Nuclear Medicine Exit Exam Practice Questions A patient with a chest tube arrives in the nuclear medicine department for an Imaging study The technologist should A Cancel the procedure because the chest tube apparatus will interfere with the study B Place the chest tubes external apparatus on the Imaging table next to the patient C Hang the chest tubes external apparatus from an IV pole and raise it above the patient s chest D Place the chest tubes external apparatus on a level lower than the patient s chest answer D Place the chest tubes external apparatus on a level lower than the patient s chest for proper drainage chest tube apparatus must always remain lower than the patient s chest Bolus 2011 Steve s Review of Nuclear Medicine Technology Preparation for certification examination 99mTc Oxidronate image of the region shown would demonstrate all the following structures except the A Costochondral Junctions B Acromion processes C Sternum D Clavicles answer B Acromion processes The image depicts an anterior view of the rib cage and proximal upper extremities The acromion processes would be demonstrated on a posterior view of the upper thorax that includes the scapulae Which of the following is common to imaging gastroesophageal reflux in both adults and children A The patient ingests diluted hydrochloric acid with the radiopharmaceutical B 99mtc sulfur colloid is the radiopharmaceutical of choice C The patient must fast from Midnight before the test D An abdominal binder is used to increase pressure over the abdomen answer B 99mtc sulfur colloid is the radiopharmaceutical of choice 99mTc Sulfur Colloid is the radiopharmaceutical used to image gastroesophageal reflux in both adults and children However adults are administered a mixture of dilute hydrochloric acid orange juice and tracer after fasting from midnight In infants and toddlers the procedure is performed at the time of a scheduled feeding so they may fast as little as two hours before receiving the tracer In adults an abdominal binder is used to increase external abdominal pressure to demonstrate more subtle instances of reflux Because the abdominal muscles are important in pediatric respiration the binder is typically not used with children particularly infants The shelf life of most 99mTc labeled radiopharmaceuticals is A 4 6 hrs B 6 8 hrs C 10 12 hrs D 16 18 hrs answer B 6 8hrs For most 99mTc Radiopharmaceuticals the expiration time is 6 hrs equal to the physical half life of 99mTC t1 2 6 hrs On an intrinsic field uniformity image the area of increased activity around the image is called A Flare phenomenon B Septal penetration C Edge packing D Halo effect answer C Edge packing The phenomenon known as Edge packing can show up as a bright rim of activity around the perimeter of the intrinsic flood To prevent Edge packing most manufacturers provide a lead shielded ring that masks the effect when attached to the edge of the camera head A patient who becomes hypoglycemic may exhibit all the following signs and symptoms except A Weakness and shakiness B Irritability C Nausea and vomiting D Confusion answer C Nausea and vomiting The onset of symptoms of hypoglycemia may be sudden and include general weakness sweating clammy cold skin tremors nervousness irritability hunger blurred vision and loss of consciousness The condition can be remedied quickly with the administration of sugar 3 pieces of candy or fruit juice Which of the following is the correct patient camera positioning for imaging a transplanted kidney Patient position Camera positions I Upright Anterior II Upright Posterior III Supine Anterior IV Supine Posterior A I B II C III D IV answer C III Imaging of renal transplants is performed with the patient supine Anterior images are obtained over the iliac fossa containing the transplanted kidney The gamma ray spectrum shown below was obtained at a voltage of 800 To move the photo peak into the window which of the following actions should be taken A The voltage should be increased B The voltage should be decreased C The window should be widened D The window should be moved answer A The voltage should be increased As voltage is increased the gamma ray spectrum moves to the right Therefore increasing the voltage will shift the photopeak toward the window and if the voltage is increased sufficiently into the window Which of the following 99mTc labeled agents is the preferred radiopharmaceutical for demonstrating intermittent gastrointestinal bleeding A Human serum albumin B Red blood cells C Lidofenin D Sulfur colloid answer B Red blood cells 99mTc heat treated red blood cells RBCs and 99mTc sulfur colloid techniques have for the most part been replaced by non heat treated 99mTc labeled red blood cell procedures for performing GI bleeding studies When the septa are removed and coincidences are recorded between detectors lying in any ring combination the data are acquired A In hybrid mode B In 2D mode C In 3D mode D In 40 mode answer C In 3D mode The sensitivity in 3D PET is highest in the axial center of the gantry and diminishes toward the periphery the sensitivity of the first and last few slices of a 3D acquisition is the same as the sensitivity of 2D mode The boost in sensitivity to true coincidences is the key motivation for the removal of septa However the sensitivity to scatter in random events in 3D mode also increases considerably If a patient receives 99mTc MAA while in an upright position which of the following statements most likely represents what will be seen on the perfusion lung images A Increased tracer activity in the lung apices B Decreased tracer activity throughout both lungs C Decrease tracer activity in the lung bases D Decrease tracer activity in the lung apices answer D Decrease tracer activity in the lung apices Technetium 99mTc MAA should be injected during quiet respiration with the patient supine to minimize the normal perfusion gradient between the apex and the lung base When the patient is supine the effect of gravity which hinders blood flow to the lung apices is minimized allowing uniform tracer distribution throughout the lung In case of a radioactive spill that involves contamination and life threatening injuries to personnel which of the following actions should be given priority A Confinement of the radioactive spill B Decontamination of the victim C Notification of the radiation safety officer D Medical treatment of the seriously injured answer D Medical treatment of the