Rajat Jain MD (MAMC) DNB FRCR (UK)
Fellow, Body Imaging University of Ottawa, Canada Consultant and Head, Department of Radiology Primus Super Speciality Hospital Chanakyapuri,
New Delhi
Virendra Jain MBBS (UCMS) MD (MAMC) FRCR (UK)
Senior Resident Maulana Azad Medical College,
New Delhi
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Review of Radiology
First Edition: 2016
9789385999000
Printed at
3Dedicated to
Our mothers
Mrs Kanta Devi Jain and Mrs Sarla Jain
for their love and moral support
4Preface
Review of Radiology, the book is intended to help students in understanding the basic concepts of the subject with the help of images, who are preparing for the postgraduate medical entrance examination (PGMEE). It is a concise review of key radiology principles to help students not just in understanding radiology which they might have missed during their clinics in MBBS but also to help them in applications of imaging modalities for various clinical conditions like in medicine and surgery. Considering the changing pattern of exam and introduction of NEET at Pan India level, we feel that application-based questions are future of entrance exams at postgraduate level. We would like to state that, this book is not a substitute for comprehensive textbooks of radiology at any level, however, we have tried to cover all the commonly asked topics in entrance exams in a concise format so that students can finish the reading of this book in two days. Some facts are presented in the boxes on the side so that they can be easily revised in the end. We feel that after reading this book, a student preparing for postgraduate entrance examination will not feel the need to refer any other radiology books or courses.
This book is a concise and considerably shorter, still complete version than the full-length, standard radiology textbook. Most of this book evolved from the latest editions of Grainger and Sutton’s Textbooks of Radiology, CT and MRI imaging—Haaga and AIIMS- MAMC-PGI CME series. All the facts in the book are checked multiple number of times to give an accurate and up-to-date content to the students.
The material is organized into 4 sections and seven chapters. Section–A includes General Radiology (Chapter 1). Section–B includes, Neuroradiology (Chapter 2), Cardiothoracic Radiology (Chapter 3), Gastrointestinal and Genitourinary System (Chapter 4) and Musculoskeletal Radiology (Chapter 5). Section–C includes Radiotherapy and Chemotherapy (Chapter 6), and Nuclear Scans (Chapter 7) and one special Section–E for Image Based Questions exercise.
Difficult concepts are explained stepwise and in form of flowcharts with special high yield points in separate boxes adjacent to text wherever relevant. More than 150 images and more than 50 flow diagrams and tables will help the students not just to understand the text but also to memorize the material quickly in a way to aid in long-term retention.
Each chapter begins with a concise theory of each topic, followed by multiple-choice questions (MCQs) and their clear, concise, proper explanations with references of the standard textbooks and/or, research papers wherever required to avoid repetition of the text. Various states PG, AIIMS and JIPMER examination questions had been separated from PGI questions, so that the students can easily concentrate different examinations according to their choice.
Each chapter has high yield points in the boxes which are predicted and highly expected new questions for future examination, based on current examination pattern.
Section-E, The IBQ section would definitely help the students in preparing for the different types of questions based in images expected to be asked in the examination. 5The online pool of questions is going to be a backbone for the preparation of IBQs in any examination not just for radiology but for other subjects too.
Finally the Section-D has a collection of important factual information of radiology including the investigations of choices, important systemic signs and important principles of radiology which might be helpful to solve questions from any clinical subject if understood rightly.
How to Read this Book
The best way to read this book is to read the theory given at the beginning of the chapter first and then solve the MCQs. The MCQs of a particular system are arranged randomly without mentioning the years. Absolute care has been taken to avoid repetition of the MCQs as lots of time is wasted in solving the same MCQ again and again. We want to stress on this fact that nowadays in the exams, same questions are not repeated but same topics are repeated and hence students are advised to focus more on the theoretical concepts rather than just MCQs. It is this reason that, deliberately years of the questions and superscript on important lines have not been put as we believe that each line written is a potential MCQ. We suggest that section A, C and D should be read together where section C should be read in associating with other clinical subjects like medicine, surgery, orthopedics, pediatrics, gynecology-obstetrics as they are interlinked.
We wish that our students will go through this book thoroughly and will do excellent in their examinations.
Best wishes for your postgraduate medical entrance examination. Your queries and feedback will always be welcomed. You are free to contact at email: reviewofradiology@gmail.com
Rajat Jain
Virendra Jain
6Tips for Winners
- Confidence is the key to success. Believe in yourself because if you won’t nobody else will.
- Don’t be daunted by the efforts others put in because everybody is a different person and you only can find a pace and method to prepare that is conducive to exclusively yourself and thus maximizes your potential.
- Never believe a person who says that you can’t do something. People will tell you certain things can’t be done when they can’t do them themselves.
- Studying smarter than others is much more important than studying harder when it comes to competitive exams.
- It is a level playing field… so forget your past performances whether good or bad because in the end everybody is preparing for the same one day game. Hence, it is important to take your best shot on that very day.
- It is never too late to start, seriously. There are a large number of success stories of people who started out late. However, the sooner the better still holds good even for those people especially in a rank based system.
- Never doubt yourself and your capabilities. Even the brightest of minds have their episodes of insecurity and uncertainty. In such times try this technique. Close your eyes and recall a past episode during which you were under stress and you handled it well, exceeding your own expectations. The feeling of being in control will return your confidence in no time and the doubt will vanish.
- BEG/BORROW/STEAL/KILL/ROB OR LOOT… but always lay your hands on the question papers of the previous few years because even if none of the questions are repeated (of which there is a slim chance of happening), you’ll at least be familiar with the pattern and the type of questions asked in that exam.
- Weeks before the exam, have an honest conversation with yourself, reassure yourself about your preparation and come to terms with the lacunae. A day before the exam, reassess the state and decide how much you expect from the exam..
- Get adequate rest, starting a week before exam… large multicentric studies have proven that it is common sense to.
- While taking the exam, take your time while marking each answer because it is marked in ink. And one wrong question takes away more than even leaving one at the end. So take your time while answering. This is where the importance of practice tests lie.
- Guessing is a tricky game. Exclude all the choices you are SURE can not be the answer then mark your favorite letter!! In cases of all choices being new, go for the first one you think is the answer. Apart from saving time most often changing your mind leads to a wrong answer.
- Personally I don’t believe in leaving any question unmarked, but it is a personal decision and should heavily depend on the state of rest of the paper and number of unmarked answers.
Cool Quotes (to be Read when on a Break)
- Motivation will almost always beat mere talent.
- A mind troubled by doubt cannot focus on the course to victory.
- Do what you can, with what you have, where you are.
- Many of life’s failures are people who did not realize how close they were to success when they gave up.
- The art of being wise is knowing what to overlook.
- Obstacles are those frightful things you see when you take your eyes off your goal.
- Too many people overvalue what they are not and undervalue what they are.
- Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending.
- The real contest is always between what you’ve done and what you’re capable of doing. You measure yourself against yourself and nobody else.
- The difference between a successful person and others is not a lack of strength, not a lack of knowledge, but rather a lack of will.
- According to aerodynamic laws, the bumblebee cannot fly. Its body weight is not the right proportion to its wingspan. Ignoring these laws, the bee flies anyway.
- The mind is like a parachute—it works only when it is open.
- Yesterday is a cancelled check; Tomorrow is a promissory note; Today is the only cash you have, so spend it wisely.
- Never mistake knowledge for wisdom. One helps you make a living, the other helps you make a life.
- The more I want to get something done, the less I call it work.
- The secret of success is to do the common things uncommonly well.
- Hard work beats talent when talent doesn’t work hard.
- Successful and unsuccessful people do not vary greatly in their abilities. They vary in their desires to reach their potential.
- You must do the very thing you think you cannot do.
- Your goal should be out of reach but not out of sight.
First of all, I (Rajat Jain) would like to thank my wife, Dr Ananta Khurana for her constant and unconditional support and also for taking care of my cute little daughter almost single handedly at this time. My special thanks to my elder daughter, Anushka and just born daughter Ahaana.
Very special thanks to my dear friend, Dr Nishith Kumar for helping me at each step during the writing of this book
A very special thanks to my dear friends, collegues and seniors Dr Thameem Saif, Dr Apurv Mehra, Dr Devesh Mishra and Dr Praveen Kumar for literally pushing me to write this book.
A very special thanks to Dr Mukesh Bhatia (Director, Dr Bhatia Medical Institute), Mr Rajesh Sharma (Director, PG-DIAMS), Dr Vineet Gupta (Director, MIST) and Dr Sukreet Sharma (Director, IAMS) for believing in me and giving me the opportunity to interact with the students and understanding my potential to be of some help to students in achieving their dream.
A special thanks to our respected teachers who have taught us enough radiology so that we are able to reach to this level to help the students in their Endeavour. The list is endless but the names that need special mention are:
Dr Veena Chowdhury (Ex-Director, GB Pant Hospital and HOD Radiology, MAMC, New Delhi)
Dr Anju Garg (HOD Radiology, MAMC, New Delhi)
Dr BB Thukral (HOD Radiology, VMMC, New Delhi)
Dr Lalendra Upreti (HOD Radiology, UCMS, New Delhi)
Dr Rama Anand (HOD Radiology, Lady Hardinge Hospital, New Delhi)
Dr UC Garga (HOD Radiology, RML Hospital New Delhi)
Dr Anjali Prakash (Faculty, MAMC, New Delhi)
Dr Rashmi dixit (Faculty, MAMC, New Delhi)
Dr Alpana Manchanda (Faculty, MAMC, New Delhi)
D Gaurav Pradhan (Faculty, MAMC, New Delhi)
Dr Sapna Singh (Faculty, MAMC, New Delhi)
Dr Jyoti Kumar (Faculty, MAMC, New Delhi)
Dr MK Mittal (Faculty, VMMC, New Delhi)
Dr Atin Kumar (Faculty, AIIMS, New Delhi
Dr Deepak Gupta (Director Radiology, Saroj Hospital, New Delhi)
We would also like to thank Dr OP BANSAL, president, Indian Radiological Imaging Association and the entire team of Delhi state branch with a special mention of Dr Upreti, Dr Atin, Dr Raghav, Dr Pankaj and Dr Lalchandani for giving us the opportunity to enhance our teaching skills by giving us the opportunity to deliver talks in various conferences at state and national level.
9We would also like to thank our other co-faculties with whom we have a lot of healthy discussions about exam including MCQs, changing pattern of exam and lot of other mischievous talks during waiting for the flight at the airport, in the flight, dinner discussions after the long class. Again, we would like to mention few names here:
Dr Rajesh Kaushal, Anatomy
Dr Ashwini, Anatomy
Dr Ashish, Physiology
Dr Ankur, Biochemistry
Dr Devesh Mishra, Pathology
Dr Praveen kumar, Pathology
Dr Akhilesh Jhamad, Forensic Medicine, Microbiology and Dermatology
Dr Gobing Rai Garg, Pharmacology
Dr Ranjan Kumar Patel, Pharamcology
Dr Saurabh, Pharmacology
Dr Vivek Jain, PSM
Dr Manisha, ENT
Dr Ray, Ophthalmology
Dr Thameem Saif, Medicine
Dr Deepak Marwah, Medicine
Dr Shubham Vats, Medicine
Dr Pritesh Singh, Surgery
Dr Tiwari, Surgery
Dr Vineet Gupta, Surgery
Dr Harmeet, Gyne & Obstetrics
Dr Vij, Gyne & Obstetrics
Dr Meenakshi, Pediatrics
Dr Apurv Mehra, Orthopedics
Dr Amit kohli, Anesthesia
Dr Manish Soni, Dermatology
Dr Dharmedra, Psychiatry
Dr Shivani jain, Ophthalmology
Dr Praveen Tripathi, Psychiatry
We are also very thankful to following coordinators for encouraging us and highlighting our positive and negative points during our teaching sessions for constant improvement.
Dr Chintan, Rajkot
Dr Neeraj, Kolkata
Dr Praneet, Hyderabad
Dr Rajeshwar Gudade, Nagpur
Mr Ajay Sharma, Ahmedabad
Mr Alok and Shivlok, Bihar and Jharkhand
Mr Anil, Mumbai
Mr Anupam, Chandigarh
Mr Dhruv Kharbanda, Lucknow
Mr Moin, Banglore
Mr Rahul, Hyderabad
Mr Rajeev Sharma, Chennai
Mr Abhishek Dubey, Bhopal
I (Virendra Jain) would like to acknowledge and thank my family for having the patience with me and supporting throughout especially my father (G.L Jain) and my brothers (Devender and Narendar Jain), who gave me encouragement in their particular way.
I would also like to thank my Seniors, Dr. Naveen Bhardwaj and Dr. Manoj Middha, who have always supported me throughout my career and authoring this book and I really appreciate it.
It is a great pleasure to acknowledge the inspiration and help of my colleagues (Kanav Kaushal and Sahil Batra) and seniors in my department for their constant help and support and my juniors (Amar, Vinayaga and Sanchit) who always were ready to help me whenever I asked for.
We would like to thank Mr Jitendar P Vij (Group Chairman) of Jaypee Brothers Medical Publishers (P) Ltd. for enabling me to publish this book. We would also like to thank Mr Rakesh Sheoran for helping us in the process of selection and editing.
Last but the most important, we would like to thank all our students who have been our inspiration and support for writing this book.
Rajat Jain
Virendra Jain
11Suggested Time-Table for Preparation in One Year
Dear Friends, there is no limit of reading as knowledge never goes waste however, being passed through the same phase and also by performing decently in exam we have realized that you can crack this exam by combined knowledge of all the 19 subjects rather than being a master of three subjects and leaving 3 subjects.
We suggest that you should have ample time to revise the topics before the exam and in the initial part of the preparation, more time should be spent on building up the concepts whereas factual parts should be kept for revision as your concepts will stay with you but facts need to be strengthen again and again. We believe that every student should follow his own time-table but we are giving a suggested time-table based on the importance of the subject in the postgraduate exam and we encourage students to use this as a baseline with individualization, depending upon the needs.
S. No. | Subject | No of days |
---|---|---|
1. | Anatomy | 8 |
2. | Physiology | 8 |
3. | Biochemistry | 10 |
4. | Pathology | 20 |
5. | Microbiology | 7 |
6. | Pharmacology | 15 |
7. | Forensic Medicine | 3 |
8. | Community Medicine | 15 |
9. | ENT | 7 |
10. | Ophthalmology | 10 |
11. | Medicine | 27 |
12. | Surgery | 25 |
13. | Gynecology and Obstetrics | 20 |
14. | Pediatrics | 10 |
15. | Orthopedics | 3 |
16. | Skin | 3 |
17. | Anesthesia | 3 |
18. | Psychiatry | 3 |
19. | Radiology | 3 |
200 |