Review Of Radiopharmaceutical Use In Medicine

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Review Of Radiopharmaceutical Use In Medicine - Quiz

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Questions and Answers
  • 1. 

    According to the Nuclear Regulatory Commission, approximately what proportion of patients in U.S. hospitals will require radioisotopes in their course of diagnostics and treatment?

    • A.

      1/2

    • B.

      1/3

    • C.

      1/4

    • D.

      1/5

    Correct Answer
    B. 1/3
    Explanation
    According to the Nuclear Regulatory Commission, approximately one-third of patients in U.S. hospitals will require radioisotopes in their course of diagnostics and treatment.

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  • 2. 

    Which of the following is not used to produce radioisotopes? 

    • A.

      Cyclotrons

    • B.

      Radioisotope generators

    • C.

      Gamma cameras

    • D.

      Nuclear reactors

    Correct Answer
    C. Gamma cameras
    Explanation
    Gamma cameras are not used to produce radioisotopes. Gamma cameras are medical imaging devices that detect gamma rays emitted by radioactive substances already present in the body. They are used for diagnostic purposes to visualize the distribution of the radioisotopes in the body. On the other hand, cyclotrons, radioisotope generators, and nuclear reactors are all used in the production of radioisotopes. Cyclotrons accelerate charged particles to produce radioisotopes, radioisotope generators produce radioisotopes through radioactive decay, and nuclear reactors can produce radioisotopes through nuclear reactions.

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  • 3. 

    How is the commonly used isotope Tc-99m produced?

    • A.

      Cyclotron

    • B.

      Gamma camera

    • C.

      Radioisotope generator

    • D.

      Linear accelerator

    Correct Answer
    C. Radioisotope generator
    Explanation
    A radioisotope generator is used to produce the commonly used isotope Tc-99m. This generator contains a parent isotope, usually Mo-99, which undergoes radioactive decay to produce the desired isotope. The parent isotope is typically produced in a nuclear reactor and then shipped to medical facilities where it is allowed to decay and produce Tc-99m. This method allows for a continuous supply of Tc-99m without the need for an on-site reactor or cyclotron.

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  • 4. 

    How is the positron emitter fluorine-18 produced? 

    • A.

      Cyclotron

    • B.

      Gamma camera

    • C.

      Radioisotope generator

    • D.

      Linear accelerator

    Correct Answer
    A. Cyclotron
    Explanation
    Fluorine-18, a positron emitter, is produced using a cyclotron. A cyclotron is a type of particle accelerator that accelerates charged particles, such as protons, in a circular path. In the case of fluorine-18 production, a proton beam is directed onto a target material, typically oxygen-18 water. The collision between the proton beam and the target material results in the production of fluorine-18. This process is commonly used in the production of fluorine-18 for medical imaging purposes, such as in positron emission tomography (PET) scans.

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  • 5. 

    How is molybdenum-99 produced?

    • A.

      Cyclotron

    • B.

      Gamma camera

    • C.

      Radioisotope generator

    • D.

      Nuclear reactor

    Correct Answer
    D. Nuclear reactor
    Explanation
    Molybdenum-99 is produced in a nuclear reactor. Nuclear reactors use a process called nuclear fission to produce a variety of isotopes, including molybdenum-99. In this process, uranium-235 or another fissile material is bombarded with neutrons, causing the uranium atoms to split and release energy. This energy is used to generate heat, which is then converted into electricity. During this fission process, molybdenum-99 is produced as a byproduct. It is then extracted and further processed for use in medical imaging and other applications.

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  • 6. 

    Why is molybdenum-99m important in nuclear medicine? 

    • A.

      It is the most widely used isotope in nuclear medicine

    • B.

      It is the daughter-isotope of the most widely used isotope in nuclear medicine

    • C.

      It is the parent-isotope of the most widely used isotope in nuclear medicine

    Correct Answer
    C. It is the parent-isotope of the most widely used isotope in nuclear medicine
    Explanation
    Molybdenum-99m is important in nuclear medicine because it is the parent-isotope of the most widely used isotope in nuclear medicine. This means that it decays into the isotope technetium-99m, which is used in various diagnostic imaging procedures. Technetium-99m has a short half-life and emits gamma rays, making it ideal for medical imaging. Therefore, molybdenum-99m is crucial in providing a steady supply of technetium-99m for nuclear medicine procedures.

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  • 7. 

    How is lack of blood perfusion visualized in nuclear medicine imaging? 

    • A.

      “hot” spots/increased activity

    • B.

      “cold” spots/lack of activity

    • C.

      Presentation depends on the isotope used

    • D.

      Presentation depends on the organ being imaged

    Correct Answer
    B. “cold” spots/lack of activity
    Explanation
    In nuclear medicine imaging, lack of blood perfusion is visualized as "cold" spots or areas of decreased activity. This means that there is a reduced uptake of the radioactive isotope in these areas, indicating a lack of blood flow. This can be useful in identifying areas of decreased perfusion in various organs or tissues, which may indicate underlying pathology or disease. The presence of "cold" spots can help guide further diagnostic or treatment decisions.

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  • 8. 

    How can images taken hours after a patient has been injected under stress conditions depict blood perfusion to the heart at stress?

    • A.

      Images can only depict blood perfusion to the heart under resting conditions

    • B.

      Computer programs calculate the estimated blood perfusion under stress conditions

    • C.

      The radiopharmaceutical localized in the heart indicative of blood flow at the time of injection

    Correct Answer
    C. The radiopharmaceutical localized in the heart indicative of blood flow at the time of injection
    Explanation
    The correct answer is that the radiopharmaceutical localized in the heart is indicative of blood flow at the time of injection. This means that when the patient is injected under stress conditions, the radiopharmaceutical will travel to the heart and show the blood flow at that specific moment. Therefore, the images taken hours later can still depict blood perfusion to the heart under stress conditions.

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  • 9. 

    What isotopes is not commonly used for imaging blood perfusion to the heart? 

    • A.

      Tl-201

    • B.

      Tc-99m

    • C.

      I-131

    • D.

      Rb-82

    Correct Answer
    C. I-131
    Explanation
    I-131 is not commonly used for imaging blood perfusion to the heart because it has a longer half-life compared to other isotopes commonly used for this purpose. This longer half-life makes it unsuitable for imaging blood perfusion in real-time, as it would take a longer time for the radioactive decay to occur. Therefore, other isotopes with shorter half-lives, such as Tl-201, Tc-99m, and Rb-82, are preferred for imaging blood perfusion to the heart.

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  • 10. 

    Why does MAA localize in the capillaries of the lung?

    • A.

      It consists of particles that are too large to travel further than the lung capillaries

    • B.

      It is inhaled

    • C.

      It doesn’t localize in the capillaries of the lung

    • D.

      The pharmaceutical has an affinity for lung tissue

    Correct Answer
    A. It consists of particles that are too large to travel further than the lung capillaries
    Explanation
    The correct answer is that MAA localizes in the capillaries of the lung because it consists of particles that are too large to travel further than the lung capillaries. This means that the particles of MAA are too big to pass through the smaller blood vessels and are therefore trapped in the lung capillaries.

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  • 11. 

    Why are radioisotopes Tc99m-labeled ECD and hexamethylpropylene HMPAO preferred for evaluation of brain death?

    • A.

      They have a short half-life

    • B.

      They are brain specific agents which allows for delayed imaging

    • C.

      They have few side effects which allows for delayed imaging

    • D.

      They have a long half-life which allows for delayed imaging

    Correct Answer
    B. They are brain specific agents which allows for delayed imaging
    Explanation
    Radioisotopes Tc99m-labeled ECD and hexamethylpropylene HMPAO are preferred for evaluation of brain death because they are brain specific agents. This means that they specifically target the brain, allowing for accurate imaging and evaluation of brain activity. Additionally, these agents allow for delayed imaging, meaning that they can be administered and then imaged at a later time, providing flexibility in the evaluation process.

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  • 12. 

    What characteristic of F-18 FDG makes it useful in tumor imaging?

    • A.

      The glucose component

    • B.

      The fluorine component

    • C.

      The phosphate component

    • D.

      The short half-life

    Correct Answer
    A. The glucose component
    Explanation
    The glucose component of F-18 FDG makes it useful in tumor imaging because cancer cells have a higher metabolic rate and therefore take up more glucose compared to normal cells. F-18 FDG is a radioactive form of glucose, which allows it to be detected using positron emission tomography (PET) scans. By injecting F-18 FDG into the patient, the PET scan can detect areas of increased glucose uptake, indicating the presence of tumors. This characteristic makes F-18 FDG an effective tool for diagnosing and monitoring cancer.

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  • 13. 

    Why does the above characteristic make F-18 FDG useful in tumor imaging? 

    • A.

      Tumors are hypometabolic and require less fluorine than most normal tissues

    • B.

      Tumors are hypometabolic and require less sugar than most normal tissues

    • C.

      Tumors are hypermetabolic and require more fluorine than most normal tissues

    • D.

      Tumors are hypermetabolic and require more sugar than most normal tissues

    Correct Answer
    D. Tumors are hypermetabolic and require more sugar than most normal tissues
    Explanation
    Tumors are hypermetabolic and require more sugar than most normal tissues. This characteristic makes F-18 FDG useful in tumor imaging because F-18 FDG is a radioactive tracer that mimics glucose. It is taken up by cells that are actively metabolizing glucose, such as tumor cells. By injecting F-18 FDG into the body and then using a PET scan to detect the radioactive signal, doctors can identify areas of high glucose metabolism, which typically indicate the presence of tumors.

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  • 14. 

    How are radioisotopes employed for infection detection? 

    • A.

      By tagging red blood cells with radioactivity

    • B.

      By tagging somatostatin receptors with radioactivity

    • C.

      By tagging white blood cells with radioactivity

    • D.

      By inhaling radioactive gas

    Correct Answer
    C. By tagging white blood cells with radioactivity
    Explanation
    Radioisotopes can be employed for infection detection by tagging white blood cells with radioactivity. White blood cells are a crucial component of the immune system and play a key role in fighting infections. By tagging these cells with radioactivity, it becomes possible to track their movement and accumulation in the body. This can help identify areas of infection or inflammation. The radioisotopes emit radiation, which can be detected using imaging techniques such as positron emission tomography (PET) or single-photon emission computed tomography (SPECT), allowing for the detection and localization of infections.

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  • 15. 

    Why is F-18 flurodeoxyglucose useful in imaging neuronal activity in the brain? 

    • A.

      Because the brain uses fluorine for energy

    • B.

      Because the brain uses glucose for energy

    • C.

      Because diseased brain tissue requires an excess of glucose

    • D.

      Because diseased brain tissue requires an excess of fluorine

    Correct Answer
    B. Because the brain uses glucose for energy
    Explanation
    F-18 flurodeoxyglucose is useful in imaging neuronal activity in the brain because the brain uses glucose for energy. F-18 flurodeoxyglucose is a radioactive tracer that is similar to glucose. When injected into the body, it is taken up by cells that require glucose for energy, such as neurons. By detecting the radioactive signals emitted by F-18 flurodeoxyglucose, imaging techniques can identify areas of increased neuronal activity in the brain. This allows researchers and clinicians to study brain function and identify abnormalities or changes in neuronal activity associated with various conditions and diseases.

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  • 16. 

    Gastrointestinal bleeding can be detected using nuclear medicine imaging regardless of whether or not the patient is actively bleeding at the time of radiotracer injection.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    False. Gastrointestinal bleeding cannot be detected using nuclear medicine imaging if the patient is not actively bleeding at the time of radiotracer injection. Nuclear medicine imaging relies on the detection of radiotracer uptake in areas of active bleeding, so if there is no active bleeding, the imaging will not be able to detect any abnormalities.

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  • 17. 

    When is quantification of lung function useful? 

    • A.

      To evaluate for pulmonary embolism

    • B.

      To evaluate for COPD

    • C.

      To assess lung function pre or post surgery

    • D.

      All of the above

    Correct Answer
    C. To assess lung function pre or post surgery
    Explanation
    Quantification of lung function is useful when assessing lung function before or after surgery. This allows healthcare professionals to determine the patient's respiratory capacity and identify any potential complications or changes in lung function. By monitoring lung function pre and post-surgery, healthcare providers can ensure that the patient is recovering well and adjust their treatment plan accordingly. Additionally, quantifying lung function can help in identifying any underlying respiratory conditions such as pulmonary embolism or COPD that may impact the patient's surgical outcome. Therefore, the correct answer is "To assess lung function pre or post surgery."

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  • 18. 

    What is often administered to patients during imaging of bladder-emptying in renal scintigraphy?

    • A.

      A sedative

    • B.

      A diuretic

    • C.

      IV saline

    • D.

      An anesthetic

    Correct Answer
    B. A diuretic
    Explanation
    A diuretic is often administered to patients during imaging of bladder-emptying in renal scintigraphy. This is because a diuretic helps to increase urine production and flow, which is important for evaluating the function of the kidneys and bladder during the imaging procedure. By increasing urine production, the diuretic helps to ensure that the bladder is adequately emptied, allowing for clear imaging of the urinary system.

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  • 19. 

    A region of interest is drawn around what organ to assess biliary function? 

    • A.

      Liver

    • B.

      Stomach

    • C.

      Intestine

    • D.

      Gallbladder

    Correct Answer
    D. Gallbladder
    Explanation
    A region of interest is drawn around the gallbladder to assess biliary function. The gallbladder is a small organ located beneath the liver that stores and releases bile, a substance produced by the liver that aids in the digestion of fats. Assessing the function of the gallbladder helps in diagnosing conditions such as gallstones, cholecystitis, or biliary obstruction. By drawing a region of interest around the gallbladder, medical professionals can analyze its size, shape, and contractility to evaluate its overall function.

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  • 20. 

    Why is sulfur colloid preferred in gastric emptying studies? 

    • A.

      It’s easy to digest

    • B.

      It’s tasteless

    • C.

      It is not absorbed by surrounding tissues

    • D.

      It’s easily absorbed by surrounding tissues

    Correct Answer
    C. It is not absorbed by surrounding tissues
    Explanation
    Sulfur colloid is preferred in gastric emptying studies because it is not absorbed by surrounding tissues. This allows for accurate measurement of the movement of the colloid through the digestive system without interference from absorption into the tissues.

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  • 21. 

    What is the route of administration for a lymphoscintigraphy study?

    • A.

      Subcutaneously

    • B.

      Intravenously

    • C.

      Orally

    • D.

      None of the above

    Correct Answer
    A. Subcutaneously
    Explanation
    Lymphoscintigraphy is a diagnostic imaging procedure used to evaluate the lymphatic system. It involves injecting a radioactive tracer into the body to track its movement through the lymphatic vessels. The tracer is typically administered subcutaneously, meaning it is injected just beneath the skin. This allows the tracer to be absorbed by the lymphatic vessels and carried to the lymph nodes for imaging. Intravenous administration would involve injecting the tracer directly into a vein, which is not the typical route for a lymphoscintigraphy study. Oral administration would not be effective as the tracer needs to be directly introduced into the lymphatic system. Therefore, the correct route of administration for a lymphoscintigraphy study is subcutaneously.

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  • 22. 

    How do therapeutic radioisotopes generally compare to diagnostic radioisotopes? 

    • A.

      They have a longer half-life

    • B.

      They have a higher energy

    • C.

      They have a shorter half-life

    • D.

      A & b

    • E.

      B & c

    Correct Answer
    D. A & b
    Explanation
    Therapeutic radioisotopes generally have a longer half-life and higher energy compared to diagnostic radioisotopes. The longer half-life allows therapeutic radioisotopes to remain active in the body for a longer period of time, increasing their effectiveness in treating diseases. The higher energy of therapeutic radioisotopes enables them to penetrate deeper into tissues, delivering a more targeted and powerful treatment. Therefore, both options a and b are correct as they highlight the key differences between therapeutic and diagnostic radioisotopes.

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  • 23. 

    What kind of radioactivity is emitted by I-131?

    • A.

      Gamma

    • B.

      Beta

    • C.

      Positron

    • D.

      A & b

    • E.

      B & c

    Correct Answer
    D. A & b
    Explanation
    I-131 emits both gamma and beta radiation. Gamma radiation consists of high-energy photons, while beta radiation consists of high-speed electrons or positrons. Therefore, the correct answer is a & b.

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  • 24. 

    What is the most commonly used palliative treatment for bone metastasis in the United States?

    • A.

      P-32

    • B.

      Sr-89

    • C.

      Sm-153

    • D.

      I-131

    Correct Answer
    C. Sm-153
    Explanation
    Sm-153 is the most commonly used palliative treatment for bone metastasis in the United States. This is because Sm-153 is a beta-emitting radionuclide that has a short range and high energy, allowing it to effectively target and destroy cancer cells in the bones. It is also well-tolerated by patients and has been shown to provide significant pain relief and improvement in quality of life. P-32, Sr-89, and I-131 are also used in the treatment of bone metastasis, but Sm-153 is the most commonly used option.

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  • 25. 

    What do the pharmaceuticals I-131 tositumomab and Y-90 ibritumomab have in common?

    • A.

      They can both be imaged for evaluation of biodistribution

    • B.

      They both target the CD20 antigen on B-lymphocytes

    • C.

      They both are used to treat Non-Hodgkin’s Lymphoma

    • D.

      A & b

    • E.

      B & c

    Correct Answer
    E. B & c
    Explanation
    Both pharmaceuticals, I-131 tositumomab and Y-90 ibritumomab, have the commonality of being used to treat Non-Hodgkin's Lymphoma. Additionally, they both target the CD20 antigen on B-lymphocytes.

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