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67 Cards in this Set
- Front
- Back
Abnormal renal activity on MDP
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chemo
radiation antibiotics pyelo ATN RVT obstruction |
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MDP accumulation in tumors
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OSA mets
NB breast meningioma lung mucinous liver mets malignant effusions and ascites |
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Abnormal stomach activity on MDP
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free TcO4 (check thyroid)
HPT (check lungs) |
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Breast activity on MDP
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cancer
radiation mastitis biopsy |
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Soft tissue activity on MDP - focal
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breast or lung cancer
malignant effusions and ascites brain and heart infarcts fibrothorax radiation pneumonitis |
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Soft tissue activity on MDP - diffuse
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venous or lymphatic obstruction
soft tissue neoplasm crush or thermal injury surgery radiation |
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Muscle activity on MDP
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over use
MO/hematoma ischemia compartment syndrome rhabdomyolysis electrical injury Fe dextran injection |
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Hepatic uptake on MDP - focal
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mets (colon, breast, ovary)
hepatoma cholangiocarcinoma |
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Hepatic uptake on MDP - diffuse
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aluminum contamination
hepatic necrosis colloid formation during preperation |
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Spleen uptake on MDP
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SS
Thalassemia hemosiderosis hematoma infarct |
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Lung uptake on MDP
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mets
metastatic Ca+ fibrothorax malignant effusion lung cancer radiation alveolar microlithiasis |
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Superscan
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Mets
HPT pagets SS/thallasemia leukemia/lymphoma |
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Cold defect on MDP
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tumor (RCC, thyroid, myeloma, chordoma)
hemangioma osteomyelitis (high pressure) AVN radiation attenuation (metal, BaSO4) |
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Increased RAIU
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graves
TMG early hashimotos recovering dequivains iodine rebound exogenous TSH |
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Decreased RAIU
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hypothyroid
IV contrast meds (PTU, Lugols, T3, T4) subacute thyroiditis late hashimotos ectopic thyroid hormone (synthroid, struma ovarii) |
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Hot thyroid nodule
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adenoma
adenomatous hyperplasia very rarely cancer |
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Cold thyroid nodule
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colloid cyst
nonfunctional adenoma carcinoma abscess hemorrhage mets lymphoma parathyroid adenoma |
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Hot liver lesion on SC
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FNH
regenerating nodule budd chiari (caudate lobe) SVC obstruction |
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Cold liver lesion on SC
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mets
adenoma abscess cyst hepatoma hemangioma |
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Delayed biliary-bowel transit of HIDA
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obstruction (partial, total)
meds (narcotics) ascending cholangitis |
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Persistent nephrogram
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ATN
obstruction RVT RAS (MAG3) |
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False positive ACEI renogram
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dehydration
ACE induced hypotension |
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Panda sign
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sarcoid
sjogrens AIDS radiation |
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Diffuse lung uptake on gallium
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sarcoid
PCP Pneumoconioses Drugs (bleomycin) pneumonia radiation HP |
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Kidney >24 hr on gallium
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obstruction
neoplasm pyelo vasculitis ATN lymphoma |
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Lung >24 hr on In111 WBC
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atelectasis
CHF pneumonia ARDS emboli |
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Bowel activity on In111 WBC
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IBD
PMC diverticulitis ischemic bowel CMV |
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VQ whole lung mismatch
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large PE (unusual)
tumor swyer james hypoplastic or stenotic PA prior shunt for CHD fibrosing mediastinitis |
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VQ patchy NSGM perfusion
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COPD/asthma
tumor microemboli CHF vasculitis fat emboli radiopharmaceutical problem |
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Abnormally high LVEF
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IHSS and hypertrophic CM
hyperthyroidism regurg (AI/MR/VSD) |
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Technical screwups
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venous extravasation (lymphatic uptake)
arterial injection (glove like) "hot spots" in lungs (syringe drawback) hot liver on MDP (Al or colloid) Fuzzy pictures (off photopeak) |
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Poor image quality
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wrong photopeak
patient too far from collimator wrong type of collimator wroing isotope cracked crystal cracked PMT tracer contamination on crystal |
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PIOPED High probability
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->80% probability
->2 large (>75%) segmental mismatches or arithmetic equivalent in mod or lrg and mod defects |
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PIOPED Intermediate probability
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-20-79%
-one moderate (25-75%)to 2 large segmental mismatches or arithmetic equivalent -single matched defect with clear CXR -triple matched defects |
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PIOPED Low probability
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-20%
-nonsegmental perfusion defects -any perfusion defect with substantially larger CXR abn -matched VQ defects with normal CXR -any number of small (<25%) perfusion defects with normal CXR |
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VQ mismatch
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PE
tumor compression of PA hypoplastic PA vasculitis atelectasis (reverse mismatch) |
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Matched VQ defects
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consolidation
COPD atelectasis tumor bulla pneumonectomy |
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Stress test endpoints
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severe angina
hypotension arrhythmias AMI fatigue dyspnea target workload achieved |
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Pharmacologic stress test
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unable to exercise
use persantine or adenosine reverse with theophylline use dobutamine if COPD on theophylline |
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Increased lung uptake on thallium
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LV failure
pulmonary venous HTN |
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False negative thallium
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submaximal exercise
noncritical stenosis small ischemic area medications |
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False positive thallium
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any cardiomyopathy
LBBB infiltrative cardiac disease ST attenuation |
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Paradoxical septal movement
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septal ischemia
previous cardiac surgery LBBB or pacemaker RV overload |
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Pyrophosphate uptake heart
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MI
LV aneurysm cardiomyopathy myocarditis pericarditis amyloid |
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GB not visualized
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acute cholecystitis
prolonged fasting recent meal cholecystectomy GB agenesis |
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Biliary system not visualized
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biliary atresia
long standing bile duct obstruction |
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Low hepatic and renal activity
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severe liver disease
neonatal hepatitis |
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Bowel not visulized on HIDA
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choledocholithiasis
ampullary stenosis CCK given prescan |
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Abnormal tracer collections on HIDA
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bile leak
choledochal cyst carolis duodenal diverticulum |
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False negative HIDA
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duodenal diverticulum simulating GB
accessory cystic duct |
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False positive HIDA
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recent meal
prolonged fasting liver dysfunction hyperalimentation |
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Free Tc99m pertechnatate
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can see gastric, salivary and thyroid activity
|
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Focal liver uptake sulfur colloid
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FNH
regenerative nodule Budd chiari (hot caudate) SVC or IVC obsruction |
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Renal transplant uptake sulfur colloid
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rejection
|
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RLQ activity on meckel scan
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meckels diverticulum with ectopic gastric mucosa
other duplication cyst with ectopic gastric mucosa renal active bleeding sites tumor IBD |
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Delayed gastric emptying
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diabetic gastroparesis
obstruction |
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Rapid gastric emptying
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postoperative
PUD ZE syndrome drugs |
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Focal renal cold defects
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tumor
cyst abscess scar duplex collecting system trauma infarct DMSA- pyelo or scar |
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Focal renal hot lesions
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collecting system
leak cross-fused ectopia horseshoe |
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Dilated ureter or collecting system
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reflux
obstructed or nonobstructed ureter |
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Nonvisualized kidney
|
nephrectomy
ectopic kidney renal artery occlusion hyperacute rejection in transplant |
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Renal transplant complications
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ATN
cyclosporine toxicity acute rejection obstruction urinoma lymphocele hematoma abscess |
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Decreased testicular uptake
|
torsion
orchiectomy |
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Increased testicular uptake
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eididymoorchitis
|
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Ring sign testicle
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late torsion
tumor with central necrosis abscess trauma |
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Focal hot bone lesions
|
tumor
inflammation- OM, arthritis congenital- OI, TORCH metabolic- marrow hyperplasia, pagets, FD trauma- fracture, stress fx, avulsion injury, AVN, RSD, THR, spondylolysis, child abuse vascular- sickle cell transient osteoporosis of hip flare phenomenon |
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Focal cold bone lesions
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mets- myeloma, lymphoma, renal, thyroid, neuroblastoma
primary bone lesions- SBC, ABC, EG vascular- infarction, AVN, radiation artifact |