AIIMS PG (DM/MCh) Entrance Radiology, Anesthesiology and Critical Care Syllabus

Radiology, Anesthesiology and Critical Care syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Radiology, Anesthesiology and Critical Care in AIIMS PG (DM/MCh) Entrance, not a summary of it.

1. 1

   Diagnostic and Interventional Radiology

   4 topics

   • Imaging Modalities
     • X-ray, CT and MRI physics and indications
     • Ultrasound and Doppler applications
   • System-based Imaging
     • Neuroimaging and chest radiology
     • Abdominal and musculoskeletal imaging
   • Interventional Radiology
     • Angiography and embolization
     • Image-guided biopsy and drainage
   • Nuclear Medicine and Radiation Safety
     • PET-CT and radionuclide scans
     • Radiation protection principles
2. 2

   Anesthesiology

   4 topics

   • Preoperative Evaluation and Airway
     • ASA classification and risk assessment
     • Difficult airway management
   • Anesthetic Agents and Techniques
     • Inhalational and intravenous agents
     • Regional and neuraxial anesthesia
   • Perioperative Monitoring
     • Hemodynamic and respiratory monitoring
     • Neuromuscular blockade and reversal
   • Pain Management
     • Acute postoperative analgesia
     • Chronic and cancer pain
3. 3

   Critical Care Medicine

   3 topics

   • Shock and Resuscitation
     • Sepsis and septic shock management
     • Fluid resuscitation and vasopressors
   • Respiratory Failure and Ventilation
     • ARDS and mechanical ventilation
     • Weaning and non-invasive ventilation
   • Organ Support and Monitoring
     • Renal replacement in the ICU
     • Nutrition and sedation protocols

Radiology, Anesthesiology and Critical Care flashcards for AIIMS PG (DM/MCh) Entrance

24 of 53 cards from the Radiology, Anesthesiology and Critical Care deck — real questions with worked answers.

1. What is the basic physical principle behind X-ray and CT image contrast?

   Differential attenuation of X-ray photons by tissues based on their density and atomic number; denser/higher-Z tissues (bone, contrast) attenuate more and appear whiter (radio-opaque).

2. What does the Hounsfield Unit (HU) scale measure, and what are the reference values for water and air?

   HU quantifies CT radiodensity relative to water. Water = 0 HU, air = -1000 HU. Bone is ~+1000 HU, fat ~ -100 HU, soft tissue ~+40 HU.

3. What is the fundamental difference in image generation between CT and MRI?

   CT uses ionizing X-rays and tissue attenuation; MRI uses a strong magnetic field plus radiofrequency pulses to excite hydrogen protons, with image contrast from T1/T2 relaxation. MRI involves no ionizing radiation.

4. On MRI, how do fat and water (fluid) appear on T1- vs T2-weighted images?

   T1: fat bright, water/fluid dark. T2: water/fluid bright, fat intermediate-to-bright. Mnemonic: 'WW2' - Water is White on T2.

5. Which imaging modality is the first-line/best for acute intracranial hemorrhage and why?

   Non-contrast CT - it is fast and acute blood appears hyperdense (bright). MRI is more sensitive for ischemia and chronic/small bleeds but slower.

6. What is the principle of ultrasound imaging and what is the piezoelectric effect's role?

   High-frequency sound waves are emitted and their echoes from tissue interfaces are detected. The piezoelectric crystal in the transducer converts electrical energy to sound and reflected sound back to electrical signals to form the image.

7. In Doppler ultrasound, what does the Doppler shift indicate?

   The change in frequency of reflected sound from moving blood/structures, used to measure direction and velocity of blood flow.

8. What is the typical first-line imaging investigation for suspected acute appendicitis in adults vs children/pregnant women?

   Adults: contrast-enhanced CT abdomen. Children and pregnant women: ultrasound first (to avoid radiation), with MRI as alternative if inconclusive in pregnancy.

9. What is the imaging modality of choice for staging most solid tumors and detecting metabolic activity?

   FDG-PET/CT - combines functional metabolic uptake (FDG glucose analog) with anatomic CT localization.

10. What is the recommended first-line imaging for suspected pulmonary embolism in a hemodynamically stable patient?

    CT pulmonary angiography (CTPA). V/Q scan is the alternative when CTPA is contraindicated (e.g., contrast allergy, renal impairment, pregnancy).

11. What chest X-ray sign indicates free air under the diaphragm and what does it suggest?

    Pneumoperitoneum - crescent of lucency under the diaphragm on erect CXR, suggesting hollow viscus perforation.

12. What are the classic CT findings of an ischemic stroke in the hyperacute vs subacute phase?

    Hyperacute (<6h): often normal or subtle - loss of grey-white differentiation, hyperdense vessel sign, insular ribbon sign. Subacute: well-defined hypodensity in vascular territory.

13. What is the imaging modality of choice for evaluating soft tissue, ligaments, spinal cord, and intracranial lesions?

    MRI - superior soft tissue contrast resolution.

14. What is the gold-standard imaging for coronary artery anatomy and the minimally invasive alternative?

    Gold standard: invasive coronary (catheter) angiography. Non-invasive alternative: CT coronary angiography (good negative predictive value).

15. Define interventional radiology (IR).

    A subspecialty using image guidance (fluoroscopy, US, CT) to perform minimally invasive diagnostic and therapeutic procedures, such as angioplasty, embolization, biopsy, drainage, and stenting.

16. What is the Seldinger technique?

    A method for percutaneous access to vessels/organs: needle puncture, pass a guidewire through the needle, remove the needle, then advance a catheter/sheath over the wire.

17. What is transarterial chemoembolization (TACE) used for?

    Locoregional treatment of hepatocellular carcinoma - delivers chemotherapy plus embolic particles into the tumor's feeding artery to cause ischemia and high local drug concentration.

18. What is a TIPS procedure and its main indications?

    Transjugular Intrahepatic Portosystemic Shunt - creates a channel between portal and hepatic veins to reduce portal hypertension. Indications: refractory variceal bleeding and refractory ascites.

19. What is uterine artery embolization used to treat?

    Symptomatic uterine fibroids (and postpartum hemorrhage) - embolic particles occlude uterine arteries to cause fibroid infarction.

20. What is the principle of nuclear medicine imaging?

    A radiopharmaceutical (radioisotope + targeting molecule) is administered, and emitted gamma radiation is detected by a gamma camera/PET scanner to map function/physiology rather than anatomy.

21. Which radioisotope is most commonly used in nuclear medicine and why?

    Technetium-99m - ideal 140 keV gamma energy, short 6-hour half-life, pure gamma emission (low radiation dose), and readily available from a Mo-99 generator.

22. What radiotracer is used in PET imaging and what does its uptake reflect?

    F-18 fluorodeoxyglucose (FDG) - a glucose analog whose uptake reflects metabolic/glycolytic activity, high in tumors, infection, and inflammation.

23. What is the radiotracer of choice for a thyroid scan and how is it used to differentiate hot vs cold nodules?

    Technetium-99m pertechnetate or radioactive iodine (I-123). Hot nodules concentrate tracer (usually benign/hyperfunctioning); cold nodules show no uptake (higher malignancy risk).

24. State the three core principles of radiation protection (ALARA).

    Time (minimize exposure duration), Distance (maximize distance - inverse square law), and Shielding (use lead/barriers). ALARA = As Low As Reasonably Achievable.

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