recouvert par la ligne de réflexion de la plèvre.
Concernant l’œsophage cervical :
A) L’œsophage cervical mesure environ 15 cm de hauteur.
L’œsophage cervical prend son origine en projection de C2-C3.
L’œsophage cervical est la continuité du larynx.
Les fibres musculaires longitudinales de l’œsophage prennent insertion sur la face postérieure du chaton (plaque) du cartilage cricoïde.
Les fibres musculaires longitudinales de l’œsophage sont plus internes que les fibres circulaires.
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