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NMT Review Exam 2
Steve's Review Exam 2 Part 1
| Question | Answer |
|---|---|
| Static bone imaging is routinely performed how long after tracer administration to an adult: A)30min B)1hr C)2-3hr D)24hr | C)2-3hr. Static bone imaging performed with a labeled diphosphonate compound is routinely performed 2-3hr after tracer administration. |
| Which of the following structures normally appear as areas of increased activity on the bone images of adults: A)anterior iliac crests B)glenoid fossa C)sternoclavicular joints D)all of the above | D)all the above. On bone images of adults, areas of normally increased tracer activity include all those listed as well as the sacroiliac, hip, and acromioclavicular joints and vertebral column. |
| Which of the following conditions is visualized on a bone image as a photopenic area: A)attenuation B)tracer infiltration C)acute myocardial infarction D)osteomyelitis | A)attenuation. A photopenic area is one in which a smaller number of photons is visualized-a cold spot. A material that absorbs photons may cause an attenuation artifact, an area of falsely decreased tracer concentration(jewelry, belt buckles, pacemaker) |
| It is safe to block a portion of the pulmonary circulation with MAA particles in patients with suspected PE because: A)# of injected particles block only a small number of precapillary arterioles B)particles are made from albumin isolated from human serum | A)# of injected particles blocks only a small number of precapillary arterioles. Less than 1% of the precapillary arterioles are blocked with the MAA particles; therefore, there is no adverse effect on the patient. |
| A nebulizer is used to administer which of the following lung ventilation radiopharmaceuticals: A)81mKr gas B)133Xe gas C)99mTc-pentetate D)99mTc-MAA | C)99mTc-pentetate. A nebulizer is a device that uses ultrasound or pressure to create airborne (aerosol) particles from a liquid. |
| Which of the following radiopharmaceuticals may be used to image acute deep vein thrombosis in the lower extremities: A)99mTc-MAA B)99mTc-arcitumomab C)131I-iobenguane D)111In-oxyquinoline | A)99mTc-MAA is used to image acute deep-vein thrombosis in the lower extremities. |
| In performing radionuclide venography with 99mTc-MAA, the radiopharmaceutical is administered at what site: A)antecubital of either arm B)either femoral vein C)dorsal veins on top of each foot D)either basilic vein | C)dorsal vein on to of each foot. The tracer is introduced into the deep venous system of the legs. Therefore, the tracer is administered into the dorsal vein of each foot. |
| After total thyroidectomy, total-body imaging with radioiodine normally will demonstrate tracer concentration in which areas: A)liver, lungs, bones B)salivary glands, stomach, and bladder C)liver, salivary glands, stomach, lungs D)bladder, liver, brain | B) The salivary glands and saliva in the mouth, the gastric mucosa and secretions into the intestine, and the urinary bladder are sites that normally concentrate radioiodine. Concentrations in other sites indicate areas of functioning thyroid metastases. |
| A parathyroid adenoma will concentrate which of the following radioparmaceuticals: A)123I-sodium iodide B)99mTc-pertechnetate C)99mTc-sestamibi D)99mTc-pertechnetate or 99mTc-sestamibi | C)99mTc-sestamibi |
| When positioning a patient for an LAO view of a gated equilibrium ventricular function study, tilting the camera toward the patient's feet separates what two structures: A)left ventricle and aorta B)left ventricle and left atrium C)left and right atria | B)left ventricle and left atrium. The left atrium is partially hidden by the aorta and pulmonary artery. Tilting the detector caudally visually brings the left atrium out from under these structures and separates it from the left ventricle. |
| Which tracer is excreted primarily via the hepatobiliary system: A)99mTc-sestamibi B)99mTc-exametazime C)99mTc-medronate D)201Tl-thallous chloride | A)99mTc-sestamibi |
| A cardiac stress test requires the placement of how many electrodes on the patient's body: A)3 B)6 C)10 D)12 | C)10. A cardiac stress test requires a 12-lead ECG tracing, which uses 10 electrodes attached to the patient. 2 arm, 2 leg, and 6 chest leads. |
| Visualization of bone marrow uptake on a 99mTc-sulfer colloid liver/spleen image is most likely the result of: A)improper colloid particle size B)insufficient tracer circulation time C)liver dysfunction D)overactive bone marrow | C)liver dysfunction. Bone marrow uptake is visualized on liver/spleen images when severe liver dysfunction, such as advanced cirrhosis, is present. |
| During hepatobiliary imaging, which structure will NOT be visualized if cystic duct obstruction is present: A)common hepatic duct B)common bile duct C)gallbladder D)small intestine | C)gallbladder. If cystic duct obstruction is present, the tracer will be unable to enter the gallbladder. The cystic duct is the passage between the common bile duct and the gallbladder. |
| How long after the administration of 99mTc-pertechnetate does imaging begin for the localization of a Meckel's diverticulum: A)immediately B)15-20min C)1hr D)2-3hr | A)immediately. For localization of a Meckel's diverticulum, imaging begins immediately after administration of the tracer. |
| All of the following 99mTc-labeled radiopharmaceuticals may be appropriate for performing a left-to-right cardiac shunt exam using the first-pass method except: A)sulfur colloid B)pentetate C)sestamibi D)tetrofosmin | A)sulfur colloid. First-pass cardiac studies to identify or quantify left-to-right shunts are performed with radiopharmaceuticals that can be administered in small volumes of 20-25mCi. |
| The glomerular filtration rate (GFR) is measured with which radiopharmaceutical: A)99mTc-pentetate B)99mTc-succimer C)99mTc-gluceptate D)99mTc-meritiatide | A)99mTc-pentetate. Determination of GFR requires an agent that is completely filtered by the glomeruli. 99mTc-pentetate (DTPA) is handled only by glomerular filtration. |
| Radionuclide cystography is performed by the direct method using which radiopharmaceutical: A)99mTc-pentetate or medronate B)99mTc-pertechnetate or sulfur colloid C)99mTc-gluceptate or sulfur colloid D)99mTc-pertechnetate or mertiatide | B)99mTc-pertechnetate or sulfur colloid. Direct radionuclide cystography is performed by instilling 99mTc-pertechnetate or sulfur colloid into the urinary bladder. Imaging is performed as the bladder is filling and emptying. |
| Filtered 99mTc-sulfur colloid is required for which of the following examinations: A)gastroesophageal reflux B)gastric emptying C)LeVeen shunt patency D)lymphoscintigraphy | D)lymphoscintigraphy. Although all procedures listed may be performed with 99mTc-sulfur colloid, only lymphoscintigraphy requires that sulfur colloid be filtered to remove the larger particles. |
| A patient with a nasogastric tube in place is transferred to the NM dept for an imaging procedure. The technologist should: A)confirm physician orders for transfer and reestablish suction if required B)cancel study C)use the tube to administer tracer | A) Nasogastric tubes are used for gastric decompression. A physician must order the transfer and interruption of suction. The tech may be required to reestablish suction upon the patient's arrival in the department. |
| The appearance of what structure indicates the beginning of the venous phase of a cerebral blood flow study: A)anterior cerebral arteries B)carotid arteries C)nasopharynx D)superior sagittal sinus | D)superior sagittal sinus. In a normal cerebral flow study, the first phase is the arterial phase, indicated by activity in the carotid and anterior cerebral arteries. The capillary phase is followed by the venous phase. |
| In performing cisternograpy, the purpose of acquiring the first image over the lower thoracic/lumbar spine is to ascertain: A)the site of tracer administration B)the flow rate of the cerebral spinal fluid C)that the tracer was not infiltrated | C)that the tracer was not infiltrated. The injection site should be imaged first to confirm that the tracer has not infiltrated outside the subarachnoid space. Reinjections may be required if infiltration is confirmed. |
| On Wednesday a patient had a I-123 thyroid study performed. A I-125plasma volume is ordered to be performed on Thursday. Should a baseline plasma sample be collected before performing the plasma volume? True or False | True. A blood sample collected before the I-125-albumin is injected can provide the background present in the patient's plasma. This will permit counts from the plasma sample containing I-125 to be corrected for any residual I-123. |
| 89Sr-chloride is used to treat which of the following conditions: A)bone pain B)polycythemia vera C)rheumatoid arthritis D)malignant effusions | A)bone pain. 89Sr-chloride is used to relieve bone pain resulting from skeletal metastases. |
| Whole-body imaging with 131I-sodium iodide is optimally performed how long after tracer administration: A)12hr B)18-24hr C)48-72hr D)96hr or longer | C)48-72hr. Although 131I whole-body imaging may be performed as early as 24hr, optimum images are obtained at 48-72hr after tracer administration. |
| During an imaging procedure a patient indicates a seizure is impending. The most appropriate action is: A)tell the patient to breathe deep to increase oxygen levels B)stop the procedure, have the patient lie on the floor with a pillow supporting the head | B)stop the procedure. Seizure patients may experience a warning that a seizure is about to occur. The tech should assist the patient to the floor and away from objects that may injure the patient. A pillow will cushion the head from the floor. |
| After administration of 111In-pentetreotide, which areas of the body should be imaged: A)anterior and posterior chest B)anterior and posterior abdomen C)anterior and posterior whole body | C)anterior and posterior whole body. Because the purpose of 111In-penetreotide imaging is to visualize the unknown primary site of the cancer or to demonstrate the extent of the disease, anterior and posterior whole-body images should be performed. |
| Which of the following is the initial positioning for visualizing gastrointestinal bleeding with labeled RBC's: A)xiphoid in middle of FOV B)symphysis pubis in middle of FOV C)lower border of liver and spleen at top of FOV | C)lower border of liver and spleen at top of FOV. RBC's labeled with 99mTc-pertechnetate are used for demonstrating intermittent lower GI bleeding. |
| Which of the tracers is preferred if a first-pass stress and rest cardiac function exam is to be performed on a patient: A)99mTc-pertechnetate B)99mTc-medronate C)99mTc-pentetate D)99mTc-sestamibi | C)99mTc-pentetate. |
| Patient preparation for breast imaging with 99mTc-sestamibi includes which of the following: A)explanation of the procedure B)fasting for 8hr before tracer administration C)discontinuation of any medications D)consumption of a fatty meal | A) There is no patient preparation for breast imaging with 99mTc-sestamibi except explanation of the procedure to the patient. |
| Historically, a Schilling test may be ordered for a patient with suspected: A)hemolytic anemia B)pernicious anemia C)iron deficiency anemia D)lymphocytic anemia | B)pernicious anemia. The Schilling test is used to measure the absorption of vitamin B-12 in patients with unexplained anemia. Pernicious anemia is a vitamin B-12 deficiency resulting from a lack of intrinsic factor. |
| The proper route of administration for a lymphoscintigrapy exam is: A)an intravenous injection B)orally C)an intrathecal injection D)a subcutaneous injection | D)a subcutaneous injection. Subcutaneous injections are needed for a lymphoscintigraphy to determine the sential node. |
| A patient's plasmacrit may be determined by: A)multiplying the patient's hematocrit by 0.9 B)subtracting the decimal hematocrit from 1 C)finding the ratio of plasma volume to RBC volume D)dividing 1 by the decimal hematocrit | B)subtracting the decimal hematocrit from 1. The hematocrit represents the portion of the blood made up of cellular components, and the plasmacrit represents the fluid portion. Together they comprise the total blood volume. |
| During a red cell sequestration study, counts are obtained from all of the following organs except: A)liver B)spleen C)heart D)kidneys | D)kidneys. Sequestration sites for RBC's include the liver and spleen. Cardiac counts are used as a standard. Renal areas are not counted. |
| In performing a plasma volume with 125I-albumn, 3 blood samples are collected a varying times after tracer administration and counted. These counts vs time are plotted on semilog graph paper. The purpose of this graph is to? | Correct for leakage of the radiopharmaceutical. There is leakage of the labeled albumin from the vascular system. The 3 blood samples provide the information needed to estimate the leakage rate and determine the plasma counts before any leakage occurred. |
| Patient preparation for a thyroid uptake test may include discontinuation of antithyroid medication. Which of the following are antithyroid drugs: A)synthroid B)potassium perchlorate C)propylthiouracil D)thyroxine | C) Propylthiouracil (PTU) interferes with the organification of iodide by the thyroid gland and is on of the antithyroid drugs available to decrease thyroid hormone production. |
| During a radiochromium red cell mass determination, an infusion set may be used to place a needle in the patient's antecubital vein. To maintain the patency of the infusion set tubing, what substance should be injected into the infusion set tubing? | Heparin. Injection of about 0.5mL of heparin is sufficient to maintain the patency of the infusion set tubing used during a red cell mass determination. |
| A gastric-emptying study uses which of the following radiopharmaceuticals: A)99mTc-medronate B)99mTc-disida C)99mTc-sulfur colloid D)99mTc-MAA | C)99mTc-sulfur colloid. Gastric-emptying studies involve combining 99mTc-sulfur colloid with eggs. (oatmeal) |
| In the case of insulinoma, which of the following radiopharmaceuticals may cause hypoglycemia: A)111In-pentetreotide B)99mTc-sestamibi C)67Ga-citrate D)18F-FDG | A)111In-pentetreiotide - binds to somatostatin receptors in certain tumors. In the case of suspected insulinoma, there is a potential for inducing severe hypoglycemia. For this reason, an intravenous infusion of glucose should be available. |
| Which of the following structures is normally visualized on an image performed with 18F-FDG: A)thyroid B)brain C)pituitary gland D)pancreas | B)brain. Structures normally visualized on an image performed with 18F-FDG include the brain, myocardium, liver, spleen, intestines, kidneys, and urine. |
| The 14C urea breath test is used to: A)detect the presence of peptic ulcers B)detect the presence of Helicobacter pylori bacteria C)identify gastric cancers D)rule out Zollinger-Ellison syndrome | B) The 14C urea breath test is used to detect the presence of Helicobacter pylori bacteria. All patients with duodenal ulcers and 80% of patients with non-drug induced gastric ulcers are infected with H. pylori. |
| What is the patient's thyroid uptake @ 1500 if a 123I-sodium iodide capsule is administered to the patient and used as the standard: Capsule-216,789cpm @ 0900; Bkgd-92cpm @ 0900; Thyroid-94,954cpm @ 1500; Thigh-521cpm @ 1500; DF=0.73 | 60%. 216,789 x DF (0.73) = 158,256cpm standard @ 1500 % thyroid uptake = thyroid cpm - thigh cpm / standard cpm - bkg cpm x 100 |
| If the elution efficiency of a 99Mo/99mTc generator is 96% and 11.7 MBq 99mTc is present on the column, approximately how much activity will be removed during elution? | 11.2MBq |
| A dry-column generator is eluted with 5mL of saline, and the eluate containing 863mCi is collected into a 10mL evacuated vial. What is the concentration of the eluate? | 172.6mCi/mL |
| If no eluate is obtained during generator elution, the technologist should next: A)attempt elution with another evacuated elution vial B)contact the generator manufacturer C)check the generator tubing for kinks or leaks D)add more saline to generator | A)attempt elution with another evacuated elution vial. Loss of vacuum from the elution vial is most likely the cause of this problem. Checking the tubing may cause increased radiation exposure. |
| According to the NRC, records of 99Mo concentration in 99mTc eluate must be maintained for how long: A)1year B)3 years C)5 years D)10 years | B)3 years. The NRC requires that records of 99Mo concentrations in 99mTc eluates be retained for 3 years. |
| According to the NRC, the concentration of what radionuclidic impurity must be determined after the first elution of a 99Mo/99mTc generator: A)Al B)free pertechnetate C)99Mo D)a and c | C)99Mo. Al is a chemical impurity and not subject to regulation by the NRC. Free pertechnetate is 99mTc-pertechnetate that is not bound to another compound. 99Mo is a radionuclidic impurity, a radionuclide other than the desired one in 99mTc eluate. |
| Based on the day's clinic schedule - Patient A:Renal function study; Patient B:Total-body bone image; Patient C:Meckel's diverticulum localization; Patient D:Hepatobiliary study - the tech should order or prepare what radiopharmaceuticals? | Patient A: 99mTc-mertiatide for renal Patient B: 99mTc-medronate for bone Patient C: 99mTc-pertechnetate for Meckel's Patient D: 99mTc-mebrofenin for hepatobiliary |
| According to NRC regulations, records of written directives must be maintained for how long: A)3 years B)5 years C)10 years D)indefinitely | A) The NRC requires that records of written directives be maintained for 3 years. |
| According to the NRC, dose calibrator quality control testing should be performed how often for Constancy Linearity Accuracy Geometry | Constancy - daily before clinical use Linearity - installation and quarterly Accuracy - Annually Geometry - installation, service, or relocation |
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