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Steves Exams > Exam 6 > Flashcards

Exam 6 Flashcards

1
Q

If one is receiving 20mR/hr exposure at a distance of 3m from a source, at what distance would one receive 500mR/hr exposure?

a. 0.36cm
b. 0.36m
c. 60cm
d. 0.60cm

A

c. 60cm

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2
Q

If an area survey reveals an ambient radiation level of 7mR/hr, which of the following radioactive signs would be the best choice to display on the door leading to this area?

a. “Caution: Radioactive Materials”
b. “Caution: Radiation Area”
c. “Caution: High Radiation Area”
d. “Grave Danger: Very High Radiation Area”

A

b. “Caution: Radiation Area”

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3
Q

An ionization chamber is left in integral mode for 10min and records a total dose of 3mR. Which of the following area posting signs should be used on the door leading into this area?

a. “Caution: Radioactive Materials”
b. “Caution: Radiation Area”
c. “Caution: High Radiation Area”
d. “Grave Danger: Very High Radiation Area”

A

b. “Caution: Radiation Area”

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4
Q

Which of the following area posting signs would not normally be found in a hospital?

a. “Caution: Radioactive Materials”
b. “Caution: Radiation Area”
c. “Caution: High Radiation Area”
d. “Grave Danger: Very High Radiation Area”

A

d. “Grave Danger: Very High Radiation Area”

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5
Q

Which of the following type of survey instruments would be best to use to survey a spill for removable contamination in a hot lab area where radioisotopes are being stored?

a. G-M detector
b. personal pocket dosimeter
c. dose calibrator with a wipe test
d. well counter with a wipe test

A

d. well counter with a wipe test

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6
Q

Four HVLs reduce the amount of incident radiation exposure to what?

a. 12.5%
b. 6.25%
c. 3.125%
d. none of the above

A

b. 6.25%

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7
Q

Which of the following is not required to be included in the records of a radioactive package receipt check in progress?

a. name of patient
b. name of radioisotope
c. amount of activity
d. both external and internal wipe checks

A

a. name of patient

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8
Q

A package is reading 2mR/hr at a distance of 2m, what is the appropriate DOT label for the package?

a. DOT I
b. DOT II
c. DOT III
d. no labeling is required

A

b. DOT II

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9
Q

The purpose of the transport index is?

a. to list the final destination of the package
b. to indicate the highest activity of the contents at 1m from the surface
c. not to give emergency personnel information about the contents of the package in an accident
d. not to list the radioisotopes in the package

A

b. to indicate the highest activity of the contents at 1m from the surface

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10
Q

If a patient who is having a bone scan urinates on the floor next to the camera, what would be the best course of action to reduce radiation exposure?

a. let the radioactive urine decay to background
b. move the camera away from the spill
c. remove the spill with some absorbent material and cover any residual activity with a lead plate or lead apron
d. notify the referring physician of a medical event

A

c. remove the spill with some absorbent material and cover any residual activity with a lead plate or lead apron

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11
Q

Which DOT radioactive labeling is entirely white?

a. DOT I
b. DOT II
c. DOT III
d. DOT IV

A

a. DOT I

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12
Q

Which absorber would be the best to use to shield strontium 89?

a. cardboard
b. plexiglass
c. lead
d. no shielding is required

A

b. plexiglass

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13
Q

Which of the following indicates the amount of radioactive substance present in a sample or source?

a. activity
b. exposure
c. absorbed dose
d. dose equivalent

A

a. activity

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14
Q

If the exposure rate is 25mR/hr and the person being exposed is present for 25min, what is his/her total exposure?

a. 25mR
b. 12.5mR
c. 10.4mR
d. 5.2mR

A

c. 10.4mR

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15
Q

What is 120Sv in millirads (quality factor = 1)?

a. 8.3 x 10 to the -8 mrad
b. 120,000 mrad
c. 1.2 million mrad
d. 12 million mrad

A

d. 12 million mrad

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16
Q

An alpha particle is similar to what?

a. an electron
b. a proton
c. a helium atom minus its electrons
d. a helium atom minus its neutrons

A

c. a helium atom minus its electrons

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17
Q

A higher or lower sensitivity is affected by all of the following except?

a. thickness of camera crystal
b. collimator design
c. properly set pulse-height analyzer and window width
d. instrument deadtime

A

c. properly set pulse-height analyzer and window width

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18
Q

Geometric variation, on a dose calibrator, should be preformed?

a. at installation and after repair
b. at installation and yearly
c. quarterly
d. daily

A

a. at installation and after repair

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19
Q

Photomultiplier tube drift is associated with which of the following?

a. auto-voltage stabilization
b. auto-gain stabilization
c. energy correction
d. linearity correction

A

b. auto-gain stabilization

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20
Q

A paralyzable counting system will?

a. decrease in count rate after some peak in count rate is obtained
b. never plateau and never obtain a peak count
c. plateau with no decrease in count rate as activity increases, which is the peak count
d. not exhibit any count rate difference

A

a. decrease in count rate after some peak in count rate is obtained

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21
Q

Sources of intrinsic nonuniformity include all of the following except?

a. “mistuned” PMTs
b. regional variations in Z-pulse amplitude
c. linearity
d. spatial distortion

A

c. linearity

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22
Q

What is added to NaI crystals to allow them to scintillate at room temperature?

a. Tl
b. Xe
c. Ce
d. Ag

A

a. Tl

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23
Q

What is the maximum percentage difference that is acceptable for most regulatory agencies for all four dose calibrator QC checks?

a. plus or minus 5%
b. plus or minus 7%
c. plus or minus 10%
d. plus or minus 15%

A

c. plus or minus 10%

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24
Q

Extrinsic quality control on a camera means quality control is done?

a. with the collimator on
b. without the collimator on
c. inside the camera
d. outside the camera

A

a. with the collimator on

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25
Q

Linearity correction involves?

a. diagonal lines
b. horizontal lines
c. vertical lines
d. horizontal and vertical lines

A

d. horizontal and vertical lines

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26
Q

Dose calibrator constancy should be performed?

a. monthly
b. quarterly
c. weekly
d. daily

A

d. daily

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27
Q

Which of the following quantitative renal techniques require (s) the calculation of kidney depth?

I. Schlegel technique
II. Gates’ method
III. Two compartment effective renal plasma flow (ERPF)
IV. Russell’s glomerular filtration rate (GFR) method

a. I
b. I and II
c. III and IV
d. II and IV

A

b. I and II

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28
Q

Which of the following functional images represents the magnitude of ventricular contraction?

a. amplitude image
b. paradox image
c. phase image
d. stroke-volume image

A

a. amplitude image

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29
Q

The background ROI used in determining percentage gastroesophageal (GE) reflux is placed over the?

a. lower left lung
b. small intestine
c. right hepatic lobe
d. upper esophagus

A

a. lower left lung

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30
Q

Geometric mean is sometimes used in quantization because it corrects for?

a. the size and shape of the organ
b. background activity
c. attenuation and organ depth
d. radioactive decay

A

c. attenuation and organ depth

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31
Q

Given a heart rate of 85 bpm, if a 24-frame gated heart study is acquired, the length of each frame in milliseconds is?

a. 0.06msecs
b. 0.3msecs
c. 29msecs
d. 705msecs

A

c. 29msecs

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32
Q

Concentric ring artifacts in a reconstructed SPECT image may be caused by?

a. improper collimation
b. large statistical fluctuations in the projection data
c. inadequate uniformity correction
d. too few angles of reconstruction

A

c. inadequate uniformity correction

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33
Q

In processing a myocardial perfusion study, a slice from which body axis is used to identify the degree to which the heart points to the left and is used to construct slices in the three opposing cardiac planes?

a. transaxial
b. horizontal long axis
c. vertical long axis
d. short axis

A

a. transaxial

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34
Q

The most important purpose of center of rotation offset correction is to?

a. eliminate the effects of detector tilt in the reconstructed images
b. minimize count sensitivity variations from one area of the crystal to another
c. ensure that all pixels are uniformly sized over the entire field of view
d. align the center of the computer matrix with the mechanical axis of the rotation

A

d. align the center of the computer matrix with the mechanical axis of the rotation

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35
Q

The x- and y- axes of a circumferential profile curve are, respectively?

a. x-axis: bull eye’s quadrant; y-axis: % maximum counts
b. x-axis: segment of the myocardium; y-axis: maximum counts
c. x-axis: time; y-axis: activity
d. x-axis: rest; y-axis: stress

A

b. x-axis: segment of the myocardium; y-axis: maximum counts

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36
Q

Diaphragmatic attenuation may be reduced by?

a. 360 degree acquisition
b. supine acquisition
c. prone acquisition
d. delayed imaging

A

c. prone acquisition

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37
Q

Which of the following is a definition of sensitivity of a diagnostic test?

a. how good the test is at detecting a true positive
b. how good the test is at detecting a true negative
c. how good the test is at detecting the difference between a true negative and a true positive
d. how good the test is at detecting something

A

a. how good the test is at detecting a true positive

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38
Q

In a patient with pulmonary embolism, the perfusion and xenon ventilation lung images will demonstrate the following findings:

a. normal perfusion and normal ventilation
b. normal perfusion and abnormal tracer retention
c. perfusion defects on perfusion and normal ventilation
d. perfusion defects on perfusion and abnormal tracer retention on ventilation

A

c. perfusion defects on perfusion and normal ventilation

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39
Q

Of the following, the biggest disadvantage of Xe133 (xenon gas) for performing ling ventilation studies is its?

a. rapid lung clearance
b. trapping and shielding required
c. high cost
d. unavailability

A

b. trapping and shielding required

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40
Q

Which of the following statements about radiolabeled aerosols used for lung ventilation imaging is true?

a. particle sizes range from 30-90um in diameter
b. it is necessary to trap any radiolabeled particles exhaled by the patient
c. the particles are deposited in ventilated areas of the lungs
d. deposition of particles in the central airway is never a problem with lung aerosol studies

A

c. the particles are deposited in ventilated areas of the lungs

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41
Q

An uptake probe is what type of detector?

a. scintillation detector
b. proportional counter
c. ionization chamber
d. Gieger-Mueller counter

A

a. scintillation detector

42
Q

The purpose of a charcoal filter in a xenon administration unit is to absorb?

a. bacteria
b. carbon dioxide
c. moisture
d. xenon

A

d. xenon

43
Q

The concentration of Xe133 gas in the lungs is increasing in which phase of a xenon ventilation study?

a. wash-in
b. equilibrium
c. washout
d. there is no phase of increasing activity

A

a. wash-in

44
Q

What is the range of particle size, in micrometers, of the majority of particles in Tc99m MAA?

a. 150-250um
b. 100-150um
c. 10-90um
d. 1-40um

A

c. 10-90um

45
Q

Following administration of a bone imaging tracer, the patient is instructed to drink fluids to?

a. decrease radiation exposure to the bones
b. clear excess tracer from the blood
c. enhance visualization of the kidneys and bladder
d. remove tracer from normal bone tissue

A

b. clear excess tracer from the blood

46
Q

Radioxenon ventilation studies should be performed in rooms whose air pressure is?

a. higher than adjacent areas
b. lower than adjacent areas
c. equal to adjacent areas
d. neither higher or lower than adjacent areas

A

b. lower than adjacent areas

47
Q

The clinical indication for a diagnostic test is?

a. a list of the patient’s symptoms
b. the patient’s diagnosis
c. a summary of the patient’s clinical history
d. the question the referring physician needs answered

A

d. the question the referring physician needs answered

48
Q

In a xenon administration unit, the purpose of soda lime is to absorb?

a. bacteria
b. carbon dioxide
c. moisture
d. xenon

A

b. carbon dioxide

49
Q

If visualized, the gallbladder fossa may be seen on what view (s) of a liver/spleen image?

a. anterior and posterior
b. anterior and right lateral
c. anterior only
d. right lateral only

A

b. anterior and right lateral

50
Q

When performing Meckel’s diverticulum imaging, which of the following would be visualized in a positive study?

a. malignant thyroid tissue
b. stomach mucosa
c. ectopic stomach mucosa
d. ectopic endometrial tissue

A

c. ectopic stomach mucosa

51
Q

Which of the following studies requires radiolabeled red blood cells?

a. infection imaging
b. renal scan
c. MUGA scan
d. liver/spleen scan

A

c. MUGA scan

52
Q

24hr images are sometimes performed over what area to demonstrate gastroesophageal reflux?

a. lower esophagus
b. lung fields
c. stomach
d. upper small intestine

A

b. lung fields

53
Q

The clinical indication for performing a C14 urea breath test is to?

a. rule out excess urea in the blood
b. determine the cause of gastric reflux
c. detect the presence of Helicobacter pylori
d. diagnose possible causes of abnormal gastric emptying

A

c. detect the presence of Helicobacter pylori

54
Q

Images acquired during a gastric-emptying study are primarily used for?

a. demonstrating exit of the tracer from the stomach
b. assessing normal biodistribution of the tracer
c. measuring the size of the stomach
d. drawing regions of interest

A

d. drawing regions of interest

55
Q

When imaging to determine LeVeen shunt patency, the camera initially is positioned anteriorly over the abdomen, and delayed images can be done?

a. over the brain
b. over the chest or abdomen
c. over the lung or liver fields
d. over the sacroiliac area

A

c. over the lung or liver fields

56
Q

In a red cell volume determination, it is necessary to add ascorbic acid to the labeled red cells to?

a. prevent additional tagging once the cells are re-injected into the patient
b. remove the Cr51 not tagged to red cells
c. suspend the cells homogeneously
d. prevent coagulation of the whole blood sample

A

a. prevent additional tagging once the cells are re-injected into the patient

57
Q

Morphine is administered during hepatobiliary imaging to cause the?

a. sphincter of Oddi to contract
b. gallbladder to empty completely
c. cystic duct to open
d. tracer to be diverted to the common bile duct

A

a. sphincter of Oddi to contract

58
Q

Which of the following is the reason that it is important to have a standardized meal size and consumption in a gastric-emptying scan?

a. it can affect the radiation dose to the patient
b. it can affect the ability to have gastric emptying
c. it can affect the rate of gastric emptying
d. it has no effect and is not necessary

A

c. it can affect the rate of gastric emptying

59
Q

Which of the following is/are not indications of renal function?

a. BUN level
b. peak transit time
c. creatinine clearance
d. CBC

A

d. CBC (complete blood count)

60
Q

If Tc99m radioactivity in the circulation from a previous nuclear medicine test occurs in a renal scan in the plasma draw?

a. the ERPF will be higher than it should
b. the ERPF will be lower than it should
c. the ERPF will not be affected
d. it is impossible to predict what will happen to the ERPF

A

b. the ERPF will be lower than it should

61
Q

Static renal parenchyma imaging would be best performed with which of the following radiopharmaceuticals?

a. Tc99m mertiatide
b. Tc99m pentetate
c. Tc99m succimer
d. Tc99m gluceplate

A

c. Tc99m succimer

62
Q

In a normal kidney, the maximum amount of tracer should be concentrated in the kidney how many minutes after administration of Tc99m mertiatide?

a. 1-2min
b. 3-5min
c. 8-10min
d. 30-35min

A

b. 3-5min

63
Q

If the tracer for an ERPF determination using the blood sampling method is administered at 0900, at what time should the blood sample be collected?

a. 0915
b. 0935
c. 0944
d. 1000

A

c. 0944

64
Q

For a GFR using the camera method one compares the kidney counts to what?

a. dynamic image ROI counts
b. pre-injection syringe counts
c. post-injection injection sites counts
d. plasma counts

A

b. pre-injection syringe counts

65
Q

Perfusion of the ventricular septum in the heart is provided primarily by which coronary artery?

a. left anterior descending
b. left circumflex
c. right coronary
d. none of the above

A

a. left anterior descending

66
Q

When performing a left ventricular function examination with Tc99m labeled red blood cells, which of the following actions is used to visually separate the ventricles from one another?

a. adjusting the anterior angle
b. adjusting the left lateral angle
c. adjusting the left anterior oblique angle
d. adjusting both the anterior and LAO angle

A

d. adjusting both the anterior and LAO angle

67
Q

Tachycardia is demonstrated on an ECG strip as?

a. a large P-R interval
b. a normal QRS heart rhythm
c. an increased heart rate
d. a decreased heart rate

A

c. an increased heart rate

68
Q

Adenosine is contraindicated for patients with which of the following conditions?

a. diabetes
b. stress-induced myocardial ischemia
c. chronic obstructive pulmonary disease
d. peripheral vascular disease

A

c. chronic obstructive pulmonary disease

69
Q

Consumption of a fatty meal may have the same effect on the hepatobiliary system as which of the following compounds?

a. cimetidine
b. furosemide
c. morphine
d. sincalide

A

d. sincalide

70
Q

Delayed improvement to perfusion following coronary artery revascularization is referred to as?

a. hibernating myocardium
b. infarcted myocardium
c. stunned myocardium
d. necrosed myocardium

A

c. stunned myocardium

71
Q

The percentage ejection fraction calculated from the following data:
Diastole = 2,750 cpm
Systole = 1,775 cpm
Is?

a. 61
b. 55
c. 35
d. 22

A

c. 35

72
Q

Which wave of the ECG is used to trigger the scintillation camera to acquire counts?

a. P wave
b. R wave
c. T wave
d. U wave

A

b. R wave

73
Q

Which of the following would not be a characteristic of an ideal myocardial perfusion agent?

a. high first-pass myocardial extraction proportional to blood flow
b. adequate imaging window
c. ability to complete both rest and stress imaging in 2 days
d. high target-to-nontarget ratio

A

c. ability to complete both rest and stress imaging in 2 days

74
Q

All of the following are advantages of the first-pass method for performing cardiac function imaging except?

a. short acquisition time
b. low background activity
c. choice of radiopharmaceuticals
d. multiple views with one tracer dose

A

d. multiple views with one tracer dose

75
Q

In the 1-day protocol for myocardial perfusion imaging performed with Tc99m labeled tracer, the larger amount of activity is administered?

a. for the rest study
b. for the stress study
c. for the study performed first
d. for the study performed second

A

d. for the study performed second

76
Q

Which of the following is most likely to interfere with performing a left ventricular ejection fraction using the gated equilibrium technique?

a. doxorubicin toxicity
b. cardiac arrhythmia
c. cardiomyopathy
d. coronary artery disease

A

b. cardiac arrhythmia

77
Q

An advantage of Tl201 thallium chloride is that it?

a. has a high photon flux at a high-energy window
b. is a calcium analog
c. has a short half-life
d. redistributes

A

d. redistributes

78
Q

A cardiac shunt would be best demonstrated with which of the following nuclear medicine techniques?

a. equilibrium-gated ventriculogram
b. first-pass radionuclide angiography
c. myocardial infarct imaging
d. myocardial perfusion imaging

A

b. first-pass radionuclide angiography

79
Q

Functional cardiac studies may be performed to evaluate wall motion abnormalities caused by all of the following except?

a. aneurysm
b. myocardial infarction
c. myocardial ischemia
d. myocardial perfusion patency

A

d. myocardial perfusion patency

80
Q

One advantage of the in vivo method of Tc99m red cell tagging is that?

a. all the circulating red cells are labeled with tracer
b. no incubation times are required at any step in the process
c. smaller amounts of stannous chloride are required
d. no manipulation of blood samples outside the body is required

A

d. no manipulation of blood samples outside the body is required

81
Q

In preparation for a stress test, patients are instructed to fast to?

a. prevent gastrointestinal upsets during exercise
b. minimize tracer uptake in the GI tract
c. enhance myocardial tracer uptake
d. standardize test conditions among patients

A

b. minimize tracer uptake in the GI tract

82
Q

Given the decay factor (DF) of a radioisotope is 0.254 for 1hr and 30mCi/mL concentration is available at 0700, how much total activity will remain in the vial at 1100 if a volume of 5mL was used to make up the kit?

a. 125uCi
b. 312uCi
c. 452uCi
d. 624uCi

A

d. 624uCi

83
Q

Which of the following statements is true when transient equilibrium occurs between Mo99 and Tc99m?

a. the ratio of the Mo99 and Tc99m activities remains constant
b. the maximum amount of Tc99m activity is present
c. the Mo99 and Tc99m activities are equal
d. Tc99m and Mo99 have the same decay constant

A

a. the ratio of the Mo99 and Tc99m activities remains constant

84
Q

The concentration of Tc99m pertechnetate is required to be 60mCi/mL. If approximately 1,200mCi Tc99m pertechnetate will be eluted from a wet-column generator, which size evacuated vial should be used to collect the eluate?

a. 5mL
b. 10mL
c. 15mL
d. 20mL

A

d. 20mL

85
Q

The average recommended number of MAA particles to be administered is?

a. 100,00 particles
b. 150,000 particles
c. 350,000 particles
d. 1,000,000 particles

A

c. 350,000 particles

86
Q

What approximate volume of Tc99m pertechnetate should be added to the medronate kit to prepare 180mCi of Tc99m medronate?

Medronate Kit:
Maximum activity to be added = 300mCi
Reconstituting volume = 1-8mL
Tc99m Pertechnetate :
Concentration = 28.7mCi/mL
Total Volume = 7.5mL

a. 0.6mL
b. 6.3mL
c. 7.5mL
d. 10.4mL

A

b. 6.3mL

87
Q

Bioavailability refers to what concerning pharmacology?

a. fraction of drug that reaches system circulation after a particular route if administration
b. fraction of drug that is excreted from the body
c. fraction of the drug that is delivered to body on the basis of weight
d. fraction of the drug that reaches the heart
e. addresses access to medication across the world

A

a. fraction of drug that reaches system circulation after a particular route if administration

88
Q

Which of the following is not a factor in generator yields?

a. time since last elution
b. column cracks
c. air leaks
d. amount of aluminum on the column

A

d. amount of aluminum on the column

89
Q

Radiopharmaceutical kits reconstituted with Tc99m pertechnetate are prepared in nitrogen- or argon-purged vials to prevent?

a. bacterial growth
b. hydrolysis
c. oxidation
d. radiolysis

A

c. oxidation

90
Q

Which of the following is not part of Tc99m radiopharmaceutical kit?

a. reducing agent
b. ascorbic acid or stannous ion
c. pyrogenocidal agent
d. lyophilized compound

A

c. pyrogenocidal agent

91
Q

Hydrolysis of reduced Tc99m during kit preparation is demonstrated on clinical images by radioactivity concentrated in the?

a. kidneys
b. liver
c. lungs
d. thyroid

A

b. liver

92
Q

When labeling Tc99m (VII), in what state is the Tc99m changed to make it more reactive?

a. Tc99m (VIII)
b. Tc99m (VI)
c. Tc99m (V)
d. Tc99m (IV)

A

d. Tc99m (IV)

93
Q

Radiochemical impurities can change?

a. radionuclide purity
b. generator yields
c. PET blank scans
d. target: nontarget ratios

A

d. target: nontarget ratios

94
Q

ITLC refers to?

a. instant transverse light chromatography
b. instant tomographic layer chromatography
c. instant thin layer chromatography
d. instant thin light chromatography

A

c. instant thin layer chromatography

95
Q

Possible radiochromatography artifacts include all of the following except?

a. using the wrong solvent
b. the strip touches the side of the developing chamber
c. the solvent evaporates before chromatography is completed
d. using tweezers to pick up the chromatography paper

A

d. using tweezers to pick up the chromatography paper

96
Q

An MAA kit has 3,000,000 total particles. If a 5mCi dose is needed at 1000 and the following information is provided:
25mCi/mL in 5mL total volume at 0700
what approximate number of particles will be given to the patient?

a. 600,000 particles
b. 120,000 particles
c. 169,635 particles
d. 134,831 particles

A

c. 169,635 particles

97
Q

If a 20uCi I123 dose is needed on Monday morning 8/15/09, at 0800 CST, what amount of I123 be sent from Atlanta at 0800 Friday morning, 8/12/09, for the right amount to be available Monday morning?

a. 878uCI
b. 925uCi
c. 988uCi
d. 1088uCi

A

b. 925uCi

98
Q

A 25mCi dose in a volume of 2mL is added to 50mL and a one sixth serial dilution is performed. What amount of total activity is present in a 5mL sample of tube no. 33?

a. 3.02 x 10 to the -25 mCi
b. 6.04 x 10 to the -25 mCi
c. 9.08 x 10 to the -25 mCi
d. 12.12 x 10 to the -25 mCi

A

a. 3.02 x 10 to the -25 mCi

99
Q

A pharmacokinetic profile of a drug depends on what?

a. time to excretion
b. mode of excretion
c. mode of administration
d. time to administration

A

c. mode of administration

100
Q

Which of the following may be used to reduce the allergic effects of contrast media?

a. acetaminophen
b. diphenhydramine
c. air
d. water

A

b. diphenhydramine

Steves Exams (9 decks)

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