Nuc Med

Question 1

Inc/Dec Uptake of Kidneys

Tc-MDP

Answer 1

Increased Uptake

• Obstruction
• Acute tubular necrosis
• Nephrotoxic meds
• Radiation nephritis
• Nephrocalcinosis

Decreased Uptake

• CKD
• Delayed scan time
• Interstitial injection
• Nephrectomy
• Superscan (Diffuse mets, Metabolic dz)

Question 2

Superscan

Answer 2

1) Diffuse Mets
2) Metabolic Dz
- Paget’s
- HyperPTH
- Osteomalacia
- SCD
- Myelofibrosis

Question 3

DDx Multifocal Uptake on Tc-MDP

Answer 3

1) Mets
2) Arthritis
3) Fracture
4) Metabolic bone disease
5) RSD
6) OM

Question 4

DDx Cold Defect on Tc-MDP

Answer 4

1) Metal artifact (pace maker, prosthesis)
2) Radiation changes
3) Early AVN/Infarct
4) Mets (RCC, Thyroid, Neuroblastoma)
5) Tumor of marrow (Lymphoma/Leukemia)

Question 5

Tumors that are PET Cold

Answer 5

1) RCC
2) Carcinoid
3) AdenoCa in-situ
4) Mucinous tumors
5) Prostate Ca

Question 6

Not Cancer, but PET Hot

Answer 6

1) Infection/Inflmmation
2) Brown fat
3) Thymus
4) Ovaries in follicular phase
5) Recent XRT/Chemo/Surgery

Question 7

Definite Roll for PET

Answer 7

1) NSCLC
2) SPN (8+ mm)
3) Lymphoma
4) H&N Cancer
5) Colon Cancer
6) Esophageal Cancer
7) Thyroid Cancer

Question 8

Flow Phase Abnormalities in Kidney Study

Answer 8

1) Symmetric Dec
- Poor bolus
2) Asymmetric Dec
- RA thrombosis
- RV thrombosis
- Chronic high grade obstruction
- Acute pyelo
3) Increased
- RA aneurysm

Question 9

Cortical Function Abnormalities in Kidney Study

Answer 9

1) ATN
2) Interstitial nephritis
3) Cyclosporin
4) CKD