NUC FINAL/ BOARDS

A patient recived 5 mCi of [131I] sodium iodide for treatment of hyperthyroidism. The pateint should adhere to all of the following instructions except

Remain at home at least 30 days

After a 99Tc spill, decontamination procedures have not been able to remove all of the spilled material. If the current exposure rate is 32mR/hr, how long will it take for the exposure rate to drop to 2 mR/hr

24 hr

If a patient must be hospitalized in isolation after receiving a high activity of 131 I, which of the following signs must be placed on the door of the isolation room

Length of time a visitor may stay in room

How soon after a medical event has occired must the NRC be notified

telephone notification no later than the following calender day

According to the NRC, written instructions must be provided to a patient who has received radionuclide therapy when

another individual may receive an exposure > 0.1 Rem (1mSv) from the patient

Which of the following statements about the shielding method of performing a dose calibrator linearity test is true

When the shields are first used, the decay method must be used to confirm the accuracy

The following dose calibrator constancy test results were obtained with a 57 Co reference source. Which of the following measured values fall within the limits accoridng to the standards of practice

57 Co, 99m Tc, 123 I

Based on the graph shown here, the full width at half maxmum (FWHM) is

50 keV

To perform a constancy test on a dose calibrator that is being used in a general nuclear medicine imaging department, the best choice of radionuclide setting on which to count the reference standard would include which of the following

99mTc, 201Tl, 123 I

The scintillation camera quality control image shown here, was obtained with which of the following transmission phantoms

orthogonal hole

The following data were obtained during a dose calibrator accuracy test: On the basis of these results, which of the following statements is true

The instrument should be repaired or replaced

Which of the following is a high-pass filter

Ramp

In quantitiating scintillation camera detector uniformity, the central field of view ( CFOV) is defined as the diamter of the useful field of view (UFOV) times:

0.75

When the heart rate is 95 beats/min, what is the length of an average R-R interval

0.63 sec

To perform pixel calibration, two capillary sources are placed on the camera surface 15 cm apart. From an image acquired using a 128x128 matrix, an activity profile is generated on the computer. If the profile shows that there are 45 lixels between the two activity peaks the pixel size is

0.33 cm

Coincidence loss is likely to occur when using a well counter if the

activity of the source is above 2 mci

To assure maximum error of 2% at the 95% confidence level, all samples that are measured in a well counter should be counted for a time interval that produces at least:

10,000 counts

If a 157 Cs source used to determine constancy of a dose calibrator was originally callibrated to contain 200 uCi on June 1, 1998, what would be the expected activity of the source on June 1, 2002 ( 1 year decay factor of 0.977; 2 year decay of 0.955)

182.4 uCi

A 57 Co source used to determine dose calibrator contancy was originally calibrated to contain 325.8 uCi 35 days ago. If the source is measured today, the dose calibrator reading must fall within what range of activities to meet the accepted standard

268.0-327.6 uCi

It has been determined that a correction factor of 1.15 must be used when a 5 ml syringe containing about 25 mCi is measured in a particular dose calibrator. If a unit dosage activity reads 26.2 mCi, what is the true activity

30.1 mCi

Which of the following creates a photopenic (cold) spot on a bone image ?

 

tracer infiltration

attenuation

osteomyelitis

acute myocardial infarction

B. attenuation

A parathyroid adenoma will concentrate which of the following radiophamaceuticals?

 

¹²³I-sodium iodide

^99mTc-sestamibi

^99mTc-pertechnetate

^99mTc-pertechnetate or -sestamibi

B. ^99mTc-sestamibi

Visualization of bone marrow uptake on a ^99mTc-sulfur colloid liver/spleen image is most likely the result of

 

improper colloid particle size

overactive bone marrow

liver dysfunction

insufficient tracer circulation time

C. liver dysfunction

Filtered ^99mTc-sulfur colloid is required for which of the following examinations?

 

LeVeen shunt patency

gastric emptying

lymphoscintigraphy

gastroesophageal reflux

C. lymphoscintigraphy

The appearance of what structure indicates the beginning of the venous phase of a cerebral blood flow study?

 

carotid arteries

superior sagittal sinus

anterior cerebral arteries

nasopharynx

B. superior sagittal sinus

After administration of ¹¹¹In-pentetreotide, which areas of the body should be imaged?

 

anterior and posterior abdomen

anterior, posterior, and laterals of head and neck

anterior and posterior chest

anterior and posterior whole body

D. anterior and posterior whole body

A patient's plasmacrit may be determined by:

 

finding the ratio of plasma volume to red blood cell volume.

dividing 1 by the decimal hematocrit.

subtracting the decimal hematocrit from 1.

multiplying the patient's hematocrit by 0.9.

C. subtracting the decimal hematocrit from 1.

During a red cell sequestration study, counts are obtained from all the following organs EXCEPT the:

 

kidneys.

liver.

spleen

heart.

A. kidneys

The following is an antithyroid drugs

 

thyroxine

potassium perchlorate

propylthiouracil

synthroid

C. propylthiouracil

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?

 

normal saline

heparin

ACD solution

bacteriostatic water

B. heparin

In the case of insulinoma, which of the following radiopharmaceuticals may cause hypoglycemia?

 

¹⁸F-fluorodeoxyglucose

¹¹¹In-pentetreotide

⁶⁷Ga-citrate

^99mTc-sestamibi

B. ¹¹¹In-pentetreotide

According to NRC regulations, records of written directives must be maintained for --

 

3 years

5 years

10 years

Indefinitely

A. 3 years

If no eluate is obtained during generator elution, the technologist should next:

 

add more saline to the generator column.

contact the generator manufacturer.

check the generator tubing for kinks or leaks. 

attempt elution with another evacuated elution vial.

D. attempt elution with another evacuated elution vial.

According to the NRC, the concentration of what radionuclidic impurity must be determined after the first elution of a ⁹⁹Mo/^99mTc generator?

 

Al⁺³

free pertechnetate

⁹⁹Mo

a and c

C. ⁹⁹Mo

If the HVL of ⁶⁰Co in lead is 1.25 cm, what percentage of ⁶⁰Co photons is absorbed from a ⁶⁰Co source shielded with 1 inch of lead?

 

25%

87.5%

75%

50%

C. 75%

If the radiation intensity of a point source at 0.5 meter measures 36 mR/h, at what distance will the intensity be halved?

 

0.5 m

0.7 m

7.1 m

2.2 m

B. 0.7 m

Which of the following exposure rates indicate that a package containing radioactive material must be labeled with a Cateogry II DOT label?

At package surface       At 1 meter

 

65 mR/h            5.5 mR/h

0.5 mR/h           No detectable radiation

52 mR/h            2.2 mR/h

35 mR/h            1.0 mR/h

D. 35 mR/h            1.0 mR/h

All of the following units are expressions of radiopharmaceutical specific activity EXCEPT:

 

mCi/hour

MBq/mole.

Ci/g.

µCi/mg.

kBq/mL.

A. mCi/hour

Which of the following federal (U.S.) agencies regulates the packaging and transport of radioactive materials?

 

Environmental Protection Agency

Nuclear Regulatory Commission

Department of Transportation

Food and Drug Administration

C. Department of Transportation

Heating is not required during the preparation of --

 

bicisate (Tc ECD)

sestamibi.

sulfur colloid.

mertiatide.

A. bicisate

If ^99mTc eluate needs to be diluted to prepare other ^99mTc-labeled products, you should use --

 

bacteriostatic saline 

sterile saline containing 0.2% thiosulfate

distilled water

preservative-free isotonic saline

D. preservative-free isotonic saline

A unit dosage of ⁶⁷Ga-citrate calibrated for 0800 on July 9 contains 5 mCi in 2.6 mL. If 3 mCi are needed on July 10 at 0800, what volume should be retained in the syringe?

 

1.9 mL

1.5 mL

0.7 mL

1.1 mL

A. 1.9 mL

Based on the data shown here:

	Time	Counts/minute
Capsule	0900	216,789
Background	0900	92
Thyroid	1500	94,954
Thigh	1500	521

what is the patient's thyroid uptake at 1500 if a¹²³I-sodium iodide capsule administered to the patient is used as the standard?

 

44%

87%

60%

32%

C. 60%

A ⁵⁷Co source used to determine dose calibrator constancy was originally calibrated to contain 325.8 µCi 35 days ago. If the source is measured today, the dose calibrator reading must fall within what range of activities to meet the accepted standard?

Days	57Co decay factor
1	0.997
2	0.995
3	0.992
4	0.990
5	0.987
10	0.975
20	0.95
30	0.926
40	0.902

 

271.5-331.9 µCi

238.2-357 µCi

268.0-327.6 µCi

280.3-342.7 µCi

C. 268.0-327.6 µCi

In order to assure a maximum error or 2% at the 95% confidence level, all samples that are measured in a well counter should be counted for a time interval that produces at least:

 

500 cpm.

1,000 cpm.

10,000 counts.

5,000 counts.

C. 10,000 counts

A technologist monitors the empty carton from a shipment of ¹³¹I-siodium iodide. The container measures 0.08 mR/h, and room background measures 0.07 mR/h. The technologist should next:

 

obliterate any radiation symbols and dispose of the container in regular trash.

notify the NRC.

dispose of the container as radioactive waste.

wipe test the container for contamination.

A. obliterate any radiation symbols and dispose of the container in regular trash

Coincidence loss is likely to occur when using a well counter if the:

 

activity of the source is above 2 mCi

energy of the radionuclide is below 50 keV.

activity of the source is below 1 µCi.

energy of the radionuclide is above 300 keV.

A. activity of the source is above 2 mCi

How soon after a misadministration has occurred must the NRC be notified?

 

written report within 30 calendar days

written report within 5 regular work days

telephone notification no later than the following calendar day

telephone notification within 72 hours

C. telephone notification no later than the following calendar day

According to the NRC, written instructions must be provided to a patient who has received radionuclide therapy when:

 

the patient resides with children younger than 18 years of age.

another individual may receive an exposure greater than 0.1 rem from the patient.

Every patient must receive instructions, regardless of dosage.

the patient is a female of childbearing age.

B. another individual may receive an exposure greater than 0.1 rem from the patient

To perform a constancy test on a dose calibrator that is being used in a general nuclear medicine imaging department, the best choice of radionuclide settings on which to count the reference standard would include which of the following?

 

^99mTc, ²⁰¹Tl, ¹²³I

¹²⁵I, ⁵⁷Co, ¹³⁷Cs 

¹²³I, ¹²⁵I, ¹³¹I

⁵⁷Co, ¹³⁷Cs, ¹³¹I

A. ^99mTc, ²⁰¹Tl, ¹²³I

The following data were obtained during a dose calibrator accuracy test:

Radionuclide	Calculated value	Measured value
57Co	80.6 µCi	71.0 µCi
137Cs	62.3 µCi	55.9 µCi

Based on these results, which of the following statements is TRUE?

 

Insufficient radioactivity was used to perform this test.

The instrument should be repaired or replaced.

The wrong radionuclides were used to perform this test.

The instrument accurately measures radionuclides of different energies.

B. The instrument should be repaired or replaced.

Which of the following filters is high-pass filter?

 

Ramp

Hanning

Parzen

Butterworth

A. Ramp

In quantitating scintillation camera detector uniformity, the central field of view (CFOV) is defined as the diameter of the useful field of view (UFOV) times:

 

0.75

0.5

0.33

0.25

A. 0.75

The following dose calibrator constancy test results were obtained with a ⁵⁷Co reference source:

Radionuclide setting	Measured value	Calculated value
57Co	56.6 µCi	57.8 µCi
99mTc	59.2 µCi	58.7 µCi
123I	46.9 µCi	51.7 µCi
201Tl	47.9 µCi	53.5 µCi

Which of the following measured values fall within the suggested limits according to the standard of practice (note: suggested repair at +/-5%, required repair at +/-10%)?

 

⁵⁷Co, ^99mTc, ¹²³I

⁵⁷Co, ^99mTc, ¹²³I, ²⁰¹Tl

⁵⁷Co, ^99mTc

^99mTc, ¹²³I, ²⁰¹Tl

A. ⁵⁷Co, ^99mTc, ¹²³I

A technologist needs 1 mCi ¹¹¹In-chloride at 0900 on May 18. The label on the radiopharmaceutical vial contains the following information:

Total activity	3.0 mCi
Total volume	3.0 mL
Assay	1200, May 21

What volume is required to obtain the necessary activity on May 18?

 

0.48 mL

0.69 mL

201 mL

1.4 mL

A. 0.48 mL

According to the NRC regulations, the annual occupational dose limit to any organ or tissue other than the eye is:

 

50 rem.

15 rem.

50 mSv.

5 mSv.

A. 50 rem

When checking a victim for breathing, you should look, listen and feel for

 

as long as it takes to detect a breath

at least 10 sec

5-10 sec

3-5 sec

D. 3-5 sec

Damaging free radical formation in the human body is often the end result of:

 

impaired carbon dioxide clearance

impaired cell proliferation 

radiolysis/ionization of water by radiation

Double strand breaks in DNA

C. radiolysis/ionization of water by radiation

Why does spreading radiation doses out over longer periods of time, in addition to adding pauses in radiation, increase an organisms ability to recover from radiation damage?

Choose all that are correct

 

The LET of the radiation decreases if it is given over a longer period of time

Decreasing the dose rate (spreading dose over a longer period) decreases the number of double strand breaks in DNA

The LET of the radiation decreases if it is given with pauses in between doses

Decreasing the dose rate (spreading dose over a longer period) plus adding pauses allow for repair of single strand breaks in DNA

The total amount of free radicals formed decreases if you give the radiation over a longer period of time

B and C

Decreasing the dose rate (spreading dose over a longer period) decreases the number of double strand breaks in DNA

The LET of the radiation decreases if it is given with pauses in between doses

A stochastic effect is best defined as an effect that:

 

is not effected by mitotic rate

the severity of the effect worsens with increasing radiation

once a threshold is reached, occurs with certainty

the probability of occurrence increases with the amount of radiation but is never certain

D. the probability of occurrence increases with the amount of radiation but is never certain

Which of the following is the most accurate description of target theory:

 

Radiation tends to avoid the most sensitive targets in a cell

The entire cell is a sensitive target, and any strike will lead to cell death

There are regions of cells that are more radiosensitive than other regions, which may be struck by accident causing cell death

Radiation seeks out the most sensitive targets in a cell, killing it

C. There are regions of cells that are more radiosensitive than other regions, which may be struck by accident causing cell death

Hormesis is best defined as:

 

the formation of free radicals by radiation 

a beneficial effect of radiation in low doses 

the final phase of the cell cycle before cell death

the in utero damage of a fetus leading to birth defects

B. a beneficial effect of radiation in low doses 

For the acute radiation syndrome (ARS), symptoms appearing immediately after an acute exposure to radiation belong to which stage of the disease?

 

latent period

proportional stage

manifest illness stage

acute “prodrome” stage

D. acute “prodrome” stage

The interpretation of a linear, non-threshold dose curve is that radiation damage is directly proportional to dose, and that:

 

only high doses cause damage

damage occurs only after a minimum dose has been exceeded

none of the above

any dose may cause damage

D. any dose may cause damage

Physical defects that are caused by radiation exposure to the developing embryo/fetus after conception, but before birth, are referred to as          effects:

 

congenital

genetic

teratogenic

mutagenic

C. teratogenic

Damage to the DNA that would most likely result in mutation instead of cell death occurs in which phase of the cell cycle?

 

G2

S

G1

Mitosis

B. S

Upon completing an image for an exam you notice that the picture looks terrible. It's very pixelated, has lots of background "noise" and it is hard to see any anatomy at all. Which of the following approaches could be used to improve the image quality on future exams?

 

- all of these

- double check cameras to make sure that they are functioning correctly

- review you your protocol to make sure that you are using the correct matrix

- image longer so that you can acquire more counts

- inject more isotope as long as you are with in safety limits

A. All the below

Which gamma camera would be considered the fastest for performing a 360 degree SPECT image?

   

 

  

 

 

- a 2 headed camera in a 180 degree orientation

- a 2 headed camera in a 90 degree orientation

- a 3 headed gamma camera

- a 12 headed gamma camera

D. a 12 headed gamma camera

What view does the image below demonstrate?

 

- Right Lateral

- Left Lateral

- D.O.C.

- Vertex

B. Left Lateral

Below is an image of a liver and a spleen which has been labeled incorrectly. What is wrong?

 

- the image is missing superior and inferior as labels

- nothing, it is actually labeled correctly

- this is actually an anterior image

- right and left have been accidentally switched

C. This is actually an anterior image

¹²³I has a half-life of 13 hours. A sample of the material has an activity of 5.6 mCi at noon today. What was its activity at noon yesterday?

 

11.2 mCi

15.3 mCi

20.1 mCi

25.2 mCi

C. 20.1 mCi

²⁰¹Tl may fail to accumulate in a particular region of myocardial tissue due to:

  

poor perfusion

poor perfusion and non-viable tissue

non-viable tissue and Thallium's poor extraction efficiency

poor perfusion, non-viable tissue, Thallium's poor extraction efficiency and redistribution

B. poor perfusion and non-viable tissue

³²P has a half-life of 14.3 days. A sample has an original activity of 200 mCi. How much will be left after 3 days?

  

173 mCi

175 mCi

179 mCi

184 mCi

B. 173 mCi

For the resting images of a ^99mTc-Sestamibi for a 2 day protocol stress test, these images are typically performed

  

immediately after the stress images are performed on the same day

one day later and only if the stress images show an abnormality 

on the first of the 2 days with the stress images being performed on the second day only if the rest images show an abnormality

2-4 hours after the stress images so that the 99mTc-Sestamibi administered during stress can redistribute allowing us to see stunned or hibernating myocardial tissue

B. one day later and only if the stress images show an abnormality 

A normal LVEF would be

  

30% - 50%

55% - 75%

50 mls

5 Liters per minute 

B. 55% - 75%

The advantages ^99mTc -labeled compounds have over ²⁰¹Tl for myocardial imaging include

  

better quality images

better quality images, faster acquisition and easily available isotope

faster acquisition and easily available isotope

better quality images, faster acquisition, easily available isotope and the ability to do first-pass studies because of higher count rates

D. better quality images, faster acquisition, easily available isotope and the ability to do first-pass studies because of higher count rates

The best way to alleviate the symptoms caused by administration of adenosine is to

  

administer theophylline

discontinue infusing the adenosine

administer a beta blocker

administer digoxin

B. discontinue infusing the adenosine

A 10 mCi dose of Tc-99m would be equal to how many Becquerels?

  

3.7

370

370,000

37,000,000

370,000,000

E. 370,000,000

Which of the following would be a good source of activity for calibration of an instrument that is designed for used with 99mTc?

  

Cs-137

Cr-51

Co-57

Ba-133

C. Co-57

Before a package that transported a radioactive material can be discarded, you should:

  

Store it for a period of 10 days

Store it for a period of ten half-lives

Flatten the cardboard to facilitate easy disposal

Deface the radioactive transport label

D. Deface the radioactive transport label

A dose equivalent of 20 mSv is equal to:

  

1 mRem

2 mRem

1 Rem

2 Rem

20 Rem

D. 2 Rem

The correct formula for determining cardiac ejection fraction is

  

EF = SV x HR

EF = (EDV - ESV) / EDV

EF = SV / CO

EF = (ESV - EDV) / EDV

B. EF = (EDV - ESV) / EDV

The intensity of radiation is 100 mR/hr at a distance of 9 feet from the source. The intensity at 3 feet from the source is ______ mR/hr.

  

33.3

300

333

900

D. 900

The amount of light generated by a NaI(Tl) crystal is directly related to the:

  

photon energy absorbed in the crystal

diameter of the crystal

thickness of the crystal

age of the crystal

A. photon energy absorbed in the crystal

A vial contains 260 mCi in 20 mL of fluid. How many mL should be withdrawn to obtain 20 mCi?

  

0.07

0.65

1.30

1.54

none of the above

D. 1.54

If the radioactivity of a Tc-99m sample was 40 mCi at 0800, what will the activity be at 2000?

  

80 mCi

20 mCi

15 mCi

10 mCi

D. 10 mCi

After equilibrium has been disturbed by elution, a TechneKow radionuclide generator will return to equilibrium in about:

  

4 daughter half-lives

4 parent half-lives

2 daughter half-lives

2 parent half-lives

A. 4 daughter half-lives

Which of the following is the correct representation of cardiac output [CO]?

  

CO = SV x HR

CO = (EDV - ESV) / EDV

CO = SV / EF

CO = (ESV - EDV) / EDV

A. CO = SV x HR

The typical side effects that can occur after dipyridamole has been administered include

  

increase in blood pressure

headache and chest pain

leg cramps

no side effects are associated with this drug

B. headache and chest pain

When should you administer ²⁰¹Tl when doing a stress test?

  

when the patient reaches the desired level of treadmill stress

1 minute after peak exercise has been achieved

10 minutes or less prior to exercise commencing

in the morning prior to the test

A. when the patient reaches the desired level of treadmill stress

²⁰¹Tl redistribution begins

  

less than 10 minutes after injection

in 1-2 hours

after 3 hours

little to no redistribution occurs

A. less than 10 minutes after injection

After injecting 99mTc MIBI for a rest test you should begin imaging

  

immediately

1-3 minutes after injection

2 hours after injection

45-90 minutes after injection

D. 45-90 minutes after injection

A radiopharmaceutical used to assess glomerular filtration should

  

be negatively charged

be protein bound

be an iodinated product

have a high molecular weight

A. be negatively charged

Hydrophobic/lipophilic radiopharmaceuticals

  

do not affect the localization mechanism

usually diffuse across the cell membranes

are insoluble

are not used in Nuclear Medicine 

B. usually diffuse across the cell membranes

The purpose(s) of a MUGA study include

  

measuring EF

assessing ventricular size, measuring EF

assessing ventricular size, measuring EF and assessing the secondary effects of conduction abnormalities like dyskinesis

assessing ventricular size, measuring EF and determination of myocardial viability

C. assessing ventricular size, measuring EF and assessing the secondary effects of conduction abnormalities like dyskinesis

When eluting a Mo/Tc generator

  

either positive or negative pressure may be used

the Mo is in the Mo-41- state

the Mo-99 adsorbs to the column less readily than the Tc-99 and Tc-99m

an organic solvent like acetone should be used

A. either positive or negative pressure may be used

A reasonable size range for sulfur colloid is

  

0.1 - 1 um

5 - 10 um

50 - 100 um

100 - 500 um

A. 0.1 - 1 um

Why is it important to hydrate a patient for a bone scan?

  

To decrease the radiation dose to the patient and to decrease the body background

Hydration is not required

To decrease the radiation dose to the patient, to decrease the amount of activity administered and to decrease the body background

To decrease the radiation dose to the patient and to decrease the amount of activity administered

A. To decrease the radiation dose to the patient and to decrease the body background

Nuclear Medicine skeletal imaging is useful for assessing

  

response to a course of therapy

bone graft viability and avascular necrosis

bone graft viability, avascular necrosis and response to a course of therapy

bone graft viability, avascular necrosis, elevated alkaline phosphatase and response to a course of cancer therapy

D. bone graft viability, avascular necrosis, elevated alkaline phosphatase and response to a course of cancer therapy

The longitudinal fissure is located between the

  

right and left cerebra

third and fourth ventricles

motor and sensory regions of the cerebra

right and left cerebella

A. right and left cerebra