id stringlengths 64 64 | question stringlengths 27 410 | images listlengths 1 1 | options unknown | answer_idx stringclasses 10
values | caption stringlengths 5 9.26k |
|---|---|---|---|---|---|
b39d4163d874bf3cb9d8dde59faecf350ae889865f9863dc6d0e77b88ddc3162 | Which cardiac chamber is directly opacified by contrast in this fluoroscopic image? | [
"images/b1/b1769ccb3a27dfb45b5eb801b8fd440178be1760888fa408815de77f1a433f7e.jpg"
] | {
"A": "Left ventricle",
"B": "Right ventricle",
"C": "Left atrium",
"D": "Right atrium"
} | B | Right ventriculography. |
d2d3129ae5b7f813b7fadffa64b67d79f5b185c37ce4cb5ba905c9a6d07d36b8 | What is the most conspicuous osseous abnormality at the arrow in panel A? | [
"images/7e/7ee46ba31dd74980e31de4d40829b062b6413007712377629cb1de6f8e90b7c0.jpg"
] | {
"A": "Expansile bone destruction with cortical disruption",
"B": "Diffuse smooth periosteal thickening without bone expansion",
"C": "Periarticular erosions centered on the joint space",
"D": "An intact cortical exostosis projecting away from the joint",
"E": "A displaced transverse fracture through normal-... | A | Imaging examinations identifying the tumor responsible for tumor-induced osteomalacia. Radiography reveals destructive changes in the third basal phalanx of the left foot. (A) The cortical bone in the distal third of the left basal phalanx exhibited pervasive expansible alterations and partial deterioration. (B, C) The... |
c698ce53c5b3e284e995435e0d1152c7c283661264a3392514ad3d2ed068bdf4 | On the 68Ga-DOTA-NOC maximum-intensity-projection image e, how is uptake in the anterior mediastinal tumor depicted? | [
"images/01/01b5abcb50b941dcb6bd0cbb4f5275e56e6424ea95d7e46cf6392e0e5e66ee36.jpg"
] | {
"A": "No visible uptake above background",
"B": "Slightly increased uptake",
"C": "Markedly increased uptake",
"D": "Uptake confined to the urinary bladder",
"E": "Diffuse uptake throughout both lungs",
"F": "A photopenic defect"
} | B | A 57-year-old woman was admitted to the hospital due to “blood pressure increased for 3 years and a full-moon face for 6 months” (atypical carcinoid of anterior mediastinum, case 14 in the staging group) 18F-FDG PET/CT [(A): MIP image, (B): axial PET, (C): axial CT, (D): axial PET/CT fusion image] showed that radioacti... |
1cc45db9c628976f82c575bb712bb85a1dc3e5e7a6d27a4541f8ea9551db3f01 | Comparing the 3D uSSFP variants, which parameter change is specifically associated with making the pulsation-related hepatic signal loss more conspicuous? | [
"images/c3/c3907ccf540fc6a6f0d17205b6ba2b3def1be4904a4247d60acee4264285961d.jpg"
] | {
"A": "Removing dummy RF pulses",
"B": "Increasing the gradient spoiler factor to 1.0",
"C": "Using no cardiac gating",
"D": "Lowering the flip angle from 22 degrees to 6 degrees"
} | B | Pulse sequence comparisons in a healthy subject. A 2D bSSFP. B 3D uSSFP, flip angle = 22°. C 3D uSSFP, flip angle = 11°. D 3D uSSFP, flip angle = 6°. E 3D uSSFP, ungated. F 3D uSSFP, systolic gated. G 3D uSSFP, gradient spoiler factor = 1.0. H 3D uSSFP, no dummy radiofrequency (RF) pulses. Note that B–F were acquired w... |
d4696d54eeb8535589cd8b0cdadbd02341786164871ba03c323e52e370aa1f2d | In the coronal fused CBCT/MRI examples, which panel demonstrates the inferior positional relationship of the inferior alveolar nerve relative to the mandibular third molar roots? | [
"images/48/48fa159625f1e46017f4f74cd8415970cc4d0915f408f8a3e25587b593244fac.jpg"
] | {
"A": "Panel C",
"B": "Panel D",
"C": "Panel B",
"D": "All panels show an interradicular course",
"E": "Panel A",
"F": "None of the panels show an inferior course"
} | A | Coronal reconstruction of a study participant’s CBCT, 3D-DESS MRI, and fused CBCT/MRI images visualizing periradicular (buccal (A); lingual (B); inferior (C)) or interradicular (between the roots (D)) relative positional relationship of the IAN at the third molar. |
11539d5c202b8a3d44aa42ef0a1fe002063bb97bb81267bc456e8e35ddc59dd9 | Two points in the image lie adjacent to the wrist crease but on opposite sides of the forearm. Which pair best matches this medial-ulnar versus lateral-radial arrangement? | [
"images/84/84477980d34b7dfc3d043096f1ce47358ae764f3e5f8698ebfe44c0ea56bfb40.jpg"
] | {
"A": "HT3 and LU9",
"B": "LU5 and HT6",
"C": "HT6 and LU5",
"D": "HT7 and LU9",
"E": "HT3 and LU5",
"F": "HT3 and HT6",
"G": "LU7 and LU9",
"H": "HT6 and LU7",
"I": "LU5 and HT7"
} | D | Locations of acupoints. Acupoints on Lung meridian—Chize (LU5): on the cubital crease, on the radial side of the tendon of biceps brachii; Lieque (LU7): on the radial margin of the forearm, 1.5 cun above the transverse crease of the wrist, between the brachioradial muscle tendon and the long abductor muscle tendon of t... |
1f09be87a44e40d8be4502ae73b8d47a61f60c91899748587cd3c09cba286de3 | What is the most likely interpretation of the abnormal vessel appearance at the skull base on this T2-weighted image? | [
"images/55/55db0e1091d5c3bba2aa0511edd8e8ec9b7ed0af61c15f3ed3562e870c8dfa47.jpg"
] | {
"A": "Jugular bulb thrombosis",
"B": "Internal carotid artery occlusion on the right",
"C": "Normal high-flow signal void within a patent artery",
"D": "Aneurysmal dilatation of the left cavernous carotid artery",
"E": "Acute mastoiditis with adjacent vascular compression"
} | B | Axial T2 weighted image of the skull base showing loss of normal flow void (arrow) within the petrous segment of the right internal carotid artery indicative of internal carotid artery occlusion. |
f76da8574cb8cc71a426193cdb99474e65eb24e19de42ef2fbae267cb3e49a41 | What is the small high-attenuation focus indicated by the arrow in CT panel B most consistent with? | [
"images/47/474d0c807beaeebf9e3b7a96f8c2843c4f754d2c3a4fd832b50e839d85e65068.jpg"
] | {
"A": "Acute hemorrhage",
"B": "Fluid",
"C": "Calcification",
"D": "Fat",
"E": "Soft-tissue edema",
"F": "Gas"
} | C | A. Computed Tomography (CT) scan of the abdomen and pelvis at the level of the sacral spine showing a U-shaped mass in the pelvis indicated by the arrow.
B. CT scan at the level of the lumbar spine showing the U-shaped mass with a calcification indicated by the arrow.
C. Digital photograph of the labial mucosa of the p... |
dbf3529e9be85d0b01745498102ddf5f9591cdccb1da5c9b1acd9f6577a457b9 | Which feature is most consistent with the lateral view shown? | [
"images/4c/4c294f5f2528dc857614c4dcb507551c6b8d7273ee985730e257010607267ed7.jpg"
] | {
"A": "Normal alignment of the tibiotalar and subtalar joints",
"B": "Posterior dislocation of the talus relative to the tibia",
"C": "Marked ankle effusion with anterior fat-pad sign",
"D": "Calcaneal compression fracture with loss of height"
} | A | AP and lateral X-ray of the 4-year-old patient with normal findings. |
94d09f2e4c77c57071c699956888f9df42b613bf458f1d019e2a24e6336fb7fb | The principal abnormality demonstrated here is best described as involving which retinal vascular structure? | [
"images/c5/c5777747b88d60bb67feda0b5b0b7dd4f7c78efd47187b855e5f057a17666e0e.jpg"
] | {
"A": "Choroidal neovascular membrane beneath the macula",
"B": "Posterior retinal arteriole wall",
"C": "Central retinal vein at the optic disc",
"D": "Peripheral retinal venule with capillary dropout"
} | B | Fluorescence angiography disclosed staining of vascular wall and late leakage along posterior retinal arteriole OD. |
ca4108343df7360164efbfe79762d478f07d24e0218abc8a316251ca431a4323 | What is the most prominent abnormality involving the visible orifice in this image? | [
"images/bf/bf6cb4ff469861979fc35c6cd20d35d2814b2c9f2024611ae81f1c854dfc321c.jpg"
] | {
"A": "Markedly wide urethral opening",
"B": "Duplication of the vaginal opening",
"C": "Severe stenosis of the urethral meatus",
"D": "Prolapsed ureterocele at the introitus"
} | A | Adolescent external genitalia in case 1. Absent vagina, hypertrophic labia minora and wide urethral opening. |
4562688dfc6fba555797f4e32a2fbf373869018bc9c75d84890cd2898a138846 | On this anterior Tc bone scintigraphy image, where is the abnormal focal radiotracer uptake most likely located? | [
"images/c3/c3e9affce7c8d666318a6a3250277ddc1b495929a90a395a9c2b02f2084cedb3.jpg"
] | {
"A": "Left mandibular condyle",
"B": "Floor of the orbit",
"C": "Mid-cervical spine",
"D": "Right zygomatic arch",
"E": "Anterior mandible",
"F": "Posterior maxilla"
} | E | Bone scintiscan (Tc scan) demonstrated increased uptake (arrow) in the anterior mandible corresponding to the cancer location without involving lower border (arrowheads). Bone invasion was considered positive on scintiscan and subsequent histology confirmed this finding. This case illustrates detection of bone invasion... |
eea7fc75326531312630f5c28f5452a870763ee8e0e8acd684e11313745b169b | In the contrast-enhanced preoperative brain image, what imaging appearance best describes the intracranial target lesion selected for biopsy? | [
"images/81/81e4a8ae261da3ba217523803d8989178039d06efa90475823c0a75dcbd673c8.jpg"
] | {
"A": "Nonenhancing cystic lesion with mural nodule",
"B": "Ring-enhancing mass with central necrosis",
"C": "Homogeneously enhancing deep-seated lesion",
"D": "Extra-axial dural-based calcified mass"
} | C | Illustrative case 1 (case 7): preoperative T1-weighted magnetic resonance image (MRI) with intravenous gadolinium administration (A) revealed a homogeneous enhanced lesion. The planned trajectory (orange line) and target (end of the orange line) corresponded to the inserted biopsy needle. The biopsy specimen under whit... |
37f5361df2922ffdca9c58ebb2e3b86314c9fedf9d336e428adea0ca73b4a75d | The abnormal fixation screw seen on this CT is associated with which component of the hip prosthesis? | [
"images/89/8977cea5cf5edeb239aa268a1f0eec57d1ef3eea1008742ac89bcd6ac7e3c28c.jpg"
] | {
"A": "Acetabular cup",
"B": "Modular femoral head",
"C": "Greater trochanteric plate",
"D": "Femoral stem"
} | A | CT scan of hip showing malpositioned and long acetabular cup screw. |
2604fa375eacbd8f2ae5f59831ba6556cdbf3bb8d69d925557379313080943da | Which combination of pelvic attachment sites shows the bilateral spur formation visible on the radiograph? | [
"images/bb/bb56fd175ac5d9bc7b7a4411806a491068d244725e73bf315766a331fa3d6f25.jpg"
] | {
"A": "Iliac crests, greater trochanters, and lesser trochanters",
"B": "Femoral heads, superior pubic rami, and sacral ala",
"C": "Obturator foramina, iliopubic eminences, and coccyx",
"D": "Acetabular fossae, femoral necks, and iliac wings only",
"E": "Ischial tuberosities, acetabular roofs, and pubic symp... | A | X-ray of pelvis with hips and CT of sacroiliac joints showing symmetrical bilateral hyperostotic spurs at the iliac crests, greater trochanter, lesser trochanter and bridging ossification at the upper part of sacroiliac joints. |
ddd3d7b3ed7a0c50a94efdd977d5bc0853fecf15ef188aee6c74a26541c825ce | The abnormal soft-tissue density in this image is centered in which anatomic compartment? | [
"images/d9/d9288d377da2c1352b633109ea5c0a0ca28ae09e05e3259c29d453145c2988a5.jpg"
] | {
"A": "Rectus sheath",
"B": "Presacral space",
"C": "Root of the sigmoid mesocolon in the pelvis",
"D": "Paracolic gutter adjacent to the ascending colon",
"E": "Retroperitoneum around the kidneys",
"F": "Greater omentum along the anterior abdominal wall",
"G": "Hepatoduodenal ligament at the porta hepat... | I | Axial contrast-enhanced computed tomography image of mesenteric panniculitis of indeterminate cause. The features resolved on follow-up computed tomography. The process is enveloping mesenteric vessels and local lymph nodes with preservation of a ring of fat around the vessels and nodes called the “fat halo” or “fat ri... |
5d6655eaed5053d3e464de3ec5f10d276c891cbf0b46b271535b1d5f3c72d5f6 | These tomographic slices are centered on which tooth? | [
"images/64/64438b62cd8575b171b356db732f3826848a7a989ffafdb440204dfc8e699bfd.jpg"
] | {
"A": "Maxillary left lateral incisor (#10)",
"B": "Maxillary right central incisor (#8)",
"C": "Maxillary left canine (#11)",
"D": "Mandibular left canine (#22)"
} | C | Tomographic slices of tooth #11. |
e5522cefe8d6492c9fb3877ef257990a491173baa201848b4f2501bd1fea7602 | On this panoramic dental radiograph, the principal abnormality is located in which region? | [
"images/b8/b8d25ae39e024f152c8703435405137ee5559a1615295f8f4a141f3fd9a25225.jpg"
] | {
"A": "left maxilla",
"B": "right maxilla",
"C": "left posterior mandible",
"D": "right posterior mandible"
} | B | Orthopantomogram showing combined lesion in right maxilla (odontoma intermixed with radiolucent lesion) |
454c161814e5c6c531d6520509a15764304555d296e3f87470bca144e0e8796c | Based on the visualized setup, which tooth region is the apparatus being applied to? | [
"images/bb/bb001015fb90df4ec51482d68f13a889fa8d9653cad9f3189d9124545575ef9b.jpg"
] | {
"A": "Maxillary anterior teeth",
"B": "Posterior mandibular molars",
"C": "Mandibular premolar region",
"D": "Edentulous alveolar ridge"
} | A | Bracket bonding procedure on the Ray set device®. |
cbd606210799da9309301afdfbebd66c82cb7767a0e185909157ee78eeea437b | How does the arrowed abnormality in panel F compare with that in panel B? | [
"images/00/00464bc90dfc3915a8eb0941bd75d90c727e917888a655ef575c7bb253e498d7.jpg"
] | {
"A": "It has extended into the optic nerve",
"B": "It is substantially smaller",
"C": "It is approximately unchanged in size",
"D": "It has shifted into the retrobulbar orbit",
"E": "It is substantially larger",
"F": "It involves both globes"
} | B | Clinically diagnosed retinoblastoma in a 44-month-old female (patient 2)
(A–H) The orbital origin of the tumor was located in the equator of the left globe with the tumor location far from the optic disk, demonstrating a slightly higher signal intensity than the ocular fluid (arrow) in axial T1-weighted MRI (A), low si... |
db80ffbbb31b52a1435cd6ddb71716932dd6a19b615c1e08c0ee510c101214e9 | Based on the distribution and appearance of the bowel gas pattern, which segment of bowel is most likely obstructed? | [
"images/48/488c08d3138c8231c146352795f6c35545e0fe3d7843085c16b7662b6e8708b5.jpg"
] | {
"A": "Small intestine",
"B": "Sigmoid colon",
"C": "Rectum",
"D": "Stomach"
} | A | Erect X-ray of the patient showing multiple air-fluid levels suggesting small bowel obstruction. |
acc0d6b2e5877a57c872226134f8fc3b820d8be86165e014fa13d2bbc805cbc6 | On the abdominal axial image in panel A, which renal perfusion finding is present? | [
"images/cf/cf4be2140f046038b1de3b1ce5457f5a9357e057d75c9f2f46201036c2aa8945.jpg"
] | {
"A": "Symmetric enhancement of both kidneys",
"B": "Reduced enhancement of the right kidney relative to the left",
"C": "Focal cortical nonenhancement confined to the left kidney",
"D": "Reduced enhancement of the left kidney relative to the right",
"E": "Absent enhancement of both kidneys",
"F": "Symmetr... | B | CT aortic angiogram. (A) Type B aortic dissection extending to the aortic bifurcation; additional retrograde extension with intramural hematoma extending to the aortic valve; absence of genuine proximal landing zone for TEVAR; evidence of end‐organ ischemia with shotgun right renal artery and delayed right nephrogram i... |
e0af9d4d1244d40227304c31d3dfd217f99629be4b4b9f605c54adbaedf0079d | What type of hip reconstruction is most clearly demonstrated on this postoperative radiograph? | [
"images/26/26f2dced051cf171f89c62332d03ca6a4ab3320b43a1fffeed88b6bd94842f0e.jpg"
] | {
"A": "Dynamic hip screw fixation for femoral neck fracture",
"B": "Total hip arthroplasty with femoral stem and acetabular cup",
"C": "Hemiarthroplasty with replacement of only the femoral head",
"D": "Hip resurfacing arthroplasty with a femoral head cap and short neck component"
} | D | Postoperative x-ray (MoM-HR) |
e5b33f1cdd0ba4df64bcefdba4d43b15997da6b1faf1fa55815e73a58468a4ec | In the composite endovascular images, which vascular segment is being traversed by the guidewire through a chronic total occlusion using a CT-fusion roadmap? | [
"images/73/7377ab19034f96705b5fda02f2958c8df7169e0a3dc9703cade087b09645f3b3.jpg"
] | {
"A": "Right external iliac artery",
"B": "Left common iliac artery",
"C": "Left external iliac artery",
"D": "Right common iliac artery",
"E": "Infrarenal abdominal aorta"
} | B | a and b: We advanced the guidewire while aiming at the center of the virtually occluded iliac artery on the CTf3D-RM image (blue arrow showed opened aorta and right CIA, red arrow showed virtual occluded vessels, white arrow showed guidewire). c: We checked the wire position in RAO view. The guide wire was almost cento... |
9d821d34cc68aaa64951159c021c12dd378afc759e1e081d565eaf17f5430a50 | In panel (b), the selected measurement point is displayed in which orientation relative to the pelvis? | [
"images/2a/2adef4d7a69cd69028beb277c538a513bb2b66616a23bcc17cb5685e90625ad9.jpg"
] | {
"A": "Sagittal orientation",
"B": "Frontal-oblique orientation",
"C": "Coronal orientation",
"D": "Axial orientation"
} | A | a Graphic display of the analysis method and the chosen measurement point in the axial plane. b Graphic display of the analysis method and the chosen measurement point in the sagittal plane. c Graphic display of the analysis method and the chosen measurement point in the coronal plane |
54fa08d901a1a85997b44b2cc5b39242f90c3ea4ead8406250b6e4f0a80b7a56 | Which ECG pattern is most clearly demonstrated in this tracing? | [
"images/76/767a598bfca5b6d30473c0fe07333ccfeb0c710dd3157b51cfe72269e43d2cd2.jpg"
] | {
"A": "Left ventricular hypertrophy with increased QRS voltage",
"B": "Atrial flutter with 2:1 conduction",
"C": "Left bundle branch block",
"D": "Acute inferior ST-elevation myocardial infarction",
"E": "Hyperkalemia with peaked T waves",
"F": "Right ventricular hypertrophy with right axis deviation"
} | A | LVH: left ventricular hypertrophy |
7fb474ce8264a66e46faddff1cf6a2541e412e7c5dc21315b64cf5c9951936bd | The arrowhead in this transverse section identifies which structure, used here as an anatomic landmark for interpreting the abnormality? | [
"images/2c/2c8814ae974ac2f83c40533aee7262ac5c9e6274c528bc5a76bfd6339c51f982.jpg"
] | {
"A": "Portal sinus",
"B": "Stomach bubble",
"C": "Urinary bladder",
"D": "Duodenum",
"E": "Gallbladder"
} | B | Transverse section at the level of stomach bubble (arrowhead) showing conjoined liver |
a55bc89b98d9f70858b252dac903ac4414d14f51225cb73f4a55009c74b2a357 | In panel E, which structure contains the focus indicated by the green arrow? | [
"images/e0/e0ad41caad9b2da9cb69931265e62eb1fd71d235483df7a3f4aa5ff6389c9d80.jpg"
] | {
"A": "Pancreatic tail",
"B": "Vertebral body",
"C": "Right adrenal gland",
"D": "Left kidney",
"E": "Spleen",
"F": "Liver"
} | F | Case 1 imaging findings
A, B: Craniocaudal and mediolateral oblique tomosynthesis views of the right breast show an oval high-density mass (red arrows) with partially spiculated margins. C: Transverse ultrasound shows an oval mixed solid and cystic mass (red arrow) with partially indistinct margins. D-F: PET demonstrat... |
fe555b5337fe3c97350a627315aaa0c9aa4d0e00d80fbb0a7cfc55ef28f01793 | The ventricular enlargement visible in panel (a) is most plausibly caused by mass effect on which CSF pathway? | [
"images/cd/cd87e5d2231c8f02f06fe0082074b1872f334bda709cc650af5021b8cdfbf8ef.jpg"
] | {
"A": "Fourth ventricle",
"B": "Third ventricle",
"C": "Anterior horn of the lateral ventricle",
"D": "Cortical subarachnoid space",
"E": "Foramen of Monro",
"F": "Superior sagittal sinus"
} | A | (a) Plain CT brain shows a lobulated, uniform hyperdense cystic lesion in right cerebellar hemisphere with coarse calcifications (black arrows) and no appreciable contrast enhancement (not shown). Note the acute angle the lesion makes with the calvarium and lobulated contour suggestive of its intraparenchymal location.... |
47f16f64bd101d022dbc32328c8c26281a20c44a6f7d71b99860b83350f268ef | The vascular abnormality suspected on the MR angiographic image is most strongly supported by which visible pattern? | [
"images/0e/0e5941327f0c0372fd5913f0163c481d5245bbb56ea8965c99d485b51e54acb4.jpg"
] | {
"A": "Symmetric fusiform enlargement of both internal carotid arteries without stenosis",
"B": "Diffuse venous sinus thrombosis with nonvisualization of the transverse sinuses",
"C": "Alternating narrowing and dilatation of the vertebral arteries suggesting aneurysmal change",
"D": "Saccular aneurysm arising ... | C | Image findings of sCAEBV patients who had angiopathy. (A,B) Magnetic resonance imaging of the brain of patient 2: Multiple cerebral (A) and cerebellar (B) micro bleeding were detected by T2 star-weighted images (arrows). (C,D) Images of patient 7: Contract-enhanced CT examination shows the dilatation of the right hyoid... |
8ed80ab126a6c3effc31998154e27fbf55f7f09944c6429251b1df37325668ae | What is the sonographic appearance of the arrowed finding in panel d? | [
"images/6f/6ff9620b19d22a5dd3d7c9388ad306b5ce0d032b457307fcdce7b96c26ed5cc7.jpg"
] | {
"A": "An irregular hypoechoic mass with posterior acoustic shadowing",
"B": "A dilated duct containing mobile echogenic debris",
"C": "A cluster of microcysts without a solid component",
"D": "A complex cystic mass with fluid-debris levels",
"E": "A parallel oval hypoechoic mass with smooth margins",
"F":... | A | Suspicious presentation of pseudoangiomatous stromal hyperplasia. A 56-year-old woman with a new focal asymmetry in the outer breast that was identified on her (a) screening mammogram and persisted on (b) additional diagnostic spot compression views (arrows). The area was palpable by the patient and the clinician. The ... |
efd3420b42ca419590c5586d500f2ec431cde7c98b05b78df809953220e81025 | In the paired bowel segments shown, which segment demonstrates the greater inflammatory severity on ultrasound elastography and color Doppler, with predominantly blue stiffness mapping and more conspicuous mural vascularity? | [
"images/9a/9ac9530e247e0c9ee88c789c3e389f6a2e596ff1cb413ef4616d043f6b38e314.jpg"
] | {
"A": "Terminal ileum",
"B": "Rectosigmoid colon",
"C": "Jejunum",
"D": "Cecal appendix",
"E": "Ascending colon"
} | E | Endoscopy, CD, semiquantitative parameters, and SE visual scan in one case of Crohn’s disease affecting the terminal ileum and ascending colon. a Endoscopy of the terminal ileum. b CD oblique scan of the terminal ileum (arrowhead) shows slight thickening of the bowel wall with preserved stratification and vascular sign... |
58cdfada935c48aa6154809b1dafe30f113dbeae02034f23a6d89579c696a7fb | Which enhancement time course is shown by the curve in panel K? | [
"images/cd/cd5a8ac237b70a98640a20476858910c9fc684bf4e5e10be135e0f88ccab64a6.jpg"
] | {
"A": "Delayed enhancement after an initial prolonged flat phase",
"B": "Early enhancement followed by a sustained plateau",
"C": "Progressive enhancement throughout acquisition",
"D": "Early enhancement followed by washout",
"E": "No measurable enhancement",
"F": "Repeated regular oscillations without an ... | D | (A–K) Clinical protocol with anatomical and functional sequences in a patient with a uveal melanoma of the right eye (arrow). (A) MS 2 mm T1. (B) MS 2 mm enhanced T1 with fat signal suppression. (C) MS 2 mm T2. (D) 3D TSE 1 mm T1. (E) 3D TSE 1 mm T1 with fat signal suppression. (F) 3D TSE 1 mm enhanced T1 with fat sign... |
c879e2dac404ab77de1e045d6171d2b37d75ac4e1077b02b29c4061749793a74 | Based on the visible foot position, which bedside motor task is the participant most likely performing? | [
"images/f3/f3fd03cf8b803c478ab7abfecb25ad0aea323e31ebb5814c333e4ae7f66deccf.jpg"
] | {
"A": "Rotating the sole laterally away from the midline",
"B": "Raising the forefoot toward the shin while keeping the heel down",
"C": "Flexing the knee against gravity",
"D": "Extending the great toe while the ankle remains neutral",
"E": "Pointing the toes downward as if pressing a gas pedal"
} | E | A demonstration of ankle plantarflexion was conducted by a participant in the study. |
423594f3aba86626ba5e9d41cfe25507c8cdefea47cbe05962cd7814ff1f5e99 | The arrowhead in the post-thrombolysis angiogram most likely identifies which vessel? | [
"images/dd/dd634919a1cd8e6cd2903c0aec3afe3b2eb457ae27b9894c660dd04184fc7274.jpg"
] | {
"A": "Posterior communicating artery",
"B": "Anterior cerebral artery",
"C": "External carotid artery",
"D": "Ophthalmic artery",
"E": "Middle cerebral artery"
} | D | Cerebral angiography images (A) Cerebral angiography before thrombolysis, B Cerebral angiography image after thrombolysis, ▲ points to the ophthalmic artery |
4c5cbd9e568b40fa2c6a411dec33639ca180325ee348bb3e937c3b45906b2822 | The arrows point to a mass involving which myocardial wall on these cardiac MR images? | [
"images/00/0044f949133259c079ca40dd6199c0d1bb9b84de9a000ea4fbf6b84086a8fe17.jpg"
] | {
"A": "Anterolateral wall",
"B": "Inferoseptal wall",
"C": "Posterior wall",
"D": "Right ventricular free wall"
} | A | Cardiovascular Magnetic Resonance Late Gadolinium Enhancement
Long-axis late gadolinium enhancement images showed inhomogeneous enhancement of the anterolateral myocardial mass (red arrows). |
f7bedae17c5de9fe1d0f29c77177450d94e0fc8fedbe55cad8851d7e0ca3e1bb | At which magnification is a small amount of polishing-related debris, such as rubber remnants, most evident on this scanning electron micrograph series? | [
"images/0c/0c6e890e195510ab4b701e31838ae26d347aa5d67e6d4cb7b2d5c82cd422f685.jpg"
] | {
"A": "It is equally obvious at all magnifications",
"B": "×3000",
"C": "×700",
"D": "×300",
"E": "×100"
} | C | Scanning electron micrograph of the surface of a Renamel specimen after polishing with Opti1Step system. (a) Original magnification ×300. (b) Original magnification ×700. (c) Original magnification ×3000. In all magnifications, a homogenous and tenacious resinous smear layer can be seen that formed during polishing. At... |
ef7c060309bdfc8bf358ab1cf2b05d6ea37175c913c7f52e4c4e0352ae9bea19 | What is the most likely aesthetic revision goal suggested by the visual appearance of this eyelid? | [
"images/85/85e90de2c53a8bdfc0b9f4f9b7337ffe97b19ccca0fc6f119906e27495690efd.jpg"
] | {
"A": "Remove excess lower eyelid skin only",
"B": "Shorten the horizontal palpebral fissure",
"C": "Eliminate the crease entirely to form a single eyelid",
"D": "Deepen the existing low crease without changing its shape",
"E": "Create pronounced lateral flare with unchanged medial fold",
"F": "Convert the... | I | RES of 7: 50-year-old woman {3, 3, 1}; had incisional method. Low, shallow, nasally joining crease shape. Preferred higher crease height and convert to parallel shape. |
dab61a97cdc3ae0ced96b13877614a6f70401695d6176a71ddfb414eb24f71d0 | What MRI sequence/plane combination is used for the orbital images labeled C and D? | [
"images/f0/f08e925113fecb0bbd3744dced82a588227104878ba5ca45bc9655f955ae609a.jpg"
] | {
"A": "Parasagittal T1-weighted images",
"B": "Diffusion-weighted echo-planar images",
"C": "Coronal STIR images",
"D": "Axial T2-weighted images"
} | A | Right (A) and left (B) fundi showing acute papilledema. Right (C) and left (D) parasagittal T1-weighted MR images showing elevated optic nerveheads (arrows). (E) Sagittal T1 FLAIR MR images revealing a partially empty sella (arrow). |
3644895a4018bab5f913c00bee2e37e85d632076ecb73c00866a314a543813fd | What complication is visible in the boxed region of the CT image in panel B? | [
"images/1f/1f5fdfb2260e6136bf6b4cf3cb3aada8bf01a63cd02fc2ad4a930f35852d1e0e.jpg"
] | {
"A": "Acute subarachnoid hemorrhage",
"B": "Acute brainstem intraparenchymal hemorrhage",
"C": "Acute cerebellar intraparenchymal hemorrhage",
"D": "Acute epidural hemorrhage",
"E": "Acute subdural hemorrhage",
"F": "Acute intraventricular hemorrhage"
} | A | Complications of FD deployment. (A) VA occlusion after FD deployment: panel 1: DSA image of the left VA showing a coiled VA aneurysm (arrow) covered by an FD; panel 2: 6-month follow-up DSA image of the right VA showing that the vessel supplies the vertebrobasilar arteries; panel 3: DSA image of the left VA showing tha... |
e58089b87825bb9bc5dce7022ecfda4a9e98550efeac7874a1105c1a33f6b1c8 | On the fused FDG PET-CT images, where are the hypermetabolic pulmonary nodules located? | [
"images/5a/5a2be76fdd9b222c79aa9de72acef482cbc724cdd487a241a3285125a5c83365.jpg"
] | {
"A": "Right upper lobe, apical and posterior segments",
"B": "Right lower lobe, superior and lateral basal segments",
"C": "Left upper lobe, lingular and apicoposterior segments",
"D": "Bilateral lower lobes, posterior basal segments",
"E": "Left lower lobe, apical and anterobasal segments"
} | E | Patient #3 PET-CT-FDG: two hypermetabolic nodes in the lower lobe of the left lung – apical and anterobasal segments (arrows). |
23e1f72a64a6988481c22cfd4e7580526b9f8442d31429ea4e3a84e0b6229839 | Which abnormality is most clearly absent in this oral photograph? | [
"images/c6/c681976edfb1f904b60fec3da32b5b3b4568863a1c2ece6e8d049f68d2706e28.jpg"
] | {
"A": "Geographic migrating erythematous patches with serpiginous borders",
"B": "Mild diffuse coating of the dorsal surface",
"C": "Extensive exophytic mass arising from the lateral border of the tongue",
"D": "Median dorsal linear fissure"
} | C | Follow up after three Months |
2307143cf344eb3ff9392b0cb81ae81f25c2aca787774b466d82d1478780f030 | On the sagittal PET/CT image (D), where is the focal uptake indicated by the arrow localized? | [
"images/3a/3aa5cc48125ab004b382cbe184e691d15d160f4d80f639066e1321124d84d4e7.jpg"
] | {
"A": "In the L2-L3 interspinous region",
"B": "Within the L2-L3 intervertebral disc",
"C": "Along the posterior cortex of the L2 vertebral body",
"D": "In the L2-L3 spinal canal",
"E": "In the L2-L3 vertebral body",
"F": "In the L2-L3 facet joint"
} | A | Restaging 18F-FDG PET/CT images: maximum-intensity projection in the frontal (A) and (B) lateral projection, sagittal (C) PET, and (D) fused PET/CT images showed no evidence of FDG avid lymphomatous lesions. However, increased uptake was observed in the L2-L3 interspinous ligament without CT correlation of destructive ... |
e5581b1cd65bb9f6933b1af74a9e0e9e846bb1117ffbb1d610e7056c212d4d2a | Which combination of side and digit best matches the abnormal finger shown on this study? | [
"images/35/3559b8c0ceef17e66fc8d144d86de4a6d5ff42550f810f32535323c36873c163.jpg"
] | {
"A": "Left thumb",
"B": "Right little finger",
"C": "Left little finger",
"D": "Left ring finger",
"E": "Right middle finger",
"F": "Right index finger"
} | C | The MCP joint of the left little finger is locked at approximately 90-degrees-flexion, but no dislocation is shown. |
a8598184d28c46771ac6eb8fcc836b7f4510b598596cef89969586fd2e88b1bd | On the breast MRI, which combination of visual findings is most consistent with the depicted lesion? | [
"images/af/af9268c860fa351a188791da9ef114c3d364ef817749ff28424683465b2e8212.jpg"
] | {
"A": "Oval right breast mass with high homogeneous T2 signal, homogeneous enhancement, and a plateau kinetic curve",
"B": "Segmental non-mass enhancement in the left breast with clustered ring enhancement and rapid washout",
"C": "Round subareolar lesion in the right breast with fat signal suppression failure a... | A | Borderline phyllodes tumor in the right breast of a 68-year-old female. 2a FS T2WI shows an oval mass with high homogeneous signal intensity. 2b DCE-MRI shows homogeneous enhancement. 2c-d TIC shows a plateau pattern by contrast-enhanced dynamic imaging. DCE-MRI, dynamic contrast-enhanced magnetic resonance imaging; FS... |
fe584801383e57bb929c9e310783570b8467cccbd313bb3db1a9d0253e8faa9a | Which location best describes the abnormal mammographic finding seen on the standard breast views? | [
"images/12/12909634b30935931cbac8c38d5303a4cb966228427b29791470b523526e6812.jpg"
] | {
"A": "Right breast, upper outer quadrant",
"B": "Left breast, upper inner quadrant",
"C": "Right breast, retroareolar region",
"D": "Left breast, lower inner quadrant"
} | A | Atypical ductal hyperplasia (ADH) and sclerosing adenosis (SA). (a) Mediolateral oblique (MLO) view; (b) craniocaudal (CC) view of the right breast showing fine pleomorphic calcifications of regional distribution (marked with arrows) in the upper outer quadrant. (c) Magnified mammographic image of fine pleomorphic calc... |
2635197f8caa7498e8843be13b089ae82ec1a059658a248e38ffa6397d7dd07d | Which description best characterizes the margin of the nodule in panel J? | [
"images/58/58b573dc1641c40a42f1a05eed4e5564969045f6c1407d6bb37a33a2794afedf.jpg"
] | {
"A": "Smooth and well circumscribed",
"B": "Branched along the airways",
"C": "Irregular with surrounding consolidation",
"D": "Cavitated with a thick irregular wall",
"E": "Spiculated with radiating strands",
"F": "Ill-defined and ground-glass"
} | A | Images from Cases 3 (A-I: chest MRI scan) and 4 (J-L: chest CT scan). Case 3: A 31-year-old male with nodules beside the posterior mediastinum discovered in physical examination. (A-I) Chest MRI nonenhanced and enhanced scans. (A) Axial T2WI: a quasicircular smooth-edged shadow about 29 mm × 17 mm × 23 mm beside the po... |
0d531cb4f3b00a7c46d16d2b09c29b30987b62c5a23834fb76102bc27c205e45 | In the surgical schematic, which labeled vessel is directly joined to the graft portal vein in an end-to-end portal venous anastomosis? | [
"images/f1/f1588a13f08739f45e62462bcfeb9abba3927e6bb03e37c8ebed112c3f35ec94.jpg"
] | {
"A": "4",
"B": "2",
"C": "1",
"D": "3"
} | B |
End-to-end portal venous anastomosis between donor and recipient portal veins. 1—Donor portal vein, 2—Recipient portal vein, 3—Recipient superior mesenteric vein, 4—Recipient splenic vein.
|
a603d9db258c0321a77ca5145c458e8053d29891de3090b076934c8e5337dcac | Examine the histologic panels. Which morphologic pattern is best demonstrated by the tumor in relation to the surrounding structures? | [
"images/3a/3a43c626b8153a69335237dfdaf6bffef0e37f28c39e91e089236fefb2f838fa.jpg"
] | {
"A": "Granulomatous inflammation with multinucleated giant cells",
"B": "Perivascular cuffing by atypical lymphoid cells",
"C": "Keratin pearl formation around necrotic vessels",
"D": "Sheets of plasma cells with Russell bodies",
"E": "Gland-forming epithelial proliferation infiltrating white matter"
} | B | (A) Atypical lymphoid cells in close relation with blood vessels. (B) Absence of spongiform changes in the cerebral cortex. (C) Positive CD3 staining of the tumour cells. |
18965fd17c6458d647c1b41f51bcf45cabb31ca3c9b444aa46f0730ff8f43d47 | Which description best matches the alignment seen between the forearm and hand in the image? | [
"images/c6/c6b863f58d55953ded9ef9394eddf177b9121753eff92c9f77f8132ebcf20923.jpg"
] | {
"A": "The wrist is held in a neutral anatomic position",
"B": "The metacarpophalangeal joints are hyperextended while the wrist remains flexed",
"C": "The hand is dorsiflexed excessively relative to the forearm",
"D": "The hand is hanging in volar flexion, consistent with wrist drop"
} | C | Hyperextension of the wrist. |
21258cc025815309b8bf677e93398c7154945937182ab4a9440c06b43514e997 | If optical coherence tomography were obtained for an eye with the non-glaucomatous cupping shown here, which pattern would be most expected compared with glaucomatous cupping? | [
"images/0e/0eb1fcc432646e579b12821015be705279401c7a58c73f9426c002c558b6674e.jpg"
] | {
"A": "Lower mean RNFL thickness in the nasal quadrant, lower average macular thickness, and lower macular volume",
"B": "Increased macular volume with preserved average macular thickness",
"C": "Selective temporal RNFL thickening with increased cup depth only",
"D": "Normal nasal RNFL thickness with isolated ... | A | Optic atrophy with apparent cupping after resolution of acute AAION. The optic disc atrophy following AAION (but not NAION) may resemble severe glaucomatous cupping. The remaining rim is usually pale after AAION but pink in glaucoma. OCT has been studied as a way to differentiate between glaucoma and atrophy after AAIO... |
95eaf44222989f03918468b5818d0f0cad9789f8a77800d0732a0c6c7bf1155a | Comparing the angiograms in panels a and c, what immediate change is visible after treatment? | [
"images/2f/2f03bbadf5f9734ab125bd997953b58d23e74911d421506ef3f58407754c0217.jpg"
] | {
"A": "The focal right hilar tumor stain is reduced",
"B": "The right hilar tumor stain is unchanged in extent and intensity",
"C": "The tumor stain shifts from the right hilum to the left hilum",
"D": "The right bronchial artery is visibly enlarged with increased tumor stain",
"E": "A new diffuse bilateral ... | A | Case presentation 1: A 23 y/o female with refractory to sorafenib
treatment. A 23 y/o female with hepatitis B developed HCC 4 years ago.
Several sessions of conventional TACE using lipiodol, hepatectomy, RFA
and sorafenib treatments had been done. However, she consulted us
complaining of severe cough, hemoptysis and ge... |
1d9fb9ca6e5e9eb5660c5f80bebe9dc84fc61b65a1ab3be66384e04cd8556fd4 | Comparing the early postcontrast image in panel C with the late postcontrast image in panel D, what happens to the visible enhancement at the mass margin? | [
"images/c0/c0a947db318217e7b978ea5f94f7805391fa12ae288b36afdd9ea93d8cf93afd.jpg"
] | {
"A": "It appears only on the late image",
"B": "It remains visible on the late image",
"C": "It shifts from the margin to the center of the mass",
"D": "It becomes confined to a distant duct",
"E": "It appears only in the early image and disappears completely on the late image",
"F": "It is absent in both... | B | Magnetic resonance imaging (MRI). MRI showed an oval mass with hypo-intensity on T1-weighted images (A), mixed hyper- and hypo-intensity on T2-weighted images (B), and retained rim enhanced until late phase on time-signal intensity curve (C; early phase, D; late phase). |
5925000b0d16972c4fe7826ce0759d4bc75d73c5e31dc30ff15a22ab4a1bbb74 | Which description best characterizes the arrowed abnormality on CT in panels A and B? | [
"images/77/773543918c24f77e08165680fac184244b45cadf6a3a98f7d5d62c1cc8f885ad.jpg"
] | {
"A": "A multiloculated low-attenuation mass",
"B": "A destructive osseous mass",
"C": "A uniformly hyperattenuating solid mass",
"D": "A gas-filled bowel loop",
"E": "A predominantly fat-density mass",
"F": "A densely calcified mass"
} | A | A 48-year-old woman (patient #8) with LAM. Co-registered CT scans (A, coronal view, B: axial view; white arrows) of 68Ga-NEB PET/CT demonstrated a large hypodense multiloculated cystic mass extending from the retroperitoneum into the pelvis, consistent with lymphangioleiomyoma. On 68Ga-NEB PET (C, coronal view; D, axia... |
97a78b2b3d88da7c7ce98dd811b3a30db077efc9fa7905db95a8dec31d6fdb39 | In panel D, the arrowheads indicate a ligamentous structure attached to which bone at the asterisk? | [
"images/af/afa9a49fedc1299bcadb59da1a6f40bbc576e625c946d1efe68b84e078264039.jpg"
] | {
"A": "Calcaneus",
"B": "Cuboid",
"C": "Tibia",
"D": "Navicular",
"E": "Fibula",
"F": "Talus"
} | C | Pre- and postoperative images
(A) Three-dimensional computed tomography (CT) shows almost the whole anterior colliculus and intercollicular groove of the medial malleolus is defective and the ossicle corresponds to this defective part. (B) Coronal plane CT reveals that there are subchondral sclerosis, cysts, and irregu... |
86e518fb009325d34fb82a51b0801070ac7d4530d02ccbfeeb7efd8945e8ff55 | What is the most prominent calvarial abnormality visible on this skull radiograph? | [
"images/84/84a4f7d7a5af9c5fb7dd9075d5bc778b9a1061c62e726a87defc77ba780950da.jpg"
] | {
"A": "Diffuse granular demineralization producing a \"salt-and-pepper\" skull",
"B": "Multiple sharply marginated punched-out lytic lesions",
"C": "Ground-glass expansion confined to the frontal bone",
"D": "Beaten-copper convolutional markings from raised intracranial pressure"
} | A | Plain X-Ray shown “salt-and-pepper” appearance of the skull in a 38 years old female patient OFC. |
6a87a67ffb2f9c8cb61b286d60aa76a7ef7b2e677596ac6d13173dd777c959a7 | Which tooth region marks the anterior extent of the radiolucent lesion seen on this panoramic film? | [
"images/bc/bcdc98995ed0e8288fa785090e882b3950d64fdc6a9a98cd298ebe35225f2723.jpg"
] | {
"A": "Right central incisor",
"B": "Left second premolar",
"C": "Left canine",
"D": "Right second premolar",
"E": "Right third molar"
} | D | Preoperative panoramic view. An ill‐defined radiolucency extending from right second premolar to the right mandibular ramus is evident |
9771c24f63816e7b7c7da1ea16340db46a408760fbd9ba74e9d96ad26eddd50a | What most likely accounts for the small bright foci within the collection on panel A, including the focus indicated by the white arrow? | [
"images/e1/e1992dafc1fda93384a07843c3010954d2f23b21ef47bdc81aba5b89ce24b794.jpg"
] | {
"A": "Fibrous septa",
"B": "Gas bubbles",
"C": "Fat lobules",
"D": "Calcified fragments",
"E": "Cortical bone fragments",
"F": "Tendon fibers"
} | C | Axial T1W (TR/TE 800/10) (A) and T2W fat saturated (TR/TE 3617/64) (B) sequences. A Morel-Lavallée lesion overlies the fascia (black arrows) in the region of the medial epicondyle (asterisks). The lesion is predominately T1 hypointense, and T2 hyperintense. There are scattered T1 hyperintense foci (white arrow), with l... |
80d8ab44e0ef821714be6e6498a29395809833eaafd3cc1097c9ee0a5c4e2dde | Which radiographic projection best demonstrates the volar direction of displacement of the dislocated metacarpal bases? | [
"images/30/303a5fb8e05ab56ba8f18aac2991467bcd43241d4e2c76a9589ed0f3c3901e71.jpg"
] | {
"A": "Carpal tunnel view",
"B": "Oblique view only",
"C": "PA clenched-fist view",
"D": "Pronated forearm view",
"E": "Anteroposterior view",
"F": "Norgaard view",
"G": "Scaphoid view",
"H": "Stress view",
"I": "Lateral view",
"J": "Ulnar deviation view"
} | I |
Anteroposterior (A), oblique (B), and lateral (C) injury radiographs demonstrating a volar dislocation of the medial four metacarpals at the carpometacarpal joints. Also note the fracture fragments from the base of the third metacarpal and the capitate (C). |
55ac3c4d76c2b12453ccf0975f8f71e33b9ba31af850500351f1f7373e589088 | Which imaging description best matches the abnormality marked on this study? | [
"images/52/527f02cb60eaa5a55eb9b95f52be6a80b1d60f1c32ba018b03184037b4ca4599.jpg"
] | {
"A": "A 1.2 cm cystic lesion in the body of the pancreas",
"B": "A calcified lesion in the pancreatic tail",
"C": "Diffuse pancreatic enlargement with peripancreatic stranding",
"D": "A hypervascular solid mass in the pancreatic head",
"E": "A large necrotic mass arising from the left adrenal gland"
} | A | Contrast-enhanced CT of the abdomen and pelvis showing a 1.2 cm cystic lesion within the body of the pancreas. |
9d1e8b5f8330813b7d1e5488b2ce1146e0fc99d19fb650ee5eb9c419ce10f4cb | On the lumbar spine CT reformats, which vertebral levels show the most extensive osseous destruction involving the posterior elements? | [
"images/07/07730c5a5233d4ed486092c5406d7b86c311010cc185592dd7b18d858f98d784.jpg"
] | {
"A": "L5 and S1",
"B": "L3 and L4",
"C": "L2 and L3",
"D": "L4 and L5",
"E": "L1 and L2"
} | D | Sagittal and axial reformatted CT images of the lumbar spine with a massive active bone osteolysis of the posterior arches of L4 and L5 (panels A and B, white arrows) and of the vertebral body of L4 (panel A, asterisk). |
8765da8eaf121230c2c721f7cdeec254a75728453d99bfa037a28353d01f1cd3 | Which comparison of the brain images in panels E and J is best supported? | [
"images/2b/2b6c124d94bc6b2e2fe2ef1651465edd79820a294564ff81f237ee58da6414da.jpg"
] | {
"A": "Panel J shows greater generalized brain volume loss",
"B": "Panel J shows no appreciable difference in brain volume",
"C": "Panel J shows ventricular compression from a mass",
"D": "Panel E shows greater ventricular enlargement without sulcal widening",
"E": "Panel E shows greater generalized brain vo... | A | Outer retinal mapping and brain volume in neurodegenerative disease.
Two representative cases with a different grade of ellipsoid zone (EZ) to retinal pigment epithelium (RPE) volume and total brain volume as measured by a percentage of intracranial volume (%ICV). Top row, A horizontal B-scan of the posterior pole cros... |
79003a48a667b86d14b10e8ac6def388e72f771f317a60bb7b1fa472b04e3949 | Which combination of pulmonary lobes contains nodules on the chest CT image? | [
"images/9d/9d28ba0343e413a76e5065e543a371e08aca2be537e8eef8d5a031dc32fbd7ce.jpg"
] | {
"A": "Left lower lobe and right upper and middle lobes",
"B": "Left upper and lower lobes only",
"C": "Left upper lobe and right upper lobe",
"D": "Left lower lobe and right middle and lower lobes"
} | D | Preoperative imaging findings. (A) Chest computed tomography showing a nodule in the left lower lobe and right middle and lower lobes. (B, C) Fluorodeoxyglucose positron emission tomography/computed tomography showing uptake in the pulmonary nodules of the left upper lobe, right lower lobe, and left hilar lymph nodes (... |
88de5e59e673f32f255f1c370a68630bc10b0395ffcd023d562ba8ae29e74de4 | What abnormality is present in the gallbladder shown in panel a? | [
"images/05/05b7c07bdc8c463f1943e9f58cfc101be629bd6d5e33b9646ceb303b6c68015d.jpg"
] | {
"A": "A focal polypoid mass",
"B": "A large shadowing intraluminal calculus",
"C": "Gas within the gallbladder wall",
"D": "Mild wall thickening",
"E": "A large pericholecystic fluid collection",
"F": "A markedly dilated common bile duct"
} | D | 9-year-old girl with MIS-C who presented with abdominal pain, vomiting, fever, hypotension and acute renal failure. (a) Transverse gray-scale ultrasound image of the right upper quadrant shows mild wall thickening of the gallbladder (GB). (b) Transverse gray-scale ultrasound image of the right lower quadrant demonstrat... |
4dbc15a51c68e5f9e0664661aaa9c8d4913c900cf5fe68e0e1a4d2e717db1dcd | On the skull radiograph in this series, which abnormality is most clearly present? | [
"images/bc/bc4465fec65a0764fa72ac8dd9fb3a09b712232c182883da382e87e9f71407d5.jpg"
] | {
"A": "Thickening and sclerosis centered at the skull base",
"B": "Depressed fracture of the parietal bone",
"C": "Marked enlargement of the paranasal sinuses",
"D": "Expansion of the diploic space with hair-on-end appearance",
"E": "Diffuse calvarial lytic lesions with a punched-out pattern"
} | A | Skeletal radiographs reveal generalized symmetric increases in bone mass. (A) The cranium shows a thickening of the skull base. (B) Chest postero‐anterior radiograph shows the stark visualization of the anterior ribs. (C) Vertebral body shows a typical endplate sclerosis, called a “sandwich spine.” (D) Iliac crest also... |
57f91724dabf62ddf7d2983103123d739095a4b6b68c7997c526dfac62b0225f | In panels b and c, where is the red-arrowed focus of tracer uptake located? | [
"images/0c/0c0dc002a7165150b204195e0ff8da2c4e69e702db49fcc5488e218e32fdcee0.jpg"
] | {
"A": "Left maxillary region",
"B": "Right mandibular region",
"C": "Right parotid region",
"D": "Left mandibular region",
"E": "Right maxillary region",
"F": "Left parotid region"
} | D | Diagnostic images and intraoral photographs: (a) Maximum intensity projection image obtained with F-18 fluorodeoxyglucose positron emission tomography showing intense uptake in the oral area (SUVmax 6.0, red arrow). (b) Coronal image obtained with F-18 fluorodeoxyglucose positron emission tomography/computed tomography... |
39447041397ee67b53e1b3b48598230128c979bbf0af04ade3b1ff58242c1f0e | Which bone is primarily involved by the abnormality shown on the CT image? | [
"images/8d/8d58924a8e18a822950fc75cdcdde20bdfc64b5ad0bbf2f568f95522e9b0ec0a.jpg"
] | {
"A": "Thoracic vertebra",
"B": "Sternum",
"C": "Scapula",
"D": "Clavicle",
"E": "Humerus",
"F": "Rib"
} | B | 18F-PSMA PET – CT showing the extensive osteolysis of the sternum and the focal radionuclide uptake supporting prostate cancer tumour activity. |
1f3bbd8f2361453dd80d28b887e93b7594e3657563154fd9f6e4f50bbc2d8566 | In this sonographic procedural image, the dark round-to-oval structures adjacent to the needle path most likely represent which of the following? | [
"images/35/35c347b563d2f36144bfab6a7a3af977d218eccbfc502f76cafd466abe5c0701.jpg"
] | {
"A": "Blood vessels",
"B": "Calcified lymph nodes",
"C": "Tendons in short axis",
"D": "Air-filled bowel loops",
"E": "Peripheral nerves"
} | A | Ultrasound image showing the needle path and vessels in the oblique approach |
7fed752f8b5a334f7fd7f696a241ab33fecd5c1d258c3d3468fe42dc3bf43fa2 | Compared with the other toes, which ray appears disproportionately shortened on visual inspection of both feet? | [
"images/19/1918f532f0b69b6c9f41158d670cee42f17054158c819d0e81d8ab277a76c99f.jpg"
] | {
"A": "Second toe",
"B": "First toe",
"C": "Fifth toe",
"D": "Fourth toe"
} | D | Shortening of all toes (particularly the fourth) |
f926d1f0d4ec25339c85188dfedc2c9c8666c14f2d8453490e59f028500f074a | The highlighted angular measurement on this image is primarily assessing the position of which tooth relative to craniofacial reference lines? | [
"images/6c/6c039650fdd6bd5ea12e5efa7949e942a38d6c94589457b7b724da11a8798f76.jpg"
] | {
"A": "Maxillary first molar",
"B": "Maxillary canine",
"C": "Mandibular canine",
"D": "Maxillary central incisor",
"E": "Mandibular first premolar"
} | B | Canine position on Lateral Cephalogram |
ddef65392cc4b87dff5fa67ae832248979dc606f0c9ac49a3cebfa15ed72e785 | Which description best characterizes the position of the disc herniation relative to the spinal canal on the axial image? | [
"images/ca/ca7417e754db57bf987738b2ef7b86ce2600f6d57cf55b3d80e8b0e5cfce4005.jpg"
] | {
"A": "Left foraminal extrusion",
"B": "Far lateral left extraforaminal disc fragment",
"C": "Right paracentral broad-based herniation",
"D": "Central broad-based protrusion"
} | C | Disc herniation. Sagittal T2 (A) and axial T2 (B) MRI of the lumbar spine demonstrating a large right paracentral broad-based disc herniation at the L5-S1 level (yellow arrow) with the herniated disc pushing into the spinal canal. On axial MRI, the herniated disc can be seen causing effacement of the right subarticular... |
b5dd7e8621398106f4c85b924c698d2583e6de06bc5eacbf0f67bd190cde4815 | The calcific deposits seen on the image are located at which anatomical site? | [
"images/ce/ce7e2031a336fd356955a7a8af8232f13435222ed09011c68e50b2e50bd291c8.jpg"
] | {
"A": "Anterior cruciate ligament at the intercondylar notch",
"B": "Quadriceps tendon insertion on the superior pole of the patella",
"C": "Distal patellar tendon at the tibial tuberosity",
"D": "Lateral retinaculum adjacent to the lateral patellar facet",
"E": "Medial collateral ligament at the femoral epi... | B | Calcificaciones múltiples en la inserción rotuliana del tendón cuadricipital. |
c6086d99bc0ff36fb46557b7b98063e28a95302438dc0a5341387669bc420ea1 | The yellow arrow is most likely indicating which structure or finding in this cardiac image? | [
"images/22/22e293a2b9ee301f8ae14b15fcca22e2431abe8235b0d41bcde7b09e65bf64fa.jpg"
] | {
"A": "A ruptured papillary muscle in the left ventricle",
"B": "A well-seated bioprosthetic valve in the mitral position",
"C": "A left atrial appendage thrombus",
"D": "A vegetation attached to the aortic valve"
} | B | Transoesophageal echocardiography post-transcatheter mitral valve implantation using Tendyne valve showing well-seated bioprosthetic valve (yellow arrow). |
3fbaf15fb00ece74123f30ed1a2a7bf005957f211156ba020025c6710b618f38 | On the radiographs of the right hand, which digit demonstrates the most conspicuous abnormality characterized by diffuse enlargement and angular deformity of the distal segment? | [
"images/e1/e1da275684b2fc79b2b5e3c68f9d3b0050bbdf31f43fc7a533282ba605df2e53.jpg"
] | {
"A": "Thumb",
"B": "Middle finger",
"C": "Index finger",
"D": "Ring finger",
"E": "Little finger"
} | B | Right Hand Lateral (a), Oblique (b), AP (c) X‐rays – Demonstrating an Enlarged Middle Finger with Ulna Deviation of the Terminal Phalanx. |
84d7736a3192c2a66607c232f81ff33e3c6bf2f5235d69a6f5162421301a7950 | On this axial CT through the maxilla, which structure contains the dominant expansile lesion with multiple internal calcified foci? | [
"images/cc/ccdec2129fead65d9727820a38ee781a0ba66949e54fbc88ee99f6e40028489a.jpg"
] | {
"A": "Nasal cavity",
"B": "Left maxillary sinus",
"C": "Left orbit",
"D": "Right maxillary sinus"
} | B | Fig 1 CT of maxillary |
da20b6f4b722eee7a02e95de103c4d9a374fc013abf1dcc52c8d06f7fc36826c | On the coronal image (A), which muscle distribution shows the conspicuous signal abnormality? | [
"images/0b/0b5d99bb162ae359383326dcf7a916b31b2363d2e01e5b3d0e6f056d327b7369.jpg"
] | {
"A": "Bilateral adductor magnus and left gracilis",
"B": "Bilateral vastus medialis and left vastus lateralis",
"C": "Bilateral vastus lateralis and left vastus medialis",
"D": "Bilateral rectus femoris and left vastus intermedius",
"E": "Bilateral hamstrings and left sartorius",
"F": "Bilateral iliopsoas... | B | The extremity coronal MRI with fat-suppressed T2-weighted images showing an inner stripe of decreased signal intensity with outer stripes of increased signal intensity, the so-called three stripes sign, both in the left vastus lateralis (A, arrow) and bilateral vastus medialis muscles. (A, arrowheads). The extremity ax... |
630754e50fe589b8b7d5d15189aa42ab0ac8113d1ae034137542fad901cf7e10 | How is ventricular depolarization best characterized by the QRS complexes on this tracing? | [
"images/cd/cd32a8b979685149460b6c10ec519c7e9c49f11682f1849253dde802e2060094.jpg"
] | {
"A": "Regular paced wide QRS complexes",
"B": "Narrow QRS complexes",
"C": "Wide QRS complexes with left bundle branch block morphology",
"D": "Wide QRS complexes with a delta wave",
"E": "Alternating narrow and wide QRS complexes",
"F": "Wide QRS complexes with right bundle branch block morphology"
} | B | An electrocardiogram showing a sinus rhythm of 78 bpm with ST-segment elevation from V2 to V6. |
1993ce0630e6142242fa693e9dbcbe5a1e87b5559bf011c8b68b81af1128f0d5 | The lesion is shown in two orthogonal planes. Which panel most likely represents the transverse view of the mass? | [
"images/41/4122d0643c6e619eefd6c4714f521896e49a8f6e08969ff44f9a21c20df4ac73.jpg"
] | {
"A": "Panel B",
"B": "Both panels are longitudinal views",
"C": "Neither panel is a transverse image",
"D": "Panel A"
} | A | Longitudinal ultrasound image (A) and transverse ultrasound image (B) shows hypoechoic mass sized 1.07 × 0.53 × 0.81 cm with posterior acoustic enhancement (red asterix). Hyperechoic fibers were noted at the proximal and distal pole of the mass (yellow asterix). (For interpretation of the references to colour in this f... |
6509593bbd00c5be70c2f71b449bb10ed85ddf04bb6d93afdf31ad141c8d88d1 | In the dorsal reconstructions, which compartment shows the earliest clearly described osteophyte formation and sclerosis before severe bilateral plateau involvement develops? | [
"images/e3/e37d286a5923997b2823cfb4d90061b35a082ae6c9bd3341be4b5e7d9374719d.jpg"
] | {
"A": "Fibular head",
"B": "Medial femoral condyle",
"C": "Lateral femoral condyle",
"D": "Intercondylar notch"
} | B | Representative photos from microCT evaluation of knee joints using the
novel scoring system. (A) Dorsal and (B) sagittal reconstructions from a 2 month
old Hartley guinea pig with no clinically significant OA lesions. This animal
received a microCT OA score of 0. (C) Dorsal reconstruction from a 5 month old
Hartley gui... |
d61a26c9912400045dd9d745f74ca53df82d6a1642847665fec664e5a8c5ae77 | Which ECG abnormality is most clearly demonstrated on this tracing despite an otherwise regular sinus rhythm? | [
"images/89/89e278820971aa47b90791b4d96cee5a1e0c48786a493fae4d8f26e4fee40df5.jpg"
] | {
"A": "Short PR interval with delta waves",
"B": "Atrial fibrillation with variable ventricular response",
"C": "Right bundle branch block",
"D": "Prolonged QT interval",
"E": "ST-segment elevation in the inferior leads"
} | D | ECG normal sinus rhythm with prolongation of QT interval (QT duration 458 ms/QTc duration 501 ms). |
9c31a5355ff96af70a9b33b3be304252ca3ca3f9f99698e2d12c647b676692b7 | On the voiding cystourethrogram image, which abnormality is most directly demonstrated by retrograde opacification of the upper urinary tract from the bladder? | [
"images/cb/cbaafe4961a3472a7543d0206f25ffc5f6548e8baffa6e210c9008c35b12bd0a.jpg"
] | {
"A": "Posterior urethral valves",
"B": "Left-sided vesicoureteral reflux",
"C": "Neurogenic bladder without reflux",
"D": "Ureterocele causing obstruction"
} | B | Vesicoureteral reflux in a patient with a single kidney.
A, B. Left ureter (arrows) is diffusely dilated and the left renal pelvis and calyces are dilated. C. Diffuse thickening of the bladder wall (arrowheads) and dilation of the retrovesical ureter (arrow) are noted. D. Voiding cystourethrogram confirms a high-grade ... |
07d32597d6e0ae060470a4a4aa7b70973b18ae6b9e6d9994c0376f07702327f4 | In sagittal image E, where is the arrowhead-marked focus located relative to the adjacent carpal bone? | [
"images/d6/d6ef746021f9210145e895effb7cbc6b36bb997ac72a318f59e1ab6c500c6390.jpg"
] | {
"A": "Within the volar cortex",
"B": "Within the adjacent bone marrow",
"C": "In the volar extraosseous soft tissues",
"D": "Within the central medullary cavity",
"E": "Within the dorsal cortex",
"F": "In the dorsal extraosseous soft tissues"
} | F | Intraosseous ganglia of the dorsal lunate. Axial STIR-w images (A, C) and axial T1-w images (B, D) show intraosseous ganglia (arrows) in the dorsal lunate at the attachment of the dorsal extrinsic ligaments. Sagittal STIR-w images (E, F) of intraosseous ganglia in the dorsal lunate. Images (A, B, E) are of symptomatic ... |
02bc563045e5b053234a8fdbb3ef19289ae09f49585217a8b73d0b16a5194489 | What cardiac silhouette finding is most apparent on the chest radiograph in panel A? | [
"images/7d/7d6f05aa534d6e7aef5b86522f6cde053bef2eb59448c85bf37d1eb30fbc1d8b.jpg"
] | {
"A": "Enlarged cardiac silhouette",
"B": "Egg-shaped cardiac silhouette with a narrow upper mediastinum",
"C": "Right-sided cardiac apex",
"D": "Small, narrow cardiac silhouette",
"E": "Air surrounding the cardiac silhouette",
"F": "Boot-shaped cardiac silhouette"
} | A | Radiological and imaging findings on admission. (A) Chest radiograph showing cardiomegaly with bilateral pleural effusion, predominantly on the right side. (B) Chest computed tomography image showing bilateral pleural effusion without significant parenchymal abnormalities. (C) Abdominal computed tomography showing subt... |
ffddd2c639276d5d4d5e89382833be67480de94c395cb0a7df4f04043d7cf290 | Besides the splenic lesions, what additional associated finding is visible on this abdominal CT? | [
"images/6d/6de116b7a2370c54a228bb0f62794e466c8ce1882f383a0bca7333246708c87e.jpg"
] | {
"A": "Massive ascites",
"B": "Bilateral hydronephrosis",
"C": "Portal venous gas",
"D": "Free intraperitoneal air",
"E": "Calcified retroperitoneal lymph nodes"
} | E | Computed tomography of the abdomen showing enlarged spleen (17.2 cm), multiple irregular splenic hypodense lesions, largest at the lower pole (10 × 5 cm, 25 Hounsfield units), along with multiple hyperdense foci suggesting abscesses with calcification, and few calcified retroperitoneal lymph nodes. |
1b20d424328d976b2141b47a7edf75fd6d54e6f23ab1297c14942e9d126a0d42 | On these axial CT images, the bowel loop indicated by the arrow is located within an abnormal recess on which side of the peritoneal cavity? | [
"images/4e/4ea7993e04b6e9e3ec165aba6232e00df3d8984c981bfef77f33ce22dc882367.jpg"
] | {
"A": "Left-sided unilateral recess",
"B": "Bilateral paracolic recesses",
"C": "Midline prevesical recess",
"D": "Right-sided unilateral recess",
"E": "Posterior retroperitoneal space"
} | A | Computed tomography: the left-sided unilateral ‘peritoneal recess’ (A) and the bowel inside the peritoneal recess (arrow) (B) |
f36546e7c288153027e459aa126b8acae412c6cc1490b709d31695e46b2b6af1 | The visual ECG features of this premature ventricular complex are most consistent with which site of origin? | [
"images/92/9217e3e873c4b0dcc5de156dc4c626204ef1dd7490f614c0b41f95bdf7a45dbb.jpg"
] | {
"A": "Inferior left ventricular summit",
"B": "Lateral mitral annulus",
"C": "Right ventricular apical free wall",
"D": "Left-sided para-Hisian outflow tract",
"E": "Left posterior fascicle"
} | D | Clinical premature ventricular construction, demonstrating RBRI morphology with V2 transition, a rapid upstroke, and a relatively narrow QRS duration of 130 ms, consistent with a left-sided para-Hisian outflow tract (OT) origin. |
aeece03532d5c6c8a45a3338c0201a330217044f0d47e4b9de5af1683294da35 | What bony abnormality is indicated by the arrows in panels C and D? | [
"images/22/227a0ed72a74e27d89cef19d7764d5032c9fe6bd26d5f6211bf6ac4b13ccdd37.jpg"
] | {
"A": "Diffuse vertebral sclerosis",
"B": "Displaced spinous process fracture",
"C": "Bilateral facet joint ankylosis",
"D": "Large anterior bridging osteophyte",
"E": "Focal erosion of the vertebral bone",
"F": "Acute vertebral compression fracture"
} | E | Sagittal (A) and axial (B) T2-weighted magnetic resonance imaging performed 39 months later showing an exacerbated bend of the spinal cord at the T5/6 level (A) with a marked lateral elongation to the left of the cord (B). The lateral part of the stretched cord showing herniation into the vertebral erosion at the lower... |
c1726c11a51f8d64f303622f8b872ef76689ffe35258ae10857a0439ca98460b | In addition to chronic airway inflammation, which microscopic finding in the airway wall most strongly supports an atypical mycobacterial infection in this specimen? | [
"images/6e/6e5c1ea1679b8b456a74dade5f4df58c7af2bac952c748f8d5ccc580b51f748f.jpg"
] | {
"A": "Loose non-necrotizing granulomas",
"B": "Fibrinoid necrosis of vessel walls",
"C": "Caseating granulomas with central acellular necrosis",
"D": "Hyaline membranes lining alveoli"
} | A |
Nontuberculous mycobacterial infection in a patient with bronchiectasis. Low-magnification photomicrograph showing an ectatic airway with severe chronic inflammation typical of bronchiectasis. In this case, the inflammation is complicated by loose non-necrotizing granulomas in the airway wall, a finding virtually diag... |
8796a7dc61d16baf117acef6894858bdcfdc30250a4d8b69ce4b74a12bc3673a | In panel b, where is the arrowed lesion located? | [
"images/ae/ae3e0bdfb82da9c833754b1e92e95d4e1f5ad275e026ebaa9837d3f28cc49c01.jpg"
] | {
"A": "Femoral head",
"B": "Greater trochanter",
"C": "Pubic ramus",
"D": "Ischial tuberosity",
"E": "Acetabular roof",
"F": "Femoral neck"
} | F | After two-years history of left hip pain, the patient underwent pelvis CT scan revealing the synchronous presence of two intracortical bone lesions consisting of a radiolucent nidus with a central punctiform hyperdensity and sclerosis of the adjacent bone, located in the left anterior acetabulum (a, arrow) and femoral ... |
2d0569a01bf0a4f012ddb046de9559bf6ef1f1b3c3c1131533aee4b85b1c4efc | Which inheritance pattern is most consistent with the pedigree shown? | [
"images/db/db92dbad503e41ac5613271701f2e8c62b4bab47b34c0468529d2cd0497e0169.jpg"
] | {
"A": "Mitochondrial",
"B": "Autosomal recessive",
"C": "X-linked recessive",
"D": "Autosomal dominant"
} | B | Pedigree with autosomal recessive retinitis pigmentosa showing cosegregation of the compound heterozygous changes, c.4325 T>C and c.15188 T>G within the USH2A gene in all affected members. Black symbols represent clinically affected subjects. Open symbols represent unaffected subjects. Patient II:5 (proband) is indicat... |
4fdf25f01d9aa7c91a141a8f7d57a72f26ba12a1029ffce9739dbc227142fa36 | The labeled osseous landmark "MT" adjacent to the plantar fascial abnormality corresponds to which site? | [
"images/0a/0ab8ed83fbe0767e663c44d87b656fde2968139fbf4aa0977dd25ab0d5b33543.jpg"
] | {
"A": "Middle talar dome",
"B": "Metatarsal tuberosity",
"C": "Medial calcaneal tubercle",
"D": "Medial malleolus"
} | C | Sonogram of a partial tear of the central cord of the plantar fascia with corresponding MR. Long axis sonogram (a) with corresponding T2-weighted MR (c) shows hypoechoic thickening, loss of normal fibrillar echotexture, and loss of sharp borders characteristic of proximal plantar fasciopathy. In addition, there is a fo... |
80cd575156c828f60ea732c302578335b986a1c40bb361b8c39b122804ae658e | Which cranial nerve is most directly affected by the lesion as demonstrated on the heavily T2-weighted image? | [
"images/c3/c37e514a8b5726b2d55e0ba8a268fc8d1c9bb6da62e484f80ca52f6b792eb6db.jpg"
] | {
"A": "Left trigeminal nerve",
"B": "Left vestibulocochlear nerve",
"C": "Left abducens nerve",
"D": "Left facial nerve"
} | A | Trigeminal ganglioneuroma in 44-year-old female.
A. Axial T1-weighted image shows well-defined mass (arrows) in left prepontine and cerebellopontine angle cistern. This has same signal intensity as adjacent brain parenchyma. B. Thin section heavily T2-weighted image shows mass (arrows) with abutting and displacement of... |
de6efdaa73fc5df12f9782717d3ef13c95d2e342c715ac13606a3ab15307ea09 | On the late gadolinium enhancement images, what is the predominant pattern of enhancement shown by the lesion? | [
"images/f8/f8d7f408e2da595e63ce01e3215943aa43186998acf8106f832391abfc98262e.jpg"
] | {
"A": "Intramyocardial enhancement within the inferolateral wall",
"B": "Transmural enhancement of the lateral wall",
"C": "Diffuse circumferential pericardial enhancement",
"D": "Subendocardial enhancement in a coronary artery territory",
"E": "No abnormal enhancement"
} | A | Myocarditis after COVID-19 vaccination. T2-short tau inversion recovery CMR short axis (a), three-chamber (b) and four-chamber view revealing edema in the infero-lateral basal segment. T2 mapping short-axis view and T2 mapping in AHA 16-segment model (d–g) showed altered values in all myocardial segments, especially in... |
eaa8142bcb3a84d320eba3070d2902478aaffce08066c4f1b2da475447d755d1 | In this operative illustration, the osteotome is being used to remove a bony prominence from which specific pelvic landmark? | [
"images/ef/efc55ce53273ac99894e11f776c7514f59bc89d7294e1e30077f79d1332c809b.jpg"
] | {
"A": "Sacral promontory",
"B": "Posterior superior iliac prominence",
"C": "Pubic tubercle",
"D": "Anterior inferior iliac spine",
"E": "Ischial tuberosity"
} | B | Illustration demonstrating resection of the posterior superior iliac prominence with an osteotome. |
02c04d162a337e889fdf5c6d2bc0a9c66925f863c354108978602b8b76a9516d | The bowel segment shown being mobilized after ligation of mesenteric vessels is primarily which portion of the large intestine? | [
"images/94/949c8ceea0c03af134ac49ae67217d845231ae692741612c38eff994eb5b3195.jpg"
] | {
"A": "Rectum",
"B": "Descending colon",
"C": "Transverse colon",
"D": "Cecum and ascending colon"
} | B |
Division of the inferior mesenteric vessels and left colic vessels to add mobility and length for a descending colostomy. (Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 1998–2015. All Rights Reserved.) |
cc04eeac88b43a4062a6fd1f70146995f757a883d15b96da23e45736d2aa407e | On the CT images of the upper abdomen, which description best matches the gallbladder and biliary tree appearance? | [
"images/cb/cb40b050776b7cc78e159f73230542b8d5bba4b04fdc86966cd1794cdb19b1c0.jpg"
] | {
"A": "Hydropic gallbladder with marked common bile duct enlargement",
"B": "Distended gallbladder with prominent bile filling and extrahepatic duct dilatation",
"C": "Collapsed gallbladder without bile filling and no biliary dilatation",
"D": "Contracted gallbladder containing multiple calcified stones with i... | C | Imaging findings of the patient. (A,B) CT: No pathological findings were found. No dilatation of intrahepatic and external bile ducts was noted. There was no thickening or enhancement of extrahepatic bile ducts. The gallbladder is collapsed without bile filling; (C,D) MRCP: Possible stenosis at the beginning of the com... |
37cb29a5994d8f63c8c3c03bb8d6def0c29c478071707c3120c1d36ac15f2176 | In which breast is the enhancing lesion indicated by the arrows located, and where is it positioned relative to the chest wall? | [
"images/93/93275989a940656ce7be274522aa5746cd3898df81b6d0bf0349fc803c24d9b2.jpg"
] | {
"A": "Right breast, anterior and near the nipple",
"B": "Right breast, posterior and near the chest wall",
"C": "Central mediastinal tissue, immediately behind both breasts",
"D": "Left breast, posterior and near the chest wall",
"E": "Subcutaneous tissue of the abdominal wall below the breasts",
"F": "Le... | D | 62-year-old woman with family history of breast cancer who presented for high-risk screening breast MRI examination.
A, Axial early phase contrast-enhanced T1-weighted MR image of both breasts shows 5-mm irregular mass (arrow) with irregular margins and homogeneous internal enhancement, which was assessed as BI-RADS ca... |
07583fd2f65fea0aba27ac9588fcbda6a3fda460d79501a7ccc6b291e1c70062 | Which extremity and side are shown in this clinical photograph? | [
"images/f5/f5bad4272803d73faf1512cc295e19dfaad09bb77585731cb75bfbf1114ccda9.jpg"
] | {
"A": "Right lower limb",
"B": "Left upper limb",
"C": "Left lower limb",
"D": "Right upper limb"
} | A | Photograph of the patient’s right leg taken after a short course of palliative radiotherapy (20 Gy in 5 fractions) and three cycles of pembrolizumab. |
97a66d3e552a98af5048e6fb986783d026f30fdb0e6ad5252af7af63b51bc7eb | In the sagittal MRI in panel (a), where does the pelvic mass project? | [
"images/14/1449274069ebd49e3c8560045711b31c86100a5b78ee0142661a41d1a55136bd.jpg"
] | {
"A": "Into the peritoneal cavity",
"B": "Into the distal ureter",
"C": "Into the rectal lumen",
"D": "Into the inferior urinary bladder",
"E": "Into the sacral spinal canal",
"F": "Into the anal canal"
} | D | Imaging studies. (a) MRI revealed a prostatic tumor protruding into the bladder, with seminal vesicle invasion, and (b) positron emission tomography revealed multiple metastases to the para‐aortic lymph nodes, bones, and bilateral lung. (c) Cystoscopy revealed a non‐papillary tumor on the bladder neck. CT (d) before an... |
6cd71b1e8d4cf36aa6e90e03e52b316659baeec21e7c8e87393521ece68cf7d7 | The diagram depicts which preparative step immediately before the sample is labeled as chromatin? | [
"images/db/db9a9c9f249ce415fa2c7dab74cd9978b6b44dd7174c6a5807ee573437f0347f.jpg"
] | {
"A": "Micrococcal nuclease digestion",
"B": "Dialysis in TE buffer with 0.80 M NaCl",
"C": "Dialysis in TE buffer with 0.050 M NaCl",
"D": "Incubation in TE buffer with 1.0 M NaCl",
"E": "Addition of EDTA to stop nuclease activity",
"F": "Dialysis in TE buffer with 0.60 M NaCl"
} | C | The DNA and the histone octamers are combined in TE Buffer containing 1.0 M NaCl. Then, the histone-DNA mixture is dialyzed sequentially against TE Buffer containing 0.80 M, 0.60 M and 0.05 M NaCl. After dialysis, the quality of the resulting chromatin is assessed by subjecting a portion of the sample to micrococcal nu... |
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