GIT Radiology (Upper GI, Lower GI, Pneumoperitoneum) MCQs

Radiology · 27 free questions with answers & explanations.

1. An erect chest radiograph of a patient with acute abdomen shows a crescent of gas beneath the right hemidiaphragm. Which diagnosis does this represent?
2. A barium enema in a 60-year-old man shows an 'apple-core' or 'napkin ring' filling defect with shouldering at the margins in the sigmoid colon. The mucosa within this segment is destroyed. What is the most likely diagnosis?
3. A barium swallow of a 50-year-old male with progressive dysphagia shows a smooth, broad-based filling defect in the mid-oesophagus at the level of the carina that appears as an extrinsic impression without mucosal destruction. This is most likely caused by:
4. On a barium meal, which of the following features on an ulcer crater would MOST favor a malignant etiology over a benign peptic ulcer?
5. On erect plain abdominal X-ray, which of the following indicates free intraperitoneal gas MOST reliably?
6. On barium enema, 'apple-core' lesion with shouldering (abrupt transition between normal and abnormal mucosa) is most characteristic of:
7. In water-soluble contrast swallow, leakage of contrast from the esophagus following esophagectomy is best evaluated using:
8. Barium swallow of a patient with achalasia cardia classically shows which appearance at the gastro-oesophageal junction?
9. On CT abdomen of a patient with acute mesenteric ischaemia, which finding indicates transmural bowel infarction and irreversibility?
10. A double-contrast barium enema shows 'collar-button' ulcers in the colon. This finding is characteristic of which condition?
11. A barium swallow study shows a smooth, broad-based filling defect in the mid-oesophagus with a 'shelf-like' edge and intact mucosa. The defect causes partial obstruction. A biopsy of the lesion shows smooth muscle bundles. The MOST characteristic barium finding distinguishing a leiomyoma from carcinoma of the oesophagus is:
12. A 70-year-old on NSAIDs presents with acute epigastric pain. Erect chest X-ray shows a thin crescentic lucency under the right hemi-diaphragm. CT abdomen confirms free air under the diaphragm. The erect CXR can detect free air as small as:
13. CT abdomen in a 35-year-old with crampy abdominal pain and bloody diarrhoea shows circumferential wall thickening of the transverse colon with 'thumb-printing' (pseudopolyps), loss of haustration in the affected segment, and pericolonic fat stranding. This 'target sign' (stratified wall enhancement) on contrast CT most specifically indicates:
14. Small bowel follow-through (SBFT) in a 30-year-old with chronic diarrhoea shows irregular thickening and nodularity of the valvulae conniventes in the jejunum, with prominent 'stacking' of valvulae (moulage sign) and a mosaic mucosal pattern. These findings point to:
15. On barium swallow, a patient shows a 'rat-tail' or 'shoulder' appearance in the mid-esophagus with abrupt irregular shouldering of the lumen. This appearance is characteristic of:
16. On CT abdomen in a patient with appendicitis, the 'arrowhead sign' refers to:
17. On small bowel barium follow-through, 'Floculation' and 'segmentation' of the barium column are radiological signs of:
18. On a barium swallow, a smooth filling defect in the mid-oesophagus on two walls with normal mucosa overlying it ('T-sign' or 'cervical oesophageal web' excluded) and pulsatile appearance suggests:
19. On erect chest X-ray, free air under the right diaphragm is best identified as a crescentic lucency between the liver and diaphragm. Which is the MINIMUM amount of free peritoneal air that a properly exposed erect chest radiograph can reliably detect?
20. In a barium enema, the 'apple-core' deformity is MOST characteristic of which colonic pathology?
21. On CT abdomen with oral and IV contrast, 'mesenteric fat stranding' with thickened mesenteric vessels in a patient with acute right iliac fossa pain is MOST suggestive of:
22. Barium swallow shows a smooth, well-defined filling defect with a 'shouldering' appearance at the gastroesophageal junction. On CT, the mass is extraluminal, heterogeneous with central necrosis. The most likely diagnosis is:
23. On erect chest X-ray, free gas under the right hemidiaphragm is seen. Which of the following conditions does NOT cause pneumoperitoneum?
24. A barium swallow in a 65-year-old woman with dysphagia shows a mid-esophageal 'rat tail' or shouldering/apple core appearance with mucosal destruction and irregular luminal narrowing. Which is the most likely diagnosis?
25. On CT of the abdomen in a 70-year-old with LIF pain and fever, there is pericolonic fat stranding, thickening of the sigmoid colon wall (>4 mm), and a 3 cm fluid collection with a rim-enhancing wall adjacent to the sigmoid. Which complication of sigmoid diverticulitis does the rim-enhancing collection represent?
26. CT of the abdomen in a patient with acute abdominal pain shows a distended cecum measuring 14 cm with a 'whirl sign' of mesenteric vessels and 'coffee bean sign'. The cecum has migrated to the left upper quadrant. What is the diagnosis?
27. On erect chest X-ray, free air under the diaphragm (pneumoperitoneum) appears as a crescent of gas. What is the minimum volume of free peritoneal gas that can be reliably detected on erect CXR?