How abdominal and gu is examined
Phase 2 of the RANZCR clinical radiology training program is assessed with examinations that test image interpretation, pathology knowledge and clinical reasoning across body systems. Formats and weightings change, so check the current RANZCR examination information and Phase 2 learning outcomes.
High-yield topics
| Topic | Key imaging points |
|---|---|
| Liver | Arterial enhancement and washout in HCC; LI-RADS |
| Pancreas | Cystic lesions and adenocarcinoma staging |
| Kidney | Bosniak classification |
| Adrenal | Unenhanced HU below 10 suggests lipid-rich adenoma |
| Acute abdomen | Free gas, obstruction, ischaemia |
Worked questions
Worked question · Adrenal
An incidental adrenal nodule measures 6 HU on unenhanced CT. What is it most likely to be?
- A Lipid-rich adenoma
- B Phaeochromocytoma
- C Metastasis
- D Adrenocortical carcinoma
- E Haematoma
Show the reasoning
Answer A. An unenhanced attenuation of 10 HU or less is diagnostic of a lipid-rich adenoma.
A search pattern for reporting
- Solid organs: liver, spleen, pancreas, kidneys, adrenals
- Hollow viscera: stomach, small and large bowel
- Vessels: aorta, mesenteric vessels, portal system
- Peritoneum, free fluid and free gas
- Lymph nodes
- Pelvic organs
- Bones and lung bases
Use the same order every time so that nothing is missed under exam conditions, then finish with a concise conclusion and recommendation.
Signs and differentials to know
| Imaging sign or finding | Think of |
|---|---|
| Arterially enhancing liver lesion with washout | HCC in a cirrhotic liver |
| Centripetal nodular enhancement | Haemangioma |
| Central scar, homogeneous enhancement | Focal nodular hyperplasia |
| Bosniak IV cyst | Enhancing soft tissue: likely malignant |
| Double duct sign | Pancreatic head or ampullary tumour |
| Pneumatosis with portal venous gas | Bowel ischaemia |
A 4-week revision block
| Week | Focus |
|---|---|
| 1 | Liver and biliary |
| 2 | Pancreas and bowel |
| 3 | Renal, adrenal and pelvis |
| 4 | Acute abdomen and mixed |
Pair reading with daily timed questions and image review on teaching files, and log every missed structure or sign.
Common traps
- Forgetting phase timing.
- Misapplying Bosniak.
- Missing bowel ischaemia signs.
Free sample abdominal and gu questions
Questions from our Radiology Phase 2 bank. Choose your answer, then open the explanation.
An adrenal nodule with unenhanced attenuation of 5 HU is:
- AMyelolipoma
- BLipid-rich adenoma
- CPhaeochromocytoma until proven otherwise
- DMetastasis
- EAdrenal carcinoma
Show answer and explanation
Answer B. Unenhanced HU 10 or less indicates a lipid-rich adenoma. Washout studies help lipid-poor lesions.
Learning point: Adrenal: 10 HU or less is adenoma.
Rigler sign indicates:
- AGallstone ileus
- BToxic megacolon
- CSmall bowel obstruction
- DSigmoid volvulus
- EPneumoperitoneum
Show answer and explanation
Answer E. Gas on both sides of the bowel wall (Rigler) indicates free intraperitoneal gas.
Learning point: Rigler sign: pneumoperitoneum.
A coffee bean sign arising from the pelvis suggests:
- APseudo-obstruction
- BSmall bowel obstruction
- CToxic megacolon
- DSigmoid volvulus
- ECaecal volvulus in the left upper quadrant
Show answer and explanation
Answer D. Sigmoid volvulus: inverted U from the pelvis toward the right upper quadrant. Caecal volvulus points to the left upper quadrant.
Learning point: Coffee bean from pelvis: sigmoid volvulus.
Practise more abdominal and gu questions free
Every abdominal and gu subtopic in our bank
The bank holds 19 abdominal and gu questions across 18 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Adrenal adenoma1
- Angiomyolipoma1
- Aortic aneurysm1
- Appendicitis CT1
- Appendicitis on CT1
- Crohn disease1
- Free gas1
- Gallbladder1
- LI-RADS1
- Liver haemangioma1
- Liver lesions1
- Mesenteric ischaemia1
- Pancreatitis1
- Pancreatitis complications1
- Renal colic imaging1
- Renal mass1
- Sigmoid volvulus1
- Small bowel obstruction2
Common questions
What does Phase 2 assess?
Image interpretation, pathology and clinical reasoning across body systems. Check RANZCR for current formats.
How should I practise?
Daily timed questions with image review, and structured reporting practice.
Which liver lesion system is used?
LI-RADS is widely used in at-risk patients.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.