Gastrointestinal imaging: 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 · Gastrointestinal imaging

Sample item

A young man has chronic diarrhoea and right iliac fossa pain. A barium follow-through shows a long, narrow, rigid terminal ileum, described as a 'string sign'. What is the most likely diagnosis?

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

The answer and the reasoning

B. Crohn disease

The string sign of Kantor represents persistent luminal narrowing from spasm and fibrosis in the terminal ileum of Crohn disease. Other signs include cobblestoning, skip lesions and fistulae. Ulcerative colitis is confined to the colon, apart from backwash ileitis.

Option by option

  • A. Ulcerative colitis

    Ulcerative colitis involves the rectum and colon continuously and spares the small bowel.

  • B. Crohn disease (correct)

    Correct. A narrowed rigid terminal ileum is the string sign of Crohn disease.

  • C. Carcinoid tumour

    A carcinoid tumour causes a mesenteric mass with kinking rather than a long narrowed segment.

  • D. Intestinal lymphangiectasia

    Lymphangiectasia gives a thickened fold pattern without strictures.

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.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Crohn disease. The string sign of Kantor represents persistent luminal narrowing from spasm and fibrosis in the terminal ileum of Crohn disease.

Why is "Ulcerative colitis" not the answer?

Ulcerative colitis involves the rectum and colon continuously and spares the small bowel.

Why is "Carcinoid tumour" not the answer?

A carcinoid tumour causes a mesenteric mass with kinking rather than a long narrowed segment.

Why is "Intestinal lymphangiectasia" not the answer?

Lymphangiectasia gives a thickened fold pattern without strictures.

What concept does this question test?

It tests Gastrointestinal imaging in Radiology. Other signs include cobblestoning, skip lesions and fistulae. Ulcerative colitis is confined to the colon, apart from backwash ileitis.

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 Gastrointestinal imaging?

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.