Nuclear medicine Exam review with
Complete Solutions
C)2-3hr. Static bone imaging performed with a labeled diphosphonate compound is
routinely performed 2-3hr after tracer administration. - ANS-Static bone imaging is
routinely performed how long after tracer administration to an adult: A)30min B)1hr C)2-
3hr D)24hr
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. - ANS-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
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) - ANS-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
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. - ANS-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
C)99mTc-pentetate. A nebulizer is a device that uses ultrasound or pressure to create
airborne (aerosol) particles from a liquid. - ANS-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
A)99mTc-MAA is used to image acute deep-vein thrombosis in the lower extremities. -
ANS-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
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. -
ANS-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
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. - ANS-
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
C)99mTc-sestamibi - ANS-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
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. - ANS-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
A)99mTc-sestamibi - ANS-Which tracer is excreted primarily via the hepatobiliary
system: A)99mTc-sestamibi B)99mTc-exametazime C)99mTc-medronate D)201Tl-
thallous chloride
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. - ANS-A cardiac stress test
requires the placement of how many electrodes on the patient's body: A)3 B)6 C)10
D)12
C)liver dysfunction. Bone marrow uptake is visualized on liver/spleen images when
severe liver dysfunction, such as advanced cirrhosis, is present. - ANS-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
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. - ANS-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
A)immediately. For localization of a Meckel's diverticulum, imaging begins immediately
after administration of the tracer. - ANS-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
,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. - ANS-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
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. -
ANS-The glomerular filtration rate (GFR) is measured with which radiopharmaceutical:
A)99mTc-pentetate B)99mTc-succimer C)99mTc-gluceptate D)99mTc-meritiatide
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. - ANS-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
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. - ANS-Filtered 99mTc-sulfur colloid is required for which of the
following examinations: A)gastroesophageal reflux B)gastric emptying C)LeVeen shunt
patency D)lymphoscintigraphy
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. - ANS-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
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. - ANS-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
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. - ANS-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
, 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. - ANS-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
A)bone pain. 89Sr-chloride is used to relieve bone pain resulting from skeletal
metastases. - ANS-89Sr-chloride is used to treat which of the following conditions:
A)bone pain B)polycythemia vera C)rheumatoid arthritis D)malignant effusions
C)48-72hr. Although 131I whole-body imaging may be performed as early as 24hr,
optimum images are obtained at 48-72hr after tracer administration. - ANS-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
B)stop the procedure. Seizure patients may experience a warning that a seizure is
about to occur. The tech should assist the patient to the floor and away from objects
that may injure the patient. A pillow will cushion the head from the floor. - ANS-During
an imaging procedure a patient indicates a seizure is impending. The most appropriate
action is: A)tell the patient to breathe deep to increase oxygen levels B)stop the
procedure, have the patient lie on the floor with a pillow supporting the head
C)anterior and posterior whole body. Because the purpose of 111In-penetreotide
imaging is to visualize the unknown primary site of the cancer or to demonstrate the
extent of the disease, anterior and posterior whole-body images should be performed. -
ANS-After administration of 111In-pentetreotide, which areas of the body should be
imaged: A)anterior and posterior chest B)anterior and posterior abdomen C)anterior and
posterior whole body
C)lower border of liver and spleen at top of FOV. RBC's labeled with 99mTc-
pertechnetate are used for demonstrating intermittent lower GI bleeding. - ANS-Which
of the following is the initial positioning for visualizing gastrointestinal bleeding with
labeled RBC's: A)xiphoid in middle of FOV B)symphysis pubis in middle of FOV C)lower
border of liver and spleen at top of FOV
C)99mTc-pentetate. - ANS-Which of the tracers is preferred if a first-pass stress and
rest cardiac function exam is to be performed on a patient: A)99mTc-pertechnetate
B)99mTc-medronate C)99mTc-pentetate D)99mTc-sestamibi
A) There is no patient preparation for breast imaging with 99mTc-sestamibi except
explanation of the procedure to the patient. - ANS-Patient preparation for breast
imaging with 99mTc-sestamibi includes which of the following: A)explanation of the
procedure B)fasting for 8hr before tracer administration C)discontinuation of any
medications D)consumption of a fatty meal
Complete Solutions
C)2-3hr. Static bone imaging performed with a labeled diphosphonate compound is
routinely performed 2-3hr after tracer administration. - ANS-Static bone imaging is
routinely performed how long after tracer administration to an adult: A)30min B)1hr C)2-
3hr D)24hr
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. - ANS-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
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) - ANS-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
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. - ANS-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
C)99mTc-pentetate. A nebulizer is a device that uses ultrasound or pressure to create
airborne (aerosol) particles from a liquid. - ANS-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
A)99mTc-MAA is used to image acute deep-vein thrombosis in the lower extremities. -
ANS-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
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. -
ANS-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
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. - ANS-
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
C)99mTc-sestamibi - ANS-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
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. - ANS-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
A)99mTc-sestamibi - ANS-Which tracer is excreted primarily via the hepatobiliary
system: A)99mTc-sestamibi B)99mTc-exametazime C)99mTc-medronate D)201Tl-
thallous chloride
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. - ANS-A cardiac stress test
requires the placement of how many electrodes on the patient's body: A)3 B)6 C)10
D)12
C)liver dysfunction. Bone marrow uptake is visualized on liver/spleen images when
severe liver dysfunction, such as advanced cirrhosis, is present. - ANS-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
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. - ANS-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
A)immediately. For localization of a Meckel's diverticulum, imaging begins immediately
after administration of the tracer. - ANS-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
,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. - ANS-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
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. -
ANS-The glomerular filtration rate (GFR) is measured with which radiopharmaceutical:
A)99mTc-pentetate B)99mTc-succimer C)99mTc-gluceptate D)99mTc-meritiatide
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. - ANS-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
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. - ANS-Filtered 99mTc-sulfur colloid is required for which of the
following examinations: A)gastroesophageal reflux B)gastric emptying C)LeVeen shunt
patency D)lymphoscintigraphy
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. - ANS-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
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. - ANS-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
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. - ANS-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
, 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. - ANS-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
A)bone pain. 89Sr-chloride is used to relieve bone pain resulting from skeletal
metastases. - ANS-89Sr-chloride is used to treat which of the following conditions:
A)bone pain B)polycythemia vera C)rheumatoid arthritis D)malignant effusions
C)48-72hr. Although 131I whole-body imaging may be performed as early as 24hr,
optimum images are obtained at 48-72hr after tracer administration. - ANS-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
B)stop the procedure. Seizure patients may experience a warning that a seizure is
about to occur. The tech should assist the patient to the floor and away from objects
that may injure the patient. A pillow will cushion the head from the floor. - ANS-During
an imaging procedure a patient indicates a seizure is impending. The most appropriate
action is: A)tell the patient to breathe deep to increase oxygen levels B)stop the
procedure, have the patient lie on the floor with a pillow supporting the head
C)anterior and posterior whole body. Because the purpose of 111In-penetreotide
imaging is to visualize the unknown primary site of the cancer or to demonstrate the
extent of the disease, anterior and posterior whole-body images should be performed. -
ANS-After administration of 111In-pentetreotide, which areas of the body should be
imaged: A)anterior and posterior chest B)anterior and posterior abdomen C)anterior and
posterior whole body
C)lower border of liver and spleen at top of FOV. RBC's labeled with 99mTc-
pertechnetate are used for demonstrating intermittent lower GI bleeding. - ANS-Which
of the following is the initial positioning for visualizing gastrointestinal bleeding with
labeled RBC's: A)xiphoid in middle of FOV B)symphysis pubis in middle of FOV C)lower
border of liver and spleen at top of FOV
C)99mTc-pentetate. - ANS-Which of the tracers is preferred if a first-pass stress and
rest cardiac function exam is to be performed on a patient: A)99mTc-pertechnetate
B)99mTc-medronate C)99mTc-pentetate D)99mTc-sestamibi
A) There is no patient preparation for breast imaging with 99mTc-sestamibi except
explanation of the procedure to the patient. - ANS-Patient preparation for breast
imaging with 99mTc-sestamibi includes which of the following: A)explanation of the
procedure B)fasting for 8hr before tracer administration C)discontinuation of any
medications D)consumption of a fatty meal
