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NMT Review Exam 1
Steve's Review Exam 1 Part 1
| Question | Answer |
|---|---|
| Before tracer administration, all the following preparations are required for a 27 year old woman referred for total-body bone imaging except: A)explain the procedure B)answer patient's questions C)rule out pregnancy D)remove attenuating materials | D)remove attenuating materials. This must be done before imaging. |
| Which of the following structures normally appear as areas of increased activity on the bone images of children? A)diaphyses of the long bones B)breast tissue C)costochondral junctions and epiphyseal plates D)lumbar spine and cranium | C)costochondral junctions and epiphyseal plates. |
| If tracer concentration is visualized in the skeleton, stomach, thyroid, and salivary glands on a bone image, the most likely explanation for these findings is that the: A)patient was imaged too soon B)radiopharmaceutical contained excess free 99m-Tc | B)radiopharmaceutical contained excess free 99mTc. Typically about 3-10% of the pertechnetate does not bind to the medronate or oxidronate, so there is always some unbound or "free" pertecnetate in any bone tracer preparation. |
| For interpretation of nuclear medicine lung images, a chest X ray is required to: A)determine cardiac size B)rule out a pulmonary embolus C)rule out previous lung surgery D)rule out possible causes of the patient's symptoms | D)rule out possible causes of the patient's symptoms. Many of the symptoms of pulmonary emboli are similar to those of rib fracture, myocardial infarction, and pneumonia. |
| Blood that is withdrawn into the syringe and allowed to mix with the 99mTc-MAA for a prolonged period may cause the MAA particles to clump together and the blood to clot. This will produce a bad image. True or False? | True If the mixture is injected into the patient, the clumped particles and "labeled" blood clots are trapped in the lung vasculature and appear as multiple small hot spots on the image. |
| The purpose of a charcoal filter in a xenon delivery unit is to absorb: A)bacteria B)carbon dioxide C)moisture D)xenon gas | D)xenon gas The NRC sets limits on the airborne concentration of 133Xe. For this reason, 133Xe that the patient exhales must be trapped for decay. |
| Radionuclide venography may be performed with which of the following radiopharmaceuticals: A)99mTc-pentetate B)99mTc-pertechnetate C)exametazime D)99mTc-MAA | D)99mTc-MAA The deep venous system of the lower extremeties may be imaged with 99mTc-MAA or 99mTc-labeled RBCs. If 99mTc-MAA is used, the lungs may be imaged after the venogram to rule out pulmonary embolism. |
| If ectopic thyroid tissue is suspected, the technologist can expect to find it most commonly in which of the following areas: A)brain B)base of tongue C)mediastinum D)base of tongue or in mediastinum | D)at the base of the tongue or in the mediastinum. Sublingual thyroid tissue occurs when the tissue does not descend from the base of the tongue to the neck during fetal development. It is often associated with hypothyroidism. |
| During parathyroid imaging, images of the chest as well as the neck are obtained to: A)correct the image series for patient motion B)visualize ectopic parathyroid tissue C)visualize substernal thyroid tissue D)diagnose hyperparathyroidism | B)visualize ectopic parathyroid tissue. The upper mediastinum between the heart and the thyroid is imaged to visualize ectopic parathyroid tissue. |
| When performing a gated equilibrium cardiac study, which of the following anatomical views best separates the right and left ventricles: A)left lateral B)left posterior oblique C)left anterior oblique D)anterior | C)left anterior oblique. The left anterior oblique view is the projection from which the ejection fraction (EF) is calculated. It is extremely important to separate the two ventricles to obtain an accurate EF value. Typically, 35-45 degrees. |
| In preparation for a 201Tl stress test, patients are instructed to fast to : A)prevent gastrointestinal upsets during exercise B)minimize tracer uptake in the gastrointestinal tract C)enhance myocardial tracer uptake D)standardize test conditions | B)minimize tracer uptake in GI tract. Digestion directs more of the cardiac output toward the gut. Excessive tracer in the upper abdominal vicera interferes with visualization of the myocardial wall, especially when the patient is supine. |
| Which of the following agents used for pharmacologic stress testing remains in the plasma for the greatest length of time: A)dobutamine B)adenosine C)dipyridamole D)nitroglycerin | C)dipyridamole. Adenosine <10 sec. Dobutamine 2 min. Regadenosin 1-3 min. Dipyridamole 15-30 min. Nitroglycerine is not used to induce pharmacoloical stress. |
| SPECT liver imaging with 99mTc-sulfur colloid is performed how soon after tracer administration: A)immediately B)10-15 min C)30-45 min D)1-2 hours | B)10-15 min. A 10-15 min time interval is necessary for the colloidal particles to be completely localized within the liver and spleen. |
| Significantly increased serum biliruben levels will most likely cause which of the following to be visualized on hepatobiliary images: A)colon B)kidneys C)lungs D)spleen | B)kidneys. Increased serum bilirubin levels indicate poorly functioning hepatocytes. Therefore, these cells cannot efficiently remove the tracer from the blood, causing the tracer to be excreted through the urinary system. |
| Localization of a Meckel's diverticulum can be accomplished with which of the following radiopharmaceuticals: A)67Ga-citrate B)99mTc-pentetate C)99mTc-pertechnetate D)99mTc-sulfur colloid | C)99mTc-pertechnetate is used to visualize a Meckel's diverticulum. Often the Meckel's diverticulum is lined with gastric mucosa that concentrates this tracer. |
| In infants, 24hr images are sometimes performed over what area to demonstrate gastroesophageal reflux: A)lung fields B)lower esophagus C)stomach D)upper small intestine | A)lung fields. 24-hr images are useful in infants for demonstrating aspiration of stomach contents. |
| Effective renal plasma flow (ERPF) is measured with which of the following radiopharmaceuticals: A)99mTc-pentetate B)99mTc-disofenin C)99mTc-medronate D)99mTc-mertiatide | D)99mTc-mertiatide. ERPF is primarily a measurement of tubular function; therefore, a renal agent that is secreted by the tubules must be used. 99mTc-mertiatide is secreted by the renal tubules and is used to determine ERPF. |
| Evaluating the quality of a bolus injection is best accomplished by which of the following techniques: A)visual inspection B)calculating the cardiac transit time C)generating a time-activity curve for the superior vena cava D)imaging the injection site. | C)generating a time-activity curve for the superior vena cava. Evaluating the quality of a bolus injection is accomplished by generating a time-activity curve over the superior vena cava and measuring the full width at half max (FWHM). |
| Which of the following is/are NOT normally visualized on a 67Ga image acquired 72 hr after tracer administration: A)kidneys B)lacrimal glands C)sternum D)liver | A)kidneys. In the first 24 hr after administration, the kidneys excrete almost one-third of the 67Ga injected. Hence, renal activity is normally visualized on images up to 48 hr after tracer administration. After 48 hr, renal activity indicates disease. |
| Which of the following statements about "transmission-based precautions" is FALSE: A)applied when a patient is known to be infected with a communicable disease B)implemented in the case of diseases such as mumps C)replace "standard precautions" | C) Transmission-based precautions are applied along with standard precautions when a patient is known to be infected with a communicable disease. They are a second level of precautions that include additional safety measures. |
| Which of the following statements about pentetreotide is TRUE: A)is labeled with 99mTc B)is a labeled antibody C)exhibits no human antimurine antibody (HAMA) effect D)excreted exclusively through the kidneys | C)it exhibits no human antimurine antibody (HAMA)effect. Pentetreotide is an analog of the hormone somatostatin that is labeled with 111In. It is a peptide rather than an antibody and for this reason does not induce the HAMA effect in patients. |
| The purpose of using acetazolamide in conjunction with a brain agent is to: A)tranquilize the patient B)evaluate cerebrovascular ischemia C)localize the area of the brain from which seizures arise D)localize brain tumors | B)evaluate cerebrovascular ischemia. Acetazolamide (Diamox(r)) is used in conjunction with SPECT brain imaging in patients with transient ischemic attacks, carotid artery disease, and cerebrovascular disease, among others. |
| The technologist's responsibilities during tracer administration for a cisternogram include: A)lumbar puncture B)obtaining consent C)monitoring the patient D)ensuring personnel and surroundings are not contaminated with radioactivity | D) One of the responsibilities of the technologist is to protect personnel in the work environment by limiting their radiation exposure and confining radioactivity to prevent the spread of contamination. |
| Sodium phosphate (32P) may be used to treat which of the following conditions: A)liver metastases B)polycythemia vera C)rheumatoid arthritis D)malignant effusions | B)polycythemia vera. Sodium phosphate (32P) is administered intravenously and may be used to treat polycythemia vera. |
| Supersaturated potassium iodide solution may be administered to the patient for therapy with which of the following radiopharmaceuticals: A)153Sm-exidronam B)89Sr-chloride C)131I-sodium iodide D)131I-tositumomab | D) To minimize thyroid uptake of unbound iodine, supersaturated potassium iodide is administered to a patient receiving 131I-tositumomab for treatment of non-Hodgkin's lymphoma. The blocking agent is given 1 day before and for the next 14 days. |
| The first step that a technologist should initiate when an adult patient experiences cardiac arrest is to: A)perform chest compressions B)establish an airway C)call for help D)perform rescue breathing | C)call for help. American Heart Association standards and guidelines indicate that after verification of cardiac arrest has occurred, the rescuer should call for help first and then initiate CPR. |
| 111In-Pentetreotide should NOT be administered through an IV line containing: A)a total parenteral nutrition mixture B)0.9% sodium chloride C)dextrose and water D)glucose | A)TPN mix. 111In-pentetreotide shouldn't be given through IV line containing TPN mixes because the tracer may form a complex with components of the TPN mixture. Because the chemical form of the tracer is now altered, its distribution in body will change. |
| Dual-isotope gastric emptying studies use which radio-pharmaceutical for the solid phase of the study and which radio-pharmaceutical for the liquid phase of the study? | Solid phase - 99mTc-sulfur colloid Liquid phase - 111In-pentetate |
| Proper placement of a urine collection bag includes: A)place it across the patients legs keeping it level with the bladder B)place it on the stretcher near the patient's feet so that it is out of FOV C)hang it from the imaging table lower than the bladder | C)hang if from the imaging table, lower than the bladder. For proper drainage, the urine collection bag must always be lower than the urinary bladder. If it is not lower, the urine may reflux back into the bladder, which may result in a UTI. |
| Which of the following rad-pharmaceuticals can be used to assess vesicoureteral reflux by the indirect method: A)99mTc-pertechnetate B)99mTc-sulfur colloid C)99mTc-albumin D)99mTc-pentetate | D)99mTc-pentetate. Radionuclide cystography is used to assess vesicoureteral reflux. This study may be performed by the indirect or the direct method. In the indirect method, a renal agent is administered intravenously. |
| If 0.02ug/kg of CCK is needed for a hepatobiliary study, what volume needs to be drawn for a 175lb patient with a solution of 10ug/mL available to draw from? | There are 2.2lbs per kg. 175lbs x 1kg/2.2lbs = 79.54kgs. 0.02ug/kg of CCK x 79.54kg = 1.59ug of CCK needed. 1.59ug of CCK x 1mL/10ug = 0.159mL |
| Parenteral administration of a drug or radio-pharmaceutical would include all of the following routes EXCEPT: A)intravenous B)intramuscular C)subcutaneous D)oral | D)oral. The term parenteral means "other than trough the intestine." |
| The red cell survival test is most often performed on a patient with suspected: A)pernicious anemia B)intestinal malabsorption C)iron deficiency anemia D)hemolytic anemia | D)hemolytic anemia. The red cell survival test is used to study the lifespan of RBC's in patients with suspected hemolytic anemia. These patients will have a cell life span shorter than normal. |
| A technologist confirms a referring physician's request for a nuclear medicine procedure for a hospitalized patient by: A)locating the order in the patient's medical record B)telephoning he patient's physician for confirmation C) asking the patient | A)locating the order in the patient's medical record. The referring physician initiates orders for diagnostic testing and enters those orders in the patient's medical record. It is the technologist's responsibility to confirm the order for every test. |
| Which type of collimator should be used for organ counting during a red cell sequestration study: A)low-energy, high-sensitivity parallel hole B)high-energy, low-resolution parallel hole C)pinhole D)flat field | D)flat field. A probe system equipped with a flat-field collimator should be used to obtain organ counts. This will allow adequate statics in reasonable time periods and exclude counts coming from areas outside the region of interest. |
| If a plasma volume has been determined to be 15L, which of the following events has most likely occurred: A)completion of a satisfactory study B)over-hydration of the patient C)leakage of tracer from circulation D)infiltration of the tracer | D)infiltration of the tracer. Depending on body weight and gender, the total blood volume normally ranges from 3-6L. If a plasma volume has been determined to be 15L, there was most likely a technical error that caused this result. |
| A bio-hazard warning label would be found on all of the following EXCEPT: A)contaminated sharps container B)refrigerator containing potentially infectious material C)unit of blood released for clinical use D)receptacle for contaminated laundry | C)labels are not required on containers of blood that have been released for clinical use, such as blood transfusion. Bio-hazard warning labels are attached to any container of regulated materials (blood or infectious materials). |
| The total blood volume may be calculated by dividing the plasma volume measured with labeled albumin by the: A)hematocrit B)plasmacrit C)corrected hematocrit D)corrected plasmacrit | D) The formula for calculating the TBV based on the plasma volume uses the corrected plasmacrit in the denominator. Correction is needed to account for trapped plasma and to adjust the venous hematocrit to an average whole-body hematocrit. |
| If radioactivity in the circulation from a previous NM test is unaccounted for, the results of a plasma volume determination will be: A)unaffected B)falsely elevated C)falsely decreased D)impossible to predict | C)falsely decreased. When residual radioactivity is present in the circulation, it appears as if the amount of radioactivity injected has been diluted in a smaller volume than it actually has. |
| The recommended amount of captopril to be given orally an hour before renal imaging in a hypertension study is: A)10-15mg B)15-20mg C)25-50mg D)55-100mg | C)25-50mg tablet, usually given orally 1hr prior to hypertension renal study. |
| Imaging with 111In-pentetreotide routinely includes what areas of the body: A)head and chest B)chest C)abdomen D)head to upper femurs | D) imaging with 111In-pentetreotide routinely includes the head to upper femurs, because detection of both the primary tumor and any metastases is the goal of the examination. If indicated, the extremities may also be included. |
| A patient scheduled for scintimammography has symptoms involving her left breast. Which of the following sites is the best choice for injection of the radiopharmaceutical: A)right antecubital B)right carotid C)left carotid D)left hand | A)right antecubital. If the suspected disease is in the left breast, it would be best to use the contralateral side of the body for injection at a site distant from the breast or lymph nodes, which may also be involved. |
| Based on the net counts data shown, Rt Lung = 175,362 Lt Lung = 325,672 What is the percentage perfusion to the right lung: A)30% B)35% C)54% D)65% | B)35%. % activity in ROI = counts in ROI/total counts in ROIs x 100 175,362/501,034 x 100 = 35% |
| If 375mCi 99mTc are on the column of a 99Mo/99mTc generator and after elution 342mCi 99mTc are assayed in the elution vial, the appx elution efficiency of the generatror is: A)110% B)91% C)33% D)11% | B)91%. Elution does not remove all 99mTc on the generator column. Elution efficiency is expressed as the percent of 99mTc activity on the column that is eluted. Elution efficiency = 99mTc activity eluted/99mTc activity on column x 100. |
| Two-hundred fifty (250) kilobecquerels are equivalent to how many microcuries: A).25uCi B)6.76uCi C)9.25uCi D)9.250uCi | B)6.76uCi Conversions between the CGS and SI systems can be accomplished easily if you remember the three following relationships: 1Ci=37GBq 1mCi=37MBq 1uCi=37kBq 250kBq x 1uCi/37kBq = 6.75uCi |
| If a 99Mo/99mTc generator is eluted on Monday at 0600, the maximum 99mTc activity could next be eluted at what time: A)1200 Monday B)1800 Monday C)0600 Tuesday D)0600 Wednesday | C)0600 Tuesday. Maximum 99mTc activity is obtained about 24 hr after the last elution of 99mTc. |
| According to the NRC, 99Mo contamination in 99mTc eluate must be measured how often: A)weekly B)daily C)after each elution D)only after the first elution | D)only after the first elution. According to the NRC, 99Mo breakthrough must be measured in the first elution from a 99Mo/99mTc generator. |
| These results were obtained when 99mTc eluate was assayed for 99Mo breakthrough at 0600: 99Mo = 10uCi 99mTc = 416mCi Which of the following statements about this elution at 1700 is true: A)the eluate should not be used B)the eluate may be used | B)the eluate may be administered to patients. At 0600, the 99Mo contamination in the eluate is below the max allowable limit of 0.15uCi 99Mo per mCi 99mTc. To determine 99Mo concentration in the eluate at 1700, decay correct both 99Mo and 99mTc for 11 hr. |
| A tech performs an Al ion breakthrough test on 99mTc eluate. When the indicator paper is spotted with Al ion solution, a faint red color is seen, but when the paper is spotted with eluate, no color change is seen. What does this mean? | The Al ion concentration in the eluate is below the USP limit. No color change represents an AL ion concentration below 10ug/ml of eluate, the USP limit. This eluate may be administered to patients and used to prepare 99mTc-labled radiopharmacuticals. |
| All of the following procedures may be performed with 99mTc-sulfur colloid EXCEPT: A)gastric-emptying study B)gastroesophageal reflux study C)GI bleeding localization D)Meckel's diverticulum localiztion | D)Meckel's divierticulum localization. 99mTc-pertechnetate is used to localize a Meckel's diverticulum. |
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