Radiology

Bingo
Question and Answer

B1A
The wrist is composed of eight carpal bones. Which of
the following is not a carpal bone?

A. Navicular
B. Trapezium
C. Cuboid
D. Hamate

Slide 1

B2
A

The lunate is the most common bone of the wrist to

develop avascular necrosis. Which carpal bone most
commonly can develop avascular necrosis after a
fracture?

A. Trapezium
B. Navicular
C. Pisiform
D. Capitate

Slide 1

B3A
The radial head fracture is the most common site for adult elbow
fracture. The most common site in the pediatric population is
which of the following:
A. Olecranon
B. Coronoid process
C. Humerus supracondylar
D. None of the above

Slide 1

B4A
The Salter-Harris System is utilized to describe pediatric joint
fractures with open epiphysis. Which Salter fracture can affect
the growth of the bone?
A. Salter Type 1
B. Salter Type 2
C. Salter Type 3
D. Salter Type 4
E. Salter Type 5

Slide 1

B5A

This patient walks in for an

X-ray after being
discharged from hospital
the previous week. What is
the first thing you should in
treating this patient?
A. Intubate the patient
B. Apply traction to his
neck
C. Make sure the cervical
collar stays on.
D. Do nothing and let him
go home since he came
in on his own accord.

Slide 1

B6A

This pediatric patient come

into the ED after hurting their
foot playing baseball. Pain is
the lateral part of the foot at
the arrow. What is the
pertinent finding?
A.
B.
C.
D.

Fracture
Epiphysis
Apophysis
Physis

Slide 1

B7A

The arrows are noting

what findings of the
elbow?
A. A fat pad from joint
effusion
B. A joint effusioin
C. Torn muscle
D. Infection

Slide 1

B8A

Pediatric patient presents

after being a passenger in
an MVA. The maximum
measurement between
C1/2 is different between
adults and children. The
maximum distance in
should should not exceed
how many mm.
A.
B.
C.
D.

2 mm
5 mm
7 mm
10 mm

Slide 1

B9A

A diabetic patient presents with swelling of the right

foot and a full thickness ulcer to the fifth metatarsal.
There is clinical concern for osteomyelitis. Which of
the following studies would be most expedient and
sensitive for the diagnosis of osteomyelitis?
A.
B.
C.
D.

Nuclear bone scan

Three phase bone scan
Nuclear medicine white blood cell study
MRI without & with contrast

Slide 1

B10A

This type of fracture in a

pediatric patient has a
unique description. It can
be described as a:
A.
B.
C.
D.

Torus fracture
Colles fracture
Greenstick fracture
Compound fracture

Slide 1

B11A A fracture is typically described with certain

terminology. Which of the following terms is not

normally used to describe the features of a fracture?
A.
B.
C.
D.

Apposition
Angulation
Compound
Simple

Slide 1

dislocations of the shoulder are the most

B12A Anterior
common glenohumeral dislocation. The events leading to
a posterior dislocation has been described to occur with
which of the following.
A.
B.
C.
D.

Windsail surfing
Internet surfing
Electrocution
Slipping on ice

Slide 1

B13A

Hip fractures are not uncommon after a fall in the

elderly population. You get an X-ray report after having
a 2 view X-ray of the hip that is negative. You have a
high suspicion that a fracture is present since the
patient cant weight bear. Which of the following
exams would be most definitive to determine the
presence of a fracture.
A.
B.
C.
D.

Ultrasound
Computed tomography with contrast
MRI without contrast
Nuclear medicine bone scan

Slide 1

B14A

Patient presents in
agonizing pain after
MVA. The ankle shows
multiple obvious
abnormalities such as
fractures and
dislocation. Which of
the following is an
additional finding?
A.
B.
C.
D.

Compound fracture
Torus fracture
Spiral fracture
Greenstick fracture

Slide 1

B15A

The fracture of the

wrist is involving
which bone?
A.
B.
C.
D.

Lunate
Capitate
Triquetrum
Scaphoid

Slide 1

I16A
The white out
hemithorax most likely
from:
A. Atelectasis of the
left lung
B. A large left pleural
effusion
C. A large left
pneumothorax
D. Pneumonia in the
left lung
E. Unilateral
pulmonary edema

Slide 3

I17A
The white out hemithorax
most likely from:
A. Atelectasis of the right
lung
B. A large right pleural
effusion
C. A large left
pneumothorax
D. Pneumonia in the right
lung
E. Unilateral pulmonary
edema

Slide 3

I18A
The white out
hemithorax most likely
from:
A. Atelectasis of the
left lung
B. A large left pleural
effusion
C. A large right
pneumothorax
D. Pneumonia in the
left lung
E. Unilateral
pulmonary edema

Slide 3

I19A

The white out

hemithorax most likely
from:
A. Atelectasis of the
left lung from
mucous plug
B. A large left pleural
effusion
C. A large right
pneumothorax
D. Pneumonia in the
left lung
E. Left lung atelectasis
from low lying ETT.

Slide 3

I20A
The white out
hemithorax most likely
from:
A. Atelectasis of the
left lung
B. A large left pleural
effusion
C. Atelectasis left lung
from mucous plug.
D. Pneumonia in the
left lung
E. Left lung removed
from prior surgery

Slide 3

I21A
Which of the following is usually not true regarding a portable
Chest X-ray:
A. The patient usually takes a shallower inspiration than than
a PA chest.
B. The posterior lower lobes cannot be fully assessed.
C. The heart is the same size or smaller than the PA chest.
D. It is more difficult to detect a compression fracture than a
two view chest.

Slide 3

I22A

The most accurate exam for detecting a

pulmonary embolus is which of the following:
A.
B.
C.
D.
E.

A conventional PA and Lateral chest X-ray

Ultrasound of the chest.
MRI of the chest with contrast
CT chest with contrast
CT chest without contrast

Slide 3

I23A

A patient presents with shortness of breath. A portable

chest X-ray is performed in the E.D. Which of the
following descriptions may correctly reflect the
causative symptoms:
A. Both lungs are clear without edema
B. Small heart with a right sided aortic arch
C. A right sided tension pneumothorax with shift of the
heart to the left
D. A less than 5% right sided apical pneumothorax

Slide 3

I24A

A patient is in chronic renal failure but not

undergoing dialysis. The patient arrives in the ED
with shortness of breath after a long airplane flight
from Brazil. You wish to evaluate for a pulmonary
embolus. Which of the following is most
appropriate:
A.
B.
C.
D.
E.

MRI chest with contrast

MRI chest without contrast
V/Q scan with chest X-ray
CT chest with contrast
CT chest without contrast

Slide 3

I25A

A radiology report includes the description of Kirley B

lines. This findings is seen with which exam?
A.
B.
C.
D.
E.

Ultrasound of the chest

MRI chest
CT chest
Chest X-ray
V/Q scan

Slide 3

I26A

A CT scan of the chest with contrast facilitates the

diagnosis of all of the following except:
A.
B.
C.
D.
E.

Aortic dissection
Pulmonary embolism
Detection of hilar lymph nodes
Rib fractures
Pulmonary vascular malformations

Slide 3

I27A

The arrow is
directed towards a
PICC line and what
anatomical
structure?
A. Ascending
aorta
B. Descending
aorta
C. SVC
D. IVC
E. Right mainstem
bronchus

Slide 3

I28A
The arrows are in
pointing to what
diagnostic finding:
A. Skin fold
B. Tension
pneumothorax
C. Pulmonary bulla
D. Pneumothorax
E. Pleural effusion

Slide 3

I29A

The oval marker is positioned in

which lobe?
A. Right Upper Lobe
B. Right Middle Lobe
C. Right Lower Lobe
D. Lingula
Slide 3

I30A
The arrow shows in CT of
the chest with contrast the
following:
A. Aortic aneurysm
B. Descending aortic
dissection
C. Partial thrombus of the
pulmonary artery
D. Ascending aortic
aneurysm and dissection
E. Ascending aortic
aneurysm and plaque

Slide 3

N31A

Patients presents to your office with the chief

complaint persistent increasing dizziness at rest and
postural changes. Which cranial nerve and imaging
exam would be best to evaluate?
A.
B.
C.
D.
E.

CN
CN
CN
CN
CN

VII and CT of the brain with contrast

VIII and CT of the brain with contrast
VIII and MRI brain without contrast
VIII and MRI brain without and with contrast
VII and MRI brain without and with contrast

Slide 3

N32A
Patient presents with left
sided weakness. The pertinent
CT finding is:
A.
B.
C.
D.

Acute intracranial bleed

Midline shift
Subdural hematoma
Edema of an ischemic
infarct

Slide 3

N33A
Patient presents with left sided
weakness. The pertinent CT
finding is:
A. Acute intracranial bleed
from infarct
B. Midline shift
C. Subdural hematoma
D. Edema of an ischemic
infarct

Slide 3

N34A

The primary reason for obtaining a CT scan of the

brain in a patient presenting with symptoms of
acute infarct is:
A.
B.
C.
D.
E.

To determine if there is a skull fracture

Assess for hydrocephalus
To determine if there is a non-acute infarct
To determine if there is an acute bleed
To evaluate for a cystic hygroma

Slide 3

N35A

The primary finding of the

CT brain is:
A.
B.
C.
D.
E.

Epidural hematoma
Acute brain infarct
Meningioma
Subdural hematoma
Brain abscess

Slide 3

N36A

The arrows point to linear

low densities, which are:
A. A cranial fracture, B
cranial suture
B. B cranial fracture, A
cranial fracture
C. A & B cranial sutures
D. A & B cranial fractures

Slide 3

N37A
This patient received
impact injury by a baseball
to the side of the skull. The
finding is:
A.
B.
C.
D.
E.

Subdural hematoma
Epidural hematoma
Meningioma
Brain tumor
Brain abscess

Slide 3

N38A

This 17 year old female

presents to the ED with
headache. While talking to her,
she goes into respiratory
arrest. The pertinent findings
include:
A.
B.
C.
D.

Midline shift
Cerebral edema
Brain abscess
All the above

Slide 3

N39A
The arrow is pointing to
what anatomic structure?
A.
B.
C.
D.
E.

Cisterna magna
3rd ventricle
4th ventricle
Pineal gland
Pontine cistern

Slide 3

N40A

The most sensitive study for identifying an acute

infarction of the brain is which of the following:
A. CT brain with contrast
B. CT brain without or with contrast
C. MRI without contrast with diffusion weighted
imaging
D. MRI brain without and with contrast
E. MRI brain with contrast only with diffusion
weighted imaging

Slide 3

N41A

This MRI of the brain was

performed with contrast
and shows the presence
of a tumor. What
anatomic structure is
associated with this
mass?
A.
B.
C.
D.

Cisterna magna
4th ventricle
Prepontine cistern
Internal auditory
canal
E. Mastoid sinus

Slide 3

N42A Imaging of the brain with contrast usually

requires obtaining renal function tests to

determine adequate function. Which contrast
agent requires the greatest or best renal
function?
A.
B.
C.
D.

Barium
Technicium pertechnetate
Iodine
Gadolinium

Slide 3

N43A

Angiography of the brain and carotid arteries

can be done without IV contrast with which
following modalities?
A.
B.
C.
D.
E.

Computed tomography angiography

Magnetic resonance angiography
Ultrasound doppler with 3-D
Nuclear medicine flow study
Catheter based angiography

Slide 3

N44A

A patient falls from a 7 foot ladder removing his

Christmas lights from his house. He says he landed
on his back. He has severe back pain. Fractures by
X-ray of the thoracic and lumbar spine at the T8,
T12 and L1 levels. His pain is not the same at all
levels. His brain is cleared. Which of the following
exams may be best to determine which level is
acute?
A.
B.
C.
D.
E.

Bone scan
X-ray tomography
Computed tomography
MRI
Ultrasound

Slide 3

N45A

A college student who lives in the dorm comes to the

ED with the complaint of a severe headache. A noncontrast CT exam is performed and is reported
normal. A MRI with contrast is performed and
reported normal. A further physical exam reveals
some rigidity. Which of the following conditions may
be present and still have a normal CT and MRI exam?
A.
B.
C.
D.
E.

Subarachnoid bleed
Pneumocephalus
Pituitary macroadenoma
Meningitis
Active multiple sclerosis

Slide 3

G46A

An inpatient has a speech pathology evaluation in

radiology and received barium contrast of various
viscosities as part of the exam protocol. The
attending calls radiology and wants to order a CT
abdomen with contrast. What is the problem in
doing this study?
A. There is actually no issue in doing the CT
study.
B. The IV contrast will react with the oral
contrast that the patient received
C. The contrast given by speech will result in
streak artifacts and limits detail of small
structures
D. The oral contrast that would be given to CT
will result in diarrhea

Slide 3

G47A

This radiograph is
demonstrating what
portion of the GI tract?
A. Cervical and thoracic
esophagus
B. Stomach
C. Duodenum
D. Ileum
E. Colon

Slide 3

G48A

The patient shows

extensive retroperitoneal
adenopathy just diagnosed
by percutaneous biopsy as
lymphoma. Patient just
returned from ERCP
complaining of abdominal
pain. What is the critical
finding?
A. Ileus
B. Retroperitoneal
adenopathy
C. Right hydronephrosis
D. Free air
E. Subcutaneous edema

Slide 3

G49A

A. Hydronephrosis
B. Ascites
C. Small bowel
obstruction
D. Large bowel
obstruction
E. Bowel
perforation

This male complains of pain shooting into his

right scrotum. You identify a hernia on physical
exam and was confirmed by CT which was
ordered to determine if a ureteral stone was
present which can give radiating pain. What is
the potential complication of this CT finding?
Slide 3

G50A

This radiograph of the abdomen was taken in

what position?
A. Upright
B. Prone
C. Left lateral decubitus
D. Right lateral decubitus

Slide 3

G51A
This radiograph is an
example:
A.
B.
C.
D.

Upper GI study
Single contrast enema
Double contrast enema
Water soluble enema

Slide 3

G52A

This clinical symptom most

frequently occurs in older
patients with complaint of
LLQ pain. The primary
diagnosis would be which
of the following?
A.
B.
C.
D.

Small bowel obstruction

Large bowel obstruction
Intususception
Diverticulitis

Slide 3

G53A
The supine abdominal X-ray
shows abnormal bowel pattern.
This presentation is
characteristic for which of the
following:
A.
B.
C.
D.

Large bowel obstruction

Small bowel obstruction
Colonic volvulus
Bowel perforation

Slide 3

G54A

This image was taken at 7 hours after the patient

began drinking barium. The finding is an example
of:
A. Small bowel intususception
B. Small bowel obstruction
C. Small bowel foreign body
D. Colonic obstruction

Slide 3

G55A

The pertinent findings of this

KUB is which of the
following:
A. Distended small bowel of
obstruction
B. A distended bladder
C. An appendolith
D. Gas distended colon with
abrupt termination of
obstruction

Slide 3

G56A

What pertinent anatomy is commonly excluded

when ordering a CT abdomen?
A.
B.
C.
D.
E.

Kidneys
Aortic bifurcation
Appendix
Spinal cord conus
Gastroesophageal junction

Slide 3

G57A
Which of the following studies is the exam of choice
for assessing right upper quadrant pain in a patient
who has fasted at least 3 hours?
A.
B.
C.
D.
E.

Nuclear medicine biliary scan

CT abdomen without contrast
MRCP
Ultrasound
ERCP

Slide 3

G58A

The reason for wanting a patient fasting prior to

evaluating the gallbladder with ultrasound is
which of the following:
A. Fasting permits the patient to become
slightly more skinny before the exam.
B. Fasting minimizes the patient from vomiting
on the sonographer
C. Fasting keeps the belly from being bloated
D. Fasting improves visibility of the gallbladder
lumen by permitting increase gallbladder
distention

Slide 3

G59A
In the United States, the most common, rapid and
sensitive exam for detecting appendicitis is by which
modality?
A.
B.
C.
D.
E.

Ultrasound
Appendiceal barium enema
Small bowel follow through
Computed tomography
MRI

Slide 3

G60A
The arrow is directed to
what pathology?
A. Diverticulitis
B. Dilated ureter from
distal stone
C. Crohns disease
D. Appendicitis
E. Psoas abscess

Slide 3

O61A

X-rays were discovered in 1895 by a physicist, who

subsequently earned a Nobel Price. What is the name
of that individual?
A.
B.
C.
D.
E.

Albert Einstein
Wilhelm Rontgen
Nikola Tesla
Max Planc
Enrico Fermi

Slide 3

O62A

The father of osteopathy was an M.D. and created

the first osteopathic medical school in Missouri in
1892. That individuals was?
A.
B.
C.
D.
E.

Johns Hopkins
Daniel Palmer
Samuel Hahnemann
Andrew Still
Benedict Lust

Slide 3

O63A

The most common intravenous contrast

used in radiology for CT and X-rays
contains which radiodense material?
A.
B.
C.
D.
E.

Barium sulfate
Magnesium
Iodine
Lead
Ferritin

Slide 3

O64A
A pregnant patient presents with history of DVT and
shortness of breath. You are concerned for a
pulmonary embolus. Which of the following tests
most frequently used today would result in the
lowest radiation dose to the fetus?
A.
B.
C.
D.

Nuclear V/Q scan

Nuclear perfusion scan
CTA chest with IV contrast
MRI of the chest

Slide 3

O65A
A pregnant patient presents with fever and
right lower quadrant pain. Which exam
would be first choice to assess for
appendicits?
A.
B.
C.
D.
E.

CT abdomen/ pelvis with IV contrast

CT abdomen/ pelvis without IV contrast
MRI of the abdomen/ pelvis
Ultrasound of the abdomen/pelvis
Single contrast barium enema

Slide 3

O66A
You are unsure which radiology exam to order
in a patient with particular symptoms. Which
of the following evidence based resources
would be the best resource that stratifies the
appropriateness of the exam on a scale of 1-9?
A. Imagewisely.org
B. Imagegently.org
C. Radiologyinfo.org
D. ACR.org/Quality-Safety/AppropriatenessCriteria

Slide 3

O67A
You are ordering an examination in a patient with a
history of contrast allergy manifested by hives.
Which of the following drugs is not usually used for
pre-medicating the patient prior to receiving
contrast?
A.
B.
C.
D.

Bendadryl
Prednisone (steroid)
Ativan
Cimetidine

Slide 3

O68A

Prior to performing an interventional radiology

procedure, the patients blood clotting factors are
evaluated. Platelets is one of the factors that can affect
bleeding complications with percutaneous drainage
procedures and biopsies. The lower limits most commonly
accepted by interventional radiology is which of the
following?
A.
B.
C.
D.

25,000 platelets per microliter

50,000
100,000
150,000

Slide 3

O69A
Diabetic patients can be challenging to image when
gadolinium intravenous contrast is required. Which of
the following is a potential complication if a patient
with diminished renal function with
GFR<30mL/min/1.73 m2 ?
A.
B.
C.
D.

Gangrene
Seizure
Nephrogenic Systemic Fibrosis
Pulmonary edema

Slide 3

O70A
A patient with bulimia and anorexia presents with
upper abdominal pain. The pancreas enzymes are
abnormal. Given the patients stature, which of the
following exams would be first choice to assess the
pancreas?
A.
B.
C.
D.

MRI
Ultrasound
CT
ERCP

Slide 3

O71A
Radiation safety should be a consideration for
all ionizing imaging studies. There are
guidelines that spell out how much occupational
radiation an individual should be exposed. A
patient needs to be held to facilitate obtaining
an X-ray. Who should be first choice to hold the
patient?
A.
B.
C.
D.
E.

The ordering physician

The radiology technologist
The radiologist
The family member or caretaker
The janitor in radiology

Slide 3

O72A

Patient presents to the ED with substernal pain

after eating steak and had the sensation that
something is stuck in his throat. After clearing for
a cardiac etiology, an esophogram is ordered.
Radiologist identifies an obstruction mass that
looks like food at the GE junction. Prior to
endoscopy, a method to attempt to relieve the
obstruction is to give effervescent granules (like
pop rocks), which builds up pressure and can force
the food into the stomach. Which of the following
is not a potential complication?
A.
B.
C.
D.

Vomiting
Aspiration
Esophageal perforation
Esophageal hiatal hernia

Slide 3

O73A

Patient presents with hematuria without flank

pain. An ultrasound of the kidneys is ordered and
the ultrasound report states the kidneys appear
within normal limits without mass or
hydronephrosis. Which of the following should be
of greatest concern?
A. A normal ultrasound excludes the possibility of
a mass.
B. A normal ultrasound can exist in the presence
of renal carcinoma.
C. It is unlikely a stone is a cause of hematuria
since there was never any pain and there is no
prior history of stones from the patient.
D. A normal ultrasound without hydronephrosis
can exist in the presence of a small ureteral
stone.
Slide 3

O74A

Interventional radiologist is a subspecialty in radiology.

Individuals in this subspecialty can typically do all of
the following procedures except for one procedure.
Which of the following procedures is not normally
accomplished by interventional radiologist?
A.
B.
C.
D.
E.

Lung biopsy
Arterial and venous stenting
Tumor ablation with internal radiation
Abscess drainage
Coronary artery angiography

Slide 3

O75A

A patient has multiple X-rays taken in the ICA. A

pregnant nurse refuses to care for the patient
since she is fearful that residual radiation can
harm her 1st trimester fetus. How much radiation
can remain after multiple portable X-rays?
A. 0 rad There is no residual radiation for
diagnostic X-rays
B. 0.5 rad
C. 1 rad
D. 5 rads

Slide 3