Saudi Nuclear Medicine Club " Quiz #4 " @saudi_nmc

1.

In a GI bleeding scan with labeled RBC, you notice a gastric activity, suspect it is a result of free pertechnetate. What could be done to confirm that?
- A.
  
  Reimage the patient in other position
- B.
  
  Change the window around the photo peak
- C.
  
  Image the thyroid
- D.
  
  Let the patient drink water and empty bladder
Correct Answer
C. Image the thyroid

Explanation
Poor RBC labeling technique and drugs interfering with efficient RBC labeling increase free 99mTc-pertechnetate in the blood pool, which in turn produces artifacts. Free 99mTc-pertechnetate can be visible in the upper GI tract due to salivary gland and/or gastric secretion. Neck images can help to determine the source of the artifact.

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2.

The least activity distribution in a normal FDG would be in the:
- A.
  
  Brain
- B.
  
  Bladder
- C.
  
  Bone
- D.
  
  Myocardium
Correct Answer
C. Bone

Explanation
The least activity distribution in a normal FDG (fluorodeoxyglucose) would be in the bone. FDG is a radiopharmaceutical that is used in positron emission tomography (PET) scans to measure glucose metabolism in the body. Glucose metabolism is typically higher in organs and tissues with high metabolic activity, such as the brain, bladder, and myocardium. However, bones have relatively lower metabolic activity compared to other organs, resulting in less FDG uptake and activity distribution in bone.

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3.

If a radiopharmaceutical is spilled on the floor, the first priority is to:
- A.
  
  Contact the Radiation Safety Officer
- B.
  
  Pour a chelating solution over the area of the spill
- C.
  
  Cover the area with absorbent paper and restrict access around it
- D.
  
  Call the housekeeping department to arrange for cleaning
Correct Answer
C. Cover the area with absorbent paper and restrict access around it

Explanation
In the event of a radiopharmaceutical spill, the first priority is to cover the area with absorbent paper and restrict access around it. This is important to prevent further spread of the spill and to minimize the potential for contamination. Contacting the Radiation Safety Officer would be the next step, as they are trained to handle such situations and can provide guidance on proper cleanup procedures. Pouring a chelating solution over the spill may be necessary depending on the specific radiopharmaceutical involved, but it is not the immediate first priority. Calling the housekeeping department to arrange for cleaning can be done after the initial steps have been taken to ensure safety.

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4.

Gaseous radiopharmaceuticals may only be used in rooms that:
- A.
  
  At a positive pressure
- B.
  
  At a negative pressure
Correct Answer
B. At a negative pressure

Explanation
Gaseous radiopharmaceuticals need to be used in rooms that are at a negative pressure. This is because negative pressure rooms ensure that any potential leaks or releases of the radioactive gas are contained within the room, preventing it from spreading to other areas. By maintaining a negative pressure, air is constantly being drawn into the room, preventing the gas from escaping and minimizing the risk of exposure to radiation.

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5.

Following injection of ^99mTc MAA for a perfusion lung scan, activity is seen in the kidneys and brain. This is indicative of:
- A.
  
  Right to left cardiac shunt
- B.
  
  Renal failure
- C.
  
  Congestive heart failure
- D.
  
  Incorrect particle size
Correct Answer
A. Right to left cardiac shunt

Explanation
The presence of activity in the kidneys and brain after injection of 99mTc MAA suggests a right to left cardiac shunt. In a normal perfusion lung scan, the particles should be trapped in the pulmonary capillaries and not reach the systemic circulation. However, in the case of a right to left cardiac shunt, there is a direct communication between the right and left sides of the heart, allowing the particles to bypass the lungs and reach other organs such as the kidneys and brain. This can be indicative of a congenital heart defect or other conditions that cause abnormal blood flow within the heart.

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6.

Cimetidine is a pharmacological used in :
- A.
  
  Gastric Empty
- B.
  
  Protein loos
- C.
  
  Protein loos
- D.
  
  Meckel’s diverticulum
Correct Answer
D. Meckel’s diverticulum

Explanation
This pharmacological agent is used as a mean of improving the detection of Meckel’s diverticulum by blocking the secretion of pertechnetate from gastric mucosa, thus improving the lesion to background ratio

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7.

What happens to image resolution if you decrease the distance between a patient and a parallel collimator ?
- A.
  
  Blur the image
- B.
  
  Improves
- C.
  
  Worsens
- D.
  
  Does not change
Correct Answer
B. Improves

Explanation

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8.

What is the main purpose of hydration and voiding after an injection in a bone scan?
- A.
  
  Reduce the radiation dose to the bladder
- B.
  
  Reduce the possibility of urine contamination
- C.
  
  Minimize the chance that the patient will ask to go to the bathroom
- D.
  
  Better image quality
Correct Answer
A. Reduce the radiation dose to the bladder

Explanation
After an injection in a bone scan, hydration and voiding help to reduce the radiation dose to the bladder. This is because when the patient drinks plenty of fluids and empties their bladder before the scan, it helps to dilute any radioactive material that may have been excreted into the bladder. By reducing the concentration of radioactive material in the bladder, the radiation dose to the bladder is minimized, thereby reducing the potential harm to the bladder tissue.

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9.

Diuretic (Lasix) causes fast emptying of a normal kidney, but it has minimal effect on a kidney that is obstructed.
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
Diuretic (Lasix) is a medication that promotes the production of urine and helps in the elimination of excess fluid from the body. It works by inhibiting the reabsorption of sodium and chloride ions in the kidneys, leading to increased urine production. In a normal kidney, diuretics like Lasix can cause fast emptying of the urine, as it enhances the filtration process. However, in a kidney that is obstructed, such as in the case of a blockage or a urinary stone, the diuretic has minimal effect as the obstruction hinders the normal flow of urine. Therefore, the statement that diuretics cause fast emptying of a normal kidney but have minimal effect on an obstructed kidney is true.

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10.

In a renogram scan, the injection of the Lasix after 15min from the radiopharmaceutical if the patient is pediatric
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
In a renogram scan, the injection of Lasix (a diuretic medication) after 15 minutes from the radiopharmaceutical is not specific to pediatric patients. This practice is followed for all patients, regardless of their age. Therefore, the correct answer is False.

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Saudi Nuclear Medicine Club " Quiz #4 " @saudi_nmc

In a GI bleeding scan with labeled RBC, you notice a gastric activity, suspect it is a result of free pertechnetate. What could be done to confirm that?

The least activity distribution in a normal FDG would be in the:

If a radiopharmaceutical is spilled on the floor, the first priority is to:

Gaseous radiopharmaceuticals may only be used in rooms that:

Following injection of 99mTc MAA for a perfusion lung scan, activity is seen in the kidneys and brain. This is indicative of:

Cimetidine is a pharmacological used in :

What happens to image resolution if you decrease the distance between a patient and a parallel collimator ?

What is the main purpose of hydration and voiding after an injection in a bone scan?

Diuretic (Lasix) causes fast emptying of a normal kidney, but it has minimal effect on a kidney that is obstructed.

In a renogram scan, the injection of the Lasix after 15min from the radiopharmaceutical if the patient is pediatric

Following injection of ^99mTc MAA for a perfusion lung scan, activity is seen in the kidneys and brain. This is indicative of: