BOARDSSSSS!!!!
positron decay
- Proton-rich nuclei undergo this [ β+ ]. P → N + β+ + v -Conversion of proton into a neutron and positron - Neutron stays in nucleus; positron ejected from nucleus & immediately undergoes annihilation; emission of neutrino (energy) - Requires ≥ 1.02 MeV of energy imparted to nucleus undergo this
electron capture
- competes with positron decay -Proton-rich nuclei with energy imparted to nucleus < 1.02 MeV undergoes this -P+e- → N+v - Proton combines w/captured inner-shell electron to form a neutron simultaneously emitting a neutrino -Outer-shell electron fills vacancy of inner-shell. In order to drop to lower energy electron shell, the outer-shell electron emits energy in the form of characteristic x-ray (don't confuse energy of electron shells with electron binding energy.....two different things)
beta decay
-Neutron-rich nuclei undergo "this" [ β_ ]. N → P + β- + antineutrino -Conversion of neutron into a proton and electron -Proton stays in nucleus; electron is ejected from atom (this ejected e- is also called "negatron" or "beta particle"); antineutrino (energy) is emitted - β_ will become free e- until it fills electron vacancy in atom of origin or another atom (or annihilates) - Z # decreases by one (isobars)
gamma emission/decay
-Nucleus that has appropriate ratio of N:P but still has too much energy undergoes this [ γ ]. -This Emission is the most useful radiodecay in nuclear medicine imaging. 1. Isomeric Transition (IT) 2. Internal Conversion (IC)
major
1 mCi of 131 Iodine
Brain flow parameters
1 sec/frame for 1-2 minutes and then sum to 2-3 sec/frame at processing. Start imaging before or exactly at beginning of bolus (make sure bolus is quick and tight). Don't blow the flow, it is crucial to the diagnosis.
peptide
111 In Pentetreotide is a therefore adverse reactions were not a common when clinical trials were being performed.
4-5 days
111 Indium Capromab is typically recommended to be imaged __ post injection?
myocardial metabolism
11C-acetate is a tracer used in the study of:
cyclotron
123I currently used in medical practice is produced in a ____.
20 mCi
123I 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?
8.05 days
131 Iodine T1/2
metastatic pheochromocytoma
131I-metaiodobenzylguanidine is used to treat:
100 uCi
137 Cesium
1.95 days
152 Samarium T 1/2
measure efficiency of all LORS
2D normalization is done to
focal increased uptake in all three phases for osteomyelitis and diffuse increased uptake in flow and blood pool images w/normal uptake on delayed imaging for cellulitis.
3-phase bone scanning for osteomyelitis versus cellulitis will show?
1 Ci
3.7 x 10^10 decays per second (equals the radioactivity emitted by 1g of radium in equilibrium with its daughter nuclides)
14.3 days
32 Phosphorus T 1/2
brain SPECT parameters
360° with 64 projections per rotation. 20 sec/stop using a 128 x 128 matrix.
Bone SPECT aquisition
360°, 60-120 stops, 10-40 sec/stop
Hepatocytes of the liver
99 Molybdenum that is injected into the patient goes to which cells of the body?
+4
99m Technicium binds most favorably with imaging compounds when it has a valance of?
10 mCi
99m Technicium, 201 Thallium, 67 Gallium
trapped by the thyroid gland
99mTc pertechnetate can be used for thyroid imaging because it is:
1 Bq
= one decay per second
SPECT filtered backprojection images
A "Ramp" filter is used for?
8
A "byte" contains how many "bits"?
synchronic
A "normal" heart beat is:
uniformity map error
A "ring" or "bullseye" artifact occurs in SPECT images because of which type of error?
16
A "word" contains how many "bits"?
15 min
A 6,000,000 count SPECT study is performed on a phantom. The count rate of the phantom is 400,000 counts per minute. If the acquisition is to have 64 stops (projections) over 360° the how long will it take to acquire the study? *Refer to Nuclear Med Math Review Book pages 147 to 149
93,750 cts per proj.
A 6,000,000 count SPECT study is to be performed on a phantom. The count rate is 400,000 cpm from the phantom. If the acquisition is to have 64 stops over the 360() acquisition then approximately how many counts will be acquired at each stop or projection?* Refer to Nuclear Medicine Math Review Book pages 147 to 149
0.23 minute per stop
A 6,000,000 count SPECT study is to be performed on a phantom. The count rate of the phantom is 400,000 cpm. If the acquisition is to have 64 stops over the 360 () then what will the time per projection be?
160 mCi
A 99Mo/99mTc generator is calibrated for 1.00 Ci of 99Mo at 7 AM Monday. The generator is eluted daily Monday through Friday at 8:00 AM, but the workload is especially heavy on Friday so the generator is eluted again at 3:00 PM to obtain more 99mTc. Assuming 100% elution efficiency, how many mCi of 99mTc will be eluted at 3:00 PM Friday?
0.56 ml
A 99Mo/99mTc generator is eluted Monday at 7:00 AM, producing 1.8 Ci of 99mTc in the eluate vial, in 20 ml saline. What volume of eluate should be withdrawn from the eluate vial into a syringe in order to inject a patient with 20 mCi of 99mTc at 3:00 PM? (Given the mc004-1.jpg of 9mTc is 6.02 hours.)
2 pm
A 99Tc pertechnetate solution has a concentration of 60mCi/ml at 8 am. What is the leatest time that a 0.5 ml bolus injection of 15 mCi may be administered to a patient? (1-hour decay factor is 0.891)
1.99 mci
A Co-57 dose calibrator reference source has an activity 5.05 mCi on the caliration date of 11-1-85. What is the activity of this source on 11-1-86?(half-life of Co-57 = 271 days)
Curies or Becquerels
A Dose Calibrator measures radiation in which unit/s?
contamination
A G-M counter is used to detect?
allergic reaction
A HAMA response in a patient increases the likelihood of which adverse condition?
ileum
A Meckels diverticulum is a congenital out-pouching containing ectopic gastric mucosa usually located within the distal 100 cm of the:
5 years
A Medical Event Misadministration (either Incident event or Medical Event) record must be kept for _____ according to the NRC?
no
A Mo-99 - Tc-99m generator is eluted at 8:00 am. Fifty uCi of Mo-99 is found in 200 mCi of Tc-99m. Can this material be used to prepare a 15 mCi dose of Tc-99m for brain scanning?
mean
A Poisson distribution can be completely described by the:
1%
A SPECT uniformity flood should have less than __ % statistical uniformity error.
treadmill testing using the "Bruce" protocol
A Tc-99m PYP scan would require all of the following for the best scan results EXCEPT:
34.5 mCi/ml
A Tc99m / Mo99 generator was calculated to contain 395 mCi of Tc99m on Tuesday morning when it was eluted with 10 ml of normal saline at 6 a.m. in the morning. When assayed in the dose calibrator the elution measured 345 mCi. What is the specific concentration?
87%
A Tc99m / Mo99 generator was calculated to have 395 mCi of activity on it's column at 8 a.m. on Monday morning. When the technologist elutes the generator with 10 ml of normal saline they obtain 345 mCi when it is assayed in the dose calibrator. What is the elution efficiency of the generator?
Carcinoembryonic Antigen (CEA)
A Tc99m Arcitumomab scan is done on patients whose tumor markers are rising as determined by laboratory tests.
lungs
A Tc99m sulfur colloid kit was made up. Upon performing the quality control on the kit it was observed that the alumina content was 20 ug /ml. Based on that information which organ would the material likely go if injected into a patient and the alumina levels that high?
bone
A _____ scan accomplished within 48 hours before brain scintigraphy using 99mTcO4- may cause a false-negative brain scan.
2 (on/off) or (0 and 1)
A binary digit (bit) can have how many "states" of operation?
62 kev
A certain atom has a K-shell binding energy of 70 kev and a L-shell binding energy of 8 kev. If an electron makes a transition from the L to the K-shell, the radiation emitted will have ________ energy.
34
A charge particle moving through air loses approximately ________ eV for every ion pair produced.
spatial definition for patient imaging
A collimator is used on a scintillation camera to provide:
High Resolution
A collimator that has a long bore and narrow holes would be classified as?
the law of constant composition
A compound, regardless of its origin or method of preparation, always contains the same elements in the same proportions by weight; this is called:
improves sensitivity, sensitivity decreases
A converging collimator _____ as one moves away from the collimator face until one reaches the focal point, beyond which the _____.
it is unstable and must be administered within 30 minutes of preparation
A disadvantage associated with imaging with 99mTc HMPAO is that:
pentagastrin
A dose of _____ helps concentrate 99mTcO4- in a Meckels diverticulum containing ectopic gastric mucosa.
cholecystokinin
A dose of _____ may allow a previously non-visualized gallbladder to accumulate activity.
0.38
A drop of Tc99m MDP is placed on a chromatography strip. The distance the solvent moves is 6 cm from the origin (drop of MDP). The distance the component (free and hydrolyzed reduced Tc99m) moves from the origin is 2.3 cm. What is the Relative Flow (Rf) of this radiopharmaceutical?
98%
A drop of Tc99m disofenin is placed on a chromatography strip and then into the solvent bath. The chromatography strip is then removed from the solvent and cut in half with a pair of scissors. Part "A" is 1/2 of the paper strip and Part "B" is the other half. Part "A" contains the solvent front and radioactive component while Part "B" contains the origin. When placed in a well counter Part "A" acquires 250 counts and Part "B" acquires 10,000 counts. What is the percent (%) labeling of the disofenin?
sinus infection
A false positive 111 In-white blood cell scan may be due to increased abdominal uptake in a patient:
173 cpm/uCi
A gamma camera took 187.568 minutes to acquire a 5,000,000 count uniformity flood. The background count was determined to be 10,000 counts in 29.411 minutes. The source used was 152 uCi of *99m Technicium as a point source. What is the approximate sensitivity of the gamma camera? *Refer to pages 147 to 149 in the Nuclear Med Mathematics Review Book
chi-square test
A good test to measure the stability (count probability) of your new well counter is:
positioning of statics for non BBB crossing RPs
A good vertex view will have visualization of the transverse and sagittal sinuses. Laterals should show the transverse sinus
2.4
A liver scan has been ordered for a child weighing 44lb. if the activity administered to adults is 5 mCi99mTc sulfur colloid and the child-to-adult ratio is 0.48, what activity, in mCi, should be administered?
800000
A lung scan kit was prepared at 8 a.m. with 20 mCi in 5 ml and a total of 2,000,000 MAA particles in the vial. The first lung scan patient received 4 mCi in 1 ml with 400,000 particles at 8 a.m. An emergency lung scan was ordered at 2 p.m. (6 hours later) and that patient received a dose of 4 mCi. How many particles of MAA did the second emergency lung scan patient get in their injection?
262,144 Words
A lung scan was acquired in static mode utilizing a 256 x 256 matrix in byte mode. If eight (8) images were taken (anterior, posterior, Rt. lateral, It. lateral, RAO and LAO) how much memory in WORDS would it take up in the computer?
filter
A mathematical algorithm that is used to decrease statistical noise in an image or to enhance edges of an image by removing or reducing frequencies that make up an image is called?
85%-100%
A maximum exercise test indicates attainment of what % of the maximum heart rate.
1.02
A minimum of ________ MeV is required for pair production.
medical event
A misadministration error where the patient was scheduled for a bone scan. They were to receive 20 mCi but received 120 mCi instead. This resulted in a an effective dose equivalent of 7 rem to the whole body
incident event
A misadministration error where the patient was supposed to receive 8 mCi of Tc99m sulfur colloid intravenously for a liver spleen scan but was given it orally by mistake
incident event
A misadministration error where the patient was supposed to received a dose of 10 mCi of Tc99m Sestamibi for a heart scan but received 15 mCi instead, resulting in a effective dose to the heart and surrounding tissue of 1.5 rem.
50 Rem or 500 mSv
A misadministration occurs if the Effective Dose Equivalent to any organ or tissue exceeds:
20
A misadministration occurs when the administered dose and the prescribed dose differ by more than __ %.
ileal loop
A neobladder made from a portion of the small bowel is called:
an organification defect
A nodule of the thyroid which appears "warm" on a 99mTc scan, yet appears "cold" on a 123I scan, is most likely due to
determining proper scan speed
A nomogram is used for:
-a sharp rise in kidney activity for the first few minutes -exponential drop in activity for the next 20 minutes. -equal perfusion and washout in both kidneys
A normal renogram can be described as what?
well counter
A nuclear medicine technologist is going to measure the wipe tests that were performed at the end of the day. The instrument with the highest efficiency for this is usually:
internal conversion
A nucleus decays by isomeric transition with emission of a gamma ray or by:
excited
A nucleus, which has more energy than it has in the ground state, is said to be a(n) ______ state.
yellow 11
A package arrives with a surface reading of 10 mrem/hr; the label should be:
Radioactive Yellow II and Transportation Index of 0.8
A package containing a 2.8 Ci 99Mo/99mTc generator produces radiation levels of 0.8 mR/h at 1 meter and 35.0 mR/h at the surface of the package. Which of the following labels would be required for this package?
Category I
A package containing radioactive material is monitored and found to have the following exposure rates: At package surface ?..0.4 mR/hr At 1 meter from surface ?..no detectable radiation Which of the following DOT labels should be affixed to the outside of the package?
Category II
A package containing radioactive material is monitored and found to have the following exposure rates: At package surface ?..12 mR/hr At 1 meter from surface ?..0.9 mR/hr Which of the following DOT labels should bed affixed to the outside of the package?
decrease in resolution
A patient appears anxious so the camera, fitted with a parallel hole collimator, is moved 10 cm farther away from the patient. An expected consequence would be:
90Y-Ibritumomab tiuxetan or 131I-tositumomab
A patient arrives in a nuclear medicine department for therapy for non-Hodgkin's lymphoma (NHL). The dose for this patient's therapy could be either:
increased rate of RBC production
A patient can have anemia but have a normal hematocrit because:
adrenal gland
A patient has a possible pheochromocytoma. The technologist should prepare to image:
right-to-left shunt
A patient has an NM lung scan. Once the particles have been injected, the technologist notices activity in the brain and other organs. The technologist recognizes this to be:
P32 sodium chloride
A patient has polycythemia vera; the technologist will prepare the patient for the administration of:
2-3 hour delays
A patient is entering the osseous phase of a routine three-phase bone scan. The technologist should:
furosemide
A patient is scheduled for a diuretic renal imaging study. The technologist prepares the radiopharmaceutical and:
I-131 NP-59
A patient is scheduled for adrenal cortical imaging. The radiopharmaceutical the technologist would order for this study is:
prepare the tracer dose for intravenous injection.
A patient is scheduled for an indirect cystogram. The technologist should
less than 33 mCi
A patient may be discharged from the hospital if it is calculated that the activity remaining in the patient is?
33.3 mCi and no they can NOT be discharged
A patient measures 150 mrem/hr at 3 meters following a 100 mCi dose of 131 Iodine. The patient is monitored daily at 3 meters on the second day and a reading of 50 mrem/hr at 3 meters is recorded. How much activity is in the patient and can they be discharged from the hospital?
can be released if there is no significant increase in radiation exposure to the general public
A patient receives a thyroid ablation dose of 75 mCi of 131I. According NRC regulations, the patient:
24 hrs
A patient was injected with 131I on Monday at 10:00 AM. On Tuesday at 10:00 AM, the thyroid probe was placed over the thyroid and produced 100,000 counts. On Thursday at 10:00 AM, the probe showed 25,000 counts. What is the effective half-life in this patient's thyroid?
15.4
A patient weighs 200 lbs. The radiopharmaceutical recommends administering 0.17 uCi per kilogram of body weight. How much radiopharmaceutical should be given? (IKg =2.2 lbs)
> 7 mR/hr at 1 meter from the patient
A patient who received 100 mCi of 131 Iodine for thyroid cancer therapy is waiting to be discharged. Which radiation reading is considered "acceptable" for the patient to return home?
sublingual postion
A patient's thyroid gland is known to have developed but not to have migrated into the usual location. On the thyroid scan, the technologist would most likely see the patient's thyroid:
has excellent sensitivity
A pinhole collimator has all of the characteristics EXCEPT it:
focal hot spot
A positive finding on a Meckel's diverticulum scan appears as a:
focal hot area
A positive finding on a Meckels diverticulum scan appears as a
ewings sarcoma
A primary malignancy of the bone most often seen in children is:
Yellow III
A radioactive material shipment package measures 20 mR/hr at the surface and 5 mR/hr at 1 meter (Tl); what label should be put on the container?
8.8 mCi
A radioactive source of 137Cs (mc009-1.jpg = 30 y) was calibrated on October 23, 2000 to contain 10 mCi. This is used as a daily accuracy check source in the dose calibrator. Presuming the dose calibrator is working properly, what activity should the dose calibrator show on April 23, 2006?
delayed (> 1hr) gallbladder visualization but gut visualization within 30 minutes
A reliable sign of chronic cholecystitis in patients with recent symptoms from 99mTc choletec or 99mTc hepatolite scintigraphy is:
245,760 bytes
A renal flow study is acquired in a 64 x 64 byte mode for 60 frames. How much memory in the computer will be required to store the image in BYTE mode? * Pg 157 Math Review
suspect this to be normal
A renogram (time-activity curve) shows prompt uptake of the tracer, with activity in the kidney peaking at 3 to 5 minutes after injection and decreasing to less than 50% of peak value by 20 minutes. The technologist should:
Myocardial ischemia
A reversible condition caused by a deficiency in the supply of oxygen (blood) to the myocardium due to atherosclerotic narrowing of the vessel.
on the right hand with the thermoluminescent dosimeter (TLD) chip facing the palm of the hand
A right-handed nuclear medicine technologist puts on a ring badge before work. The ring should probably be worn:
600 plus or minus 37
A sample and a background are counted and result in 1000 and 400 counts respectively. The net count and standard deviation is __________ counts.
gain or high voltage
A scintillation detector system is calibrated by adjusting the:
Two (2) 8 bit bytes
A sixteen bit word contains BYTES?
12 mCi
A source of 18F (mc010-1.jpg approximately 2 hr) is noted to contain 3 mCi at noon. What was the radioactivity at 8 AM that same day?
87.5%
A source of Cr-51 is shielded by 6mm of lead. How much of the photon emission is attenuated by the shielding if it possesses a HVL = 2mm?
90 mCi
A source of mc002-1.jpg is delivered to the nuclear medicine department calibrated for 100 mCi at 0800 on Monday. If this radioactivity is injected into a patient at noon on the following Tuesday, what radioactivity will the patient receive?
• Primary & secondary hyperparathyroidism • Diffuse metastatic disease • Renal osteodystrophy
A superscan appearance on a bone scan can be caused by:
not exceed 500 mrem to the fetus during gestation
A technologist declares her pregnancy. Her exposure should:
2.1 ml
A technologist eluted a Tc99m / Mo99 generator at 8 a.m. and obtained 345 mCi of Tc99m in a volume of 10 ml of normal saline. The technologist needs to reconstitute a multi dose Methylene Disphosphonate Bone kit with 65 mCi of Tc99m to inject three patients in the waiting room at 9 a.m. How much volume should be drawn up to obtain 65 mCi at 9 a.m.? *Decay constant is 0.89 per hour
0.67
A technologist is handling a radiation source that has an exposure rate of 20 mr/hr. What is the dose to the technologist if they handle the source for 2 minutes?
have a bioassay between 6 and 72 hours after participating in the administration
A technologist is in the room when a patient receives a therapeutic administration of 131I sodium iodide for thyroid ablation. The technologist should:
0.51 ml
A technologist must administer 3 mCi of Thallous chloride at 1400 hours (2 p.m.) on June 7. If the concentration of radiopharmaceutical is 3.0 mCi/ml at 1200 hrs (12 noon) on June 10, what volume should be drawn up and administered to the patient on June 7? (Tl/2p = 74 hrs)
0.75 ml
A technologist must administer 5 mCi of Tc99m Mebrofenin to a patient at 12 noon. A kit was prepared with the following label: How much volume should be given based on this label information? Calibration time: 7:00 a.m. Total volume = 8.5 ml Activity = 100 mCi Concentration = 11.8 mCi/ml at 7 a.m.
recognize this as a pattern for a possible PE
A technologist performs a lung scan that demonstrates a relatively normal ventilation scan and is accompanied by a perfusion scan demonstrating segmental defects. The technologist should:
18 to 20 inches above vein
A technologist should be careful to keep a patient's IV solution:
178 mCi
A total of five patients are scheduled for bone scan from 8 a.m. until 1 p.m. If each dose requires 20 mCi per patient (100 mCi total) approximately how much Tc99m should be added to the kit at 8 a.m. to make sure there will be 100 mCi at 1 p.m.?
50 ml
A vial contains 250 uCi of Se-75 in 5 ml of fluid. The concentration is
11.67
A vial contains 350 mCi of Tc-99m in 30 ml of fluid. What is the concentration?
0.78
A vial contains 385 uCi of Co-57 in 3 ml of fluid. How many ml should be withdrawn from the vial to obtain 100 uCi?
0.26
A vial contains Tc-99m at a concentration of 58 mCi/ml. A dose of 15 mCi is desired. How many ml should be withdrawn into the syringe?
12.5 mR/hr
A vial of unshielded 99m Tc measured 100 mR/hr at 3 feet. What would the intensity be if three (3) Half value layers was used to shield it?
record the wipe test as negative for contamination
A wipe test is completed using a well counter that has 30% efficiency. The area being wiped has a reading of 60 cpm with a background count of 40 cpm. The Nuclear Medicine Technologist should:
10500 dpm
A wipe test was performed on a radioactive shipment. 300 centimeters squared was wipe down with filter paper and yielded 4200 counts per minute. According to department records this particular well counter had a resolving time of 100 mSec and an efficiency of 40%. What is the true dpm of the wipe test?
external measurements using a scintillation camera
Activity deposited in an organ of interest can be estimated by:
absent, increased, decreased
Activity on an abnormal cerebral radionuclide angiogram may appear as being:
contract sphincter of oddi
Administration of morphine sulfate serves to:
cholestrol compounds
Adrenal gland imaging can be accomplished with the use of radiolabeled ..
23-30 mCi
Adult dose range for bone scan
vascular tuft
Afferent arteriole delivers blood to the
10 minutes
After IV administration of sincalide contractile response of the gallbladder can be expected within how many minutes
24 hours
After a Mo-99/Tc-99m generator is eluted, it takes approximately how many hours for the Tc-99m activity to built up to a maximum level?
Caution: Radioactive Material
After administering a therapeutic amount of 131 Iodine to a patient what kind of "Radiation Sign" must be put on the door?
dry swallow every 15 seconds for 5 minutes while images are taken
After administration of the radiopharmaceutical for a radionuclide oropharyngeal study, the patient is instructed to:
(A) = 32, (Z) = 16
After beta-minus decay of P-32 (Element #15), the mass number (A) and atomic number (Z) become:
5 - 8 days
After dosing a patient with 150 mCi of I-131, how soon can a whole body metastatic survey be performed?
standing
After injecting a patient with 99mTc sulfur colloid, the technologist finds out that the patient had a barium enema earlier that morning. In order to improve image quality, the technologist would image the patient:
5-10 minutes
After injection of the radiopharmaceutical for a scintimammogram, when should imaging begin?
regular hospital garbage and biohazardous containers if used syringes, needles, etc. are present
After radioactive waste has been decayed to background radiation levels it can be disposed of in the _____ after the radioactive labels have been removed or defaced?
Tc99m MAG-3 (mercaptoacetyltriglycine) and I-131 OIH (orthoidohippuran).
Agents that measure effective renal plasma flow (ERPF) are
The State in which the material was produced
All accelerator-produced radionuclides fall under the jurisdiction of the?
provides better anatomic detail
All of the following are advantages of the use of radionuclide brain scintigraphy over the use of computed topography as a screening method for detecting brain lesions EXCEPT that brain scintigraphy:
fan beam
All of the following are parallel hole collimators EXCEPT:
the elution efficiency of the generator
All of the following factors affect the amount of 99mTc eluted from a 99Mo/99Tc generator EXCEPT:
lining imaging room walls with lead
All of the following practices are consistent with the ALARA concept as described in NRC regulations EXCEPT
Meckels diverticulum localization
All of the following procedures may be performed with 99mTc sulfur colloid EXCEPT:
One HVL of lead is the same thickness as one HVL of aluminum
All of the following statements about the half-value layer (HVL) are true EXCEPT:
meningioma
All of the following will produce a localized reduced perfusion appearance on a cerebral radionuclide angiogram EXCEPT:
accelerator produced radionuclides
All positron emitters are classified as?
Particulate
Along with electromagnetic, what is the other major category of radiation?
within the nucleus of a radioactive atom
Alpha particles are produced in the:
posses mass
Alpha particles differ from gamma rays in that alpha particles:
the molybdenum column
Alumina Trioxide is used in a Tc99m / Mo99 generator for?
An end window tube must be pointed directly at a radiation source to accurately detect it while a pancake probe does not need to be pointed directly at the source
An "end window" G-M tube is different from a "pancake" probe in that?
patient prep for brain scan
An I.V. line should be started 15-20 minutes before the tracer is administered. Patients should be injected with their eyes open and their ears unplugged in a low light, reduced noise, and minimal traffic environment. Environmental conditions should be maintained for 10 minutes before and after the tracer is given. This is specifically important if SPECT images are going to be obtained
auger effect
An alternative process to the emission of a characteristic x-ray is:
dobutamine
An asthmatic patient arrives for a pharmacologic myocardial stress test, the technologist will most likely perform the study using:
0.5
An average Tc-99m MAA pulmonary dose consisting of particles with a mean size of 30 um in a healthy patient blocks almost no lung capillaries but about _____% of precapillary arterioles.
photon that produces an ionized electron, which subsequently produces multiple ionizations
An example of an indirectly ionizing radiation is a(n):
pancreatic beta cells
An insulinoma originates in:
175,000
An intensity setting of 250 on a display screen may produce a suitable image for a bar phantom with 500K counts in the acquisition. Now it is desired to change to 350K counts in the image. The intensity on the screen is known to change linearly with the intensity control setting. What intensity setting should be used for the new 350K-count image?
Myocardial infarction
An irreversible condition leading to death of a portion of the myocardium caused by total occlusion of a coronary artery.
spacial resolution and linearity
An orthogonal-hole phantom is used when testing an imaging system's:
radioactivity
An unstable nucleus will become stable by ejecting portions of its nucleus or by emitting energy (γ rays).
reduced number of RBCs
Anemia refers to a condition of
- vasoconstriction - aldosterone secretion - thirst - ADH secretion
Angiotensin II promotes what
characteristic xrays
Another term for fluorenscent x-rays is
Radiation: Restricted area
Any location where the radiation measurement is greater than 2 mRem in one hour but less than 5 mRem in one hour at 30 em from the radiation source
randoms
Apparent coincidence events caused by unrelated photons instead of actual annihilation radiation event photons are called?
• Upper and lower extremities • Pectoral and pelvic girdles
Appendicular skeleton consists of:
4%
Approximately ____% of administered 201Tl localizes in the myocardium immediately after a stress study.
1200 ml
Approximately how much blood enters the renal arteries per minute?
4%
Approximately what % of the administered dose localizes to the myocardium which is about the percentage of cardiac output supplied to the coronary arteries.
avascular necrosis
Areas of increased activity noted on bone images occur from all of the following except:
the hepatic artery
Arterial blood is delivered to the liver through
at least 2
As a general rule, a lesion should be seen on _____ view(s) before the brain scan is considered positive.
high sensitivity
As compared to a low-energy collimator, a high-energy collimator will have all of the following EXCEPT:
greater
As particle LET increases, ________ biologic damage usually occurs.
resolution
As the Sensitivity of a collimator increases, which factor DECREASES?
increases
As the energy of the x-ray photon increases, the probability of Compton scatter occurring:
reduced
As the sample volume is increased, well counting efficiencies are:
sensitivity increases
As the window becomes WIDER on a pulse height analyzer; what happens to the sensitivity of the gamma camera?
2 hours
Assuming the biological half-life of 99mTc-MAA is 3 hours, what would be the effective half-life?
606 mCi
At 3:00 pm, a sample of 99mTc has an activity of 270 mCi. What was its activity at 8:00 am?
decay equation
At = A0e^-0.693t/T1⁄2
3 inches
At a distance of 30 inches a source measures 0.5 mR/hr. At what distance will it measure 50 mR/hr?
120 mg/dl
At the time of a PET scan, the blood glucose level should ideally not be above:
internal and external carotid arteries
At the upper portion of the thyroid cartilage, the common carotid arteries bifurcate into the:
neutron and protons
Atomic mass of an element is the total number of ____ in the atom.
isotopes
Atoms that differ only in the number of neutrons present in the nucleus are called:
• Skull • Vertebral column • Sternum • Sacrum and coccyx
Axial skeleton consists of:
pyrogen testing
Bacterial endotoxin testing (BET) is used for:
advantageous to perform the ventilation prior to the perfusion
Because of the importance of the wash-out phase in a xenon ventilation study, it is technically:
creatinine level
Before the administration of radiopaque contrast media (ROCM), the technologist should know the patient's:
hemangioma
Benign tumors of dilated blood vessels Typically cold defect on flow and immediate statics. They increase in intensity over time becoming hypervascular. Smaller ones can be detected with SPECT.
Uptake probe
Between a well counter and an uptake probe, which device can handle higher counting rates?
131 iodine
Bioassays are primarily done on technologists who administer which radionuclide?
afferent arteriole
Blood enters the glomerulus via
resolution is improved
Body contour orbits improve image quality over circular orbits because ______________ with the detector closer to the patient.
-30%-50%
Bone demineralization changes of what % must occur before density changes can be distinguished on x-rays.
• Explanation of the procedure • Rule out pregnancy • Drink lots of fluids • Urinate frequently • Have patient urinate right before imaging and remove all attenuating articles from patient.
Bone scan patient preparation:
epiphyses
Bone scans in pediatric patients will show increased uptake where?
generalized decreased skeletal activity
Bone scans of patients with long-term steroid will appear as having:
2
Bowman's capsule has ____ layers
PM tube
By changing your instrument's high voltage, you are changing the voltage to your:
0.02 mcg/kg
CCK dose
Tc99m Ceretec (HMPAO) and Tc99m Neurolite (bicisate)
CNS RPs
The narrowest bar spacing in the phantom was too wide to detect changes.
Clinical images obtained from a scintillation camera have recently deteriorated in quality, but routine flood and bar phantom images appear unchanged. Which of the following statements best explains this discrepancy?
benign and malignant
Cold goiter is related to
sensitivity
Combining efficiency and geometry results in:
• Neoplastic disease • Occult fracture • Osteomyelitis • Avascular necrosis • Stress fracture • Paget's disease • Detect loosening of hip/knee prosthesis • Abnormal PSA levels • Abnormal alkaline phosphatase levels
Common indications for a bone scan:
• MDP (methylene diphosphonate) • HMDP (hydroxymethylene diphosphonate)
Common radiopharmaceuticals used for bone scan
early satiety, bloating, nausea and vomiting
Common symptoms of delayed gastric emptying
ZERO
Compared to electrons, gamma rays have a charge of:
outer shell electron
Compton scatter is an interaction between an incidental x-ray photon and:
thyroxine and tetraiodothyronine
Coupling of two diiodotyrosine molecules results in the formation of ___.
a type of hypothyroidism seen in infants and children with an inherited enzyme defect.
Cretinism is ...
bladder
Critical organ of bone scan
dioiodotyrosine
DIT=
death of zygote
Damage to the developing embryo from 5 rad at 10 days post fertilization can result in:
68 %
Data from a hepatobiliary study are given below. What is the ejection fraction of the gallbladder? Net maximum gallbladder counts = 235,000 Net minimum gallbladder counts = 75, 000
decay schematics
Decay of a nuclide from unstable state to stable state can occur in a series of steps. Standard notation is used to describe these steps.
• Bone cysts • Avascular necrosis • Multiple myeloma • Bone infarction
Decreased tracer accumulation can be caused by:
Addisons disease
Deficient secretion of aldosterone by the adrenal glands
grave's disease
Diffused goiter is related to
P-C-P
Diphosponates have what mind of bond?
a neutron, a proton, or an alpha particle is subsequently ejected from the nucleus.
During photo disentegration
subdural hematoma
During planar brain imaging using radiopharmaceuticals that do not penetrate the intact blood-brain barrier, the "crescent sign" is highly suggestive of what condition?
a tumor with central necrosis an abscess a hematoma
During planar brain imaging using radiopharmaceuticals that do not penetrate the intact blood-brain barrier, the "doughnut sign" may be indicative of:
particle size in the solution
During routine lung imaging with 98mTc MAA, liver accumulation is noted.Which of the following quality control parameters would best explain this finding?
speed up imaging time by causing the salivary glands to quickly excrete the 99mTcO4-
During salivary imaging, a dose of Perchlorate or a few drops of lemon juice is given to the patient to:
600 ml/min
ERPF is approx.
the chemical reactions that all members of the family undergo
Each family of simple organic compounds is characterized by a functional group that determines:
5 uCi
Each patient dose of Tc-99m shall not contain more than _____ uCi of Mo-99.
(ED-ES counts)/(ED counts) x 100 = EF
Ejection fraction calculation:
0.5 Rem (5 mSv)
Embry of Fetus dose for the entire pregnancy
immediately
Emptying of the liquid meal begins when
80-140 kVp
Energies required for typical PET/CT studies of the body will be in the range of:
applied to the image as scintillation events are acquired
Energy correction is:
99Tc pertechmetate
Epididymitis and testicular torsion are differentiated using what radiopharmaceutical?
one area is imaged for preset counts with the time recorded and all subsequent images are taken for that same time interval.
Equal-time imaging for bone scanning refers to the technique in which:
Internal Conversion
Excited nucleus emits energy in form of gamma ray; gamma ray hits and ejects electron (Auger Electron); outer electron fills inner electron vacancy; characteristic x-ray emitted (can eject another electron continuing cycle).
Isomeric Transition
Excited nucleus emits energy in form of gamma rays (aka photon).
47%
F-18 has a decay constant of 0.0063 min-1. What percentage of the activity will be left after 2 hours?
Nuclear Regulatory Commission
Federal Facilities (VA Hospitals and Military Hospitals) within agreement states are regulated by?
daily
Field uniformity of the gamma camera is required to be performed?
esophageal motility disorder
Fifteen minutes following the oral administration of 300 ml orange juice containing 99mTc sulfur colloid, a patient?s esophagus is visualized. If the activity persists after the patient drank 30 ml of water, the most likely cause would be:
spontaneous; induced
Fission may be _____ or _____.
Larger than normal
Flocculation or "clumping" causes the Tc99m sulfur colloid particles to become?
hepatic polygonal cells
Following IV administration, 99mTc-Sn-DISIDA is extracted via active transport from the blood by
a characteristics x-rays or Auger electron
Following a photoelectric event, an absorber atom is most likely to emit:
have patient lie down
Following a procedure, a patient experiences syncope. The technologist should:
at 6 hours
Following the injection of 67Ga-citrate, imaging can begin:
photon energy loss increases as scattering angle increases
For Compton scattering the relationship between photon energy loss and scattering angle is:
-a whole-body sweep -a SPECT on the area of interest -10 minute statics
For an In-111 Octreotide scan, you will perform
carbon dioxide and hydrogen
For breath testing with 14C-labeled compounds, the two most important gases of the five principle colonic gases for breath analysis ar
ionization
For gas-filled detectors the saturation voltage is found in which region?
contain an excess of 1.02 Mev energy
For positron emission to occur the parent nucleus must
radiochemical
Free I-131 in a I-131-triolein capsule is an example of a _____ impurity.
resolution
Full width at half maximum (FWHM) is a measurement of:
the base of the tongue, along the esophagus or in the mediastinum.
Functioning thyroid tissue is sometimes found
rule out ureteropelvic obstruction
Furosemide is sometimes administered during renal imaging to:
pre CCK cts - post CCK cts/pre CCK cts x 100
GBEF equation
systemic blood pressure and the diameters of both the afferent and efferent arterioles
GFR depends on:
120 ml/min
GFR is approx.
Tc99m labeled RBCs
GI bleed RP
Focus of tracer activity which usually becomes more intense w/time and is not related to abnormal structures.
GI bleed abnormal results
Heart
GI bleed critical organ
20-30 mCi
GI bleed dose range
60 sec/frame for 60 minutes.
GI bleed dynamic protocol
-LEAP or LEHR -FLOW: 2-5 sec/frame for 60-180 seconds.
GI bleed flow protocol
Detection and localization of bleeding sites in patients with active or intermittent GI bleeding. Detection and localization of secondary blood loss.
GI bleed indications
compartmental
GI bleed localization
-Heart and great vessels prominent. -Bladder, bowel and penile activity likely.
GI bleed normal results
none
GI bleed patient prep
-500-2,000 kcts -Patient supine - camera anterior. -Field of view to cover from base of the heart to the symphysis pubis (include bladder).
GI bleed static protocol
origins
Gamma rays differ from x-rays in that they have different:
oxygen
Gases commonly used in gas-filled detectors include all of the following EXCEPT:
any activity is visualized in the esophagus
Gastroesophageal reflux scintigraphy is considered positive when:
active transport
HIDA RP localization
Tc99m Choletec (mebrofenin) or Tc99m Hepatolite (disofenin).
HIDA RPS
-Nonvisualization of the -Nonvisualization of the gallbladder within 1 hour w/ common bile duct and bowel activity (suspicious for acute chole). Generally morphine is given at this time or patient is brought back for delayed imaging. -Nonvisualization of the bowel within 7 hour w/visualization of gallbladder (possible sphincter of Oddi dysfunction). Have patient walk around for a couple of minutes and then reimage. -Nonvisualization of the gallbladder or bowel at 1 hour with liver uptake (suspicious for complete or near complete hepatic duct obstruction). -Pooling of activity either in area of extracted gallbladder or in abdominal cavity adjacent to area. -Ejection fraction of less than 35%. small bowel.
HIDA abdnormal results
large intestine
HIDA critical organ
5-10 mCi (higher dose given to patients with elevated bilirubin concentration).
HIDA dose range
-LEAP or LEHR collimator -Dynamic study = 60 sec/frame for 60 minutes (anterior or LAO). -Statics = 90-180 seconds or for approx. 750 kcts (anterior w/marker, LAO, right lateral, etc).
HIDA imaging protocol
Evaluation of cholecystitis, evaluation of obstruction, evaluation for biliary leak, evaluation of biliary atresia in children.
HIDA indications
-Ejection fraction 35% or greater. -Gallbladder within 5-20 minutes up to 60 minutes. -Intestinal activity visualizing and moving 10-60 minutes. -No pooling of activity around liver or in abdomen after cholecystectomy.
HIDA normal results
PT to be NPO for 4-6 hours, no opiates for 4 hours prior to imaging (morphine, Demerol, etc.)
HIDA patient prep
density (atomic number Z) of the absorber
HVL decreases with
increasing photon energy
HVL increases with
increases resolution
Hardware magnification or zoom:
there will be a more homogenous distribution of particles
Having patients for lung scans injected with the macroaggregate albumin (MAA) while supine is important because:
acute cholecystitis
Hepatic uptake and gut excretion of 99mTc IDA analogs without gallbladder visualization at 4 hours is indicative of:
the liver, gallbladder and biliary ducts leading to the duodenum.
Hepatobiliary system consists of
Low-pass filter
High frequency noise (statistical count rate fluctuations) are best decreased with which type of filter?
28 KeV
How WIDE is the window for a 20% window utilizing a 140 KeV *99m Tc radionuclide?
utilizing filters
How does a Thermoluminescent dosimeter determine whether the radiation it detected was penetrating or non-penetrating?
3 years
How long must records pertaining to survey and inspection of radioactive material shipments be maintained?
at least 4 hours
How long should patients be NPO for myocardial perfusion imaging?
32,768
How many bytes of memory are required to store a 128 x 128 x 16 image?
753
How many disintegrations/minute will give a count rate of 640 cpm when measured by a detector with an efficiency of 85%?
16,384
How many pixels are utilized by the computer if a 128 x 128 matrix is used?
99%
How much of the glomerular filtrate is reabsorbed through the renal tubules into the bloodstream?
annually
How often must a dose calibrator accuracy test be performed?
Reticuloendothelial (stationary phagocytic cells in the liver, spleen and bone marrow)
Hydrolysed-Reduced 99m Technicium will localize primarily in which system or organ?
• Calcium • Phosphate • Hydroxl ions
Hydroxyapatite salts of the bone consist of:
Cushings syndrome
Hypersecretion of glucocorticoids by the adrenal glands, associated with a tumor or excess stimulation by the anterior pituitary
Propothyouricil (PTU) and other thioamide derivatives
Hyperthyroidism may be treated medically with the use of (you may chose more than one)
cretinism
Hyposecretion of thyroid hormones during the growth years results in
grainy or pixelated
IF a study is "underfiltered" (critical frequency set too high) the image will be?
319
If 375 mCi 99mTc are present on the column of a 99Mo generator and the generator has an 85% generator efficiency, what is the amount of 99mTc that you could expect to elute from this generator?
3.5 mL
If a dose calibrator linearity test begins withassaying 50 mCi of 99mTc pertechnetate, for how long must the test be carried out to comply with NRC regulations?
7 mR/hr
If a dose calibrator linearity test begins withassaying 50 mCi of 99mTc pertechnetate, for how long must the test be carried out to comply with NRC regulations?
Obtain a survey meter and measure the radiation intensity at 1 meter and at the surface of the package
If a package containing radioactive material appears damaged or wet on visual inspection, the technologist must first:
Tumor uptake of 18 F FOG will be decreased
If a patient is HYPERGLYCEMIC the uptake in the tumor will be effected in which way?
0.1 rem
If a person is likely to receive more than _____ from a patient who was discharged after receiving radioactive material, written instructions must be given to the patient and other individuals as to how to minimize their exposure.
4.2 mR/hr
If a point source produces an exposure rate of 30 mR/hr at a distance of 15 cm, what is the exposure rate at 40 cm from the source?
correct dose, correct radiopharmaceutical, incorrect route of administration
If a technologist injects a patient with 1 mCi of 99mTc DTPA, intravenously, for a ventricular shunt study, the administration of the radiopharmaceutical is:
629 KeV to 695 KeV
If a well counter or uptake probe has an Upper and Lower Level Discriminator (ULD and LLD) and *137 Cesium (662 KeV photopeak) is being counted with a 10% window; The upper and lower level discriminators should be set at?
6,600 disintegrations per minute
If an area of 300 cm squared was wipe tested, what is the highest reading that could be acceptable of no evidence of surface contamination?
smoothed too much
If an image is processed and the critical frequency is set too low (over filtered) the image will be?
120 ml/min
If normal effective renal plasma flow is about 600 ml/min, normal glomerular filtration rate is:
subcutaneously
If peripheral veins are inaccessible for brain scintigraphy using 99mTcO4- in a pediatric patient, the radiopharmaceutical may be administered:
22 disintegrations per minute per centimeter squared
If removable contamination exceeds on the wipe test, the NRC and the carrier need to be notified.
Misshapen or distorted image
If the "X" and "Y" ratio circuit is out of alignment it will primarily effect the image on the gamma camera in which respect?
75%
If the HVL of Co-60 in lead is 1.25 cm, what percentage of Co-60 photons is absorbed from a Co-60 source shielded with 2.5 cm of lead?
positron emission or electron capture
If the N/P ratio is too low for stability radio active decay is accomplished through either
reduced to one-quarter of the original exposure rate.
If the distance between a radiation point source and a survey meter is doubled, the measured radiation exposure rate is:
0.6 em/pixel
If the distance between two (2) radiation sources measures 30 em with a ruler on the surface of the detector and measures 50 pixels on a computer matrix; what would be the pixel size? *Page 38: Nuclear Medicine Review of Mathematics
175 mCi
If the following reagents are available, what is the maximum amount of 99mTc HDP, in mCi, that can be prepared from one kit? HDP Kit,Maximum 99mTc activity to be added: 250 mCi,Reconstituting volume: 1.0-5.0 ml,99mTc Pertechnetate,Concentration: 35.0 mCi/ml,Total volume: 10ml
4 hours
If the gallbladder, common bile duct, and the duodenum are not visualized within 1 hour on 99mTc choletec or 99mTc hepatolite images, delayed imaging should continue hourly up to:
3 pm
If the generator was eluted at 8 a.m. and it was determined there was 25 uCi of Mo and 345 mCi of Tc99m. At approximately what time of day will the concentration of 99 Molybdenum be unacceptable for the elution to be used because the allowable limits are exceeded? Formula: - In (uCi of Mo99 / mCi of Tc99m) / 0.105 - 18.03 Formula: 9.531 x 1n (0.15 / x) where x = uCi of Mo99 / mCi of Tc99m
0.9 cm
If the half-value layer (HVL) for I-131 in lead is 0.3 cm, what is the minimum thickness of lead that is required to reduce the exposure rate of an I-131 source from 12 mR/hr to below 2 mR/hr?
4500 mR/hr
If the radiation intensity from a point source is 500 mR/hr at 3 m from the source, what is the radiation intensity at 1 m?
0.7 m
If the radiation intensity of a point source at 0.5 m measures 36 mR/hr, at what distance will the intensity be halved?
Flocculation (clumping) of the Tc99m sulfur colloid
If too much alumina is present in the elution when Tc99m sulfur colloid kits are prepared, which problem is likely to occur?
prefiltering and reconstruction filtering
Image filtering in SPECT reconstruction images usually includes:
show decreased activity in salivary tissue w/patchy decrease in concentration
Images of a patient w/Sjögren's syndrome typically show
as a liquid meal
In 99mTc sulfur colloid gastroesophageal reflux scintigraphy, the radioactivity is delivered to the patient:
The scattered photon travels in the same direction as the electron.
In Compton scatter a photon interacts with an atomic electron. Which of the following statements is NOT true about such an interaction:
scatters with a loss of energy
In Compton scattering, the incoming photon:
to compensate for the variable attenuation in tissues
In PET imaging, the purpose of a transmission scan is:
creates streak/star artifact
In PET reconstruction, filtered back-projection:
requires less time per projection
In SPECT imaging, increasing the patients dose of radiopharmaceutical injected for a scan has what effect on the amount of time required for a projection?
electronic collimator
In a PET scanner, the determination of the annihilation event is made possible by:
weekly
In a PET system, gain update calibration should be performed at least:
in the center
In a bull's-eye display of SPECT myocardial perfusion images, the apex of the ventricle appears:
each crystal
In a dedicated PET scanner, reflective material surrounds:
resolving time
In a gas-filled detector system, the time representing how long it takes to count a given event is called:
attenuation correction for the PET portion of the exam
In a hybrid PET/CT scanner the CT portion of the study is primarily used for?
bore diameter decreases
In a needle, as the gauge increases:
less than 10 minutes
In a nonobstructed kidney, the washout half-time after Lasix administration is how long?
gallbladder by 30 minutes and the GI tract by 45 - 60 minutes
In a normal hepatobiliary study, one would expect to see the:
amount of change
In a phase analysis of a cardiac wall-motion study, the amplitude represents the:
same as the half-life of the parent (=T1)
In a radionuclide generator, once TRANSIENT equilibrium is reached, the APPARENT half-life of the daughter (T2) is:
ion
In a radionuclide generator, the radioactive material is absorbed on a(n) _____ exchange column.
total lung capacity
In a ventilation study, the single-breath image following a bolus of xenon gas demonstrates:
isotope
In an (n, gamma) reaction, the product is always an _____ of the target.
localization of the appropriate pixel into which the gamma event is recorded
In an imaging computer system, the ADC allows for the:
tungsten
In an x-ray tube the anode, for the most part, is most commonly constructed from
low energy bremsstrahlung xrays
In an x-ray tube, a low kVp results in:
produced via bremsstrahlung
In an x-ray tube, the x-rays are predominately:
Bremsstrahlung and characteristic x-rays increase
In an x-ray tube, when the milliamperes (mA) are increased
1022 Kev
In annihilation, the energy released is:
a neutrino carries off part of the energy
In beta decay the beta particles usually carries off less than the energy available (E(max), transition energy) because:
decreases by one
In beta minus decay, the number of neutrons in the nucleus:
the electron is created at the moment of emission
In beta-minus (negatron) emission:
a neutrino carries off part of the energy
In beta-minus decay, the beta particle usually carries off less than the available energy (Emax) because:
long axis of the left ventricle
In cardiac SPECT imaging, the transverse slices are reoriented along the:
right ventricle, septum, and posterior wall
In cardiac SPECT imaging, the transverse slices are reoriented along the:
immediately
In cerebral radionuclide angiography, the scintillation camera should be started _____ after the injection of the radiopharmaceutical.
it will take longer for the patient to achieve the necessary heart rate
In comparison with the Bruce protocol, when using a modified Bruce protocol for myocardial stress imaging, it is important to remember that:
kshell
In electron capture the electron is usually captured from:
-1
In electron capture, the Z number changes by:
alveoli
In emphysema, the main damage is to the
0
In gamma emission, the mass number changes by:
at a diminished rate
In general, and compared to normal thyroid tissue, at what rate do thyroid carcinomas trap iodide, as well as produce and store thyroid hormone?
chemical
In measuring the amount of Aluminum present in the elution, what type of impurity is being assessed?
myocardial creep
In myocardial perfusion imaging, it is recommended that SPECT imaging begin about 10 minutes after high-level stress exercise to avoid
brain
In normal physiologic conditions 99mTcO4- accumulates in all the following sites EXCEPT the:
thyroid follicle
In normal thyroid physiology, where is the site of most T-3 & T-4 storage?
resolution
In nuclear medicine, the ability of a system to accurately depict two separate events is called:
injection, inhalation, and ingestion
In nuclear medicine, unstable isotopes are administered by:
fission to larger fragments
In nuclear reactor when an irradiated target nucleus absorbs a neutron which one of the following nuclear processes does NOT take place:
reduced to Tc (IV)
In order to bind Tc to phosphorus-oxygen compounds for bone scanning the Tc must be
the liquid and solid phase empty in a similar fashion
In patients with a partial gastrectomy:
isobar
In positron decay the resulting product is
positively charged electron and a neutrino
In positron decay which of the following is emitted
Z number decreases by 1
In positron decay which statement is true
chronic rejection
In renal transplant evaluation, what is typically seen as poor perfusion, poor uptake, flow progressive excretion.
ANT (acute tubular necrosis)
In renal transplant evaluation, what typically is associated with good perfusion, poor uptake with little or no excretion.
the end point of scatter interactions of photons in the crystal
In scintillation spectrometry, the Compton edge represents
analytic balance
In setting up a laboratory where mass measurements of solids in small quantities are routinely required, the technologist should be certain to include a(n):
86
In the 99Mo/99mTc generator, the percentage of 99Mo that decays to 99mTc is:
1000
In the adult human, the approximate number of capillaries per alveolus is:
are used to detect disease elsewhere
In the evaluation of primary bone neoplasms, bone scans
an electron is raised to a higher energy level
In the excitation of an atom:
has an energy equal to that of the photon minus the binding energy of the electron
In the photoelectric process, a photoelectron is ejected from the atom. The electron:
is completely absorbed
In the photoelectric process, the incoming photon:
13.5 mCi/ml
In the preparation of Tc99m Sulfur Colloid the following materials were observed: The generator eluted Tc99m concentration is 450 mCi in 10 ml of saline = 45 mCi/ml Reaction Vial = 3 ml of Sodium Thiosulfate Maximum volume the reaction vial can contain = 10 ml Syringe A = 2 ml of Hydrochloric Acid Syringe B = 2 ml of Buffer solution Maximum Tc99m Activity that can be added to the vial = 200 mCi Maximum volume of Tc99m that can be added to the vial: Range of 1 to 3 ml What is the MAXIMUM final Specific Concentration that can be obtained from this kit?
separating the organ from the background or nearby structures
In the reconstruction of SPECT images, segmenting refers to:
Saturation - ionization
In which gas region does an ionization type radiation meter work?
positron
In which type of decay would the z number decrease by one
overestimate of red blood cell mass
Inadvertently damaged red cells are injected when a red cell mass determination is being performed. This can result in:
degenerative changes
Increased activity noted in the lower cervical spine on a whole body bone scan on an older patient is most likely due to:
pituitary microadenoma
Indications for SPECT perfusion imaging include all of the following EXCEPT:
Detection of brain death, evaluation of cerebrovascular disease, neuropsychiatric disorders, convulsive disorders, etc.
Indications for brain scan
origin
Insoluble components of the radiopharmaceutical remain at the _____ of a chromatography strip.
Inhalation, Ingestion, Absorption through skin IV. Standing near radiation sources
Internal Exposure to technologists from Radionuclides can occur as a result of:
99mTc labeled RBCs
Intraabdominal bleeds are best detected by imaging methods using:
a rise in common bile duct pressure which will cause a backflow of bile in the bladder.
Intravenous morphine can be used when performing gall bladder imaging to improve the specificity of the exam by causing:
without a collimator
Intrinsic resolution refers to a camera resolution:
10 uCi
Iodine 125 dose
high calcium ingestion
Iodine deficiency is related to
Excreted mainly in the urine
Iodine which is not used in hormone synthesis is
large sources of radioactivity
Ionization meters should be used when surveying:
a different number of neutrons
Isotopes are different forms of a specific element that have:
If disposable items and foods containing radioactive saliva get into the trash, they can set off radiation detectors at the dump site
It is recommended by the NRC that a family member treated with radioiodine for thyroid cancer therapy use a single set of non-disposable dishes which arc washed separately from the rest of the family members dishes and not eat foods that leave residue (chicken bones, rib bones, apple cores etc.) because?
111 Indium PENTETREOTIDE
It is recommended that the patient be well hydrated for 24 hours following the administration of this radionuclide as well as taking a mild laxative 24 hrs before tracer administration and continue for 48 hrs afterward. Which tumor imaging agent requires this patient preparation?
120,000,000
It is recommended to acquire __counts when performing a SPECT uniformity flood using a 128 x 128 computer matrix on a standard or large field of view gamma camera?
24-48 hours
It is recommended to begin imaging with 111 In Pentetreotide at post injection? Note: Some facilities perform 4 hr images to avoid activity in the gastrointestinal tract.
-Excretion of waste products -Reabsorption of important body constituents -Maintenance of acid-base balance -Maintenance of fluid balance
Kidneys major functions:
graves disease
LATS (long acting thyroid substances) would most likely be found in patients with ...
common hepatic duct
Left and right hepatic ducts join to form the
elevated levels of aluminum (Al+3) in the Tc-99m eluate causing the formation of aluminum-technetium colloid particles.
Liver uptake seen on a bone scan can be due to what?
sulfur colloid
Liver/spleen RP
20 min
Localization of 99mTc for thyroid imaging requires ______ min
monoiodotyrosine
MIT=
Thallium 201
MPI RP for viability
8-30 mCi.
MPI dose range
Detection and evaluation of coronary artery disease, pre-transplant and/or surgical workup, symptoms of chest pain, shortness of breath and/or family history of heart disease.
MPI indications
• Patient supine with left arm above head, or both arms above head. • 64 x 64 matrix with LEAP or LEHR collimator. • 180° SPECT (RAO TO LPO), 32 or 64 projections @ 20 sec/frame. • 3-lead EKG for gating of stress images at 8 frames/cycle. Rest images can also be gated.
MPI protocol
Tc99m labeled RBCs (Ultra-Tag, in vivo or modified in vivo).
MUGA RP
Abnormal movement of one or more walls. Low EF (35-45%) or lower of the left ventricle.
MUGA abnormal results
Heart
MUGA critical organ
20-30 mCi
MUGA dose range
Evaluation of left and sometimes right wall motion, calculation of ejection fraction, evaluation of heart condition for pending surgery, chemotherapy or radiation therapy, etc.
MUGA indication
Compartmental
MUGA localization
Circulation and heart should present clearly. Cine should show fair amount of motion in all walls. EF = 50-75% for the left ventricle and 40-60% for the right ventricle.
MUGA normal results
none
MUGA patient prep
• Reinject tagged RBCs. • Patient supine, hookup 3-lead EKG (find optimal R-R wave). • Acquire LAO, left lateral and anterior views (300-600 beats or for 5-10 minutes per view). Start with the LAO image first beginning at 45° and then looking for the best septal wall separation. LAO is the most important view (this is what you calculate your LVEF from).
MUGA protocol
• 65-70% inorganic • 25-30% organic • 5-10% water
Material that constitutes bone by weight:
spatial resolution
Matrix size primarily affects?
pertechnetate
Meckel's RP
association with barrettes esophagus
Meckel's diverticulum is characterized by:
1-3%
Meckels diverticula occur in approximately ___% of the general population.
10-15 mCi
Meckles dose range
multiple sites
Metastatic brain tumors usually appear on brain scintigrams:
detected as a photon-deficient area
Metastatic lesions that have no osteoblastic activity are usually:
Chemisorption
Method of localization of Bone scan RP's
radionuclidic
Mo-99 in the eluate of Mo-99 - Tc-99m generator is an example of a _____ impurity.
global and regional changes in renal function
Morphologic renal imaging can be used to document:
360°
Most SPECT acquisitions of organs (except the heart) require how many degrees of rotation around the patient?
two
Most computer words contain how many BYTEs?
lobar bronchi
Most of the resistance to air flow in the lungs is found at the
neutrons, protons
Most stable nuclei have more ________ than ________
MUGA
Multiple gated acquisition or ERNA (equilibrium radionuclide angiogram):
tissue damage calcification blood flow
Myocardial uptake of Tc-99m pyrophosphate used in acute myocardial infarct scintigraphy depends upon
radiopharmaceutical used is incorrect for the designated study.
Name: Ann Rollins; Age: 54 Diagnosis: Hepatitis Procedure: Liver Scan RP/Dose: 99mTc Mebrofenin 5mCi I.V. Date/Time: 8/20/01/1400 Notes: outpatient,With regards to the above prescription, a correct statement is that the:
are all cancerous
Neuroendocrine tumors are:
111 Indium Penetreotide
Neuroendocrine tumors that contain somatostatin receptor sites are best imaged with?
secrete hormones
Neuroendocrine tumors:
oxygen and glucose
Neurotransmission is dependent upon the presence of _____ to provide the energy (ATP), required for proper functioning.
Hyper, Hypo, Euthyroid
Nodular goiter is related to
- Liver, Spleen, Kidneys -Pituitary Gland -Genitalia
Normal biodistribution of In-111 Octreotide is
a 1.5 to 2.0 increase in
Normal human lungs in the upright position have __________________ ventilation per unit lung volume from the apices of the lungs to the bases.
approx. 45 min
Normal liquid digestive T1/2:
Heterogeneous uptake throughout the myocardium of the left ventricle. LVEF 50-80%.
Normal results for MPI
45-110 minutes
Normal solid digestive T1/2:
glucose
Nuclear medicine provides a vehicle for assessing the rate of consumption of the main energy for the brain, which is/are:
proton into a neutron
Nuclides having a low neutron to proton ratio decay by converting a
5 Rem (50 mSv)
Occupational Whole-Body TEDE
pentetreotide
Octreotide is also known as
84 uCi
On May 30, 2003, 14 capsules of I-131 were calibrated to measure 0.175 mCi. How many uCi were given on May 8, 2003 in one capsule?
the better the spatial resolution
On a filter such as a Butterworth filter, the lower the critical frequency:
superior sagittal sinus
On a normal anterior static brain image, the midline band of activity extending from the apex to the high activity region of the base of the skull represents:
hypoactive spot
On a scan, within the thyroid, thyroid carcinoma is often seen as
should be smaller than half of the system spatial resolution
On an Anger camera, to accurately portray a signal, the pixel dimensions:
1/3 system resolution
On average, pixel size should be:
1:1
On posterior images there should be what ratio of tracer uptake between the liver and spleen.
40%
On the test pattern shown above, which of the numbers shown represents the mid-density level output of the laser printer?
roll from side-to-side for 60 to 90 minutes
Once 99mTc-SC is administered as a pretreatment for abdominal malignant effusion therapy, the patient is instructed to:
FDG becoming trapped in the cell
Once in the cell's cytosol, FDG adds a phosphate group and proceeds with further transformation. This change in FDG results in:
relax for 10 min and refrain from talking
Once the intravenous line is started for the FDG injection, the patient should:
localizes on the choroid plexus
One of the main disadvantages of the use of 99mTcO4- as a radiopharmaceutical for brain scintigraphy is that it:
hydration
One of the most important steps in patient preparation prior to the Tc99m MDP scan is:
a dose based on selecting a radiation absorbed dose to the thyroid
One of the three basic approaches to selecting the dose of 131I to be administered as therapy for hyperthyroidism is:
the patient must be actively bleeding at time of injection in order to detect the bleed
One shortcoming of the use of 99mTc sulfur colloid for site detection of acute GI Bleeding is that:
50 Rem or 500 mSv per year
Organ or tissue (TEDE)
thyroid
Organic iodine is secreted into the extrathyroidal iodide pool by the _________.
• Production of osteoid • Mineralization of matrix to form bone • Bone remodeling by reabsorption and reformation
Osteogenesis (the process of bone formation) involves three main steps:
diametrically opposed detectors
PET imaging of the brain requires the use of:
calcium and phosphorous levels in the blood by increasing osteoclastic activity in bone and decreasing calcium release by the kidneys.
PTH regulates
in the neck alongside the thyroid gland lying either adjacent, beneath or within the substance of the thyroid.
Parathyroid glands are located
within the thymus and within the mediastinum due to their embryonic origins.
Parathyroid glands can also be found
to regulate calcium ion concentration in the body fluids, a tropic hormone,regulating the production of the active form of vitamin D., to increase serum levels of inorganic phosphates
Parathyroid hormone (PTH) functions ....(you may select more than one)
sublingual
Parenteral routes of administration include all of the following EXCEPT:
Patient off thyroid hormones: thyroxine (T4) for 4 weeks, triiodothyronine (T3) for 10 days, PTU for 3 days. Iodinated contrast material for at least three weeks. Low iodine diet.
Patient prep for I-131 whole body scan
Patient should be off: T4 for at least 10 days, T3 for at least 3 days, anti-thyroid medications (PTU, diazole) for at least 3 days. No iodinated contrast material for at least three weeks (IVP, CT contrast,milligram, angora).
Patient prep for thyroid uptake/scan
an enema the morning of the imaging
Patient preparation for a 111In-capromab pendetide imaging procedure should include:
eating a meal because of the time involved with the study
Patient preparation for a PET scan includes all of the following EXCEPT:
the taping of the penis over the pubis
Patient preparation for testicular scintigraphy includes:
reduce radiation to the bladder
Patients having a bone scan should be encouraged to void urine frequently between injection and delayed scanning to
0.5 rem
Patients treated with radioiodine do not need to be placed in radiation isolation provided the Total Effective Dose Equivalent (TEDE) from the patient to other individuals does not exceed?
hyperbilirubinemia and jaundice.
Patients with biliary atresia present with...
cerebral infarction
Patients with suspected _____ should not undergo brain scintigraphy until at least 7 days after insult.
efferent arteriole
Peritubular capillaries are the capillary network which originate from
efferent arteriole
Peritubular capillaries are the capillary network which originate from:
trapping mechanism excretory function
Physiologic information that can be ascertained by 99mTcO4- salivary scintigraphy includes alterations in the gland?s usual:
In-111 oxine
Platelet kinetics are best studied using platelets labeled with:
solitary or multiple autonomously hypermetabolic nodules
Plummer's disease of the thyroid gland is characterized by ...
Bone flow aquisiton
Position area to be imaged in the field of view, 30-60 frames for approximately 1-4 sec/frame. 64 x 64 matrix.
at the base of the skull.
Positive brain death scan will show tracer stopping where?
neutron poor
Positron decay comes from the nucleus that is:
45-60 min
Post inj. delay for sestamibi
5-30 min
Post inj. delay for tetrofosmin
Thyroid uptake is then determined between 2 and 4 hours after administration of the dose. Potassium perchlorate 109 mg/kg is then administered orally and a repeat measurement of RAIU performed in 30 to 60 minutes. A decrease in RAIU greater than 10-15% following perchlorate administration is indicative of any organification defect. The test is rarely performed since the treatment for primary hypothyroidism is thyroid hormone replacement regardless of the cause or site of defective thyroid hormone synthesis.
Prechlorate washout test protocol
identity testing
Prerelease testing for each batch of 18F-FDG should include:
Conns syndrome
Primary aldosteronism usually associated with a solitary adrenal adenoma
children
Primary bone tumors are found most often in which age group?
negative feedback mechanism
Production and secretion of thyroid hormones is regulated by
electron capture
Proton rich radionuclides decay isobarically by positron decay or by:
high count rate
Pulse pileup (deadtime) occurs at:
tc99m MAA
Quantification of the amount of right-to-left cardiac shunting may be made by determining the amount of activity distributed throughout the body after injection of:
111 Indium PENTETREOTIDE
RP Recommended for Pituitary and endocrine tumors
111 Indium PENTETREOTIDE
RP Recommended for carcinoids
Sodium 13 1 Iodine (Na131 I)
RP for Hyperthyroidism
I-131 capsule or liquid
RP for I-131 whole body scan
90 Yttrium-Ibritumoab Tiuxetan
RP for Non-Hodgkins Lymphoma
Chromic 32 Phosphate
RP for Peritoneal Effusions
Chromic 32 Phosphate
RP for Plueral effusions
Sodium 32 Phosphorus (Na 32 P)
RP for Polycythemia Vera
153 Samarium - Lexidronam
RP for Skeletal Metastasis agent that has a half-life of 1.95 days
I-123 or I-131 mIBG (meta- iodobenzylguanidine)
RP for adrenal medulla (mIBG)
Tc99m Sestamibi (hexakis [2-methoxyisobutylisonitril]
RP for parathyroid scan
I-131 capsule or liquid
RP for thyroid ablation
Tc99mO4- (pertechnetate)
RP for thyroid scan
I-131 capsule or liquid
RP for thyroid therapy
I-123 and I-131
RP for thyroid uptake/scan
Tc99m DMSA (dimercaptosuccinic acid) and Tc99m GHA (glucoheptonate)
RP used to assess the appearance of the renal parenchyma.
Tc99m DTPA
RP used used for GFR calculations.
Pertechnetate, Tc99m DTPA, Tc99m glucoheptonate.
RPs that don't cross the BBB
high radiation area sign
Radiation levels outside a room are such that an individual could receive 0.30 rem in 1 hour. According to the Nuclear Regulatory Commission (NRC), the technologist should:
random
Radioactive decay is a series of ______ events.
120 days
Radioactive materials that have half-life of less than _____ may be allowed to decay in storage before being disposed of?
120 days
Radioactive materials with half-lifes of less than _____ may be retained in shielded storage areas until they've decayed to background levels?
orally
Radioactive vitamin B-12 used for a Schilling test is administered by what route.
lateral ventricles
Radioactivity is visualized in all of the following areas during a normal cisternographc study EXCEPT the:
chromatography
Radiochemical purity can be determined with which method?
an exchange reaction with fluoride ion and triflate mannose
Radiolabeling of fluorodeoxyglucose (FDG) with F-18 is best described as:
malignancy of the choroid plexus
Radionuclide cisternography is used for determination of all of the following EXCEPT:
low contrast tissue
Radiopaque contrast media (ROCM) is used in CT procedures to better visualize:
0.95
Readers are encouraged to use Microsoft Excel to solve this problem. In a nuclear medicine technology training program, the students wonder if their final exam grade in their training program is related to their subsequent board score on the NMTCB exam. The five students attain the following pairs of scores (exam score, board score) = (72,60), (84,74), (88,71), (68,60), (91,79). What is the linear correlation coefficient r between exam score and board score?
34%
Readers are encouraged to use Microsoft Excel to solve this problem. What is the coefficient of variation (CV) of the following five numbers: 6.40, 7.20, 3.50, 9.20, 5.10?
48-72 hours
Recommended delayed imaging times following the injection of 67 Gallium for oncologic studies include:
111 Indium PENTETREOTIDE
Recommended for Medullary thyroid cancer
111 Indium PENTETREOTIDE
Recommended for Paraganglioma tumors
Tc99m Arcitumomab
Recommended for colorectal and adenocarcinoma imaging
Gallium 67 Citrate
Recommended for imaging Lymphoma, lung cancer and multiple myeloma
111 Indium CAPROMAB PENDETIDE
Recommended for prostate specific membrane antigen
111 Indium PENTETREOTIDE
Recommended for small -cell lung cancer
18 Fluorine Fluorodeoxyglucose
Recommended for various types of tumors that a more metabolically active than normal tissue
at least as strict as
Regulations established by states must be _______when compared to regulations developed by the Nuclear Regulatory Commission (NRC).
ionization
Removal of an electron of a neutral atom is called:
100 mRem per hour
Requires the following sign: Caution: High Radiation Area
500 rads per hour
Requires the following sign: GRAVE DANGER: Very High Radiation Area
diverging
Resolution = decreases Sensitivity = decreases Magnification = decreases
pinhole
Resolution = decreases Sensitivity = increases Magnification = decreases
Thallium 201
Rubidium 82 (82Rb) behaves physiologically similar to:
potassium
Rubidium-82 is an analog to:
2-7 mCi
SC Dose rang for liver/spleen
Shallow dose equivalent
SDE is the acronym for:
weekly
SPECT Center of Rotation (COR) should be performed at what frequency?
specialized ring detectors or rotating Anger cameras
SPECT is performed with:
weekly
SPECT uniformity correction should be performed at what frequency?
Tc04- (pertechnetate)
Salivary gland RP
8-12 mCi
Salivary gland dose range
compartmental to blood supply
Salivary gland localization
pulse height analyzer
Scatter rejection is provided by the:
TSH
Secondary hypothyroidism is the result of a deficiency of:
Iodineingested,convertedtoiodideinthelarge intestine, trapped by the thyroid, oxidized (becomes iodine again), organified (iodine bound to tyrosine and form MIT and DIT), coupling (MIT and DIT combine to form T3 and T4), then stored within follicles or released.
Sequence of conversion of iodine to T3 and T4
plastic
Shielding strontium-89 with ________ is preferable.
bone blood pool aquisition
Should be acquired within 10 minutes of tracer injection. 128 x 128 matrix. 300-500 kcts axial skeleton. 150-200 kcts extremities.
Caution: Radiation area
Sign required to be posted in areas where airborne radioactivity is used
89 Strontium Chloride
Skeletal Metastasis agent that has a half-life 52.7 days
gently under tepid water
Skin that is contaminated with a radioactive material should be washed with soap or a commercial radioactive decontaminating agent:
bremsstrahlung
Small charged particles such as electrons or positrons may be deflected by nuclei as they pass through matter, which may be attributed to the positive charge of the nucleus. This type of "braking radiation" generates x-rays
weekly
Spatial linearity on a gamma camera is required to be performed at what frequency?
Agreement states
States that have been given permission by the Nuclear Regulatory Commission to assume responsibility for all radioactive materials used within the state are called?
high
Statistical noise occurs throughout and image but is MOST apparent in which frequencies?
lung cancer
Stochastic effects of ionizing radiation include
calcium
Strontium is an analog of:
Kupffer cells in the liver.
Sulfur colloid is phagocytized by what cells
0.1 - 1.0 um
Sulfur colloid particle size for Liver/spleen
Normal results for brain perfusion study
Symmetric perfusion in the anterior projection that looks like a trident. On static images radioactivity does not lie in the brain itself because of the integrity of the blood-brain barrier. Activity seen in sagittal and transverse sinuses.
Headaches, excess sweating, racing heart, anxiety, nausea, weight loss, heat intolerance, etc.
Symptoms of pheochromocytomas are:
palpitations, diaphoresis, weakness and diarrhea
Symptoms of rapid gastric empty
intrinsic and collimator resolution
System spatial resolution is determined by:
true
T/F A written report must be submitted to the NRC within 15 days
true
T/F Approximately 65% of the water filtered through the glomerulus will be reabsorbed into the bloodstream through the PCT.
false
T/F If nephrons become injured or diseased, new ones will form
false
T/F Normal CSF imaging protocols demonstrate the visualization of the radiotracer within the ventricles
true
T/F Somatostatin functions as a neurotransmitter in some instances
False
T/F The spinal cord is on average between 16 - 18 inches in length and extends from the foramen magnum to the sacral spine.
true
T/F? The doubling dose for cancer is higher than for genetic changes.
true
T/F? 1 microsievert/hr to 1 millisievert/hr is the NRC required range for G-M detectors when using the 81 (Systeme International) units
false
T/F? 111 In Pentetreotide is likely to cause HAMA reactions in patients having follow up scans so it is recommended the technologist be prepared with epinephrine and antihistamines in the event of an allergic reaction You Answered
true
T/F? 131 Iodine therapy and ablation patients may be released from the hospital provided that written instructions on how to minimize radiation exposure to others if it is likely the other people can receive a dose of more than 0.1 rem (1 mSv) from the treated patient.
true
T/F? 67 Gallium citrate is used to image lung cancer
true
T/F? A Geiger-Mueller (GM) detector is more sensitive to radiation detection than a portable ionization meter (high intensity) Cutie Pie
true
T/F? A medium energy collimator has thicker septa when compared to a low energy collimator
false
T/F? A portable ionization meter (high intensity) is more sensitive to radiation detection than a Geiger-Mueller (GM) detector
false
T/F? A refillable flood phantom filled with Tc99m is recommended for SPECT uniformity floods
false
T/F? A rise in the level of plasma creatinine is indicative of good renal function
true
T/F? A uniformity correction map must be acquired for each type of collimator (low, medium and high energy) and for each matrix size used
true
T/F? A wipe test must be performed by using an absorbent material to cover 100 cm2 and counted in a well counter and be done at the same frequency (daily) as area surveys.
false
T/F? Approximately 65% of the water filtered through the glomerulus will be reabsorbed into the bloodstream through the PCT
true
T/F? As the urinary bladder fills with urine, pressure inside compresses the ureteral openings and prevents backup of urine into the ureters
true
T/F? Authorization to use radioactive materials in humans is granted by the Nuclear Regulatory Commission or state agencies in the form of a facility license
false
T/F? Children and pregnant women are allowed to visit patients treated with therapeutic amounts of radioactive iodine provided they stay a minimum distance of six feet (2 meters) from the patient
true
T/F? Discontinue iodide containing preparations (cold remedies etc.), iodine supplements (vitamins), thyroid hormones or other medications that could effect the ability of the thyroid tissue to pick up iodine
true
T/F? If a substance is filtered by the nephron, but not secreted and not reabsorbed at all, then its clearance equals the glomerular filtration rate.
false
T/F? Incineration of limited amounts radioactive material is no longer allowed by the NRC as a method of disposal.
true
T/F? Increasing the number of counts acquired in a computer image decreases the signal-to-noise ratio (noise) and improves the image quality
true
T/F? Liquid 131 Iodine is volatile at room temperatures and can turn into iodine gas. Therefore it is important to be careful of airborne contamination
true
T/F? Nephrons control blood concentration and volume by removing selected amounts of water and solutes.
false
T/F? Nephrons do not remove toxic wastes from the blood
true
T/F? Radioactive Labels on shipping container are required to be defaced or removed after the box has been surveyed with a GM tube and disposed of in the regular hospital trash.
true
T/F? Recent surgery or chemotherapy can effect the distribution of 67 Gallium Citrate so the technologist should inform the physician interpreting the scan of either of those conditions
true
T/F? Renal calculi, or kidney stones, may be formed in any portion of the urinary tract.
true
T/F? Renal plasma clearance (ERPF) expresses how effectively the kidneys remove a substance from blood plasma.
false
T/F? The efferent arteriole is larger in diameter than the afferent arteriol
true
T/F? The nephron consists of the renal corpuscle and the renal tubule
true
T/F? The urinary bladder is a freely movable organ held in place by folds of the peritoneum
true
T/F? There are several categories of licenses; each specifies which radioactive material is authorized for what purpose and who the authorized users are.
true
T/F? Wait to cleanup the spill
triiodothyronine
T3
3 times
T3 is how much more biologically active than T4?
thyroxine
T4
mucin-producing parietal cells in the stomach
Tc04- taken up by what
brain death study
Tc99m DTPA can also be used for what type of brain scan
25-40 mCi
Tc99m DTPA dose range lung
- LEAP or LEHR collimator. • Static images: 500-1,000 kcts (usually same views as perfusion). • Inject DTPA into canister on nebulizer. Place mouth piece in patient's mouth, attach nose clamp and hookup nebulizer to approx. 10 liters of oxygen. Instruct patient to breath normally for five minutes. Remove equipment and image. (Refer to Shacketts' for the noncondensed version).
Tc99m DTPA lung protocol
compartmental
Tc99m DTPA lung. localization
somatostatin receptors
Tc99m Depreotide (Neotect) binds to which type of receptors in normal tissue and malignant tumors?
Neo Tect
Tc99m Depreotide is also known as?
2-6 mCi
Tc99m MAA dose range
RE cells
Tc99m MAA particles are phagocytized by
- LEAP or LEHR collimator. • Statics: 500-1,000 kcts in anterior, posterior, RAO, LAO, RPO, RAO, right lateral and left lateral views.
Tc99m MAA protocol
chemisorption
Tc99m medronate localizes in bone through the method of:
half life 73 hours. Energies: 68-80, 135, 167 keV
Thallium 201 properties
Energy correction factors for the positron emission detector energy blocks
The "Blank Scan" on a PET scanner is mainly used for what purpose?
the change in mass between the starting and product nuclei
The "Q" or energy value for a given nuclear reaction can be calculated from:
the time of peak activity in the distal stomach
The "lag phase" of the curve demonstrating the results of a solid-phase gastric emptying study corresponds to:
99 Molybdenum
The "parent" in a 99m Technicium / 99 Molybdenum generator is?
low frequencies
The "star" artifact is mainly observed in which type of spatial frequencies?
0.2 mRem/hr
The "trigger" level for reporting radiation exposure to the Radiation Safety Officer must be set at no less than _____ for unrestricted areas?
KeV -kiloelectron volts
The "window" of a well counter or uptake probe is expressed in which units?
stomach infection by H pylori bacterium
The 14C-urea breath tests enables detection of:
transient equilibrium system
The 99Mo/99mTc generator is an example of:
determination of metastatic liver disease
The 99mTc labeled hepatobiliary agents are used for all of the following EXCEPT:
intermittent bleed
The 99mTc-labeled red blood cell technique for imaging a gastrointestinal bleed is preferred by investigators for:
10 mr/hr
The ALLOWABLE exposure rate at one meter from any radioactive material shipment container should NOT exceed?
200 mR/hr
The ALLOWABLE radiation exposure at the surface of ANY radioactive material shipment must not exceed _____?
The alumina is within acceptable limits so it can be used to make up radiopharmaceutical kits
The Alumina test revealed 0.8 ug/ml in the eluant. What should be done with the Tc99m elution?
the amount of repair of sublethal damage
The Dq is a measure of:
quenching
The Geiger counter is restored to its normal quiescent state by a process called:
december 1 2007
The Geiger-Mueller (GM) meter in a nuclear medicine department was calibrated on December 1, 2006. According to the Nuclear Regulator Commission (NRC), arrangements should be made to have the meter recalibrated before:
Identify mechanical problems with the scanner or the detectors
The MAIN purpose for obtaining a background rate for PET scanning is to
Allow the technologist to survey a larger area
The MAIN purpose of a "pancake" probe attached to a G-M detector is?
1 curie per year
The MAXIMUM amount of radio active materials that may be disposed of in the sewer, excluding patient excreta according to the NRC; is?
uranium
The Molybdenum generator most commonly used in nuclear medicine comes from the fission by-product of ?
by telephone within the next calendar
The NRC must be notified of a "medical event", misadministration within what time frame?
Wear personnel monitoring devices at all times when on duty
The NRC requires licensees to use facility designs and operational procedures to minimize contamination. Which of the following is NOT one of the NRC's recommendations to minimize contamination?
dose calibrator make and model number
The NRC requires that all of the following information be included in unit dose measurement records EXCEPT the:
5.0 mrem/year
The Nuclear Regulatory Commission must be notified of any whole body exposure to radiation when it exceeds?
0.1 millirem to 100 millirem per hour
The Nuclear Regulatory Commission requires a G-M meter be capable of detecting a range of_____ to _____ at the facility in which it is being used.
right and left ventricle
The QRS complex in a normal ECG represents transmission of an electrical pulse through the
effectiveness of one radiation compared to a standard radiation
The Relative Biological Effectiveness (RBE) is a measure of:
Sv
The SI radiation unit that takes biologic effect into account is the:
enzymatic hydrolysis
The Tc99m MAA particles are cleared by
3 years
The Tc99m elution and quality control records must be retained for a period of _____ according to the Nuclear Regulatory Commission?
Critical frequency (cutoff-frequency) and Power factor (order)
The Two (2) variable parameters of a Butterworth Filter are:
right side
The _____ of the heart is (are) responsible for receiving systemic venous blood and pumping it into the pulmonary circulation for oxygenation.
the deposition of calcium in the damaged myocardium
The _____ of the heart is (are) responsible for receiving systemic venous blood and pumping it into the pulmonary circulation for oxygenation.
ventricles
The _____ of the heart is (are) responsible for receiving systemic venous blood and pumping it into the pulmonary circulation for oxygenation.
linearity
The ability of a gamma camera to produce a uniform image with straight lines corresponding to the "straight lines" of a "bar" or Orthogonal hole phantom is the definition for which quality control parameter?
half value layer
The ability of a material to absorb or attenuate x-rays and gamma rays are expressed in which units?
uniformity
The ability of a scintillation detector (camera) to produce a uniform image when the source provides a uniform distribution of photons over the detector is the definition for?
spatial resolution
The ability of the scinitillation camera to separate small objects in space or how much each point in an image is blurred is the definition for which quality control test?
contrast
The ability to see the difference in count activity between adjacent pixels in a frame is the definition for _____ when pertaining to a computer image?
size, shape of the source and target and distance between them
The absorbed fraction is dependent upon the
alleviate bone pain from mets
The administration of 89Sr chloride is used to
2 protons and 2 neutrons
The alpha particle consists of:
binding energy
The amount of energy that keeps an electron within its orbital position is termed:
linear energy transfer
The amount of energy transferred in a given distance by a particle moving through an absorber
W
The amount of incident radiation energy transferred per ion pair created is characteristic of the materials in the absorber
specific activity
The amount of radioactivity per unit mass of a radionuclide is called?
pyramidal lobe
The appearance of a narrow strip of thyroid tissue which extends upward from the isthmus along the thyroid cartilage is a normal variation called the
V = A/C
The appropriate formula for determining the volume (V) required for a dose of activity (A) with a concentration (C) is
9:1
The approximate lung blood supply ration of the right and left pulmonary arteries to systemic circulation is about
9:6
The arterial phase on normal cerebral radionuclide angiography usually appears _____ seconds after radiopharmaceutical administration and lasts approximately _____ seconds.
0.072 uci/1 mci
The assay of the 99 Molybdenum in the eluant showed 25 uCi. What is the concentration per mCi of Tc99m if the activity at 8 a.m. was 345 mCi?
kshell
The atomic shell closest to the nucleus is the:
10-12 cm long; 5.0-7.5 cm wide; 2.5 cm thick
The average adult kidney measures approximately:
80%
The average elution efficiency of a Tc99m / Mo99 generator is?
1/3 the maximum energy
The average energy of a beta particle is usually
nephron
The basic functional unit of the kidney is
device that converts radiation to an electrical signal
The basic model of the detector is a:
high energy
The best collimator to use when imaging with 131 I is:
24 - 72 hours
The best imaging period for the evaluation of acute myocardial infarcts with Tc-99m pyrophosphate is ___ post infarction.
anterior view
The best view for demonstrating a horseshoe kidney is the:
employ a high sensitivity low energy collimator
The best way to increase the relatively poor statistics of a cerebral radionuclide angiogram using a 99mTc-labeled radiopharmaceutical is to:
electron
The beta particle is the same as a(n):
efferent arteriole
The blood leaves the glomerulus through the
an anatomic and physiological concept
The blood-brain barrier is:
result in the formation of one or more "new" substances
The chemical properties of a substance may be affected by a change in conditions. If this occurs, the change will:
the number of protons minus the number of neutrons
The chemical properties of an atom are determined by:
short axis
The circumferential profile technique used to quantitate SPECT myocardial perfusion studies is performed on what set of tomographic slices?
is extremely pale, puffy face, has fluid retention and is lethargic.
The classic myxedematous patient (patient with myxedema) ...
straight bore
The collimator used with a thyroid uptake probe is known as a _________.
C = activity / volume
The concentration (C) of a radiopharmaceutical is given by
I-125 HSA
The conventional agent used for the estimation of plasma volume is:
transmutation
The conversion of one element to another by radioactive decay is called:
Pixels would be 4 x 4 mm
The coordinates were measured for a pixel calibration on a gamma camera and computer image; it was determined the pixel size was 8 x 8 mm for a 64 x 64 word mode acquisition. What change in pixel size would occur if the matrix was changed to 128 x 128 word mode acquisition?
ascending aorta
The coronary arteries originate at the
4-5%
The coronary artery circulation receives approximately ___% of the cardiac output of the heart.
the common bile duct.
The cystic duct and common hepatic duct combine to form
counts or counts/minute
The datum (information reported) used in most reporting of results from well counters and uptake probes is given in which units?
5 rem
The dose equivalent for occupational whole-body exposure is commonly limited to 50 mSv. How many rem is this?
draining venous blood from the brain
The dural sinuses within the brain are responsible for
the sum of the reciprocal of T one half phys and T one half biological
The effective half-life is
electrical activity
The electrocardiogram presents a visible record of the heart's
energy
The electron volt (ev) is a measure of:
171 and 245 keV
The energy peaks you will image octreoscan at are:
V1N1 = V2N2
The equation used for calculation of the quantity of an acid or base in a given sample is:
transient
The equilibrium that would be established in a Mo-99 - Tc-99m generator if it were allowed to come to equilibrium is called _____ equilibrium.
a capillary
The exchange of respiratory gases occurs at the alveoli. Each alveolus is in contact with
photomultiplier tube
The exponential increase in number of electrons from cathode to anode occurs in the:
42
The exposure rate from a radioactive source is 250 mrem/hr at 2 meters. What would be the exposure in mrem/hr at 3 m?
3.65 mR/h
The exposure rate in air at two meters from a 33-mCi point source of I-131 is approximately: (gamma = 2.2 R-cm(2)/mCi-h)
they are broken up and removed by the liver and spleen
The fate of MAA particles is:
none
The federal agency responsible for the regulation of the use of general x-ray producing machines and machine-generated radioactive material (e.g., PET) isotopes is:
NRC
The federal agency that is responsible for the regulation of the uses of byproduct material is:
energy and penetration of the radiation
The filter on a personnel monitoring device is designed to detect which aspect of the radiation?
normal variant
The finding of a prominent right transverse sinus on a posterior static brain image most likely is a:
Critical frequency or Cutoff Frequency
The frequency at which the filter magnitude drops to zero or the frequency at which the filter drops below a given value is called?
uranium; plutonium
The fuel for most nuclear reactors is composed of _____ and/or _____.
17.3
The gamma camera seems to be producing erratic results. A 57Co flood source is counted 10 times, producing the following count values: 1000, 975, 1032, 1096, 982, 997, 1012, 1090, 994, 977. What is the c2 value for these counts?
The same -including volume, sample container, and sample placement (location in the well or detector, distance etc.)
The geometry used when counting sources of radiation with a well counter or uptake probe must be _____?
Tc-99m pentetate
The glomerular filtration rate (GFR) is measured with which of the following radiopharmaceuticals?
water and plasma
The glomerulus filters the following into the capsular space
pulse height (energy) spectrum
The graph of the pulse heights received from a detector plotted on the x-axis, and the number of such pulses on the y-axis, is called the:
15.75 mR/hr
The half value layer for 99m Tc is 0.27 mm of lead. If a vial measured 250 mR/hr at 1 meter, what would the intensity measure if 1.08 mm of lead were used to shield it?
25%
The half-value layer (HVL) for annihilation radiation in tissue is 7.5 cm; what percentage of a beam of 511 keV gamma rays will penetrate 15 cm of tissue:
40
The hematocrit value for the blood sample shown below would be what percent?
growth and maintenance of the thyroid gland and stimulation of thyroid hormone secretion
The hormone TSH is required for
JCAHO
The hospital in which a technologist is working is said to be accredited. The accreditation for the hospital would be issued by the:
thyrotropin releasing factor
The hypothalamus secretes
the gamma-ray counts stored within a pixel
The image density for each pixel is determined by:
collimator
The image-forming aperture of the scintillation camera is the:
prepare for reinjection
The images in a cerebrospinal fluid study show an initial wide segmental appearance with no activity in the basal cisterns at 2 to 3 hours after injection. The technologist should:
decreases; increases
The incidence of salivary gland tumors _____ with the gland?s size; tumor malignancy _____ with decreasing gland size.
sialography
The indication on a patient's requisition is xerostomia. The procedure for which the technologist prepares the room is:
99mTc-fanolesomab
The indications for a nuclear medicine study are equivocal signs and symptoms of appendicitis. The radiopharmaceutical that would be most appropriate for this study is:
subclavian
The inferior thyroid artery branches from which of the following major arteries?
anterior cerebral artery middle cerebral artery
The internal carotid artery supplies blood to the cerebral hemispheres via the:
albumin, pre-albumin, and thyroid binding globulin
The iodothyronine circulates in both free and bound forms in the bloodstream. Which of the following are plasma proteins involved in binding
ureter
The kidney connects to the urinary bladder via the
cells, which are mitotically active, are radiosensitive
The law of Bergonie and Tribondeau states in part that:
0.1 rem
The licensee shall provide the released individual (patient treated with 131 Iodine) with written instructions to keep the radiation dose to other individuals (general public) to below __.
10 ug/ml for reaction of Mo-99
The limit of aluminum in the eluate of Mo-99 generator is
U U=0.693/HVL
The linear attenuation coefficient
The average energy lost by a particle per unit distance traveled
The linear stopping power is defined as:
segments
The lobes of the lungs are anatomically further divided into sections known as
vascular extravasation
The localization mechanism of 99mTc sulfur colloid at the site of an active GI Bleed is:
mechanical blockage
The localization mechanism of either Tc-99m MAA or Tc-99m HAM within the lungs is by
accurate
The longer the "response time" of a detector, the more __the detector is?
Medulla oblongata
The lowermost portion of the vertebrate brain, continuous with the spinal cord, responsible for the control of respiration, circulation, and certain other bodily functions.
delivering oxygen to the bloodstream and the removal of carbon dioxide from the bloodstream
The lungs chief functions are ...
lymphatics
The lungs' main function is the
movement and exchange of gases
The lungs' main function is the
volume
The main determinant of the rate of liquid gastric emptying is:
very specific
The main problem associated with 99mTcO4- salivary gland scintigraphy is the fact that it is not:
lower the activity per ml (specific concentration) of the standard or sample to prevent coincidence loss or paralysis of the detector
The main reason for diluting standards when using a well counter (according to the book) is?
The major cause of focal biliary obstruction in a neonate is:
The major cause of focal biliary obstruction in a neonate is:
thrombi from deep venous thrombophlebitis
The major cause of pulmonary embolism (PE)
23 hours
The maximum Tc99m activity occurs approximately every _____ after elution of the generator?
0.5 pixels
The maximum data shift allowed for Center of Rotation corrections is plus or minus (+ or -)
29.9 mCi
The maximum dose of radioiodine (I-131) which may be given on an outpatient basis is
65,536
The maximum number of counts that can be recorded in a pixel that has sixteen bits (16) or (2*16)is?
15 rem
The maximum permissible dose for the lens of the eye shall not exceed _____ in any one year.
It is inversely related to the half-life.
The maximum theoretical specific activity of a radionuclide is related to the half-life in what way:
-protect the kidney from trauma -hold the kidney in place
The middle layer of the of tissue surrounding the kidney, the adipose capsule, serves to:
1.022
The minimum MeV photon energy required for pair production is:
10,000
The minimum number of counts needed to obtain a 2% error at the 95% Confidence level for 2 standard deviations is?
mice
The monoclonal antibodies used for nuclear medicine imaging come from what type of animal?
0.59 ml
The morning elution of the 99Mo - 99mTc generator yields 850 mCi of 99mTc radioactivity in 20 ml of saline eluate. What volume should be withdrawn from the eluate vial into a patient syringe to immediately perform a 25-mCi patient scan?
SPECT imaging with morphologic agent DMSA
The most accurate nuclear medicine technique for measuring renal size is:
diabetes
The most common cause of gastroparesis
normal pressure hydrocephalus (NPH)
The most common clinical indication(s) for cisternography (of CSF imaging) include(s):
glioma
The most common general class of tumors detectable by brain scintigraphy is the:
hypothyroid
The most common side effect of radioiodine treatment for hyperthyroidism is
ureterovesicular junction
The most common site of obstruction in adults is where?
a radionuclide generator
The most common way of obtaining a short-lived daughter from a long-lived parent is
Alumina column
The most commonly used Mo-99 - Tc-99m generator is the _____ generator.
radionuclide procedure
The most definitive and sensitive tool available to clinicians to detect active lower gastrointestinal bleeds (GI Bleed) on an emergency basis is (the):
prevent transmission of the pathogen from the reservoir to a susceptible host.
The most direct way to intervene in the cycle of infection is to:
jasczak
The most widely used scatter correction method was developed by:
tubular reabsorption
The movement of water and solutes back into the blood of a peritubular capillary is called _____
different exposure rates
The multiple scales (0.1, 1, 10, and 100) allow it to detect?
5-20 mCi
The normal dose of 18 F FOG administered to a patient is within what range?
fission
The nuclear reactor is an example of controlled
256 c.16
The number of "on/off' combinations determines the number of counts that can be recorded in a single pixel (byte mode or word mode). According to the box (Box on page 32), how many counts can be contained in a pixel that has a depth of eight bits (2 *8)?
information density
The number of counts per square centimeter is used to describe which aspect of a nuclear medicine image?
180° to 360°
The number of degrees the gamma camera rotates around the patient for a SPECT scan is?
7 HVL
The number of half-value-layers (HVL) required to reduce the dose rate from 200 mrem/h to just less than 2 mrem/h is:
the tomographic resolution and the circumference of the object you are imaging
The number of images necessary for a SPECT study is determined by:
specific ionization
The number of ion pairs created per unit distance the radiation travels
approximately 100-150,000 particles
The number of particles given should be decreased to what for patients with pulmonary hypertension, right-to-left cardiac shunt and pediatric patients
vision and combines visual images with other sensory experiences
The occipital lobe is responsible for
source
The only difference between x-rays and gamma rays is their:
the cortex
The outer region of the kidney is called the
anchor the kidney to its surrounding structures and the abdominal wall
The outermost layer of tissue surrounding the kidney, the renal fascia, serves to
acidic
The pH of a solution is determined to be 6. This solution would be considered:
cortex and renal pyramids
The parenchyma of the kidney consists of
the understanding of speech and is responsible for the sensations of the temp, touch, pressure and pain from the skin.
The parietal lobe is involved in
active transport
The passage of substances across the BBB is accomplished primarily by:
patient NPO at least 4 hours prior to study
The patient preparation of 99mTc IDA scintigraphy to evaluate cystic duct patency is:
neither incident or medical
The patient was scheduled for an injection of 5 mCi of Tc99m Mebrofenin for a gallbladder but received 5.5 mCi instead.
waters position
The patients head should be placed in the _____ position against the gamma camera for the dynamic portion of 99mTcO4- salivary imaging.
resolution
The percent full width at half maximum (FWHM) is often used as a measure of:
740 ans 780 keV
The photon energy/energies of 99 Molybdenum are?
R-wave
The physiologic trigger used as a gating signal in a MUGA
thyroid-stimulating hormone (TSH) to stimulate the thyroid gland
The pituitary gland secretes
transaxial
The planar projections acquired during SPECT study are first reconstructed into tomographic slices of which axis?
confluence
The point at which the superior sagittal and transverse sinuses of the brain join is the:
peptide
The portion of an amino acid molecule that naturally binds to receptors on the cell surface is?
thyroid gland
The portion of an amino acid molecule that naturally binds to receptors on the cell surface is?
should be down
The position of the bevel of a scalp vein needle upon venipuncture
220-patient's age in years.
The predicted maximum heart rate per age is calculated as
Tc-99mO4-
The presence of Barretts esophagus, an abnormality of the esophagus which contains ectopic gastric mucosa, may be determined by scintigraphic means using:
Negatrons (Beta minus) (B-)
The primary radiation responsible for treating certain cancers is?
intercostals muscles and the diaphragm.
The primary respiratory muscles
statistically limited number of electrons emitted from the photocathode
The principle reason that NaI (Tl) detectors produce a broadened photopeak is because of the:
increases
The probability of Compton scattering ________ with increasing energy of the incoming photon.
ionization
The process in which a photon or particle removes an electron from its orbital location is termed:
micturition
The process of expelling urine from the urinary bladder is called _____
bremsstrahlung and characteristic
The processes used to produce x-rays include:
salt and water
The products of a neutralization reaction are:
140 keV
The pulse height analyzer on a gamma camera utilizes a "centerline" setting in determining which radionuclides will be detected. According to the book the "centerline" setting on a pulse height analyzer for 99m Technicium should be?
Allows certain energies of radionuclides to be detected by the system
The pulse height analyzer on a well counter or uptake probe is used for?
establish a baseline plasma count
The purpose of taking blood samples from a patient suspected of a CSF leak is to:
differentiate areas of infracted tissue from ischemic areas.
The purpose of using acetazolamide in conjunction with a brain agent is to:
end diastolic volume
The quantity of blood in the ventricles at the end of ventricular relaxation is called:
B
The radiation safety officer was reviewing monthly film badge reports. Which technologist is likely to exceed the NRC exposure limits if that technologist continues to receive the levels of exposure they are getting now? Technologist A: Monthly reading = 75 mrem Technologist B: Monthly reading = 417 mrem Technologist C: = 378 merem Technologist D: = 278 mrem
Reduces the valence of the Tc99m
The radiolysis of water in a Te Tc99m / Mo99 generator has what effect on the Tc99m?
0.22 microns
The radionuclide is filtered through a Millipore filter prior to injection. This ensures the particles are smaller than?
Tc99m Sulfur colloid
The radionuclide of choice for lymphoscintography is?
I-131
The radionuclide therapy used for the management of either hyperthyroidism or thyroid carcinoma is:
111In-capromab pendetide
The radionuclide used for imaging in the diagnostic assessment of prostate cancer is:
111In-pentetreotide
The radionuclide used to visualize primary neuroendocrine tumors is:
fasting 6 hours prior to scanning
The radionuclidic procedure for determining gastric emptying half-time of the stomach requires the patient to be
Tl-201 chloride
The radiopharmaceutical most commonly used for the detection of acute myocardial infarction is
In-111 DTPA
The radiopharmaceutical most often used for CSF imaging is:
intrathecally
The radiopharmaceutical used for assessment of CSF dynamics is administered:
99mTc-depreotide
The radiopharmaceutical used to gather additional diagnostic information on a patient with pulmonary lesions found on CT is:
Tc-99m pyrophosphate
The radiopharmaceutical with the highest acute myocardial infarct-to-normal uptake ratio is
5 mCi
The recommended dose of 111 Indium Capromab Pendetide is?
200,000 to 700,000
The recommended dose of MAA particles for a perfusion lung scan is between?
15-20 mCi
The recommended dose of Tc99m Depreotide (NeoTect) is?
20-30 mCi
The recommended dose range for the radionuclide used in scintimammography is?
25-30 mCi
The recommended dose range of Tc99m Arcitumomabe is?
50,000
The recommended number of particles in a dose of Tc-99m MAA or Tc-99m HAM for a newborn should be limited to
HVL = 0.693/u
The relationship between the linear attenuation coefficient (u) and the half-value layer (HVL) is given by:
protect the kidney against the spread of infection and protect the kidney from trauma
The renal capsule, the innermost layer of tissue surrounding the kidney, serves to:
Low atomic number materials like plastic or glass
The required shielding material for pure negatron (B-) beta particles is?
the collimator surface
The resolution of parallel hole collimators is best at:
The eluate does not contain sufficient 99mTc activity.
The results shown below were obtained when 99mTc eluate was assayed for 99Mo breakthrough at 0600, immediately following elution. 99Mo,10 uCi, 99mTc, 416mCi Which of the following statement is TRUE about this elution at 1700?
location and energy
The scintillation camera uses the signals from the photomultiplier tubes to determine the ______________________ of the detected event.
the more penetrating it is
The shorter the wavelength of electromagnetic radiation how penetrating is it
the venous sinus system is visualized
The signal for the end of capillary flush phase on an anterior cerebral radionuclide angiogram occurs when:
right route
The six rights of a correct administration of a pharmaceutical include:
molecule
The smallest particle of a chemical compound that retains all the chemical properties is a(n):
marked increased; decreased
The so-called "superscan" of bone scintigraphy has ______ uptake activity and ____ kidneys/bladder uptake
0.02 mci/g
The specific activity of one curie of I-131 in 50kg of sawdust is:
simple back projection
The star artifact is the result of:
Fundus, body and antrum.
The stomach is divided into three regions:
Thallium one-day imaging protocol
The stress is done first with imaging beginning as soon as possible (thallium begins to redistribute 20 minutes after injection). If imaging is delayed > 20 minutes after injection, subtle lesions may be missed in patients with ischemia. The rest image is done 3-4 hours after injection using thallium's ability to redistribute. Some will perform a 24-hour view with reinjection of 1 mCi to detect hibernating tissue.
the difference between end diastolic and systolic volumes
The stroke volume of the left ventricle is
Total Effective Dose Equivalent
The sum of Deep Dose Equivalent and Committed Effective Dose Equivalent
spatial linearity
The system spatial resolution of a scintillation camera does NOT depend on:
non-obstructed, dilated ureter of the
The technologist is performing a diuretic renogram on a patient with a possible left kidney obstruction. When processing the renogram curves, it is noted that the left kidney curve shows a delay in reaching peak activity with normal emptying after the administration of lasix. This would be indicative of a ____________ left kidney.
0.25
The technologist is preparing to start working with F-18 radiopharmaceuticals and need to order a syringe shield. One vendor sells a 5.2 mm tungsten shield. The half value layer of tungsten for 511 keV annihilation photons generated by F-18 is about 2.6 mm. By what fraction will the dose be reduced to using this shield as compared to using no shield?
hearing and used in the memory of visual scenes, music and other complex sensory patterns
The temporal lobe is responsible for
bremsstrahlung
The term for braking radiation is
photon
The term used to describe all forms of electromagnetic radiation is:
8 mCi
The therapeutic dose of Na131I administered for the treatment of hyperthyroidism is ____________.
higher energy radionuclides
The thicker a well counter crystal, the more efficient the system is at counting:
Half Value Layer
The thickness of a material required to reduce the radiation intensity to half it's original value is the definition for?
meninges
The three membranes which cover the brain and spinal cord. These include the dura, arachnoid and pia mater.
ionization, excitation, Bremsstrahlung
The three primary interaction mechanisms for charged particles in matter are:
trachea
The thyroid consists of two lobes connected by an isthmus that overlies the __________.
half life
The time it takes for half of the atoms in a large sample to decay is called the half-life.
40-50 cc
The total cerebrospinal fluid in an adult is:
main stem bronchi
The trachea divides into the
isomeric
The transition of 99mTc to 99Tc is considered to be
x-rays
The two forms of electromagnetic radiation are gamma rays and
the fundus and antrum
The two functionally distinct areas of the stomach involved in gastric emptying are the
9mTc-DMSA and 99mTc-glucoheptonate
The two most common agents used for morphologic renal imaging are:
beta partcles
The type of decay observed when too many neutrons are present in the nucleus is
continuous spectrum of polyenergetic.
The type of energy spectrum observed with beta decay is
15-20 mCi
The typical dose of 99mTcO4- used for routine brain scintigraphy is:
cancer cells use glucose at a faster rate than normal cells
The use of F-18-FDG in cancer imaging is based on the fact that:
5-10 mCi
The usual adult dose of 99mTc labeled hepatobiliary agents is:
250 uCi
The usual adult dose of Se-75 for pancreas imaging is:
20 mCi
The usual average dose for 99mTc-labeled SPECT perfusion imaging agents such as HMPAO (Certec) and ECD (Neurolite) is:
3-6 mCi
The usual average dose for I-123-labeled SPECT perfusion imaging agents such as IMP and its analog HIPDM is:
5-10 minutes; 60 minutes
The usual imaging protocol for Meckels diverticulum scintigraphy calls for acquiring 500kct anterior images of the abdomen every ____ up to ____ after 99mTcO4- is administered.
300-500 kcts
The usual number of counts for static brain scintigraphy is:
2 seconds
The usual time per image frame for adult cerebral radionuclide angiography is:
45%
The values for a Schilling test that has a 2% standard are: Standard = 9500 cpm Urine sample = 658 cpm Urine sample volume = 4 ml Total urine volume = 1300 ml The percent excretion for this patient is:
right atrium
The venous blood supply returning via the superior and inferior vena cava enters the heart at the
the arrival of activity in the superior sagittal sinus
The venous phase of a perfusion study is marked by:
tidal volume
The volume of air exhaled in a normal breath is called:
4-5 liters
The volume of blood pumped out by the adult heart per minute is
30 g
The weight of the thyroid gland in an adult is approximately ____ grams
protons
The z number of an element represents the number of ______ in the nucleus of an atom.
blotchy appearance
There were 100,000 particles in a macroaggregated albumin (MAA) dose that a technologist prepared for a normal lung scan. The scan resulted in:
Radiation exposure to the hands
Thermoluminescent dosimeters are primarily used in nuclear medicine to monitor?
interaction of photons with matter
This interaction is a function of the energy of the photons and the atomic number (Z number) of elements composing the matte
Prechlorate washout test
This test is used to identify congenital or acquired organification defects which most commonly involves the enzyme iodide peroxidase
• Papillary(leastdeadly,morecommon) • Follicular • Medullary • Anaplastic(mostdeadly,leastcommon)
Thyroid cancers:
• Regulationofmetabolism. • Regulationofgrowthanddevelopment. • Regulationoftheactivityofthenervoussystem.
Thyroid hormones have three principal effects on the body
rapidly cleared from the blood with a myocardial first pass extraction of 85-90%.
Tl-201 clearance
Tc99m DTPA
To allow for a repeat study, a radiopharmaceutical used to acquire a first-pass study is:
decay in storage
To comply with NRC regulations, records of all of the following types of radioactive waste disposal must be retained indefinitely EXCEPT:
immediate
To evaluate hepatocyte function with 99mTc labeled hepatobiliary agents, imaging must begin _____ after administration of the radiopharmaceutical.
via instillation
To perform a direct cystogram, the radioactive material is administered:
70 degrees F
To prevent the overheating of gamma cameras and computers, it is recommended that room temperature be maintained near:
high-energy multipurpose collimator
To reduce septal penetration of gamma rays when a 131-Iodine whole body metastatic survey is performed, the technologist should use a:
1.2 L/min
Total renal blood flow is
false
True or False As the Z# of the absorbing material increases, the probability of photoelectric absorption occurring decreases.
false
True or False Beta particles are a form of electromagnetic radiation.
true
True or False Gamma rays travel at the speed of light
false
True or False Non-ionizing radiation will produce an ion pair.
false
True or False The closer an orbital electron is to the nucleus, the weaker the binding energy is between the two.
true
True or False There is no positive benefit with Compton scatter.
True
True or False: Absorbed-dose rate in an organ is equal to the energy-release rate from activity in that organ.
- proximal convoluted tubule - loop of Henle - distal convoluted tubule
Tubular reabsorption occurs primarily in th
gut
Two hours after administration to a normal patient, most of the 99mTc mebrofenin or 99mTc disofenin should be located in the:
hemangiomas
Two hours after injection of 99mTc-labeled, non-heat-treated red blood cells, there remains increased activity in the liver. This finding is most consistent with:
• Breast • Prostate • Lung • Kidney • Thyroid
Types of cancers known to metastasize to the bone:
10 um - 40 um
Typical preparations of Tc-99m MAA have average particle sizes ranging from
axial skeleton
Typically, skeletal metastatic disease has the greatest involvement in:
2 mRem per hour
Uncontrolled area radiation level
a lethal condition at an early age
Untreated biliary atresia is...
shallow dose equivalent
Used to calculate exposure to the skin or any h appendage
yes
Using Table 1-5 in the book, does a linear correlation coefficient r=0.95 for n=5 data points indicate a statistically significant linear relationship between the X and Y variables?
0.01 < P < 0.05
Using Table 1-5 in the book, what is the P-value for the linear correlation coefficient r in question 31?
increase in contrast resolution
Using a higher mA results in:
the count rate to be calculated using a region of interest (ROI) over the entire esophagus
Using the condensed image method to display results of an esophageal transit study allows for the display of:
72
Using the regression equation in Problem 31, if your training program exam score was 84, what does the regression equation predict for your board score?
nuclear fission
Very large unstable atom may break into larger fragments than helium nucleus
Alpha decay
Very large unstable atoms undergo this...emission of 2 protons and 2 neutrons from nucleus (aka "helium nucleus"). Not used in diagnostic medical imaging as is too damaging to tissue
trauma
Visible rib lesions which are arranged in a linear fashion are generally indicative of what?
a patent cystic duct
Visualization of the gallbladder within 20 minutes after the injection of 99mTc choletec or 99mTc hepatolite implies
Functional residual capacity
Volume of air in the lungs at the end of a normal breath
Total lung capacity
Volume of air in the lungs when as much as possible has been inhaled.
Residual volume
Volume of air left in the lungs after a complete exhalation
a focal area of increased activity w/in a salivary gland
Warthin's tumor presents as
pediatric dose
Weight in pounds x Adult dosage is used to calculate _____ according to Clarks Rule 150 pounds
10 ug/ml
What are the allowable limits of Alumina allowed in the eluate of Tc99m?
frame and list
What are the two types of acquisition modes described in the book?
PM tube voltage
What does not affect the efficiency of a NaI(Tl) crystal?
Tc
What element has NO stable isostope?
It is completely absorbed during the interaction
What happens to the original x-ray photon during photoelectric effect?
Sensitivity flood for lines of response (LOR)
What image or product is the result of a "blank" scan that is used in the quality control of a PET scanner
Sodium iodide - Thallium activated scintillation crystal
What is the "medium" or material used in a well counter to detect radiation?
Cut-off or critical frequency
What is the "single" parameter used in a Hanning filter?
0.045
What is the 3-hour decay factor for Mo99?
22 dpm
What is the ALLOWABLE limit of disintegrations per minute per cm2 for wipe testing of radioactive shipments?
Incorrect or misadjusted photopeak
What is the MOST likely cause of photomultiplier tubes that appear "hot" or "cold" on a uniformity flood image?
0.02 to 0.05 mrem
What is the acceptable range considered for background levels according to the NRC?
SPECT Backprojection reconstruction
What is the cause of the "star" artifact when an image is reconstructed?
+3
What is the chemical valance of alumina?
0.5%
What is the coefficient of variation of 40,000 counts?
28 days
What is the half-life of Cr-51?
22.8 days
What is the half-life of a radionuclide whose decay constant is 0.0304/days?
85
What is the minimum number of millicuries of 99mTc MDP needed at 8 am to deliver three 20-mCi doses that are to be injected at 8:30 am, 10:00 am, and 1:30 PM? the 1-hour decay factor is 0.891 and 30-minute decay factor is 0.944.
3.8
What is the proper number of decimal places in the sum of (0.3) + (3.5264)?
Oxidize the excess stannous ion and prevent any additional radioactive tagging
What is the purpose of adding filtered air to the reaction vial of Tc99m Mertiatide (MAG 3) following the addition of Tc99m?
stannous chloride
What is the reducing agent used in Tc99m radiopharmaceuticals
16 MBq
What is the total activity of 8 mL of Tc-99m eluate that has a concentration of 2.0 MBq/mL?
+7
What is the valence of the Tc99m when it is eluted from the generator?
P-C-P
What kind of bonds are more stable in vivo?
35%
What percentage of the original radionuclide would remain after 6 hours? (99mTc from #5)
68 Germanium
What radiation source is used for the "blank" scan a part of a PET scanner quality control program?
662 x 0.1
What should a well counter or uptake probe setting be set at to count *137 Cesium with a 10% window if it has ONLY a Lower Level Discriminator (LLD)? The LLD should be set at _____ and the "window width" at _____?
blood vessels lymph vessels nerves ureter
What structures enter and leave the kidney through the hilus
white one
What type of Radiation label must be affixed to a package that measures 0.3 mR/hr at the surface and no detectable radiation at 1 meter (TI)?
laser light
What type of device is used to read the Optically Stimulated Luminescent personnel radiation monitor?
yellow III
What type of label is required for a radioactive material shipment where the surface reading is 100 mR/hr and the 1 meter (Tl) is 5 mR/hr?
Sodium iodide - Thallium activated scintillation crystal
What type of material is used to detect the radiation in an uptake probe?
5.772
What would be the average life of the 99mTc in problem #5
The results would be erroneously high
What would be the expected test results if some of the radiopharmaceutical was infiltrated during injection of 125i human albumin of a plasma volume determination?
methylene blue stabilizer
When 99Tc HHPAO is used to label the white blood cells, which of the following reagents is omitted from its preparation?
100-200 mCi
When I-131 is used in the treatment of thyroid carcinoma, the usual dose range is
annihilation
When a positron meets a free electron, it's explosive, literally. The combined mass of the two particles is instantly converted to energy in the form of two oppositely directed photons, each of 511 keV.
30,000,000
When acquiring a SPECT uniformity flood, the recommended number of counts to obtain for a 64 x 64 computer matrix on a standard field or large field of view camera is?
flush at least 10 ml saline
When administering a radiopharmaceutical dose via an IV line, preparation is made for:
plasma and cells
When blood is collected with an anticoagulant, the whole blood separates into:
higher target to background ration
When compared to FDG PET images, 99m Tc-MIBI SPECT brain images have a lower resolution and:
neutrons
When fission takes place, _____ are released.
512x512
When imaging In-111 Pentetreotide, you should use a _____ matrix
2
When imaging In-111 Pentetreotide, you should use a _____ zoom:
supine and upright postion
When imaging a patient with a ptotic kidney, the technologist should take images in the:
during ictal state
When imaging for epileptic foci, the radiopharmaceutical injection occurs:
the top of the liver through the bladder
When imaging your In-111 Octreotide patient, you will position the patient such that the following is in the FOV:
ion pair
When ionization occurs, the ionized atom is positively charged and the ejected electron is negatively charged.
prevent clotting
When labeling red blood cells using the in vitro method, acid-citrate-dextrose (ACD) is added to the aliquot of patient's blood to:
excessive catecholamine
When looking at the blood test results in a chart of a patient with hyperparathyroidism, a technologist will most likely see evidence of:
increased utilization of glucose in ischemic tissue
When performing PET myocardial perfusion imaging with FDG, FDG reflects the relatively:
When performing PET myocardial perfusion imaging with FDG, FDG reflects the relatively:
When performing PET/CT or SPECT/CT of the heart, misregistration can be caused by:
thyroid
When performing a 51Cr-labeled splenic sequestration study, the technologist does NOT take counts over the:
the radiopharmaceutical should be injected at peak stress and the exercise continued for 1 to 2 minutes
When performing a myocardial perfusion exercise stress test, ideally:
3-4 hours after stress imaging
When performing a myocardial perfusion stress test with Thallium, redistribution imaging begins:
20 to 30 mintutes after inj
When performing a normal liver/spleen study, following the blood pool image the technologist should begin imaging:
halfway into adenosine infusion
When performing a pharmacological stress test using adenosine, the radiopharmaceutical should be injected:
more sensitive to tissue attenuation
When performing a radioactive iodine uptake, it should be remembered that in comparison with 131I, 123I is:
to better define nodules that may be on the anterior or posterior surface
When performing a thyroid scan, in addition to an anterior view, oblique views should be taken:
128x128
When performing cardiac studies on a large field of view camera, the data are typically recorded in the matrix size of:
heart rate is regular
When performing equilibrium-gated blood pool imaging, temporal smoothing should be used only when:
include small margins of the liver and spleen in the field of view
When positioning a patient for a gastrointestinal bleed study using 99mTc sulfur colloid, care should be taken to:
dim lights, let patient relax, immobilize patients head
When preparing to scan a patient to be injected with a perfusion SPECT radiopharmaceutical, it is a good idea to:
dim the lights and let the patient relax immobilize the patient's head
When preparing to scan a patient to be injected with a perfusion SPECT radiopharmaceutical, it is a good idea to:
increases
When the center-of-rotation (COR) error increases, the full-width-at-half-maximum (FWHM) of a reconstructed line or point:
ring artifact
When the same nonuniformity is back-projected at each of the angles of acquisition, the result is:
graves disease
When the thyroid gland is the source of excessive thyroid hormone, is diffusely large, and is homogenously active, it is characteristic of:
intravenously, intramuscularly, and orally
When used for brain imaging, 99mTcO4- may be administered:
little postreconstructive filtering is required
When using iterative reconstruction techniques:
timing marks are not needed for data collection
When using list mode to acquire a gated cardiac study all of the following are true EXCEPT:
free pertechnetate, free reduced technetium, and labeled radiopharmaceutical
When using radiochromatography to evaluate the percentage of radiochemical purity in the reduced soluble 99mTc radiopharmaceuticals, the technologist checks for the percentages of:
stop tagging procedure
When using the 51Cr ascorbic acid method to label erythrocytes, the ascorbic acid is added to:
90-120 minutes post inj
When using the double-phase study for imaging the parathyroid gland, the technologist should repeat images:
24 and 48 hrs
When will you image after dosing your patient with In-111 Octreotide?
Nuclear Regulatory Commission (NRC)
Which Federal agency adopted a "RISK INFORMED, PERFORMANCE BASED" approach in October of 2002; where there are NO specifications for which methods and how frequently radiation safety procedures must be performed?
Department of Transportation
Which Federal agency controls the packaging and interstate movement of hazardous materials including radioactivity?
concentration, oxidation, iodination, coupling, and storage
Which best describes iodine metabolism in the thyroid ?
converging
Which collimator has a focal plane and as the distance from the patient increases there is a decrease in resolution, and increase in sensitivity and then a decrease in sensitivity beyond the focal plane. Magnification increases beyond the focal plane too
MEAP
Which collimator will you use for an In-111 Pentetreotide study?
ionization chamber
Which detector provides a reading of the rate of radiation exposure?
well counter
Which device is more EFFICIENT at detecting low quantities of radiation?
Thyroid iodine uptake tests - RAIU
Which exam or procedure does NOT use a well counter to obtain nuclear medicine data?
showing too much variation
Which expression describes the operation of the gamma camera in question 16?
10 CFR Part 20
Which federal regulation specifies occupational radiation dose limits for radiation workers exposed to source, special, nuclear, and byproduct materials?
thyroid
Which hormone is NOT inhibited by SOMATOSTATIN?
64 x 64 word
Which image would take up more space in the computer memory?
T4
Which is more abundant T3 or T4?
high ratio of protons to neutrons eg: 10 to 1
Which is not a characteristic of a stable nucleus
left anterior oblique (45-60%)
Which is the best view to delineate the left ventricle on a nuclear medicine scan?
bit mode
Which method is NOT used to save computer data?
256 x 256 word mode
Which method of computer acquisition is recommended for high count (500k per view) planar images of the lungs where more than 256 counts per pixel are likely to be recorded?
- Insulinoma - Small Cell Lung CA - Carcinoid Tumors
Which of the following are correct indications for an In-111 Pentetreotide Scan?
a blood-brain barrier study using 99mTc DTPA
Which of the following central nervous system studies is routinely used for the determination of brain death?
- ingestion of excessive calcium - decrease in the amount of water intake - abnormally alkaline or acidic urine - overactivity of the parathyroid glands
Which of the following conditions lead to kidney stone formation
USP purified water (0.2% sodium thiosulfate)
Which of the following diluents is recommended for use with I-131 sodium iodide solutions?
Recapping venipuncture needles.
Which of the following does not follow established guidelines for standard precautions?
aspirin
Which of the following drugs do NOT inhibit the transport of Stannous Ion across the cell membrane when labeling red blood cells?
35 mR/hr at surface; 1.0 mR/hr at 1 meter
Which of the following exposure rates indicate that a package containing radioactive material should be labeled with a Category II DOT label?
56 mR/hr at surface; 3.5 mR/hr at 1 meter
Which of the following exposure rates indicate that a package containing radioactive material should be labeled with a Category III DOT label?
I and II
Which of the following filters are classified as "LOW PASS" filters? I Butterworth II. Hanning III. Ramp IV. Unique cardiac V. FRAM
Improved signal-to-noise ratio
Which of the following is NOT an advantage of attenuation correction in PET:
Radiation measurements taken at the package surface
Which of the following is NOT required to appear on the label of radioactive material shipment packages or containers according to Department of Transportation (DOT) requirements?
The resolution is improved by n.
Which of the following is NOT true about multiple head cameras when compared to single head cameras, all other components being equal: (n= the number of heads)
the same A (mass) number
Which of the following is NOT true of isotopes
Penetrates tissues with relatively little attenuation.
Which of the following is characteristic of a gamma particle?
Helium nucleus with two neutrons and two positively charged protons
Which of the following is characteristic of an alpha particle
specific activity
Which of the following is measured in "mCi/mg" (millicuries per milligram)?
TRH
Which of the following is secreted into the anterior portion of the pituitary gland by the hypothalamus?
TRH
Which of the following is secreted into the anterior portion of the pituitary gland by the hypothalamus?
supine/anterior
Which of the following is the correct patient/camera positioning for imaging a transplanted kidney? Answers will be listed as patient position/camera placement.
Net Pt. Neck counts/Net Standard counts x 100
Which of the following is the most correct formula for the calculation of percent radioiodine uptake by the thyroid gland?
Tc99m
Which of the following is/are NOT organified by the normal thyroid?
plastic
Which of the following materials is the best choice for shielding P-32?
Thyroid uptake 24 hours after handling the solution
Which of the following monitoring techniques should be employed to rule out internal contamination after handling a radioiodine solution?
Age
Which of the following most likely affects the rate of flow of CSF?
Normal resting 201TI thallium chloride, abnormal stress 201TI thallium chloride.
Which of the following myocardial perfusion patterns suggest that the patient has myocardial ischemia?
d = .15 mm, L = 3.0 cm
Which of the following parallel hole collimator configurations would be expected to yield the best geometrical resolution at 10 cm from the collimator: (d = hole diameter, L = length of collimator)
constancy
Which of the following quality control tests should be performed each day as the survey meter is use?
Portable ionization chamber
Which of the following radiation monitoring devices is best suited to survey a patient who has received 150 mCi of I-131 for therapy?
Tl-201
Which of the following radionuclides is NOT a byproduct material:
111 Indium Capromab Pendetide
Which of the following radionuclides is a monoclonal antibody?
Indium 111
Which of the following radionuclides would be considered accelerator-produced?
99mTc HMPAO
Which of the following radiopharmaceuticals is NOT based on detecting a compromised BBB?
There is no hope for improving the image quality with improvements in instrumentation
Which of the following statements about Hybrid PET / SPECT is NOT true:
filtered back projection
Which of the following techniques is used to eliminate the star effect created during tomographic reconstruction?
pixel callibration
Which of the following tests of the gamma camera would be MOST useful in helping a doctor determine the size of an organ or lesion?
Formation of hydroxyl radicals
Which of the following typifies the concept of indirect action:
isobar is formed
Which of the following will be the result of beta decay
tc99m
Which of the following yields the lowest absorbed radiation dose to the thyroid per mCi of administered dose?
Accuracy of attenuation correction
Which one of the following is specifically a SPECT acceptance test:
K-shell
Which one of the following orbital shell electrons possesses the greatest amount of energy between it and the nucleus?
Physical Purity
Which one of the following parameters is NOT part of a routine radiopharmaceutical quality control program:
F-18
Which one of the following radionuclides would be suitable for coincidence imaging with a coincidence SPECT imaging system:
A significant COR error.
Which one of the following will NOT produce "ring" artifacts in clinical SPECT studies:
liver
Which organ will NOT pick up unbound or "Free" Technicium?
power factor or order
Which part of the Butterworth filter is related to how fast the filter cut-off is initiated or how quickly the transition is made between frequencies that are kept and those that are eliminated from the image?
The CT portion since the attenuation correction needs to be applied to the PET study for reconstruction purposes
Which part of the PET/CT scan needs to be done first?
alpha
Which particle radiation has the greatest mass (AMU)
Pocket ionization chamber
Which personnel monitoring device is subject to inaccurate readings if it is not carefully handled?
Rollo
Which phantom is NOT used for evaluating the spatial resolution of a gamma camera?
count rate is decreased due to loss of counts because of instrument "dead time"
Which problem occurs when too many photons strike the crystal of a well counter?
neuroendocrine tumor imaging
Which procedure may incorporate imaging with both III Indium and Tc99m labeled red blood cells?
S-factor
Which quantity groups factors dependent on radionuclide properties relative to a size and position of various organs in a model phantom:
Portable ionization chamber - Cutie Pie
Which radiation detector is recommended for measuring high dose rates or patient's who've received therapeutic amounts of 131 Iodine?
beta particles and positrons
Which radiation has a continuous energy spectrum
111 In Capromab Pendetide
Which radionuclide has a patient preparation where laxatives are given 24 hours before the procedure starts and continues for four to five days afterwards. It is further recommended by some sources that the bladder be catherized and irrigated to remove all residual urine from the field of view.
111 Indium Capromab Pendetide
Which radionuclide requires imaging of the pelvis and abdomen 30 minutes to 4 hours post injection to delineate the blood pool for use during interpretation?
111 Indium Capromab Pendetide
Which radionuclide should be administered to a patient who has had surgery but now their PSA levels are rising?
131 Iodine liquid solution
Which radionuclide should be kept tightly capped and only opened in a fume hood to avoid inhalation of volitile radioactive gases?
131 Iodine liquid and 133 Xenon
Which radionuclides require the use of a "fume hood" to reduce internal exposure to technologists:
sulfur colloid
Which radiopharmaceutical does NOT require reducing agents be added to the kit for binding molecules to the Tc99m?
Nuclear Regulatory Commission (NRC)
Which regulatory agency is responsible for the regulation of purchase, receipt, use and disposal of radioactive material produced by nuclear reactors?
z number decreases by 2
Which statement is true regarding alpha decay
uptake is predominately in the white matter
Which statement regarding 99mTc HMPAO is FALSE?
Diverging (LEDP)
Which term is NOT associated with a PARALLEL HOLE collimator classification?
Tc99m Arcitumomab
Which tumor imaging agent is a fragment of an antibody that is expressed against carcinoembryonic antigen?
list mode
Which type of acquisition occurs when the counts are stored sequentially as x and y coordinates with time markers at various points in the list of counts?
High Sensitivity
Which type of collimator has wide holes and a short bore?
all purpose
Which type of collimator is designed to optimize both resolution and sensitivity?
frame mode
Which type of computer acquisition mode is MOST commonly used in nuclear medicine acquisition studies?
Unfiltered SPECT acquisition
Which type of computer acquisition produces a "star" artifact when reconstructing an image?
Portable ionization meter (high intensity) Cutie Pie
Which type of detector is more accurate to radiation detection
ramp
Which type of filter is commonly used to suppress the "star" artifact and is commonly used to enhance the edges of an image?
Positron Emission Tomography (PET)
Which type of imaging is dependent upon the detection of "coincidence" events?
Type B
Which type of packaging for transport of radioactive materials is more accident resistant and is used for very large quantities of radioactive materials.
Thermoluminescent dosimeter
Which type of personal monitor uses Lithium Fluoride crystals which are "read" by heating the crystal to a high temperature and measuring the light given off by the crystals?
Optically stimulated Luminescent dosimeter
Which type of personnel monitor device utilizes aluminoxide to detect radiation?
Pocket Ionization chamber
Which type of personnel monitoring device is capable of giving an immediate radiation exposure measurement to the technologist?
Film badge
Which type of personnel monitoring device relies on measuring the optical density after development.
high energy negatrons (B-)
Which type of radiation may require a "correction factor" when placed in a dose calibrator to calculate the dose of radiopharmaceutical?
Geiger Mueller (GM) detector
Which type of radiation monitoring device is NOT recommended for nursing personnel caring for a patient who has been treated with 131 Iodine?
PET imaging
Which type of study requires the use of a transmission source that rotates around the patient during or after the acquisition?
MRI studies of the patient using Gadolinium contrast agents
Which type of test using contrast agents may effect the biodistribution of 67 Gallium?
extrinsic uniformity
Which type of testing monitors the condition of the gamma camera as it would be used in the clinical situation imaging patients with the collimator on?
intrinsic uniformity
Which type of testing monitors the condition of the sodium iodide crystal and the electronics associated with the scintillation camera without the collimator on?
gamma and high energy negatrons (B-)
Which type/s or radiation are measured in a dose calibrator?
trauma to chest wall
While performing a whole body bone scan on a 62-year-old male, you notice focal areas of increase uptake on 4 adjacent rids that appear to be in a linear arrangement. The most probable reason for the appearance of this scan is:
hyperkinesia
While waiting for a scan, a diabetic patient develops hypoglycemia. The symptoms may include all of the following EXCEPT:
Bone delayed images aquisition
Whole body sweep, 10-14 cm/min, 256 x1024 matrix. Statics, 256 x 256 matrix, extremities 200- 300 kcts, torso 500-800 kcts.
disintegrations per minute
Wipe test measurements are reported with which unit?
2200 dpm
Wipe tests for removable contamination are performed using the same criteria as those required for surveys. Wipe tests may be analyzed using an appropriate instrument such as a well counter or an uncollimated gamma camera. The RSO must be notified if a trigger level of _____ is reached in a restricted or unrestricted area.
anti-neturino
With beta decay the maximum energy of a particle is soldom observed. With which particle is the energy shared
the long axis is not parallel to the surface of the camera crystal.
With planar scintigraphy, the kidney may appear smaller than its normal size if:
bone marrow
With severe hepatic disease, the radiation dose of 99mTc sulfur colloid to the _____ is tripled.
5.24 days
Xe-133 T1/2
10-20 mCi
Xe-133 dose range
-LEAP or LEHR collimator. • Dynamic sequences, 20-60 seconds each for 6-8 minutes. These dynamic images will demonstrate single breath, equilibrium and washout. • Images are taken posteriorly. • Pulmonex used for administration and washout of Xenon. (Make sure to check your Drierite and Soda lime containers before every study).
Xe-133 protocol
radiochemical
_____ purity is the fraction of the stated radionuclide present in the stated chemical form.
The sphincter of Oddi
a muscular sphincter that exists at the entrance to the duodenum
The liver
a solid, lobulated organ located in the RUQ of the abdomen. The right and left lobes are separated by the falciform ligament
• 24 hour image demonstrates ventricular activity and persistent activity in the basal cisterns without evidence of activity over the convexities. Ventricular activity persists on the 48 hour exam. Positive for normal pressure hydrocephalus. • A ratio of nasal to plasma radioactivity greater than 1.3:1 is considered positive for a CSF leak.
abnormal result for cisternogram
Areas of decreased activity where lung was not ventilated.
abnormal results for T99m DTPA lung
-Segmental or wedge-shaped areas of decreased activity. -Mismatched with ventilation = PE. -Matched with ventilation = COPD, lung dysfunction, or tumors. -Reverse mismatch = Pneumonia
abnormal results for Tc99m MAA
Decreased areas of activity where lung is not ventilated. COPD presents as inhomogeneous wash-in, patchy equilibrium and areas of trapping delaying washout
abnormal results for Xe-133
Focal areas of increased activity that increase more over time.
abnormal results of mIBG
portrayed as areas of diminished or absent activity.
abnormal ventilation for krypton-81m
Tidal volume
air breathed out in a normal breath
low-pass filter
allows low frequencies to pass and blocks higher ones
Amplitude analysis
amplitude image shows the magnitude of blood ejected from each pixel within the ventricular chamber. The image is calculated from the entire timeactivity curve.
isotope
an atom with the same number of protons but different number of neutrons as its stable counterpart
Sjogren syndrome
an autoimmune disease in which the body's immune system mistakenly attacks its own moisture producing glands. Nine out of ten patients are women. The average age of onset is late 40s although occurs in all age groups in both women and men. The hallmark symptoms are dry eyes and dry mouth. may also cause dryness of other organs, affecting the kidneys, GI tract, blood vessels, lung, liver, pancreas, and the central nervous system.
slow
at what speed should you push the In-111 Octreotide injection
Grave's disease
autoimmune disorder. Some symptoms include weight loss, nervousness, irritability, excessive sweating and exophthalmus. Images will have a diffusely large gland and patient will have a very high uptake value.
Plummer's disease
autonomous multinodular goiter.
THYROID SUPPRESSION TEST
based on the premise that normal thyroid activity is suppressed by exogenously administered thyroid hormone. The test is used to determine the autonomy of a hot nodule or diffusely enlarged gland.
Adenosine/dipyridamole
both induce hyperemia by causing coronary vasodilatation but by different mechanisms.
LEAP or LEHR
brain scan collimators
A byte
can represent 256 numbers, 0-255
Subacute thyroiditis (de Quervain's syndrome)
caused by a viral infection. Hyperthyroidism caused by leaking of thyroid hormones from damaged thyroid cells. This is a temporary situation. You will not visualize the thyroid when imaging.
Acute (suppurative thyroiditis
caused from a bacterial infection.
Osteoblasts
cells involved in ossification (buildup) of bone.
Osteoclasts
cells that deossify (breakdown) bone.
it does not completely dissociate in water
characteristic of a weak acid
Liquidity, texture, volume, weight, particle size, caloric density, nutrient composition
characteristics of a meal that affect the rate of gastric emptying
non penetrating radiation
charged particles undergo many closely spaced interactions, which limits their penetration. Because of the strong electrical force between a charged particle and the atoms of an absorber, charged particles can be stopped by matter with ease. Compared to photons, they transfer a greater amount of energy in a shorter distance and come to rest more rapidly.
Hashimoto's thyroidism
chronic inflammatory disease can begin as hyperthyroidism but is truly a hypothyroid disorder and will end up hypo.
In-111 DTPA
cisternogram RP
Hepatocytes
clear the IDA labeled materials from the blood in a mechanism similar to the transport mechanism of bilirubin
cystic duct
common hepatic duct joints with the
Horseshoe kidney
congenital abnormality where the bottom of each kidney is joined. Visualized best on an anterior view.
stomach
crescent-shaped pouch-like organ that lies just below the diaphragm.
thyroid
critical for thyroid ablation
thyroid
critical organ for I-131 whole body scan
kidneys
critical organ for Tc99m DMSA for tubular fixation
bladder
critical organ for Tc99m DTPA for glomerular filtration
bladder
critical organ for Tc99m MAG3 for tubular secretion
thyroid
critical organ for adrenal medulla (mIBG)
large intesting
critical organ for liver/spleen scan
thyroid
critical organ for thyroid therapy
Colon
critical organ of MPI
bladder (because of breakdown process
critical organ of Tc99m DTPA lung
kidneys
critical organ of Tl-201
lungs
critical organ of Xe-133
lacrimal glands and GB wall
critical organ of ceretec
gallbladder wall
critical organ of neurolite
bladder
critical organ of thyroid scan
gallbladder
cystic duct connects with
decay constant= 0.693/t1/2
decay constant formula
Colloid shift
decreased uptake of colloid by the liver and increased uptake by the spleen caused by liver dysfunction or a shift in blood flow (i.e. portal hypertension).
3 HVL
decreases original exposure rate by 12.5% (or 0.125) .....etc.
2 HVL
decreases original exposure rate by 25% (or 0.25)
1 HVL
decreases original exposure rate by 50% (or 0.50)
Glucagons
decreases peristalsis and increases persistence of activity in ectopic mucosa.
Cimetidine
decreases release of pertechnetate from ectopic mucosa into bowel lumen and increases gastric uptake.
Hydronephrosis
dilatation of the renal pelvis and ureter due to either obstruction or simply nonobstructed dilated collecting system.
at least three times the first inj
dose for second inj on one day protocol
1-5 mCi
dose range for I-131 whole body scan
I-123: 3-10 mCi. I-131: 500 uCi-1 mCi
dose range for adrenal medulla (mIBG)
0.5-1.5 mCi
dose range for cisternogram
15-30 mCi
dose range for create/neurolite
16-30 mCi
dose range for parathyroid scan
30-300 mCi
dose range for thyroid ablation
10 mCi
dose range for thyroid scan
1-30 mCi
dose range for thyroid therapy
I-123 200-400 uCi
dose range for thyroid uptake/scan
2-5 mCi
dose range of Tl-201
nephrotosis
downward displacement of the kidney
right
due to displacement of the liver which kidney is slightly lower?
P wave
electrical signal to the atria to contract.
Beta minus 806 KeV - Gamma 364 KeV
energy of 131 Iodine
Beta minus 800 KeV Gamma 70 KeV and 103 KeV
energy of 153 Samarium
Beta minus 1.71 MeV- No gamma
energy of 32 Phosphorus
Beta minus 1.46 Mev - Gamma 91 KeV
energy of 89 Strontium
2.27 MeV
energy of 90 Yttrium
81 keV
energy of Xe-133
191 keV
energy of krypton-81m
Xerostomia
excessive dry mouth. Xerostomia results when the salivary glands stop functioning properly.
15% liver-gut 75% kidney
excretion of Tc-ECD (48 hrs post inj.)
50% liver-gut 40% kidneys
excretion of Tc-HMPAO (48 hrs post in.)
Dipyridamole
exerts its effect indirectly by increasing circulatory levels of endogenous adenosine. Peak physiologic response is seen about 6.5 minutes after a 4-min infusion is started. Coronary blood flow returns to baseline values at about 30 minutes post infusion. Patient needs to be off caffeine (at least 24 hours) and phylline (theophylline, etc.) drugs because they are the antidote to adenosine. Not for patients with asthma. Injection of tracer at 3-4 minutes after conclusion of persantine infusion.
small intestine
extends from pyloric sphincter of the stomach to the ileocecal valve and is divided into the duodenum, jejunum and ileum. It is responsible for digestion and absorption of all nutrients in the body.
large intestine
extends from the ileocecal valve to the anus and is divided into the cecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum. Very little absorption of nutrients occurs here with notable exception of some vitamins. The major function is reabsorption of water.
saliva
fluid that initiates the chemical breakdown of food and is continuously secreted into the mouth.
Discontinue all thyroid medications for at least 2 days. No iodinated contrast material for three weeks before dosing. Low iodine diet. Avoid multivitamins containing large amounts of iodine . After ingestion: No close contact w/anyone for 48 hours(no closer than 3 feet). Don't share utensils or food w/others. Flush toilet twice after each use. Wash clothes and linen thoroughly. Don't hug or hold children close for 2 days. Inform patient that they may feel a scratchy throat. It will take up to at least a week or more to feel any difference in symptoms of hyperthyroidism.
for thyroid therapy
penetrating radiation
gamma ray and x-ray radiation have the ability to penetrate considerable thickness of a material. An individual photon may travel several cm or farther into tissue before it interacts.
-Solid is generally hardboiled egg(s) withTc99m sulfur colloid and liquid phase In-111 DTPA in water.
gastric empty RP
60 sec/frame for 60-120 minutes.
gastric empty dynamic protocol
-LEAP or LEHR -STATICS: 60-120 seconds (50 kcts) every 5-10 minutes.
gastric empty imaging static protocol
Determination of gastric emptying rate, evaluation of mechanical obstruction, evaluation of anatomic obstruction, evaluation of altered function, etc.
gastric empty indication
compartmental
gastric empty localization
-NPO for 4-12 hours before examination. -Patient needs to eat meal w/in 10 min.
gastric empty patient prep
4:1
gray to white matter ration of Tc-ECD
2-3:1
gray to white matter ration of Tc-HMPAO
lighter particles
have less charge (like beta particles), and/or have greater energy
heavier particles
have less charge (like beta particles), and/or have greater energy travel farther than particles that are heavier
buffer solution
helps maintain pH
renal
how is MDP/HMDP excreted?
3-30 minutes
how is cck administered
at least 30 minutes for injection
how long should patients be of nitroglycerin products for myocardial perfusion imaging?
2
how many IDA molecules does it take to chelate to one Tc99m molecule
3
how many layer of the bladder wall
3
how many layers of tissue surrounding each kidney
millions
how many nephrons in a normally functioning kidney
4-7%
how much brain uptake of Tc-ECD
2-3%
how much brain uptake of Tc-HMPAO
12-14% first hr, then 6%/hour
how much brain washout of Tc-ECD
12-15% over 15 minutes
how much brain washout of Tc-HMPAO
500 ml/min/100 grams
how much is Normal cerebral blood flow in an adult
70%
how much of a bone does is eliminated in 6 hours?
98%
how much of the dose of the mebrofenin and disofenin is taken up by the liver.
20 %
how much oxygen utilized by the entire body is consumed by the brain
1000-1500 ml
how much urine is produced each day?
2-5 minutes
how soon is response to lasix
T wave
identifies an electrical reset of the ventricles for the next cardiac cycle.
With pertechnetate you will only image the thyroid. You cannot obtain uptakes because Tc99m is only trapped by the thyroid, not organified. Wait 15-20 minutes post injection before imaging (this is when peak uptake in the thyroid occurs). Situate the patient to lay supine with the neck hyperextended. Statics: Anterior, anterior w/markers (SSN and chin), RAO, LAO. 300 seconds per static or 100 kcts.
image protocol for thyroid scan
MEPH collimator. Imaging is done 48 hours after administration of dose. Statics = 256 x 256 matrix, 600 sec each. Whole body sweep = usually head to thigh 10 cm/min or slower. Some facilities like marker views of chin, SSN and both ends of scar from thyroidectomy.
imaging protocol for I-131 whole body scan
• Assaydose. • Count capsule in neck phantom with thyroid probe for 60 seconds. Then remove capsule and count background for 60 seconds. Always use the same set distance when counting. • Administercapsule. • Patient returns 4-6 hours later. Count patient's neck (region of thyroid) at set distance for 60 seconds. Count patient's thigh at set distance for 60 seconds for background. • Image at 4-6hours. Place patient supine with the neck hyperextended. Obtain static images: Anterior, anterior w/markers (SSN, chin) RAO, and LAO for 300 seconds or 100 kcts. Images can be obtained with pin- hole collimator or LEAP, LEHR collimators. • Patient returns at 24hours for same procedure as above with the thyroid probe. No imaging at this time.
imaging protocol for thyroid uptake/scan
up to 2 hours
imaging time post inj of Tc-ECD
up to 4 hours
imaging time post inj of Tc-HMPAO
greater than 20 minutes
in an obstructed kidney the washout half-time is generally how long?
Localization and evaluation of residual functioning thyroid tissue of total thyroidectomy. Localization and evaluation for metastasizing or recurrent thyroid carcinoma.
indications for I-131 whole body scan
Pulmonary embolism, evaluation of COPD (chronic obstructive pulmonary disease), evaluation of chest pain, evaluation of pulmonary retention, etc.
indications for Tc99m DTPA lung
same for xenon (done together)
indications for Tc99m MAA
Detection and localization of benign and malignant pheochromocytomas, localization of sites of hormone overproduction, detection and localization of nerve tissue tumors, detection and localization of neuroblastomas, detection and localization of neuroendocrine tumors such as carcinoid, medullary thyroid tumors, schwannoma, small cell lung carcinoma, etc.
indications for adrenal medulla (mIBG)
Evaluation of CSF flow in the spinal column and brain, detection of CSF leak, evaluation of normal pressure hydrocephalus, etc.
indications for cisternogram
Detection and localization of primary or secondary parathyroid cancer. Identification of parathyroid adenoma(s) in patients with elevated PTH levels and Hypercalcemia. Localization of cancer for surgery candidates. Localization of persistent or recurrent parathyroid tissue after surgery.
indications for parathyroid scan
hyperthyroidism, graves disease, nodules that are indeterminate, evaluation of toxic multi nodular goiter,
indications for suppression test
Ablation of residual functioning thyroid carcinoma, ablation of residual functioning normal thyroid tissue after total or partial thyroidectomy.
indications for thyroid ablation
Treatment for hyperthyroidism.
indications for thyroid therapy
Further evaluation of palpable nodule, determine functional status of nodules, diagnosis of Grave's disease, evaluate subacute and chronic thyroiditis and evaluate hypo- or hyperthyroidism.
indications for thyroid uptake/scan
Pulmonary embolism, evaluation of COPD (chronic obstructive pulmonary disease), evaluation of chest pain, evaluation of pulmonary retention, etc.
indications of Xe-133
Polycystic kidney disease
inherited disease that causes multiple large cysts in the kidneys and liver. These cysts increase in size as the patient ages and often result in renal failure.
treadmill
injection of radiotracer when patient reaches 85% of maximum predicted heart rate or when instructed by the cardiologist.
0.04 mg/kg of Vasotec (max 2.5 mg)
is administered intravenously and renal imaging can begin as soon as 15 minutes
half value layer
is an absorber's effectiveness as a photon attenuator for a beam of photons of a given energy. Meaning, as the photon energy changes (like from 140 keV to 511 keV), so too does the half-value layer. This is the thickness of a slab of an absorber that will remove exactly half of the photons from the beam. A second one will remove half of the remainder (one-quarter of the original beam).
4.8
is attempt took 9 minutes. Question 1 0 / 1 pts A patient has been prescribed 4 mCi of a therapeutic radiopharmaceutical. What is the maximum activity, in mCi, that can be administered and not be a wrong dosage according to NRC regulations?
count
is the registration of a single decay by a detector such as a Geiger counter (not to be confused with decay/unit time).
13 seconds
krypton-81 T1/2
0.15 uCi/mCi
limit of Mo99m in a TC99m dose for administration
is created by the detection of an annihilation photon pair by opposing crystals
line of response
LET = SI x W
linear energy transfer equation
Tc99m labeled RBCs
liver hemangioma RP
heart wall
liver hemangioma RP critical organ
20-30 mCi
liver hemangioma RP dose range
compartmental
liver hemangioma RP localization
-Two hours after injection. -1.4-1.5 mag, -elliptical orbit - 64 x 64 or 128 x 128 matrix -360° - 64 stops @ 20-30 sec/stop.
liver hemangioma SPECT protocol
- LEAP or LEHR - flow: 1-5 sec/frame for 30-120 seconds
liver hemangioma flow imaging protocol
detection and localization of hepatic hemangiomas
liver hemangioma indications
none
liver hemangioma patient prep
-500-2,000 kcts. -Anterior and posterior @ immediate and 2 hour delay.
liver hemangioma static protocol
-600-1,000 kcts. - Anterior w/marker, anterior, RAO, right lateral, LAO, left lateral, posterior views.
liver spleen static protocol
-360° rotation, -128 x 128 matrix, - 120 stops for 30 sec/stop.
liver/spleen SPECT protocol
-LEAP or LEHR -FLOW = 1-3 sec/frame for 1 minute followed by -immediate blood pool (60 seconds or 500 kcts).
liver/spleen imaging protocol
none
liver/spleen patient prep
Assessment of anatomy, size and position of the liver and spleen. Evaluation of hepatomegaly, splenomegaly, splenic infarcts, spleen and/or liver disease, etc.
liver\spleen indications
active transport
localization for I-131 whole body scan
Blood flow, absorbed much the same as norepinephrine.
localization for adrenal medulla (mIBG)
compartmental
localization for cisternogram
Passive transport in proportion to blood flow.
localization for parathyroid scan
Active transport
localization for thyroid ablation
Active transport
localization for thyroid therapy
active transport
localization for thyroid uptake/scan
Passive transport into myocardial mitochondria in proportion to blood flow.
localization of MPI RPs
Phagocytosis by the RE cells
localization of SC for liver/spleen
Capillary blockade
localization of Tc99m MAA
distributes with Na/K pump within 20 minutes of injection, then seeps out of the myocardium and redistributes.
localization of Tl-201
compartmental
localization of Xe-133
active transport
localization of thyroid scan
Sublingual glands
located beneath the tongue
Submandibular glands
located beneath the tongue in the posterior aspect of the floor of the mouth and empty directly into the mouth.
Parotid glands
located within the cheeks, below and in front of the ears. They empty into the mouth though Stenson's duct.
Tc99m MAA (macroaggregated albumin)
lung perfusion RP
Xenon-133 gas, Tc99m DTPA, and Krypton-81m
lung vent RPs
major
major or minor spill? 10 mCi of 67 Gallium Citrate
major
major/minor spill? 1 mCi of 89 Strontium
minor
major/minor? 0.5 mCi of 89 Strontium
major
major/minor? 1 mCi of 131 Iodine liquid
major
major/minor? 10 mCi of 67 Gallium
major
major/minor? 2 mCi of 32 Phosphorus
minor
major/minor? 5 mCi of Tc99m
thyroid
meckel's critical organ
Localization of Meckel's diverticulum w/functioning gastric mucosa.
meckel's indication
active transport
meckel's localization
-NPO for 4-12 hours. -Discontinue thyroid blocking agents for 48 hours. No barium studies for 48 hours prior.
meckel's patient prep
-LEAP or LEHR -FLOW: 1-5 sec/frame for 1 min
meckels flow protocol
Increased gastric uptake and renal activity in first 10-20 minutes of study, decreasing with time.
meckels normal results
500-1,000 kcts per image. Anterior view from xiphoid to pubis.
meckels static protocol
Focally increased activity not associated with normal structures, particularly in RLQ. Activity appears @ same time as gastric mucosa and remains in same place despite peristalsis.
meckles abnormal results
15 sec/frame for 29 minutes or 1 min/frame for 15 minutes.
meckles dynamic protocol
mostly bleeding but also inflammation, obstruction, intussuception, perforation of the bowel.
meckles symptoms
passive diffusion
method of localization create
70,000
minimum amount of Tc99m MAA particles to obtain quality scan
0.04 mg/kg (administered by a nurse)
morphine dose
Cardiolite (Sestamibi) or Myoview (tetrofosmin)
myocardial perfusion radiopharmaceutical
You will normally visualize any of the following: Salivary glands, stomach, mouth and bladder
normal results for I-131 whole body scan
pharynx shows bright from inhalation. Stomach and gut may show from swallowing contaminated saliva. Homogeneous distribution in the lungs. Wash-in, equilibrium and washout images are not obtained with Tc99m DTPA.
normal results for Tc99m DTPA lung.
Homogeneous uptake in both lungs.
normal results for Tc99m MAA
Uniform symmetric wash-in, equilibrium and washout with left lung having the typical cardiac notch. Washout fairly complete with no retention of gas by the end of imaging.
normal results for Xe-133
- No activity is seen within the ventricular system on a normal study done for normal pressure hydrocephalus. - Ratio of nasal to plasma radioactivity less than 1.3:1.
normal results for cisternogram
Initially heterogeneous uptake of thyroid, parathyroid, salivary glands and heart and gut. Delayed images will show washout from the thyroid. A focal hot spot at this time will indicate a parathyroid adenoma.
normal results for parathyroid scan
the pituitary, salivary glands, thyroid, liver and spleen.
normal uptake of mIBG
deteriorates as the acquisition matrix size decreases
on a computer, image resolution:
Hyperthyroidism
over active thyroid
I-123: LEAP or LEHR collimator. Images taken 3, 18, and 40 hours after administration. Statics: 256 x 256 matrix for 500 kcts. Whole body continuous: 5-10 cm/min head-to-pelvis. SPECT: 360°, 64 stops, 20 sec/stop. I-131: Images taken 24, 48 and 72 hours after administration. MEGP or MEHR collimator. Statics: 100 kcts or 5-20 minutes each. Whole body continuous: Same as above. SPECT: Same as above.
parameters for adrenal medulla (mIBG)
LEAP or LEHR collimator. Wait 15 minutes after administration for initial images. Place patient in supine position with neck hyperextended. Statics: Anterior, anterior with markers (chin and SSN), RAO and LAO (30°), and anterior chest view for aberrant parathyroid adenomas. 5-10 minutes or 1,000 kcts. Delayed images will be obtained 2-3 hours after administration of radiotracer. Same statics obtained as above. SPECT: 360°, 64 stops, 20-25 sec/stop, 128 x 128 matrix.
parameters for parathyroid scan
10-90 microns with no particles larger than 150 microns. (Optimal size is between 30-40 microns).
particle size for Tc99m MAA
none
patient prep for Tc99m DTPA lung
none
patient prep for Tc99m MAA
SSKI or Lugol's beginning day before injection and until 6 days after (blocks free iodine uptake in the thyroid), laxative for 3 days before imaging, possible enema day of imaging to reduce bowel activity. Patient to be off these types of medications for 2-3 weeks before injection: Steroids, antihypertensives, reserpine, tricyclic antidepressants, sympathomimetics, and diuretics (see attached jpg.file for some specific names and refer to Shackett's).
patient prep for adrenal medulla (mIBG)
• MEPH collimator • Patient injected by doctor intrathecally • Image injection site immediately after injection to make sure the dose was not extravasated. • Obtain images 1-2 hours after injection. Anterior head, laterals and vertex view. 50-200 kcts each. • Repeat delayed views 4, 24, 48, 72 hours afterwards according to protocol.
patient prep for cisternogram
not pregnancy/bf
patient prep for parathyroid scan
Low-iodine diet for 1 week before therapy. Discontinue thyroid meds for 2-4 weeks. No iodinated contrast material for three weeks before. Negative pregnancy test for female patients. Discontinuation of breast feeding.
patient prep for thyroid ablation
rule out pregnancy/BF
patient prep for thyroid scan
2 min
peak brain activity of Tc-ECD
2 minutes
peak brain activity of Tc-HMPAO
Systole
period of ventricular contraction.
Diastole
period of ventricular reaction.
none
prep for Xe-133
<4%.
probability of cancer in hot nodule is
0.1733
problem #5 What would be the decay constant for 99mTc if the half life was 4 hours?
pledgets are placed by an ENT doctor prior to injection. CSF leak study can also be done with Tc99m DTPA 8-12 mCi.
procedure for CSF leak
fission
process in which a heavy nucleus splits into two lighter nuclei
count rate
proportional to the decay rate and is commonly used to measure radioactivity.
glove phenomenon
radiotracer injected into artery
Cold nodules
reflects lack of organification. Single cold nodules are the most worrisome for malignancy (25-30% are malignant).
patient should be well hyrdrated
renal patient prep
type of decay
represented by downward diagonal or vertical line (follows pattern of periodic table ... to the left the Z # decreases, to the right the Z# increases)
parent nuclides
represented by horizontal line
daughter nuclide
represented by horizontal line below parent
electron capture
represented down & to the left (Atomic Number decreases by one)
beta decay
represented down & to the right (Atomic Number increases by one)
positron decay
represented peg legged down & to the left (Atomic Number decreases by one) [pegleg is to differentiate between β+ & EC]
isomeric transition
represented straight down (no increase or decrease in Atomic Number)
neurons
responsible for the transmission of a nerve impulse from one point to another. Consists of cell body and two types of "branches". Axon carries nerve impulses away from the cell body. Dendrite carries nerve impulses toward the cell body. Types of neurons: sensory (afferent) and motor (efferent).
4.5 hours (new generator everyday)
rubidium-81m T1/2
Increased uptake nonsymetrically. Activity remains after lemon administration.
salivary gland abnormal results
thyroid
salivary gland critical organ
1-3 min/image for 30-60 minutes.
salivary gland dynamic protocol
-LEAP or LEHR -128 x 128 matrix -FLOW: 1 sec/image for 60 seconds (sum @ processing).
salivary gland flow protocol
Evaluation for Warthin's tumor, evaluation for function of palpable masses in parotid or salivary tissue, evaluation of anatomic size and position of salivary glands, etc.
salivary gland indications
Symmetric uptake in parotid and submandibular glands, uptake in sublingual and thyroid glands and nasal cavity. Signification reduction of activity in salivary glands after lemon administration.
salivary gland normal results
Withhold thyroid blocking agents for 48 hours
salivary gland patient prep
-300 kcts or 180 sec/view -Patient supine w/neck extended. Obtain anterior, anterior w/marker (chin and SSN), right and left laterals.
salivary gland static protocol
Dobutamine
simulates stress with direct stimulation of the alpha and beta adrenergic receptor sites within the myocardium, producing a response similar to physical stress thereby increasing oxygen demand for the myocardium. The drug has a half-life of about two minutes. Patient needs to be off beta-blockers for at least 24 hours. Atropine given if heart rate is not increasing. Injection of radiotracer when patient reaches 85% of maximum predicted heart rate. 10 mcg/kg/min up to 40 mcg/kg/min, increasing by 10 mcg every three minutes.
A bull's-eye display of myocardial perfusion data is constructed by:
stacking reconstructed/reoriented short-axis slices
differentiating between malignant and benign tissue
standard uptake value is useful in
Bruce protocol
starts at a lower workload than the Bruce, and is used for patients who are post MI, whose history suggests symptoms at a low workload, and for elderly or sedentary patients who may not be able to keep up with the faster Bruce protocol. The third Stage of the modified Bruce protocol corresponds to the first Stage of the Bruce protocol. Thus, the person who does 9 minutes in the Modified protocol does the same workload as 3 minutes on the Bruce; 12 minutes on the Modified is the same as 6 minutes on the Bruce.
pentagastrin
stimulates ectopic gastric mucosa uptake of Tc04- by 30-60% while decreasing emptying time into small bowel and decreasing background.
Left anterior descending artery
supplies blood to the interventricular septum and anterior wall of the left ventricle.
Right coronary artery
supplies the inferior wall of the left ventricle.
Left circumflex artery
supplies the posterior and lateral walls of the left ventricle.
Parathyroid glands
synthesize, store and secrete PTH (parathyroid hormone).
true
t/f The purpose of performing the perchlorate discharge test is to detect and/or confirm an organification defect in the thyroid's metabolism of iodine.
true
t/f The radioiodine thyroid uptake (RAIU) test is an estimate of radioactive iodine accumulation by the thyroid. This accumulation is directly related to the flow of iodide from the extrathyroidal pool into the thyroid organic iodine pool.
gallbladder
target areas of Tc-ECD
lacrimal glands, gallbladder wall
target areas of Tc-HMPAO
Pheochromocytomas
ten % tumor
low and medium frequencies
the activity from tissue (the target organ) usually consists of which type of spatial frequencies?
spleen
the antibodies used for some cancer imaging agents come from what organ?
an example of low pass filter
the butterworth filter
Tc99m IDA (iminodiacetic acid) analogs
the class of radiopharmaceutical used for cholescintigraphy
renal pelvis
the collecting ducts deposit urine into the...
Biliary atresia
the congenital absence or closure of the ducts that drain bile from the liver.
the glomeruli
the cortex contains...
de-excitation
the displaced electron promptly returns to the lower- energy shell, releasing its recently acquired energy as an x-ray in a process called de-excitation.
range
the distance radiation travels through the absorber
higher mental activities (personality, judgment, etc.) and controls movement of the skeletal muscles
the frontal lobe is involved in...
Pons
the largest portion of the brain and is divided into two hemispheres where the right side controls the left side of the body and the left side controls the right side of the body (contralateral)
the cerebrum
the largest portion of the brain and is divided into two hemispheres where the right side controls the left side of the body and the left side controls the right side of the body (contralateral)
Somatostatin Receptor binding
the method of localization of In-111 Octreotide.
Phase analysis
the phase image readily identifies abnormal timing of ventricular contraction. Areas of akinesis show up black, and areas which change activity over time are assigned a color. If the ventricles are the same color then they contract at the same time. Atria should be a different color than the ventricles.
duodenum
the stomach is connected distally to the
esophagus
the stomach is connected proximally to the...
posteriorly
the ureteres enter the bladder...
A baseline scan and uptake are performed. The patient is then placed on T3 (Cytomel 25 ug TID [50-75 ug daily] for 7 days) to suppress TSH production. Iodine uptake should normally fall to 50% of pre-suppression value in a non- autonomously functioning nodule.
thyroid suppression test protocol
anterior pituitary to secrete TSH
thyrotropin releasing factor simulates
2-4 hours
time for delay images for bone scan
CSF
transudate of blood formed by the secretion from the choroids plexus. CSF is a clear, colorless liquid that protects the brain from shocks, delivers nutrition substances and removes waste from the brain and spinal cord
a pair of annihilation gamma rays strike two detectors at the same time
true coincidence event occurs when
Flow, blood pool and delayed imaging.
types of 3-phase bone scan:
hypothyroidism
under activity thyroid
A multiple-channel analyzer (MCA
used to determine the number of detected photons versus absorbed energy or pulse height.
Bile
useful in digestion, it breaks down and emulsifies fats
80 %
what % fractures can be seen on a bone scan @ 24 hours
20-25%
what % of cardiac output goes to normally functioning kidneys?
95%
what % of fractures can be seen on a bone scan @ 72 hours.
Tc-HMPAO and TC-ECD
what RPs cross the blood brain barrier
the cerebellum
what aids in voluntary movement and is ipsilateral (same side, opposite of contralateral).
Hexadecimal numbers
what are are easier for humans to use than binary numbers
TOD (tail on detector)
what bone scan view can better help visualize the pelvis?
methylene blue
what can be used to stabilize ceretec complex for 4-6 hours
the portal system
what carries blood from the gut to the liver and spleen
Morphine
what causes contraction of the sphincter of Oddi and increases pressure in the biliary tree facilitating entrance of the radiotracer into the cystic duct if patent.
angiotensin II
what causes vasoconstriction of the efferent arteriole thus helping to preserve filtration pressure and GFR
blue/pink
what color is drierite when its dry? when it has absorbed moisture?
the gallbladder
what concentrates and stores bile
solid phase
what digestive phase is more sensitive
Bone cancers, metastases and other bone disorders
what disorders produce extremely high levels of alkaline phosphatase in the blood.
epinephrine and norepinephrine.
what does the adrenal medullary tissue synthesizes and secretes
brain and spinal cord
what does the central nervous system consist of?
nerves that connect the brain and spinal cord to all parts of the body
what does the peripheral nervous system consist of?
phenobarbital
what enhances bilirubin conjugation and excretion and also accumulation and excretion of IDA analogues. Increases sensitivity of diagnosis to 90% or greater. 5 mg/kg for 5 days.
circle of willis
what equalize blood pressure to the brain and provides collateral blood flow
the rolando (central) fissure
what fissures seperate the frontal and parietal lobe
sylvius (lateral) fissure
what fissures seperate the frontal and temporal lobe
Support • Protection • Movement • Blood formation
what functions does the skeleton perform
diuretics
what increase urine production and can also lower blood pressure
soda lime
what is a highly efficient CO2 absorber
the spinal cord
what is composed of both gray and white matter and extends from the foramen magnum to the second lumbar vertebra.
50 mg of Captopril
what is is given orally 1 hour prior to renal imaging
the aorta
what is located closer to the left kidney
the inferior vena cava
what is located closer to the right kidney
Naturally occurring cholecystokinen
what is secreted into the blood by the duodenum and stimulates gallbladder contraction and then secretion of pancreatic enzymes.
renogram
what is simply a time-activity curve that provides a graphic representation of the uptake and excretion of the radiopharmaceutical by the kidneys
posterior
what is the best view to determine spleen size
It prevents patients from rebreathing carbon dioxide
what is the purpose of soda lime
SPECT
what kind of imaging allows for the detection of liver/spleen smaller lesions.
Radionuclidic
what kind of purity is the proportion of total activity present as the stated radionuclide.
right
what lobe of the liver is larger
Computer busses
what modularize computer components by defining a hardware interface.
blocking agent- perchlorate
what needs to be administered 30 min- 1 hr prior to in of pertechnetate?
75%
what percentage of pediatric brain tumors are located in the posterior fossa
liquid phase
what phase is always normal when the solid phase is normal
supine
what position should patient be in when injecting MAA
The juxtaglomerular apparatus
what releases rennin when perfusion pressure decreases in the afferent arteriole
Tc99m labeled RBCs
what rp provide a long-lived blood pool tracer that can identify areas of upper and lower intermittent GI bleeding.
drierite
what serves as a moisture trap for the air going through the charcoal trap.
SA node
what serves as the impulse generator (pacemaker) of the heart.
the blood brain barrier
what serves to protect the brain from potentially toxic substances. Movement of substances across the blood-brain barrier is controlled by either active transport or the degree of lipophilicity of the substance which makes it possible for them to cross the cells
lemon
what should be administered to the patient For the assessment of salivary gland function
gently invert syringe
what should be done to MAA prior to injection
If the patient has not eaten for 24 hours or more
what should patients be pretreated with CCK before radiopharmaceutical injection?
hot nose
what sign may be seen in brain death and is due to increased flow in the external carotid circulation.
Administration of a solid meal with a liquid meal
what slows the emptying of the liquid meal
an image of the head should be obtained to prove this (activity in brain=right-to-left cardiac shunt)
what to do in lung imaging if the patient is suspected of having a right-to-left cardiac shunt
Right lateral or LAO (best) static
what views can be obtained to distinguish gallbladder from small bowel.
cause clotting of the particles and result in "hot spots" on your images
what will pulling blood into the MAA syringe do
a Rubidium-81m generator
what would be necessary in order to use krypton-81m
an orbital electron is captured and combined with a proton to form a neutron
when electron capture occurs
15 minutes
when is maximal diuresis reach after injection of lasix
5-15 min
when is peak Tl-201 uptake in myocardium post inj
before it turns pink
when should drierite be changed
15 minutes before pertechnetate.
when should pentagastrin be administered
fusion
when two light nuclei coalesce to form a heavier nucleus
in the ileum
where are most meckels located
axial skeleton
where is metastases usually seen first
by the choroid plexus
where is pertechnetate accumulated?
Tc99m sulfur colloid
which rp can be used to visualize only active bleeding sites.
newborns
who does biliary atresia effect?
they are lipophilic agents
why do neurolite and create cross the BBB
It blocks the conversion of angiotensin I to angiotensin II and it is used to evaluate for renal artery stenosis
why is catopril given before renal imaging?
barium attenuates gamma photons causing photopeninc areas
why should sarium studies not precede liver imaging
photoelectric effect
• Dominant type of interaction in materials with higher atomic numbers such as lead (Z = 82) • A gamma ray of low energy, or one that has lost most of its energy through Compton interactions, may transfer its remaining energy to an orbital (generally inner-shell) electron. This process is photoelectric effect and the ejected electron is called a photoelectron. • Energy of photoelectron equals the energy of the incident photon minus the binding energy of the electron. Ephotoelectron = Ephoton - Ebinding
compton scatter
• Dominant type of interaction in materials with lower atomic numbers such as human tissue (Z = 7.5) • Incident photon transfers part of its energy to an outer shell or essentially "free" electron, ejecting it from the atom. Upon ejection, this electron is called the Compton Electron. The photon is scattered at an angle that depends on the amount of energy transferred from the photon to the electron. • The scattered photon may continue to interact with matter. • The scatter angle ranges from 0 - 180 degrees. The greater the scatter angle, the less energy left in the scattered photon.
attenuation of photons in matter
• In photon interactions with matter, there is a reduction of a beam of photons as the beam passes through matter. The loss of photons is called attenuation, and the matter is referred to as the absorber. • The degree of attenuation is dependent on the energy of the incident photons, as well as, on the atomic number (Z number) and thickness of the absorber.
Co-57
According to the NRC, all of the following radionuclides may be decayed in storage in preparation for disposal EXCEPT:
daily
According to the NRC, areas where radiopharmaceuticals are prepared or administered must be surveyed:
was placed in storage
According to the NRC, decay in storage records must include the date that the radioactive material:
bioassay
According to the NRC, records about all of the following must be retained for three years EXCEPT:
a description of the calibration procedure. correction factors derived from the calibration. measured exposure rates from the calibration source.
According to the NRC, records of survey instrument calibration must include:
80 days
According to the NRC, what is the minimum length of time that I-131 must be held for decay in storage prior to disposal?
coincidence loss
According to the book, quantities of radiation that are higher than 2 uCi cause which problem with a well counter?
only after the first elution
Accourding to the NRC, 99Mo contamination in 99mTc eluate must be measured how often?
is excitatory in the brain and inhibitory in the heart
Acetylcholine is a pharmaceutical that:
incorrected flood field nonuniformities
Circular ring artifacts (often called bulls-eye artifacts) in tomographic reconstructions are the result of:
0.5 mR/hr at the surface and no detectable radiation measured at one meter
According to the NRC, what is/are the allowable exposure rates for a White I package?
waste disposal by transfer
According to the NRC, which of the following records must be maintained until the radioactive materials license is terminated?
100 mRem
"Caution: High Radiation Area" signs must be posted in locations where an individual could receive more than _____ in one hour at a distance of 30 cm from the radiation source?
5 mRem
"Caution: Radiation Area": signs must be posted in areas where an individual could receive a dose of more than ____ in one hour at 30 cm from the radiation source.
Quantities of certain radionuclides are contained in the area
"Caution: Radioactive Materials" sign must be posted when
semiannually
"Normalization" of a PET scanner is done at what frequency as part of a quality control program?
Total effective dose equivalent
"TEDE" is the acronym for?
Magnify small organs to make them appear larger in the image
"Zoom" mode is used in what computer applications?
40-50%
% of the bone scan compound will be affixed to bone by 3 to 4 hours after injection.
85 % liver 10% spleen 5 % bone marrow
% of uptake of sulfur colloid
Adensoine
(140 ugm/kg/min for 6 minutes) = naturally occurring in the body and found in all cells in the body. Adenosine activates the A2 receptors in the endothelium and smooth muscle of the coronary resistance muscles. Peak physiologic effect is seen at about three minutes after beginning a continuous infusion. Disappearance of side effects usually occurs within two minutes after infusion of the drug. Patient needs to be off caffeine (at least 24 hours) and phylline (theophylline, etc.) drugs because they are the antidote. Not for patients with asthma. Injection of radiotracer at 3 minutes into infusion.
alumina (Al+3)
According to the US Phamacopea, which impurity must be tested in the elution of a Tc99m / Mo99 Generator?
Have "bars" that match the resolution specifications of the gamma camera as described by the manufacturer
According to the book, Bar phantoms used for spatial resolution measurements of gamma cameras should?
lymphoma
67 Gallium Citrate is used to commonly image which kind of tumors?
plasma protein
67Ga-citrate has slow plasma clearance because the gallium becomes bound to:
transferrin
67Ga-citrate has slow plasma clearance because the gallium becomes bound to:
1.25 x 10E11
7.5 x 10E18 dpm are equal to _________ MBq.
20.7
725 mCi of Tc99m are eluted from a generator. What volume of normal saline is required to obtain a specific concentration of 35 mCi/ml?
30 uCi
According to the book, a Dose Calibrator is designed to measure doses as low as?
100 uCi
89 Strontium
52.7 days
89 Strontium T 1/2
2.66 days
90 Yttrium T 1/2
50 rem
According to the NRC regulations, the annual occupational dose limit to any organ or tissue, other than the eye, is:
5 mRem/hr
According to the NRC the "trigger" level for notifying the Radiation Safety Officer must be not less than _____ for a restricted area.
2 mr/hr
According to the NRC what is the allowable exposure rate for a "visitor" who is seeing their friend or relative whose been treated with 100 mCi of 131 Iodine?
prescribed dose
According to the NRC, a written directive for the administration of 15 mCi of I-131 sodium iodide must include the following information:
20 mCi 99mTc pertechnetate
According to the NRC, a written directive is required for the administration of all of the following radiopharmaceuticals EXCEPT:
obstructive uropathy
ACEI augmented renal studies in patients with
principal cells in the DCT
ADH acts on the:
Defect on stress but not on rest images = ischemia (reversible. Defect on both stress and rest images = infarct (fixed).
Abnormal results for MPI
quarterly
Absolute activity calibrations should be performed after a major service as well as:
virtually complete
Absorption of orally administered radioiodine from the GI tract is
500 rad
According the NRC, a sign with the words ?Caution: Very High Radiation Area? should be posted in an area when an individual could receive an absorbed radiation dose in an hour that exceeds:
Caution: Radioactive Materials
According the NRC, imaging rooms should be posted with which of the following signs?
patient excreta
According to NRC regulations, amounts of which of the following radioactive materials are exempt from any limits when discarded into the sewerage system?
150 mSv
According to NRC regulations, the annual occupational dose limit to the eye is:
5000 mrem
According to NRC regulations, the annual whole body occupational dose limit for adults is:
can be held for decay in storage
According to Nuclear Regulatory Commission (NRC) regulations, radioactive waste from P-32:
2
According to Nuclear Regulatory Commission (NRC) regulations, the exposure rate in mrem/hr in unrestricted areas should not exceed:
Resolution and sensitivity decrease with no change in magnification of the image
According to Table 4.1 on page 31 of Chapter 4, the effect of increasing the collimator to source (patient) distance has what effect on a parallel hole collimator?
50 rem
According to U. S. Nuclear Regulatory Commission regulations, the annual occupational dose limit to the skin and extremities is:
5th grade level
According to the American Medical Association (AMA), when writing material related to a medical procedure that will be distributed to the public, and to ensure that the patient can understand the material, the information must be written at the:
131 - Iodine thyroid cancer treatment with 100 mCi of 131 Iodine
According to the NRC Bioassays are required by personnel who handle volatile radionuclides if there is a possibility that inhaled activity exceeds NRC limits. Which situation may require bioassay monitoring of a technologist?
Administration of a therapeutic radiopharmaceutical through a central arteria line when intravenous injection is prescribed.
According to the NRC criteria, which of the following is a medical event?
subarachnoid
CSF (cerebral spinal fluid) circulates in the _____ space.
fourth ventricle
CSF leaves the ventricular system via the:
Tc99m sestamibi
Can be used as a heart imaging agent as well as a tumor imaging agent
brain statics parameter
Canthomeatal line should be parallel to camera on vertex view and perpendicular to camera on anterior view. 200-800 kcts in anterior, posterior, both laterals and vertex view.
GI tract
Carcinoid Tumors originate in:
choroid plexus
Cerebrospinal fluid (CSF) is produced within the:
is very good at stopping 511 keV photons
Characteristics of the bismuth germinate crystal include that fact that it:
normal pressure hydrocephalus
Characterized by the clinical triad of mental status changes, incontinence, and ataxia, with hydrocephalus and normal CSF pressures
ionization and excitation
Charged paritcles interactions are primarily by
excitation
Charged particles (alphas, betas, positrons) interact with the electrons surrounding the atom's nucleus by transferring some of their kinetic energy to the electrons. The energy transferred from a low-energy particle is often only sufficient to bump an electron from an inner to an outer shell of the atom.
ionization
Charged particles with sufficient energy may transfer enough energy to an electron (usually outer-shell electron) to eject the electron from the atom.