Nuclear medicine board review

one advantage of the in vivo method of Tc99m red cell tagging is that:

no manipulation of blood samples outside the body is required

boiling a Tc99m sulfur colloid preparation for too long will result in colloidal particles that are:

too large

Which of the following components in a Tc99m medronate prep is a radiochemical impurity?

a. aluminum

b. Mo99

c. 0.9% NaCl

d. Tc99m pertechnetate

e. ascrobic acid

Tc99m pertechnetate

which of the following image findings is most consistent with chromatography results of a tc99m oxidronate sample demonstrating 65% radiochemical purity?

a. well-defined bone uptake

b. stomach and thyroid uptake

c. lung uptake

d. gi activity

e. heart uptake

b. stomach and thyroid uptake

In what way does the modified in vivo method of labeling RBCs with Tc99m pertechnetate differ from the in vivo method?

the modified method mixes Tc99m pertechnetate with only a small volume of the patient's blood

What is true about the modified in vivo method for labeling red blood cells with Tc99m pertechnetate?

a sample of the patien'ts "pretinned" blood is incubaed with Tc99m pertechnetate outside of the patient

If a Mo99/Tc99m generator is eluted at 0700 and again at 1300, the next day's Tc99m yield at 0700:

will be decreased

127 millicuries is equivalent to how many gigabecquerels?

4.70 GBq

if a new generator is eluted several times and each time the amount of alumnum in the eluate exceeds the USP limit, the tech should:

contact the generator manufacturer

the shelf life of most tc99m labeled RP's is:

6-8 hours

Which of the following medical history is relevant to In111 capromab pendetide imaging?

a. breast feeding schedule

b. mammogram result

c. last menstrual cycle

d. pregnancy status

e. PSA level

PSA level

Which of the following is not recommended during HMPAO/ECD administration?

a. dim the lights

b. inject using an IV line

c. talk calmingly to the patient during injection

d. ask them to keep eyes and ears open

talk calmingly to the patient during injection

pentagastrin is commonly used in which of the following scans?

Meckel's diverticulum

If an anticoagulant is added to a blood sample, the fluid portion of the blood sample is known as:

plasma

Contraindication for performing MPI resting study is:

having a nitroglycerin drip

to help clear the thyroid, liver, and bowel when performing a cardiac perfusion study with sestamibi, a tech should give what before imaging?

a glass of cold water

where is the x-ray generator located in a CT scanner?

inside the gantry

In performing a GET, imaging should begin:

immediately after meal consumption, then every 15 minutes for at least 2 hours

every hour for 2 minutes at ku

administration technique for Tc99m bicisate includes which of the following?

a. direct venous stick

b. infusion at peak cardiac stress

c. bolus injection technique

d. infusion over 3 hours

e. minimize environmental stimuli

e. minimize environmental stimuli

patient prep for instilling colloidal P32 chromic phosphate into the peritoneal cavity includes:

introducing tc99m sulfur colloid into the cavity to confirm that the P32 will disperse evenly

SPECT brain imaging may begin how soon after the administration of tc99m exametazime?

1-2 hours

What dont you have to do when a tech cares for a patient who is not known to have a communicable disease and following infection control measures are still implemented?

do not need to decontaminate imaging equipment with an antiseptic

Normal sinus rhythm is characterized by:

60-100 beats/min

R wave occuring at constant intervals

PR interval 0.12-0.20 sec long

After stress myocardial imaging with Tl201 thallous chloride, 1-1.5 mCi of Tl201 thallous chloride may be given before rest imaging to:

demonstrate reversible ischemia more readily

prep for the patient for Meckel's diverticulum localization includes:

fasting for at least 2 hour before imaging

which of the following Tc99m labeled agents is the preferred tracer for demonstrating intermittent GI bleeding?

RBC's

furosemide is sometimes administered during renal imaging to:

rule out uteropelvic obstruction

what is a normal response when furosemide is given near the end of a renal function study?

radioactivity is cleared from the renal pelvic into the bladder

early (6 hr after injection) Ga67 imaging should be performed if which condition is suspected?

osteomyelitis

In111 pentetreotide localized in what sites:

pituitary gland, spleen, thyroid gland, and liver

if a patient is injected with Tc99m MAA while in an upright position, what is most likely to be seen on the perfusion lung images?

decreased tracer activity in the lung apices

if the usual adult dosage of Tc99m MAA is 4 mCi, a patient who has had a right pneumonectomy should receive what dosage?

2 mCi

thyroid imaging may be performed with which collimators?

pinhole or parallel hole

LVEF%=

ED-ES/ED x100

in the radiochromium labeling process, ascorbic acid is used as?

reducing agent

according to NRC regulations, wihch of the following signs should be posted in unrestricted areas?

no posting is required

a package containing radioactive material is monitored and found to produce 12 mR/hr at the surface and 0.9 mR/hr at 1 m from the surface. which DOT label must be on the outside of the package?

Category II

according to the NRC, decay in storage records must include the date that the radioactive material was:

disposed

One HVL will absorb the same amount of radiation as:

one HVL of aluminum

If a patient receives 20 mCi of I131 sodium iodide instead of the prescribed dosage of 15 mCi for therapy of hyperthyroidism, which individual/agencies must be notified?

NRC and referring physician

annual whole body occupational dose limit (TEDE) for adults it:

5 rem or 5000 mRem

according to the NRC, areas where therapeutic RP's are prepared or administered must be surveyed:

at the end of each day a therapeutic dosage is prepared or administered

according to the NRC, the NRC and the final delivery carrier must be notified if the exposure rate at the surface of a package containing radioactive materials exceeds:

200 mR/hr

T/F? Restricted areas must be locked when authorized personnel are not present.

true

radioactive waste can be decayed in storage if:

it has a physical half life of less than 120 days

what must be performed before a package containing radioactive materials can be returned to a vendor?

perform a wipe test to assure there is no surface contamination

what is the primary source of radiation exposure to the tech who performs PET imaging?

compton scatter from patient

what personnel monitor would be appropriate for use when monitors are changed at 3 month intervals?

TLD or OSL

a dose calibrator accuracy test may be performed with which radioactive source?

At least 50 uCi of Cs137, Co57, or Ba133

which technique is used to help eliminate the "star" effect created during tomographic reconstruction?

filtered backprojection

which instrument is most appropriate for detecting low level accidental contamination?

geiger-mueller counter

image noise can be decreased during dedicated PET imaging by:

scanning for a longer time

What is the standard max acceptable % energy resolution measured with cs137 for a NaI (Tl) scintillation detector?

12%

COR limits;

should vary by no more than 1/2 pixel. Deviations greater than 1/2 pixel may degrade resolution in reconstructed images.

If tc99m exametazime is prepared at 0900 to label WBC's, it should be used no later than what time?

0900; need to use within 30 minutes

upon visual inspection of Tc99m medronate, a vial appears to be white and slightly turbid. What should the tech do?

prepare another vail of tc99m medronate

which needle size is most likely to cause coring of the rubber closure of a medication vial?

22 gauge, 1 inch length

according to NRC regulations, which sign should be posted on the door of a radiopharmacy lab in which radiation levels have been measured to be 7.5 mR/hr

Caution: High radiation area

personnel radiation exposure records must be maintained:

indefinitely

a written directive for the administration of 15 mCi of I131 sodium iodide must include what information:

dosage

annual radiation exposure to members of the general public must be limited to no more than:

100 mRem

0.1 Rem

a tech cannot use a diagnostic dose that exceeds 20% of the dosage prescribed by the authorized user unless:

the authorized user approves the individual dosage

wipe tests must be reported as

dpm

15 mRem is equivalent to how many mSv?

1.5 mSv

images acquired with zoom:

image resolution is increased

what is the effect of changing the order of butterworth filter from 3 to 5?

the image will be sharper

if a PLES transmission phantom is used, how many images must be acquired to assess linearity over the entire FOV of a scintillation camera?

2

after administration of tc99m pentetate aerosol with a face mask, radioactive contamination is likely to be found where?

around the patients mouth, patients chest, the floor between the patient and nebulizer, and on the patients face

what must be discontinued for at least 24-36 hours before the administration of dipyridamole?

theophylline

in a normal hepatobiliary study, excretion of the tracer into the intestine should occur a max of how long after tracer administration?

20-30 minutes

which procedure is the RP administered orally?

a. vesicoureteral reflux

b. GI bleed

c. salivary gland imaging

d. gastric emptying

e. GBEF

d. gastric emptying

static renal imaging is performed how long after administration of Tc99m succimer?

2 hours

patient prep for Ga67 citrate imaging includes?

laxatives

a normal biodistribution of In111-labeled leukocytes will demonstrate the greatest tracer uptake at 24 hours after injection in which site?

the spleen

hypoglycemic patient will exhibit what symptoms?

weakness, shakiness, confusion, irritability, and low blood sugar

counting cotton gauze that has been placed in a patients nose after intrathecal tracer administration is most useful when which condition is suspected?

rhinorrhea

colloidal (32 chromic phosphate is administered by which route?

intraperitoneal

on the basis of blood flow, what is visualized as an area of high tracer concentration on a brain image performed with Tc99m exametazime?

gray matter

LeVeen shunt patency may be demonstrated with which RP?

Tc99m MAA or Tc99m sulfur colloid

what is common to imaging gastroesophageal reflux in both adults and children?

tc99m sulfur colloid is the tracer of choice

ROI for detection of a left-to-right cardiac shunt are drawn around which structures?

one or both lungs

common antecubital vein used for IV administration of a RP is the:

cephalic

acceptable flow rate is how many drops per minute?

10-20

after a mo99/tc99m generator is eluted, it takes how many hours for the tc99m activity to build up to a maximum level?

24 hours

a wet column generator is equipped with all of the following parts:

alumina column, lead shield, saline supply, and collection port

which ingredients in a sulfur colloid kit are combine and heated?

tc99m pertechnetate, thiosulfate mixture, and acid

what is the average CT number for the lung in Hounsfield units?

-500

what equipment is needed to verify the size and number of MAA particles in a Tc99m MAA preparation?

hemocytometer, light microscope

records of patient dosage determinations must be retained for how long?

3 years

upon visual inspection, a vial of Tc99m MAA has a white, slightly cloudy appearance. what should the tech do next?

prepare unit doses from the vial

The NRC defines an unrestricted area as one in which an individual will receive less than how many millirems in an hour: A)2mrem B)5mrem C)50mrem D)100mrem

2 mrem

the NRC requires that all of the following information be included in unit dosage measurement records except the:

dose calibrator make and model number

if the distance between a radiation point source and a survey meter is doubled, the measured radiation exposure rate is reduced:

to one-quarter of the original exposure rate

example of a radiopharmaceutical misadministration error that must be reported to the NRC:

a patient receives a whole-body scan dosage of I131 instead of I123 for a thyroid uptake and scan

a written directive for the administration of Sr89 chloride must include all of the following:

radiopharmaceutical name, route of administration, signature of an authorized user, and patients name

radiation dose to the fetus of a declared pregnant worker must not exceed how many Rems during the pregnancy?

0.5 Rem

packages with which of the following DOT labels must be checked for contamination using a wipe test?

White I, Yellow II, and Yellow III

10 millisieverts is equivalent to how many milliRems?

1,000

if a tech receives dosimeter readings that are nearly equal to the NRC limits, what is the most appropriate action?

the RSO must review the tech's work habits

records of survey meter calibration are retained for how long?

3 years