Free Diagnostic Radiology Practice Questions

Question 1

A new 14-mm spiculated mammographic mass has a nonparallel, shadowing ultrasound correlate and is assessed as BI-RADS 5. Ultrasound-guided core biopsy yields nonspecific benign breast tissue and stromal fibrosis without atypia or malignancy. Postbiopsy images confirm that the marker is within the mass. What should the radiologist recommend at imaging-pathology review?

Accepted Answer

Arrange further tissue sampling for imaging-pathology discordance

Answer

Accept the benign result and resume routine screening mammography

Answer

Obtain contrast-enhanced breast MRI and resample only if the mass enhances

Answer

Perform targeted ultrasound in six months to document stability

Question 2

A 70-year-old man develops aphasia and right hemiparesis. Noncontrast CT shows early ischemic change in the left insula and lentiform nucleus at the basal ganglia level, and in the lateral MCA cortex above the basal ganglia. The caudate, internal capsule, and remaining cortical regions are preserved; there is no hemorrhage. What ASPECTS should be reported?

Accepted Answer

7

Answer

3

Answer

6

Answer

8

Question 3

An incidental thyroid nodule measures 1.3 cm. It is solid, hypoechoic but brighter than the strap muscles, wider than tall, and smoothly marginated. A macrocalcification produces posterior shadowing; there are no punctate echogenic foci or rim calcifications. The patient has no compressive symptoms, high-risk history, or suspicious cervical lymph nodes. Under ACR TI-RADS, which recommendation belongs in the report?

Accepted Answer

TR4; ultrasound surveillance without FNA

Answer

TR3; no biopsy or ultrasound follow-up

Answer

TR4; FNA because the nodule exceeds 1 cm

Answer

TR5; FNA because the nodule contains calcification

Question 4

On day 5 of life, an infant who had been feeding normally develops bilious emesis. The abdominal radiograph shows gas throughout the bowel. During an urgent upper gastrointestinal study, the duodenojejunal junction remains to the right of the spine, and the distal duodenum and proximal jejunum follow a tight corkscrew course. The fluoroscopic findings establish which diagnosis?

Accepted Answer

Malrotation with midgut volvulus

Answer

Intestinal malrotation without volvulus

Answer

Incomplete duodenal obstruction from a web

Answer

Duodenal narrowing from annular pancreas

Question 5

To improve visualization of low-contrast liver lesions, a CT protocol review sets a maximum acceptable image-noise standard deviation of 12 HU. A uniform phantom produces 18 HU of noise at 100 mAs. Imaging is quantum-noise limited, automatic exposure control is off, and kVp, pitch, slice thickness, and reconstruction settings will remain unchanged. Which is the lowest listed tube-current-time product expected to meet the noise target?

Accepted Answer

225 mAs

Answer

150 mAs

Answer

300 mAs

Answer

400 mAs

Question 6

A patient with long-standing diabetes has a rocker-bottom foot and a new plantar ulcer. MRI already demonstrates fragmentation and subluxation across several midfoot joints. Which additional MRI finding most strongly favors superimposed osteomyelitis?

Accepted Answer

An ulcer tract contacting the cuboid at a focus of confluent T1 marrow replacement

Answer

Periarticular fragmentation with chronic joint malalignment

Answer

Subchondral edema on both sides of several tarsometatarsal joints

Answer

Small effusions distributed across the disorganized midfoot articulations

Question 7

Baseline low-dose lung cancer screening CT in an asymptomatic 66-year-old current smoker shows a solitary part-solid nodule. Its total mean diameter is 18 mm; the solid component measures 4 mm. There is no spiculation, adenopathy, or other suspicious finding. Select the Lung-RADS v2022 assessment and follow-up.

Accepted Answer

Category 3; low-dose CT in 6 months

Answer

Category 2; low-dose CT in 12 months

Answer

Category 4A; low-dose CT in 3 months

Answer

Category 4B; diagnostic evaluation with consideration of tissue sampling

Question 8

An incidental 3.8-cm renal lesion is homogeneous at 78 HU on unenhanced CT and has a smooth, imperceptible wall. Renal-protocol MRI confirms homogeneous T1 hyperintensity and no enhancement on well-registered subtraction images. There are no septa or mural nodules. The patient is asymptomatic and has no hereditary renal tumor syndrome. Using Bosniak v2019, how should this lesion be managed?

Accepted Answer

Classify it as Bosniak II; no routine imaging follow-up

Answer

Classify it as Bosniak IIF and begin imaging surveillance

Answer

Obtain a percutaneous core biopsy to exclude a hypovascular solid tumor

Answer

Refer for surgical assessment of a Bosniak III lesion

Question 9

Supine stress and rest Tc-99m sestamibi SPECT show an inferior-wall perfusion defect. Regional wall motion and systolic thickening are normal. Prone images obtained after the same stress injection show uniform inferior-wall activity. What best accounts for the apparent defect?

Accepted Answer

Diaphragmatic attenuation

Answer

Stress-induced right coronary ischemia

Answer

A completed inferior myocardial infarction

Answer

Balanced multivessel ischemia

Question 10

CT is obtained for persistent pain and vomiting in a woman with prior abdominal surgery. A fluid-filled, C-shaped small-bowel segment has two adjacent transition points, converging mesenteric vessels, and substantially reduced mural enhancement. There is surrounding mesenteric edema but no free intraperitoneal gas. What should the CT impression emphasize?

Accepted Answer

A closed-loop obstruction with findings concerning for strangulation

Answer

An uncomplicated adhesive obstruction without evidence of threatened bowel

Answer

An adynamic ileus with reactive mesenteric edema

Answer

An inflammatory small-bowel stricture without a vascular complication

Free Diagnostic Radiology Practice Questions

Domain 1: Ultrasound 9% of exam

Question 1

Domain 2: Breast Imaging 9% of exam

Question 2

Domain 3: Thoracic Imaging 8% of exam

Question 3

Domain 4: Genitourinary Tract Imaging 8% of exam

Question 4

Domain 5: Basic Knowledge of Physics 8% of exam

Question 5

Domain 6: Gastrointestinal Studies (Contrast and Non-Contrast) 8% of exam

Question 6

Domain 9: Neuroradiology 9% of exam

Question 7

Domain 10: Musculoskeletal Imaging 9% of exam

Question 8

Domain 11: Nuclear Medicine 8% of exam

Question 9

Domain 12: Pediatrics 8% of exam

Question 10

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