Clinical procedures and Therapies Flashcards
The normal Glomerular filtration rate is.
a) 25mL/min
b) 50mL/min
c) 100mL/min
d) 125mL/min
d) 125mL/min
Thirty minutes after injection of 8mCi of Tc99m MAG3, there is significant activity remaining in the renal pelvis. What will most likely follow?
a) The patient will be asked to void before reimaging
b) A diuretic will be administered
c) Imaging will be extended for 20min
d) All of the above
d) All of the above
If after administration of furosemide, a patient still has activity in the renal calyces, there is probably?
a) Poor renal function
b) Renal artery occlusion
c) Renal infarction
d) Collecting system obstruction
d) Collecting system obstruction
What is the imaging protocol that was most probably used to obtain the image(transplant kidney scan)?
a) Consecutive 1sec images for 15 sec
b) Consecutive 3sec images for 45sec
c) 15 consecutive 10sec images
d) 15 consecutive 15sec images
b) Consecutive 3sec images for 45sec
Evaluating a renal transplant includes the following considerations?
a) The best imaging will be obtained posteriorly
b) A lower dose of Tc99m MAG3 should be given to protect the transplant.
c) Uptake RPH is usually delayed in the transplanted kidneys relative to native
d) The detector face should be centered over the right or left Iliac Fossa.
d) The detector face should be centered over the right or left Iliac Fossa.
The kidney is normally perfused via the Illiac artery
a) False
b) True
a) False
Radionuclide cystography is most often performed to?
a) Visualize space-occupying lesions in the bladder
b) Detect vesicoureteral reflux
c) Evaluate renal perfusion
d) Determine transplant function
b) Detect vesicoureteral reflux
The expected bladder capacity for a 6-year-old child is?
a) 50mL
b) 240mL
c) 500mL
d)120mL
b) 240mL
The reason for the calculation of expected bladder capacity before radionuclide cystography is?
a) To use the result in calculations of residual volume
b) To use the result in calculations of reflux volume
c) To have an idea of when maximum bladder filling will be reached
d) All of the above
c) To have an idea of when maximum bladder filling will be reached
Which RPH can be used to determine effective renal plasma flow?
a) Tc99m-MAG3
b) Tc99m-DTPA
c) I131-OIH
d) A & B
a) Tc99m-MAG3
b) Tc99m-DTPA
If a SPECT is being performed using a single head camera involving 64 projections and 52,000 counts are collected during each 20-second stop, what are the total counts for the study and the total acquisition time?
a) 3.3 million counts, 12 min
b) 1.1 million counts, 21 min
c) 1 million counts, 20 min
d) 3.3 million counts, 25 min
b) 1.1 million counts, 21min
Which of the following is not correct?
a) To perform 82Rb PET/CT and then FDG-PET/CT on the same date.
b) To perform sestamibi SPECT and then FDG-PET/CT on the same day.
c) To perform sestamibi SPECT rest and then 82Rb PET/CT stress on the same day.
d) To perform FDG-PET/CT and then 82Rb PET/CT on the same day.
d) To perform FDG-PET/CT and then 82Rb PET/CT on the same day
During a gated study, 24 images per cardiac cycle are obtained. If the patient’s heart rate is 65 bpm, the length of time per image is?
a) 38ms
b) 3.8ms
c) 4.1ms
d) 41ms
a) 38ms
When In111-WBC scan is used to evaluate Osteomyelitis Tc99m SC imaging is commonly included because Tc99m SC imaging may?
a) Increase the sensitivity of the In111-WBC scan
b) Increase the specificity of the In111-WBC scan
c) Decrease nonspecific uptake of In111-WBC imaging
d) Increase specific uptake of In111-WBC imaging
b) Increase the specificity of the In111-WBC scan
Cardiac contraction is initiated in the?
a) AV node
b) SA node
c) Bundle of His
d) P wave
b) SA node
To perform a pharmaceutical sestamibi myocardial perfusion study, which of the following is correct?
a) Sestamibi should be injected immediately after Persantine administration
b) Sestamibi should be injected immediately after Dobutamine administration
c) Sestamibi should be injected during Lexiscan administration.
d) Sestamibi should be injected during dobutamine administration
e) Sestamibi should be injected 2 minutes after Lexiscan administration.
d) Sestamibi should be injected during dobutamine administration
what percentage of cardiac output is directed to the kidneys?
a) 10%
b) 25%
c) 40%
d) 50%
b) 25%
Which of the following is a malignant bone disease?
a) Paget’s disease
b) Ewings sarcoma
c) Osteomyelitis
d) Osteoid Osteoma
b) Ewings sarcoma
What could be the cause of generalized, diffuse activity in the abdomen on a bone scan?
a) Free Pertechnetate
b) Malignant ascites
c) Pacemaker
d) Bone cyst
b) Malignant ascites
A focal hot spot near the left femur shows up on a bone scan. What is/at the best way to proceed?
a) Change to pinhole collimator and image
b) Perform SPECT imaging
c) Have the patient remove clothing from that area
d) Ask the patient to wash the skin in that area with soap and water
e) c & d
e) c & d
c) Have the patient remove clothing of that area
d) Ask the patient to wash the skin in that area with soap and water
What timing protocol best describes a four-phase bone scan?
a) During injection, immediately following injection, 2-4hr, and 18-24hr
b) During injection, 2-4hr, 24hr, and 48hr
c) During injection, immediately following injection, 2- 4hr and 6hr
d) None of the above
a) During injection, immediately following injection, 2-4hr, and 18-24hr
By what mechanism do diphosphonates localize in the bone?
a) Capillary blockage
b) Active transport
c) Ion exchange
d) Phagocytosis
c) Ion exchange
What percentage of the injected particles is normally taken up by the livers?
a) 25%
b) 70%
c) 80-90%
d) 50-100%
c) 80-90%
The most commonly used RPH for liver/spleen imaging is?
a) Tc99m Sulfur Colloid
b) Tc99m-MAA
c) Tc99m-O4
d) Tc99m-MAG3
a) Tc99m Sulfur Colloid
Kupffer cells, a part of the RES(reticuloendothelial system) play a role in?
a) Antibody formation
b) Phagocytizing foreign particles
c) Breaking down blood pigments for bile formation
d) B & C
b) Phagocytizing foreign particles
Optimal uptake in the liver of normal patients requires____before imaging. However, wait time for a patient with compromised liver function may require the patient to wait____before imaging.
a) 10-15min, 20-30min
b) 4-6min, 1hr
c) 1-5mins, 10-20mins
d) 20-30minus, 2hr
a) 10-15min, 20-30min
During a liver spleen scan, what view could be used to separate the left lobe of the liver from the spleen?
a) Right posterior oblique
b) Left lateral
c) Anterior
d) Left anterior oblique
a) Right posterior oblique
Liver/spleen imaging is useful in?
a) Evaluation organ shape, size, and position
b) Detecting lesions such as malignancy and cyst
c) Evaluation of hepatitis or cirrhosis
d) a and c
d) a and c
a) Evaluation organ shape, size, and position
c) Evaluation of hepatitis or cirrhosis
Colloid shift refers to:
a) Small colloid particles clumped together to form large particles which localize in the lungs
b) Tc99m-SC changing into albumin colloid
c) Increased uptake of colloid in the spleen and bone marrow relative to the liver
d) The redistribution of colloid within the liver over time
c) Increased uptake of colloid in the spleen and bone marrow relative to the liver
Which of the following will not affect thyroid uptake?
a) Iodinated contrast media
b) Propylthiouracil
c) Thyroid hormones
d) Beta-Blokers
d) Beta-Blokers
Which of the following are used to image the parathyroid?
a) 99mTc-Pertechnetate
b) 99mTc-Sestamibi
c) 201Tl- Chloride
d) a & b
e) b & c
e) b & c
b) 99mTc-Sestamibi
c) 201Tl- Chloride
On anterior-view thyroid images taken using I123 Sodium iodide, the right lobe appears to be larger than the left. The explanation for this is:
a) A right hemigoiter
b) A hypo-functioning left lobe
c) A normal finding
d) The patient’s head was turned slightly to the left
e)The patient’s head was turned slightly to the right
c) A normal finding
About 90% of the thyroid hormone secreted into the blood is in the form of:
a) Thyroxine
b)Triiodothyronine
c) Thyroglobulin
d) Thyrotropin
a) Thyroxine
What is the normal range of thyroid scan?
a) 50-90%
b) 20-85%
c) 10-35%
d) 12-30%
c) 10-35%
When do we use I131 in nuclear medicine?
a) None of these
b) To find aberrant thyroid tissues during Metascan
c) For patients without thyroid
d) Abletion, Hypotension, and Euthyroid
b) To find aberrant thyroid tissues during Metascan
c) For patients without thyroid
d) Abletion, Hypotension, and Euthyroid
When do we use I123 in nuclear medicine?
a) For patients with too much thyroid hormone
b) For thyroid U&S and Meta scan
c) All of these
d) Used for Graves and Hyperthyroidism
c) All of these
Which thyroid RPH bio-rought through organification trapping?
a) I-123
b)All of these
c) I-131
d) 99mTc-Pertechnate
a) I-123
c) I-131
Which thyroid RPH bio-rought through just trapping?
a) I-123
b)All of these
c) I-131
d) 99mTc-Pertechnate
d) 99mTc-Pertechnate
What should you do for a thyroid uptake scan in case you forgot or have only one I-123 capsule for the patient?
a) You can count the capsule as standard capsule first before giving it to the patient
b) You must use the decay formulas to have the activity of the standard capsule on the day of imaging
C) You can reschedule the patient to redo the scan when you have enough capsules.
d) None of these.
a) You can count the capsule as standard capsule first before giving it to the patient
b) You must use the decay formulas to have the activity of the standard capsule on the day of imaging
Radiocolloids are cleared from the circulation in a Liver/Spleen scan by what?
a) Kupffer cells
b) Urinary track
c) Bowels
d) Phagocytosis
a) Kupffer cells
d) Phagocytosis
Which of the following would cause decreased uptake in the liver/spleen scan?
a) Abscess
b) Adenoma
c) Focal nodular hyperplasia
d) Cyst
c) Focal nodular hyperplasia
Hypovascular tumors of the liver are ___ On early and late images, and hypervascular tumors are usually ___ activity on early images but may be hot or cold on delayed images.
a) Focal; Increased
b) Hot; decreased
c) Decreased; decreased
d) Photopenic; Increased
d) Photopenic; Increased
What is an acceptable pediatric dose for a Meckel’s scan?
a) 220uCi/Kg 99mTc pertechnetate
b) 5mCi 99mTc-SC
c) 20mCi 99mTc-Labeled RBC’s
d) 15mCi 99mTc-Pertechnate
a) 220uCi/Kg 99mTc pertechnetate
During liver scan, what view could be used to separate the left lobe of the liver from the spleen?
a) Right posterior oblique
b) Left lateral
c) Anterior
d) Left anterior oblique
a) Right posterior oblique
GI bleed scan with 99mTc-labeled RBCs is most useful in patients with?
a) Severe lower GI hemorrhage
b) Suspected “intermittent” Bleed
c) Occult bleeding
d)Chronic lower GI blood loss
b) Suspected “intermittent” Bleed
What best describes the normal blood flow to the lungs in a supine patient?
a) Largely uniform
b) Decreased flow to apices relative to bases
c) Increase flow to the upper lobes
d) None of the above
b) Decreased flow to apices relative to bases
The distribution of aerosolize particles in the lungs is influenced by all of the following except?
a) Turbulent air flow
b) Amount of technetium added
c) Rate of air flow
d) Particle size
b) Amount of technetium added
In general how many capillaries are blocked when a perfusion lung scan using Tc99m is performed?
a) Fewer than 1 in 1000
b) <0.1%
c) Both (a) and (b)
d) none of the above
b) <0.1%
A Perfusion lung scan shows a cold defect in the right base. If the ventilation study for the same patient is normal, what is the most probable explanation for the defect?
a) Pacemaker
b) Pulmonary Embolism
c) Attenuation from the heart
d) COPD
b) Pulmonary Embolism
What gaseous agents are not available?
a) Xe133
b) Xe127
c) Kr81
d) a & b
e) b & c
f) All of the above
e) b & c
A patient with pulmonary hypertension you should not give more than 100,000 particles.
a) true
b) false
a) true
What system removes the particles by phagocytosis?
a) Kupffer cells of the liver
b) Reticuloendothelial System
c) Nephrons of the kidney
b) Reticuloendothelial System
The recommended number of particles per injection for perfusion lung imaging is?
a) 200,000 to 700,000
b) 100,000 to 150,000
c) 10,000 to 20,000
d) None of the above
a) 200,000 to 700,000
Although the _____ view is excellent for the demonstration of defects in some lobes such as the right middle lobes, “shine- through” from the other lung may obscure small defects?
a) RAO
b) Lateral
C)LPO
d) Anterior
b) Lateral
One or two sub segments or a single segment of V/Q mismatches can be interpreted as what probability of pulmonary embolism?
a) Indeterminate
b) Low
c) High
d) Moderate
d) Moderate
Pulmonary emphysema causes significant:
a) Decrease of lung size
b) Inhomogeneity of distribution of pulmonary blood flow
c) Normal lung size
d) Increase in lung size
e) Homogeneity of distribution of pulmonary blood flow
f) b & d
f) b & d
b) Inhomogeneity of distribution of pulmonary blood flow
d) Increase in lung size
In a normal patient lying flat, the pulmonary blood flow is?
a) More abundant in the base of the lung
b) More abundant in the apex of the lung
c) Uniformly distributed throughout the lung, greater toward the posterior
d) The patient’s position doesn’t influence the pulmonary blood distribution
c) Uniformly distributed throughout the lung, greater toward the posterior
The amount of air that enters the lung with each breath is called:
a) Residual volume
b) Tidal volume
c) Total lung capacity
d) Expiratory reserve volume
e) Vital capacity
b) Tidal volume
Defects due to pulmonary embolism can be distinguished from those due to emphysema and carcinoma by repeating scanning. On subsequent scans, defects that are due to PE will:
a) Remain unchanged
b) show a changing pattern
c) Become more visible
d) None of the above
b) show a changing pattern
If Xe-133 ventilation imaging is performed after Tc-99m MAA imaging, which of the following will degrade the quality of the images?
a) Off peak window needed for perfusion study
b) Decreased dose for the perfusion study
c) Up-scatter of Xe-133
d) Down-scatter of Tc-99m
d) Down-scatter of Tc-99m
To localize an abnormality in the vertebral body, disk space, or posterior elements of the spine, ______imaging is recommended.
a) MRI
b) CT
c) SPECT
d) fluoroscopy
c) SEPCT
What are the two most common radio pharmaceuticals used for bone imaging?
a) NaF
b) Tc99m-HDP
c) Tc99m- MDP
d) All of the above
d) All of the above
What diseases or conditions can cause decreased activity on delayed bone imaging?
a) Diabetes
b) Kidney failure
c) Dose infiltration
d) All of the above
d) All of the above
What could be the cause of generalized, diffuse activity in the abdomen on bone scan?
a) Free pertechnetate
b) Malignant Ascites
c) Pacemaker
d) Bone cyst
b) Malignant Ascites
A focal hot spot near the left femur shows up on a bone scan. What is are the best ways to proceed?
a) Change to pinhole collimator and image
b) Perform SPECT imaging
c) Have the patient remove clothing of that area
d) Ask patient to wash the skin in that area with soap and water
e) c and d
e) c and d
Splenic uptake on a bone scan is often associated with?
a) Liver failure
b) Sickle cell disease
c) Splenic abscess
d) Paget’s disease
b) Sickle cell disease
What is often used in imaging-suspected avascular necrosis of the hip?
a) SPECT imaging
b) Pinhole collimation
c) Diverging collimation
d) Both a & b
d) Both a & b
What is not an indication for a bone scan?
a) Metastatic disease
b) Osteoporosis
c) Cellulitis
d) Avascular necrosis
b) Osteoporosis
The first phase of a 3-phase bone scan is best performed by?
a) Bolus injection followed by dynamic 2-s images for 60-s
b) Bolus injection followed by dynamic 20-s images for 3min
c) Bolus injection followed by a static 500-600K count image
d) Bolus injection followed by dynamic 1-s images for 30-s
a) Bolus injection followed by dynamic 2-s images for 60-s
What is the purpose of a stannous ion in a diphosphonate kit?
a) Acts as a reducing agent
b) Acts as an oxidizing agent
c) Provides a stabilizing force
d) Maintains particle size
b) Acts as an oxidizing agent
Which group shows the highest rate of primary bone tumors?
a) Elderly
b) Children
c) Males
d) Females
b) Children
The radiation dose from a bone scan is highest to the?
a) Bone marrow
b) Chest
c) Bladder
d) Brain
b) Chest
When performing a bolus injection for 3-phase bone scan why would the tourniquet be released, and injection delayed for 1 min?
a) To minimize pain during injection
b) To reduce transient hyperemia resulting from vasodilatation
c) To double check the dynamic sequence settings
d) To obtain a better bolus
b) To reduce transient hyperemia resulting from vasodilatation
What is an advantage of spot planar imaging over whole-body imaging for a bone scan?
a) Speed
b) Decreased patient to detector distance
c) Less film is used
d) No need for COR correction
b) Decreased patient to detector distance
The mechanism of localizing for bone marrow scanning is.
a) Active transport
b) Ion exchange
c) Phagocytosis
d) Capillary blockade
c) Phagocytosis
What imaging agent can be used to image the skeleton as well as myocardial infraction?
a) Tc99m-MDP
b) Tc99m-HDP
c) Tc99m-PYP
d) Tl-201 Chloride
c) Tc99m-PYP
Rib fracture often show up as.
a) Multiple focal hot spots located in consecutive ribs
b) A linear distribution along the long axis of the rib
c) Diffuse activity in the chest cavity
d) Cold spots
a) Multiple focal hot spots located in consecutive ribs
The venous phase of a cerebral blood flow study is signaled by:
a) Visualization of the jugular veins
b) Appearance of the RPH in the superior Sagittal Sinus
c) Disappearance of RPH form the carotid arteries
d) Appearance of RPH in the middle cerebral arteries
b) Appearance of the RPH in the superior Sagittal Sinus
The localization of Tc99m-HMPAO is related to?
a) A breakdown of the blood brain barrier
b)Cerebral blood flow
c) Glucose metabolism
d) Distribution of neuroreceptors
b)Cerebral blood flow
CSF is made mostly of
a) Protein
b) Water
c) glucose
d) blood
b) Water
