Nuclear Medicine Technology Review Quest Mock Exam

In which radiopharmaceutical is Tc-99m left in the valence state of +7?

Sulfur colloid

A technologist receives a request for a patient to receive Sm-153 for palliation of pain from bone metastases. The patient has a leukocyte count of 3500 and 40,000 platelets. What should happen next?

The therapy should be delayed until the platelet count is at least 60,000.

A sulfur colloid kit requires the addition of 1-3 ml containing no more than 500 mCi of Tc-99m pertechnetate. In addition, 1.5 ml of Solution A must be added before boiling, and 1.5 ml of Solution B must be added after cooling. If the kit is correctly prepared, what is the maximum concentration of Tc-99m it could contain?

125 mCi/ml

A Hine-Duley phantom is useful for testing the spatial resolution and spatial linearity with only one image.

False

The wall of the heart indicated by the arrow on Fig. 1 is the:

Anterior

The advantage of a lung ventilation scan performed with Xe-133 is:

The ability to detect delayed washout

A diphosphonate kit contains 180 mCi of Tc-99m in 30 ml when it is prepared at 8:00 a.m. Immediately, a 20-mCi dose is withdrawn for a bone scan. If the patient arrives late at 9:30 and half the volume is accidentally discharged, how much volume from the kit must now be added to the syringe to correct the dose to 20 mCi? (No other doses have been withdrawn meanwhile, and the decay factor for 1.5 h is 0.841.)

2.3 ml

A whole body bone scan film shows a good posterior image, but the anterior view appears diffuse and with greater soft tissue activity. What is the probable cause?

Increased patient to detector distance on the anterior relative to the posterior.

Which of the following will not reduce the probability of contamination from perspiration and saliva of a therapy patient?

Collecting the patient's waste and storing until decayed to background

Why would an image of the brain be obtained during a lung perfusion scan using Tc-99m MAA?

To detect a right to left cardiac shunt

Bone marrow imaging is performed using:

Tc-99m sulfur colloid

Al of the following have an effect on the concentration of eluate obtained from a wet generator except:

Volume of saline added to the charging port

A Mo-99/Tc-99m generator has an elution efficiency of 89%. If 1.1 Ci of Tc-99m are present on the column, what is the estimated activity of eluate that will be obtained?

979 mCi

Tc-99m DTPA has been used for all of the following except:

Spleen scanning

Which of the following is not used as an anticoagulant?

Ascorbic acid

If the concentration of a solution desired is 2 mCi/ml and the 325 mCi of solute is contained in a volume of 2.5 ml, how much water should be added to create the solution?

162.5 ml

The inferior wall of the heart is supplied by the:

Right coronary artery

The uptake of F-18 FDG by tumors is based on:

The higher glycolytic rate of tumors relative to normal tissue

In-111 delivers a lower radiation dose to the patient than Ga-67 because it has only one gamma emission, whereas Ga-67 has four.

False

If dipyridamole is supplied in a 50-ml vial containing 250 mg and a patient weighs 205 lb, how much volume wil need to be withdrawn from the vial to prepare his dose of 0.56 mg/kg?

10.4

If 450 mCi of Tc-99m eluted from a generator contain 200 Ci of Mo-99m, is the eluate within the standards of radionuclidic purity set forth by the NRC?

No

If SPECT images taken with a 360° rotation, 32 stops for 15 s/stop, and matrix of 64 × 64 have significant star artifact, which imaging parameter would be best to change and to correct the image?

Change the number of stops to 64.

The images in Fig. 2 were taken 2h following the intrathecal injection of a radiopharmaceutical. These are images from a:

Cisternogram

Which radiopharmaceutical is best to use for renal scanning if a determination of effective renal plasma flow is also desired?

Tc-99m MAG3

Ga-68 DOTATATE PET is a radiolabeled:

Neuropeptide

Which of the following cannot be studied with a MUGA study?

Regional wall perfusion

Free Tc-99m pertechnetate in a bone scan kit will result in activity in the:

Gastric Mucosa and Thyroid

A superscan is the result of:

Diffuse skeletal metastases

Which of the following is not true regarding Tc-99m HMPAO?

None of the above

Which of the following may cause a false-positive hepatobiliary scan?

Both

Phagocytosis of Tc-99m albumin colloid is performed by the:

Kupffer cells

Which will perfuse first following an intravenous injection of Tc-99m DTPA?

Lungs

A patient with high blood pressure undergoes renography followed by captopril renography, and the curve of renal uptake from the second exam is lower than the first. What does this mean?

The patient has renovascular hypertension.

The left and right lobes of the thyroid are connected by the

Isthmus

The exposure rate at the surface of a package to be shipped is 50 mrem/h. What label is required?

DOT Radioactive Yellow II.

If the exposure rate at 5 m from a source is 75 mR/h, what will it be at 2 m?

469 mR/h

If a patient has persistent activity in the renal pelvis during renography, furosemide administration may:

Help rule out mechanical obstruction

The NRC requires the use of tongs for moving vials between the shields and the dose calibrator.

False

Which of the following may be used for thyroid uptake and scanning?

I-123 sodium iodide

The lowest point on a time activity curve generated over the cardiac cycle of a patient following a gated blood pool study represents:

End systole

The images in Fig. 3 were obtained during a ventilation scan taken with the use of:

Xe-133 gas

Pinhole collimation is not commonly used during:

V/Q scan

A sentinel node is:

The first draining lymph node from a primary cancer

Which method of data collection allows the greatest flexibility for manipulation of data after collection?

List mode

The second phase in a four-phase bone scan takes place

A few minutes after injection

The NRC recommends but does not require the use of syringe shields during preparation and administration of radiopharmaceuticals.

False

Which of the following is true regarding albumin colloid?

The particle size is smaller than that of sulfur colloid.

For a patient with intermittent gastrointestinal bleeding, the best radiopharmaceutical to locate the bleed is:

None of the above

Which is not a beta emitter?

Kr-81m

Which are used for the imaging of neoplasms?

All of the above

Constancy of a dose calibrator must be performed:

Daily

The valence state of Tc-99m is usually reduced when preparing kits through the use of:

Stannous ions

First-pass cardiac studies require:

A compact bolus of radiopharmaceutical

Most of the thyroid hormone in the circulation is:

T4

Which of the following guidelines apply to position a patient for a flow study of native kidneys?

Xiphoid process should be over the upper part of the detector face.

Xe-133 gas may be used:

In rooms that are held at a negative pressure to the surrounding areas

Given the following data, calculate the left ventricle ejection

fraction.

Net counts, end systole: 20,582

Net counts, end diastole: 44,653

53.9%

Calculation of gallbladder ejection fraction requires:

Cholecystokinin

Which study does not require any fasting before the examination?

Meckel's diverticulum

The usual adult dose for hepatobiliary imaging with Tc-99m iminodiacetic acid is:

5-8 mCi

What is the effective half-life of a radiopharmaceutical with a physical half-life of 6 h and a biologic half-life of 10 h?

3.8 h

If a technologist absorbs a dose rate of 2.5 mrem/h while working 3 ft. from a therapy patient, what distance will need to be maintained in order to absorb only 2 mrem/h?

3.4 ft

At least 30 million counts should be obtained when assessing the uniformity of a planar imaging system

False

Records of dose calibrator linearity must be kept for:

3 years

Transport index refers to:

The exposure rate measured at 1 m from the package

If a vial of I-131 contains 100 mCi on December 1, approximately how much activity will it contain on December 17 provided none is withdrawn?

25 mCi

Which of the following is an example of radiochemical impurity?

Presence of pyrogens in reconstituted kits

What does dyspnea mean?

Labored breathing

Which of the following is not used to image the heart

Tc-99m diphosphonate

Arrhythmia filtering rejects cardiac cycles:

That have an R-R interval outside the preset limits

If a SPECT is being performed using a single head camera involving 64 projections and 52,000 counts are collected during each 20-s stop, what are the total counts for the study and the total acquisition time?

3.3 million counts, 21 min

A SPECT study is required to consist of 2 million counts. If there are 64 stops and the count rate is 65,000 cpm, how many seconds should each stop last?

29 s

If a MDP kit contains 230 mCi of Tc-99m in 9 ml at 7:00 a.m., how much will have to be withdrawn for a 20-mCi dose at 1:00 p.m.?

1.6 ml

In 20 ml of Tc-99m eluate, there are 30 μg of Al³⁺ present. Can this eluate be used for reconstituting kits for patient injection?

Yes

If 800 mCi of Tc-99m is eluted from a Mo-99/Tc-99m generator, what is the maximum amount of Mo allowed in the eluate by the NRC?

120 μCi

If a technologist stands 2 ft from a radioactive source and receives 1 mrem/h from it, what will he or she absorb by stepping 1 ft closer to the source?

4.0 mrem/h

A locked storage closet next to the radiopharmacy containing phantoms and sealed sources has a measured exposure rate of 3 mR/h. It should be posted with a sign reading:

Caution: Radioactive Materials

A technologist is preparing an HDP kit at 8:00 a.m. If the schedule of doses required is as follows and the eluate available has 7 mCi/ml, what is the minimum volume of Tc-99m pertechnetate that should be added?

9:00 Bone scan 20 mCi

10:00 Bone scan 20 mCi

11:00 Bone scan 20 mC

10.8 ml

When injecting Tc-99m MAA, which of the following are true?

All of the above

Following a spill of 50 mCi of Tc-99m mebrofenin in the nuclear medicine department, the first priority is to:

Contain the spill by covering it and restricting access to the area

The annual TEDE limit for a technologist's hands is:

50 rem

Center of rotation must be determined for:

All of the above

If the HVL of lead for I-131 is 3 mm and a lead vial shield holding the iodine is 6-mm thick, what percentage of the original exposure rate will remain?

25%

1 ml of a liquid is assayed and contains 206 mCi. If it is diluted with 9 ml and subsequently is assayed at 180 mCi, what is the geometric correction factor?

1.14

Increasing the matrix size of a SPECT acquisition:

Increases spatial resolution

An MAA kit has an average of 900,000 particles. If 50 mCi of Tc-99m pertechnetate in 7 ml are added, how many particles will a patient who gets a 3-mCi dose receive?

72,000

To minimize oxidation of stannous chloride, which of the following may be added to radiopharmaceutical kits?

Nitrogen

On an intrinsic field uniformity image, the area of increased activity around the image is called:

Septal penetration

The photomultiplier tube functions to:

Convert light to electrical signal

Film badges should be worn:

Between the shoulder and waist