Which of the following is NOT true about Colloid Shift?

Is due to increased uptake by hepatocytes

Some of the symptoms associated with Meckels Diverticulum are

bleeding, inflammation, and perforation

Which does not require particle reduction for pulmonary imaging?

adult with obstructive lung disease

Which is NOT true of Tc99m MAA pulmonary imaging?

b. Recommended to inject into IV line

What does ALARA stand for?

As Low As Reasonably Achievable

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Answers

1
Which Radiopharmaceutical is matched to the correct procedure?
c.) Solid Gastric Emptying; Tc 99m DTPA
a.) Chronic GI Bleed: Tc 99m Sulfur Colloid
d.) HIDA: Tc 99m Choletec
b.) Acute GI Bleed: TcO4
2
A blood clot in the lungs is defined as…
COPD
Lung Cancer
Pleural Effusion
Pulmonary Embolism
3
For a parathyroid scan, a patient will receive a dose within ______ range of _______ RPh.
c. 20-30 mCi of Tc-99m MIBG
d. 20-30 mCi of Tc-99m MIBI
b. 20-30 uCi of Tc-99m MIBI
a. 20-30 uCi of Tc-99m MIBG
4
What agent or compound is associated with radionuclidic impurity?
b. Molybdenum 99
c. Aluminum
d. Iodine
a. Free Tc04
5
Breastfeeding would be terminated indefinitely when using radiopharmaceuticals that are made up of
I-131
Tc-99m
Xe-133
I-123
6
The flow of air through the lungs is defined as…
perfusion
ventilation
inhalation
respiration
7
Which of the following is NOT true about Colloid Shift?
Will result in increased bone marrow and spleen uptake
It is a sign of liver cirrhosis and portal hypertension
Is due to increased uptake by hepatocytes
Will show a spleen-liver ratio of 2:1
8
Which is not true of Tc99m DTPA pulmonary imaging?
a. Dose: 25-40 mCi in 3-4ml saline
b. Negative pressure nebulizer
c. One way breathing valve
d. Ventilate patient to 2-3 kcps
9
What is the MOL for lung perfusion imaging with Tc-MAA?
active transport
phagocytosis
capillary blockade
compartmentalization
10
What is (are) the function(s) of parathyroid hormone (PTH)?
c. Increase excretion of phosphorus through the renal/urinary system
b. Stimulate osteoclast activity- bone resorption
d. All of the Above
a. Increase calcium absorption from bowel
11
Which of the following is NOT a part of the solid GE standardized meal?
4oz egg whites
30g jam or jelly
20g of mashed potatoes
2 slices of toast
12
Body positioning that is referred to a foot or a footlike part is known as:
lateral
cephalic
dorsal
pedal
13
T/F sulfur colloid particles range from 0.1-1.0 microns for a liver/spleen scan?
True
False
14
The image below is not conclusive with a positive GI bleed
True
False
15
The detection element in a gamma camera is a single NaI crystal.
True
False
16
Catecholamines include
cortisol
epinephrine
glucagon
none of the above
17
Some of the symptoms associated with Meckels Diverticulum are
bile leak
right upper quadrant pain
bleeding, inflammation, and perforation
nausea and vomiting
18
The typical adult dose of Mebrofenin is:
10mCi
8mCi
15mCi
20mCi
19
What type of cells localizes the radiopharmaceutical used in Meckel’s Diverticulum?
parietal cells
kupffer cells
mucin producing cells
hepatic cells
20
_____ happens when fluid builds up behind the eye causing the muscles to push the eyes forward.
c. shunts
a. Hashimoto’s
d. Goiter
b. Exophthalmos
21
All of the following are clinical indications of hyperparathyroidism EXCEPT:
b. Bone pain
d. Myxedema
c. Lump in the neck
a. Fatigue
22
Which does not require particle reduction for pulmonary imaging?
adult with obstructive lung disease
pregnant women
children
patient with R to L shunt
23
What is the method of localization for MDP/HDP in a bone scan?
active transport
capillary blockade
stannous chloride
chemisorption
24
What is the radiotracer used for a liver/spleen scan?
Tc-99m pertechnetate
Tc-99m sulfur colloid
Tc-99m tagged RBCs
Tc-99m HDP
25
Tc-99m decays by isomeric transition.
False
True
26
What prompts the thyroid to release T3 and T4?
Thyrogen
TSH
TRH
Tyrosine
27
For 99m TC-IDA radiopharmaceuticals the critical organ is
d. Stomach
b. Large bowel
c. Bladder
a. Gallbladder
28
Which rph below is not used in NM pulmonary imaging?
Tc-99m MAA
I-131
Tc-99m DTPA
Xe-133
29
When tagging blood using an ultra tag kit, it is important that you take an equal volume of air out the vial
True
False
30
99m TC-IDA radiopharmaceuticals are taken up by
Kupffer cells
red blood cells
white blood cells
hepatocytes
31
The organ the Rph travels to by default, stays the longest, and receives the most radiation burden
Target organ
Exposed organ
Critical organ
Default organ
32
Identify the hidden piece (indicated by arrow)
hepatic flexure
descending colon
cecum
splenic flexure
33
Lung quantification is performed prior to…
b. Lung cancer surgery
a. Removal of lung
d. All of the above
c. Pnemonectomy
34
All of the following except ___ indicate normal, healthy lungs.
d. Even distribution
a. Mismatched defects
b. No missing chunks
c. Heart shadow
35
9. T/F hepatocytes secrete bile?
True
False
36
In order to prevent thyroid uptake on an mIBG scan, you would treat patient with
B and C
Morphine
CCK
Lugols solution
37
In adrenal imaging with mIBG, delay imaging is taken after
3hr
24hr
6hr
12hr
38
What lab values are the primary reason leading to a parathyroid scan?
b. TSH and Ca2+
a. PTH and Ca2+
d. TRH and TSH
c. PSA and TSH
39
Which is NOT true of Tc99m MAA pulmonary imaging?
b. Recommended to inject into IV line
c. Invert syringe to mix particles
d. Do not pull back on syringe
a. Patient should be supine
40
In a bone scan, what is the critical organ?
lungs
bones
bladder
liver
41
Pheochromocytomas are associated with
d. All of the above
c. Symptoms of increased heart rate and bp
b. Production of large amounts of epinephrine and nor-epinephrine
a. Benign or malignant tumors
42
What does ALARA stand for?
As Large As Reasonably Achievable
As Little As Reasonably Acceptable
As Low As Reasonably Achievable
As Low As Reasonably Acceptable
43
Lead syringe shields are most appropriate for shielding gamma emissions.
False
True
44
Which is not an indication of liver/spleen scan?
assessment of anatomy, size, and position
assessment of bladder size
hepatic hemangioma
acute or chronic liver disease
45
Which is the path by which a drug, fluid, or substance is taken into the body?
Method of Localization
Biodistribution
Method of Excretion
Method of Administration
46
Another name for CCK is
morphine
choletec
mebrofenin
sincalide
47
Which of the following can not be used for bone scanning?
PYP
MDP
DTPA
HDP
48
What component of the egg binds the Sulfur Colloid?
albumin in the egg whites
Lipids in the egg whites
amino acids in the yolk
Iron in the yolk
49
Inverse square law states that radiation exposure is inversely proportional to distance and is reduced by a factor of
6
3
4
2
50
Which of the follow is a key criteria for a GI bleed to be diagnosed
a change in intensity
appearance of activity outside of blood pool structures
all of the above
movement of activity over time
51
A chest x-ray must be performed within 24h of a V/Q scan
True
False
52
Solids empty at what rate compared to liquids
slower rate
exponentially faster
the same rate
faster rate
53
What radiopharmaceutical is used during a Meckel’s Diverticulum scan?
Tc-Mebrofenin
Tc-Sulfur colloid
Tc-Medronate
Tc-Pertechnetate
54
Blood flow to the lungs is defined as perfusion.
FALSE
TRUE
55
For HIDA imaging, patients cannot have opiates for _______ hours , prior to test.
6
48
24
12
56
Before injecting Tc99m MAA, do not pull back on the syringe.
True
False
57
One of the medications that can be used as an interventional agent for Meckels imaging is
Tylenol
Morphine
Zantac
Synthroid
58
Where does the thyroid originate?
the base of the tongue
the brainstem
the base of the lungs
Inside the ear
59
T/F: A patient needs to be pretreated with CCK if they have been NPO more than 6 hours
False
True
60
Which RAIU value indicates a patient with hypothyroidism?
12%
30%
7%
80%
61
Hyperparathyroidism is caused by an insufficient level of PTH which leads to a decrease serum calcium (hypocalcemia).
False
True
62
It is normal to see the esophagus and stomach in a lung scan
False
True
63
Which of the following primary cancer sites does bone metastasis commonly result from?
Liver, brain, lungs
Small cell lung, liver, prostate
4. Prostate, breast, liver
Breast, small cell lung, prostate
64
Gamma is the particulate emission with a large, unstable mass and helium nucleus emitted.
True
False
65
In parathyroid imaging, what do Tl-201 and Tc-99m Sestamibi bind to?
Mitochondrial enzymes
Mitochondrial proteins
catecholamines
ligands
66
What is the MOL of liver/spleen scan?
passive transport
active transport
compartmentalization
phagocytosis by Kupffer cells
67
When the gallbladder is visualized within 60 minutes, you can administer morphine
False
True
68
By 15 minutes of HIDA imaging, you should be able to see:
d. Bowel
a. Gallbladder
b. Stomach
c. Biliary activity
69
During HIDA imaging, delayed biliary to bowel transit past 60 minutes indicates:
gallbladder sludge
common bile duct obstruction
chronic cholecystitis
acute cholecystitis
70
Meckel’s Diverticulum is caused by
c. Inflammation of the upper GI
a. An abnormal malformation in the transverse colon
b. Inflammation of the appendix
d. An incomplete obliteration of the vitelline duct
71
Which of the following are NOT among the 4 "rights" you must consider before administering any drug to a patient?
c. acquisition
d. patient
a. medication (drug)
b. route
72
Which rph is best for diagnosing COPD?
Tc-DTPA
Xe-133
Kr-81
Tc-technegas
73
Parathyroid hormone works on a negative feedback loop with the hypothalamus and pituitary gland
True
False
74
Chromaffin cells (located w/in medulla of the adrenal gland) are the most common site for
Adrenocortical carcinoma
Neuroblastomas
Paragangliomas
Pheochromocytomas
75
By 3 hours, what percentage of MDP/HDP is taken up in the bone?
25
50
18
30
76
Anti-thyroid meds provide a block at the organification step of thyroid hormone synthesis.
False
True
77
What is the conversion of 65 uCi to mCi?
6500mCi
0.65 mCi
0.065mCi
650mCi
78
What is the energy level for a liver/spleen scan using sulfur colloid?
140keV
120keV
81keV
364keV
79
The dose used for adults in Meckels imaging is
1-5mCi
10-18mCi
20-25mCi
8-12mCi
80
If you administer morphine, you will still administer CCK
True
False
81
What is a normal finding that you could see while performing a whole body bone scan on a pediatric patient?
nose fracture
finger fractures
epiphyseal plates
no bladder
82
The pediatric dose when imaging a Meckel’s Diverticulum is
a. 0.02uCi/kg
b. 0.1uCi/kg
c. 0.05uCi/kg
d. 1mCi/kg
83
99m TC-IDA radipharmaceuticals method of localization is
compartmentalization
active transport
capillary blockade
chemisorption
84
GB inflammation or sludge with no gallstones or cystic duct obstruction when the GB may or may not be visualized is
b. Chronic cholecystitis
a. Acute cholecystitis
c. Acalculous cholecystitis
d. Gastroparesis
85
Foods that may interfere with uptake of mIGB . . .
a. chocolate
c. broccoli
b. blue-veined cheese
d. A and B
86
99mTc04-, I-123, 99mTc-Mibi, and Tl-201 are all used to image the parathyroid in dual-isotope imaging.
True
False
87
Which is the indication for Whole Body bone scans?
c. Metastatic disease
d. Osteomyelitis vs. Cellulitis
a. Embolism
b. Peristalsis
88
Adrenal glands contain _____ cells which secrete ______
a. Hepatocyte; bile
c. Chromaffin; catecholamines
b. Beta; insulin
d. Alpha; glucagon
89
All of the following are methods for tagging except...
modified In-vitro
In-vitro
modified In-vivo
In-vivo
90
The radiopharmaceutical used for acute GI bleeds is…
Tc-99m sulfur colloid
Tc-99m tagged RBCs
Tc-99m MAG 3
Tc-99m myoview
91
Method of localization of adrenal imaging agent I-123/I-131 mIBG
a. Active transport
b. Passive diffusion
c. Phagocytosis
d. Chemisorption
92
Which of the following are/is indication(s) for a whole body
all of the above
Padgett’s disease
arthritis
fracture
93
Which of the following is NOT a cause of poor blood tag for a GI bleed scan?
b.) Too much free Tc-99m
d.) Injecting into IV line
a.) A large number of erythrocytes
c.) Chemotherapy
94
For a skeletal study, why is it important for patient to drink 4-6 glasses of fluids after injection?
Improves target to background ratio
Improves patient mood
Bladder appears more clearly on image
Patient becomes more calm
95
Iodine binds to _____ in the thyroid
Tyrosine
Thyrogen
TSH
T3
96
No visualization of the gallbladder generally indicates
a. Acute cholecystitis
b. Chronic cholecystitis
c. Gallbladder stones
d. Gallbladder sludge
97
One condition that satisfies the rule of 2’s associated with Meckel’s is
Has 2 types of localization in the cell
Occurs in 2% of the population
The average length is 2 mm
all of the above
98
What is the correct concentration for CCK administration
c.) .02ug/kg in sterile water
a.) .05ug/kg in sterile water
b.) .1ug/kg in sterile water
d.) .2ug/kg in sterile water
99
An increased sulfur colloid uptake in the spleen and bone marrow with decreased uptake in the liver is known as what?
Kinevac shift
Hemangioma
Colloid shift
Colon cancer
100
What is the likely diagnosis for the patient based on the following image?
d. Pheochromocytoma
b. Ectopic parathormone
c. Parathyroid Adenoma
a. Malignant parathyroid

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