Nuclear medicine exam review exam with
complete solutions
Static bone imaging is routinely performed how long after tracer administration to
an adult: A)30min B)1hr C)2-3hr D)24hr - ANSWER-C)2-3hr. Static bone imaging
performed with a labeled diphosphonate compound is routinely performed 2-3hr
after tracer administration.
Which of the following structures normally appear as areas of increased activity
on the bone images of adults: A)anterior iliac crests B)glenoid fossa
C)sternoclavicular joints D)all of the above - ANSWER-D)all the above. On bone
images of adults, areas of normally increased tracer activity include all those
listed as well as the sacroiliac, hip, and acromioclavicular joints and vertebral
column.
Which of the following conditions is visualized on a bone image as a photopenic
area: A)attenuation B)tracer infiltration C)acute myocardial infarction
D)osteomyelitis - ANSWER-A)attenuation. A photopenic area is one in which a
smaller number of photons is visualized-a cold spot. A material that absorbs
photons may cause an attenuation artifact, an area of falsely decreased tracer
concentration(jewelry, belt buckles, pacemaker)
It is safe to block a portion of the pulmonary circulation with MAA particles in
patients with suspected PE because: A)# of injected particles block only a small
number of precapillary arterioles B)particles are made from albumin isolated from
human serum - ANSWER-A)# of injected particles blocks only a small number of
precapillary arterioles. Less than 1% of the precapillary arterioles are blocked
with the MAA particles; therefore, there is no adverse effect on the patient.
A nebulizer is used to administer which of the following lung ventilation
radiopharmaceuticals: A)81mKr gas B)133Xe gas C)99mTc-pentetate D)99mTc-
MAA - ANSWER-C)99mTc-pentetate. A nebulizer is a device that uses ultrasound
or pressure to create airborne (aerosol) particles from a liquid.
,Which of the following radiopharmaceuticals may be used to image acute deep
vein thrombosis in the lower extremities: A)99mTc-MAA B)99mTc-arcitumomab
C)131I-iobenguane D)111In-oxyquinoline - ANSWER-A)99mTc-MAA is used to
image acute deep-vein thrombosis in the lower extremities.
In performing radionuclide venography with 99mTc-MAA, the
radiopharmaceutical is administered at what site: A)antecubital of either arm
B)either femoral vein C)dorsal veins on top of each foot D)either basilic vein -
ANSWER-C)dorsal vein on to of each foot. The tracer is introduced into the deep
venous system of the legs. Therefore, the tracer is administered into the dorsal
vein of each foot.
After total thyroidectomy, total-body imaging with radioiodine normally will
demonstrate tracer concentration in which areas: A)liver, lungs, bones B)salivary
glands, stomach, and bladder C)liver, salivary glands, stomach, lungs D)bladder,
liver, brain - ANSWER-B) The salivary glands and saliva in the mouth, the gastric
mucosa and secretions into the intestine, and the urinary bladder are sites that
normally concentrate radioiodine. Concentrations in other sites indicate areas of
functioning thyroid metastases.
A parathyroid adenoma will concentrate which of the following
radioparmaceuticals: A)123I-sodium iodide B)99mTc-pertechnetate C)99mTc-
sestamibi D)99mTc-pertechnetate or 99mTc-sestamibi - ANSWER-C)99mTc-
sestamibi
When positioning a patient for an LAO view of a gated equilibrium ventricular
function study, tilting the camera toward the patient's feet separates what two
structures: A)left ventricle and aorta B)left ventricle and left atrium C)left and
right atria - ANSWER-B)left ventricle and left atrium. The left atrium is partially
hidden by the aorta and pulmonary artery. Tilting the detector caudally visually
brings the left atrium out from under these structures and separates it from the
left ventricle.
Which tracer is excreted primarily via the hepatobiliary system: A)99mTc-
sestamibi B)99mTc-exametazime C)99mTc-medronate D)201Tl-thallous chloride -
ANSWER-A)99mTc-sestamibi
A cardiac stress test requires the placement of how many electrodes on the
patient's body: A)3 B)6 C)10 D)12 - ANSWER-C)10. A cardiac stress test requires a
12-lead ECG tracing, which uses 10 electrodes attached to the patient. 2 arm, 2
leg, and 6 chest leads.
,Visualization of bone marrow uptake on a 99mTc-sulfer colloid liver/spleen image
is most likely the result of: A)improper colloid particle size B)insufficient tracer
circulation time C)liver dysfunction D)overactive bone marrow - ANSWER-C)liver
dysfunction. Bone marrow uptake is visualized on liver/spleen images when
severe liver dysfunction, such as advanced cirrhosis, is present.
During hepatobiliary imaging, which structure will NOT be visualized if cystic
duct obstruction is present: A)common hepatic duct B)common bile duct
C)gallbladder D)small intestine - ANSWER-C)gallbladder. If cystic duct
obstruction is present, the tracer will be unable to enter the gallbladder. The
cystic duct is the passage between the common bile duct and the gallbladder.
How long after the administration of 99mTc-pertechnetate does imaging begin for
the localization of a Meckel's diverticulum: A)immediately B)15-20min C)1hr D)2-
3hr - ANSWER-A)immediately. For localization of a Meckel's diverticulum,
imaging begins immediately after administration of the tracer.
All of the following 99mTc-labeled radiopharmaceuticals may be appropriate for
performing a left-to-right cardiac shunt exam using the first-pass method except:
A)sulfur colloid B)pentetate C)sestamibi D)tetrofosmin - ANSWER-A)sulfur
colloid. First-pass cardiac studies to identify or quantify left-to-right shunts are
performed with radiopharmaceuticals that can be administered in small volumes
of 20-25mCi.
The glomerular filtration rate (GFR) is measured with which radiopharmaceutical:
A)99mTc-pentetate B)99mTc-succimer C)99mTc-gluceptate D)99mTc-meritiatide -
ANSWER-A)99mTc-pentetate. Determination of GFR requires an agent that is
completely filtered by the glomeruli. 99mTc-pentetate (DTPA) is handled only by
glomerular filtration.
Radionuclide cystography is performed by the direct method using which
radiopharmaceutical: A)99mTc-pentetate or medronate B)99mTc-pertechnetate or
sulfur colloid C)99mTc-gluceptate or sulfur colloid D)99mTc-pertechnetate or
mertiatide - ANSWER-B)99mTc-pertechnetate or sulfur colloid. Direct
radionuclide cystography is performed by instilling 99mTc-pentetate, or sulfur
colloid, into the urinary bladder. Imaging is performed as the bladder is filling and
emptying.
Filtered 99mTc-sulfur colloid is required for which of the following examinations:
A)gastroesophageal reflux B)gastric emptying C)LeVeen shunt patency
, D)lymphoscintigraphy - ANSWER-D)lymphoscintigraphy. Although all procedures
listed may be performed with 99mTc-sulfur colloid, only lymphoscintigraphy
requires that sulfur colloid be filtered to remove the larger particles.
A patient with a nasogastric tube in place is transferred to the NM dept for an
imaging procedure. The technologist should: A)confirm physician orders for
transfer and reestablish suction if required B)cancel study C)use the tube to
administer tracer - ANSWER-A) Nasogastric tubes are used for gastric
decompression. A physician must order the transfer and interruption of suction.
The tech may be required to reestablish suction upon the patient's arrival in the
department.
The appearance of what structure indicates the beginning of the venous phase of
a cerebral blood flow study: A)anterior cerebral arteries B)carotid arteries
C)nasopharynx D)superior sagittal sinus - ANSWER-D)superior sagittal sinus. In a
normal cerebral flow study, the first phase is the arterial phase, indicated by
activity in the carotid and anterior cerebral arteries. The capillary phase is
followed by the venous phase.
In performing cisternograpy, the purpose of acquiring the first image over the
lower thoracic/lumbar spine is to ascertain: A)the site of tracer administration
B)the flow rate of the cerebral spinal fluid C)that the tracer was not infiltrated -
ANSWER-C)that the tracer was not infiltrated. The injection site should be imaged
first to confirm that the tracer has not infiltrated outside the subarachnoid space.
Reinjections may be required if infiltration is confirmed.
On Wednesday a patient had a 125I thyroid study performed; a 125I plasma
volume is ordered to be performed on Thursday. Should a baseline plasma
sample be collected before performing the plasma volume? True or False -
ANSWER-True. A blood sample collected before the 125I-albumin is injected can
provide the background present in the patient's plasma. This will permit counts
from the plasma sample containing 125I to be corrected for any residual 123I.
89Sr-chloride is used to treat which of the following conditions: A)bone pain
B)polycythemia vera C)rheumatoid arthritis D)malignant effusions - ANSWER-
A)bone pain. 89Sr-chloride is used to relieve bone pain resulting from skeletal
metastases.
Whole-body imaging with 131I-sodium iodide is optimally performed how long
after tracer administration: A)12hr B)18-24hr C)48-72hr D)96hr or longer -
complete solutions
Static bone imaging is routinely performed how long after tracer administration to
an adult: A)30min B)1hr C)2-3hr D)24hr - ANSWER-C)2-3hr. Static bone imaging
performed with a labeled diphosphonate compound is routinely performed 2-3hr
after tracer administration.
Which of the following structures normally appear as areas of increased activity
on the bone images of adults: A)anterior iliac crests B)glenoid fossa
C)sternoclavicular joints D)all of the above - ANSWER-D)all the above. On bone
images of adults, areas of normally increased tracer activity include all those
listed as well as the sacroiliac, hip, and acromioclavicular joints and vertebral
column.
Which of the following conditions is visualized on a bone image as a photopenic
area: A)attenuation B)tracer infiltration C)acute myocardial infarction
D)osteomyelitis - ANSWER-A)attenuation. A photopenic area is one in which a
smaller number of photons is visualized-a cold spot. A material that absorbs
photons may cause an attenuation artifact, an area of falsely decreased tracer
concentration(jewelry, belt buckles, pacemaker)
It is safe to block a portion of the pulmonary circulation with MAA particles in
patients with suspected PE because: A)# of injected particles block only a small
number of precapillary arterioles B)particles are made from albumin isolated from
human serum - ANSWER-A)# of injected particles blocks only a small number of
precapillary arterioles. Less than 1% of the precapillary arterioles are blocked
with the MAA particles; therefore, there is no adverse effect on the patient.
A nebulizer is used to administer which of the following lung ventilation
radiopharmaceuticals: A)81mKr gas B)133Xe gas C)99mTc-pentetate D)99mTc-
MAA - ANSWER-C)99mTc-pentetate. A nebulizer is a device that uses ultrasound
or pressure to create airborne (aerosol) particles from a liquid.
,Which of the following radiopharmaceuticals may be used to image acute deep
vein thrombosis in the lower extremities: A)99mTc-MAA B)99mTc-arcitumomab
C)131I-iobenguane D)111In-oxyquinoline - ANSWER-A)99mTc-MAA is used to
image acute deep-vein thrombosis in the lower extremities.
In performing radionuclide venography with 99mTc-MAA, the
radiopharmaceutical is administered at what site: A)antecubital of either arm
B)either femoral vein C)dorsal veins on top of each foot D)either basilic vein -
ANSWER-C)dorsal vein on to of each foot. The tracer is introduced into the deep
venous system of the legs. Therefore, the tracer is administered into the dorsal
vein of each foot.
After total thyroidectomy, total-body imaging with radioiodine normally will
demonstrate tracer concentration in which areas: A)liver, lungs, bones B)salivary
glands, stomach, and bladder C)liver, salivary glands, stomach, lungs D)bladder,
liver, brain - ANSWER-B) The salivary glands and saliva in the mouth, the gastric
mucosa and secretions into the intestine, and the urinary bladder are sites that
normally concentrate radioiodine. Concentrations in other sites indicate areas of
functioning thyroid metastases.
A parathyroid adenoma will concentrate which of the following
radioparmaceuticals: A)123I-sodium iodide B)99mTc-pertechnetate C)99mTc-
sestamibi D)99mTc-pertechnetate or 99mTc-sestamibi - ANSWER-C)99mTc-
sestamibi
When positioning a patient for an LAO view of a gated equilibrium ventricular
function study, tilting the camera toward the patient's feet separates what two
structures: A)left ventricle and aorta B)left ventricle and left atrium C)left and
right atria - ANSWER-B)left ventricle and left atrium. The left atrium is partially
hidden by the aorta and pulmonary artery. Tilting the detector caudally visually
brings the left atrium out from under these structures and separates it from the
left ventricle.
Which tracer is excreted primarily via the hepatobiliary system: A)99mTc-
sestamibi B)99mTc-exametazime C)99mTc-medronate D)201Tl-thallous chloride -
ANSWER-A)99mTc-sestamibi
A cardiac stress test requires the placement of how many electrodes on the
patient's body: A)3 B)6 C)10 D)12 - ANSWER-C)10. A cardiac stress test requires a
12-lead ECG tracing, which uses 10 electrodes attached to the patient. 2 arm, 2
leg, and 6 chest leads.
,Visualization of bone marrow uptake on a 99mTc-sulfer colloid liver/spleen image
is most likely the result of: A)improper colloid particle size B)insufficient tracer
circulation time C)liver dysfunction D)overactive bone marrow - ANSWER-C)liver
dysfunction. Bone marrow uptake is visualized on liver/spleen images when
severe liver dysfunction, such as advanced cirrhosis, is present.
During hepatobiliary imaging, which structure will NOT be visualized if cystic
duct obstruction is present: A)common hepatic duct B)common bile duct
C)gallbladder D)small intestine - ANSWER-C)gallbladder. If cystic duct
obstruction is present, the tracer will be unable to enter the gallbladder. The
cystic duct is the passage between the common bile duct and the gallbladder.
How long after the administration of 99mTc-pertechnetate does imaging begin for
the localization of a Meckel's diverticulum: A)immediately B)15-20min C)1hr D)2-
3hr - ANSWER-A)immediately. For localization of a Meckel's diverticulum,
imaging begins immediately after administration of the tracer.
All of the following 99mTc-labeled radiopharmaceuticals may be appropriate for
performing a left-to-right cardiac shunt exam using the first-pass method except:
A)sulfur colloid B)pentetate C)sestamibi D)tetrofosmin - ANSWER-A)sulfur
colloid. First-pass cardiac studies to identify or quantify left-to-right shunts are
performed with radiopharmaceuticals that can be administered in small volumes
of 20-25mCi.
The glomerular filtration rate (GFR) is measured with which radiopharmaceutical:
A)99mTc-pentetate B)99mTc-succimer C)99mTc-gluceptate D)99mTc-meritiatide -
ANSWER-A)99mTc-pentetate. Determination of GFR requires an agent that is
completely filtered by the glomeruli. 99mTc-pentetate (DTPA) is handled only by
glomerular filtration.
Radionuclide cystography is performed by the direct method using which
radiopharmaceutical: A)99mTc-pentetate or medronate B)99mTc-pertechnetate or
sulfur colloid C)99mTc-gluceptate or sulfur colloid D)99mTc-pertechnetate or
mertiatide - ANSWER-B)99mTc-pertechnetate or sulfur colloid. Direct
radionuclide cystography is performed by instilling 99mTc-pentetate, or sulfur
colloid, into the urinary bladder. Imaging is performed as the bladder is filling and
emptying.
Filtered 99mTc-sulfur colloid is required for which of the following examinations:
A)gastroesophageal reflux B)gastric emptying C)LeVeen shunt patency
, D)lymphoscintigraphy - ANSWER-D)lymphoscintigraphy. Although all procedures
listed may be performed with 99mTc-sulfur colloid, only lymphoscintigraphy
requires that sulfur colloid be filtered to remove the larger particles.
A patient with a nasogastric tube in place is transferred to the NM dept for an
imaging procedure. The technologist should: A)confirm physician orders for
transfer and reestablish suction if required B)cancel study C)use the tube to
administer tracer - ANSWER-A) Nasogastric tubes are used for gastric
decompression. A physician must order the transfer and interruption of suction.
The tech may be required to reestablish suction upon the patient's arrival in the
department.
The appearance of what structure indicates the beginning of the venous phase of
a cerebral blood flow study: A)anterior cerebral arteries B)carotid arteries
C)nasopharynx D)superior sagittal sinus - ANSWER-D)superior sagittal sinus. In a
normal cerebral flow study, the first phase is the arterial phase, indicated by
activity in the carotid and anterior cerebral arteries. The capillary phase is
followed by the venous phase.
In performing cisternograpy, the purpose of acquiring the first image over the
lower thoracic/lumbar spine is to ascertain: A)the site of tracer administration
B)the flow rate of the cerebral spinal fluid C)that the tracer was not infiltrated -
ANSWER-C)that the tracer was not infiltrated. The injection site should be imaged
first to confirm that the tracer has not infiltrated outside the subarachnoid space.
Reinjections may be required if infiltration is confirmed.
On Wednesday a patient had a 125I thyroid study performed; a 125I plasma
volume is ordered to be performed on Thursday. Should a baseline plasma
sample be collected before performing the plasma volume? True or False -
ANSWER-True. A blood sample collected before the 125I-albumin is injected can
provide the background present in the patient's plasma. This will permit counts
from the plasma sample containing 125I to be corrected for any residual 123I.
89Sr-chloride is used to treat which of the following conditions: A)bone pain
B)polycythemia vera C)rheumatoid arthritis D)malignant effusions - ANSWER-
A)bone pain. 89Sr-chloride is used to relieve bone pain resulting from skeletal
metastases.
Whole-body imaging with 131I-sodium iodide is optimally performed how long
after tracer administration: A)12hr B)18-24hr C)48-72hr D)96hr or longer -
