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NMT Review Exam 3
Steve's Review Exam 3 Part 1
| Question | Answer |
|---|---|
| Static bone imaging is performed several hours after tracer administration to permit: A)maximum tracer uptake in skeleton B)blood clearance of excess tracer C)tracer clearance from sites of infiltration D)tracer clearance from normal bone tissue | B) Maximum skeletal uptake of 99mTc-medronate and 99mTc-oxidronate occurs within 45 min after tracer administration, and imaging is to allow the excess circulating tracer to be cleared from the blood by the kidneys. |
| For which clinical indications would limited bone imaging be most appropriate: A)evaluate TMJ pain B)evaluate Paget's disease C)rule out skeletal metastases D)history of child abuse; rule out occult fractures | A) Paget's disease, skeletal metastases, and occult fractures resulting from child abuse all have the potential to be widespread. TMJ pain is localized; therefore, "spot" view imaging of the skull, face, and cervical spine is indicated. |
| 3 or 4 phase bone imaging is particularly useful when which condition is suspected: A)skeletal metastases B)osteoporosis C)osteomyelitis D)stress fracture | C) Early images are important in diagnosing inflammatory conditions such as osteomyelitis. In osteomyelitis, tracer concentration remains increased throughout the phases. |
| The standard views performed in a lung perfusion study are: A)anterior and posterior B)posterior and obliques C)anterior, posterior, and lateral D)anterior, posterior, laterals, and obliques | D) At least 6 views should be performed in a lung perfusion study: anterior, posterior, right and left-laterals, and right and left posterior obliques. |
| If a patient sits up quickly and complains of dizziness and feeling faint, the most appropriate action for the tech would be to: A)talk with the patient and have the patient breathe slowly and deeply B)check vital signs C)have the patient lie down again | A)To help minimize the severity of orthostatic hypotension, the patient should be encouraged to talk and breathe slowly and deeply. Symptoms should subside within a few minutes. |
| Which statement about performing a lung ventilation study with 99mTc-pentetate aerosol is False: A)the patient is disconnected from the nebulizer after inhalation of the aerosol B)the patient is imaged while inhaling particles from the nebulizer | B)After inhalation of the tracer, the patient is disconnected from the delivery apparatus. Then, the patient is imaged. |
| The purpose of wrapping the legs with elastic bandages before performing a radionuclide venogram with 99mTc-MAA is to: A)distend the veins in the feet B)suppress superficial circulation C)prevent blood clots from traveling to the lungs | B)Elastic bandages are used to wrap the legs between the ankles and knees to divert blood flow from the superficial circulation to the deep venous system. |
| When radiation levels coming from a radioiodine therapy patient in isolation is measured, it should be measured: A)every day B)every day at same time C)the same distance from patient each time D)every day at the same distance from the patient each time | D)every day at the same distance from the patient each time, using the same instrument and counting geometry. |
| The function of a draw sheet is to provide: A)warmth to the patient during the procedure B)support for the patient during a stretcher to bed transfer C)protection from infectious disease D)patient privacy during procedure | B) The draw sheet is the one on which the patient is lying and is used for transferring the patient from stretcher to imaging table. |
| A gated equilibrium ventricular function study can be performed with which 99mTc-labeled tracers: A)pentetate B)medronate C)pyrophosphate D)human serum albumin | D)Many departments label the patient's RBC's with 99mTc-pertechnetate, but other facilities prefer the immediate availability of 99mTc-albumin. Currently 99mTc-albumin is available only outside the United States. |
| The 99mTc-complexes such as PYP, MDP, and HDP are the agents used for what type of imaging? | Bone |
| Stress-rest myocardial imaging performed with 99mTc-sestamibi requires two dose administrations of tracer, because the tracer: A)does not redistribute B)rapidly washes out of the myocardium C)has too short a half-life to permit delayed imaging | A) 99mTc-sestamibi is taken up into the myocardium in proportion to blood flow. It does not redistribute the way 201Tl-thalous chloride does. |
| In a normal hepatobiliary study, which structure will not be visualized: A)liver B)spleen C)common bile duct D)gallbladder | B)spleen. Hepatobiliary agents are cleared from the blood by the hepatocytes in the liver. The tracer is cleared from the hepatocytes into the common bile duct and gallbladder and from there into the small intestine. |
| In preparation for hepatobiliary imaging, patients are required to fast to: A)prevent renal uptake of the tracer B)enhance liver uptake of the tracer C)avoid stimulating the gallbladder D)minimize risk of radioactive emesis | C) Ingestion of food may cause the gallbladder to contract, potentially causing a false-positive result; that is, the gallbladder is not visualized. |
| To determine the patency of a LeVeen shunt, the radiopharmaceutical is administered into: A)a vein B)the peritoneal cavity C)the intrathecal space D)the shunt tubing | B) The physician performs an intraperitoneal injection of the tracer. |
| What is the correct patient/camera position for imaging a transplanted kidney: A)upright/anterior B)supine/anterior C)upright/posterior D)supine/posterior | B) A transplanted kidney is placed in the iliac fossa. Therefore, a transplanted kidney should be imaged with the patient supine and the camera placed anteriorly over the pelvis. |
| In performing an effective renal plasma flow determination, the injection site should be imaged to: A)quantitate the amount of tracer deposited at injection site B)rule out tracer infiltration C)calculate the amount of injected activity | B) Because ERPF is a quantitative study, any tracer infiltration will invalidate the calculated ERPF values. It is essential to confirm the entire amount of activity was injected into the circulatory system. |
| Radionuclide cystography performed by the direct method requires: A)intravenous injection of tracer B)use of a renal agent C)catheterization of the patient D)administration of furosemide | C)Direct radionuclide cystography requires that the patient be catheterized and the bladder drained. |
| All of the following conditions may demonstrate uptake of 111In-labeled leukocytes except: A)osteomyelitis B)dental abscess C)pulmonary embolism D)ostomy site | C) Leukocytes accumulate in areas of infection or inflammation. Not PE. |
| Signs/symptoms that a patient is going into anaphylactic shock include all of the following except: A)hot, dry skin B)pallor C)restlessness D)tachycardia | A) Pale, cold, clammy skin is characteristic of shock. The patient may also exhibit restlessness and tachycardia. |
| Which of the following radiopharmaceuticals crosses the intact blood-brain barrier: A)99mTc-bicisate B)99mTc-gluceptate C)99mTc-pentetate D)99mTc-pertechnetate | A) 99mTc-bicisate and 99mTc-exametazime normally cross the blood-brain barrier and are taken up in brain tissue in proportions to blood flow |
| The patency of ventriculoperitoneal shunts may be assessed with which tracer: A)111In-chloride B)99mTc-pertechnetate C)99mTc-bicisate D)99mTc-MAA | B) The patency of the shunt can be ascertained by injecting a tracer, typically 99mTc-pertechnetate, into the shunt tubing and imaging the movement of the tracer down the tube into the peritoneum. |
| According to the FDA, written informed consent must be obtained to administer which radiopharmaceutical: A)123I-sodium iodide B)99mTc-sestamibi C)99mTc-bicisate D)any IND | D) Written consent must be obtained for any radiopharmaceutical that is investigational. These drugs are referred to as investigational new drugs (INDs). |
| Patient preparation for 89Sr-chloride therapy includes all except: A)nuclear medicine bone imaging B)complete blood count C)discontinuation of pain medication D)renal function studies | C)discontinuation of pain medication |
| Patient preparation for 131I therapy for thyroid cancer includes all except: A)ruling out pregnancy B)administering oral potassium iodide C)reviewing isolation requirements D)discontinuing breast-feeding | B) Oral potassium iodide may be administered to personnel who are exposed to airborne radioiodine as a means of preventing tracer uptake in the thyroid gland. |
| One verification method used to ensure that the correct radiopharmaceutical is being administered is to check the label found on the vial. The best times to check this label would include all except: A)before administration B)after administration | B) Verification should be done before injection, and the label should be checked when the radiopharmaceutical is removed from the shelf, when it is dispensed, and when it is returned to the shelf. |
| When dual-radionuclide myocardial perfusion imaging is performed, which tracer is used for stress and which for rest? | Stress: 99mTc-sestamibi Rest: 201Tl-thallous chloride |
| If 99mTc-SC is administered to demo GI bleeding, the bleeding can be best visualized how long after it is administered? A) 10-15 min B) 20-30 min C) 45 min-1 hr D) Anytime up to 24 hrs. | A) 10-15 min: 99mTc-sulfur colloid is cleared and localized in the liver and spleen within 15 min of administration. Therefore, to demonstrate gastrointestinal bleeding with this tracer, it will have to occur while the tracer is still circulating. |
| Which of the following areas is the recommended injection site for a cardiac first-pass study: A)median basilic vein B)cephalic vein C)axillary vein D)dorsal vein | A) A cardiac first-pass study requires a bolus injection technique to demonstrate each of the cardiac chambers separately. Therefore, a large peripheral vein, such as he median basilic or external jugular, is needed. |
| Patient prep for a 131I therapy includes: A)low-iodine diet for 1 week prior to therapy B)high-iodine diet for 1 week prior to therapy C)low-carb diet for 3 days prior to therapy D)no salt for 1 week prior to therapy | A) Patient prep for 131I therapy includes a low-iodine diet for 1 week prior to therapy to help increase the ability of the thyroid gland or metastatic cancer as a whole to uptake the radioactive 131I versus stable iodine. |
| For 67Ga infection imaging, the proper rout of administration of the radiopharmaceutical is: A)intravenously B)intramuscularly C)orally D)inhalation | A) The proper rout of administration for 67Ga infection imaging is intravenously. |
| When performing a plasma volume test, intravenous injection should be performed in an antecubital vein in one arm, and subsequent blood samples should be obtained from an antecubital vein in the opposite arm. True or False? | True. Because radioiodinated serum albumin is "sticky," it has a tendency to adhere to substances, including tissue. |
| When administering an intravenous injection, the needle should be inserted into the vein at an angle of ___ degrees: A)90 B)45 C)15 D)5 | C) An intravenous injection should be done with the needle at about a 15-degree angle to the vein it is being inserted into. |
| When counting 51Cr RBC samples in a scintillation well counter, the window should be set around the photopeak at: A)81keV B)159keV C)320keV D)511keV | C) The gamma energy of 51Cr is 320keV. Therefore, the scintillation detector should be set to accommodate this photopeak. |
| Which tomographic plane of the heart displays all walls of the left ventricle: A)horizontal long axis B)short axis C)transaxial D)vertical long axis | B) The short-axis slice displays all walls of the left ventricle. |
| When performing a radioiodine thyroid uptake with an uptake probe, the most appropriate collimator to use is a A)converging B)straight-bore C)flat-field | C) A scintillation probe with a flat-filed collimator is used for a radioiodine uptake test. The flat-field collimator allows for small variations in organ depth without affecting statistical accuracy. |
| Which would NOT be in accordance with electrical safety guidelines: A)use of 3 pronged plugs and outlets B)disconnecting an electrical plug from the wall by pulling on the cord C)keeping walk areas free from electrical cords | B) Cords should be disconnected from the wall by grasping and pulling on the plug, not the cord. |
| A linearity test indicates the dose calibrator's ability to measure the activity over a wide range of values. True or False? | True. Normally, dose calibrators exhibit a linear response for activities up to 200mCi (7.4GBq) to 2Ci (74GBq), depending on the chamber and geometry and the electronics of the dose calibrator, and tend to underestimate at higher activities. |
| When using 18F-FDG for PET imaging a consideration must be made for which of the following being a contraindication for performing the study: A)blood glucose level of 200mg/dL B)blood glucose level of 120mg/dL C)high-iodine diet within past week | A) Ideally, the blood glucose should be less than 120mg/dL when imaging with 18F-FDG. The 18F-FDG competes for glucose receptors, and a high blood glucose level reduces potential uptake of the 18F-FDG. |
| A 1:25 dilution of a solution with a concentration of 10uCi/mL is prepared. What is the tracer concentration in the dilution? | 0.4uCi/mL) A 1:25 dilution means that the concentration in the dilution is 1/25 of the original concentration. 1/25 x 10uCi/mL = 0.4uCi/mL |
| In preparation for 18F-FDG imaging, patients are required to fast to: A)prevent hypoglycemic episodes B)enhance cardiac uptake C)maximize tumor uptake D)eliminate the need for laxatives | C) In preparation for 18F-FDG imaging, patients are required to fast to maximize tumor uptake. |
| Which step is performed before the administration of 90Y-ibritumomab tiuxetan therapy: A)determine PSA level B)fasting for 8 hr C)whole-body imaging with 111In-ibritumomab tiuxetan D)intravenous hydration for 4 hr | C) Before administration of 90Y-ibritumomab tiuxetan therapy, a whole-body image is performed with 111In-ibritumomab tiuxetan. |
| The size of a 99Mo/99mTc generator is expressed as the total activity of: A)99Mo on the column B)99mTc on the column C)99mTc eluted from the column D)decay-corrected 99mTc available at time of elution | A) The size of a 99Mo/99mTc generator is expressed as the total 99Mo activity on the column at the time of initial assay (calibration). |
| If 1.2Ci of 99mTc are eluted from a generator in a 5.7mL volume, what is the concentration of the eluate? | 210mCi/mL. 1.2Ci/5.7mL = 0.210Ci/mL 0.210Ci/mL x 1000mCi/1Ci = 210mCi |
| If 633mCi are expected to be eluted from a wet-column generator, what volume evacuated vial should be used to obtain an eluate concentration of approximately 30mCi/mL: A)5mL B)10mL C)15mL D)20mL | D-20mL) eluate vol = total activity / desired concentration; A 21 mL evacuated vial is not available, but the 20 mL will produce a concentration of approximately 30mCi/mL |
| The maximum allowable limit of Al(3+) in 99mTc eluate is set by the: A)NRC B)U.S. Pharmacopeia C)EPA D)U.S. DOT | B) Aluminum is a nonradioactive, chemical impurity. The allowable limit is set by the U.S. Pharmacopeia. |
| If the following measurements were obtained from an assay of 99mTc eluate: 99Mo=8uCi; 99mTc=652mCi: then the 99Mo concentration in 1mCi of 99mTc is: A)81.5uCi/mCi B)8.0uCi/mCi C)0.012uCi/mCi D)0.000012uCi/mCi | C) 8uCi/652mCi = 0.012uCi99Mo/99mTc |
| Increased levels of Al(3+) in 99mTc eluate used to prepare 99mTc-sulfur colloid may cause the tracer to concentrate in the: A)liver B)lungs C)RBC's D)thyroid | B) Increased levels of aluminum ions in 99mTc eluate cause the colloidal particles in 99mTc-sulfer colloid to clump together, forming particles large enough to be trapped in the blood vessels of the lung. |
| Which radiopharmaceutical may be ordered to treat bone pain caused by bony metastases: A)131I-sodium iodide B)111In-oxine C)32P-chromic phosphate D)153Sm-exidronam | D) Of the radiopharmaceuticals listed, 153Sm-exidronam is the agent used in treating bone pain. |
| According to NRC regulations, reports of medical events sent to the NRC must include all information except: A)whether patient or relative was notified B)description of incident C)referring physicians name D)patient's name | D) The patient's name |
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