Sample Questions from 2005 Examination
Specimen Examination from 2001
The following are examples of questions, which were used or were in the final selection list for the 2001 examination for the Diploma of The European College of Veterinary Diagnostic Imaging.
Theoretical Part
Multiple choice / matching questions
In 2001, candidates were given 100 questions, to be answered in 5 hours
Example
An increase in transducer ultrasound frequency primarily:
A ___ Improves axial resolution
B ___ Improves lateral resolution
C ___ Increases the beam width in the focal region
D ___ Increases the duty factor
E ___ Increases the pulse length
The correct option in this case is "A". For this question type the options are listed in alphabetical order, there is only one correct answer; the false options may "sound" plausible but are incorrect beyond dispute.
Short answer question:
In 2001, candidates were given 5 hours to provide written answers to 20 questions in this section:
Example 1:
What are the radiographic signs of hyperparathyroidism?
Example 2:
Explain briefly the following diagnostic ultrasound artifacts:
a) acoustic shadowing
b) acoustic enhancement
c) mirror image artifact
d) side lobe artifact
e) reverberation
f) comet-tail
Comment: In order to gain full marks in this question the candidate was expected to state the situation(s) where each of the above may arise, describe its appearance on the image and give an explanation of the physical principal(s) involved.
Practical film reading
Written examination:
In 2001, candidates were given a series of 12 cases (may contain a number of images and or modalities) and were asked to provide a structured written report including
a) species, approx. age, sex, region examined, and, very brief, technical flaws
b) description of imaging sets, concentrating on abnormal findings
c) summary of pertinent findings
d) imaging diagnosis and relevant differentials
e) recommendations for further workup and case management, emphasizing imaging procedures
No clinical history or information was provided. Three hours were allotted to this task.
Example
Please note there is a substantial loss of quality in formatting images for web display. Clicking the images will open a larger version.
Candidates were given two radiographs and a 2 minute video clip from an ultrasound examination.
They were asked to provide a written report as detailed above
Specimen Answer
Patient details/radiographic information:
-
Canine, skeletally mature, good body condition, male
Radiographs right recumbent lateral and ventro-dorsal views abdomen
No technical faults identified
Ultrasound "clip" from cranial abdomen : Mainly midline sagittal
Description of imaging sets:
Radiographs:
There is a uniform soft tissue opacity in the cranial abdomen. This has a well defined smooth serosal margin caudally. It has a folded or compartmentalized appearance and extends from the cranial extremity of the abdomen caudally beyond the costal arch. It silhouettes with or is part of the gastric wall in the ventral abdomen where gas within the pylorus can be identified. This gastric gas is normal in position. There is displacement (mass effect) of small intestinal loops caudally and to the right and displacement of the transverse colon caudally.
The right kidney cannot be identified on these films.
The mass probably represents an enlarged stomach. This may be fluid filled or may be due to mural thickening.
Diffuse hepatic enlargement is less likely, due to absence of gastric displacement, but focal hepatic enlargement is possible
Pancreatic mass is least likely left limb may cause displacement of the transverse colon but deformation of the gastric axis might be expected as may some loss of serosal detail in certain cases.
Ultrasound "video clip"
The area of the scan is identified as cranial abdomen as the transducer is fanned to show area of normal liver. Caudal to the liver a thick walled (2 cm) structure is seen. This contains a highly echogenic interphase following the pattern typical of gastric rugal folds. The gastric wall is hypoechoic relative to serosal fat and does not have a discernable layered appearance. The gastric wall is of uniform width over all the areas imaged on this clip.
Conclusion:
This mass represents an abnormal stomach. There is a diffuse thickening of the gastric wall. The stomach is empty but for a small quantity of gas.
Imaging diagnosis and relevant differentials
Radiographic Imaging study:
- Diffuse Gastric mass/Thickening/infiltrate/dilation
- Adenoarcinoma
- Lymphoma
- Leiomyosarcoma
- Non neoplastic infiltrate:
- Eosinophils
- Hepatic mass (left sided)
- Lymph node enlargement
- Pancreatic mass / cyst
Refined differential after Ultrasound examination
- Gastric lesion diffuse
- Adenoarcinoma
- Lymphoma
- Leiomyosarcoma (usually more focal)
- Non neoplastic infiltrate
- Eosinophils
- Inflammatory
Further studies
- Ultrasound guided Biopsy FNAB
- Gastroscopy - mucosal surface
- Thoracic radiographs R& L lat (possibly DV/VD) met check.
- Mention role of imaging in management
- Monitor response to treatment/progression/search for metastasis
Oral examination
In 2001, candidates were given a series of 5 cases (which may contain a number of images and or modalities) and were asked to provide an oral/verbal report on these. This oral report should follow the format of the written report and in addition the candidate should describe how they are assessing the films, their methods and the criteria they apply for for the abnormal findings they report.. One hour was allotted to this task. In order to maintain an impartial and uniform examination all candidates received the same films in the same order. No clinical history or clinical or other findings were given to the candidates for any of the cases. No free discussion was entered into; questions were asked only if the examiner leading the case was unclear about or did not hear, what was said. The intention, in the interests of fairness and uniformity, was to give no feedback during the examination, either positive or negative to any statement made.
Marking
For both the written and oral practical examination marks were allotted following a standardized scheme for key points in each component part of the report. In awarding marks, account was taken of the reasoning the candidate gave for exclusion, inclusion and prioritization of the various differentials and for other areas where value judgments were required.
