100+ Free FRCR Part 2B Practice Questions

Prepare for the Final FRCR Part B Examination (Clinical Radiology) - CR2B exam with instant access — no signup required.

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Sample FRCR Part 2B Practice Questions

Try these sample questions to test your FRCR Part 2B exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 55-year-old smoker has a chest radiograph showing a peripheral right upper lobe mass. Which radiographic sign on the frontal film most reliably indicates that the lesion arises within the lung rather than the mediastinum or pleura?

A.Acute angles with the lung and a complete, well-defined border

B.An obtuse angle with the chest wall and incomplete border

C.Silhouetting of the right heart border

D.Elevation of the right hemidiaphragm

Explanation: An intrapulmonary lesion typically forms acute angles with the pleural surface and has a complete, sharply defined border on at least part of its circumference. Extrapulmonary (pleural/mediastinal) lesions form obtuse angles and have incomplete borders where they merge with adjacent soft tissue.

2On a frontal chest radiograph of a patient with left lower lobe collapse, which finding would you expect to report?

A.A raised right hemidiaphragm with a tented costophrenic angle

B.A 'sail sign' producing a triangular opacity behind the heart with loss of the medial left hemidiaphragm

C.Widening of the right paratracheal stripe

D.A meniscus at the left costophrenic angle with tracheal deviation to the right

Explanation: Left lower lobe collapse produces a triangular retrocardiac opacity (the 'sail sign'), loss of the medial part of the left hemidiaphragm outline, and a depressed/medially displaced left hilum. Recognising the retrocardiac triangle is a classic exam pitfall as it is easily missed behind the cardiac shadow.

3A 30-year-old presents with acute pleuritic chest pain and breathlessness. CT pulmonary angiogram shows a filling defect. Which CT finding indicates acute pulmonary embolism rather than chronic thromboembolic disease?

A.Webs and bands within the pulmonary arteries

B.Eccentric, crescentic thrombus contiguous with the vessel wall forming obtuse angles

C.A central, partially occlusive filling defect forming acute angles with the vessel wall

D.Mosaic attenuation with vessel calibre variation

Explanation: Acute PE typically appears as a central intraluminal filling defect surrounded by contrast (the 'polo mint'/railway track sign) that forms acute angles with the vessel wall. Chronic disease shows eccentric mural thrombus forming obtuse angles, webs/bands, abrupt vessel cut-offs and mosaic perfusion.

4A long-case CT chest in a 62-year-old shows subpleural reticulation, honeycombing and traction bronchiectasis with a basal and peripheral predominance, and no significant ground-glass. Which pattern should you report?

A.Non-specific interstitial pneumonia (NSIP)

B.Organising pneumonia

C.Hypersensitivity pneumonitis

D.Usual interstitial pneumonia (UIP)

Explanation: Basal, subpleural-predominant honeycombing with traction bronchiectasis and reticulation, in the absence of features that suggest an alternative diagnosis, is the typical UIP pattern, most often idiopathic pulmonary fibrosis. Honeycombing is the key discriminator from NSIP.

5Under the UK Fleischner Society guidance applied in NHS practice, a solid incidental pulmonary nodule of 7 mm in a low-risk patient warrants which recommendation?

A.CT follow-up at 6-12 months, then consider at 18-24 months

B.No routine follow-up required

C.Immediate PET-CT and biopsy

D.CT follow-up at 3 months only

Explanation: Per Fleischner 2017 criteria (widely used in the UK alongside BTS guidance), a single solid nodule of 6-8 mm in a low-risk individual should be followed up with CT at 6-12 months, then considered again at 18-24 months. Nodules under 6 mm in low-risk patients need no routine follow-up.

6A frontal chest radiograph shows a 'water bottle' configuration of the cardiac silhouette with clear lung fields in a breathless patient. What is the most likely diagnosis to report?

A.Left ventricular failure

B.Large pericardial effusion

C.Atrial septal defect

D.Aortic dissection

Explanation: A globular 'water bottle'-shaped cardiomegaly with clear lung fields (no pulmonary oedema) in a symptomatic patient suggests a large pericardial effusion. Echocardiography is the next step to confirm and assess for tamponade physiology.

7A rapid-reporting trauma chest radiograph shows deep sulcus sign with an unusually lucent left hemithorax and a sharply outlined cardiac border. What should you report?

A.Left lower lobe collapse

B.Left pleural effusion

C.Left tension pneumothorax

D.Pneumomediastinum

Explanation: On a supine radiograph, air collects anteriorly and inferiorly, producing a deep, lucent costophrenic sulcus (deep sulcus sign) and a sharply outlined heart border. Combined with hyperlucency this indicates pneumothorax; mediastinal shift away would indicate tension requiring urgent decompression.

8An HRCT in a young non-smoker shows multiple thin-walled cysts of varying size and shape with irregular contours, sparing the costophrenic angles, in a patient with recurrent pneumothoraces. Which diagnosis fits best?

A.Lymphangioleiomyomatosis (LAM)

B.Centrilobular emphysema

C.Lymphocytic interstitial pneumonia

D.Pulmonary Langerhans cell histiocytosis

Explanation: Bizarre, irregularly shaped cysts (some bilobed/branching) with upper- and mid-zone predominance, costophrenic angle sparing and nodules in a young smoker point to pulmonary Langerhans cell histiocytosis. Recurrent pneumothorax is a recognised complication.

9A CT in an elderly patient shows a large hiatus hernia, but you also note a 6 cm fusiform dilatation of the ascending thoracic aorta. At what maximal ascending aortic diameter does UK practice generally recommend referral for consideration of elective surgical repair in an otherwise non-syndromic patient?

A.5.5 cm

B.4.0 cm

C.4.5 cm

D.7.0 cm

Explanation: For degenerative (non-syndromic) ascending thoracic aortic aneurysms, elective repair is generally considered at around 5.5 cm. Lower thresholds apply in connective tissue disorders such as Marfan syndrome or bicuspid aortic valve. A 6 cm aneurysm therefore warrants surgical referral.

10A long case shows a chest radiograph with bilateral symmetrical hilar enlargement and right paratracheal nodal enlargement, in a 35-year-old with erythema nodosum. Which diagnosis should head your differential?

A.Lymphoma

B.Sarcoidosis

C.Tuberculosis

D.Metastatic disease

Explanation: Bilateral symmetrical hilar lymphadenopathy with right paratracheal nodes (the '1-2-3' or Garland triad) in a young adult with erythema nodosum is classic for sarcoidosis (Lofgren syndrome). Symmetry is the key feature distinguishing it from malignant or infective causes.

About the FRCR Part 2B Exam

The Final FRCR Part B (CR2B) is the last hurdle of the FRCR clinical radiology examination, testing image interpretation, diagnosis and management across all radiology subspecialties. It comprises short/rapid case reporting, long case reporting and a two-station oral (viva), all in one sitting against the RCR Specialty Training Curriculum for Clinical Radiology.

Assessment

Two image-reporting components (short/rapid case reporting and long case reporting) plus a two-station oral/viva, all taken at one sitting on the risr/Assess platform.

Time Limit

Short/rapid case reporting 120 min; long case reporting 75 min; oral 2 x 30 min

Passing Score

Standard-set per sitting using Angoff/Ebel methodology; a candidate must reach the pass mark in at least two of the three components (with limited compensation within one standard error of measurement). The oral pass mark was set at 281/480 (58.5%) at introduction.

Exam Fee

Approximately GBP 801-1,063 for members (venue-dependent) and around GBP 1,414 for non-members, per the RCR 2025/26 fee schedule. (Royal College of Radiologists (RCR))

FRCR Part 2B Exam Content Outline

18%

Cardiothoracic and vascular

Chest radiograph and CT interpretation including lobar collapse, interstitial lung disease, pulmonary embolism, mediastinal masses and aortic and cardiac pathology.

19%

Genitourinary, adrenal, breast and obstetrics/gynaecology

Renal tract, adrenal, prostate, scrotal, gynaecological, obstetric and breast imaging including staging, Bosniak, PI-RADS and screening principles.

16%

Musculoskeletal and trauma

Fractures, dislocations, occult injuries, arthropathies, bone tumours and joint MRI in rapid reporting and long cases.

14%

Gastrointestinal and hepatobiliary

Acute abdomen, bowel obstruction, inflammatory and neoplastic GI disease and liver, pancreas and biliary imaging.

14%

Neuroradiology and head and neck

Stroke, haemorrhage, intracranial tumours, demyelination, sellar and CPA lesions, and sinus and neck pathology.

Paediatric radiology

Neonatal and paediatric chest and abdomen, intussusception, pyloric stenosis, NAI skeletal survey and paediatric hip pathology.

11%

Nuclear medicine, physics and radiation safety

Bone scintigraphy, PET-CT (Deauville) response, V/Q scanning, IR(ME)R justification and contrast/gadolinium safety and governance.

How to Pass the FRCR Part 2B Exam

What You Need to Know

Passing score: Standard-set per sitting using Angoff/Ebel methodology; a candidate must reach the pass mark in at least two of the three components (with limited compensation within one standard error of measurement). The oral pass mark was set at 281/480 (58.5%) at introduction.
Assessment: Two image-reporting components (short/rapid case reporting and long case reporting) plus a two-station oral/viva, all taken at one sitting on the risr/Assess platform.
Time limit: Short/rapid case reporting 120 min; long case reporting 75 min; oral 2 x 30 min
Exam fee: Approximately GBP 801-1,063 for members (venue-dependent) and around GBP 1,414 for non-members, per the RCR 2025/26 fee schedule.

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

FRCR Part 2B Study Tips from Top Performers

1Build a fixed, systematic search pattern for each body part so you can confidently call normal cases in rapid reporting, where roughly half the cases are normal and over-calling loses marks.

2Practise structured long-case reports (observations, interpretation, main diagnosis, differential, further management) under timed conditions, treating each case as you would in day-to-day NHS reporting.

3Rehearse spoken case presentation for the viva, prioritising critical findings and clear clinical safety and management recommendations, since these are explicitly assessed domains.

Frequently Asked Questions

What are the three components of the FRCR Part 2B (CR2B) exam?

It comprises a short/rapid case reporting component (25 cases in 120 minutes), a long case reporting component (6 cases in 75 minutes) and an oral (viva) of two 30-minute stations, all taken at one sitting on the risr/Assess platform.

How is the FRCR 2B exam scored and what is the pass mark?

Each component is standard-set per sitting using Angoff/Ebel methodology, so the exact pass mark varies by sitting. Candidates must reach the pass mark in at least two of the three components, with limited compensation. The oral pass mark was set at 281/480 (58.5%) when introduced.

What changed in the FRCR 2B exam in 2025?

From 2025 the RCR updated the CR2B format and standard-setting and delivered all components digitally on the risr/Assess platform. The three-component structure of reporting plus an oral component was retained while the rapid/short reporting session and marking were refreshed.

Which subspecialties does the FRCR 2B cover?

It tests all of clinical radiology against the RCR curriculum, including cardiothoracic, musculoskeletal, gastrointestinal, genitourinary, breast, obstetric/gynaecological, neuroradiology, head and neck, paediatric imaging, nuclear medicine and radiation safety.