100+ Free Arab Board Radiology Final Written Practice Questions

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Sample Arab Board Radiology Final Written Practice Questions

Try these sample questions to test your Arab Board Radiology Final Written exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 68-year-old male presents 90 minutes after the sudden onset of right-sided hemiplegia and expressive aphasia. An emergent non-contrast head CT is performed. Which of the following early parenchymal ischemic signs is caused by cytotoxic edema causing loss of gray-white matter differentiation in the lateral basal ganglia?

A.Obscuration of the lentiform nucleus

B.Dense middle cerebral artery (MCA) sign

C.Hyperdense basilar artery sign

D.Sulcal effacement over the high parietal vertex

Explanation: Obscuration or loss of definition of the lentiform nucleus (putamen and globus pallidus) is one of the earliest parenchymal signs of acute middle cerebral artery territory infarction on non-contrast CT. Cytotoxic edema causes water influx into cells, decreasing tissue attenuation and blurring the normal interface between the gray matter of the basal ganglia and adjacent white matter tracts (internal/external capsules).

2A 52-year-old female presents to the emergency department with a sudden-onset 'worst headache of life' and neck stiffness. Non-contrast head CT demonstrates extensive hyperattenuating subarachnoid hemorrhage centered in the basal cisterns and anterior interhemispheric fissure. What is the most common anatomical site of origin for a ruptured saccular intracranial aneurysm presenting with this pattern?

A.Anterior communicating artery

B.Posterior inferior cerebellar artery (PICA)

C.Basilar artery bifurcation

D.Ophthalmic segment of the internal carotid artery

Explanation: The anterior communicating artery (Acom) is the single most common site for ruptured intracranial saccular (berry) aneurysms, accounting for approximately 30-35% of all cases. Ruptured Acom aneurysms characteristically cause hemorrhage predominantly within the anterior interhemispheric fissure, basal cisterns, and suprasellar cistern, often with intraventricular extension into the frontal horns.

3A 58-year-old male presents with progressive headaches, personality changes, and new-onset seizures. Brain MRI demonstrates an intra-axial mass in the left frontotemporal white matter with a thick, irregular, nodular ring-enhancing wall, central non-enhancing necrosis, extensive surrounding T2/FLAIR vasogenic edema, and marked elevated cerebral blood volume (rCBV) on dynamic susceptibility contrast perfusion MRI. Which imaging feature most reliably differentiates glioblastoma multiforme (GBM) from a pyogenic brain abscess?

A.Elevated perfusion (high rCBV) and restricted diffusion in the enhancing rim rather than the necrotic center

B.Marked central restricted diffusion on DWI with low ADC within the fluid-filled core

C.Complete, smooth, thin T2-hypointense rim with dual-rim sign

D.Absence of surrounding vasogenic edema on T2/FLAIR sequences

Explanation: In glioblastoma (high-grade glioma), neoangiogenesis in the hypercellular tumor rim produces elevated relative cerebral blood volume (rCBV) on perfusion MRI, and restricted diffusion (low ADC) is found in the cellular tumor rim, while the necrotic core exhibits facilitated diffusion. In contrast, a pyogenic brain abscess demonstrates marked central restricted diffusion (bright DWI, dark ADC) due to viscous pus, and its wall typically displays a smooth, thin T2-hypointense rim without elevated rCBV.

4A 45-year-old female undergoes brain MRI for investigation of chronic headaches. Imaging reveals an extra-axial mass along the anterior convexity that is isointense to cortex on T1- and T2-weighted images, exhibits avid homogeneous contrast enhancement, and displays a tapering line of contrast-enhanced dura adjacent to the tumor margin. What is this tapering dural enhancement sign termed, and what is the most likely diagnosis?

A.Dural tail sign; Meningioma

B.Cap sign; Schwannoma

C.Pachymeningeal rim sign; Epidermoid cyst

D.Floating dural sign; Metastatic adenocarcinoma

Explanation: The dural tail sign (thickening and avid enhancement of the tapering dura adjacent to an extra-axial mass) is classic for a meningioma, seen in up to 70% of cases. It represents reactive hypervascularity or localized tumor infiltration of the contiguous dura mater. Other supportive features include broad dural base, CSF cleft, and adjacent hyperostosis.

5A 28-year-old female presents with subacute visual loss in the right eye followed by lower extremity paresthesias. Brain MRI reveals multiple ovoid T2/FLAIR hyperintense lesions oriented perpendicularly along the subependymal venules of the corpus callosum and callososeptal interface. What are these characteristic imaging findings called, and what do they represent?

A.Dawson fingers; Perivenular demyelinating plaques in multiple sclerosis

B.Radial bands; Cortical dysplasia in tuberous sclerosis

C.Virchow-Robin spaces; Prominent perivascular spaces in hypertensive microangiopathy

D.Leopard spots; Metachromatic leukodystrophy

Explanation: Dawson fingers are elongated demyelinating plaques oriented perpendicularly to the lateral ventricles along the path of deep medullary venules. They reflect the perivenular inflammatory demyelination characteristic of multiple sclerosis (MS) and are best appreciated on sagittal FLAIR images at the callososeptal junction.

6A 34-year-old male presents to the emergency department with acute fever, confusion, olfactory hallucinations, and behavioral disturbance. Brain MRI reveals asymmetric high T2/FLAIR signal with cortical swelling, gyriform restricted diffusion on DWI, and petechial cortical hemorrhage involving the medial temporal lobes, insular cortex, and inferior frontal lobes, with complete sparing of the basal ganglia. What is the most likely diagnosis?

A.Herpes simplex virus type 1 (HSV-1) encephalitis

B.Japanese encephalitis

C.Middle cerebral artery territory acute infarction

D.Glioblastoma involving the bilateral temporal lobes

Explanation: HSV-1 encephalitis characteristically causes necrotizing, asymmetric inflammation and cytotoxic edema in the limbic system (medial temporal lobes, insula, subfrontal cortex, and cingulate gyrus). Sparing of the lentiform nucleus and caudate head is a classic feature that distinguishes HSV encephalitis from middle cerebral artery infarction and viral encephalitides targeting deep gray nuclei.

7A 48-year-old male presents with progressive right sensorineural hearing loss and tinnitus. MRI of the internal auditory canals (IAC) demonstrates an avidly enhancing, well-circumscribed mass centered within the right internal auditory canal that widens the porus acusticus and extends into the cerebellopontine angle (CPA) cistern with an 'ice cream cone' configuration. What is the most likely diagnosis?

A.Vestibular schwannoma

B.Cerebellopontine angle meningioma

C.Epidermoid cyst

D.Arachnoid cyst of the CPA

Explanation: Vestibular schwannoma (acoustic neuroma) is the most common CPA neoplasm (85%), arising from the Schwann cells of the vestibular nerve inside the IAC. Expansion of the internal auditory canal (the 'cone') with a rounded cisternal component (the 'ice cream') is pathognomonic. CPA meningiomas, by contrast, are centered outside the IAC, form obtuse angles with the petrous bone, and exhibit a dural tail.

8A 62-year-old male with a history of cutaneous malignant melanoma presents with acute severe headache and ataxia. Non-contrast brain CT shows multiple hyperdense lesions with surrounding low-attenuation vasogenic edema at the gray-white matter junctions, several of which demonstrate intrinsic T1 hyperintensity and T2* susceptibility blooming on MRI. Which of the following primary neoplasms has the highest propensity to produce hyperdense, spontaneously hemorrhagic brain metastases?

A.Melanoma

B.Invasive lobular breast carcinoma

C.Prostate adenocarcinoma

D.Pancreatic ductal adenocarcinoma

Explanation: Melanoma has a notoriously high propensity for spontaneous intracranial hemorrhage (often producing intrinsic T1 hyperintensity due to both melanin and methemoglobin) and hyperdense appearance on CT. Other primaries prone to hemorrhagic brain metastases include renal cell carcinoma, choriocarcinoma, thyroid carcinoma, and bronchogenic carcinoma.

9A 55-year-old female presents with pulsatile tinnitus and an audible bruit behind the left ear. Catheter digital subtraction angiography (DSA) confirms a dural arteriovenous fistula (dAVF) involving the transverse-sigmoid sinus junction. According to the Cognard and Borden classification systems, which angiographic feature is the strongest predictor of aggressive clinical behavior and intracranial hemorrhage?

A.Retrograde cortical venous drainage (leptomeningeal venous reflux)

B.Supply from branches of the external carotid artery (middle meningeal artery)

C.Anterograde drainage directly into the internal jugular vein

D.Absence of direct nidus formation

Explanation: In both the Borden (Type II and III) and Cognard (Types IIb, III, IV, and V) classifications, the presence of retrograde cortical venous drainage (leptomeningeal venous reflux) is the primary determinant of intracranial venous hypertension, venous infarction, and intracranial hemorrhage. Fistulas with purely anterograde sinus drainage (Borden I / Cognard I) follow a benign natural history.

10A 26-year-old obese female presents with chronic daily throbbing headaches, transient visual obscurations, and bilateral papilledema. Lumbar puncture demonstrates an opening pressure of 34 cm H2O with normal CSF composition. Which combination of neuroimaging findings on brain MRI and MR venography (MRV) is most characteristic of Idiopathic Intracranial Hypertension (IIH)?

A.Empty sella, posterior scleral flattening, distended perioptic subarachnoid spaces, and bilateral transverse sinus stenosis

B.Pachymeningeal enhancement, sagging brainstem, engorged venous sinuses, and subdural fluid collections

C.Hydrocephalus with periventricular interstitial edema and transependymal flow

D.Aqueductal web with dilation of the lateral and third ventricles and a small fourth ventricle

Explanation: Idiopathic Intracranial Hypertension (pseudotumor cerebri) characteristically demonstrates signs of elevated CSF pressure on MRI: partially empty or empty sella turcica, flattening of the posterior globe/sclera, intraocular protrusion of the optic nerve head (papilledema), dilation and tortuosity of the perioptic CSF sheath, and smooth bilateral transverse sinus narrowing/stenosis on MRV.

About the Arab Board Radiology Final Written Exam

The Arab Board Diagnostic Radiology Final Written Exam is the culminating written assessment in the ABHS diagnostic radiology residency training curriculum across Arab League member states. Designed for senior trainees completing their residency, the examination evaluates clinical diagnostic acumen, advanced cross-sectional image interpretation, emergency imaging decision-making, structured reporting systems (BI-RADS, LI-RADS, PI-RADS, CAD-RADS, O-RADS), basic interventional procedures, and radiation safety. Passing the final written examination is the prerequisite for sitting the final oral/OSCE clinical board examination.

Assessment

A comprehensive single-best-answer written paper of clinical-vignette questions assessing diagnostic interpretation, modality selection, image-guided procedural principles, and patient safety across all diagnostic radiology subspecialties.

Time Limit

Approximately 3 hours

Passing Score

Approximately 60% (determined by standard-setting procedures of the ABHS Scientific Council)

Exam Fee

Set by ABHS and national councils; varies by country and training center. (Arab Board of Health Specializations (ABHS))

Arab Board Radiology Final Written Exam Content Outline

15%

Neuroradiology and Head/Neck

Cerebrovascular disease and stroke imaging, intracranial neoplasms, demyelinating and inflammatory disorders, spinal pathology and cord lesions, and head and neck mucosal and deep space lesions.

14%

Abdominal and Gastrointestinal Radiology

Focal liver lesions and LI-RADS, biliary and pancreatic diseases, bowel inflammation, bowel obstruction and ischemia, peritoneal pathology, and abdominal trauma.

13%

Thoracic and Pulmonary Radiology

Pulmonary nodule evaluation and lung cancer staging, interstitial lung diseases, thoracic infections, mediastinal masses, and pleural pathology.

12%

Musculoskeletal Radiology

Benign and malignant bone tumors, joint arthritides, sports injuries and internal derangements, marrow abnormalities, trauma, and musculoskeletal infections.

11%

Genitourinary Radiology

Renal masses and Bosniak classification, adrenal pathology, urinary tract infection and trauma, female pelvic imaging (O-RADS, uterine neoplasms), and male GU imaging (PI-RADS, scrotal pathology).

10%

Pediatric Radiology

Neonatal chest conditions, pediatric gastrointestinal emergencies (volvulus, intussusception, pyloric stenosis), pediatric renal/adrenal tumors, and congenital/skeletal abnormalities.

Cardiovascular Radiology

Acute aortic syndromes, coronary CT angiography and CAD-RADS, cardiac MRI tissue characterization (LGE, cardiomyopathies, myocarditis), and pulmonary vascular diseases.

Breast Imaging

Mammography interpretation and calcification descriptors, breast ultrasound criteria, breast MRI kinetic curves, BI-RADS lexicon categories, and image-guided biopsy indications.

Emergency, Interventional Radiology and Radiation Safety

Trauma whole-body imaging, non-vascular and vascular interventional radiology procedures, contrast media safety and adverse reaction protocols, and diagnostic radiation protection.

How to Pass the Arab Board Radiology Final Written Exam

What You Need to Know

Passing score: Approximately 60% (determined by standard-setting procedures of the ABHS Scientific Council)
Assessment: A comprehensive single-best-answer written paper of clinical-vignette questions assessing diagnostic interpretation, modality selection, image-guided procedural principles, and patient safety across all diagnostic radiology subspecialties.
Time limit: Approximately 3 hours
Exam fee: Set by ABHS and national councils; varies by country and training center.

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

Arab Board Radiology Final Written Study Tips from Top Performers

1Master structured reporting and classification criteria (BI-RADS, LI-RADS, PI-RADS, CAD-RADS, Bosniak, and Fleischner guidelines) as they provide clear, high-yield diagnostic criteria directly tested on board questions.

2Review characteristic MRI signal patterns and contrast enhancement dynamics across organ systems (such as late gadolinium enhancement in cardiac MRI, chemical shift imaging in adrenal and liver lesions, and multiphase liver CT/MRI washin/washout).

3Focus on differentiating critical emergency and trauma imaging findings, including signs of bowel ischemia/strangulation, active vascular contrast extravasation, acute aortic syndromes, and non-accidental trauma in pediatrics.

Frequently Asked Questions

What is the format and structure of the Arab Board Diagnostic Radiology Final Written Exam?

The final written examination consists of a single paper containing approximately 150 single-best-answer multiple-choice questions (MCQs), administered over approximately 3 hours. Questions feature clinical vignettes testing image findings, differential diagnosis, next best imaging step, pathology correlation, and management decisions across all subspecialties.

What is the passing score for the Arab Board Radiology Final Written Examination?

The standard pass mark is generally around 60%, established through standard-setting procedures by the Scientific Council of Diagnostic Radiology of the ABHS. Candidates must pass the final written exam to be eligible for the final clinical oral/OSCE examination.

Which subspecialty domains carry the highest weight on the final written exam?

The examination provides broad coverage of all diagnostic radiology domains, with neuroradiology, abdominal/GI imaging, thoracic radiology, and musculoskeletal imaging carrying the largest individual weights, alongside genitourinary, pediatric, cardiovascular, breast, and emergency/interventional radiology.

Are standardized reporting systems (such as BI-RADS, LI-RADS, and PI-RADS) tested on the exam?

Yes. Standardized reporting classifications including BI-RADS (breast), LI-RADS (liver), PI-RADS (prostate), CAD-RADS (coronary artery), O-RADS (ovary), and Bosniak (renal cysts) are frequently tested in diagnostic decision-making and management recommendations.

100+ Free Arab Board Radiology Final Written Practice Questions

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