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24 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Prior to tracer administration, all of the following preparations are required for a 27 year old female for a total bone imaging except:
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A). explaining the procedure to the patient.
B). Answering the patient questions C). Ruling out Pregnancy D). Removing attenuating materials from the patient |
ANSWER
D |
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Static bone images is routinely performed how long after tracer adm. to an adult?
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A). 30 minuets
B). 1 hour C). 2-3 hours D). 24 hours |
ANSWER
C |
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Static bone imaging is performed several hours following tracer adm. to permit:
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A). Maximum tracer uptake in the skeleton
B). blood clearance of excess tracer C). tracer clearance from sites of infiltration D). tracer clearance from normal bone tissue |
ANSWER
B = Maximum skeletal uptake of Tc-99m medronate and oxidronate occurs within 45 minutes of tracer adm. The extended waiting period between tracer adm. and imaging is to allow the excess circulating tracer to be cleared from the blood by the kidneys. Such clearance is necessary to increase the target (bone) to nontarget (soft tissue) ratio for an optimal image. |
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Which of the following structures normally appear as areas of increased activity on the bone images of children?
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A). diaphyses of the long bones
B). breast tissue C). costochonddral junctions and epiphyseal plates D). Lumbar spine and cranium |
ANSWER
c = In children increased tracer activity appears in areas of active bone growth. These areas include the epiphyseal plates at the ends of the long bones and the costochondral junctions in the ribs. |
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Which of the following structures appear normally as areas of increased activity on the bone images of adults?
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A). Anterior illac crests
B). Glenoid fossa C). Sternoclavicular joints D). all of the above |
ANSWER
D = On bone imaging of adults..... areas of normally increased tracer activity include all of the following listed as well as the sacroiliac,hip, and acromioclacicular joints, and vertebral column. |
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For which of the following clincial indications would limited bone imaging (spot views) be most appropriate?
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A). Evaluate temporomandibular joint pain.
B). Evaluate Paget's disease C). Rule out skeletal metastases D). History of child abuse; rule out occult fractures. |
ANSWER
A = Temporomandibular joint pain is localized therefore, spot imaging of the skull, face, especially in the areas of TMJs, and cervical spine is indicated. |
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In performing a bone image, which of the following views would best demonstrate an abnormality in the calcaneus?
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A). Lateral views of the patella
B). Post void views of the pelvis C). Plantar view of the feet D). Anterior view of the distal humerus and radius. |
ANSWER
c |
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For a patient undergoing bone imaging, which of the following information from the medical history is relevant to the interpretation of the bone image?
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A). results of previous bone imaging procedures
B). abdominal surgery 10 days ago C). radiation therapy to the breast 6 months ago D). all of the above |
ANSWER
D |
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If tracer concentration is visualized in the skeleton, stomach, thyroid, and salivary glands on a bone image, the most commonly likely explanation is:
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A). patient was imaged too soon following tracer
B). radiopharmaceutical contained excess free Tc-99m pertechnetate. C). patient's renal function is compromised. D). incorrect radiopharmaceutical was administered. |
ANSWER
B = Tc-99m labeled bone agents are prepared by combining medronate or oxidronate with Tc-99m pertechnetate. Typically, about 3-10% of the pertechnetate does not bind to the MDP or oxidronate, so there is always some unbound or "free" pertechnetate in and bone tracer preparation. Thus, if the tracer was not properly compounded or the Tc-99m label detached from the chemical compound......the excess Tc-99m pertechnetate taken up by the thyroid, salivary glands and stomach is demonstrated on the bone images. |
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Which of the following conditions is visualized on a bone image as a photopenic area?
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A). Attenuation
B). Tracer infiltration C). acute myocardial infarction D). osteomyelitis |
ANSWER
A |
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Three or four phase bone imaging is particularly useful when which of the following conditions is suspected?
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A). skeletal metastases
B). osteoporosis C). osteomyelitis D). Stress fracture |
ANSWER
C |
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All of the following statements about four phase bone imaging are true except for:
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A). This study includes both dynamic and static images.
B). The study may be performed with any blood pool agent C). The patient is positioned under the camera prior to tracer adm. D). The third phase is performed 5-6 hrs following tracer adm. |
ANSWER
B |
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If a patient receives Tc-99m MAA while in an upright position, which of the following is most likely to be demonstrated on the perfusion lung images?
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A).increased tracer activity in the lung apices
B).decreased tracer activity in the lung apices C). decreased tracer activity in the lung bases D). decreased tracer activity throughout both lungs |
ANSWER
B |
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For interpretation of nuclear medicine lung images, a chest x-ray is for
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A). Determine cardiac sizr
B). rule out PE C). rule out previous lung surgery D). rule out possible causes of the patient's symptoms. |
ANSWER
D = MANY of the symptoms of PE are similar to those of rib fracture, myocardial infarction and pneumonia. X-ray of the chest allows the physician to rule out these conditions. |
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IT is safe to block the pulmonary circulation with MAA particles in patients with suspected PE because the:
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A). Number of injected particles block only a small number of pre-capillary arterioles.
B), particles are made from albumin isolated from human serum C). Particles are rapidly phagocytize by lung macrophages. D). albumin is denatured before it is made into particles |
ANSWER
A |
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The standard views performed in a lung perfusion study are:
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A). Anterior and posterior only
B). Posterior and obliques only C). Anterior, posterior, and lateral of the affected lungs D). Anterior, posterior, laterals and obliques |
ANSWER
D |
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Which of the following patients should receive fewer particles than typically adm. for lung perfusion imaging?
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A). 80 year old woman suspected pulmonary embolism
B). 65 year old man with COPD C). adult patient with right to left cardiac shunt D). a,b,c |
ANSWER
C |
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IF THE usual adult dose of Tc-99m MAA is 4 mCi, a patient who has had a right pnemonectomy should receive?
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A). 1 mCi
B). 2 mCi C). 3 mCi D). 4 mCi |
ANSWER
B |
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A nebulizer is used to administer which of the following lung ventilation radiopharmaceutical?
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A). Kr-81m gas
B). Xe-127 or Xe-133 gas C). Tc-99mm pentetate D). A and C |
ANSWER
C = A nebulizer is a device that uses a ultrasound or pressure to create airborne (aerosol) particles from a liquid. Straight Tc-99m (DTPA) is introduced into the nebulizer in liquid form. When the nebulizer is activated, the liquid is converted into small radioactive droplets that are inhaled by the patient through tubing connected to the nebulizer. |
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An advantage of Xe-127 gas over Xe-133 gas for performing lung ventilation studies is that Xe-127?
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A). has a shorter half life
B). is more readily available C). exhibits faster lung clearance D). has more optimum gamma ray energy |
ANSWER
THE photon energy of Xe-133 is 80 KeV which is easily attenuated by the body tissues. In patients with large chests, attenuation affects the quality of image. Xenon-127 has a photon energy of 202 KeV, a energy that is better suited for cameras optimized for imaging energies in the 100-200 KeV range and there is less attenuation and more energetic photon. The disadvantages of Xe-127 includes a half life of 27 days, much longer then the 5 day half-life of Xe-133 and Xe-127 is more expensive and less available. Both Xenon's have the same lung clearance. |
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Which of the following statements is true about the wash in wash out method for performing xenon ventilation studies?
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A). The patient breathes a mixture of xenon and oxygen during the wash in phase.
B). The patient can be disconnected from the gas trapping apparatus following the wash in phase. C). This method is not recommended for comatose patients D). It is not necessary to introduce oxygen or air into the xenon delivery system |
ANSWER
A |
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Advantages of using Kr-81 gas for assessing lung ventilation include all of the following EXCEPT:
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A). cost
B). optimum gamma ray energy C). minimal radiation safety hazards D). imaging multiple projections |
ANSWER
A |
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The purpose of a charcoal filter in a xenon delivery unit is to absorb:
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A). bacteria
B). carbon dioxide C). moisture D). xenon gas |
ANSWER
D = THE NRC sets limits on airborne concentration of Xe-133. For this reason, Xe-133 that the patients exhales must be trapped for decay. Certain xenon delivery units use activated charcoal for trapping the xenon. |
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Which of the following are needed to perform a lung ventilation study with Kr-81m?
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A). humidified oxygen supply, nasal cannula
B). humidified oxygen supply, nasal cannula, trapping device. C). nebulizer, trapping device D). nebulizer, nose clamps, trapping device. |
ANSWER
A = Krypton-81m is eluted form the patient radionuclide Rb-81 as humidified oxygen flows through the Rb-81/Kr-81m generator. The patient breathes Kr-81m directly from the generator through tubing that is connected to a nasal cannula placed in the patient nose. Because Kr-81m has a half life of only 13 seconds....trapping the radionuclide gas is not necessary as it decays rapidly. |
