Radiology most important signs sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)

Earliest radiological sign of Pulmonary Venous Hypertension in Chest X-ray is:
A: Cephalization of pulmonary vascularity
B: Pleural effusion
C: Kerley B lines
D: Alveolar pulmonary edema
Correct Ans:A
Explanation
The first radiographic sign of pulmonary venous hypertension is cephalization of the
pulmonary vessels due to pulmonary vein and artery dilatation.
In the normal individual, there is continuous passage of fluid from the pulmonary veins into
adjacent interlobular lymphatics that return the fluid to the central mediastinal veins. If the
lympatic reserve is overcome by increased transudate as a result of elevated pulmonary
venous pressure, the interlobular septa are thickened and become visible radiographically.
The first radiologic sign of pulmonary venous hypertension is cephalization of the
pulmonary vessels.
Ref: Atlas of Pulmonary Vascular Imaging By Conard Wittram, Page 51; Textbook of
Radiology and Imaging By David Sutton, 5th Edition, Pages 288-89
Sample Previous Year Question on Radiological Signs based on previous Year
Questions of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit
www.medicoapps.org for more such Quizzes
A 8 year old boy is being treated for rickets. Which of the following investigations shows
the earliest evidence for healing?
A: Serum Ca
B: Serum phosphates
C: Radiological examination of long bones
D: Serum ALP
Correct Ans:C
Explanation
The earliest feature of healing in rickets is seen in X ray of growing end of the bones.

Allergic reactions to radiological contrast agents are:
A: Anaphylactic reactions
B:
IgE mediated
reactions
C: Urticaria
D: Edema
Correct Ans:A
Explanation
In radiological imaging it is usually believed that the adverse effects of contrast media are
non-IgE mediated anaphylactoid reactions, as a result of released vasoactive amines
(histamine, serotonin, etc) which trigger the mast cells directly. Since anaphylactoid
reaction is not given in the choice, anaphylactic reaction may be the right choice.
Ref: Encyclopedia of Diagnostic Imaging By Albert L Baert Pages 44-46
Which radiological procedure is used for studying vesico-ureteric reflux?
A: Ascending pyelogram
B:
Cystogra
m
C: Intravenous urogram
D: Micturition cystourethrogram
Correct Ans:D
Explanation
The diagnosis of vesico ureteric reflux is made using micturition cystourethrogram. Other
techniques used in diagnosing vesico ureteric reflux are simple or delayed cystography or
voiding cinefluoroscopy.
In a case of vesico ureteral reflux, cystogram may show one of the following findings:
Persistently dilated lower ureter, areas of dilatation in the ureter, ureter visualized
throughout its entire length shows, presence of hydroureteronephrosis with a narrow
juxtavesical ureteral segment or changes of healed pyelonephritis.

Ref: Smith's General Urology, 17e, Chapter 12
Radiological appearance of ‘thimble’ bladder is seen in the following condition:
A: Cystitis cystica
B: Chronic tuberculous cystitis
C: Neurogenic bladder
D: Acute tuberculous cystitis
Correct Ans:B
Explanation
Early tuberculosis of the bladder commences around the ureteric orifice or trigone, the
earliest evidence being pallor of the mucosa due to submucosal oedema. Subsequently,
tubercles may be seen and, in long standing cases, there is marked fibrosis and the capacity
of the bladder is greatly reduced giving the radiological appearance of ‘thimble bladder’.
Ref: Bailey & Love's Short Practice of Surgery 26E edited by
Norman Williams, Christopher Bulstrode, P Ronan O'Connell,
2013, Page 1327-1328
Routine radiological examination of a middle aged man shows "Spongy appearance" with
central sunburst calcification. This is seen in:
A: Pancreatic adenocarcinoma
B: Mucinous cystadenocarcinoma
C: Somatostatinoma
D: Serous cystadenoma
Correct Ans:D
Explanation

Serous cystadenoma is a rare solitary, benign cystic neoplasm of the pancreas. It consists of
multiple small locules lined by cuboidal epithelium, the cells of which contain abundant glycogen (also
called microcystic, serous, and glycogen-rich cystadenoma).
Radiological appearance of serous cystadenoma of pancreas shows characteristic central sunburst
calcificationwhich is pathognomonic.
Ref: The Pancreas: An Integrated Textbook of Basic Science, Medicine, and Surgery
edited by Hans-Gunther Beger, Markus Buchler, Richard Kozarek, Markus Lerch, John
Neoptolemos, Andrew Warshaw, David Whitcomb, Keiko Shiratori, 2009, Page 933.
Which of the following is the radiological finding of a benign gastric ulcer?
A: Hampton line
B: Collar at the neck of the ulcer
C: Projection from the lumen of the stomach
D: All of the above
Correct Ans:D
Explanation
The radiographic features that suggest a benign gastric ulcer include,
• Projection from the lumen of the stomach
• Smooth lucent line (Hampton line) or collar at the neck of the ulcer
• Normal rugal folds that radiate to the edge of the ulcer collection
• Complete and permanent healing of the ulcer on repeat radiographic or
endoscopic examination of the stomach
If at least two or more of these findings are present, a
confident radiographic diagnosis of benign gastric ulcer is
possible.
Ref: Ott D.J. (2011). Chapter 10. Gastrointestinal Tract. In M.Y. Chen, T.L. Pope, D.J. Ott
(Eds), Basic Radiology, 2e.
Which of the following statements best describes 'Background Radiation'?

A: Radiation in the background of nuclear reactors
B: Radiation in the background during radiological investigations
C: Radiation present constantly from natural sources
D: Radiation from nuclear fall out
Correct Ans:C
Explanation
Background radiation refers to those coming from the environment of natural radioactivity
at the earths surface and the those from direct cosmic radiation that arrives at the earths
surface.
Ref: Radiation Biophysics By Edward L. Alpen, Page 432; The Biological Basis of Nursing :
Cancer By William T. Blows, Page 54, 56
A 43 year old male during the preoperative evaluation of hernia repair is found to have a
solitary pulmonary nodule. What is the important radiological feature to suggest its benign
nature?
A: Large lesion with calcification
B: Irregular shape
C: No calcification
D: 1 cm lesion with uniform calcification
Correct Ans:D
Explanation
The important radiological characteristics to suggest benign lesion in solitary pulmonary
nodule:
• No growth in follow up imaging in two years and calcification
• Younger age group
• Regular shape
• Normal edge
Ref: Lange radiology, Edition - 7, Page - 256.

Which of the following radiological sign will be present in a young lady with symptoms
suggestive of pulmonary embolism?
A: Hampton's hump
B:
Westermark
sign
C: Fleischner sign
D: All of the above
Correct Ans:D
Explanation
Pulmonary infarction may occur if the pulmonary venous pressure is elevated or the
bronchial arterial supply to a region is deficient. The cone-shaped area of pulmonary
infarction has been called a Hampton's hump. An area of radiolucency, corresponding to
diminished pulmonary vascularity distal to a pulmonary embolism, is occasionally seen and
is called the Westermark sign. There may also be an increase in the size of the pulmonary
artery proximal to a large central pulmonary embolus (Fleischner sign).
Ref: Chiles C., Gulla S.M. (2011). Chapter 4. Radiology of the Chest. In M.Y. Chen, T.L. Pope,
D.J. Ott (Eds), Basic Radiology, 2e.
All of the following are radiological signs of scurvy, EXCEPT:
A: Trimmerfeld zone
B:
Frenkel's
line
C: Pelican spur
D: Soap bubble appearance
Correct Ans:D
Explanation
Ascorbic acid is essential for the hydroxylation of lysine and proline in collagen, hence the
impairment in wound healing. Collagen is an important part if bone also, so the defect in

bones occurs.
Soap bubble appearence in the xrays is usually seen in osteoblastoma and in gaint cell
tumour.
Ref: Terry Yochum, Lindsay Rowe (2005), Chapter 14, “Nutritional, Metabolic and Endocrine
disorders”, In the Book, “Essentials of Skeletal Radiology”, Volume 1, 3rd Edition, USA,
Page 1517 ; Text Book of Radiology and Imaging By Sutton, 7th Edition, Page 1356
Which of the following condition gives the characteristic radiological finding "bone within a
bone" appearance?
A: Osteogenesis imperfecta
B:
Osteopetrosi
s
C: Scurvy
D: Rickets
Correct Ans:B
Explanation
Radiologic examination of osteopetrosis shows increased bone density and transverse
bands in the shafts, clubbing of ends, and vertical striations of long bones. Thickening
about the cranial foramina is present, and heterotopic calcification of soft tissues is
possible. Other characteristic findings include a miniature bone inset within each vertebral
body (bone-within-a bone appearance) and increased density at the end plates (sandwich
vertebrae).
Ref: Clinical Imaging: An Atlas of Differential Diagnosis By Ronald L. Eisenberg, 2012, Page
1088.
20 years old female with complaints of nausea, vomiting, dizziness and pain in the legs. Her
physical examination and all lab investigations and radiological investigations are normal.
What would be the most probable diagnosis?

A: Generalized anxiety disorder
B:
Conversion
disorder
C: Somatoform pain disorder
D: Somatisation disorder
Correct Ans:D
Explanation
Here the patient presents with multiple, medically unexplained symptoms (MUS). This is an
example of Somatisation Disorder. In somatoform pain disorder the major symptom will be
unexplained chronic pain, which is usually isolated. Patients have a long history of
complaints of severe pain out of proportion to any biomedical findings that are present.
Exacerbations and remission of complaints correlate with psychogenic factors
The term somatization refers to the experience and reporting of physical symptoms that
cause distress but lack a corresponding level of tissue damage or pathology and are linked
to psychosocial stress.
In contrast to this broad and inclusive view of the process, psychiatrists have developed
strict diagnostic criteria that define several distinct disorders, which are collectively
referred to as the somatoform disorders. As such, clinicians should be careful to distinguish
between somatization, as defined above, and somatization disorder, which is one type of
somatoform disorder. In general, these conditions are chronic and reflect an enduring way
for the affected individuals to cope with psychosocial stressors.
Ref: Shim J., Eisendrath S.J. (2008). Chapter 25. Somatization. In M.D. Feldman, J.F.
Christensen (Eds), Behavioral Medicine: A Guide for Clinical Practice, 3e.
Radiological examination shows evidence of bone infarct in a child. She may have the
following condition:
A: Iron deficiency anaemia
B:
Thalassemi
a
C: Sickle cell disease
D: Hereditary spherocytosis
Correct Ans:C
Explanation
Sickle cell disease is frequently associated with bone infarction resulting from
vasoocclusion secondary to the sickling of red cells. Bone infarction also occurs in
hemoglobin sickle cell disease and sickle cell thalassemia. The bone pain in sickle cell crisis
is due to bone and bone marrow infarction.

In children, infarction of the epiphyseal growth plate interferes with normal growth of the
affected extremity. Radiographically, infarction of the bone cortex results in periosteal
elevation and irregular thickening of the bone cortex. Infarction in the bone marrow leads
to lysis, fibrosis, and new bone formation.
Ref: Langford C.A. (2012). Chapter 336. Arthritis Associated with Systemic Disease, and
Other Arthritides. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J.
Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
A 65-year-old man develops oliguria and peripheral edema over a period of weeks.
Urinalysis reveals hematuria and proteinuria; examination of the urinary sediment reveals
red cell casts. Radiological and ultrasound studies fail to demonstrate an obstructive lesion.
Renal biopsy shows many glomerular crescents. This presentation is most suggestive of
which of the following conditions?
A: Anti-glomerular basement membrane disease
B: Diabetic nephropathy
C: Hypertensive nephropathy
D: Lupus nephritis
Correct Ans:A
Explanation
The two principal causes of rapidly progressive glomerulonephritis are anti-glomerular
basement membrane (including both Goodpasture's syndrome and isolated anti-glomerular
basement disease) and primary systemic vasculitis (including Wegener's granulomatosis,
microscopic polyarteritis, idiopathic rapidly progressive glomerulonephritis, Churg-Strauss
syndrome, polyarteritis nodosa, giant-cell arteritis, and Takayasu's arteritis). A very large
variety of other systemic and primary glomerular disease may occasionally cause rapidly
progressive glomerulonephritis, but this is usually not the typical presentation for these
diseases.
Diabetic nephropathy typically begins with microalbuminuria and hypertension and
progresses over a 10 to 20 year period to renal failure.
Hypertensive nephropathy due to essential hypertension typically presents with slowly
rising BUN and creatinine; hypertensive nephropathy due to malignant hypertension
presents with more rapidly rising BUN and creatinine.
Lupus nephritis can have many presentations, but the most typical is proteinuria, which
may be severe enough to cause nephrotic syndrome. Also, 90% of cases of systemic lupus

erythematosus occur in women, usually of childbearing age.
Ref: Lewis J.B., Neilson E.G. (2012). Chapter 283. Glomerular Diseases. In D.L. Longo, A.S.
Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of
Internal Medicine, 18e
Which of the following condition is associated with radiological ‘Spalding sign'?
A: Mummification
B:
Maceratio
n
C: Hanging
D: Drowning
Correct Ans:B
Explanation
‘Spalding sign' is a sign of maceration. Loss of alignment and overriding of the bones of the
cranial vault occur due to shrinkage of the cerebrum can be seen in X-ray after death of the
foetus. The sign will develop earlier with a vertex presentation than with a breech. It may
be detected within a few days of death of the foetus.
Signs of dead birth other than maceration are rigor mortis at delivery and mummification.
Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 27th edition,
Page 382-383.
What is the ICRP (International Commission on Radiological Protection)
recommended genetic dose of radiation exposure for general population?
A: 5 rems over a period of 30 years
B: 30 rems over a period of 30 years
C: 5 rems over a period of 5 years
D: 30 rems over a period of 5 years

Correct Ans:A
Explanation
ICRP recommends that genetic dose to population should not exceed 5 rems over
a period of 30 years.
Ref: Park’s textbook of Preventive and Social Medicine, 21st edition, page-687
One of the following disease will show urinary bladder calcification radiologically which
resembles fetal head in pelvis:
A: Tuberculosis
B: Schistosomiasis
C: Chronic cystitis
D: Malignancy
Correct Ans:B
Explanation
A plain film of the abdomen may show areas of grayness in the flank (enlarged
hydronephrotic kidney) or in the bladder area (large tumor). Opacifications (stones) may
be noted in the kidney, ureter, or bladder. Linear calcification may be seen in the ureteral
and bladder walls. Punctate calcification of the ureter (ureteritis calcinosa) and a
honeycombed calcification of the seminal vesicle may be obvious. The classic presentation
of a calcified bladder, which looks like a fetal head in the pelvis, is pathognomonic of
chronic urinary schistosomiasis.
Ref: Tanagho E.A., Kane C.J. (2008). Chapter 14. Specific Infections of the Genitourinary
Tract. In E.A. Tanagho, J.W. McAninch (Eds), Smith's General Urology, 17e.
All of the following are correct statements about radiological evaluation of a patient with
Cushing's syndrome, EXCEPT:
A: MRI of the sella tursica will always identify a pituitary cause for Cushing's syndrome

B:
Petrosal sinus sampling is the best way to distinguish a pituitary
tumor from an ectopic ACTH producing tumor
C: MRI of the adrenals may distinguish adrenal adenoma from carcinoma
D:
Adrenal CT scan distinguished adrenal cortical hyperplasia from
an adrenal tumor
Correct Ans:A
Explanation
Most ACTH-secreting pituitary tumors are <5 mm in diameter, and about half are undetectable by
sensitive MRI. So MRI is not a useful investigation in identifying pituitary cause of Cushing's
syndrome.
Ref: Harrison’s Internal Medicine, 18th Edition, Chapter 339; CURRENT Diagnosis and Treatment:
Surgery, 13th Edition, Chapter 33
Radiological appearance of ‘corkscrew oesophagus’ is a characteristic finding seen in the
condition:
A: Achalasia cardia
B: Diffuse esophageal spasm
C: Carcinoma esophagus
D: Reflux oesophagitis
Correct Ans:B
Explanation
The lower esophageal sphincter in patients with diffuse esophageal spasm (DES) usually
shows a normal resting pressure and relaxation on swallowing. A hypertensive sphincter
with poor relaxation may also be present. In patients with advanced disease, the
radiographic appearance of tertiary contractions appears helical, and has been
termed corkscrew esophagus or pseudodiverticulosis. Patients with segmental or diffuse
esophageal spasm can compartmentalize the esophagus and develop an epiphrenic or mid
esophageal diverticulum between two areas of high pressure occurring simultaneously.
Ref: Jobe B.A., Hunter J.G., Peters J.H. (2010). Chapter 25. Esophagus and Diaphragmatic
Hernia. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews,
R.E. Pollock (Eds), Schwartz's Principles of Surgery, 9e.

A 50 year old female is admitted with abdominal pain and anuria. Radiological studies
revealed bilateral impacted ureteric stones with hydronephrosis. Urine analysis showed
RBCs with pus cells in urine. Serum creatinine level was 16 mg/dl and urea level was 200
mmol/1. Which of the following should be the immediate treatment?
A: Hemodialysis
B: 'J' stent drainage
C: Lithotripsy
D: Ureteroscopic removal of stones
Correct Ans:B
Explanation
This is the best modality of treatment to immediately revert anuria in patients with bilateral
obstructing renal stone. Stenting can be done in other scenarios such as pyelonephritis due
to obstructed stone, severe renal colic, long term obstruction.
Ref: Urinary Stone Disease : The Practical Guide to Medical and Surgical Management By
Marshall L. Stoller, Maxwell V. Meng, 2007, Page 475
A 50 year old female is admitted with abdominal pain and anuria. Radiological studies
revealed bilateral impacted ureteric stones with hydronephrosis. Urine analysis showed
RBCs with pus cells in urine. Serum creatinine level was 16 mg/dl and urea level was 200
mmol/1. Which of the following should be the immediate treatment?
A: Hemodialysis
B: 'J' stent drainage
C: Lithotripsy
D: Ureteroscopic removal of stones
Correct Ans:B
Explanation
'J' stent drainage is the best modality of treatment to immediately revert anuria in patients
with bilateral obstruction of renal stone. Stenting can be done in other scenarios such as
pyelonephritis due to obstructed stone, severe renal colic, long term obstruction.

All of the following are correct statements about radiological evaluation of a patient with
Cushing's syndrome, EXCEPT:
A: MRI of the sella tursica will always identify a pituitary cause for Cushing's syndrome
B:
Petrosal sinus sampling is the best way to distinguish a pituitary
tumor from an ectopic ACTH producing tumor
C: MRI of the adrenals may distinguish adrenal adenoma from carcinoma
D:
Adrenal CT scan distinguished adrenal cortical hyperplasia from
an adrenal tumor
Correct Ans:A
Explanation
Most ACTH-secreting pituitary tumors are <5 mm in diameter, and about half are undetectable by
sensitive MRI. So MRI is not a useful investigation in identifying pituitary cause of Cushing's
syndrome.
Ref: Harrison’s Internal Medicine, 18th Edition, Chapter 339; CURRENT Diagnosis and Treatment:
Surgery, 13th Edition, Chapter 33
Which of the following is the best radiological investigation in a case of suspected splenic
rupture?
A: CT
B: USG
C: MRI
D: Peritoneal rupture
Correct Ans:A
Explanation
CT can clearly show the extend of splenic injury. It can also distinguish the viable portion of the
spleen.

A 45 year old female presented with a breast lump. You are
suspecting carcinoma in this patient and want to do a triple
assessment.
Assessment: Triple assessment is a combination of clinical assessment, radiological imaging and a
tissue sample taken for either cytological or histological analysis.
Reason: The positive predictive value of this combination will exceed 99.9%.
A: Both Assertion and Reason are true, and Reason is the correct explanation for Assertion
B:
Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C: Assertion is true, but Reason is false
D: Assertion is false, but Reason is true
Correct Ans:A
Explanation
In any patient who presents with a breast lump or other symptoms suspicious of
carcinoma, the diagnosis should be made by triple assessment.
Ref: Bailey & Love’s Short Practice of Surgery, 24th Edition, Page 826.
A 2 month old infant is presented with failure to thrive, recurrent emesis,
hepatosplenomegaly, and adrenal insufficiency. Adrenal calcification is noted radiologically.
What is the most likely diagnosis?
A: Adrenal hemorrhage
B:
Wolman's
disease
C: Pheochromocytoma
D: Addison's disease
Correct Ans:B

Explanation
This child is showing features of Wolman disease.
Wolman disease appear in the first few weeks of life and presents with persistent vomiting
and diarrhea, hepatosplenomegaly, xanthomatosis and adrenal calcification. Patients have
a complete absence of enzyme A of lysosome acid lipase.
Investigations: shows liver enzyme abnormalities, decreased adrenal responsiveness to
ACTH stimulation, normal or decreased plasma lipids. Cholesterol ester and triglyceride
deposition occur in the lysosomes of liver parenchymal and Kuppfer cells, and in
macrophages of adrenal gland, lymph node, intestinal mucosa etc.
Shenton’s line is a radiological line used to determine the pathology of:
A: Hip
B: Ankle
C: Elbow
D: Shoulder
Correct Ans:A
Explanation
Shenton’s line is an imaginary semi-circular line joining medial cortex of the femoral neck
to lower border of the superior pubic ramus. Shenton’s line is broken in posterior
dislocation of the hip.
Ref: Essential Orthopedics by Maheshwari, 3rd edition, Page 111.
A sixty five year old lady presents with a long standing history of pain and swelling in her
right knee. Pain is significantly interfering with her activities of daily living. Radiological
evaluation shows grade III changes of osteoarthritis. Which of the following is the
recommended line of management?

A: Conservative management
B: Arthroscopic lavage/washout
C: Partial knee replacement
D: Total knee replacement
Correct Ans:D
Explanation
This patients history strongly supports for a total knee replacement. As she is sixty five years old and
radiological reports showing evidence of grade III changes of osteoarthritis in this patient, the best
recommendation would be a Total knee arthroplasty. Patients with severe symptomatic Osteoarthritis
have failed to respond to medical therapy and have progressive limitations in their daily activities
should be referred for surgical options such as arthroplasty or joint reconstruction like osteotomy or
arthrodesis.
Ref: Osteoarthritis: Diagnosis and medical/surgical management, by Roland W.Moskowitz,
Page 402, 403.
A child with a history of pain over lower extremities since few moths shows radiological
evidence of osteosarcoma. Most common site of osteosarcoma is:
A:
Upper end of
femur
B: Lower end of femur
C: Lower end of fibula
D: Lower end of tibia
Correct Ans:B
Explanation
The classic form of osteosarcoma is typically seen in patients in their second or third
decade, with a peak in the adolescent growth spurt. It occurs more frequently in males than
in females and is found in the metaphyseal areas of long bones, with 50% of lesions seen
about the knee joint. The distal femur is the most common site, followed by the proximal
tibia and then the proximal humerus.

Ref: Randall R.L., Hoang B.H. (2006). Chapter 6. Musculoskeletal Oncology. In H.B. Skinner
(Ed), CURRENT Diagnosis & Treatment in Orthopedics, 4e.
Radiological features of left ventricular heart failure are all, EXCEPT:
A: Kerley B lines
B:
Cardiomegal
y
C: Oligemic lung fields
D: Increased flow in upper lobe veins
Correct Ans:C
Explanation
Classic signs of acute heart failure that can be seen on a chest x-ray of left ventricular
failure are:
• Cardiomegaly
• Upper lobe blood diversion
• "Bat's wing" alveolar edema
• Pleural effusions
Echocardiography is the investigation of choice and can identify and quantify LVH and
dysfunction (both systolic and diastolic) as well as examine causes of heart failure, such as
valve abnormalities.
Oligemic lung fields seen in Pulmonary atresia, stenosis; Ebstein’s anomaly.
Also Know:
Chest X ray Findings
• Boot shaped heart - TOF
• “3”like appearance - Coarctation of aorta.
• Figure of ‘8’- TAPVC(Total anomalous pulmonary venous connection)
• Bat wings appearance -Pulmonary edema.
Ref: O'Rourke R.A., Gilkeson R.C. (2011). Chapter 17. Cardiac Radiography. In V. Fuster,
R.A. Walsh, R.A. Harrington (Eds), Hurst's The Heart, 13e.

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Radiology most important signs sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)