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100+ Free FC Rad Diag(SA) Part II Practice Questions
Fellowship of the College of Radiologists of South Africa - Diagnostic: FC Rad Diag(SA) Part II practice questions are available now; exam metadata is being verified.
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Sample FC Rad Diag(SA) Part II Practice Questions
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1A 45-year-old male presents with progressive head pain, ataxia, and papilloedema. Brain MRI demonstrates a cystic mass in the right cerebellar hemisphere with a strongly enhancing peripheral mural nodule. The cystic fluid is iso-to-hyperintense to CSF on T1-weighted images. MRI spectroscopy shows elevated lipid/lactate peak and decreased N-acetylaspartate (NAA). What is the most likely diagnosis?
A.Hemangioblastoma
B.Pilocytic astrocytoma
C.Medulloblastoma
D.Brain abscess
Explanation: Hemangioblastoma classically presents in adults as a cerebellar cystic mass with a hyperenhancing mural nodule that abuts the pial surface. Prominent flow voids are frequently identified within or surrounding the mural nodule, reflecting its high vascularity.
2A 52-year-old female presents with progressive right-sided sensorineural hearing loss and tinnitus. Contrast-enhanced temporal bone MRI reveals a ice-cream cone shaped mass centered at the internal auditory canal (IAC) extending into the cerebellopontine angle (CPA) forming acute angles with the petrous bone. What is the most characteristic imaging feature of this mass?
A.Internal auditory canal enlargement with intense enhancement
B.Dural tail sign forming obtuse angles with petrous temporal bone
C.Restricted diffusion on DWI/ADC sequences
D.Extensive erosion of the jugular foramen
Explanation: Vestibular schwannoma (acoustic neuroma) typically originates within the internal auditory canal, causing IAC widening and extension into the CPA with acute margin angles ('ice-cream cone' appearance). Intense homogenous enhancement is characteristic.
3A 34-year-old female presents with relapsing-remitting neurological deficits. Brain MRI demonstrates multiple oval hyperintense T2/FLAIR lesions in the periventricular white matter oriented perpendicular to the lateral ventricles. What is the classic radiologic name for this specific lesion distribution?
A.Dawson fingers
B.Virchow-Robin spaces
C.Marchiafava-Bignami lesions
D.Lhermitte-Duclos stripes
Explanation: Dawson fingers refer to demyelinating plaques centered around medullary venules perpendicular to the lateral ventricles in multiple sclerosis. Corpus callosum undersurface involvement is another highly specific location.
4A 68-year-old male presenting with sudden onset left hemiparesis undergoes hyperacute stroke Non-Contrast CT (NCCT). Which early ischemic change score system evaluates 10 anatomical regions supplied by the middle cerebral artery?
A.ASPECTS
B.NIHSS
C.mRS
D.mTIMI
Explanation: ASPECTS (Alberta Stroke Program Early CT Score) evaluates 10 middle cerebral artery regions (M1-M6, insular ribbon, caudate, lentiform, internal capsule) on NCCT, subtracting 1 point per ischemic region from 10.
5A 60-year-old male presenting with severe headaches has a CT head showing subarachnoid hemorrhage centered in the suprasellar and basal cisterns. CT angiography demonstrates a saccular aneurysm at the junction of the internal carotid artery and posterior communicating artery. Which cranial nerve palsy is most associated with this location?
A.Oculomotor nerve (CN III)
B.Abducens nerve (CN VI)
C.Trigeminal nerve (CN V)
D.Facial nerve (CN VII)
Explanation: PCoA (posterior communicating artery) aneurysms frequently compress the adjacent oculomotor nerve (CN III), causing ipsilateral ptosis, a fixed dilated pupil, and 'down-and-out' eye deviation.
6A 28-year-old male involved in a high-speed motor vehicle collision arrives comatose. Initial CT brain shows small petechial hemorrhages in the corpus callosum splenium and dorsolateral brainstem, out of proportion to severe clinical deficits. What is the diagnosis?
A.Diffuse axonal injury (DAI)
B.Subdural hematoma
C.Epidural hematoma
D.Cerebral contusion
Explanation: Diffuse axonal injury (DAI) occurs due to severe rotational acceleration-deceleration forces. Gradient echo (GRE) / SWI MRI sensitively detects microhemorrhages in the lobar grey-white junction (Grade I), corpus callosum (Grade II), and dorsolateral brainstem (Grade III).
7A 40-year-old female presents with galactorrhea and amenorrhea. Sellar MRI reveals a 7 mm well-circumscribed hypointense lesion on T1-weighted images within the anterior pituitary lobe that enhances less than adjacent pituitary stroma after gadolinium. What is the diagnosis?
A.Pituitary microadenoma
B.Craniopharyngioma
C.Rathke cleft cyst
D.Pituitary macroadenoma
Explanation: Pituitary microadenoma measures <10 mm in diameter. On dynamic contrast-enhanced MRI, microadenomas exhibit delayed wash-in relative to normal enhancing pituitary parenchyma, appearing hypointense.
8A 10-year-old boy presents with progressive headache, vomiting, and visual loss. CT head reveals a suprasellar mass with lobulated cystic areas, nodular peripheral calcifications, and solid enhancing components. What is the diagnosis?
A.Adamantinomatous craniopharyngioma
B.Germinoma
C.Optic pathway glioma
D.Pituitary adenoma
Explanation: Adamantinomatous craniopharyngioma classically affects children and features the triad of cystic spaces ('machinery oil'), dense nodular calcifications (90%), and solid component enhancement.
9On neck CT, a cystic lesion located anterior to the sternocleidomastoid muscle at the angle of the mandible, lateral to the carotid sheath, is identified in a 22-year-old female. What is the diagnosis?
A.Second branchial cleft cyst
B.Thyroglossal duct cyst
C.Dermoid cyst
D.Cervical lymphangioma
Explanation: Second branchial cleft cysts account for ~95% of branchial anomalies, typically located anteromedial to the sternocleidomastoid muscle, lateral to the carotid space, and posterior to the submandibular gland.
10A 55-year-old male with a history of alcohol overuse presents with confusion, ophthalmoplegia, and ataxia. Brain MRI demonstrates symmetrical hyperintensity on T2/FLAIR images in the mamillary bodies, periaqueductal grey matter, and medial thalami. What is the diagnosis?
A.Wernicke encephalopathy
B.Extrapontine myelinolysis
C.Herpes simplex encephalitis
D.Creutzfeldt-Jakob disease
Explanation: Wernicke encephalopathy secondary to thiamine (vitamin B1) deficiency exhibits characteristic symmetric T2/FLAIR hyperintensity in the mamillary bodies, tectal plate, periaqueductal grey, and medial thalamic nuclei.
About the FC Rad Diag(SA) Part II Practice Questions
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