ST:11 (Test 7) Flashcards
If a 20 mCi dose of 99mTc HDP are needed at 9am, how much activity should the syringe contain if the technologist prepares it at 7am? (2hr decay factor on chart is 1.259)
a. 26.7 mCi
b. 21.26 mCi
c. 25.18 mCi
d. 15.9 mCi
c. 25.18 mCi
Using table 2.1b determine the decay factor for 99mTc at 7 hours (chart displays 3hr DF= .707 and 4hr DF= .630)
a. 0.551
b. 1.337
c. 0.445
d. 0.432
c. 0.445
On Monday morning at 6am, a technologist is preparing a 99mTc ECD kit that is to be used for the SPECT brain scans at 8am,9am,10am. Each patient should receive 10mCi. What is the minimum activity that should be added to the kit during preparation?
a. 42.6 mCi
b. 52.0 mCi
c. 44.5 mCi
d. 30.0 mCi
a. 42.6 mCi
A chromatography strip is used to test a kit for radiopharmaceutical impurity and is counted in a well counter. Part A contains 99mTc pertechnetate, and Pat B contains bound 99mTc in the desired from. If the results show 258,000 cpm in Part B, and 55,000 cpm in Part A, can this kit be used for injection into patients?
a. No
b. Yes
a. No
A chromatography strip is used to test a kit for radiochemical impurity and is counted in a well counter. Part A contains 99mTc pertechnetate, and Pat B contains bound 99mTc in the desired from. If the results show 258,000 cpm in Part B, and 55,000 cpm in Part A, What is the approximate labeling efficiency for the kit?
a. 18%
b. 79%
c. 82%
d. 21%
c. 82%
A chromatography strip is used to test a kit for radiopharmaceutical impurity and is counted in a well counter. Part A contains 99mTc pertechnetate, and Pat B contains bound 99mTc in the desired from. If the results show 258,000 cpm in Part B, and 55,000 cpm in Part A, what is the approximate radiochemical impurity?
a. 79%
b. 82%
c. 21%
d. 18%
d. 18%
A vial of 99mTc eluate is tested for 99Mo breakthrough, and the amount of breakthrough is 25 uCi in 775mCi at 6am. Following the preparation of all kits to be used that day, 450 mCi of 99mTc is left. That night, a technologist is asked to perform a scrotal scan at 11pm. Must the generator be eluted again?
a. Yes, because the molybdenum breakthrough will now exceed the limit allowed by the NRC
b. No
c. Yes, because the amount of eluate will have decayed to below the amount needed for a patient dose
a. Yes, because the molybdenum breakthrough will now exceed the limit allowed by the NRC
A 99mTc MDP bone scan dose was prepared at 7am and contained 32 mCi/2 ml. At 9am, when the patient arrives, the technologist realizes that the patients age was overlooked (13 years). The technologist would now like to adjust the dose to 11 mCi. Given a 2 hr decay factor of 0.794, what volume should be discarded so that the correct dose remains in the syringe?
a. 1.13 ml
b. 1.5 ml
c. 0.87 ml
d. 0.65 ml
a. 1.13 ml
To reduce the possibility of pyrogenic reactions, all kits should be prepared using saline that contains bacteriostatic preservatives
a. False
b. True
a. False
While performing a GI bleeding study with labeled red blood cells, a technologist notices gastric activity that he suspects is the results of free pertechnetate. What could be done to support this suspicion?
a. Image the thyroid
b. Have the patient drink 2 glasses of water and empty his or her bladder
c. Narrow the window around the photopeak
d. Reimage the patient in the erect position
a. Image the thyroid
Convert 23 mCi to SI units
a. 850 MBq
b. None of the above
c. 850 GBq
d. 850 kBq
a. 850 MBq
23 mCi x 37 MBq/1 mCi=
If excessive aluminum is present in 99mTc eluate, which of the following would be expected on a bone scan?
a. Lung uptake
b. Liver uptake
c. Gastric uptake
d. Thyroid uptake
b. Liver uptake
Radiochemical impurities often result from
a. Introduction of water into the kit AND introduction of oxygen into the kit
b. Introduction of nitrogen into the kit
c. Introduction of water into the kit
d. All of the above
e. Introduction of oxygen into the kit
a. Introduction of water into the kit AND introduction of oxygen into the kit
Which of the following is the most effective means of measuring low levels of removable radiation?
a. With a pocket dosimeter
b. By performing an area survey
c. By performing a wipe test
d. With a TLD
c. By performing a wipe test
What is the dose rate limit at the package surface for a shipment of radioactive material bearing a Yellow III label?
a. 50 mR/hr
b. 200 rads
c. 200 mR/hr
d. 200 mrem
c. 200 mR/hr
Which of the following measures absorbed doses?
a. Millicurie
b. Gray
c. All of the above
d. Becquerel
b. Gray
If the dose rate at 3 meters from a radioactive source is 100 mrem/hr, what will the dose rate be at 6 meters?
a. 12.5 mR/hr
b. 25 mR/hr
c. 75 mR/hr
d. 50 mR/hr
b. 25 mR/hr
The philosophy of the ALARA program is to keep the radiation dose:
a. As low as reasonably achievable
b. As long as reasonably acceptable
c. As low as recently authorized
d. As long as reasonably attained
a. As low as reasonably achievable
All of the following are critical factors in keeping radiation exposure to a minimum except:
a. Time spent near the radioactive source
b. Distance from the source of radiation
c. Geometry of the container holding the source of radiation
d. Shielding of the radioactive source
c. Geometry of the container holding the source of radiation
Gaseous radio-pharmaceuticals may only be used in rooms that
a. Contain an oxygen supply
b. Have at least one window
c. Are at a negative pressure compared to surrounding rooms
d. Are at a positive pressure compared to surrounding rooms
c. Are at a negative pressure compared to surrounding rooms
If the exposure rate at 4 meters from a radioactive source is 5 mR/hr, what will the exposure rate be at 3 meters?
a. 6.5 mR/hr
b. 7.4 mR/hr
c. 2.8 mR/hr
d. 8.9 mR/hr
d. 8.9 mR/hr
If the exposure rate at 10 meters from a radioactive source is 15 mR/hr, what will the exposure rate be at 25 meters?
a. 6 mR/hr
b. 3 mR/hr
c. 10 mR/hr
d. 2.4 mR/hr
d. 2.4 mR/hr
A spill of 99mTc increases the exposure rate in a room from 1.7 mR/hr to 3.15 mR/hr. The room is posted with a sign reading “Caution-Radioactive Materials”. What would be the ideal solution?
a. Change the sign to one reading “Caution-Radiation Area”
b. Place absorbent paper over the spill and close the room until the activity has decayed
c. Decontaminate the floor with water and cleanser
d. Call the NRC
b. Place absorbent paper over the spill and close the room until the activity has decayed
A technologist has 500 mrem registered on his ring badge in one month. What should be done to decrease exposure in the future?
a. Use lead pigs and syringe shields when preparing radio-pharmaceuticals
b. Wear lead aprons
c. Have another technologist elute the generator
d. All of the above
a. Use lead pigs and syringe shields when preparing radio-pharmaceuticals
OSHA requires that personnel exposure records be provided to employees
a. Monthly
b. Quarterly
c. Annually
d. Biannually
c. Annually
A room containing a 57Co sheet source is posed with a sign reading “Caution-Radioactive Materials”. The exposure rate measured next to the source is 5.2 mR/hr. What should be done?
a. Change the sign to one reading “Caution- Radioactive Area”
b. Store the source in a leaded container
c. Monitor the length of time the technologist can work near the source
d. None of the above
b. Store the source in a leaded container
What part of an imaging system emits light when it has absorbed a photon?
a. Photomultiplier tube
b. Collimator
c. Pulse height analyzer
d. Scintillation crystal
d. Scintillation crystal
Most of the photons emitted from the radiopharmaceutical which has been administered to a patient:
a. Do not contribute to the final image
b. Are received by the sodium iodide crystal AND are converted to a voltage signal
c. Are received by the sodium iodide crystal
d. Do not contribute to the final image AND are received by the sodium iodide crystal
e. Are converted to a voltage signal
a. Do not contribute to the final image
To obtain high resolution images of a small organ, gland or joint which collimator will be most useful?
a. Flat field
b. Low energy parallel hole
c. Pinhole
d. Diverging
c. Pinhole
As septal length _____, septal penetration _____.
a. Decreases, increases
b. Decreases. Decreases
c. Increases, increases
d. Increases, decreases
e. Increases, decreases AND decreases, increases
e. Increases, decreases AND decreases, increases
Which of the following degrade images?
a. Photon scatter in the patient AND increased patient to detector distance
b. Septal penetration
c. Photon scatter in the patient
d. All of the above
e. Increased patient to detector distance
d. All of the above
A technologist covers the collimator (which is facing the ceiling) with absorbent paper and obtains a uniformity image using a liquid flood source with added 99mTc.
A round cold spot is seen on the image. Subsequently the technologist removes the collimator, turns the camera face down and obtains another image using a point source placed on the floor. This image appears uniform.
What is the most likely cause of the cold spot on the first image?
a. Decoupled photomultiplier tube
b. Collimator defect
c. Improper energy peaking
d. Subtle crystal crack
a. Decoupled photo-multiplier tube
If two photons strike a sodium iodide crystal at the same time what will occur?
a. The system will perceive only one event which will contain the summed energy of both photons
b. Both will be correctly perceived
c. None of the above
d. Neither event will trigger production of light
a. The system will perceive only one event which will contain the summed energy of both photons
The time after a crystal has absorbed a photon before it able to respond to another event is called:
a. Dead time
b. Count rate
c. Distortion
d. Sensitivity
a. Dead time
The Z component of the signal in the photo-multiplier tube will:
a. Be removed by the PMT
b. All of the above
c. Be recorded on the Count rate time
d. Be processed by the pulse height analyzer
d. Be processed by the pulse height analyzer
The purpose of the photo-multiplier tube is to:
a. To filter out photons which strike the crustal from oblique angles
b. Keep any of the electrical signal which resulted from scatter or background from contribution to the final image
c. To convert light into an electrical signal and to magnify that signal
d. To convert radioactivity into light
c. To convert light into an electrical signal and to magnify that signal
A camera with three pulse height analyzers will be most useful for imaging:
a. 67Ga
b. 67Ga AND 133Xe
c. 111In
d. 99mTc
e. 133Xe
a. 67Ga
A technologist has set a 15% symmetric window for a 140 keV photopeak. What will happen to a 158 keV signal?
a. It will be accepted by the pulse height analyzer
b. It will be rejected by the pulse height analyzer
b. It will be rejected by the pulse height analyzer
A typical energy spectrum of 99mTc from a patient contains a broad peak around 90-140keV that is not present on the energy spectrum from a point source of the same isotope. This represents:
a. Compton scatter
b. The iodine escape peak
c. Lead X-ray peak
d. The signal from 99mTc
a. Compton scatter
Image exposure time may be determined by:
a. A preset number of counts
b. A preset time
c. information density
d. All of the above
d. All of the above
Which of the following is measured in millimetres?
a. Energy resolution
b. Spatial resolution
c. Temporal resolution
d. Field uniformity
b. Spatial resolution
The spatial resolution of an image is better with a _____ energy isotope than with an energy _____ -isotope.
a. Higher, lower
b. Lower, higher
a. Higher, lower
If the energy range for 137Cs at half maximum ranges from 620-695, what is the percent energy resolution, and is the system operating within acceptable limits?
a. 13.5, no
b. 10.8, yes
c. 11.3, yes
d. 7.5, no
c. 11.3, yes
According to the curve for 137Cs shown in figure 4.1, what is the energy resolution of the system?
FIGURE 4.1 ENERGY (keV)
a. 10.5
b. 6.9
c. 11.6 (answer)
d. 8.2
c. 11.6 (answer)
Of the following types of transmission phantoms, which one requires the fewest images to test the spatial resolution over the entire detector face?
a. Orthogonal hole phantom
b. Parallel line equal space phantom
c. Four quadrant bar phantom
d. Hine-Duley phantom
a. Orthogonal hole phantom
An orthogonal hole phantom cannot be used to test spatial linearity since it does not contain lead bars.
a. False
b. True
a. False
When using a 150 uCi source of 99mTc to check uniformity, a technologist measures the counts in one minute as 53,125. If the background in the room is 352 cpm, what is the sensitivity of the system?
a. 354 cpm/uCi
b. 360 cpm/uCi
c. 351 cpm/uCi
d. 356 cpm/uCi
c. 351 cpm/uCi
With a matrix size of 64x64, and two sources placed 30 cm apart there are 44 pixels between the activity peaks on the activity profile that is generated. What is the pixel size?
a. 1.4 mm/pixel
b. None of the above
c. 6.8 cm/pixel
d. 6.8 mm/pixel
e. 0.14 cm/pixel
d. 6.8 mm/pixel
What steps should be taken to reduce or remove a star artifact from reconstructed SPECT images?
a. Decrease the matrix size
b. Increase the number of projections
c. Increase the radius of projection
d. Increase the time per projection
b. Increase the number of projections
The _____ method of SPECT acquisition requires slightly more time, but has less blurring than the ____ method.
a. Step and shoot, continuous rotation
b. Continuous rotation, step and shoot
a. Step and shoot, continuous rotation
As matrix size increases, what must also increase?
a. Computer memory used
b. Total imaging time
c. Number of projections
d. Total imaging time AND computer memory used
e. All of the above
d. Total imaging time AND computer memory used
If the distance between 2 point sources placed on the camera surface is 35 mm, and the number of pixels between their activity profile peaks is 52 in the x axis and 55 in the y axis, are the pixel dimensions in the x and y direction within 0.5 mm of one another?
a. No
b. Yes
b. Yes
A technologist measures a standard of known activity in the dose calibrator three times. She subtracts background from each measurement and compares these measurements to the decay corrected activity of the standard. This was a test of:
a. Geometric dependence
b. Accuracy
c. Linearity
d. Constancy
b. Accuracy
Records of dose calibrator checks must be kept for:
a. 3 years
b. 10 years
c. As long as the license is valid
d. 5 years
a. 3 years
Survey meters must be calibrated:
a. Annually
b. Following repair
c. All of the above
d. Before first use
c. All of the above
Survey meters must be checked for proper operation against a sealed source:
a. Every six months
b. Before each day of use
c. Monthly
d. Weekly
b. Before each day of use
Which of the following would be used to perform a survey of an area in which a small amount of radioactivity is expected to be present?
a. Single probe counting system
b. Geiger-Muller counter
c. Well counter
d. Ionization chamber
b. Geiger-Muller counter
The axial skeleton contains:
a. The skull
b. The vertebral column
c. All of the above
d. The ribs
e. The ilium
f. The ribs, skull, and vertebral column ONLY
f. The ribs, skull, and vertebral column ONLY
By what mechanism do diphosphonates localize if the bone?
a. Active transport
b. Phagocytosis
c. Chemisorption
d. Capillary blockade
c. Chemisorption
Which of the following describe a pediatric bone scan?
a. Decreased uptake along epiphyseal plates
b. Increased uptake along epiphyseal plates
c. Increased uptake in long bones
d. Overall decreased uptake in bone
b. Increased uptake along epiphyseal plates
The first phase of a three-phase bone scan is best performed by:
a. Bolus injection followed by dynamic 1 second images for 30 seconds
b. Bolus injection followed by a static 500-600 K count image
c. Bolus injection followed by dynamic 20 second images for 3 minutes
d. Bolus injection, followed by dynamic 2 second images for 60 seconds
d. Bolus injection, followed by dynamic 2 second images for 60 seconds
What pharmaceuticals may be used for bone marrow imaging?
a. All of the above
b. 99mTc albumin colloid
c. 99mmTc PYP
d. 99mTc albumin colloid AND 99mTc sulfur colloid
e. 99mTc sulfur colloid
d. 99mTc albumin colloid AND 99mTc sulfur colloid
Splenic uptake on a bone scan is often associated with:
a. Paget’s disease
b. Splenic abscess
c. Sickle cell disease
d. Liver failure
c. Sickle cell disease
Bone is made of:
a. Hydrogen peroxide AND hydroxyapatite mineral ONLY
b. Hydroxyapatite mineral
c. Collagen
d. Hydrogen peroxide
e. All of the above
f. Hydroxyapatite mineral AND collagen ONLY
f. Hydroxyapatite mineral AND collagen ONLY
Osteoblastic activity refers to:
a. Bone compression
b. Destruction and reabsorption of bone
c. Bone marrow biopsy
d. New bone formation
d. New bone formation
A technologist neglects to fie a patient potassium perchlorate before injection with 20 mCi of 99mTc pertechnetate. How will this affect the static brain images take at 1 hour after injection?
a. Choroid plexus may be seen
b. Thyroid activity may be seen
c. Salivary glands may be seen
a. Choroid plexus may be seen
Radionuclide CNS angiography is most commonly used to:
a. Investigate brain perfusion
b. Confirm brain death
c. Locate neoplasms
d. Evaluate cerebrovascular reserve
a. Investigate brain perfusion
In which area is the radiopharmaceutical not visible in a normal Cisternogram?
a. Lateral ventricles
b. Basal cisterns
c. Cerebral convexities
d. Sylvian fissure
a. Lateral ventricles
CSF dynamics are studied following administration of In-111 DTPA:
a. Via intradermal injection
b. Via intravenous injection
c. Via intrathecal injection
d. Via intraperitoneal injection
c. Via intrathecal injection
What is the usual dose for a radionuclide Cisternogram in adults?
a. 500 uCi of 111In DTPA
b. 5 mCi of 111In DTPA
c. 100 uCi of 111In DTPA
d. 2.5 mCi of 111In DTPA
a. 500 uCi of 111In DTPA
What is the purpose of pledget placement in suspected CSF leak?
a. To make the patient more comfortable during subarachnoid puncture
b. To avoid contamination of the scintillation detection system
c. To test them for contamination suggesting the presence of leaking CSF in the nose or ears
d. To alter the biodistribution of the radiotracer
c. To test them for contamination suggesting the presence of leaking CSF in the nose or ears
Why is 111In DTPA preferred over 99mTc DTPA for cisternography in adults?
a. Because it has a longer half-life allowing delayed imaging
b. Because it has a superior biodistribution
c. Because it has lower energy photons
d. Because it has 2 photopeaks
a. Because it has a longer half-life allowing delayed imaging
99mTc labeled lipophilic radiopharmaceuticals are preferable to radioiodinated amines because:
a. Administered activity is higher, providing superior images
b. They deliver a lower radiation dose to patients AND administered activity is higher, providing superior images
c. They deliver a lower radiation dose to patients
d. They are more rapidly extracted from the bloodstream
e. All of he above
b. They deliver a lower radiation dose to patients AND administered activity is higher, providing superior images
99mTclabeledlipoplilic(i.e. having an affinity for fat) radiopharmaceuticals (e.g. bicisate and exametazime) deliver a lower radiation dose, so higher activity can be administered. For this reason, they are superior for SPECT imaging. Also, they do not significantly redistribute in the brain, while radioiodinated amines do. For this reason, they have largely replaced the radioiodinated amines for brain SPECT.
Considerations for successful SPECT imaging of the brain include:
a. Immobilizing the patient
b. Minimizing patient to detector distance AND immobilizing the patient
c. Minimizing patient to detector distance
d. All of the above
e. Minimizing sensory stimulation during injection
d. All of the above
What portion of an EKG wave represents the depolarization of the ventricles?
a. T segment
b. QRS complex
c. P-wave
d. T-wave
b. QRS complex
A patient is only able to tolerate 3 images during a 201TI chloride myocardial perfusion study. From those views listed, which would be the best choice of images to obtain?
a. Anterior, LAO 45 and LAO 70
b. RAO 10, LAO 45, and left lateral
c. Anterior, LAO 25 and LAO 60
d. Anterior, LAO 70 and left lateral
a. Anterior, LAO 45 and LAO 70
Of the choices offered, which is the best imaging view for calculating right ejection fraction?
a. LAO 10%
b. RAO 60%
c. RAO 30%
d. Anterior
c. RAO 30%
Of the choices offered, which is the best imaging view for calculating left ejection fraction?
a. Left lateral
b. Anterior
c. LAO 5%
d. LAO 45%
d. LAO 45%
Given the data below, calculate the left ventricular ejection fraction
Net ED = 58,219
Net ES = 35,317
a. 39%
b. 43%
c. 16%
d. 60%
a. 39%
The left ventricular ejection fraction determined of 40% is within the normal range.
a. False
b. True
a. False
Figure 8.1 (p.66) shows computer generated time activity curves over a cardiac cycle for two patients. Which curve represents the patient with the higher ejection fraction? (upper curve small dip, lower curve, big dip)
a. Upper curve
b. Lower curve
b. Lower curve
Which of the following cannot be evaluated by a MUGA scan?
a. Wall thickness
b. Aneurysmal flow
c. Vessel patency
d. Wall motion
a. Wall thickness
The images in Figure 8.2 represent: ( > )
a. None of the above
b. Vertical long axis
c. Horizontal long axis
d. Short axis
b. Vertical long axis
During a gated study, 24 images per cardiac cycle are obtained. If the patient’s heart rate is 65 bpm, the length of time per image is:
a. 41. msec
b. 38 msec
c. 41 msec
d. 3.8 msec
b. 38 msec
A right anterior oblique is useful for:
a. Separation of ventricles form stomach of first pass
b. Increasing patient comfort and potentially improving image quality
c. Visualizing the lateral wall of the left ventricle
d. Facilitating calculation of LVEF and RVEF on first past
d. Facilitating calculation of LVEF and RVEF on first past
What will reverse the effects of dipyridamole?
a. Cholecystokinin
b. Adenosine
c. Thallium
d. Regadenoson
e. Aminophylline
f. Dobutamine
e. Aminophylline
Which of the following will most negatively affect radionuclide ventriculography?
a. Sinus bradycardia
b. Long QT interval
c. Occasional PVC
d. Sinus arrythmia
e. Sinus tachycardia
d. Sinus arrythmia
The vertical long axis view of the heart is most comparable to a:
a. Coronal image
b. Transverse image
c. Sagittal image
c. Sagittal image
As an alternative to exercise studies, pharmacologic stress can be achieved through the use of any of the following except:
a. Aminophylline
b. Adenosine
c. Dipyridamole
d. Regadenoson
e. Dobutamine
Aminophylline
In multi-gated analysis of the left ventricular, end systole is best described as:
a. The frame with the lowest number of counts in the ROI around the right ventricle
b. All of the above
c. The frame with the highest number of counts in the ROI around the left ventricle
d. The frame with the lowest number of counts in the ROI around the left ventricle, plus the counts from the background ROI
e. None of the above
e. None of the above
All of the following will negatively affect a myocardial resting study with 201Tl chloride except:
a. Arrhythmia
b. Wrong collimator
c. None of the above
d. Increased patient to detector distance
e. Incorrect COR
a. Arrhythmia
Dipyridamole is supplied to a nuclear medicine department in 10ml vials, each containing 50mg. If a patient weighs 155 pounds, how many milliliters must be injected for him to receive 0.56mg/kg?
a. 7.9 ml
b. 8.7 ml
c. 39.5 ml
d. 17.4 ml
a. 7.9 ml
Which of the following does not describe correct preparation for an exercise myocardial study?
a. Catheter placement for injection of radiopharmaceutical during exercise
b. NPO of at least 4 hours prior to radiopharmaceutical administration
c. None of the above
d. Halt all medications 24 hours before study
d. Halt all medications 24 hours before study
During an exercise gated study, the ECG pattern suddenly becomes dramatically different, although the patient is responsive, has an unchanged pulse rate, continues to exercise, and has no pain. The technologist should first:
a. Call a code
b. Call the referring physician
c. Check for a disconnected lead
d. Start CPR
e. Do nothing
c. Check for a disconnected lead
Which of the following radiopharmaceuticals is not used to study the heart?
a. 99mTc Sestamibi
b. 99mTc WBCs
c. 99mTc PYP
d. 99mTc HAS
e. Both 99mTc WBCs and 99mTc HAS
b. 99mTc WBCs
Which of the following is not a critical factor in obtaining a gated first pass study?
a. Positioning the heart in the center of the field of view
b. Injection of at least 10 mi of radiotracer
c. Regular heart beat
d. Tracer bolus of small volume
e. Use of a multi crystal camera
e. Use of a multi crystal camera
The best collimator to use during a first pass study is:
a. LEAP
b. Medium energy
c. High resolution
d. High sensitivity
d. High sensitivity
A neonatal first pass study is performed and the time activity curve for the ROI around the left ventricle shows a peak of activity on the lung ROI. This most likely indicates:
a. Interventricular shunt
b. Prolapsed mitral valve
c. Improperly drawn regions of interest
d. Radiotracer contained in too high of volume
a. Interventricular shunt
Cardiac contraction is initiated in the:
a. P wave
b. Bundle of His
c. AV node
d. SA node
d. SA node
Treadmill exercise increases heart rate by:
a. Simulating artifact
b. All of the above
c. Increasing treadmill speed
d. Increasing the resistance of the treadmill
c. Increasing treadmill speed
