Pancreatic imaging: chain of lakes: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Pancreatic imaging: chain of lakes

Sample item

A chronic alcoholic with recurrent upper abdominal pain has a CT showing pancreatic calcifications, an atrophic gland and an irregular beaded dilated main pancreatic duct. What is the appearance of the duct called?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Chain of lakes

In chronic pancreatitis, strictures alternate with dilated segments of the duct, giving a chain of lakes pattern on MRCP or ERCP. Calcification within the duct is virtually diagnostic.

Option by option

  • A. Chain of lakes (correct)

    Correct. Alternating stricture and dilatation form the chain of lakes.

  • B. Comet tail

    A comet tail is an ultrasound reverberation artefact.

  • C. Double duct sign

    The double duct sign is dilatation of both the bile and pancreatic ducts from a head mass.

  • D. String of beads of fibromuscular dysplasia

    String of beads describes renal artery fibromuscular dysplasia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Chain of lakes. In chronic pancreatitis, strictures alternate with dilated segments of the duct, giving a chain of lakes pattern on MRCP or ERCP.

Why is "Comet tail" not the answer?

A comet tail is an ultrasound reverberation artefact.

Why is "Double duct sign" not the answer?

The double duct sign is dilatation of both the bile and pancreatic ducts from a head mass.

Why is "String of beads of fibromuscular dysplasia" not the answer?

String of beads describes renal artery fibromuscular dysplasia.

What concept does this question test?

It tests Pancreatic imaging: chain of lakes in Radiology. Calcification within the duct is virtually diagnostic.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pancreatic imaging: chain of lakes?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.