MCQS SET TWO - CHEST & CVS

Q1.The following are known manifestations of SLE -
a. renal aneurysms
b. mucosal ulcerations
c. hepatosplenomagaly
d. pulmonary fibrosis
e. mediastinal lymphadenopathy

ans 1 -
T
T
T
T
T ( mediastinal lymph nodes are rare )

Q2. What is true regarding connective tissue disorders involving the respiratory system
a. painful pleural effusions are commonly seen in SLE
b. the most common manifestation of rheumatoid lung is diffuse fibrosis
c. scleroderma is associated withan increased incidence of lung cancer
d. thoracic involvement is most commonly seen in RA
e.necrobitoc nodules in RA commonly calcify

ans 2 -
T
F- pleural disease
T
F - SLE
F - no calcification

Q3. Regarding asbestos exposure,following are true:
a. Chryosolite fibres are most commonly associated with asbestos related pleural disease
b. lung cancer risk increases by a factor of ten
c. the earliest asbestos related pleural disease is pleural thickening
d. the term asbestosis refers to pleural calcifictaion
e. pleural calcification starts in the parietal pleura

ans 3.
F - crocidolite
F - five in nonsmokers, hundred in smokers
F- effusion
F- pulmonary fibrosis
F- visceral pleura

Q4. Regarding malignant mesothelioma, the following are true
a. risk factors include asbestos exposure and tuberculosis
b. latent period post asbestos exposure is 10 - 20 years
c. is usually associated with rib destruction
d. majority of asbestos workers will develop malignant mesothelioma
e. smokers are at an increased risk

Ans 4-
T
F- 20 -40yrs
F - 20%
F- 5-10%,
F - No risk

Q5. Regarding aspergillosis -
a. tuberculosis predisposes to aspergillosis
b hemoptysis is a common manifestation of noninvasive aspergillosis
c. In a patient with invasive pulmonary aspergillosis, cavitation signifies a better prognosis than consolidation alone
d. aspergilloma is an uncommon finding in ABPA
e. CT halo sign is seen is a feature of ABPA

Ans 5.
T
T
T
T - 7%
F- invasive aspergillosis

Q6. Causes of reversed bat wing sign include
a. pulmonary alveolar proteinosis
b. pulmonary edema
c. sarcoidosis
d. eosinophilic pneumonia
e. lymphoma

Ans 6.
F
T- resolving pulm edema can result in such an appearance
T
T
F

Q7. Regarding pulmonary AVM -
a. commonly associated with hereditary hemorrhagic telengiectasia
b. are usually multiple
c. are a cause of left to right shunt
d. medial one third of lungs are the most common site of involvement
e. stroke is a known complication

Ans 7.
T- 30-88% have HHT, 15 -40% HHT pt have pulm AVM
F - one third,
F - R to L shunt
T
T - 18%

Q8. Causes of SVCO syndrome include
a. Bronchogenic carcinoma
b. fibrosing mediastinitis
c. lymphoma
d. substernal goitre
e. central venous line

Ans 8
T
T
T
T
T

Q9. The following are true-
a. Majority of vascular rings are due to double aortic arch
b. Right sided aortic arch is seen in 1-2 % population
c. Right sided aortic arch with aberrant left subclavian artery is commonly associated with congenital cardiac anomalies
d. Right sided aortic arch with mirror branching is usually associated with acyanotic CHD
e. Aberrant right subclavian aretry in a left sided aortic arch may lie anterior to the trachea

Ans 9-
T - 55%
T
F - 5-12%
F - cyanotic CHD
T - 5%


Q10. Causes of cyanosis with pulmonary plethora include -
a. TGA
b. TAPVC
c. Ebstein anomaly
d. Truncus arteriosus
e. single ventricle

Ans 10
T
T
F
T
T

MCQ SESSION FOR FRCR PART 2A

We will be updating the MCQs on a regular basis - the plan is to cover the important topics in every module and then round off with a module ending mock exam on the pattern of the actual exam. Lets start off with GIT and HBS ( a long and seemingly never ending module) – the first few sessions will cover important topics and FAQs related to the liver

MCQS SESSION 1 – LIVER

Q1. Regarding hepatic anatomy,
a) ligamentum teres contains the remnant of the umbilical vein
b) the quadrate lobe is part of the right lobe of liver
c) the caudate lobe has a venous drainage distinct from the rest of the liver
d) Reidl’s lobe is more common in males
e) The fissure for the ligementum venosum separates the quadrate lobe from the rest of the liver

Answers :
a) True
b) False, left lobe
c) True
d) False
e) False, caudate lobe

Q2 . Regarding the hepatic vasculature,
a) celiac artery is the artery of the embryonic midgut
b) cystic artery is most commonly a branch of the common hepatic artery
c) completely supplied by the SMA in 5 % population
d) hepatic veins have an extrahepatic component
e) the replaced right hepatic artery commonly arises from SMA

Answers :
a) False, foregut
b) False, right hepatic A
c) True ( 2.5 – 5%)
d) False
e) True

Q3. The following statements are true :
a) Hepatic CT attenuation is 80 to 100 HU on precontrast scans
b) Precontrast hepatic attenuation is equal to/less than the pancreas
c) CTAP is the preferred technique for hypovascular lesions
d) Hepatic signal intensity is less than the spleen on T1W SE images
e) Hepatic signal intensity is more than the spleen on T2w SE images

Answers:
a) false, 40-70 HU
b) false, greater
c) True
d)
e)

Q4) The following are causes of increased hepatic attenuation

a) fatty liver
b) amiodarone
c) glycogen storage disorders
d) viral hepatitis
e) wilsons disease

Answers :

a) False
b) True
c) True
d) False
e) True

Q5) causes of diffusely decreased hepatic echogenicity include
a) fatty liver
b) acute viral hepatitis
c) glycogen storage disorders
d) cardiac failure
e) cirrhosis

Answers :
a) false
b) true
c) false
d) true
e) false

Q6 ) Regarding primary hemochromatosis, the following are true
a) Is linked to chromosome 11
b) is associated with an increased risk of hepatic adenoma
c) is associated with decreased hepatic CT attenuation
d) normal pancreatic signal in noncirrhotics
e) commonly affects hepatic RES cells

Answers :
a) false, chr 6
b) false, HCC ( 14-30%)
c) false, increased
d) true
e) false , parenchymal
Q7) The following are true regarding abdominal echinococcal infection
a) peritoneum is the second most common site in the body
b) multiple hepatic lesions are seen in majority
c) communication with biliary tree is most commonly with the common heptic duct
d) percutaneous aspiration is associated with a risk of anaphylaxis in 5%
e) calcification of the wall implies dead parasite

Answers :

a)false, lung
b) false, 20%
c) false, Right hepatic duct
d) false, 0.3%
e) false

Q8) Regarding hepatic infections :
a) Schistosomiasis is associated with an increased risk of HCC
b) amebic abscesses are commonly multiple
c) majority of hepatic abcesses are pyogenic
d) hepatic echinococcal cysts rupture in 10%
e)cluster sign is more commonly seen in pyogenic abscesses of
biliary origin

Answers :
a) true
b) false
c) true, 85%
d) false, 50 – 90%
e) true

TIPS FOR PREPARATION FOR FRCR PART 2A

· Preparation for 2A should begin with a thorough reading of a basic textbook ( Grainger or Sutton).

· Follow this up by practicing MCQS teamed with retrograde study of the relevant / important topics from Dahnert and if required detailed textbooks dedicated to a particular system ( eg. Osborn for CNS)
A word about Dahnert – almost everyone who has taken the exam will vouch for its worth ( “A mine of information”, “covers almost everything”, “must do for the exam” and so on). All quite true, yet its also one of the most frustating books to read for an exam – the reason being its not meant to be a textbook. The best way to tackle Dahnert , I feel, is to use it the way it was meant to be used – as a reference book. So once you are done with a basic textbook for a module and are attempting the MCQs, read the topics covered in the MCQs from Dahnert. Once you have read the important topics in a particular system from Dahnert, you”ll have the familiarity and confidence to revise that system from Dahnert cover to cover.

· The MCQs are of varying difficulty --- the key to the exam is to maximize points on the easy ones and avoid guessing on the ones you don’t know. The range of topics covered in the MCQs may seem mind boggling at first glance but remember you are only expected to know half the paper ( 45%). And with proper preparation that should not be too difficult !!

· As with any MCQ based exam , there is a sort of pattern to this exam too….the first few questions are related to physic( Fahrs should suffice for this segment), anatomy and procedures( read Chapmans procedures) and nuclear medicine ( Fahrs/ Chapman / Dahnert). Some questions are related to differentials ( cover lists of important differentials from Chapmans differentials / Dahnert – does sound boring but will hold you in good stead in both 2A and 2B ! ). Next expect a few questions on some pet topics ( eg sarcoidosis, retroperitoneal fibrosis ). Finally there are the unpredictable questions – these are loose cannons both in terms of the subjects covered and the level of difficulty. A little difficult to prepare for these because you never know what to expect ; but a thorough reading of the text ( and a few prayers !!) would probably be useful.
· While questions may or may not be repeated , the commonly covered topics in the different modules remain fairly consistent, expect questions on these topics in every exam and study them thoroughly(including the infamous Dahnert percentages! ) . We will be dedicating a lot of space to these topics in our MCQ sessions going forward.

· Practice as many MCQs as possible – keep doing mock tests, mark yourself honestly and you will get a fair assessment of your preparation and progress. You will also realise whether you are a good guesser or a poor one. Work out your own strategy for attempting MCQs and you will figure out what works for you . Though the pass percentage is 45% , keep a safe figure like 60 % in mind to keep a margin for careless mistakes etc. If you consistently score more than 60 % in mock tests, that should be good enough ( barring of course the element of luck and a tough unpredictable “ OH MY GOD” exam – regular prayers are strongly recommended to take care of these variables ; atheists may have to outsource to more god fearing relatives !)

FRCR PART 2 A RELEVENT INFORMATION

RELEVANT INFORMATION


· This part consists of 6 modules : - 1) Chest and Cardiovascular
2) GIT and Hepatobiliary
3) Musculoskeletal
4) CNS including head and neck
5) Genitourinary ( including breast, O&G)
6) Pediatrics

· All modules will contain a few questions on : general physics ( related to ultrasound, MRI, CT)
: relevant systemic anatomy, procedures, interventions and nuclear medicine


· Chest and GIT contain 40 true and false questions with 5 stems each , the duration is 2 hrs; the remaining modules consist of 30 questions with 5 stems each, the duration is 1.5hrs

· The pass percentage is 45 % . The scoring format is +1 for a correct mark, -1 for an incorrect answer.