Nuclear medicine exam review
Questions with correct Answers
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 - answer 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.
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 -
answer 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.
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 - answer 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.
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 - answer 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.
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 - answer C)99mTc-pentetate.
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 - answer A)
There is no patient preparation for breast imaging with 99mTc-sestamibi except
explanation of the procedure to the patient.
Questions with correct Answers
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 - answer 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.
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 -
answer 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.
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 - answer 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.
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 - answer 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.
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 - answer C)99mTc-pentetate.
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 - answer A)
There is no patient preparation for breast imaging with 99mTc-sestamibi except
explanation of the procedure to the patient.
