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Nuclear Med Review
Review
| Question | Answer |
|---|---|
| What are the three most important factors to be considered when handling radioactive materials? | Time, distance, and shielding |
| The ALARA concept in radiation protection refers to what? | keeping exposure to radiation as low as reasonable achievable |
| If the intensity of radiation is 10mrem/hr at 2 meters from the source, the intensity at 8 meters from the source is what? | 0.625 mrem/hr |
| Upon arrival, a package containing radioactive material with a DOT category II yellow label must have a dose rate which at the surface does not exceed what? | 50 mrem/hr |
| If you work in an area where a major part of your body could receive greater than 100 mrem in five consecutive days what sign should be posted? | Caution: Radiation Area |
| Personnel radiation exposure records should be kept for how long? | indefinitely |
| Aspects of radioactive material which are under strict federal regulations include all of the following except: *production *price *possession *use *disposal | price |
| The best way for a technologist to decontaminate a 99mTc pertechnetate spill to the hands is by use of what? | soap and water |
| If a misadministration of a patient dose occurs and is documented on March 3, 1996, what is the earliest date those records may be destroyed? | March 3, 2006 |
| Radioactive materials that decay through ten physical half lives are reduced to what? | background |
| The intensity of radiation is 100mrem/hr at 9 feet from the source. What is the intensity at 3 feet from the source? | 900 mrem/hr |
| When a radiation worker will be exposed to large amounts of radiation and are on an infrequent schedule which monitoring device(s) would be the most useful? | pocket dosimeter and TLD |
| What is the easiest and most practical way for a technologist to reduce the radiation exposure from patients injected for nuclear medicine studies? | distance |
| A radiation beam of 100mrem/hr is reduced to 25 mrem/hr by an attenuating material. This material is equal to ____ half value layers? | 2 |
| The most important factor(s) in reducing the radiation dose to the patient include what? | the correct radiopharmaceutical dose is administered to the patient and the dose calibrator is calibrated to ensure accurate readings |
| T/F A technologist must use a syringe shield while administering a dose to the patient, but may prepare radiopharmaceuticals without a syringe shield as long as there are no other individuals in the radiopharmacy during preparation. | False |
| Who is the first person a staff technologist should report an excessive radiation exposure to? | RSO or the chief technologist |
| T/F While adhering to ALARA is important for radiation workers, it is not a concern for the patient since the benefit of the study outweighs the risk of radiation exposure. | False |
| T/F Urine from a Schilling's test must be kept in storage for a period of ten half lives before it can be disposed of into sanitary sewer? | False |
| Before a package that transported radioactive material can be discarded, what should be done? | deface the radioactive transport label |
| A package arrives with a half life of 8 days and a total quantity of 30mCi. According to the NRC regulations: A. a wipe test is necessary B. The package is exempt from wipe test requirements C. The NRC should be notified | B. The package is exempt from wipe test requirements |
| T/F The dose limit for members of the public includes both external and internal doses? | True |
| A 20mCi dose of Tc99m HDP results in a total body absorbed dose of approximately 0.25 rads. This values is equivalent to what in mGy? | 2.50 mGy |
| Of the following sources used to calibrate a dose calibrator, which has the longest half life: 133 Ba 137 Cs 99mTc 57 Co | 137 Cs |
| The 99Mo column, if separated from a 99Mo/Tc99m generator, must be held for at least _____ hours prior to disposal as nonradioactive waste? | 660 |
| A 10 mCi dose of a radionuclide would be equal to what activity in MBq? | 370MBq |
| A dose equivalent of 20mSv is equal to how many rem? | 2 rem |
| Venting of 133 Xe gas to the atmosphere is acceptable in all of the conditions except: A. A rooftop designated as a restricted are B. An activated charcoal filter is used as a trap C.The activity released is 10% or less of legal requirements | All are acceptable |
| The amount of light generated by a sodium iodide crystal is directly related to what? | photon energy absorbed in the crystal |
| The photopeak of a spectrum of Tc99m represents gamma rays that do what? | interact in the crystal sand deposit all of their energy there |
| If the FWHM is 15 keV, what is the energy resolution for the photopeak of Tc99m? | 11% |
| What are the two most important quality assurance measurements of a scintillation camera imaging system? | field uniformity and spatial resolution |
| Which of the following radionuclides would be used as a source to calibrate a detection system used for Tc99m: Cs137 Cr51 Co57 Ba133 | Co57 |
| What is the basic function of all collimators? | limit access of photons to the instrument |
| For parallel hole collimators, where is the best resolution at? | the collimator surface |
| When one increases the resolution of a collimator, its efficiency ___ . | decreases |
| The resolving power of collimators decreases with increasing gamma ray energy for what reason? | increased septal penetration |
| Which collimator is used for thyroid uptake studies with radioiodine? | flat field |
| All of the following are gas detectors except: A. gamma camera B.cutie pie C.dose calibrator D.GM | gamma camera |
| Dose calibrators are examples of what type of detector? | ionization chamber |
| If a noticeable change in field uniformity of a gamma camera occurs, the technologist should first check what? | photopeaking |
| What phantom determines the resolution of all areas of the detector with one image? | orthogonal hole |
| In addition to spatial resolution, what other parameter of the detector can be assessed with either a bar or orthogonal hole phantom? | spatial linearity |
| What is the advantage of a cutie pie as a survey meter? | it is independent of the energy of the radiation |
| The primary difference between the cutie pie detector and the GM is what? | operating potential |
| What dose calibrator quality control test is require daily by the NRC? | constancy |
| When assaying a patient dose, if the sample is elevated slightly in the dose calibrator, the dose readout will be____. | lower than the actual dose |
| When performing quality control tests of constancy, accuracy, linearity, and geometric variation, the NRC directs correction by repair, replacement, or use of correction factors if the error is greater than what? | 10% |
| How is percent energy resolution defined or calculated? | FWHM (kev)/photopeak (kev) X100 |
| Reasons why good energy resolution is a desirable characteristic for NaI detector include: A.Precise identification of gamma rays B.Separation of gamma energies that are similar C. All of the above D.A&B only | A&B only |
| Energy resolution of a NaI detecting system increases with increasing gamma ray energy. Expressed as %FWHM, this means the %FWHM ____ as gamma energy increases. | decreases |
| Counting errors above those that could be predicted using Poisson statistics can be checked for using the ____ test. | Chi-Square |
| The nuclear medicine technologist performs a Chi-Square test and finds P value that is 0.5. What does this indicate? | The instrument is counting within an acceptable range and variations matched the expected |
| A uniform response to a wide range of radioactivities is a parameter of dose calibrator performance known as: | linearity |
| The parameter that measures the degree to which a dose calibrator measures sample or patient dose that agrees with the actual or true dose: | accuracy |
| The sensitivity of the dose calibrator chamber to different source configuration is measure by: | geometric calibration |
| The ability of the dose calibrator to consistently reproduce results of activity measurement is: | precision |
| T/F All SPECT imaging devices are computer controlled for both data acquisition and data analysis. | True |
| Pixels are picture elements of the image matrix that represent individual location counts in the x and y directions. In SPECT imaging adding depth makes pixels become what? | volume elements |
| In SPECT imaging, parallel hole collimators are used to insure that the detectors see only photons along a narrow band that extends from the detector to organ in the radius of rotation. What is this narrow band called? | ray |
| Scanning of a ray across a plane in the subject at a particular angular increment forms a what? | projection |
| After a complete set of projections are obtained, the computer sorts the data and reconstructs an image of activity distribution in the ____ of interests. | plane |
| The "star" effect in an image may be created by what? | Artifacts produced by the overlapping ray sums |
| The "star" effect may be reduced by what? | increasing the number of projections acquired |
| How is the star artifact removed? | filtering |
| Attenuation correction methods are used in SPECT imaging for what reason? | The attenuation of photons by the patients body makes it difficult to obtain accurate radiotracer uptake information |
| Accurate quantitative information about radiopharmaceutical uptake in SPECT is limited by what? | attenuation of photons by the patient's body |
| The center of rotation analysis correction program: A. should be applied with each collimator change B. Interprets the axis of rotation for each patient C. compensates for minor misalignments D.all of the above E. A&C | E. should be applied with each collimator change and compensates for minor misalignments |
| One of the most prevalent causes of defects seen in the reconstructed SPECT image is the result of what? | gamma camera non-uniformity |
| A circular path of a "cold" area and ring and "bull's eye" artifacts are the result of what? | gamma camera non-uniformity |
| Although manufacturers may differ on uniformity correction flood techniques, the one recommendation by all vendors is what? | use of high count flood correction matrix |
| Including an area of the patient with an infiltrated dose in the field of view will result in an artifact called what? | star artifact |
| An increase in matrix size from 64x64 byte mode to 128X128 word mode for SPECT imaging will result in a ____ factor increase in time and computer storage space. | 4 |
| When a technologist is setting up for a SPECT acquisition, selection of the acquisition time should include consideration of what? | patients ability to hold still and the resolution required for the study |
| The filter algorithm selected by the technologist should include consideration of what? | the preference of the interpreting physician, target-to-nontarget ratio, the background or noise level |
| As the number of counts in a reconstructed image increases what happens? | The less smoothing the window function will need |
| The most important factor(s) in determining quality of the tomograph include what? | distance from collimator to patient and collimator resolution |
| What determines pixel size? | zoom factor and matrix size |
| Normalization of nuclear medicine images allows for what? | comparison of information from different size regions of interest |
| In esophageal transit studies the computer may be used for what? | to generate a time activity curve for proximal, mid, distal regions of the esophagus and to demonstrate suspected disorders of esophageal motility |
| Do patients need to be premedicated for gastric emptying studies with antacids? | no |
| Gallbladder ejection fractions following CCK administration is calculated with what formula? | preCCK counts( -background)-post cck counts (-bkgd)/preCCK counts (-bkgd) X100 |
| Accurate assessment of cardiac ejection fractions can be obtained with a minimum of how many frames? | 16 |
| In the radionuclide ventriculogram, the work image matrix which provides the best compromise between image resolution and memory required to store the image is what? | 64X64 |
| What is a buffer when talking about computers in nuclear medicine? | temporary storage for acquired data |
| What mode is a serial acquisition mode? | list mode |
| True/False In general, the number of images acquired in a 360 degree SPECT acquisition is related to the size of the organ being imaged and the resolution of the imaging system? | True |
| Pateint motion is one of the most common artifacts on SPECT studies. The most effective way for the technologist to detect motion is to do what? | evaluate the raw planar images in cine format |
| When transporting a patient by stretcher, the use of safety belts or side rails is required for what type of patients? | All patients |
| What needs to be done for patients who suffer from orthopnea? | elevate their heads so that they can breathe |
| What can be done to comfort an individual with severe abdominal pain? | elevate head, and place sponge under knees |
| In case of electrical fire, what type of fire extinguisher can be used to extinguish the fire? | CO2 foam and halon |
| When placing the patients in a supine position, consideration should be taken for which of the following conditions? A. Patients with dyspnea or orthopnea B. patients who are nauseated C. patients with abdominal pain D .A and B E. all of the above | E |
| Which of the following are not a microorganism? A. bacteria B. fungi C. vectors D. protozoans E. Viruses | C. Vectors |
| What is a fomite? | a contaminated object |
| Under the system of body system precautions, the health care worker who is trained to start or discontinue IVs must always wear what? | gloves |
| What is the best way a health care worker can prevent the spread of microorganisms from one patient to another? | hand washing |
| Scrubbing with soap and water is an example of what? | chemical removal of bacteria, mechanical removal of bacteria, and personal hygiene |
| What are ideal conditions for the growth of pathogenic bacteria? | warmth and moisture |
| Hand washing when caring for a patient in isolation is referred to as creating a ______. | barrier |
| T/F AIDS can be transmitted by casual contact. | False |
| Serious viral diseases, which may be spread through infected blood and body fluids, include: A. tuberculosis B. Hep B C. AIDS D.Dystentery E. B and C F. All of the above | E. Hep B and AIDS |
| What does NPO mean? | nothing given by mouth |
| When checking a patient for cyanosis, one should note the coloration of what parts of the body? | lips and nail beds |
| What does diaphoretic mean? | sweaty |
| Blood pressure can accurately be defined as what? | pressure of blood on the walls of the arteries |
| The diaphragm of the stethoscope should be placed over which artery when measuring blood pressure in the arm? | brachial |
| Treating an item as to make it completely free of all organisms and their spores is called what? | disinfection |
| What is the most common sterilization process in the hospital? | steam under pressure |
| A plastic tubing to an instrument must be sterilized. What is the best method to do so? | ethylene oxide gas |
| Gas sterilization is used primarily for all of the following except: A. cytoscopic and fiber optic instruments B. thermometers, blood pressure cuffs, and stethoscopes C. metal instruments D. plastic and rubber items | C. metal instruments |
| A metal instrument must be sterilized, what is the best way to do so? | steam under pressure |
| Drugs given prior to surgery in certain procedures for the purpose of suppressing secretions belong to what category of drugs? | anticholinergics |
| A drug usually takes effect most rapidly when administered via what route? | intravenously |
| When extravasation occurs as a result of an IV injection, what does treatment involve? | moist heat |
| Failure to apply pressure to the vein after discontinuing an IV may result in? | a hematoma |
| What is the most common site for IV injection? | The antecubital vein |
| What are drugs that relax the walls of blood vessels, permitting a greater flow of blood? | vasodilators |
| All parenteral medications are given using strict _____. | surgical aseptic technique |
| When preparing a parenteral injection it is essential to keep which area of a syringe sterile? | needle shaft and tip |
| What medications can cause respiratory depression? | tranquilizers/sedatives |
| Drugs that prevent or counteract respiratory depression and other depressive effects of morphine and related drugs are called what? | narcotic antagonist |
| The technique in which a vein is punctured to withdraw a specimen of blood, to instill a medication or start and IV infusion is called what? | Venipuncture |
| Which vein of the forearm is most commonly used for venipuncture? | Median cubital |
| While performing a venipuncture, transfixation can result in what? | formation of a deep hematoma |
| If the patient continues to bleed once the needle is removed what should be done? | apply pressure tot he site with a gauze pad until bleeding stops |
| When one palpitates a thrombosed vein, what is felt? | lack of resilience, cord like vein, and they roll easy |
| The bevel of the needle should be in which position, before entering the vein? | facing upward |
| Which of the following is not classified as a barrier precaution: A. HBV vaccine B. gloves C. goggles D. gown or apron | HBV vaccine |
| This recent OSHA regulation requires all healthcare personnel at risk for exposure to ____ to receive a vaccine. | HBV |
| If a technologist is unsure about performing a study that is ordered on a patient's requisition, what should the technologist do? | confirm the study with the ordering physician or the nuclear medicine physician |
| What should be done if a nursing patient is to be studied in the nuclear medicine department? | patient should be advised to cease nursing for at least 24 hours |
| What is the danger in imaging patients in the standing position? | the patient may become hypotensive and fall |
| The body weight of a standardized man for dose calculations is based on the _____kg man model. | 70 |
| The concentration of a radiopharmaceutical is given by what formula? | activity/volume = concentration |
| A vial contains 250 uCi of In111 in 5 ml of fluid. What is the concentration? | 50uCi/ml |
| A vial contains Tc99m at a concentration of 58 mCi/ml. A dose of 15mCi is desired, How many ml should be withdrawn into the syringe? | 0.26ml |
| A vial contains 350 mCi of Tc99m in 30ml of fluid. What is the concentration? | 11.7 mCi/ml |
| 180mCi in 10ml is added to 100 ml. What is the resulting concentration? | 1.6 mCi/ml |
| A vial contains 260 mCi in 20 ml of fluid. How many ml should be withdrawn to obtain 20mCi? | 1.54 ml |
| The half life of a radioactive substance is the time is takes to do what? | To decay to one half of its original activity. To deliver one-half of its radiation dose. For the number of radioactive nuclei to decrease by one half. |
| What is the decay constant? | The fraction of nuclei which decay per unit time |
| P32 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 |
| A 57Co capsule is dissolved in 50ml of water. How many ml should be withdrawn to make a 10% standard? | 5.0 |
| A pediatric dose must be prepared for a patient undergoing a bone scan. It has been determined that the patient should receive 67% of the standard dose of 20 mCi. What is the dose in mCi that the patient should receive? | 13.4mCi |
| I123 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? | 20mCi |
| A radiopharmaceutical kit is prepared at 11:00 am with 3 ml of Tc99m pertechnetate from generator eluate that is calibrated for 600mCi/ml at 6:00am. How much activity is will the kit contain? | 202 mCi |
| On April 4, a radiopharmaceutical is received and calibrated at 150uCi/ml. What is the concentration in uCi/ml on April 20? | 37.5 uCi/ml |
| 210 uCi of I131 hippuran is to be used on May 3. There was 300 uCi on the date of assay, April 29. Is the activity present on May 3 acceptable for the prescribed dose? | Yes, because the activity remaining is within 10% of the prescribed dose |
| In a Tc99m / 99Mo radionuclide generator, what is the material onto which the parent radionuclide is adsorbed? | alumina |
| After equilibrium has been disturbed by elution, a radionuclide generation will return to equilibrium and after how many daughter half lives? | 4 daughter half lives |
| Aluminum breakthrough in a 99Mo generator can be a problem because they aluminum ions can affect what? | the biodistribution and tagging reactions |
| The USP has established a maximum limit of ____ Al+3/ml eluate. | 10ug |
| The presence of aluminum ions in the 99mTc eluate is an example of what? | chemical impurity |
| A patient injected with Tc99m MDP and scanned 2 hours post injection demonstrated activity in the liver. This was most likely due to what? | presence of Tc99m Tin colloids |
| A bone agent was prepared at 0730 and a patient dose is administered at 1300. The patient was scanned 2 hours post injection and the bone scan shows activity in the salivary glands and stomach. The activity is most likely due to what? | free or unbound Tc99m pertechnetate |
| Following the administration of a radiopharmaceutical for a diagnostic imaging study, the patient develops a high fever and chills. What type of reaction is most likely? | pyrogenic |
| The remaining Tc99m that remains untagged after the preparation of Tc99m MDP are called what? | radiochemical impurities |
| The presence of 99Mo in the Tc99m Pertechnetate eluate is called what? | radionuclidic impurity |
| A 99Mo/Tc99m generator is eluted at 2:00pm for an emergency study and is assayed. They technologist records 47uCi of 99Mo in 270 mCi Tc99m pertechnetate. What should happen next? | The 99Mo breakthrough is greater than allowable by the NRC and should not be used for patient administration |
| Records established on April 1, 1996, on 99Mo breakthrough tests on elutions from the 99Mo/Tc99m generator elutions must be kept for a period of _____ years or until April, ______. | Three; 1999 |
| Which elution process is most commonly used in a 99Mo/Tc99m generator? | ion exchange |
| Persantine (dipyridamole), used during myocardial imaging, acts as what type of agent? | vasodilator |
| What does persantine prohibit the uptake of? | adenosine |
| The vasodilatory effects of Persantine are reversed by administering what medicine? | aminophylline |
| What factors can cause malabsorption of vitamin B12? | antibiotics and excessive alcohol consumption |
| Which of the following medications enhance Tc99m concentration in the gastric mucosa? a.cimetidine b.lasix c.pyrophosphate d.persantine | a.cimetidine |
| T/F In111 passes through WBC membranes | False |
| What is the minimum number of radiolabeled particles (MAA) for satisfactory lung perfusion? | 60,000 |
| A technologist could perform the quality control testing on MAA to include what? | instant thin layer chromatography and particle sizing |
| Full generation of the 99Mo/Tc99m column takes at least how long? | 24 hours |
| Adding saline to a 99Mo/Tc99m generator is required for what type of generator? | Dry column |
| Tc99m sulfur colloid localizes in functional liver tissue as a result of what? | phagocytosis |
| P32 is best described as what type of emitter? | beta emitter |
| Which of the following radionuclides is not routinely used for lung ventilation studies? A.Xe133 B. Tc99m DTPA aerosol C.67Ga D.81mKr | 67Ga |
| What occurs as filtered air is introduced into is introduced into the MAG3 reaction vial during the boiling phase? | oxidation of excess stannous ions |
| Which of the following gases is released upon adding Tc99m Pertechnetate to a MAG3 reagent vial? | argon |
| The stannous ion found within a reagent vial may hydroloyze to stannous hydroxide when what occurs? | what is present |
| When does oxidation of the stannous ion occur? | air is introduced |
| What is a common contaminant of I123? | I124 |
| Radioaerosol particle sizing must be within the following ranges? | 0.50-3.00u |
| Tc99m HMPAO is a lipophilic brain agent also known as what? | Tc99m exametazime |
| What function of the liver is utilized in imaging the liver using an IDA compound? | bile production and secretion |
| The majority of radiolabeled particles used for pulmonary perfusion imaging should fall within what range? | 15-70u |
| The principle radionuclide contaminant of a Tc99m eluant is what? | molybdenum |
| What is the keV of Xe133 and how does it decay? | 80keV and beta-gamma emission |
| What radiopharmaceutical is best to evaluate the renal cortex? | Tc99m DMSA |
| Instant thin layer chromatography for water-insoluble radiopharmaceuticals reveals what? | Free Tech |
| Reoxidation of Tc99m may be reduced by packaging the non radioactive reagent kit in what? | a nitrogen atmosphere |
| When testing MAA and using acetone as an ITLC solvent, free 99mTc is evident at what location? | the solvent front |
| What are common ITLC solvents? | acetone, methyl ethyl ketone, and saline |
| Solvents used during ITLC move via what methods? | adsorption and capillary action |
| Particle size of Tc99m Sulfur colloid preparations are affected by all of the following except: A. amount of 99mTc added to the preparation B. amount of gelatin used C. heating time D. presence of contaminants | A. amount of 99mTc added to the preparation |
| What Is included in the appendicular skeleton? | upper and lower extremities, and pectoral and pelvic girdles |
| As osteoplastic activity increases in relationship to osteoblastic activity, what happens to bone deposition? | decreases or ceases |
| In a person who is 45 years old or older, bone resorption is _____ bone deposition. | greater than |
| What do hydroxyapatite salts of the bone consist of? | calcium phosphate and calcium carbonate |
| T/F Bone, once it is formed undergoes continuous change. | True |
| What covers the outer portion of all bones? | periosteum |
| Bone loses ____% of its calcium content before it is detectable on a Tc99m MDP or HDP bone scan? A. a minimal B.20 C.30 D.50 | a minimal |
| How much calcium does bone need to lose before it is detectable on xray? | 30-50% |
| What is the mechanism by which 99mTc labeled compounds accumulate in the bones? | ion exchange |
| What organ receives the greatest radiation dose using a Tc99m phosphate bone imaging agent? | bladder |
| The amount of soft tissue activity seen on a bone scan is related to what? | the tagging efficiency of the radiopharmaceutical, the dose to scan time, the patients age, and the patients renal function |
| Why is imaging the skeleton with radiotracers an important diagnostic tool? | the skeleton is a frequent site of mets from neoplasms which are primary elsewhere |
| In the 99mTc polyphosphate bone image, the inferior tips of the scapulae can be mistaken for what? | rib lesions |
| The usual adult dose for bone scintigraphy using Tc99m agents is what? | 15-20mCi |
Created by:
krniya