Contrast: barium versus water-soluble: 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 · Contrast: barium versus water-soluble

Sample item

A patient with suspected perforation of the oesophagus after a foreign body needs a contrast swallow. Which agent should be used first?

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

The answer and the reasoning

B. Water-soluble iodinated contrast

Water-soluble contrast is absorbed from the mediastinum and peritoneum and is not irritant, so it is first choice in suspected perforation. Barium causes severe mediastinitis or peritonitis if it leaks. If the study is negative, barium can follow for higher sensitivity.

Option by option

  • A. Barium sulphate suspension

    Barium in the mediastinum or peritoneum causes inflammation and fibrosis.

  • B. Water-soluble iodinated contrast (correct)

    Correct. Water-soluble contrast is safe if it leaks.

  • C. Gadolinium

    Gadolinium is not used for GI luminal studies.

  • D. Air only

    Air alone cannot detect a perforation reliably.

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 B, Water-soluble iodinated contrast. Water-soluble contrast is absorbed from the mediastinum and peritoneum and is not irritant, so it is first choice in suspected perforation.

Why is "Barium sulphate suspension" not the answer?

Barium in the mediastinum or peritoneum causes inflammation and fibrosis.

Why is "Gadolinium" not the answer?

Gadolinium is not used for GI luminal studies.

Why is "Air only" not the answer?

Air alone cannot detect a perforation reliably.

What concept does this question test?

It tests Contrast: barium versus water-soluble in Radiology. Barium causes severe mediastinitis or peritonitis if it leaks. If the study is negative, barium can follow for higher sensitivity.

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 Contrast: barium versus water-soluble?

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.