Procedures final exam study guide
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  • Which of the following is NOT a factor for osteoporosis?

    Women (white)

    Elderly

    Calcium

    Vitamin D deficient

    health osteoporosis

  • What percentage of fractures can be visualized on a bone scan by 24 hours?

    50%

    80%

    70%

    90%

    radiology bone_scan

  • What helps to clear the injected material from your soft tissue during a bone scan?

    Resting

    Smoking

    Drinking fluids

    Eating

    health bone_scan

  • How are 99m Tc-bound phosphates taken to bones?

    By nerves

    By muscle contraction

    By blood

    By lymphatic system

    radiology skeletal_system

  • What types of slices are obtained from a SPECT acquisition?

    Sagittal, coronal, and axial

    Transverse, sagittal, and coronal

    Radial, static, and dynamic

    Horizontal, vertical, and axial

    imaging spect

  • When evaluating a prosthesis with a bone scan, what can be assessed?

    Bone density

    Muscle strength

    Infection around the prosthesis

    Blood flow

    Placement of the prosthesis
    radiology prosthesis

  • What is the characteristic of Paget's disease?

    Accelerated remodeling process

    Osteomyelitis

    Decreased vascularity

    Bone fragility

    disease paget's_disease

  • How many mCi of Tc-99m diphosphonates should be given for an adult 3 phase limited bone scan?

    10

    30

    50

    20
    procedure bone_scan

  • How do Mets appear on a bone scan?

    A focal hot spot

    Widespread diffusion

    Decreased uptake

    Uniform intensity

    diagnosis bone_scan

  • What will radiation therapy defects show as?

    Focal enhancement

    Decreased accumulation of the RP

    Increased uptake

    Homogeneous distribution

    radiology radiation_therapy

  • Metabolic disorders like hyperthyroidism appear as what on a bone scan?

    Hot spot

    Super scan

    Normal scan

    Cold spot

    metabolism diagnosis

  • Why was Sr-85 limited to a dose of about 100 uCi?

    Short decay time

    Low half-life

    Long effective half life

    High activity

    radiology dosing

  • Where does Tc-99m Polyphosphate show increased localization?

    Lungs

    Brain

    Kidneys

    Liver
    radiopharmaceuticals localization

  • When is the blood pool image of a 3 phase bone scan taken?

    90 sec

    120 sec

    60 sec post injection

    30 sec

    timing bone_scan

  • What is the body's critical organ for radiation dose in skeletal scintigraphy?

    Heart

    Bladder

    Brain

    Liver

    radiology critical_organ

  • What should the flow of a 3 phase bone scan be?

    2-5 photons/sec

    1-2 photons/sec

    10-15 photons/sec

    5-10 photons/sec

    procedure bone_scan

  • What is the purpose of a 2-4 hour delay after the injection of the RP in a bone scan?

    Improved image quality

    Reduced radiation exposure

    Increased washout of the RP from soft tissue

    Increased retention

    procedure bone_scan

  • What diagnosis is indicated for a 15 yo male with upper right femur pain and mass?

    Osteoporosis

    Arthritis

    Fracture

    Primary bone tumor
    diagnosis tumor

  • Which condition causes inflammation of the bone?

    Arthritis

    Osteoporosis

    Fibromyalgia

    Osteomyelitis
    inflammation bone

  • Accumulation of the RP is based on what?

    Mineral content

    Vascularity

    Bone density

    Cellularity

    radiology accumulation

  • Where do blood vessels perforate into bones?

    Haversian canal

    Medullary cavity

    Volkman's canal

    Nutrient foramen

    anatomy bones

  • Where is the most appropriate injection site for this scan?

    Back

    Right wrist

    Left thigh

    Left antecubital
    procedures injections

  • Which bone imaging RP has the fastest blood clearance?

    Iodine-123

    Tc-99m MDP

    Tc-99m HDP

    Thallium-201

    radiopharmaceuticals bone_imaging

  • Which of the following is not an indication for a bone scan?

    R/O a PE in the bone

    Diagnosis of reflex sympathetic dystrophy

    Evaluation of Paget's disease

    Detection of stress fractures

    diagnosis bone_scan

  • Which minerals are needed for bone remodeling?

    Fe, Zn, and Cu

    K, Na, and Cl

    Ca, Mg, and B

    P, S, and I

    nutrition bone_health

  • Which RP is not used for skeletal imaging?

    Tc-99m HDP

    99mTC-DTPA

    Thallium-201

    Tc-99m MDP

    radiopharmaceuticals skeletal_imaging

  • Which vitamin is used primarily during bone development?

    Vit C

    Vit D

    Calcium

    Vit A
    nutrition bone_health

  • Why are post-menopausal women more likely to get osteoporosis?

    Lack of estrogen

    Frequent exercise

    Excessive vitamin D

    High calcium intake

    health osteoporosis

  • Young children have very hot _____ plates reflecting the high metabolic rate.

    Medullary

    Periosteal

    Cortical

    Epiphyseal
    physiology development

  • Bones are never metabolically at rest. True or False?

    True

    False

    anatomy metabolism

  • Breast visualization is normal in young females. True or False?

    False

    True
    anatomy health

  • METS are easy to distinguish because they show up with a discernable pattern. True or False?

    True

    False
    diagnosis imaging

  • In acute osteomyelitis, blood flow is increased in the arterial phase. True or False?

    False

    True
    physiology osteomyelitis

  • Is bone labeling increased significantly after 30 minutes?

    True

    False
    bone labeling

  • What is palliative therapy used for?

    Pain from METS

    Preventing metastasis

    Increasing bone density

    Surgical correction

    palliative therapy

  • Which radionuclides can be used for therapy of bone METS?

    Radium-223

    131 Iodine

    153 Sm- Ethlendiaminetetramethylene, 89-SR, and 186 hydroxyethylen

    Cobalt-60

    therapy bone mets

  • What is the term for increased uptake following chemotherapy due to bone healing?

    Stability index

    Flare phenomenon

    Cortical blunting

    Decrement effect

    chemotherapy flare

  • Which of the following is least likely to cause an artifact on a bone scan?

    Obesity

    Recent surgery

    Metal implants

    Colostomy bag
    bone_scan artifact

  • What is the appearance of newly infarcted bone on a bone scan?

    Normal uptake

    Variable uptake

    Cold lesion

    Hot lesion

    bone scan

  • Do metastases usually affect the axial skeleton before the appendicular skeleton?

    True

    False

    metastases skeleton

  • Which group shows the highest rate of primary bone tumors?

    Adults

    Elderly

    Children

    Teenagers

    tumors bone

  • What occurs in the acute phase of avascular necrosis of bone?

    Normal perfusion

    Hyperperfusion

    Hypoperfusion on blood flow phase and hypoactivity on delayed skeletal phase

    Increased activity

    avascular_necrosis bone

  • Which cancer is least likely to metastasize to bone?

    Breast

    Lung

    Ovary

    Prostate

    cancer metastasis

  • What factors can reduce the quality of a bone scan?

    Smoking and diet

    Exercise history

    Congestive heart failure, renal insufficiency, and obesity

    Age and sex

    bone_scan quality

  • How many lobes does each lung have?

    Right has 2, Left has 3

    Right has 4, Left has 2

    Right has 3, Left has 1

    Right has 3, Left has 2
    respiratory anatomy

  • What view does a normal lung scan show if viewed from the front?

    Medial due to lung structure

    Posterior due to diaphragm

    Lateral due to oblique fissures

    Anterior due to cardiac notch
    respiratory imaging

  • In a 99mTc-MAA perfusion lung scan, how many particles should you use?

    200,000-400,000 particles at 10-30 um

    400,000-600,000 particles at 20-30 um

    100,000-200,000 particles at 5-10 um

    300,000-500,000 particles at 15-25 um

    radiology lung_scan

  • Which of the following radionuclides can be used in a ventilation lung scan?

    Co-60, Ge-68, In-111

    Xe-133, Xe-127, 99mTc-DTPA

    Xe-135, Ga-67, I-123

    I-131, Tc-99m, Kr-78

    radiology ventilation

  • What are three risk factors for pulmonary embolism (PE)?

    Diabetes, hypertension, travel history

    High cholesterol, family history, inactivity

    Smoking, BC, history of DVT

    Obesity, age over 60, recent surgery

    respiratory health

  • How long should you wait after injecting TC-99m MAA before scanning?

    Half an hour

    45 minutes

    1 hour

    15 minutes

    procedure radiology

  • What is the physical half-life of Xe-133?

    7 days

    5 days

    3 days

    10 days

    radiopharmacology half-life

  • What is one main function of the lungs?

    Filter waste from the blood

    Regulate blood sugar

    Deliver oxygen to the blood

    Store carbon dioxide

    physiology respiratory

  • What is one advantage of using 133-Xe gas in a vent lung scan?

    Better for COPD

    More expensive

    Longer scan time

    Increased radiation

    ventilation lung_scan

  • What activity should be loaded into the nebulizer for a vent lung scan?

    15 mCi

    20 mCi

    45 mCi

    30 mCi
    radiology dosage

  • Why is the right lung thicker and shorter than the left?

    Due to a larger heart

    Less air capacity

    Due to the liver underneath

    More blood flow

    anatomy respiratory

  • What does Atelectasis refer to?

    Infection in lung tissue

    Air in the pleural cavity

    Collapsed lung

    Blood in the pleural cavity

    medical_terms lung_conditions

  • What does Hemothorax mean?

    Inflammation of lung lining

    Pleural cavity fills with blood

    Fluid in lung tissue

    Air in the pleural cavity

    medical_terms lung_conditions

  • What is Pleurisy associated with?

    Coughing up blood

    High fever

    Shortness of breath

    Back and chest pain from friction
    medical_terms lung_conditions

  • What kind of bacteria causes Tuberculosis?

    Fungal infection

    Bacteria that destroys lung tissue

    Viral infection

    Non-infectious disease

    medical_terms lung_conditions

  • What is a PE in medical terms?

    Pleural effusion

    Pulmonary embolism

    Blood clot in pulmonary artery

    Pneumonia

    medical_terms lung_conditions

  • What does Pneumothorax refer to?

    Blockage in airway

    Air in the pleural cavity

    Fluid in lungs

    Inflammation of lung tissue

    medical_terms lung_conditions

  • What condition involves disintegration of alveolar walls?

    Interstitial lung disease

    Asthma

    Emphysema

    Bronchitis

    medical_terms lung_conditions

  • What does Hilus refer to in lung anatomy?

    Air sacs in lungs

    Portion allowing blood vessels to enter and exit

    Pleural lining

    Bronchial tubes

    anatomy lung

  • What does Hypoxia mean?

    High level of carbon dioxide

    Normal oxygen levels

    Low level of oxygen in the body

    Dehydration

    medical_terms respiratory

  • What does Bronchography examine?

    Blood vessels

    Bronchial tree

    Pleural membranes

    Lung tissue

    medical_terms examination

  • What could cause a cold defect in the right base on a lung scan?

    Poor blood flow

    Infection

    Tuberculosis

    Inhaled irritants

    diagnosis lung_scan

  • How many capillaries generally become blocked during a perfusion lung scan using 99mTc MAA?

    Fewer than 1 in 1000 and less than 0.1%

    1 in 500

    Less than 1 in 100

    More than 1 in 1000

    lung_scan perfusion 99mtc

  • What is the air pressure in the lungs before inspiration?

    1000 mmHg

    750 mmHg

    Atmospheric pressure and 760 mmHg

    500 mmHg

    respiration lung_pressure

  • By what process do respiratory gases get exchanged in the lungs?

    Osmosis

    Diffusion

    Active transport

    Filtration
    respiration gas_exchange

  • How does 99mTc MAA localize in the lungs?

    By simple diffusion

    By ion exchange

    It does not localize by active transport, simple diffusion, filtration, or ion exchange

    Through active transport

    99mtc_maa localization

  • How many mCi of 99mTc MAA are injected for a perfusion lung scan?

    5

    1

    10

    15

    lung_scan 99mtc_maa

  • If only one scan can be performed, which lung scan should be done to rule out a PE?

    CT scan

    MRI scan

    Perfusion

    Ventilation

    lung_scan pulmonary_embolism

  • Does perfusion and ventilation lung imaging remove the need for a chest X-ray?

    False

    Depends on the case

    Only sometimes

    True

    imaging chest_x-ray

  • What is the substance dispensed into a patient using the shown equipment?

    Air

    99mTc MAA

    Radioactive iodine

    99mTc-DTPA
    imaging 99mtc-dtpa

  • What type of scan is shown in the image?

    Chest X-ray

    Ventilation

    CT scan

    Perfusion

    lung_scan ventilation

  • In the posterior view, which lung is affected by the large PE?

    Both

    None

    Left

    Right

    pulmonary_embolism lung

  • What is the most common treatment for a pulmonary embolism?

    Warfarin

    Heparin solution treatment

    Aspirin

    Oxygen therapy

    treatment pulmonary_embolism

  • In how many steps can a lung quantification study be completed?

    5-6 steps

    2-3 steps

    3-4 steps

    1-2 steps

    lung_quantification study_procedure

  • Where are oxygen and CO2 exchanged in the lungs?

    Lungs

    Trachea

    Bronchi

    Alveoli
    gas_exchange alveoli

  • Which of the following is not caused by smoking?

    Lung cancer

    Chronic bronchitis

    Emphysema

    Asthma
    health smoking diseases

  • Which of the following is not a symptom of a pulmonary embolism?

    Chest pain

    Pulmonary infarction

    Shortness of breath

    Cough

    health pulmonary_embolism symptoms

  • What should not be done when injecting Tc-99m MAA for a lung scan?

    You should draw blood back into the syringe and you should inject with the patient standing

    Monitor patient vitals

    Inject slowly

    Use a sterile syringe

    health lung_scan tc-99m

  • Which phase of a Xe-133 vent lung scan requires the patient to rebreath Xe-133?

    Initial

    Final

    Equilibrium

    Clearance

    health lung_scan xe-133

  • What are the 3 diagnostic categories for a PE with a V/Q scan?

    Minor, moderate, severe

    Beginner, intermediate, expert

    Low, intermediate, and high

    Normal, abnormal, critical

    health pulmonary_embolism diagnostics

  • How can a perfusion scan be used to manage patients with lung cancer who are candidates for surgical resection?

    Monitoring heart rate

    Checking blood pressure

    Assessing lung function

    Quantitation of the scan
    health lung_cancer perfusion_scan

  • What process removes particles used for perfusion imaging by the lung?

    Osmosis

    Diffusion

    Phagocytosis

    Filtration

    health lung imaging

  • Which view is the most important to take in a perfusion lung scan?

    Anterior

    Oblique

    Lateral

    Post
    health lung_scan views

  • Which view represents a normal lung scan?

    Anterior

    Right lateral

    Left lateral

    Posterior

    health lung_scan normal

  • Will a normal lung scan show a matched defect?

    False

    True

    health lung_scan defects

  • What is the current gold standard test for imaging the lung?

    CT angiography

    X-ray

    MRI

    Ultrasound

    health lung_imaging ct

  • Is oxygen optional to hook up to a nebulizer for inhaling TC99m DTPA?

    False

    True

    health nebulizer tc99m

  • Can cold spots appear in lung images when blood clots form in the syringe used to inject 99mTC-MAA?

    False

    True

    health lung_imaging cold_spots

  • Are there 2 secondary bronchi in the inferior lobe of the left lung?

    True

    False
    health anatomy lungs

  • How long is the biological half-life of Xe-133 clearing from the lungs?

    1 minute

    5 minutes

    30 seconds

    10 seconds

    health xe-133 half-life

  • How quickly can pulmonary emboli resolve?

    1 week

    1 month

    1 day

    3 days

    medical pulmonary

  • What connects the thyroid lobes?

    Base

    Vein

    Apex

    Isthmus
    anatomy thyroid

  • What does a whole body I-131 study determine?

    Lung function

    METS for thyroid cancer

    Heart health

    Bone density

    medical diagnostics

  • Which radiopharmaceutical allows you to scan the thyroid sooner?

    I-123

    Ga-67

    I-131

    TC-99m
    radiology thyroid

  • Why can Tc99m be used for a thyroid scan but not an uptake?

    It only identifies cancer

    It gets trapped but not organified

    It is too radioactive

    It doesn't bind to receptors

    medical radiology

  • What condition is characterized by hypersecretion of HGH in adulthood?

    Diabetes Mellitus

    Giantism

    Cushing's syndrome

    Acromegaly
    endocrine hormones

  • What causes Cretinism?

    Autoimmune thyroid disease

    Hyposecretion of thyroid hormones during fetal life or infancy

    Excessive glucose in the blood

    Hypersecretion of HGH

    endocrine development

  • Which disease involves the production of an antibody that mimics TSH?

    Cushing's syndrome

    Acromegaly

    Diabetes Mellitus

    Graves disease
    endocrine autoimmune

  • What does Diabetes Mellitus result in?

    Increase in cortisol

    High thyroid hormones

    Low insulin levels

    Elevation of glucose in the blood
    endocrine metabolism

  • What condition results from hyposecretion of glucocorticoids and aldosterone?

    Addison's disease

    Hashimoto's disease

    Goiter

    Pituitary dwarfism

    endocrine disease

  • What is the general term for an enlarged thyroid gland?

    Thyroiditis

    Grave's disease

    Pituitary dwarfism

    Goiter
    endocrine thyroid

  • What causes pituitary dwarfism?

    Thyroid dysfunction

    Hypersecretion of hGH

    Growth hormone resistance

    Hyposecretion of hGH during childhood
    endocrine growth

  • What happens in Hashimoto's disease?

    Overactive adrenal response

    Antibodies bind to TSH receptors, causing thyroid growth

    Excess thyroid hormone production

    Complete thyroid shutdown

    endocrine thyroid

  • What is the half-life of I-131?

    8 days

    3 days

    12 days

    24 hours

    radiology thyroid

  • What can a bird's eye view in a thyroid scan not show?

    Bladder

    Thyroid size

    Thyroid nodules

    Parathyroid glands

    radiology thyroid

  • What is a disadvantage of using I-123 over 99mTC in thyroid scans?

    More expensive and less available

    Lower radiation exposure

    Shorter half-life

    Lower accuracy

    radiology thyroid

  • What is a normal 24-hour uptake percentage for the thyroid?

    25%

    10%

    40%

    30%

    radiology thyroid

  • How much I-131 is typically given for a 24-hour thyroid uptake?

    15 uCi

    10 uCi

    20 uCi

    5 uCi

    radiology thyroid

  • What would the 24-hour uptake be for a patient diagnosed with Grave's disease?

    25%

    45%

    20%

    40%
    radiology thyroid

  • What is a common indication for doing a thyroid uptake measurement?

    Addison's disease

    Pituitary dwarfism

    Cushing's syndrome

    Grave's disease
    endocrine diagnostics

  • What is the purpose of the Co-57 marker in thyroid imaging?

    Treatment

    Quantification

    Localization

    Isolation

    radiology thyroid

  • Where does a normal thyroid originate?

    Above the heart

    At the base of the tongue

    Behind the sternum

    In the chest

    anatomy thyroid

  • Which cells of the thyroid produce thyroid hormones?

    Parafollicular

    Clear

    C-cells

    Follicular
    anatomy thyroid

  • Which major hormone does the pituitary gland secrete to stimulate T3 and T4 synthesis?

    TSH

    FSH

    ACTH

    LH

    endocrine hormones

  • Which patient prep is not necessary for a thyroid scan with I-123?

    Fasting for 24 hours

    Avoiding iodine-rich foods

    (options not provided in text)

    Discontinuing medications

    radiology thyroid

  • Which of the following is not true concerning a thyroid uptake procedure using I-123?

    The patient must refrain from caffeine for 24 hours

    Standard counts must always be obtained

    The pt's leg should hang straight down when taking pt's bkg

    A cold nodule has a lesser chance of cancer

    thyroid uptake i-123

  • What is the normal range for a 6-hour thyroid uptake for I-131?

    2%

    25%

    10%

    6-18%
    thyroid uptake i-131

  • What is a functioning thyroid tissue in the thyroglossal duct remnant called?

    Thyroid gland

    Pyramidal lobe

    Follicular unit

    Isthmus

    thyroid anatomy

  • How much 99mTc Napertechnetate is administered orally for a thyroid scan?

    15 mCi

    10 mCi

    20 mCi

    5 mCi

    thyroid 99mtc

  • Is it true that a cold thyroid nodule has a greater chance of being cancerous than a hot nodule?

    False

    Not applicable

    Depends on the size

    True
    thyroid nodule cancer

  • Does the procedure for a 24-hour thyroid uptake differ from a 6-hour uptake?

    False

    True

    It varies based on medication

    They are completely different

    thyroid uptake procedure

  • What solution blocks the thyroid from I-131?

    Calcium solution

    Lugol's solution

    Potassium iodide

    Sodium iodide

    thyroid i-131 blocking

  • What radiopharmaceutical is used for adrenal medulla imaging?

    I-131 Meta

    Lu-177

    Ga-68

    Tc-99m

    adrenal imaging i-131

  • Where is a child's thyroid located?

    Base of the tongue

    Chest

    Below the jaw

    Neck

    thyroid anatomy child

  • When should the first phase of imaging begin after a MIBI parathyroid study?

    5-10 min

    30-45 min

    60 min

    15-20 min
    parathyroid mibi imaging

  • MIBG acts as an analog to what neurotransmitter?

    Serotonin

    Dopamine

    Epinephrine

    Norepinephrine
    mibg neurotransmitter

  • Which is an anti-thyroid drug that may need to be discontinued for a thyroid uptake test?

    Levothyroxine

    Propylthiouracil

    Liothyronine

    Methimazole

    thyroid medication uptake

  • What is essential for thyroid hormone synthesis?

    The trapping and secretion of iodine

    Vitamin D synthesis

    Iron metabolism

    Calcium absorption

    endocrine thyroid

  • What are patients receiving a thyroid ablation dose of 75mCi of I-131 instructed to do?

    Immediately discharged

    Stay in the hospital indefinitely

    Take a follow-up dose

    Sent home with special instructions
    treatment thyroid

  • Which imaging techniques can be used for thyroid imaging?

    X-ray or ultrasound

    Fluoroscopy only

    CT or MRI

    Pinhole or parallel
    imaging thyroid

  • What effect does collecting thyroid counts 5 cm from the neck have?

    The uptake value will falsely increase

    It shows no influence

    The uptake value will decrease

    The value remains the same

    thyroid uptake

  • Which glands in the neck can be visualized with thyroid imaging?

    Thymus

    Salivary glands

    Pancreas

    Adrenal glands

    anatomy glands

  • What does low circulating thyroid hormone trigger in the pituitary?

    No change occurs

    To decrease TSH production

    To increase pituitary synthesis of TSH

    To increase T3 synthesis

    endocrine tsh

  • What is thyrтotropin also known as?

    T4

    TRH

    T3

    TSH

    hormones thyroid

  • What patient prep is needed for a SPECT brain scan?

    CT scan prior is mandatory

    Water fasting required

    There is no patient prep for a SPECT brain scan

    Medication withholding necessary

    cns spect

  • What view does a SPECT brain scan typically represent?

    Sagittal

    Transverse

    Coronal

    Horizontal

    imaging cns

  • What type of injection is required for a planar brain scan?

    Continuous infusion

    Subcutaneous injection

    Intramuscular injection

    Bolus injection
    injection brain_scan

  • What radiopharmaceutical is used in a cisternogram?

    750 uCi of I-123

    1000 uCi of Tc-99m

    500 uCi of In-111 DTPA

    200 uCi of Ga-67

    pharmaceuticals cisternogram

  • What is the hot nose sign associated with in brain imaging?

    Increased flow in the external carotid circulation

    Sinus blockage

    Cerebellar dysfunction

    Decreased brain activity

    imaging cns

  • What happens to perfusion and metabolism in seizure foci during the ictal and interictal phases?

    Remain constant

    Decrease and increase

    Increase and remain constant

    Increase and decrease
    neuroscience seizures

  • Which procedure can a NM tech not inject for?

    PET

    Cisternogram

    Bone scan

    SPECT

    nuclear_medicine procedures

  • Which statement is not true of SPECT brain procedures?

    Injection timing does not affect outcomes

    Patient consent is not required

    The tech should explain the procedure as the injection is performed

    SPECT is not used for brain imaging

    nuclear_medicine spect

  • What is one function of cerebrospinal fluid (CSF)?

    Protects the brain from shocks and delivers glucose to the brain

    Provides oxygen to the brain

    Supports blood circulation

    Acts as a neurotransmitter

    cns csf

  • What is true about normal pressure hydrocephalus?

    It has no effect on brain structure

    It causes enlargement of a brain ventricle

    It causes decreased ventricular size

    It is unrelated to pressure changes

    neurology hydrocephalus

  • How long after injection does peak brain uptake of Tc-99m HMPAO occur?

    5 min

    2 min

    10 min

    30 sec

    nuclear_medicine uptake

  • In a brain-dead patient, where can activity still be seen?

    Jugular vein

    Carotid artery

    Pulmonary artery

    Aorta

    neuroscience brain_death

  • What type of radiopharmaceutical is 99mTc HMPAO?

    Soluble in water

    Only for bone imaging

    Neutral lipid-soluble and crosses the BBB

    Highly polar and does not cross the BBB

    radiopharmaceuticals hmpao

  • Should potassium perchlorate be given if Tc-99m HMPAO is used for brain flow scintigraphy?

    Only in high doses

    True

    Only for elderly patients

    False
    nuclear_medicine scintigraphy

  • What view does the SPECT brain represent?

    Sagittal

    Coronal

    Frontal

    Transverse

    imaging spect

  • What does flow look like in a cerebrovascular accident?

    Shows asymmetry

    No flow observed

    Shows symmetry

    Shows increased flow

    cva neuroscience

  • What is the best radiopharmaceutical for a SPECT brain study?

    Co-57

    F-18

    99mTc- HMPAO

    I-123

    radiopharmaceuticals spect

  • What does intrathecal injection for CSF imaging allow for?

    Dose to be administered into the subarachnoid space

    Dose to be injected into muscle

    Dose to be administered orally

    Dose to enter the bloodstream

    csf injections

  • What should a tech prepare for an injection for a CSF shunt evaluation?

    Injection into the brain

    Injection into the spinal cord

    Injection into the lumbar region

    Injection into the shunt reservoir
    nuclear_medicine csf

  • What are the four main parts of the brain?

    Frontal, parietal, temporal, and occipital

    Cerebrum, cerebellum, diencephalon, and brain stem

    Brain stem, cerebellum, hippocampus, and amygdala

    Cerebellum, medulla, thalamus, and cortex

    anatomy brain

  • How can you tell if a patient has had a stroke or a TIA?

    The amount of time that the blood supply is reduced to the brain

    Presence of slurred speech

    An increase in blood glucose levels

    A decrease in blood pressure

    medical diagnosis

  • Why is a patient kept in a horizontal position for 2 hours after a cisternogram injection?

    To minimize headache

    To ensure proper imaging

    To enhance drug absorption

    To prevent nausea

    medical procedures

  • Where should activity be seen in a normal cisternogram by 4 hours?

    In the subarachnoid space

    In the lateral ventricles

    In the cerebral cortex

    In the basal cisterns
    imaging cisternogram

  • What indicates brain death in SPECT imaging?

    A pattern of no intracranial blood supply to the brain

    Reduced glucose metabolism

    Increased blood flow

    Normal blood supply in specific regions

    neurology brain_death

  • Cerebral glucose metabolism and blood flow during seizures are what?

    Completely absent

    Increased

    Unchanged

    Decreased

    neurology seizures

  • Which area is useful to detect infiltration of the osteo in the CSF procedure?

    Lumbar spine

    Cervical spine

    Thoracic spine

    Lumbosacral junction

    anatomy csf

  • What is the typical scintigraphic pattern of Alzheimer's disease on cerebral perfusion imaging?

    Uniform perfusion across all areas

    Increased perfusion in the frontal lobe

    Decreased perfusion in temporoparietal areas

    No significant changes

    neurology alzheimer's

  • What is a reason for using 111In-DTPA in a Cisternogram?

    It is easier to inject

    It has a desirable physical half-life for the test

    It produces clearer images

    It's less expensive

    nuclear_medicine cisternogram

  • What imaging technique is recommended for a cerebral perfusion scan?

    CT scan

    BBB imaging

    MRI

    X-ray

    imaging cerebral_perfusion

  • Which view does a SPECT brain scan represent?

    Sagittal

    Axial

    Transverse

    Coronal
    imaging brain_scan

  • How long does it take for the radiotracer to clear from the basal cisterns?

    72 hrs

    24 hrs

    48 hrs

    12 hrs

    radiotracer timing

  • In Alzheimer's disease, where does a symmetric decrease in perfusion occur?

    Frontal lobe

    Cerebellum

    Occipital lobe

    Temporal parietal lobes
    alzheimer's perfusion

  • Which of the following is true about Tl-201 brain imaging?

    Tl-201 is effective for all tumors

    Tl-201 accumulation is dependant on tumor grade

    Tl-201 is not useful for CNS imaging

    Tl-201 accumulation is minimal at sites of radiation necrosis

    Tl-201 will not cross an intact BBB

    Tl-201 can easily cross the BBB

    tl-201 brain_imaging

  • How can CSF leaks be documented?

    Activity detected in swabs placed in nose or ears

    MRI results

    Blood tests

    CT scan images

    csf leaks

  • Which part of the brain has the greatest blood flow seen on a NM brain scan?

    White matter

    Cerebellum

    Brainstem

    Grey matter
    brain_anatomy blood_flow

  • What will hydrocephalus cause an increase in?

    Blood volume

    CSF

    Lymph fluid

    Brain tissue

    hydrocephalus csf

  • Which of the following are indications for a SPECT brain scan?

    Evaluate cerebrovascular disease

    Check for osteoporosis

    Assess lung function

    Evaluate for seizures foci

    Evaluate kidney stones

    Evaluate dementia
    spect indications

  • What does a CNS 111In-DTPA study assess?

    Tumor size

    Cerebral spinal flow dynamics

    Cerebrospinal fluid pressure

    Blood flow

    cns_study flow_dynamics

  • Which radiopharmaceutical (RP) is used for ictal SECT imaging?

    99mTC-DTPA

    Tl-201

    99mTc-RBC

    99mTc-HMPAO
    imaging radiopharmaceuticals

  • True or False: The blood-brain barrier protects the brain from potentially toxic substances.

    False

    True
    cns blood-brain_barrier

  • True or False: 99mTC-DTPA may cross an altered blood-brain barrier.

    False

    True
    cns radiopharmaceuticals

  • Which substance does the brain need a constant supply of?

    Ketones

    Carbon Dioxide

    Oxygen

    Glucose

    cns physiology

  • True or False: 99mTc-RBC are labeled in vivo for a MUGA scan.

    True

    False
    cardio muga

  • What is the hollow center through which blood flows called?

    Septum

    Ventricle

    Atrium

    Lumen
    anatomy cardio

  • When performing Dual isotope myocardial perfusion imaging, should the stress be performed first?

    False

    True

    cardio imaging_procedures

  • What is the correct order of a normal heart conduction system?

    AV, SA, bundle branches, Bundle of HIS

    Bundle branches, AV, SA, Bundle of HIS

    Bundle of HIS, SA, AV, bundle branches

    SA, AV, Bundle of HIS, bundle branches
    anatomy cardio

  • True or False: Blood is heavier, thicker, and less viscous than water.

    True

    False

    physiology blood

  • What is the cause of reduced uptake on the post-stress images with fill in on delayed images?

    Myocardial ischemia

    Heart failure

    Valvular disease

    Cardiac arrest

    cardio imaging

  • Which RP causes more prominent attenuation artifacts in a myocardial perfusion stress test?

    99mTc-DTPA

    99mTc-HMPAO

    Tl-201

    99mTc-RBC

    imaging radiopharmaceuticals

  • Which of the following represents an abnormal EF for a MUGA scan?

    40%

    50%

    60%

    70%

    cardio muga

  • When performing equilibrium gated blood pool studies, when is the first frame of data recorded?

    P wave

    T wave

    S wave

    R wave
    cardio imaging_procedures

  • What does transient dilation of the left ventricle on an exercise stress image signify?

    Left ventricular dysfunction

    Decreased blood flow

    Increased cardiac efficiency

    Normal ventricular function

    cardiology stress_testing

  • Why is the modified protocol for myocardial stress imaging important?

    It provides more detailed images

    It will take longer for the patient to achieve the necessary heart rate

    It is less invasive

    It uses a higher dose of contrast

    cardiology protocols

  • How are 99m Tc labeled RBCs prepared?

    By direct injection

    In vivo

    In vitro

    Using a thermal procedure

    nuclear_medicine rbcs

  • How many frames per cycle does a gated myocardial perfusion stress test use?

    4 frames

    8 frames

    6 frames

    12 frames

    cardiology gated_imaging

  • Which radiopharmaceutical could be used for an infarct avid study?

    99mTc-PYP

    99mTc-Sestamibi

    99mTc-MIBI

    201Tl

    nuclear_medicine radiopharmaceuticals

  • Which radiopharmaceutical is not used for myocardial perfusion imaging?

    99mTc-Tetrofosmin

    201Tl

    99mTc-MIBI

    99mPYP
    nuclear_medicine imaging

  • How long should a patient having a Dipyridamole stress test avoid caffeine?

    24 hours

    6 hours

    48 hours

    12 hours

    cardiology stress_testing

  • Which radiopharmaceutical would localize more in the myocardium?

    99m Tc-MIBI

    99mTc-PYP

    99mTc-Sestamibi

    201-Tl
    nuclear_medicine myocardium

  • What are the primary functions of the blood?

    Digestion, respiration

    Excretion, filtration

    Transportation, regulation

    Protection, absorption

    physiology blood_functions

  • What is a common characteristic of anemia?

    Decreased platelet count

    Higher than normal white blood cells

    Higher than normal hemoglobin

    Lower than normal number of RBCs
    hematology anemia

  • Which condition indicates high blood pressure caused by the kidneys?

    Malignant hypertension

    Hypertensive crisis

    Secondary hypertension

    Primary hypertension

    cardiology hypertension

  • What does vasodilator refer to?

    Reduce blood flow

    Decrease the lumen of the blood vessel

    Increase the lumen of the blood vessel

    Stabilize blood pressure

    physiology vascular

  • What is Warfarin classified as?

    A vasodilator

    A thrombolytic agent

    A blood pressure medication

    An anticoagulant that is slower acting than heparin
    pharmacology anticoagulants

  • What does hemophilia indicate?

    Deficiency of coagulation

    Excessive clotting

    High white blood cell count

    Low platelet count

    hematology hemophilia

  • What characterizes primary hypertension?

    High BP due to kidney issues

    High BP with known causes

    High BP due to medication

    Higher BP with no identifiable cause
    cardiology hypertension

  • What does vasoconstriction refer to?

    Decrease the lumen of the blood vessel

    Increase the lumen of the blood vessel

    Open the blood vessel

    Thicken the blood vessel wall

    physiology vascular

  • What is the purpose of exercise for 1-2 minutes post-injection of the RP?

    Circulate and localize the tracer on the myocardium

    Reduce injection pain

    Shorten imaging time

    Enhance tracer stability

    cardiology procedure

  • What does 2011 refer to in myocardial imaging?

    MRI

    Ultrasound

    CT scan

    Cyclotron
    imaging technologies

  • Which drugs will increase blood pressure and heart rate?

    Dobutamine

    Losartan

    Atenolol

    Metoprolol

    pharmacology cardiology

  • Which is a disadvantage of using 201Tl for myocardial perfusion stress tests?

    Lower energy creates attenuation

    Reduced accuracy

    High cost

    Short half life

    Lower doses do not permit gating

    Long effective half life
    cardiology diagnostics

  • What is the flow of deoxygenated blood from the heart?

    Sup/inf vena cava to right atria to right ventricle to pulmonary artery

    Left atria to left ventricle to pulmonary artery

    Right atria to right ventricle to aorta

    Pulmonary vein to left ventricle to aorta

    cardiology circulation

  • What types of artifacts may occur during imaging?

    Attenuation and motion

    Clarity and color

    Resolution and focus

    Brightness and depth

    imaging artifacts

  • When does clearance or redistribution of thallium occur?

    After 2 hours

    Over the course of about 4 hours post injection

    Immediately after injection

    After 6 hours

    cardiology diagnostics

  • What does MUGA stand for?

    Multiple graded assessment

    Multi gated acquisition

    Magnetic ultrasound gated assessment

    Myocardial gated analysis

    cardiology imaging

  • In which wall of the heart is there a large myocardial infarction in the short axis view?

    Anterior

    Inferior

    Septal

    Lateral

    cardiology anatomy

  • What effect does 80% stenosis in a coronary artery have on blood flow at rest?

    Increased blood flow

    Normal blood flow

    No effect

    Decreased blood flow
    cardiology stenosis

  • Which radiopharmaceutical (RP) is preferred for ischemia and why?

    201Tl has a higher sensitivity

    99mTc has a longer half-life

    99mTc has higher specificity

    201Tl is less expensive

    radiopharmaceuticals ischemia

  • What agent is most likely used for pharmacological myocardial stress testing in bronchospastic patients?

    Regadenoson

    Dobutamine

    Adenosine

    Dipyridamole

    stress_testing pharmacology

  • Why do males have more red blood cells (RBCs)?

    Fewer fluid levels

    More testosterone

    More physical activity

    Higher oxygen levels

    hematology gender

  • What is the best view for separating the ventricles to calculate ejection fraction in a MUGA?

    Left lateral view

    Anterior view

    45 degree LAO

    Posteroanterior view

    cardiology muga

  • In a 2-day protocol for a 99mTc-sestamibi myocardial perfusion stress test, what is the dose range for both days?

    30-40 mCi

    50-60 mCi

    40-50 mCi

    20-30 mCi

    radiology myocardial_perfusion

  • Which parameter is not assessed from a first-pass ventriculography?

    Ejection fraction

    Myocardial perfusion

    Cardiac output

    Heart rate

    cardiology ventriculography

  • What structure makes up the apex of the heart?

    Chambers

    Ventricles

    Valves

    Atria

    anatomy heart

  • What is the expected motion for the inferior wall in a long-axis heart image?

    Dyskinetic

    Normal

    Hypokinetic

    Akinetic

    cardiology imaging

  • Why must a 201-Tl stress test not be imaged within 10 minutes or after 20 minutes?

    To avoid radiation exposure

    For optimal imaging angle

    Due to cardiac creep and redistribution

    To prevent patient fatigue

    radiology stress_testing

  • What type of display is used to present myocardial perfusion data?

    Line graph

    Bull's eye display

    Scatter plot

    3D imaging

    cardiology data_visualization

  • What does it indicate if a 65-year-old male reaches a max heart rate of 140 during a stress test?

    He has normal function

    He has ischemia in his wall

    He has tachycardia

    He is healthy

    cardiology stress_testing

  • What does suboptimal stress during a stress test indicate?

    Ischemic

    Normal

    Non-ischemic

    Healthy

    cardiology stress_test

  • In cardiac SPECT imaging, the transverse slices are reoriented along which axis?

    Short axis of the left ventricle

    Long axis of the left ventricle

    Coronary arteries

    Right atrium

    imaging spect

  • When injecting the RP during a myocardial perfusion stress test, when should it ideally be injected?

    At rest

    Post-exercise

    Peak stress

    Before exercise

    myocardial_perfusion stress_test

  • What is the quantitative presentation of myocardial uptake and washout known as?

    Bulls-eye

    Slice view

    Cardiac map

    Heart profile

    imaging myocardial

  • How many flaps or cusps does the mitral valve have?

    2

    1

    3

    4

    anatomy valves

  • Which of the following is not a contraindication for adenosine?

    Hypotension

    Asthma

    Eating within 24 hr

    Heart block

    pharmacology adenosine

  • How does a RBC diffuse into the cell if it is 8um in diameter with a 5um membrane?

    Heavy and round

    Rigid and flat

    They are flexible and concave

    Large and spherical

    cell_biology rbc

  • What is the target heart rate for a 50-year-old male during a myocardial perfusion stress test?

    130

    144

    120

    160

    cardiology heart_rate

  • How does filtering prevent arrhythmias during a MUGA scan?

    Ensures at least 6 cardiac cycles without arrhythmias

    Normalizes blood pressure

    Limits heart rate variability

    Increases cardiac output

    arrhythmias muga

  • What RP is used to image myocardial necrosis?

    Gallium-67

    99mTC-HDP

    Thallium-201

    Fluorodeoxyglucose

    imaging necrosis

  • Which artery primarily supplies the inferior wall of the heart?

    LAD

    RCA

    LCX

    PDA

    anatomy coronary_artery

  • When should SPECT imaging begin after high-level stress exercise?

    Before resting

    Immediately after exercise

    After 10 minutes

    When respiration has returned to normal
    imaging spect

  • What does Dipyridamole allow the heart to achieve during stress testing?

    100% of its max HR

    85% of its max HR

    75% of its max HR

    60% of its max HR

    cardiology stress_test

  • What does a grade of 0 indicate in an infarct avid study?

    Normal myocardium with no myocardial infarctions

    Severe myocardial infarction

    Unknown myocardial condition

    Mild myocardial injury

    cardiology diagnostics

  • What view of the esophagus is used to perform an esophageal transit study?

    Supine

    Post

    Ant

    Lateral

    gi imaging

  • Which of the following is NOT an indication for liver/spleen imaging?

    Ascites

    Cirrhosis

    Bile stones in the liver

    Liver tumors

    liver imaging

  • What is the typical dose of mCi given to an adult pt in a Meckel's diverticulum scan?

    20

    10

    15

    5

    gi radiology

  • What substance plays a role in emulsification?

    Bile

    Saliva

    Pancreatic enzyme

    Gastric juice

    digestion biochemistry

  • What is a common cause of a GI bleed in children?

    Gastric ulcers

    Meckel diverticulum

    Food allergies

    Inflammatory bowel disease

    pediatrics gi

  • In a Hepatobiliary scan, where should the liver be positioned in relation to your imaging screen?

    Upper right corner

    Upper left corner

    Lower right corner

    Center

    imaging liver

  • What is the target organ for 99mTc pertechnetate?

    Liver

    Kidney

    Pancreas

    Stomach
    radiology pharmacology

  • What are two derivatives of 99mTc IDA?

    Choletec and Mebro

    Bile and Gastrin

    Thyroid and Gallium

    HIDA and SPECT

    radiopharmacy imaging

  • For a patient with xerostomia, which procedure should the tech prepare the room for?

    CT scan

    Ultrasound

    MRI

    Sialography
    radiology oral_health

  • How many uCi of HIDA are given in a cholescintigraphy study?

    7500

    2500

    5000

    1000

    radiology hida

  • Which of the following is NOT an action of saliva?

    Facilitates taste

    Cleanses mouth

    Aids in digestion

    Dissolves gastric juices
    digestive_system saliva

  • What are the actions of saliva?

    Absorbs nutrients

    Lubricates food, dissolves food, initiates chemical breakdown

    Evaluates esophageal transit

    Contracts sphincter of Oddi

    anatomy digestive

  • Why is the head tilted backward during salivary gland imaging?

    To prevent thyroid superimposition over the salivary glands

    To increase saliva production

    To enhance visual clarity

    To align with the esophagus

    procedure imaging

  • What can esophageal imaging evaluate?

    Liver function

    Nutrient absorption

    Gallbladder visualization

    Movement of foods through the esophagus
    anatomy digestive

  • What is visualized in the first hour of a normal hepatobiliary scan?

    Common duct, gallbladder, duodenum

    Spleen, small intestine, liver

    Thyroid gland, pancreas, ileum

    Esophagus, stomach, colon

    imaging gastrointestinal

  • What is commonly used for salivary gland imaging?

    Gallium-67

    Iodine-123

    99mTc

    Technetium-98

    imaging nuclear

  • Which of the following is NOT a function of the liver?

    Protein metabolism

    Absorption of nutrients

    Regulating blood sugar

    Phagocytosis

    anatomy liver

  • At what size will solids remain in the stomach without being secreted into the intestines?

    1mm

    10mm

    5mm

    3mm
    anatomy gastrointestinal

  • What does nonvisualization of the gallbladder in cholescintigraphy indicate?

    Chronic gastritis

    Liver cirrhosis

    Acute cholecystitis

    Esophageal rupture

    imaging diagnosis

  • How long can delays on a GI bleed scan extend?

    12 hours

    48 hours

    36 hours

    24 hours
    procedure imaging

  • Are decay and attenuation corrections used for gastric emptying half time calculations?

    False

    Only during advanced scans

    Only in pediatric patients

    True
    imaging procedure

  • How long should a patient fast before an esophageal transit study?

    10 hours

    6 hours

    8 hours

    4 hours

    procedure preparation

  • What should be included in the field of view during a gastrointestinal bleed study?

    Liver only

    Only the small intestine

    Small margins of liver and spleen

    Only the stomach

    imaging procedure

  • What is the purpose of administering morphine sulfate in imaging?

    Contract the sphincter of Oddi

    Enhance gallbladder visibility

    Increase saliva production

    Relax the diaphragm

    procedure pharmacology

  • What percent of 99mTC SC will go to a normal spleen?

    5

    10

    15

    20

    radiology nuclear_medicine

  • What is the purpose of salivary gland imaging?

    Blood flow analysis

    Size, location, and function

    Tumor detection

    Nutrient absorption

    radiology imaging

  • Where does most digestion and absorption of nutrients occur?

    Stomach

    Large intestines

    Pancreas

    Small intestines
    gastrointestinal nutrition

  • Should a Meckels Diverticulum study get more activity than a GI bleed scan?

    False

    Only in children

    It depends

    True

    gastrointestinal nuclear_medicine

  • When should imaging begin for a 99mTc SC technique for identifying a gastrointestinal bleed?

    Immediately after injection

    With an anterior flow study for 2-3 min and static every 1 to 2 min for 20-30 min thereafter

    Only during static imaging

    After a 1 hr waiting period

    radiology nuclear_medicine

  • How many pairs of salivary glands are there?

    2

    1

    4

    3
    anatomy salivary_glands

  • What is the alimentary canal also known as?

    Epidermis

    Digestive system

    GI tract

    Cardiovascular system

    anatomy gastrointestinal

  • What cells compose the liver?

    B cells, T cells, and macrophages

    Adipocytes and fibroblasts

    Osteoblasts and osteoclasts

    Kupffer cells, phagocytic cells, and hepatocytes
    anatomy liver

  • Which region of the stomach acts as a reservoir?

    Cardia

    Fundus

    Pylorus

    Body

    anatomy stomach

  • Why is the Tc-99m labeled RBC technique preferred for imaging gastrointestinal bleeds?

    For intermittent bleeds

    For constant bleeds

    For detecting tumors

    For liver function tests

    radiology nuclear_medicine

  • What will the flow study demonstrate in a liver/spleen scan?

    Tumor presence

    Fluid accumulation

    Vascularity defect

    Solid organ size

    radiology liver

  • What is the appropriate volume of solution for RN imaging for gastroesophageal reflux?

    200ml of orange juice only

    300ml (150 ml of orange juice and 150ml of acid)

    400ml total

    150ml total

    gastrointestinal imaging

  • How are radiocolloids cleared from circulation?

    Kupffer cells

    Phagocytes

    Macrophages

    Neutrophils

    radiology liver

  • What are stones in the gallbladder that may or may not cause symptoms called?

    Cholecystitis

    Gallbladder disease

    Choledocholithiasis

    Cholelithiasis
    gastrointestinal gallbladder

  • Should a 1 hr fasting be avoided in a cholescintigraphy study?

    Depends on medication

    True

    Only in children

    False

    gastrointestinal nuclear_medicine

  • Which of the following is not an activity of the digestive system?

    Digestion

    Absorption

    Secretion

    Urination
    digestive_system anatomy

  • What condition occurs when the esophageal sphincter fails to relax after food is eaten?

    Acid reflux

    Dysphagia

    Gastroesophageal reflux

    Achalasia
    digestive_system conditions

  • What does the stomach secrete?

    Amylase and lipase

    Bile and enzymes

    Saliva and insulin

    Mucus and hydrochloric acid
    digestive_system physiology

  • Where is the gallbladder located?

    Inferior to the pancreas

    Posterior to the stomach

    Medial to the spleen

    Visceral to the liver
    anatomy gallbladder

  • What is the term for saclike outpouching of the wall of the colon?

    Meckel's diverticulum

    Diverticulosis

    Herniation

    Appendicitis

    digestive_system conditions

  • How long should a patient fast prior to a cholescintigraphy?

    2-5 hours

    1 hour

    8 hours

    12 hours

    procedures fasting

  • Chronic cholecystitis will cause the gallbladder to visualize at what time?

    90 minutes

    120 minutes

    60 minutes

    30 minutes

    gallbladder diagnosis

  • Which anatomical region of the stomach controls the emptying rate for liquids?

    Fundus

    Body

    Pylorus

    Cardia

    anatomy stomach

  • What is demonstrated by a marker image taken for a liver/spleen scan?

    Shape

    Tissue type

    Size

    Blood flow

    liver scan

  • Cholecystokinin is a hormone secreted by the duodenum that stimulates which action?

    Bile secretion

    Insulin secretion

    Gallbladder contraction

    Stomach acid production

    hormones digestive_system

  • What is the most common cause of chronic gastroparesis?

    Hyperthyroidism

    Cholecystitis

    Diabetes

    Cirrhosis

    digestive_system conditions

  • In preparation for an esophageal transit study, how much 99mTC SC is prepared?

    500 uci

    300 uci

    200 uci

    100 uci

    studies esophagus

  • A cold spot on a liver/spleen scan represents what?

    Tumors

    Inflammation

    Cysts

    Abscesses

    diagnosis liver

  • What effect does CCK have on the gallbladder and the sphincter of Oddi?

    Relaxes; contracts

    Contracts; contracts

    Contracts; relaxes

    Relaxes; relaxes

    hormones digestive_system

  • What is the main determinant of the rate of liquid gastric emptying?

    Temperature

    Caloric content

    Viscosity of contents

    pH level

    physiology gastric

  • What effect does Captopril have on GFR in a stenotic kidney?

    No effect

    Increase

    Decrease

    Variable

    renal pharmacology

  • Which RP is used in a direct cystogram?

    99mTc HMPAO

    99mTc DTPA

    99mTc DMSA

    99mTc SC
    renal imaging

  • What is a normal ERPF?

    800 ml/min

    600 ml/min

    1000 ml/min

    400 ml/min

    renal physiology

  • Does a transplanted kidney create new nephrons?

    Only in children

    True

    Only in adults

    False
    renal anatomy

  • How is 99mTc DTPA cleared from the kidney?

    Passive diffusion

    Tubular secretion

    Active transport

    GFR
    renal pharmacology

  • What indicates a split renal function of 43% and 57% during a captopril renal scan?

    Equivalent function

    Normal

    Abnormal

    Insufficient data

    renal function

  • Which RP has some clearance by the renal tubules?

    99mTc SC

    GH, MAG 3, OIH

    99mTc MUGA

    99mTc DMSA

    renal pharmacology

  • When assessing relative renal function, what is useful for imaging?

    30 min image

    1-2 min image

    15 min image

    5 min image

    renal imaging

  • In a renal scan, if the right kidney is slightly lower than the left, what should the technician do?

    Stop the scan

    Alter the patient position

    Repeat the scan

    Continue the scan; this is normal
    renal imaging

  • Which phase of the time activity curve shows the peak transit time?

    Preparatory

    Filtration

    Excretory

    Secretory
    renal imaging

  • What is the normal peak transit time in a functional renal scan?

    6 min

    4 min

    2 min

    8 min

    renal scans

  • Which renal imaging agent is cleared by tubular secretion?

    GH

    DTPA

    DMSA

    MAG3
    renal imaging agents

  • What is the normal GFR value?

    200 ml/min

    125 ml/min

    150 ml/min

    100 ml/min

    renal gfr

  • What does a diuretic renal imaging study help differentiate?

    Renal failure from normal function

    Tumors from cysts

    Dilation from obstructed renal collecting system

    Infections from stones

    renal imaging differentiation

  • What is the notch near the center of the kidney called?

    Cortex

    Medulla

    Hilus

    Pelvis

    renal anatomy

  • ACE augments renal studies in patients with what condition?

    Chronic kidney disease

    Heart failure

    Diabetes

    RAS related hypertension
    renal ace hypertension

  • Which agents are commonly used for morphologic renal imaging?

    MAG3 and DTPA

    MAG3 and ultrasound

    DTPA and creatinine

    DMSA and GH
    renal imaging agents

  • Is the split renal function measured using GFR and ERPF advantageous over BUN and creatinine?

    Sometimes

    True

    False

    Not always

    renal function measurements

  • What are the examples of functions of the nephrons?

    Water balance

    None

    Aldosterone

    Glucose reabsorption

    renal nephrons

  • Which conditions are indicators for renal scintigraphy?

    Acute asthma

    Chronic renal failure

    Liver disease

    Heart failure

    renal scintigraphy

  • What is the most accurate nuclear medicine technique for measuring renal size?

    Ultrasound

    Nuclear imaging technique

    CT Scan

    X-Ray

    renal nuclear size

  • What is a characteristic of the morphologic renal tracer DMSA?

    Retention in the renal parenchyma for a prolonged period of time

    Low sensitivity for renal function

    Only used in emergency cases

    Rapid elimination from the body

    renal imaging

  • What radioactive pharmaceutical (RP) was likely used in renal perfusion imaging?

    Technecium-99m

    Mag3

    DMSA

    I-131 mIBG

    renal radiopharmaceuticals

  • What should a patient receiving I-131 mIBG for pheochromocytoma also receive?

    Lugol's solution

    Water

    Vitamin B12

    Captopril

    pheochromocytoma treatment

  • What substance is produced as a result of protein catabolism?

    Creatinine

    Glucose

    Urea, ammonia, and NH3

    Lactate

    biochemistry metabolism

  • What is a cytogram also referred to as?

    Kidney scan

    CT Urogram

    Urine culture

    Vesicouretal reflux study
    urology diagnosis

  • What happens to GFR when blood pressure drops?

    Short term increase

    Stay the same

    Increase

    Decrease
    renal physiology

  • What must be done if the patient arrives late for a renal imaging study?

    Wait for the patient to arrive in 1 hour

    Use the same kit for 24 hours

    A new kit has to be made

    Proceed with the original kit

    protocol imaging

  • What is a primary effect of Angiotensin II in the body?

    Lower GFR, decrease blood volume, and decrease blood pressure

    Raise GFR and decrease blood pressure

    Raise GFR, increase blood volume, and increase blood pressure

    Increase GFR, decrease blood volume, and increase blood pressure

    physiology endocrine

  • What medication is also known as furosemide?

    ACE inhibitor

    Potassium-sparing diuretic

    Loop diuretic

    Thiazide diuretic

    pharmacology cardiovascular
Study Notes

Skeletal System Test

Osteoporosis Risk Factors

  • 4 Factors:
  • Women (especially white, thin, short)
  • Vitamin D deficiency
  • Elderly age
  • Family history
  • Other factors: smoking, sedentary lifestyle, cancer, calcium deficiency, premature menopause

Bone Scan Procedures

  1. 99m Tc-bound phosphates: taken to bones by blood.
  2. Fracture visualization: 80% seen within 24 hours.
  3. Prosthesis Evaluation: placement and infection checked via bone scan.
  4. SPECT slices: transverse, sagittal, and coronal.
  5. Functions of Bone: include electrolyte balance except for muscle contraction.
  6. Hormones in Bone Growth: Calcium is not a hormone that affects remodeling.
  7. Fluid Intake: Encouraged to clear injected materials, enhancing scan quality.

Pathologies Observed in Bone Scans

  • Paget's Disease: characterized by accelerated remodeling and bone thickening.
  • Metastases: appear as focal hot spots.
  • Bone infarcts: identified as cold lesions.

Miscellaneous Facts

  • Tc-99m dose for adult 3-phase scan: typically 20 mCi.
  • Radiation therapy effects: show decreased activity.
  • Osteomyelitis diagnosis: indicated by inflammation in bone scans.
  • Blood vessel perforation into bones: occurs via Volkman's canal.

Understanding Bone Health

  • Prevalent in Post-Menopausal Women: due to lack of estrogen promoting osteoporosis.
  • Young Children: display high metabolic rates with actively growing epiphyseal plates.

Respiratory System Test

Lung Structure

  • Lobes: Right lung has 3, left lung has 2.

Lung Scan Procedures

  1. 99mTc-MAA particles: 200,000 to 400,000 particles (10-30μm) required for scans.
  2. Normal lung scan: requires anterior view due to cardiac notch.
  3. Ventilation vs Perfusion Scan: perfusion scans show cold defects due to PE, while ventilation assessments remain normal.
  4. Common lung conditions:
  5. Atelectasis: collapsed lung.
  6. Pneumothorax: air in pleural cavity.
  7. Pleurisy: inflammation causing chest pain.

Ventilation Study Tips

  • Wait 30 minutes after administering 99mTc MAA for optimal imaging.
  • Xe-133: has a 5-day half-life and 81 KeV energy for lung scans.
  • 3 main lung functions: deliver oxygen, remove CO2, and assist in gas exchange.

Endocrine System Test

Thyroid Scan Indications

  • Assess size, shape, and function of the thyroid gland.
  • Check if nodules are functioning or detect ectopic thyroid tissue.

Thyroid Uptake Measurement

  • Administer I-131 for metastatic thyroid cancer assessment.
  • Normal uptake range: 24-hour uptake around 25%.

Thyroid Function Tests

  • Lugol's solution blocks iodine uptake in preparation for scans.
  • Grave’s disease: often a primary indication for uptake measurements.

CNS Procedures Test

Brain Scan Preparation

  • SPECT brain scans require no patient prep.
  • Injection types: bolus injection needed for planar brain scans.

Key Concepts in Brain Imaging

  • Hot Nose Sign: increased flow seen in external carotid circulation.
  • Seizure Activity: perfusion increases during ictal phase; decreases during interictal phase.

SPECT Image Interpretation

  • Normal pressure hydrocephalus displays enlarged brain ventricles.
  • Regional oxygen extraction fraction changes during ischemic conditions.

Cardiovascular Procedures Test

Myocardial Perfusion Imaging

  1. Heart conduction sequence: SA node → AV node → Bundle of HIS → Bundle branches.
  2. Myocardial ischemia: indicated by reduced uptake post stress imaging.
  3. Common RPs: use of 99mTc-MIBI preferred for localizing myocardial infarction.

Stress Testing Details

  • Exercise post-injection: circulates the tracer effectively.
  • Normal ejection fraction in MUGA scans should be around 55-70%.

Potential Issues During Imaging

  • Artifacts: can originate from body mass or movement during scans.

Gastrointestinal Procedures Test

Esophageal Imaging

  • Transit studies: performed with an anterior view.
  • Mechanics of saliva: lubricates food and initiates breakdown; not involved in gastric juice dissolution.

Hepatobiliary Scan Insights

  • Liver positioning: upper left corner of the screen for optimal imaging.
  • Gallbladder nonvisualization: indicates acute cholecystitis.

Administration Protocols

  • Esophageal transit study prep: require 8 hours fasting.
  • Cholecystokinin role: stimulates gallbladder contraction.

Renal Procedures Test

Renal Function Tests

  • Captopril effects: decreases GFR in stenotic kidneys.
  • Normal GFR benchmark: approximately 125 ml/min.

Radiopharmaceuticals in Renal Imaging

  • Preferred agents: MAG3 for tubular secretion; DMSA is useful for structural imaging.
  • Split renal function: normal values between 43%-57% accepted.

Techniques for Assessing Kidney Function

  • Direct cystogram: utilizes 99mTc SC for imaging.
  • Post-captopril challenge: delays can indicate stenosis presence in renal flow.