Revision course nuc med

Question 1

SClerotic mets are which

Answer 1

Prostate
Some breast
carcinoid
medulloblastoma

colonic -some
lymphoma
lung

Question 2

Lytic diseases

Answer 2

thyroid
rcc
melanoma

HCC
lung
GI m

Question 3

If bone mets in prostate - what does that mena staging

Answer 3

8+

T3B+

Question 4

Osteoid osteoma on nuc med

Answer 4

nidus will be hot

Question 5

Cuases of super scan

Answer 5

Mets everywhere

metabolic - osteopetrosis, dystrophy, hyperparathyroidism

Question 6

3 phase bone scan

3 diagnosis

Answer 6

Early pool
Blood pool
Bone pool

Infeciton hot on all
Aseptic loosening - only on bone
Soft tissue inflammation - NOT hot on bone.

Question 7

indications for VQ

Answer 7

PE
Chronic Pulmonary Hypertension
Surgical planning

Question 8

rules on order of nucs in VQ

Answer 8

if using technetium have to do the ventilation bit first.

Question 9

causes of mismatch perfusion

Answer 9

PE
vasculitis
asthma

Question 10

cause of a matched defect

Answer 10

consolidatoin

Question 11

when to do a DMSA for UTI

Answer 11

after 6 weeks so scarring has gone

Question 12

MAG3 looks at

Answer 12

tubular excretion

Question 13

when to do a MAG3

Answer 13

consideration of hydronephrosis where no obstructing cause is seen

Question 14

nuclear med cystogram for what

Answer 14

reflux.

Question 15

HIDA

hot rim sign

Answer 15

cholecystitis

appearance of an absent GB due to upatek fo adjacent tissue

Question 16

other causes of HIDA

absent gb sign

Answer 16

no gb, cholecystitis, gallstones

Question 17

gastric dumping syndrome is what definition

Answer 17

70% gone in 3 mins

Question 18

drawback of using white cell scan

Answer 18

have to stop abx for 2 weeks as can interfere with scan

Question 19

Meckels scan

Answer 19

pertechnetate

Question 20

Neuroendocrine/carcinoid/NET

Answer 20

Somatostatin receptor –> Octretide

MIBG Indin 124
FDG PET Fl18

Question 21

relationship of Ki 67 mitotic index and expresison of neuroendocrine tumours

Answer 21

low ki67 - well differentiated.
lots of somatostain – god or octretide
FDG cold as slow growing.

high ki67, poorly differentiate and fast growing. FDG hot.
not good for octreatide.

Question 22

MIBG will light up where normally

Answer 22

hot cheeks hot liver.
sympathetic adrenergic tissue

NO SPLEEN

Question 23

parathyroid adneoma work up

Answer 23

US first

then if not found do SESTAMIBI scan at 20 min and 3 hours.

PTH adenoma will retain at 3 hours.

Question 24

Thyroid nodule work up

Answer 24

Pertechnetate. or I123 for diagnosis

Iodine 131 for papillary thyroid cancer therapy

Question 25

what does a DAT scan use

Answer 25

Iodine 123 Loflupnane will bind to the caudate end of the nerves from the substantia nigra

Question 26

hummingbird sign

Answer 26

PSP

Question 27

Nuc med for dementia

Answer 27

HMPAO or FDG

same patterns

Question 28

F18 is made in a

Answer 28

cyclotron

Question 29

Tc 99 is made in a

Answer 29

generator

Question 30

indsications for a PET

Answer 30

mets
occult primary
biopsy target
recurrent tumour

Question 31

when can you do a PET after different interventions?

Answer 31

1 week - biopsy
6 weeks - surgery
4 weeks - radiofrequency ablation
2-4 weeks - chemo
2-6 months - radiotherapy

Question 32

what sizew lesion is occult on PET

Answer 32

<7mm

Question 33

Lymphoma staging

Answer 33

1 - single group
2
3 - above the diaphragm

Question 34

Types of NHL

Answer 34

diffuse B cell - look luike anything, mets

follicular - nodes everywhere

Question 35

GIST are seen on

Answer 35

PET

80% positive