Genitourinary and OBG Radiology MCQs

Radiology · 26 free questions with answers & explanations.

1. A 30-year-old pregnant woman at 20 weeks gestation undergoes obstetric ultrasound. The placenta is located anteriorly and its lower edge extends to and covers the internal cervical os. What is this placental position called?
2. A 35-year-old woman with recurrent urinary tract infections undergoes intravenous urography. The pelvicalyceal system of the right kidney is duplex, with two separate collecting systems joining to form a single ureter at the mid-ureter. The upper pole moiety drains into the bladder at an ectopic location medially and inferiorly to the normal ureteral orifice. Which rule describes the relative orifice positions of a duplex system?
3. Ultrasound of a 28-year-old woman with right-sided pelvic pain shows a right adnexal cyst with uniform low-level internal echoes ('ground glass' appearance) measuring 5 cm, no internal vascularity on Doppler, and no solid nodules. This appearance is most characteristic of:
4. On ultrasound, which feature is MOST suggestive of malignancy in an adnexal cystic lesion?
5. In renal artery stenosis assessment, which Doppler parameter measured at the renal hilum is the most reliable indirect sign of hemodynamically significant stenosis?
6. On obstetric ultrasound at 20 weeks, the placenta appears to completely cover the internal os. On repeat ultrasound at 32 weeks, the lower edge of the placenta is 2 cm from the internal os. The correct interpretation is:
7. On CT urogram, a renal transitional cell carcinoma (TCC) of the upper ureter produces which classic appearance?
8. On obstetric ultrasound at 18 weeks, the 'lemon sign' and 'banana sign' are associated with which neural tube defect?
9. On MRI of the female pelvis, 'junctional zone' thickness >12 mm is the MRI criterion for diagnosing which condition?
10. Ultrasound of a 32-year-old woman with pelvis pain shows a 5 cm ovarian cyst with homogeneous low-level internal echoes (ground glass) and no mural nodularity or vascularity. MRI confirms a T1 hyperintense, T2 hypointense (shading) unilocular cyst with no enhancement. This is the 'T2 shading sign'. The most likely diagnosis is:
11. CT urogram (CTU) in a 60-year-old male with painless haematuria and a right ureteric filling defect shows an eccentric hyperdense filling defect in the proximal ureter on nephrographic phase with upstream hydronephrosis. The finding is stable in appearance on delayed phase. The most important CT feature differentiating ureteric transitional cell carcinoma (TCC) from a ureteric calculus is:
12. A 28-week foetal ultrasound shows a posterior fossa cyst communicating freely with the fourth ventricle, absent vermis, and the tentorium cerebelli is elevated. This triad is diagnostic of:
13. On contrast-enhanced CT of the abdomen-pelvis in a patient with renal cell carcinoma (RCC), the tumor enhancement is measured as +40 HU on pre-contrast and +100 HU on post-contrast study. CT enhancement of ≥15 HU in a renal mass indicates:
14. On MRI pelvis with dedicated sequences, a Mullerian duct anomaly is most accurately classified using which system, and which anomaly is associated with the highest risk of obstetric complications?
15. On ultrasound evaluation of a fetus at 20 weeks gestation, the amniotic fluid index (AFI) is 5 cm. This indicates:
16. On intravenous urography (IVU), the 'rim sign' (shell of opacified parenchyma around a lucent central area) in the kidney is seen in which condition?
17. On renal ultrasound, the finding of a renal cortical cyst with internal echoes, septations, and a mural nodule corresponds to which Bosniak category, requiring surgical excision?
18. On obstetric ultrasound at 20 weeks, a foetus is found to have bilateral renal agenesis. Which of the following is NOT a component of Potter sequence associated with this finding?
19. CT urogram in a 58-year-old male shows a 3 cm solid, enhancing renal mass in the upper pole of the left kidney. CT attenuation values of 35 HU on unenhanced and 95 HU on nephrographic phase images. The degree of enhancement is:
20. MRI pelvis in a 40-year-old woman with heavy menstrual bleeding shows a 5 cm intramural fibroid with isointense signal on T1, heterogeneous hyperintense signal on T2, and no enhancement on post-contrast. The T2 signal appearance of leiomyomata (fibroids) and their MRI characteristics indicating degeneration are important for pre-surgical planning. A fibroid showing central high T2 signal with no enhancement after contrast indicates:
21. CT urogram of a 60-year-old male with painless haematuria shows an enhancing soft tissue mass in the left renal pelvis causing hydronephrosis, and filling defect in the ureter. The most important differential investigation to guide management is:
22. On ultrasound of the scrotum, a testicular mass shows a hypoechoic area with peripheral calcifications and a 'snowstorm' appearance of fine internal calcifications scattered throughout both testes. This bilateral calcification pattern is termed:
23. Transvaginal ultrasound shows a 5 cm adnexal mass with a smooth thin wall, anechoic interior, no internal echoes or solid components, and no Doppler flow. The IOTA simple rules classify this as a benign lesion. This corresponds to IOTA B-feature:
24. CT urogram (CTU) in a 60-year-old male smoker shows a 2 cm filling defect in the right renal pelvis with surrounding fat stranding. Urine cytology is positive for malignant cells. What is the most likely diagnosis and standard treatment?
25. Renal ultrasound in a 4-year-old boy shows a large unilateral heterogeneous mass replacing the kidney with areas of necrosis. CT confirms a well-encapsulated mass with a 'claw sign' of residual normal renal parenchyma. What is the most likely diagnosis and the staging investigation of choice for pulmonary metastases?
26. On CT urogram (CTU), a renal mass showing 15 HU enhancement after contrast (>10 HU considered significant enhancement) should be classified using which scoring system to determine surgical vs. surveillance management?