INI-CET High Yield Questions for Radiology

Mastering the INI-CET demands a strategic approach to preparation, with an emphasis on high-yield topics proving to be a successful tactic. This blog zeroes in on exactly that – a curated list of high-yield questions in Radiology that are highly likely to appear on the INI-CET. By acquainting yourself with these questions and their detailed explanations, you'll deepen your understanding of Radiology concepts, enhancing your confidence and readiness for exam day.

1. Identify the structure A in the given image:

A. Anterior cerebral artery (ACA)

B. Middle cerebral artery (MCA)

C. Posterior cerebral artery (PCA)

D. Basilar artery (BA)

Correct Option A - Anterior cerebral artery (ACA):

• The anterior cerebral artery (ACA) is labeled as "A" in the image.
• The anterior cerebral artery is a terminal branch of the internal carotid artery.
• Terminal arteries lack connections with other arteries to ensure continuous blood flow to tissues and organs.
• The anterior cerebral artery connects with its contralateral counterpart via the anterior communicating artery.
• This connection forms part of the cerebral circle, also known as the circle of Willis.
• The circle of Willis is an anastomotic ring of arteries located at the base of the brain, providing collateral circulation and backup blood supply to the cerebral hemispheres.

Incorrect Options:

Option B - Middle cerebral artery (MCA): MCA supplies the primary motor cortex, primary somatosensory cortex, and parts of the frontal, temporal, and parietal lobes.

Option C - Posterior cerebral artery (PCA): PCA supplies occipital lobes responsible for visual processing, the thalamus, and the midbrain.

Option D - Basilar artery (BA): Supply the brainstem,  the pons, and the upper part of the medulla oblongata

2. Which technique is used to protect normal tissues in lung cancer by exposing radiation only when the tumor is in the line of the beam during respiration?

A. 3-Dimensional Conformal Radiation Therapy (3DCRT)

B. Intensity Modulated Radiation Therapy (IMRT)

C. Gating

D. Stereotactic Body Radiotherapy (SBRT)

Correct Option C - Gating:

• Gating is the technique used to protect normal tissues in lung cancer by exposing radiation only when the tumor is in the line of the beam during respiration. This is particularly important in lung cancer treatment, where the tumor may move with the patient's breathing. Gating involves synchronizing the radiation beam with the patient's respiratory cycle.
• The radiation is produced only when the tumor is in the desired position, and if the tumor moves away from the beam line during respiration, the radiation is automatically halted, minimizing exposure to healthy surrounding tissues.

Incorrect Options:

Option A - 3-Dimensional Conformal Radiation Therapy (3DCRT):

• 3DCRT uses computer-generated 3D images to deliver radiation precisely to the tumor.
• It shapes the radiation beams to match the shape of the tumor.
• However, it doesn't specifically address respiratory motion.

Option B - Intensity Modulated Radiation Therapy (IMRT):

• IMRT delivers varying intensity radiation levels to different parts of the tumor.
• It provides better dose conformity than 3DCRT.
• While it improves precision, it doesn't inherently address respiratory motion.

Option D - Stereotactic Body Radiotherapy (SBRT):

• SBRT delivers highly precise, high-dose radiation to tumors in a few sessions.
• It's effective for small, well-defined tumors.
• While it's precise, it may not specifically account for respiratory motion without additional techniques like gating.

3. A 60-year-old male presents with progressive dysphagia and unintentional weight loss. A barium swallow study is performed and is given below. What is the most likely diagnosis?

A. Esophageal stricture

B. Gastroesophageal reflux disease (GERD)

C. Achalasia cardia

D. Carcinoma esophagus

Correct Option D: Carcinoma esophagus

• Carcinoma esophagus refers to malignant tumors originating from the esophageal epithelium. On a barium swallow study, carcinoma esophagus typically presents as irregular narrowing, ulceration, and the characteristic "shouldering" appearance, which represents an abrupt transition between the narrowed and dilated segments.

Incorrect Options:

Option A - Esophageal stricture: Esophageal stricture refers to the narrowing(ususally smooth) of the esophageal lumen, usually due to chronic inflammation or scarring. 

Option B - Gastroesophageal reflux disease (GERD): GERD is a condition characterized by the backward flow of gastric contents into the esophagus. It may cause symptoms such as heartburn and regurgitation but does not typically present with the characteristic findings of carcinoma esophagus, including the "shouldering" appearance.

Option C - Achalasia cardia: Achalasia is a motility disorder characterized by impaired relaxation of the lower esophageal sphincter and absent peristalsis in the esophagus. It is associated with a characteristic "bird's beak" appearance on a barium swallow study.

4. A 45-year-old female presents with a complaint of chest pain while eating spicy food. A barium swallow study is performed and is shown below. What is the most likely diagnosis?

A. Esophageal stricture

B. Gastroesophageal reflux disease (GERD)

C. Diffuse Esophageal Spasm

D. Esophageal carcinoma

Correct Option C: Diffuse Esophageal Spasm

• Diffuse esophageal spasm is a motility disorder characterized by uncoordinated contractions of the esophageal muscles. It can cause symptoms such as chest pain and dysphagia. On a barium swallow study, it appears as a "corkscrew" appearance due to the irregular and simultaneous contractions of the esophagus.

Incorrect Options:

Option A - Esophageal stricture: Esophageal stricture refers to the narrowing of the esophageal lumen, usually due to chronic inflammation or scarring. “Waist" or "hourglass" appearance is seen on the barium swallow study.

Option B - Gastroesophageal reflux disease (GERD): GERD is a condition characterized by the backward flow of gastric contents into the esophagus. While GERD can cause chest pain, it does not typically present with the characteristic "corkscrew" appearance seen in diffuse esophageal spasm.

Option D - Esophageal carcinoma: Esophageal carcinoma refers to malignant tumors arising from the esophageal epithelium. While it can cause chest pain and dysphagia, a shoulder-like appearance is seen instead of a "corkscrew" appearance on the barium swallow study.

5. A 45-year-old female presents with recurrent episodes of heartburn and regurgitation. A CT scan and barium swallow study are performed. The CT scan reveals the gastroesophageal junction positioned above the diaphragm, and the barium swallow shows a retrograde flow of contrast into the distal esophagus. What is the most likely diagnosis?

A. Sliding Hiatus hernia

B. Paraesophageal hiatal hernia

C. Esophageal rings

D. Congenital Diaphragmatic Hernia

Correct Option A: Sliding Hiatus hernia

• Sliding Hiatus hernia is characterized by the protrusion of the gastroesophageal junction and a portion of the stomach into the thoracic cavity through the esophageal hiatus of the diaphragm. On a CT scan, the gastroesophageal junction is visualized above the diaphragm. The barium swallow study typically shows a retrograde flow of contrast into the distal esophagus due to the displacement of the lower esophageal sphincter (LES) above the diaphragm.

In the given case, the gastro-oesophagal junction is sliding up the hiatus

Incorrect Options:

Option B - Paraesophageal hiatal hernia: A paraesophageal hiatal hernia, also known as a type II hiatal hernia, is a condition where a portion of the stomach herniates through the diaphragm and into the chest cavity alongside the esophagus. This type of hernia is different from a sliding hiatal hernia, where the gastroesophageal junction (where the esophagus meets the stomach) moves into the chest.

Option C - Esophageal rings: Esophageal rings, also known as Schatzki rings, are circular or ring-like structures that can develop in the lower part of the esophagus, causing dysphagia.

Option D - Congenital Diaphragmatic Hernia:

• Etiology: Caused by a defect in the development of the diaphragm.
• Pathophysiology: Bowel loops herniate into the thorax, causing mediastinal shift and pulmonary hypoplasia, contributing to a poor prognosis.
• Clinical Presentation: Newborns typically present with respiratory distress due to pulmonary underdevelopment.
• Bag and mask ventilation is contraindicated as it may worsen the herniation.

Also Read: INI-CET Previous Year Question Papers

6. A newborn presents with failure to pass meconium, abdominal distension, and delayed passage of stool. On radiographic evaluation, the following is seen.

1. Appendicitis
2. Intussusception
3. Hirschsprung disease
4. Diverticulosis

Correct Option C - Hirschsprung disease:

• Hirschsprung disease is a congenital disorder characterized by the absence of myenteric (Auerbach's) plexus in the distal colon, leading to functional obstruction. The transition zone seen on radiographic evaluation corresponds to the area of aganglionosis, with a dilated proximal colon and a narrowed distal colon. This finding is highly suggestive of Hirschsprung disease.

Incorrect Options:

Option A - Appendicitis:

• The radiographic findings described in the case scenario, including a transition zone and dilated proximal colon, are not consistent with appendicitis.

Option B - Intussusception:

• The classic radiographic finding in intussusception is the claw sign and coiled spring sign on barium enema.

Option D - Diverticulosis

• The radiographic findings described in the case scenario, including a transition zone and dilated proximal colon, are not consistent with Diverticulosis. Diverticulosis shows saw toothed appearance.

7. Which of the following radioisotopes is used in the treatment of polycythemia vera?

1. Strontium-90
2. Phosphorus-32
3. Iodine-125
4. Cobalt-60

8. A 35-year-old radiology technician working in a hospital is concerned about radiation exposure during pregnancy. According to the guidelines set by the Atomic Energy Regulatory Board (AERB), what is the maximum whole-body effective dose allowed for a radiation worker after the declaration of pregnancy?

1. 1 millisievert on the embryo or fetus
2. 2 millisieverts on the embryo or fetus
3. 5 millisieverts on the embryo or fetus
4. 10 millisieverts on the embryo or fetus

Correct Option A- 1 millisievert on the embryo or fetus:

• For a pregnant radiation worker, the maximum whole-body effective dose allowed on the embryo or fetus is 1 millisievert. This limit ensures that radiation exposure is kept as low as reasonably achievable to minimize potential risks to the developing baby.

Incorrect Options:

Options B, C, and D are incorrect options. Refer to the explanation of option A.

9. A 45-year-old female presents with a history of recurrent headaches. An MRI of the brain is ordered to evaluate the cause. An image from the MRI study is shown below. Gadolinium contrast was administered during the scan. Which of the following is the most likely interpretation of the given radiographical image?

1. Normal brain parenchyma
2. Acute hemorrhage
3. Meningioma
4. Medulloblastoma

Correct Option C: Meningioma

The CT shows an extra-axial enhancing mass with dural tail sign which is suggestive of meningioma.

Incorrect Options:

Option A - Normal brain parenchyma: It refers to the healthy brain tissue without any abnormality or pathology. Normal brain tissue would not typically present as a well-defined lesion.

Option B - Acute hemorrhage: Acute hemorrhage appears hypointense (dark) on T1-weighted images without the need for gadolinium contrast enhancement in brain imaging.

Option D - Medulloblastoma: It is a malignant brain tumor that primarily occurs in the posterior fossa, typically in children. Medulloblastoma typically appears as a solid cystic mass in the posterior fossa on MRI, exhibiting intense and homogeneous enhancement upon contrast administration. The tumor may cause a midline shift and extend into the fourth ventricle.

10. What are the essential requirements for achieving effective mammography?

A. Low resolution and high radiation dose

B. Low resolution and low radiation dose

C. High resolution and high radiation dose

D. High resolution and low radiation dose

Correct Option D: Low radiation exposure - Mammography - Specialized x-ray of the breast.

• To achieve effective mammography, it is essential to maintain a consistent production of high-quality images characterized by optimal contrast, high resolution, and minimal radiation dose. This is particularly critical for detecting small cancers, as their radiologic signs may be subtle. Therefore, mammography equipment and techniques must accommodate the diverse range of breast sizes, varying amounts of fat, presence of glandular and stromal tissue, and the challenge of distinguishing between normal breast tissue and common pathological lesions due to low contrast.

Incorrect Options:

Options A, B, and C are incorrect. Refer to the explanation of option D.

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