Imaging

Question 1

What is the target HR calculation, based on age?

Answer 1

(220-Age) x 0.85 = target HR

Question 2

What pre-existing conditions may screw up the cardiac stress test?

Answer 2

if the pt already has baseline ST segment abnormalities

Question 3

What must you do in conjunction to the EKG stress test to bring the results to 90%?

Answer 3

radionucleotide imaging

Question 4

This is the version of thallium that u use right after exercise, as it works by being transported into the myocytes by the Na/K ATPase.

Answer 4

Thallium-201 (201Tl)

Question 5

What will show up on the thallium-201 scan if the myocute is scarred (like in an MI) or ischemic?

Answer 5

The thallium is not taken up

Question 6

True or False: Thallium-201 redistributes so you can further classify cold spots when you image them 3-4 hours after exercise.

Answer 6

True

Question 7

What is it called when a previous cold spot “fills in” after 3-4 hours?

Answer 7

Hibernating myocardium

Question 8

And what if the previous cold spot does not fill in after 3-4 hours? What’s that called?

Answer 8

Fixed defect

Question 9

This is the radionucleotide that is lipophilic, so it can be taken up into the myocardium in proportion to blood flow.

Answer 9

Tecnetium-99m (99mTc)

Question 10

True or False: 99mTc does not redistribute and stays solely in the mitochrondria.

Answer 10

true

Question 11

So injection of 99mTc shows what at the moment of injection?

Answer 11

perfusion

Question 12

Which radionucleotide (201Tl or 99mTc) has a better detection of myocardial viability?

Answer 12

201Tl

Question 13

Which radionucleotide (201Tl or 99mTc) has a better image quality?

Answer 13

99mTc

Question 14

Which radionucleotide (201Tl or 99mTc) has a shorter half life?

Answer 14

99mTc

Question 15

Which radionucleotide (201Tl or 99mTc) requires separate stress and rest injections to detect regions of myocardial ischemia?

Answer 15

99mTc

Question 16

Which radionucleotide (201Tl or 99mTc) has a long half life (around 73 hrs)?

Answer 16

201Tl

Question 17

This is the radionucleotide that is lipophilic, so it can be taken up into the myocardium in proportion to blood flow.

Answer 17

Tecnetium-99m (99mTc)

Question 18

True or False: 99mTc does not redistribute and stays solely in the mitochrondria.

Answer 18

true

Question 19

So injection of 99mTc shows what at the moment of injection?

Answer 19

perfusion

Question 20

Which radionucleotide (201Tl or 99mTc) has a better detection of myocardial viability?

Answer 20

201Tl

Question 21

Which radionucleotide (201Tl or 99mTc) has a better image quality?

Answer 21

99mTc

Question 22

Which radionucleotide (201Tl or 99mTc) has a shorter half life?

Answer 22

99mTc

Question 23

Which radionucleotide (201Tl or 99mTc) requires separate stress and rest injections to detect regions of myocardial ischemia?

Answer 23

99mTc

Question 24

Which radionucleotide (201Tl or 99mTc) has a long half life (around 73 hrs)?

Answer 24

201Tl

Question 25

Under which condition should u choose a stress test?

Answer 25

CAD

Question 26

What must the pt be able to do if you choose to do the exercise stress test?

Answer 26

Must be able to achieve the target HR

Question 27

Which 4 cardiac conditions is a contraindication to do the exercise stress testing?

Answer 27

1. hypertrophic cardiomypathy 2. severe aortic stenosis 3. LBBB 4. ventricularly paces EKG rhythm

Question 28

So what happens if they can't do the exercise stress test? what is another stress test u can do?

Answer 28

drug stress test

Question 29

What are the 3 drugs u can give to do the drug stress test?

Answer 29

dipyridamole, adenosine, dobutamine

Question 30

What 2 drugs do u avoid if the pt has a Hx of bronchospastic pulmonary disease or wheezing?

Answer 30

dipyridamole and adenosine

Question 31

What 2 drugs do u avoid if the pt has a Hx of taking theophylline or aminophylline or caffeine ingesting within the previous 12 hours?

Answer 31

dipyridamole and adenosine

Question 32

What drug do u avoid if the pt has a LBBB or electronically-paced rhtyhm?

Answer 32

dobutamine

Question 33

So what would be the tests for heart ischemia (generally)?

Answer 33

stress test and nuclear imaging

Question 34

What would be the test for hibernating myocardium, detects myocardial viability, and lets u decide if revascularization is worth doing?

Answer 34

PET

Question 35

What test reveals infarcted myocardium?

Answer 35

CMR

Question 36

What test is good for aneurysms, looking at big vessles, fluid accumulations, and calcifications?

Answer 36

CT

Question 37

Theres a specific CT scan to detect coronary artery calcification. Which 1 is that?

Answer 37

EBCT

Question 38

Theres a specific CT scan to detect atherosclerosis stenosis. Which 1 is that?

Answer 38

MDCT

Question 39

This test is good to see wall motion in specific areas and see if thre is suspected LV aneurysm.

Answer 39

ERNA

Question 40

This test asses cardiac performance in 1 view, can see intracardiac shunts, and can quanitify valvular regurgitation.

Answer 40

FPRNA