Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiology Secrets > NUCLEAR CARDIOLOGY > Flashcards

NUCLEAR CARDIOLOGY Flashcards

1
Q

What is nuclear cardiology?

A

A field of cardiology that uses radioisotopes to assess myocardial perfusion and myocardial function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is myocardial perfusion imaging (MPI)?

A

A noninvasive imaging method that utilizes radioisotopes to assess regional myocardial blood flow, function, and viability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What imaging techniques can be used in MPI?

A
  • Single-photon emission computed tomography (SPECT)
  • Positron emission tomography (PET)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens during the stress portion of an MPI test?

A

Exercise increases myocardial demand or a pharmacologic agent is used to produce vasodilation in the coronary vascular bed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does a normal blood vessel respond to stress during MPI?

A

A normal vessel can increase coronary blood flow up to four times its baseline.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a perfusion defect?

A

An area of reduced radiotracer uptake in the myocardium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What differentiates a fixed defect from a reversible defect in MPI?

A

A fixed defect occurs during both stress and rest, while a reversible defect is present only during stress.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the uses of myocardial perfusion imaging?

A
  • Diagnose coronary artery disease (CAD)
  • Localize and quantify ischemia
  • Determine infarct size
  • Risk stratification
  • Assess residual ischemia after revascularization
  • Assess myocardial viability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the sensitivity and specificity of MPI compared to stress echocardiography?

A

Sensitivity: 85% vs. 75%; Specificity: 79% vs. 88%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the two main radiopharmaceutical agents used in MPI SPECT?

A
  • Thallium-201 (Tl-201)
  • Technetium-99m (Tc-99m)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the half-life of Thallium-201?

A

73 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a key characteristic of Thallium-201 in MPI?

A

Myocardial redistribution after initial uptake.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the half-life of Technetium-99m?

A

6 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the importance of Technetium’s short half-life?

A

It reduces radiation exposure to the patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the stress modalities for myocardial perfusion imaging?

A
  • Exercise-induced
  • Pharmacologic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are common forms of exercise used in stress testing?

A
  • Treadmill
  • Bicycle
  • Isometric handgrip
17
Q

What is a major contraindication for exercise stress testing?

A

Severe aortic stenosis or decompensated heart failure.

18
Q

What is the sum difference score (SDS) in MPI?

A

The difference between summed rest score (SRS) and summed stress score (SSS), representing the amount of ischemia.

19
Q

Fill in the blank: A _______ defect suggests the presence of ischemia.

A

reversible

20
Q

True or False: A fixed defect always indicates myocardial scar.

A

False.

21
Q

What is the method used for semiquantitative analysis of perfusion defects?

A

Scores from 0 to 4 are assigned to each segment based on severity.

22
Q

What does a score of 0 indicate in semiquantitative evaluation?

A

Normal count.

23
Q

What does a score of 4 indicate in semiquantitative evaluation?

A

Absence of uptake.

24
Q

What is dobutamine used for?

A

Diagnose CAD, assess risk for those who cannot exercise

CAD stands for coronary artery disease.

25
Q

List contraindications for the use of dobutamine.

A
  • Cannot exercise
  • LBBB on ECG
  • Severe AS
  • Decompensated heart failure
  • Active acute coronary syndrome
  • Bronchospastic COPD or asthma
  • Heart block
  • Hypotension
  • Tachyarrhythmias
  • Uncontrolled hypertension

LBBB stands for left bundle branch block; AS stands for aortic stenosis; COPD stands for chronic obstructive pulmonary disease.

26
Q

What is a notable advantage of using dobutamine in stress testing?

A

Produces excellent vasodilation equal to that of exercise

FS refers to functional status.

27
Q

What is the Duke treadmill score used for?

A

Determining prognosis for cardiac events

It takes into account exercise time, chest pain grade, and ST-segment deviation.

28
Q

What is the significance of achieving 85% of maximal predicted heart rate during exercise?

A

It indicates that pharmacologic agents can be used if unable to exercise to that level

Maximal predicted heart rate is calculated as ‘220 - age’.

29
Q

What are the pharmacologic stress agents mentioned?

A
  • Dobutamine
  • Dipyridamole
  • Adenosine
  • Regadenoson
30
Q

How do dipyridamole, adenosine, and regadenoson function as vasodilators?

A

They act on adenosine receptors causing a 3.5- to 5-fold increase in myocardial blood flow

Dipyridamole increases endogenous adenosine levels, while adenosine and regadenoson increase levels exogenously.

31
Q

What are common side effects of vasodilators?

A
  • Flushing
  • Headache
  • Nausea
  • Shortness of breath
32
Q

True or False: Vasodilators are safe for patients with severe bronchospastic COPD.

A

False

However, recent research shows regadenoson may be safe for patients with mild and moderate COPD.

33
Q

What is the purpose of gated SPECT imaging?

A

To assess left ventricular volumes and left ventricular ejection fraction (LVEF)

Gating allows determination of ventricular volumes at different points in the cardiac cycle.

34
Q

What does first-pass radionuclide angiography (FPRNA) assess?

A

LVEF, right ventricular ejection fraction, regional wall motion, and cardiopulmonary shunts

It uses a bolus technique and rapid acquisition.

35
Q

List the benefits of using radionuclide angiography to assess LVEF.

A
  • Accurate and reproducible measure
  • Less expensive than MRI
  • Useful when other methods are not possible
  • Independent predictor of cardiac events
36
Q

What is the range of radiation exposure for patients during nuclear tests?

A

From about 3 mSv to upward of 30 mSv

mSv stands for milliSievert.

37
Q

What is the ALARA principle in the context of radiation exposure?

A

To keep radiation exposure as low as reasonably achievable

This is important to minimize the risk of developing malignancy.

38
Q

What should physicians discuss with patients prior to nuclear tests?

A

Risks and benefits of radiation exposure

Cardiology Secrets (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions