Nuclear Medicine

Question 1

radioisotope perfusion tracers used in myocardial perfusion imaging (MPI)

Answer 1

Thallium - 201

Technetium -99m

Question 2

radioisotope tracer used in PET?

Answer 2

Rubidium -82

N ammonia

Question 3

2 preferred agents that increase blood flow similar to exercise

Answer 3

Adenosine

Dipyridamole

Question 4

preferred pharmacologic agent for patients with bronchospastic disease

Answer 4

dobutamine

• bronchospastic disease is a contraindication for use of adenosime amd dipyridamole

Question 5

2 most commonly used technologies in nuclear cardiology

Answer 5

SPECT (single photon emission CT)

PET (positron emission CT)

Question 6

what is the advantage of TECHNETIUM over thallium?

Answer 6

shorter physical half lives

others: shorter imaging time and better image quality

Question 7

what is the advantage of THALLIUM over technetium?

Answer 7

lower cost
measures increased pulmonary uptake
lower energy level

Question 8

what is better for assessment of myocardial perfusion? thallium or technetium?

Answer 8

technetium - perfusion

thallium - myocardial viability

in Tc99m, it remains bound intracellularly in mitochondria of viable myocyte of stunned myocardium
thallium “redistributes” over time in zones of low flow means greater uptake in zones of viable myocardium

Question 9

“cold” thyroid nodules. benign or malignant?

Answer 9

cold = benign

a hot malignancy!!

Question 10

which of the following does not have low RAI uotake on thyroid scan?
subacute thyroiditis
graves disease
ectopic thyroid tissue
thyrotoxicosis factitia
iodine excess

Answer 10

graves disease

–> increased tracer uptake in an enlarged gland with homogenous distribution

Question 11

multiple areas of relatively increased/decreased tracer uptake

Answer 11

multinodular toxic goiter

Question 12

will metastatic thyroid ca deposits in thyroid scan result to a decreased or an increased tracer uptake?

Answer 12

decreased tracer uptake

Question 13

drug that enhances RAS in renography with use of Tc99m DTPA or Tc99m

Answer 13

captopril

Question 14

V/Q SCAN is useful for diagnosing what disease?

Answer 14

pulmonary embolism

Question 15

high probability criteria of PE if seen on vq scan

Answer 15

> 2 segmental perfusion defects in presence of normal ventilation
~ depicts areas of focal oligemia

Question 16

high risk SPECT MPI findings?

Answer 16

severe resting or poststress LV systolic dysfunction
large or multiple stress induced defects
large fixed defects with LV dilatation

Question 17

aside from SPECT and PET, this nuclear technique may also be utilized to assess LV function and volumes

Answer 17

multiple gated blood pool acquisition (MUGA)