ST:7 Flashcards
When the heart rate if 90 beats/min, how many beats are there per sec?
(a)0.011 beat
(b) 1.5 beat
(c) 0.67 beat
(d) 0.006 beat
(e) 0.016 beat
(b) By using dimensional analysis, we know that there are 60 seconds in 1 minute.
90 beats / 1 min = 1.5 beats
90 beats / 60 sec = 1.5 beats/second
In operating a G-M meter on a daily basis, what is the first thing you should always do?
(a)Use a check source to make sure the meter is working correctly.
(b) Set it to the most-sensitive scale/setting.
(c) Insert the batteries.
(d) Check the batteries.
(e) Set it to the least-sensitive scale/setting.
(d) It is always important to verify that the battery in the survey meter is working correctly to ensure proper detector response.
Dobutamine is contraindicated for stress testing in patients with all of the following conditions EXCEPT?
(a)severe aortic stenosis
(b) blood glucose about 200 mg/dL
(c) ejection fraction below 15%
(d) unstable angina
(e) severe hypertension
(b) A patient who has severe aortic stenosis, unstable angina, or an ejection fraction below 15% is a contraindication for using dobutamine as a stress test. Dobutamine raises the heart rate and blood pressure, hence it could be dangerous for such a patient to undergo this stress test.
Which of the following is/are medical event(s) according to the NRC?
(a)A second dose of [99mTc]MAA is administered after the first is inadvertently infiltrated.
(b) [99mTc]DTPA for renal function imaging is requested by the referring physician, but [99mTc]mertiatide is prescribed by the nuclear medicine physician.
(c) A [131I]sodium iodide (15 mCi) is prescribed for therapy, but 19 mCi are administered.
(d) A myocardial perfusion dose is given to a therapy patient by mistake.
(e) A second dose of [99mTc]medronate is administered after the first is inadvertently infiltrated.
(c) Since this is a therapy dose, it must be within +-20% of the prescribed dose. 20% of 15 mCi is 3 mCi, and 3 + 15 = 18 mCi. 18 mCi is thus the maximum that can be given, so 19 mCi would be considered a medical event in this case.
[90Y]ibritumomab tiuxetan is used in conjunction with which chemotherapeutic agent?
(a)interferon
(b) ribavirin
(c) cyclosporine
(d) methotrexate
(e) rituximab
(e) Yttrium-90 ibritumomba tiuxetan is used in conjunction with rituximab chemotherapeutic agent. Y-90 is not used in conjunction with interferon, cyclosporine, or methotrexate.
Fever, dehydration, and slightly elevated white cell count are all symptoms of:
(a)nontoxic goiter
(b) euthyroid
(c) hypothyroidism
(d) benign thyroid goiter
(e) hyperthyroidism
(e) Some of the symptoms of hyperthyroidism include fever, sweating, dehydration, palpitations, increased heart rate, and elevated white blood cell counts.
Which of the following is cited as an advantage of [99mTc]tetrofosmin over [99mTc]sestamibi for myocardial imaging?
(a)it redistributes
(b) one-day stress-rest protocol can be used
(c) faster tracer clearance from the GI system
(d) stress and rest images can be obtained with one tracer dose
(e) higher activities may be administered
(c) When given [99mTc]tetrofosmin, the patient only has to wait 5-30 min for clearance of the GI system. When given [99mTc]sestamibi, the patient has to wait 45-60 min for clearance of GI system. Therefore, tetrofosmin has a faster GI clearance.
Advantages of using [99mTc]sestamibi for myocardial perfusion imaging include all of the following EXCEPT:
(a)no redistribution of tracer
(b) acquisition of ventricular function information
(c) completion of stress and rest imaging on the same day
(d) flexibility in the time of imaging following tracer administration
(e) acquisition of stress and rest images with one tracer dose
(e) If using [99mTc]sestamibi, you will have to use more than one tracer dose for the acquisitions of stress and rest iamges. The sestamibi will have been partially decayed by the time it is ready for both images to be taken.
The property where an antibody reacts with two or more antigens of similar structure is know as:
(a)sensitivity
(b) cross-reactivity
(c) tolerance
(d) immunoreactivity
(e) avidity
(b) The property where an antibody reacts with two or more antigens of similar structure is called cross-reactivity.
Which agent is preferred for acute myocardial infarction imaging?
(a)[201Tl]Cl
(b) [99mTc]pyrophosphate
(c) [99mTc]sestamibi
(d) [99mTc]tetrofosmin
(e) [99mTc]sulfur colloid
(b) [99mTc]pyrophosphate is a bone agent that flows with the bloodstream. Pyrophosphate deposition accumulates with calcium in the mitochondria and within the cytoplasm of necrotic myocardial tissue, so it is preferred for acute myocardial infarction imaging.
In doing a room survey, you discover that a therapy patient’s room has removable contamination above acceptable levels. What is the acceptable level?
(a)<367 Bq/100 cm^2
(b) <200 MBq/100 cm^2
(c) <12,000 Bq/100 cm^2
(d) <200 Bq/100 cm^2
(e) <15,000 Bq/100 cm^2
(a) To stay in compliance with NRC regulations, the room radiation levels must be below this level of removable contamination: <367 Bq/100cm^2 or 22,000 dpm/100cm^2
Which of the following structures normally appear as areas of increased activity on the bone images of a child vs. an adult?
(a)ribs
(b) femur
(c) humerus
(d) sternoclavicular joints
(e) costochondral junctions
(e) Normal uptake in children and adults includes the ribs, femur, and joints (sterno-clavicle joints included). However, in children, the growth plates show increased activity during bone imaging and do not in adults.
Non-reactivity toward a particular antigen is called:
(a)tolerance
(b) immunity
(c) immunogenicity
(d) anaphylaxis
(e) autoimmunity
(a) Tolerance refers to non-reactivity toward a particular antigen.
Treatment of the adverse effects induced by dipyridamole involves the administration of:
(a)aminophylline
(b) adenosine
(c) antihistamines
(d) nitroglycerin
(e) dobutamine
(a) Some physicians administer aminophylline and/or caffeine to all patients as a precautionary measure before releasing them, regardless of symptoms after dipyridamole. Some physicians do this selectively.
Which of the following agents used for pharmacologic stress testing has the longest plasma half-life?
(a)adenosine
(b) dipyridamole
(c) dobutamine
(d) nitroglycerin
(e) atropine
(b) Dipyridamole has a half-life of up to 30 min and can last several hours. Adenosine’s half-life is only 10 sec, and dobutamine and nitroglycerin only have half-lives of a couple of min.
A patient scheduled for PET imaging with [18F]FDG should avoid which of the following foods in the last meal before fasting?
(a)steak and mushrooms
(b) blackened fish and spinach salad
(c) grilled chicken and broccoli
(d) spaghetti and garlic bread
(e) eggs and bacon
(d) There is more emphasis on medications and food in terms of glucose intake (meaning a high protein and low carbohydrate diet) and physical activity before PET imaging with [18F]FDG.
If no eluate appears in the collection vial during generator elution, the technologist should first:
(a)attempt to eluate the generator with a different (new) collection vial
(b) contact the manufacturer for advice
(c) change the generator tubing
(d) add more elution solvent to the column
(e) inspect the column
(a) Attempt to elute the generator with a different (new) collection vial first to see if the evacuated vial was compromised.
A syringe that contains 50 mCi of a 99mTc-labeled compound at 0600 will contain how much radioactivity at 1000?
(a)1.17 GBq
(b) 116.0 MBq
(c) 1169 kBq
(d) 11.7 GBq
(e) 17 Bq
(a) A = Ao(0.5)^(n(t/T1/2) Ao = 50 mCi T1/2 = 6 hr half-life for 99mTc t = 10:00 - 6:00 = 4 3.7 GBq = 100 mCi A = 50 mCi(0.5)^(4/6) A = 31.,5 mCi 31.5 mCi x 3.7 GBq / 100 mCi = 1.17 GBq
The allowed dose of ionizing radiation to a declared pregnant woman’s embryo/fetus is:
(a)10% of the standard occupational workers whole-body dose per year
(b) 1% of the standard occupational workers whole-body dose per year
(c) 20% of the standard yearly occupational dose for the gestation period
(d) 1% of the standard yearly occupational dose for the gestation period
(e) 10% of the standard yearly occupational dose for the gestation period
(e) It is recommended that women who are pregnant stay within or lower than 10% (500 mRem) of the regular occupational limit of 5,000 mRem/yr for the duration of the gestational period.
For an occupational worker who has received 14,000 mRem of exposure to the eyes in 1 year on his/her eye dose dosimeter, which course of action would be appropriate?
(a)Recommend eye chelation therapy.
(b) Review ALARA standards to reduce exposure because because s/he is close to exceeding their annual eye dose limit.
(c) Review ALARA standards to reduce exposure because s/he has exceeded his/her annual eye dose limit.
(d) Recommend s/he use leaded eyeglasses to reduce exposure.
(e) Recommend s/he use thyroid shields.
(b) An occupational radiation worker is allowed up to 15,000 mRem/yr dose to the eye. Since this worker is close to but not exceeding the yearly dose, a review of the ALARA concept and a dedicated reduction in eye exposure in the future is recommended.
Which of the following is most characteristic of a neutron activation product produced from an (n,p) reaction?
(a)decay by electron capture
(b) can be made nearly carrier free
(c) relatively low specific activity
(d) more expensive than cyclotron products
(e) cannot be added to preservative-free saline
(b) In an (n,p) reaction, the product nuclide is an isotope of a different element, which allows for the production of high-specific activity, carrier-free (no stable isotope of the same element) radioisotopes.
Preparation of patients undergoing PET imaging for an oncologic clinical indication includes all of the following EXCEPT:
(a)checking blood glucose levels
(b) installation of IV line
(c) 12-lead ECG monitoring
(d) fasting
(e) hydration
(c) For PET oncologic studies, the patient should hydrate right before the test and fast for at least 6 hr before test to reduce insulin levels and uptake in certain organs. An IV should be installed in the patient so the injection can be flushed with saline. A 12-lead ECG monitoring is not required.
For which of the following clinical indications would limited bone imaging (“spot” views) be most appropriate?
(a)rule out avascular necrosis of the right femoral head
(b) rule out metastatic prostate cancer
(c) determine extent of Paget’s disease
(d) history of child abuse; rule out occult fractures
(e) rule out metastatic breast cancer
(a) Spot views are individual images of certain areas after the initial whole-body image has been performed. They provide detailed images of areas not clearly visualized on the whole-body images. The right femoral head is a specific area that has to be images, which makes limited imaging the appropriate choice.
If a physician prescribes a radiopharmaceutical according to the patient’s body weight, approximately how much activity should a 185 lb patient receive if 55 uCi/kg is prescribed?
(a)1.6 mCi
(b) 6.4 mCi
(c) 9.6 mCi
(d) 46.0 mCi
(e) 4.6 mCi
(e) 2.2 lbs = 1 kg 1 mCi = 1000 uCi 185 lbs x 1 kg / 2.2 lbs = 84.09 kg (55 uCi / 1 kg) x 84.09 kg = 4625 uCi 4625 uCi x 1 mCi / 1000 uCi = 4.6 mCi
Which of the following is used for SPECT system performance?
(a)high count flood
(b) COR offset measurement
(c) PLES phantom
(d) Jaszczak phantom
(e) 3D or 4D operation
(d) A Jaszczak phantom consists of a 20-cm-diameter plexiglass cylinder with rod and spheres inserted. The Jaszczak phantom provides excellent information about SPECT performance.
The major antibody class found in normal human serum is: (a)IgG
(b) IgM
(c) IgA
(d) IgD
(e) IgE
(a) IgG is the major antibody found in normal human serum. It is also the smallest and most-common antibody. IgM is the primary antibody against A & B antigen on red blood cells. IgA is primarily an aid in mucosal immunity, and IgD makes up 1% of proteins in plasma membranes of mature B-lymphocytes.
For SPECT acquisition, a reasonable choice for pixel size would be:
(a)5.25 mm^2
(b) 1/3 FWHM of detector resolution or smaller
(c) equal to 3 FWHM
(d) equal to 2 FWHM
(e) 3.12 mm^2
(e) If a test image of two point sources is acquired in a 128 x 128 image matrix, the approximate pixel size would be 3.133 mm in one plane. Both the x and y planes are needed.
Which of the following operations would help in improving the image contrast AFTER display?
(a)use a smoothing filter
(b) use an edge enhancement filter
(c) use windowing
(d) use a formatter
(e) use a PHA
(c) Neither smoothing nor edge enhancement filters will improve image contrast after display . A formatter is no longer widely used in most facilities because it is for a gamma camera using film.
Gas amplification is a phenomenon associated with instruments that operate in which region of the gas curve for radiation detectors?
(a)recombination
(b) ionization
(c) proportional
(d) continuous discharge
(e) G-M
(c) Within the proportional region of the characteristic voltage curve for gaseous detectors, charged particles collide with gas molecules to produce additional ionization events. This additional ionization results in an amplified current that is proportional to the number of original ion pairs created by the incident radiation. Because ions collide with gas to create an amplified current, this occurrence is called gas amplification.
During the IV injection of unit doses, all of the following practices are standard aseptic technique EXCEPT:
(a)assembling the syringe and needle aseptically
(b) using disposable equipment before its expiration date
(c) aseptically cleaning the venipuncture site before injection with an alcohol swab
(d) uncapping the needle immediately before the injection
(e) wearing sterile gloves
(e) Using disposable equipment before its expiration date, aseptically cleaning the venipuncture site before injection with an alcohol swab, and uncapping the needle immediately before injection are all standard aseptic technique practice. Wearing sterile gloves is not part of standard aseptic technique. Disposable gloves are used during venipuncture.
According to the NRC, survey meters must be calibrated _____ and following any repairs.
(a)semiannually (twice a year)
(b) biannually (every other year)
(c) monthly (once a month)
(d) yearly (once a year)
(e) quarterly (four times a year)
(d) Survey meters are calibrated annually to make sure that the instrument is performing within NRC regulation guidelines.
If a G-M meter has a scale of 1-5 mR/hr. If a deflection on the meter reads 4.5 and the meter is set on the X0.1 setting, what is the reading?
(a)40.5 mR/hr
(b) 4.5 mR/hr
(c) 0.45 mR/hr
(d) 0.045 mR/hr
(e) 45 mR/hr
(c) The reading determined by using the G-M meter was 4.5 mR/hr. However, it was measured on the X0.1 setting. Therefore, the initial reading of 4.5 mR/hr has to be multiplied by X0.1 to get the reading form the meter correctly.
Form X or NRC Form 3 includes all of the following EXCEPT:
(a)The employer must abide by the state and federal regulations.
(b) The worker is required to become familiar with the regulations and operating procedures for the work engaged in.
(c) The worker must abide by the state and federal regulations.
(d) The employer will make available to the worker a copy of all applicable state and federal regulations, licenses, and operating procedures pertaining to the work.
(e) The employer is not required to post any notices of violations of the regulations involving radiological working conditions.
(e) According to the NRC, the employer is required to post any notices or violations of the regulations to employees.
Which of the following radiation signs would be required if a survey meter reading were 40 mRem/hr at 60 cm from a source in the room?
(a)”Caution: Radioactive Material”
(b) “Caution: High Radiation Area”
(c) “Caution: Radiation Area”
(d) “Grave Danger: Very High Radiation Area”
(e) “Caution: Very High Radiation Area”
(b) Different radiation caution signs are used depending on the amount of radiation an individual is likely to receive in that area in the course of 1 hr while 30 cm from a radioactive source or surface. Using the Inverse Square Law and the information given, it can be determined that an individual in this circumstance would receive 160 mRem/hr at a distance of 30 cm. For an area where an individual is exposed to radiation levels in excess of 100 mRem/hr, the correct sign to post is the “Caution: High Radiation Area” sign.
Which of the following would NOT normally appear as an area of increased activity on the bone image of an adult?
(a)anterior iliac crests
(b) epiphyseal plates
(c) sacroiliac joints
(d) nasopharyngeal area
(e) kidneys
(b) Iliac crests, sacroiliac joints, and the nasopharyngeal areas are typical “hot spots” in adult bone imaging. Typically there is symmetrical, increased uptake in all joints, junctions, and scapulas. Epiphyseal plates, also known as “growth plates,” are bright hot spots in pediatric images. Children are steadily growing, which causes increased uptake in those areas.
Which of the following pharmacologic stress agents would be a contraindication for severe aortic stenosis?
(a)dobutamine
(b) adenosine
(c) dipyidamole
(d) esmolol
(e) atropine
(a) Dobutamine injection is contraindicated in patients with idiopathic hypertrophic subaortic stenosis (severe aortic stenosis) and in patients who have shown previous manifestations of hypersensitivity to dobutamine.
When a DOT II radioactive label on a package reads 9 mR/hr at 1 m, what is the appropriate action to take?
(a)Log in the package as you normally would.
(b) Contact the regional office of the NRC.
(c) Inform the vendor that the wrong label was on the container.
(d) Notify the DOT that a “shipment event” has occurred.
(e) Notify the DOT that a “medical event” has occurred.
(c) If a package reads 9 mRem/hr at 1 meter, it should have a DOT yellow III shipping label. A DOT Yellow II shipping label is limited to a reading of 1 mRem/hr at 1 m. When a package arrives with the wrong label, the vendor should be contacted. DOT I (white) At contact, not more than 0.5 mR/hr At 3 feet (1 m), no detectible radiation (NDR) DOT II (yellow) At contact, not more than 50 mR/hr At 3 feet (1 m), not more than 1 mR/hr DOT III (yellow) At contact, not more than 200 mR/hr At 3 feet (1 m), not more than 10 mR/hr
The output pulse height of a gaseous detector is, in most cases, dependent upon what?
(a)the quantity of radiation that passes through the gas
(b) numbers of ions produced in the gas
(c) volume of gas in the detector
(d) pressure of the gas in the tube
(e) type of gas in the tube
(b) The pulse height represents the amount of radiation detected in the gas chamber. The amount of radioactivity is based upon the number of ions produced by the interactions between the gas and radiation.
Which of the following pharmacologic stress agents should NOT be administered to patients with asthma or bronchospastic disease?
(a)both adenosine and dipyridamole
(b) both atropine and adenosine
(c) dobutamine
(d) adenosine
(e) atropine
(a) Adenosine and dipyridamole both have side effects of a feeling of breathlessness and heaviness in the chest. Dobutamine just increases the heart rate and blood pressure by increasing the myocardial work of the heart.
Which of the following is the correct method to calculate gall bladder (GB) ejection fraction?
(a)(net min GB cts - net max GB cts) / net min GB cts
(b) (net max GB cts - net min GB cts) x 100 / net min GB cts
(c) (net max GB cts - net min GB cts) / net max GB cts
(d) (net max GB cts) x 100 / (net max GB cts - net min GB cts)
(e) (net max GB cts - net min GB cts) x 100 / net max GB cts
(e) This is the only equation given that accurately represents the true total net value of counts from the gallbladder by using the percent difference equation. This equation can also be represented as:
(pre-CCK cts - lowest post - CCK cts) x 100 / pre-CCK cts
