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z Nuc Med z > GI practice test > Flashcards

GI practice test Flashcards

1
Q

The patient preparation for a gastric emptying study is

  • that the patient must void before imaging
  • NPO for 4 - 8 hours
  • the patient should have a barium enema within the 24 hours before this exam
  • no patient preparation is required
A

NPO for 4 to 8 hours

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2
Q

In performing a gastric-emptying study, imaging should begin

  • 15 minutes after meal consumption and continue for 1 hours
  • immediately after meal consumption, and continue for at least 2 to 4 hours
  • 1 hour after meal consumption then once an hour for 6 hours
  • immediately after meal consumption, and continue for 1 hours
A

immediately after meal & continued for at least 2hours to 4 hours

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3
Q

When performing a gastric emptying study what is the purpose of giving Reglan (Metoclopramide)

  • this increases the rate of gastric emptying in attempt to determine if the the gastroparesis is treatable
  • this stimulates the production of bile to increase the rate of digestion
  • this drug is used for gall bladder imaging not gastric emptying
  • this increases the amount of acid production to prevent an obstruction from forming out of the food
A

this increase the rate of gastric emptying in attempt to determine if the gastroparesis is treatable

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4
Q

When administering Reglan (Metoclopramide) what special precautions should be taken?

  • have a antidote pharmaceutical available in case the drug causes respiratory arrest
  • do not administer this drug until after the patient has received an injection of CCK (Kinevac)
  • there are no precaustions and this drug has no known side effects
  • do not quickly bolus inject the pharmaceutical because it can lead to a rapid drop in blood pressure
A

do not quickly bolus inject the pharmaceutical because it can lead to a rapid drop in blood pressure

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5
Q

When performing a gastric emptying study with a solid meal, what is considered to be the minimum normal range?

50% of the meal should have left the stomach by 3 hours after eating the meal
30% of the meal should have left the stomach by 1 hours after eating the meal
60% of the meal should have left the stomach by 2 hours after eating the meal
95% of the meal should have left the stomach by 2 hours after eating the meal

A

60% of the meal should have left the stomach by 2 hours after eating the meal

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6
Q

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

  • It can affect the radiation dose to the patient
  • It can affect the ability to have gastric emptying
  • It can affect the rate of gastric emptying
  • It can cause gastric tissue necrosis
A

It can affect the rate of gastric emptying

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7
Q

A gastric-emptying study uses which of the following radiopharmaceuticals?

Tc-99m sulfur colloid
Tc-99m Macroaggregated Albumin
Tc-99m disida
Tc-99m medronate

A

Tc-99m sulfur colloid

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8
Q

When performing a gastric empty scan with a dual head camera, the most accurate measurement of emptying can be calculated by:

  • performing a calculation of the geometric mean of the anterior and posterior views
  • just image from the anterior view since the posterior view is to far away from the stomach
  • average the counts in the anterior and posterior views
  • divide the counts measured in the anterior views by the counts measured in the posterior views
A

performing a calculation of the geometric mean of the anterior and posterior views

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9
Q

Egg white substitute is preferred over scrambled fresh whole eggs because

  • None of the above
  • the exam is more reproducible and it has a higher binding percentage and is less likely to disintegrate in gastric fluid
  • it has a higher fat content and results in a stronger stomache contraction
  • it is more cost-effective and less likely to spoil
A

the exam is more reproducible and it has a higher binding percentage and is less likely to disintegrate in gastric fluid

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10
Q

The advantage of performing gastric emptying with a solid instead of a liquid is

  • imaging with solids is more sensitive and accurate for abnormalities
  • the labeling procedure is easier (faster)
  • solids are emptied faster
  • the patient does not need to be fasting
A

imaging with solids is more sensitive and accurate for abnormalities

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11
Q

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

  • detecting the presence of Heliobacter-Pylori infection
  • quantifying the rate at which the tracer is leaving the stomach
  • determining when the tracer first exits the stomach
  • determination of an effective gastric plasma flow
A

quantifying the rate at which the tracer is leaving the stomach

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12
Q

A normal esophageal transit study result is

  • a clearance half-time of 4-6 minutes
  • no activity reaching the esophagus
  • small localized hot spots throughout the esophagus
  • more than 90% has traversed the esophagus by the end of 15 seconds
A

more than 90% has traversed the esophagus by the end of 15 seconds

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13
Q

Which imaging study is acquired while an abdominal binder (resembling a large blood pressure cuff) is inflated to increasing pressures?

  • Gastric emptying study
  • Esophageal transit study
  • Gastrointestinal bleeding
  • Esophageal reflux study
A

esophageal reflux study

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14
Q

In infants, 24-hour images are sometimes performed over what area to demonstrate gastroesophageal reflux?

Upper small intestine
Lower esophagus
Spleen
Lung Fields

A

Lung Fluids

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15
Q

What would be considered a normal result for an esophageal reflux study in an adult?

  • significant activity in the esophagus only after 50 mm of pressure
  • significant activity in the esophagus within 5 minutes of administration
  • no activity in the esophagus
  • no activity in the stomach
A

no activity in the esophagus

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16
Q

In assessing gastric reflux of a non-pediatric patient, ROIs should be placed over the

  • esophagus and lungs
  • esophagus and stomach
  • esophagus, small bowel, and stomach
  • esophagus, small bowel, stomach, and liver/gallbladder
A

esophagus and stomach

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17
Q

What procedure should you follow in performing the pediatric equivalent of an adult esophageal reflux study?

  • inject reduced activity according to the size of the child
  • image sooner than in adults
  • image the lungs
  • reduce the pressure on the abdomen by about one-half
A

image the lungs

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18
Q

Patient preparation for a Meckel’s study on an infant includes

  • CCK administration 15 minutes before starting the exam
  • written informed consent from the patient receiving the exam must be obtained
  • NPO for 6 - 12 hours and consider administering ranatidine or glucagon
  • perform a barium study in conjunction with this study
A

NPO for 6 - 12 hours and consider administering ranitidine or glucagon

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19
Q

What patient population is most commonly associated with Meckel’s diverticulum scanning?

  • the elderly
  • it is commonly used in all age populations
  • young adults
  • children younger than 2 years old
A

children younger than 2 years old

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20
Q

A positive Meckel’s diverticulum study demonstrates

  • focal area of increased activity in the upper left quadrant that moves with time
  • unusualy increased activity in the stomach
  • diffuse activity by 20 minutes after the injection in the bowel that fades with time
  • focal area of increased activity in the right lower quadrant or mid-abdomen
A

focal area of increased activity in the right lower quadrant or mid-abdomen

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21
Q

After acquiring the images below on a patient suspected of having a Meckel’s diverticulum, the technologist should

A

submit images for reporting, the exam is complete

22
Q

Localization of Meckel’s diverticulum can be accomplished with which of the following radiopharmaceuticals?

Tc-99m pertechnetate
Tc-99m MAA
Tc-99m sulfur colloid
Tc-99m mebrofenin

A

Tc-99m pertechnetate

23
Q

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

Hepatic uptake
Ectopic stomach mucosa
Malignant colon tissue
Ectopic endometrial tissue

A

Ectopic stomach mucosa

24
Q

One disadvantage of using sulfur colloid for assessing a GI bleed is

  • its lack of sensitivity
  • it takes a relatively long time to perform the exam
  • the persistent high body background from circulating Tc S.C. in the blood stream
  • it is only good if the patient is actively bleeding
A

it is only good if the patient is actively bleeding

25
Q

To perform a sulfur colloid GI bleed study

  • do a static image every 10 minutes for 90 - 120 minutes
  • perform a flow study of the abdome
  • Tc99m Sulfur Colloid can not be used to perform GI Bleed studies
  • ensure the entire liver and spleen are visualized by placing them in the center of the field of view
A

perform a flow study of the abdomen

26
Q

Which of the following is the initial positioning for visualizing gastrointestinal bleeding with Tc99m labeled red blood cells?

  • Xiphoid (center of the chest) in middle of field of view
  • Symphysis pubis (lower pelvis) in middle of field of view
  • Lower esophagus at top of field of view
  • Lower border of liver and spleen at top of field of view and pubic symhasis at the bottom of the field of view
A

Lower border of liver and spleen at top of field of view and pubic symphysis at the bottom of the field of view

27
Q

When labeling RBCs with Tc-99m, the stannous ions (tin form a cold PYP vial)

  • is not required to label RBCs and is primarily used for bone imaging.
  • lower the oxidation state of the Tc-99m that enters the cells trapping it inside of the cells
  • stabilize the RBCs so that they live longer
  • allows the Tc-99m to enter the RBCs by oxidizing it
A

lower the oxidation state of the Tc-99m that enters the cells trapping it inside of the cells

28
Q

A nuclear medicine GI bleed study is used to

  • localize the bleeding site
  • detect the presence of ulcers
  • determine if the bowel is obstructed
  • quantitate the amount of blood from the gastrointestinal tract
A

localize the bleeding site

29
Q

The advantage of a nuclear medicine GI bleed study over other modalities is it

  • rarely produces false-positive or false-negative results.
  • it usually takes very little time
  • is able to locate bleeds precisely
  • is very sensitive for low-volume bleeds
A

is very sensitive for low-volume bleeds

30
Q

During a GI bleed study, lateral or oblique views are sometimes acquired to

  • distinguish between a bleed and a hemangioma
  • lateral and oblique views are never necessary for this study
  • quantitate the bleed
  • more accurately localize the bleed
A

more accurately localize the bleed

31
Q

After imaging a GI bleed study with Tc99m labeled RBCs for 60 - 90 minutes, no focus of activity has appeared in the abdomen. The technologist should

  • administer cimetidene
  • perform a SPECT study
  • administer 10 mg IV reglan to increase gastric motility
  • discontinue the study or obtain delayed images of intervals from 2-6 hours and/or 18-24 hours
A

discontinue the study or obtain delayed images of intervals from 2-6 hours and/or 18-24 hours

32
Q

Which radiopharmaceutical is commonly used to image cavernous hemangioma?

Tc-99m albumin colloid
Tc-99m sulfur colloid
Tc-99m pertechnetate
Tc-99m RBCs

A

Tc-99m RBCs

33
Q

A Tc99m labeled RBC liver scan demonstrates normal blood flow image and a focally increased blood pool on the delayed images. The most likely explanation for these findings is a(n)

hepatoma
abscess
cavernous hemangioma
focal nodular hyperplasia (FNH)

A

cavernous hemangioma

34
Q

What is the preferred radiopharmaceutical used when imaging spleen tissue?

Tc99m Labeled Red Blood Cells
In111 White Blood Cells
Tc99m Heat treated Red Blood Cells
Tc99m Sulfur Colloid

A

Tc-99m Heat Treated RBC

35
Q

What is the normal biodistribution of sulfur colloid?

  • 70% spleen, 20% Liver, 10% bone marrow
  • 60% liver, 30% spleen, 5% bone marrow, 5% lung
  • 85% liver, 10% spleen, 5% bone marrow
  • 30% liver, 60% spleen, 5% bone marrow, 5% lung
A

85% liver, 10% spleen, 5% bone marrow

36
Q

What best describes the liver/spleen images below?

A

this study shows colloidal shift decreased liver function

37
Q

What appearance is most common with the presence of metastasis on a liver/spleen sulfur colloid scan?

hepatomegaly
multiple hot spots
multiple cold spots
increased flow to the entire lobe containing the affected area

A

multiple cold spots

38
Q

In SPECT liver imaging with Tc-99m sulfur colloid, how long after the injection should liver imaging typically begin?

5 to 20 minutes
you should start immediately
3 - 4 hours
1 - 2 hours

A

5 to 20 mins

39
Q

What is the major advantage of performing a SPECT liver/spleen study?

improved sensitivity
decrease the dose of radiopharmaceutical
improved spatial resolution
decrease in imaging time

A

improved sensitivity

40
Q

Typical appearance(s) of hepatitis on a liver/spleen sulfur colloid scan include(s)?

  • hepatomegaly and a decrease in activity in both the liver and the spleen
  • homogeneous increased activity in the liver with normal uptake in the spleen
  • hepatomegaly and a homogeneous increased of activity in the liver, and increased visualization of the spleen
  • hepatomegaly, increased activity in the spleen, and decreased activity in the liver
A

hepatomegaly, increase activity in the spleen, and decreased activity in the liver

41
Q

Sulfur colloid uptake in the lungs usually means

  • the patient has severe liver disease or the particles injected are too large
  • there is increased lung function
  • a lung tumor is present
  • the spleen is missing or has been removed
A

the patient has severe liver disease or the particles injected are too large

42
Q

Finding >20% of sulfur colloid activity administered, depositing in the bone marrow may indicate which of the following?

  • Particles are too small or the patient has severe liver disease
  • Acute avascular necrosis
  • Anemia
  • Invasive metastatic disease in the bone marrow
A

Particles are too small or the patient has severe liver disease

43
Q

LeVeen shunts are placed to relieve?

hepatomegaly
reflux
ascites
bronchitis

A

ascites

44
Q

The patency of a LeVeen shunt may be demonstrated with which of the following radiopharmaceuticals?

  • Tc-99m HDP or Tc-99m MDP
  • Tc-99m MAA or Tc-99m sulfur colloid
  • Tc-99m pertechnetate or Tc-99m labeled red blood cells
  • Tc-99m mebrofenin or Tc-99m disofenin
A

Tc-99m MAA or Tc-99m sulfur colloid

45
Q

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

over the brain
over the gastrointestinal tract
over the bladder
over the lung or liver fields (depending on the radiopharmaceutical chosen)

A

over the lung or liver fields (depending on the radiopharmaceutical)

46
Q

You have a patient that has just been diagnosed with multiple small masses in their abdomen on a CT scan. They are 5 years post motor vehicle accident (MVA) and surgical removal of their spleen and you really suspect that this is remnant spleen tissue. How would you best determine (least invasive, simple, cheap, accurate) if the masses are remnant spleen tissue or some form of malignancy.
In other words choose the best option even though multiple options are somewhat correct

  • do a biopsy of multiple nodules
  • do a liver spleen scan with sulfur colloid
  • do a whole body bone scan looking for metastatic disease
  • Do a spleen scan with denatured red blood cells
A

Do a spleen scan with denatured red blood cells

47
Q

a tech decided to use a single head camera in the anterior position for a normal solid phase GE study. For the first 10 minutes the counts will

A

increase

48
Q

You have a patient whom you have just performed a liver spleen scan on but no spleen was visualized even though their spleen is visible on the CT scan. When you perform a spleen scan, again no spleen is visualized. What is this most likely cause of this anomaly

A

the patient has a spleen but is not functioning

49
Q

which of the following should not be performed immediately before liver/spleen imaging with Tc99m sulfur colloid

A

radiographic upper GI series using barium

50
Q

a liver spleen image using Tc sulfur colloid indicative of a liver abscess will demonstrate which of the following characteristics?

A

single (possibly) multiple focal cold spots usually without colloidal shift

z Nuc Med z (14 decks)

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