NUCLEAR MEDICINE QUESTIONS AND SOLUTIONS
GUARANTEE A+
✔✔Octreoscan mechanism of uptake? - ✔✔Somatostatin analog. Neuroendocrine
tumors.
✔✔In-111 octreoscan normal distribution? - ✔✔Intense renal cortex. Spleen, liver,
pituitary, salivary, GI, bladder. Variable: breast, thyroid.
✔✔FDG-PET dose? Gamma energies? Half-life? Time to imaging? - ✔✔10-15 mCi. 511
keV. 2 hrs. 1 hr.
✔✔FDG-PET mechanism of uptake? - ✔✔Glucose analog. Active transport into cell.
Phosphorylated and trapped.
✔✔FDG-Pet normal distribution - ✔✔Intense urinary activity and cerebral cortex. GU,
liver, spleen, marrow. Variable: thyroid, cardiac, GI, muscle.
✔✔In-111 WBC dose? Gamma energies? Half-life? Time to imaging? - ✔✔0.5 mCi.
172, 247 keV. 67 hrs. 24 hrs.
✔✔In-111 WBC mechanism of uptake? - ✔✔WBC localized at infection.
✔✔In-111 WBC normal distribution? - ✔✔Spleen >> Liver > marrow. No renal or GI
activity.
✔✔Tc-99 WBC dose? Gamma energies? Half-life? Time to imaging? - ✔✔20 mCi. 140
keV. 6 hrs. 1-4, 24 hrs.
✔✔Intense cardiac activity radiotracer? - ✔✔MIBG. PET.
✔✔Intense spleen activity radiotracer? - ✔✔WBC.
✔✔Intense renal activity radiotracer? - ✔✔Octreotide.
✔✔Lacrimal activity? - ✔✔Gallium-67.
✔✔For about __ months after hip replacement surgery, the bone around the prosthesis
is expected to have increased osteoblastic activity. - ✔✔6 months.
✔✔Refers to a hot spot at the tip of a prosthesis and two areas of increased uptake at
the proximal end. - ✔✔Toggle sign. Prosthetic loosening.
, ✔✔Three phases of bone scan osteomyelitis? - ✔✔First phase: Early arterial flow,
seconds after injection. Second phase: Blood pool, few minutes after injection.Third
phase: Bone labeling, 3 or more hours after injection. All three positive in infection.
✔✔Contraindications to perfusion lung scanning include - ✔✔Severe pulmonary
hypertension. Allergy to human serum albumin products.
✔✔Acute (suppurative) thyroiditis - ✔✔Bacterial infections caused by Streptococcus,
Staphylococcus, or Pneumococcus. Fever, severe sore throat, and asymmetric
swelling. May result in sepsis from hematogenous spread or extend into mediastinum
via fascial planes.
✔✔Subacute (viral) thyroiditis (de Quervain or granulomatous thyroiditis). - ✔✔Thyroid
pain and hyperthyroidism following upper respiratory infection. Disrupted gland releases
thyroid hormone. Iodine uptake is usually decreased or absent in acute stages.
✔✔Hashimoto thyroiditis - ✔✔Most common cause of goiter and primary
hypothyroidism in adults in developed countries. Autoimmune disorder with circulating
antithyroid antibody.
✔✔Riedel thyroiditis - ✔✔Rare inflammatory fibrosiS that involves thyroid and
commonly extends into neck. Radionuclide uptake is absent (cold) in involved areas.
✔✔Secondary hyperthyroidism may develop in patients with - ✔✔Hydatidiform moles or
choriocarcinoma (secrete HCG). Subunit of HCG is similar to TSH, which may directly
stimulating thyroid.
✔✔Single cold nodules have a _______ incidence of malignancy, whereas malignancy
is exceedingly rare in hot nodules. - ✔✔10% to 15%.
✔✔Thyroid nodule differential - ✔✔Follicular adenoma. Adenomatous hyperplasia.
Thyroid cysts. Hemorrhagic cyst.
✔✔Most common benign neoplasm of the thyroid and represents about 20% of thyroid
nodules. - ✔✔Follicular adenoma.
✔✔Adenomatous nodules, also called ________, are not true neoplasms but are the
result of cycles of hyperplasia and involution of a thyroid lobule. - ✔✔Colloid nodules.
✔✔Signs Suggesting Benign Etiology of Thyroid Nodules - ✔✔Extensive cystic
component. Multiple nodules. Hot on radionuclide scan. Peripheral calcification.
Shrinkage in size following levothyroxine suppression hormone therapy. Sudden onset.
Female gender. Older patient.
GUARANTEE A+
✔✔Octreoscan mechanism of uptake? - ✔✔Somatostatin analog. Neuroendocrine
tumors.
✔✔In-111 octreoscan normal distribution? - ✔✔Intense renal cortex. Spleen, liver,
pituitary, salivary, GI, bladder. Variable: breast, thyroid.
✔✔FDG-PET dose? Gamma energies? Half-life? Time to imaging? - ✔✔10-15 mCi. 511
keV. 2 hrs. 1 hr.
✔✔FDG-PET mechanism of uptake? - ✔✔Glucose analog. Active transport into cell.
Phosphorylated and trapped.
✔✔FDG-Pet normal distribution - ✔✔Intense urinary activity and cerebral cortex. GU,
liver, spleen, marrow. Variable: thyroid, cardiac, GI, muscle.
✔✔In-111 WBC dose? Gamma energies? Half-life? Time to imaging? - ✔✔0.5 mCi.
172, 247 keV. 67 hrs. 24 hrs.
✔✔In-111 WBC mechanism of uptake? - ✔✔WBC localized at infection.
✔✔In-111 WBC normal distribution? - ✔✔Spleen >> Liver > marrow. No renal or GI
activity.
✔✔Tc-99 WBC dose? Gamma energies? Half-life? Time to imaging? - ✔✔20 mCi. 140
keV. 6 hrs. 1-4, 24 hrs.
✔✔Intense cardiac activity radiotracer? - ✔✔MIBG. PET.
✔✔Intense spleen activity radiotracer? - ✔✔WBC.
✔✔Intense renal activity radiotracer? - ✔✔Octreotide.
✔✔Lacrimal activity? - ✔✔Gallium-67.
✔✔For about __ months after hip replacement surgery, the bone around the prosthesis
is expected to have increased osteoblastic activity. - ✔✔6 months.
✔✔Refers to a hot spot at the tip of a prosthesis and two areas of increased uptake at
the proximal end. - ✔✔Toggle sign. Prosthetic loosening.
, ✔✔Three phases of bone scan osteomyelitis? - ✔✔First phase: Early arterial flow,
seconds after injection. Second phase: Blood pool, few minutes after injection.Third
phase: Bone labeling, 3 or more hours after injection. All three positive in infection.
✔✔Contraindications to perfusion lung scanning include - ✔✔Severe pulmonary
hypertension. Allergy to human serum albumin products.
✔✔Acute (suppurative) thyroiditis - ✔✔Bacterial infections caused by Streptococcus,
Staphylococcus, or Pneumococcus. Fever, severe sore throat, and asymmetric
swelling. May result in sepsis from hematogenous spread or extend into mediastinum
via fascial planes.
✔✔Subacute (viral) thyroiditis (de Quervain or granulomatous thyroiditis). - ✔✔Thyroid
pain and hyperthyroidism following upper respiratory infection. Disrupted gland releases
thyroid hormone. Iodine uptake is usually decreased or absent in acute stages.
✔✔Hashimoto thyroiditis - ✔✔Most common cause of goiter and primary
hypothyroidism in adults in developed countries. Autoimmune disorder with circulating
antithyroid antibody.
✔✔Riedel thyroiditis - ✔✔Rare inflammatory fibrosiS that involves thyroid and
commonly extends into neck. Radionuclide uptake is absent (cold) in involved areas.
✔✔Secondary hyperthyroidism may develop in patients with - ✔✔Hydatidiform moles or
choriocarcinoma (secrete HCG). Subunit of HCG is similar to TSH, which may directly
stimulating thyroid.
✔✔Single cold nodules have a _______ incidence of malignancy, whereas malignancy
is exceedingly rare in hot nodules. - ✔✔10% to 15%.
✔✔Thyroid nodule differential - ✔✔Follicular adenoma. Adenomatous hyperplasia.
Thyroid cysts. Hemorrhagic cyst.
✔✔Most common benign neoplasm of the thyroid and represents about 20% of thyroid
nodules. - ✔✔Follicular adenoma.
✔✔Adenomatous nodules, also called ________, are not true neoplasms but are the
result of cycles of hyperplasia and involution of a thyroid lobule. - ✔✔Colloid nodules.
✔✔Signs Suggesting Benign Etiology of Thyroid Nodules - ✔✔Extensive cystic
component. Multiple nodules. Hot on radionuclide scan. Peripheral calcification.
Shrinkage in size following levothyroxine suppression hormone therapy. Sudden onset.
Female gender. Older patient.
