TEST BANK
Practical Radiology: A Symptom-Based Approach
Edward C. Weber, Joel A. Vilensky, and Alysa M. Fog
1st Edition
,Table of Contents
Chapter 01 Modalities of Medical Imaging 1
Chapter 02 Shoulder, Pelvis, and Limbs 5
Chapter 03 Spine and Spinal Cord 31
Chapter 04 Brain 48
Chapter 05 Eyes, Ears, Nose, and Throat 59
Chapter 06 Chest 72
Chapter 07 Breast 86
Chapter 08 Abdomen 90
Chapter 09 Male and Female Urinary Tract and Male Genital Tract 99
Chapter 10 Female Pelvic Imaging 105
Chapter 11 Imaging of Bone Disease and Endocrine Disorders 112
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Test Bank - Practical Radiology: A Symptom-Based Approach, 1st Edition (Weber, 2013)
Chapter 1. Modalities of Medical Imaging
MULTIPLE CHOICE
1. Which of the following shows the order of radiologic densities from most dense to least
dense?
A. Metal, calcium, air, fat, water
B. Calcium, metal, fat, water, air
C. Metal, calcium, water, fat, air
D. Calcium, metal, fat, air, water
E. Metal, calcium, water, air, fat
ANS: C
Radiographic density relates to atomic number and thickness of tissue, and densities are
shown in order of metal, calcium, water, fat, and air in Table 1.1 of the text.
2. The finding of an air-fluid level on a radiologic image may reveal all of the following
except:
A. the presence of fluid in an air cavity such as a paranasal sinus.
B. the presence of gas and purulent fluid in an abscess.
C. the orientation of the patient when the radiograph was done.
D. the normal presence of fluid and air in the stomach.
E. the radiographic density of pathologic fluid.
ANS: E
According to the text, an air-fluid level is the horizontal edge between air and fluid in any
medical image; it does not reveal the radiographic density of pathologic fluid.
3. The three types of resolution fundamental to radiologic imaging are:
A. spatial, temporal, and color.
B. spatial, sensitivity, and contrast.
C. spatial, temporal, and sensitivity.
D. spatial, contrast, and color.
E. spatial, contrast, and temporal.
ANS: E
As discussed under the heading “Types of Resolution” in chapter 1, the three resolutions
fundamental to radiologic imaging are spatial, contrast, and temporal.
4. Which of the following is not true about radiographic projections?
A. The heart appears larger in an AP than in a PA projection.
B. A portable x-ray of a supine bedridden patient would be an AP projection.
C. In a lateral projection, a side marker indicates the side of the patient closest to the
detector.
D. Oblique projections always have the patient’s right side closer to the detector.
E. Both AP and PA projections are viewed as if the patient is looking at you.
ANS: D
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,______________________________________________________________________________________________
Test Bank - Practical Radiology: A Symptom-Based Approach, 1st Edition (Weber, 2013)
The statement “Oblique projections always have the patient’s right side closer to the
detector” is not true. As the text states, “It doesn’t matter if the oblique view was done as a
right posterior oblique or a left anterior oblique, as long as an ‘R’ marker indicates to the
viewer which side of the image is the Right side of the patient or an ‘L’ marker indicates the
Left side of the patient.”
5. Which of the following is not true about partial volume averaging?
A. It is more likely to occur in thin sections than in thicker sections.
B. It is applicable to CT.
C. It is applicable to MR.
D. It may result in a missed diagnosis because of an apparent loss of contrast
resolution.
ANS: A
Thicker reconstructed sections, not thin sections, may lead to an artifact called partial
volume averaging. If a thickly reconstructed slice includes tissues of different CT densities,
the apparent Hounsfield density measurement will be an average of all of these tissues, and
not an accurate measurement of any one of the individual anatomic structures included
(partial volume averaging).
6. A narrow CT window refers to:
A. a narrow opening by which ionizing radiation is emitted from the CT scanner.
B. a narrow opening in the CT gantry for the patient, which enhances image quality.
C. a CT scan in which small differences in CT attenuation are clearly visible.
D. a CT scan in which small differences in CT attenuation are less evident.
ANS: C
Narrow window CT images are perceived as high contrast, or very black and white, images.
These images make conspicuous very slight differences in CT density among tissues.
7. In the most common T2-weighted MRI images without fat suppression:
A. fluid has high signal (shown as bright), and fat has low signal (shown as dark).
B. fluid has low signal, and fat has low signal.
C. fluid has high signal, and fat commonly also has high signal.
D. fluid has low signal, and fat has high signal.
ANS: C
In T2-weighted images, fluids (or tissue with high water content) have a high signal and
appear bright (T2 hyperintensity). There are both T1 and T2 sequences that use a variety of
techniques to suppress the MR signal from lipid. The main reason for a fat suppressed T2
sequence is so that a high signal from a lipid-containing tissue (seen with the most common
T2 sequences) does not obscure a high signal from adjacent fluid.
8. Ultrasound imaging:
A. is excellent for cortical bone.
B. is excellent for lung.
C. usually shows enhancement posterior to fluid structures.
D. is always based on using strict orthogonal planes.
E. should not be used on pregnant patients.
ANS: C
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,______________________________________________________________________________________________
Test Bank - Practical Radiology: A Symptom-Based Approach, 1st Edition (Weber, 2013)
Because sound travels unimpeded through fluid, the echoes that are deep to a fluid
collection (the “far side” in relation to the transducer) are brighter than in adjacent tissue.
This is referred to as acoustic enhancement. Radiography and CT are excellent for cortical
bone, whereas ultrasound may only be able to show a displaced cortical fracture in a
relatively superficial bone. CT is also excellent for the lungs, whereas ultrasound has very
limited and specific uses for pleural and lung disease. Ultrasound is not based on using strict
orthogonal planes. Ultrasound images tend to be more difficult to interpret than CT, MRI, or
radiography because the display of anatomic structures completely depends on the particular
orientation and angulation of the transducer at any given moment during this generally “free
hand” imaging modality.
9. Nuclear medicine:
A. has better contrast resolution than MRI.
B. has better spatial resolution than radiography.
C. provides more information about physiologic activity than CT.
D. involves significantly more ionizing radiation risks than CT.
ANS: C
Nuclear medicine is fundamentally different from other types of radiologic imaging because
it emphasizes physiology rather than morphology. The images produced by nuclear
medicine procedures have poor spatial resolution but can provide functional information
about body tissues and organs that cannot be obtained any other way.
10. Which of the following is not true about gadolinium-based contrast material?
A. It is used with CT.
B. It is used with MRI.
C. It is associated with nephrogenic systemic fibrosis in a very small percentage of
patients with advanced renal failure.
D. It generally differentiates vascularized tissue from relatively avascular tissue such
as an area of fibrosis, and in the brain differentiates areas of intact blood-brain
barrier from damaged or absent blood-brain barrier.
ANS: A
Gadolinium-based contrast agents are used in MRI, not CT. Some very ill patients with
renal failure who had large doses or multiple doses of gadolinium-based contrast material
within a short time frame develop a systemic illness called nephrogenic systemic fibrosis.
The degree of contrast enhancement usually varies with the vascularity of tissues. As a
general principle, hypervascular tissue displays more intense enhancement than other tissues
in both CT and MRI. The neovascularity of many tumors results in their detection with
contrast enhanced imaging. One can also differentiate viable tissue from necrotic debris by
whether or not a tissue enhances.
11. Which of the following type of information is not part of a radiology report?
A. Patient demographic data
B. Clinical history
C. Differential diagnosis
D. Cost data
E. Modalities done
ANS: D
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, ______________________________________________________________________________________________
Test Bank - Practical Radiology: A Symptom-Based Approach, 1st Edition (Weber, 2013)
An ideal radiology report should contain four basic sections: demographics, clinical
information, descriptive information, and a diagnostic conclusion followed by further
lengthy discussion about what is on the report. There is no mention of cost being part of the
report.
12. Clinically relevant information should be included on a radiology order for all of the
following reasons except:
A. to help focus the radiologist’s attention on the acute clinical concern.
B. to improve the sensitivity and specificity of the radiologic interpretation.
C. for the benefit of the patient.
D. to increase the likelihood of the radiology report having clinical relevance.
E. to reduce expenses.
ANS: E
Of the many reasons discussed in the text for providing relevant clinical information on a
radiology requisition or order, reduction of expenses was not one of the reasons given.
Providing appropriate clinical information to the radiologist can make the difference
between establishing a correct diagnosis and having an important piece of information lost
because of poor communication between medical practitioners.
______________________________________________________________________________________________
4|Page
Practical Radiology: A Symptom-Based Approach
Edward C. Weber, Joel A. Vilensky, and Alysa M. Fog
1st Edition
,Table of Contents
Chapter 01 Modalities of Medical Imaging 1
Chapter 02 Shoulder, Pelvis, and Limbs 5
Chapter 03 Spine and Spinal Cord 31
Chapter 04 Brain 48
Chapter 05 Eyes, Ears, Nose, and Throat 59
Chapter 06 Chest 72
Chapter 07 Breast 86
Chapter 08 Abdomen 90
Chapter 09 Male and Female Urinary Tract and Male Genital Tract 99
Chapter 10 Female Pelvic Imaging 105
Chapter 11 Imaging of Bone Disease and Endocrine Disorders 112
,______________________________________________________________________________________________
Test Bank - Practical Radiology: A Symptom-Based Approach, 1st Edition (Weber, 2013)
Chapter 1. Modalities of Medical Imaging
MULTIPLE CHOICE
1. Which of the following shows the order of radiologic densities from most dense to least
dense?
A. Metal, calcium, air, fat, water
B. Calcium, metal, fat, water, air
C. Metal, calcium, water, fat, air
D. Calcium, metal, fat, air, water
E. Metal, calcium, water, air, fat
ANS: C
Radiographic density relates to atomic number and thickness of tissue, and densities are
shown in order of metal, calcium, water, fat, and air in Table 1.1 of the text.
2. The finding of an air-fluid level on a radiologic image may reveal all of the following
except:
A. the presence of fluid in an air cavity such as a paranasal sinus.
B. the presence of gas and purulent fluid in an abscess.
C. the orientation of the patient when the radiograph was done.
D. the normal presence of fluid and air in the stomach.
E. the radiographic density of pathologic fluid.
ANS: E
According to the text, an air-fluid level is the horizontal edge between air and fluid in any
medical image; it does not reveal the radiographic density of pathologic fluid.
3. The three types of resolution fundamental to radiologic imaging are:
A. spatial, temporal, and color.
B. spatial, sensitivity, and contrast.
C. spatial, temporal, and sensitivity.
D. spatial, contrast, and color.
E. spatial, contrast, and temporal.
ANS: E
As discussed under the heading “Types of Resolution” in chapter 1, the three resolutions
fundamental to radiologic imaging are spatial, contrast, and temporal.
4. Which of the following is not true about radiographic projections?
A. The heart appears larger in an AP than in a PA projection.
B. A portable x-ray of a supine bedridden patient would be an AP projection.
C. In a lateral projection, a side marker indicates the side of the patient closest to the
detector.
D. Oblique projections always have the patient’s right side closer to the detector.
E. Both AP and PA projections are viewed as if the patient is looking at you.
ANS: D
______________________________________________________________________________________________
1|Page
,______________________________________________________________________________________________
Test Bank - Practical Radiology: A Symptom-Based Approach, 1st Edition (Weber, 2013)
The statement “Oblique projections always have the patient’s right side closer to the
detector” is not true. As the text states, “It doesn’t matter if the oblique view was done as a
right posterior oblique or a left anterior oblique, as long as an ‘R’ marker indicates to the
viewer which side of the image is the Right side of the patient or an ‘L’ marker indicates the
Left side of the patient.”
5. Which of the following is not true about partial volume averaging?
A. It is more likely to occur in thin sections than in thicker sections.
B. It is applicable to CT.
C. It is applicable to MR.
D. It may result in a missed diagnosis because of an apparent loss of contrast
resolution.
ANS: A
Thicker reconstructed sections, not thin sections, may lead to an artifact called partial
volume averaging. If a thickly reconstructed slice includes tissues of different CT densities,
the apparent Hounsfield density measurement will be an average of all of these tissues, and
not an accurate measurement of any one of the individual anatomic structures included
(partial volume averaging).
6. A narrow CT window refers to:
A. a narrow opening by which ionizing radiation is emitted from the CT scanner.
B. a narrow opening in the CT gantry for the patient, which enhances image quality.
C. a CT scan in which small differences in CT attenuation are clearly visible.
D. a CT scan in which small differences in CT attenuation are less evident.
ANS: C
Narrow window CT images are perceived as high contrast, or very black and white, images.
These images make conspicuous very slight differences in CT density among tissues.
7. In the most common T2-weighted MRI images without fat suppression:
A. fluid has high signal (shown as bright), and fat has low signal (shown as dark).
B. fluid has low signal, and fat has low signal.
C. fluid has high signal, and fat commonly also has high signal.
D. fluid has low signal, and fat has high signal.
ANS: C
In T2-weighted images, fluids (or tissue with high water content) have a high signal and
appear bright (T2 hyperintensity). There are both T1 and T2 sequences that use a variety of
techniques to suppress the MR signal from lipid. The main reason for a fat suppressed T2
sequence is so that a high signal from a lipid-containing tissue (seen with the most common
T2 sequences) does not obscure a high signal from adjacent fluid.
8. Ultrasound imaging:
A. is excellent for cortical bone.
B. is excellent for lung.
C. usually shows enhancement posterior to fluid structures.
D. is always based on using strict orthogonal planes.
E. should not be used on pregnant patients.
ANS: C
______________________________________________________________________________________________
2|Page
,______________________________________________________________________________________________
Test Bank - Practical Radiology: A Symptom-Based Approach, 1st Edition (Weber, 2013)
Because sound travels unimpeded through fluid, the echoes that are deep to a fluid
collection (the “far side” in relation to the transducer) are brighter than in adjacent tissue.
This is referred to as acoustic enhancement. Radiography and CT are excellent for cortical
bone, whereas ultrasound may only be able to show a displaced cortical fracture in a
relatively superficial bone. CT is also excellent for the lungs, whereas ultrasound has very
limited and specific uses for pleural and lung disease. Ultrasound is not based on using strict
orthogonal planes. Ultrasound images tend to be more difficult to interpret than CT, MRI, or
radiography because the display of anatomic structures completely depends on the particular
orientation and angulation of the transducer at any given moment during this generally “free
hand” imaging modality.
9. Nuclear medicine:
A. has better contrast resolution than MRI.
B. has better spatial resolution than radiography.
C. provides more information about physiologic activity than CT.
D. involves significantly more ionizing radiation risks than CT.
ANS: C
Nuclear medicine is fundamentally different from other types of radiologic imaging because
it emphasizes physiology rather than morphology. The images produced by nuclear
medicine procedures have poor spatial resolution but can provide functional information
about body tissues and organs that cannot be obtained any other way.
10. Which of the following is not true about gadolinium-based contrast material?
A. It is used with CT.
B. It is used with MRI.
C. It is associated with nephrogenic systemic fibrosis in a very small percentage of
patients with advanced renal failure.
D. It generally differentiates vascularized tissue from relatively avascular tissue such
as an area of fibrosis, and in the brain differentiates areas of intact blood-brain
barrier from damaged or absent blood-brain barrier.
ANS: A
Gadolinium-based contrast agents are used in MRI, not CT. Some very ill patients with
renal failure who had large doses or multiple doses of gadolinium-based contrast material
within a short time frame develop a systemic illness called nephrogenic systemic fibrosis.
The degree of contrast enhancement usually varies with the vascularity of tissues. As a
general principle, hypervascular tissue displays more intense enhancement than other tissues
in both CT and MRI. The neovascularity of many tumors results in their detection with
contrast enhanced imaging. One can also differentiate viable tissue from necrotic debris by
whether or not a tissue enhances.
11. Which of the following type of information is not part of a radiology report?
A. Patient demographic data
B. Clinical history
C. Differential diagnosis
D. Cost data
E. Modalities done
ANS: D
______________________________________________________________________________________________
3|Page
, ______________________________________________________________________________________________
Test Bank - Practical Radiology: A Symptom-Based Approach, 1st Edition (Weber, 2013)
An ideal radiology report should contain four basic sections: demographics, clinical
information, descriptive information, and a diagnostic conclusion followed by further
lengthy discussion about what is on the report. There is no mention of cost being part of the
report.
12. Clinically relevant information should be included on a radiology order for all of the
following reasons except:
A. to help focus the radiologist’s attention on the acute clinical concern.
B. to improve the sensitivity and specificity of the radiologic interpretation.
C. for the benefit of the patient.
D. to increase the likelihood of the radiology report having clinical relevance.
E. to reduce expenses.
ANS: E
Of the many reasons discussed in the text for providing relevant clinical information on a
radiology requisition or order, reduction of expenses was not one of the reasons given.
Providing appropriate clinical information to the radiologist can make the difference
between establishing a correct diagnosis and having an important piece of information lost
because of poor communication between medical practitioners.
______________________________________________________________________________________________
4|Page
