Nuclear Cardiology Midterm Study Guide

Infusion of intravenous aminophylline antagonizes the effects of:

The vasodilator stress agents

Which pharmacologic stress agents act as vasodilators in myocardial perfusion imaging?

Adenosine, dipyridamole, and regadenoson

Which radiopharmaceutical is most commonly used in SPECT myocardial perfusion imaging?

Technetium-99m Sestamibi

Before performing a pharmacologic stress test, patients should avoid caffeine and methylxanthines for at least:

24 hours

If a patient does not reach the target heart rate during treadmill stress testing, the study is considered:

Suboptimal level of exercise

An adenosine injection is contraindicated in patients with:

Pacemaker

A modified Bruce protocol is used for patients who are:

Old and frail

Chest pain that develops commonly during pharmacologic vasodilator stress testing:

Is a non-specific finding

Upward creep of the heart observed during SPECT acquisition can be prevented by:

Allowing bed rest before SPECT

When performing a pharmacologic stress test with Lexiscan, the radiopharmaceutical is injected:

Immediately after the saline flush

The areas of ECG electrode application are prepped using an alcohol pad to remove:

Oil

The maximum heart rate (HR) for stress testing can be estimated using which formula?

HR = (220 − age in years) × 0.85

The use of electrocardiography (ECG) gating in nuclear cardiology is primarily for:

Coordinating image acquisition with the heartbeat to assess wall motion and ejection fraction

Define Cardiomyopathy

Disease of the heart muscle that weakens its ability to pump blood

Define Diastole

Phase when the ventricles relax and fill with blood

Define Systole

Phase when the ventricles contract to pump blood

Define Hypercholesterolemia

High cholesterol levels in the blood

Define Hyperlipidemia

Elevated levels of fats (lipids) in the blood

Define Hypertension

Chronically high blood pressure

A perfusion defect that appears both during rest and stress is consistent with:

Myocardial infarction

Compared to Thallium-201, Technetium-99m labeled agents have:

Higher photon energy and shorter half-life

The first commercially available SPECT camera for cardiac imaging appeared in:

Late 1970s

The proportion of tracer extracted from the vascular space through the myocardium represents:

First-pass extraction fraction

Which of the following best describes the purpose of ECG gating in nuclear cardiology?

To coordinate image acquisition with heartbeats and display different phases of the cardiac cycle

The development of SPECT allowed for:

Three-dimensional tomographic imaging

The MPI artifact described as false abnormalities from irregular cardiac cycles is:

Gating error

During a gated SPECT acquisition, the cardiac cycle is represented by the:

R-R interval

Peak exercise in normal subjects increases myocardial blood flow by:

A threefold to fourfold

Which of these doctors performed the first human cardiac catheterization?

Werner Forssmann

The adoption of quantitative software in nuclear cardiology allows for:

Automated interpretation and standardized evaluation

The most common adverse effect of adenosine administration is:

Hypotension

The distribution information of Tc-99m tracers reflects myocardial perfusion at the time of:

Injection

 All the following are examples of quantitative MPI software except:

McKesson Practice Choice Software

The counts distribution displayed as concentric rings is called:

A bull’s eye (polar map)

The principle of myocardial perfusion imaging is based on:

Tracer uptake proportional to myocardial blood flow and demand

Which pharmacologic agent acts as a selective A2A receptor agonist for stress testing in nuclear cardiology?

Regadenoson

Medications such as calcium channel blockers and beta blockers alter which physiologic parameter?

The heart rate

The administered dose of which of the following pharmacologic agents is NOT weight-adjusted?

Regadenoson

The typical ejection fraction (EF) of a normal left ventricle is:

58%

The insertion of an intravenous line before radiopharmaceutical injection primarily helps to

Reduce the possibility of an infiltrated dose

Optimizing selection of patients with intermediate probability of CAD is best achieved with:

Stress MPI study

In healthy patients, the following changes occur during exercise EXCEPT:

Diastolic blood pressure decreases

Visual comparison of MPI stress–rest images shows a reversible perfusion defect that is seen on stress but not on rest. This indicates:

Ischemic myocardium

The primary diagnostic purpose of myocardial perfusion imaging (MPI) is to:

Assess myocardial perfusion and function

Heparin and warfarin are:

Anticoagulants

Technetium-99m labeled agents were introduced to overcome which limitation of thallium-201?

Poor image resolution

The MPI test sensitivity for ischemia is optimal when:

The maximal 85% of age-predicted heart rate is reached

The above diagram is called a ______.
What are the vessels represented by this diagram? (3 vessels)

The image on your screen is a polar map (bull’s-eye plot) used in myocardial perfusion imaging (MPI).

1. Left Anterior Descending (LAD)

2. Left Circumflex (LCx)

3. Right Coronary Artery (RCA)