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Final Exam Review

Total questions: 159

Worksheet time: 1hrs 20mins

Name
Class
Date
1.

“For a 64 x 64 matrix, more time and more counts are needed per stop.”

a)

True

b)

False

2.

For a 128 x 128 matrix less time and less counts are needed per image stop.

a)

True

b)

False

3.

“If there are low counts, then less time is needed per image stop.”

a)

True

b)

False

4.

“The greater the number of image stops, the better the statistics are for the acquisition.”

a)

True

b)

False

5.

An appropriate number of projections is required to cancel the star artifact

a)

True

b)

False

6.

A small organ on a large FOV (field of view) needs less zoom for more pixel coverage.

a)

True

b)

False

7.

Using filters and smoothing reduces resolution.

a)

True

b)

False

8.

How often is COR routinely done?

a)

Weekly

b)

Daily

c)

Monthly

d)

Quarterly

9.

What filter is used for moderate to high count studies?

a)

Iterative

b)

Wiener and Metz

c)

Hanning

d)

Butterworth

10.

All imaging are plagued by statistical variation, commonly referred to as                      

a)

Noise

b)

Signal

c)

signal to noise

d)

noise to signal

11.

The general principles that are incorporated into quantitative analysis of myocardial perfusion and function images include all of the following EXCEPT

___________________.

a)

Analyze the processed data to extract specific features

b)

Evaluate the patient’s study of motion

c)

Compare the patient’s cardiac features with the normal population

d)

Enhance image to measure physiologic parameters

12.

“To eliminate the “star artifact” and reconstruct the tracer distribution more accurately, each projection should first be filtered with a:”

a)

ramp filter

b)

Butterworth filter

c)

Hanning filter

d)

Sheep/Logan filter

13.

High-pass filters:

a)

Include the Butterworth filter

b)

Remove noise in an image by smoothing the image

c)

Preserve spatial resolution

d)

Allow low-frequency data to pass through

14.

What is the difference between a Hanning filter and a Butterworth filter?

a)

Only one parameter is needed to define Butterworth filter whereas 2 are required for the Hanning filter.

b)

The Hanning is a high pass filter and the Butterworth is a low-pass filter.

c)

The Hanning is a low-pass filter and the BUtterworth is a high pass filter.

d)

Only one parameter is needed to define Hanning filter, whereas 2 are required for the Butterworth filter.

15.

The critical frequency is when the filter begins to:

a)

Decrease to 0

b)

Decrease to 1

c)

Increase to 0

d)

Increase to 1

16.

“What can be done if an image is too “noisy”?”

a)

filtered back projection could be applied

b)

A ramp filter could be applied

c)

a low-pass filter could be applied

d)

A high-pass filter could be applied

17.

Power factor is usually ______________times the order.

a)

4

b)

3

c)

1

d)

2

18.

It is common practice to reorient the transaxial images into

_____________images.

a)

2-dimensional

b)

short-axis

c)

vertical axis

d)

3-demensional

19.

Errors in the placement of the long axis on the transaxial slices will result in improperly defined foreshortened views of the :

a)

short axis

b)

vertical long axis

c)

lateral axis

d)

horizontal axis

20.

How often should energy peaking be performed in camera QC?

a)

Daily

b)

Weekly

c)

Monthly

d)

Annually

21.

What is the advantage of performing intrinsic floods?

a)

higher uniformity numbers

b)

collimators are checked at the same time

c)

higher count rate

d)

two heads are checked at once

22.

Bar pattern phantoms are used to examine:

a)

spatial resolution

b)

uniformity

c)

photomultiplier tubes

d)

crystal damage

23.

What is the recommended standard integral uniformity parameter?

a)

Less than 20%

b)

Less than 10%

c)

More than 5%

d)

Less than 3%

24.

What is the typical pattern of crystal cracks on a flood image?

a)

Large cold spot

b)

Cold region with hot rims

c)

Cold spot 2 o 3 times larger than PM tube diameter

d)

Moire pattern

25.

What type of QC problems is demonstrated as a tuning fork artifact?

a)

Off-peak energy spectrum

b)

Nonlinearity

c)

COR offset

d)

Nonuniformity

26.

The center of rotation calibration is used to correct for:

a)

The alignment of the imaging table

b)

The position of the patient in relationship to the camera orbit

c)

Differences in the mechanical and electronic axis of rotation

d)

Variation of activity in camera orbit

27.

Spatial resolution will ____________with increasing distance from a parallel hole collimator.

a)

Degrade

b)

Improve

c)

Remain unchanged

d)

improve initially, then improve

28.

“According to the ASNC imaging guidelines, to correct for sensitivity variations due to collimator, ____________count images are acquired for each detector and stored for uniformity correction.”

a)

More than 100 million

b)

3 - 10 miliion

c)

3 - 10 kilo

d)

30 - 100 million

29.

What is the typical pattern of a defective PM tube on a flood image?

a)

Cold region with hot rims

b)

Large cold spot

c)

Cold spot 2 to 3 times larger than PM tube diameter

d)

Moire pattern

30.

What is the typical pattern of a decoupled PM tube on a flood image?

a)

loss of light signal and shows a bubble pattern

b)

Large cold spot

c)

Cold spot 2 to 3 times larger than PM tube diameter

d)

Moire pattern

31.

The ring artifact in SPECT imaging is due to:

a)

A nonuniform flood

b)

COR error

c)

Nonlinearity bar pattern

32.

Which of the following is a common problem found in transmission scans used with attenuation correction?

a)

High radiation exposure o the patient

b)

Requirement that the body shape be uniform in attenuation

c)

No uniform transmission map

d)

That part of the body is truncated in the transmission projections

33.

What is the major consequence of MPI scan image artifacts?

a)

false-negative scan results

b)

Unpredictable scan results

c)

false-positive scan results

d)

No major consequences

34.

Artifacts caused by patient motion are most effectively differentiated from the true perfusion defect by:

a)

Applying motion correction software

b)

Reviewing the wall motion from the ECG gated images

c)

Quantitative analysis with proper normal limits

d)

Processing with iterative reconstruction (OSEM)

35.

A patient who exercises with left bundle branch block may have a

_______________artifact on an MPI study.

a)

anterior wall

b)

inferior wall

c)

lateral wall

d)

septal wall

36.

Which of the following may cause left ventricular hypertrophy on aged myocardial perfusion SPECT imaging.

a)

Falsely higher ejection fraction

b)

Falsely lower ejection fraction

c)

Falsely lower end-systolic volume

d)

Falsely higher end-diastolic volume

37.

The advantage of prone imaging includes all of the following EXCEPT:

a)

less antero-septal attenuation artifact

b)

less diaphragmatic attenuation defect

c)

less motion artifact

d)

overall less and more uniform breast attenuation artifact

38.

Which of the following is NOT the potential source of artifacts on an equilibrium radionuclide angiography study?

a)

poor tagging or labeling of red blood cell technique

b)

poor positioning

c)

gated planar acquisition instead of gated SPECT acquisition

39.

The in-Vivo method yield the lowest labeling efficiency.

a)

True

b)

False

40.

The general principles that are incorporated into quantitative analysis of myocardial perfusion and function images include all of the following EXCEPT

___________________.

a)

Enhance the image o measure physiologic parameters

b)

Evaluate the patient’s study for motion

c)

Analyze the processed data to extract specific features

41.

Motion on a myocardial perfusion scan can be best evaluated from the

_________________.

a)

Save screen image

b)

Circumferential

c)

Gated acquisition

d)

Raw fine image

42.

Quantitation of a myocardial perfusion image can evaluate all of the following EXCEPT _____________defect.

a)

flow reserve

b)

extent

c)

severity

d)

reversibility

43.

What is the advantage of utilizing the 17 segment score over the 20 segment score model?

a)

Less normal and severely abnormal scans

b)

Better prognostic results

c)

Fewer mildly abnormal scans

d)

Faster and simpler quantitation results

44.

Which of the following is NOT the result of quantitation of ventricular function analysis?

a)

EDV and ESV

b)

TID

c)

Wall motion and Wall Thickening

d)

Phase analysis

45.

What is the significance of a high TID ratio?

a)

Sign of acute myocardial infarction

b)

Serves as a marker of severe and extensive coronary artery disease

c)

Patients with multiple risk factors (hypertension, high cholesterol, diabetes mellitus, smoking)

d)

Patients with symptoms

46.

In comparing 8-frame vs 16-frame gating, which of the following is TRUE?

a)

16-frame gating will result in 4% increase in ejection fraction

b)

Both can measure diastolic function accurately

c)

8-frame gating is usually more accurate for ejection fraction

d)

8-frame gating will result in 4% increase in ejection fraction

47.

Normal database profiles (normal limits) are based on the calculation of normal pixel count values from patients with low likelihood of coronary artery disease. The normal limits are _______specific.

a)

attenuation correction method

b)

Imaging position (prone or upright)

c)

Age, gender, height, weight, and reconstruction method

d)

Gender, tracer, and imaging protocol

48.

The myocardial perfusion imaging report is ultimately the critical piece of information to _________________.

a)

Relay the information to the referring physician regarding an abnormal scan

b)

Document what was done for reimbursement

c)

Guide patient management

d)

All of the above

49.

The Five C’s of a myocardial perfusion imaging report are

_________________.

a)

Clarity, completeness, common, clinical relevancy and communication

b)

Correct, completeness, consistency, clinical relevancy and communication

c)

Clarity, completeness, consistency, clinical relevancy and communication

d)

Clarity, compact, consistency, clinical relevancy and communication

50.

After a final report has been dictated, what is the recommended reporting time?

a)

As soon as possible

b)

Within 2 business days after the final report was dictated

c)

Within 3 business day, if the results are positive

d)

There are no guidelines on how long an interpretive physician has to send a report to the referring physician

51.

What is the typical pattern of crystal cracks on a flood image?

a)

Moire pattern

b)

cold spot 2 to 3 times larger than PM tube diameter

c)

large cold spot

d)

cold region with hot rims

52.

What type of QC problems is demonstrated as a tuning form artifact?

a)

COR offset

b)

off-peak energy spectrum

c)

nonlinearity

d)

nonuniformity

53.

The center of rotation calibration is used to correct for:

a)

The alignment of the imaging table

b)

The position of the patient in relation to the camera orbit

c)

differences in the mechanical and electronic axis of rotation

d)

Variation of activity in camera orbit

54.

Spatial resolution will _____________with increasing distance from a parallel hole collimator.

a)

Improve

b)

Degrade

c)

Remain unchanged

d)

Improve initially, then improve

55.

Cutoff frequency ___________.

a)

Is the frequency at which a filter increases the amplitude

b)

Defines the start of the downward turn of he Butterworth filter

c)

Defines the steepness of the Butterworth filter

d)

Is combined with the Hanning filter to reduce noise

56.

Low pass filters___________.

a)

Have little effect on final image quality

b)

Are typically used din a ramp filter

c)

Filter out low frequency data and sharpen images.

d)

Filter out high frequency data and smooth images

57.

The filter in the term “Filtered Back Projection” that erases the blur of simple back projection is the:

a)

Ramp filter

b)

Hanning fliter

c)

Butterworth filter

d)

Metz filter

58.

What could be the cause of flashing pattern of flickering with bright pixel in rotating raw data?

a)

Motion artifact

b)

Uniformity artifacts

c)

Gating artifact

d)

COR artifacts

59.

The ideal volume of a point source for intrinsic uniformity testing is ________ml.

a)

0.5

b)

0.1

c)

1.0

d)

10

60.

What will reverse the effects of dipyridamole?

a)

Dobutamine

b)

Adenosine

c)

Thallium

d)

Aminophylline

61.

The right coronary artery defects are best seen in the

a)

Short axis and vertical long axis

b)

short axis only

c)

horizontal long axis only

d)

short axis and horizontal long axis

62.

Which of the following is a FALSE statement for the advantage of prone imaging?

a)

Less septal wall due to left bundle branch artifacts

b)

Less motion artifacts

c)

Less inferior wall due to diaphragmatic attenuation artifacts

d)

Less anterior wall due to breast attenuation artifacts

63.

What effect does appropriately increasing the cutoff frequency have on myocardial perfusion images?

a)

increased resolution

b)

decreased sensitivity

c)

smoother images

d)

increased count rate

64.

When using Tl-201:

a)

there is no redistribution

b)

redistribution begins immediately

c)

redistribution begins 2 hours after

d)

redistribution begins 24 hours post injection

65.

Dobutamine infusion should start at a dose of: 

a)

20 to 25 ug/kg/min

b)

15 to 20 ug/kg/min

c)

5 to 10 ug/kg/min

d)

10 to 15 ug/kg/min

66.

Which group of drugs is often the drug of choice to treat hypertension and congestive heart failure?

a)

Anticoagulants

b)

Antiarrhythmics

c)

Calcium Channel blockers

d)

ACE inhibitors

67.

Which of the following classes of drugs inhibits lower arteriolar resistance and increases venous capacitance, thereby increasing cardiac output, stroke work, and stroke volume?

a)

Lasix

b)

ACE inhibitors

c)

Acetylsalicylic acids

d)

Antiarrhythmic drugs

68.

Which of the following is NOT a class of cholesterol-lowering drugs?

a)

Statins

b)

Niacin

c)

Bile sequestrants

d)

Aspirin

69.

Which of the following is NOT one of the 3 major indications for performing myocardial perfusion imaging:

a)

Detection of heart and lung disease

b)

risk stratification

c)

Detection of CAD

d)

Evaluation of therapeutic intervention

70.

Which of the following medications is a type of beta-blocker?

a)

Acetylsalicylic acid

b)

Propanolol

c)

Dypridamole

d)

Captopril

71.

Which of the following radiopharmaceuticals is used to study the heart?

a)

DTPA

b)

sestamibi

c)

MAA

d)

WBC

72.

Which radiopharmaceutical is used to label RBCs with 99mTC?

a)

exametazine

b)

albumin

c)

pertechnetate

73.

Which radiopharmaceutical used for metastatic pheochromocytoma is also used for the evaluation cardiac failure?

a)

99mTc-tetrofosmin

b)

99mTc-NOET

c)

I-123 BMIPP

d)

I-123 MIBG

74.

Which two methods for labeling RBCs have the highest labeling efficiency of approximately 95%?

a)

Ultratag and in vitro

b)

Ultratag and modified in vivo

c)

Modified in vivo and in vitro

d)

Modified in vivo and in vivo

75.

"A technologist injects a patient with 1 mg of unlabeled stannous phosphate. After 20 minutes, 20 mCi of 99mTc pertechnetate is administered. This is:"

a)

none of the choices

b)

a modified in vivo labeling procedures

c)

an in vivo labeling procedure

d)

an in vitro labeling procedure

76.

"According to the American Society Nuclear Cardiology (ASNC) guidelines, it is important to withhold caffeine products for how long before a pharmacologic stress test?"

a)

products containing caffeine do not need to be withheld

b)

at least 8 hours

c)

at least 4 - 6 hours

d)

at least 12 hours

77.

"According to the textbook what is the dose range when using Tl-201, ?"

a)

20 to 25 mCi

b)

10 to 30 mCi

c)

1 to 4 mCi

d)

5 to 10 mCi

78.

"As an alternative to exercise studies, pharmacologic stress can be achieved through the use of any of the following EXCEPT:"

a)

aminophylline

b)

dobutamine

c)

adenosine

d)

dipyridamole

79.

"Because diagnosis of myocardial infarction is usually made within 12 hours, imaging with 99mTc-PYP is infrequently performed."

a)

True

b)

False

80.

"During a MUGA study, data collection is stopped when:"

a)

a preset time has been reached

b)

a preset number of cardiac cycles has been reached

c)

a preset number of counts has been acquired

d)

when either a preset number of counts or a preset number of cardiac cycles has been reached

81.

"During an exercise gated study, the ECG pattern suddenly becomes dramatically different, although the patient is responsive, has an unchanged pulse rate, continues to exercise, and has no pain. The technologist should first:"

a)

call the referring physician

b)

call a code

c)

check for a disconnected lead

d)

start CPR

82.

"Following injection of 99mTc sestamibi, during a resting myocardial perfusion study, imaging is delayed for one hour because:"

a)

liver and gallbladder activity is too high to allow high quality images of the myocardium

b)

respiratory motion will decrease

c)

"until one hour after injection, sestamibi has not had sufficient time to be taken up by the myocardium"

d)

the patient should be monitored

83.

"If the end-diastolic volume is 135 liters and the end systolic volume is 60 liters, what is the Stroke Volume for this patient?"

a)

135 liters/60 liters

b)

135 liters X 60 liters

c)

135 liters - 60 liters

d)

135 liters + 60 liters

84.

"If the ventricular rate is less than 60 beats/min, it is considered bradycardia."

a)

True

b)

False

85.

"If the ventricular rate is more than 100 beats/min, it is considered tachycardia."

a)

True

b)

False

86.

"Of the choices offered, which is the best imaging view for calculating left ejection fraction?"

a)

RAO

b)

LLAT

c)

LAO

d)

ANT

87.

"This drug has been shown to rapidly reverse the pharmacologic actions of adenosine, dipyridamole, and regadenoson typically within 1 minute."

a)

Aspirin

b)

Aminophylline

c)

Atropine

d)

Esmolol

88.

"When imaging 99mTc-labeled RBCs, excessive liver and kidney uptake may be related to:"

a)

incomplete reduction of 99mTc

b)

99mTc-labeled tin

c)

99mTc-labeled heparin

d)

free unlabeled 99mTc-pertechnetate

89.

"When labeling RBCs with 99mTc for imaging, the highest labeling efficiency will be obtained by:"

a)

all result in the same labeling efficiency

b)

the modified in vivo/in vitro method

c)

the in vitro method

d)

in vivo method

90.

"When observing a 12-lead ECG, a diagnosis or left bundle branch block is made if:"

a)

there is an R-R in V1 and V2

b)

there is an S wave in V1 and an R wave in V5

c)

there is an R wave in V1 and an S wave in V5

d)

there is an R-R in V5 and V6

91.

"When performing RBC labeling using the Ultratag kit, the labeled blood should be injected within ____________ minutes."

a)

10

b)

20

c)

30

d)

40

92.

"When performing a dual isotope myocardial perfusion rest/stress study, which isotope should be injected first?"

a)

"it doesn't matter which is injected first, as long as 99mTc is used for the stress study"

b)

201thallium chloride

c)

99mTc

d)

either can be injected first without any consequence

93.

Which of the following is NOT one of the three broad descriptions of motion that can affect study results?

a)

Upward creep

b)

Bouncing

c)

Swinging

d)

Returning and non-returning shifting

94.

What is a sinogram?

a)

An image made up of one line of pixels that shows only vertical motion

b)

An image made up of one line of pixels that shows only horizontal motion

c)

An image made up of multiple lines of pixels that shows both vertical and horizontal motion

d)

An image made up of one line of pixels that best shows horizontal motion

95.

What is the recommended course of action if significant motion is detected on cine displays of planar projections?

a)

Ignore the motion and proceed with the analysis

b)

Repeat the acquisition

c)

Use multiple detectors to reduce the artifact

d)

d) Increase the number of pixels in the display

96.

What is the advantage of using iterative reconstruction algorithms for SPECT reconstruction compared to filtered back-projection?

a)

It produces more accurate results

b)

It requires less input data

c)

It is faster and more efficient

d)

It reduces reconstruction artifacts caused by extra cardiac activity and can easily incorporate attenuation correction

97.

How are normal limits for identifying abnormal tracer distribution in myocardial perfusion imaging determined?

a)

Based on the calculation of normal pixel count values from patients without coronary artery disease

b)

Based on the calculation of abnormal pixel count values from patients with a high likelihood of coronary artery disease

c)

Based on the calculation of normal pixel count values from patients with a low likelihood of coronary artery disease

d)

Based on the calculation of abnormal pixel count values from patients with no history of coronary artery disease

98.

What is the functionality provided automatically by QPS in myocardial perfusion imaging?

a)

Generation of LV outer surface only from short-axis perfusion SPECT data

b)

Display of only stress projection images in static and cine mode

c)

Computation of RV chamber volume

d)

Generation of stress, rest, and reversibility surfaces and polar maps as well as display of the severity and extent of perfusion defects using isotope- and gender-specific normal limits

99.

How is the degree of lung uptake of myocardial perfusion tracers assessed?

a)

By analyzing the stress and rest projection images

b)

By visually inspecting the short-axis SPECT images

c)

By quantifying a lung/heart ratio (LHR) from a representative anterior projection image

d)

By generating stress, rest, and reversibility surfaces and polar maps

100.

What is the significance of increased lung uptake after thallium perfusion imaging?

a)

It is a marker of severe and extensive coronary artery disease

b)

It indicates good prognosis

c)

It indicates poor prognosis

d)

It has no clinical significance

101.

What is usually the cause of ventricular dilation on both rest and post-stress images?

a)

Ischemic dilation

b)

Non-ischemic dilation

c)

Normal cardiac function

d)

Low risk coronary artery disease (CAD)

102.

What is the benefit of using standardized reporting in nuclear cardiology?

a)

Consistency in the reports

b)

Reducing the accuracy of the reports

c)

Increasing the amount of information conveyed in the reports

d)

Increasing patient anxiety

103.

What is the final and most important component of the nuclear cardiology report?

a)

Patient information

b)

Imaging study results

c)

The impression

d)

Recommendations for further testing

104.

How do AUC help guide physician decision making in cardiovascular imaging studies?

a)

By making the decision for the physician

b)

By providing guidelines on when and how often to perform an imaging study

c)

By limiting the use of imaging studies

d)

By increasing the cost of imaging studies

105.

Which of the following is true about electronic corrections in nuclear imaging?

a)

Corruption of the electronic correction files has no effect on the images

b)

Electronic corrections do not affect the uniformity of the images

c)

The energy, linearity, and uniformity corrections work together to give the best possible uniformity in the images

d)

Performing daily floods is not necessary for proper corrections

106.

Which of the following is critical for the use of CT images for SPECT attenuation correction?

a)

Monthly calibration and field uniformity test

b)

The presence of a special calibration phantom

c)

Accurate absolute CT numbers in Hounsfield units

d)

The use of SPECT/CT systems

107.

What is the purpose of performing phantom tests on a camera system in nuclear medicine?

a)

To prepare for accreditation by the ACR and the Joint Commission

b)

To improve the quality of patient care

c)

To increase the cost of imaging studies

d)

To determine the number of patients that can be seen in a day

108.

What should be done to eliminate Co56/Co58 contamination artifacts seen in nuclear imaging when a flood source is new?

a)

Lower the flood source closer to the collimated surface

b)

Increase the number of counts acquired during the imaging study

c)

Use a different type of collimator

d)

Raise the flood source approximately 10cm from the collimated surface

109.

What are the recommended delay times for the injection of 99m/Tc tracer in different protocols according to ASNC guidelines?

a)

30 minutes for resting, 15 minutes for exercise stress, and 60 minutes for pharmacologic stress.

b)

15 minutes for resting, 60 minutes for exercise stress, and 30 minutes for pharmacologic stress.

c)

60 minutes for resting, 15 minutes for exercise stress, and 30 minutes for pharmacologic stress.

d)

15 minutes for resting, 30 minutes for exercise stress, and 60 minutes for pharmacologic stress.

110.

What is the potential consequence of infiltration during a same-day rest/stress study?

a)

It may result in less radiotracer uptake by the myocardium, leading to lower counting statistics and decreased study quality.

b)

It may lead to visualization of lymph nodes due to altered distribution of the radiotracers, potentially causing an investigation for malignancy.

c)

It may mask stress-induced ischemia during the second phase of the study, causing a false negative error due to the lack of difference in counts.

d)

All of the above.

111.

What is the "hurricane sign" artifact in SPECT imaging?

a)

It is a pattern of image distortion caused by patient motion during SPECT image acquisition, often seen in patients who move horizontally.

b)

It is a typical finding in patients with abnormal lung function, characterized by a whirlwind-like appearance on SPECT images.

c)

It is a characteristic artifact of patient motion during SPECT image acquisition, characterized by a pattern of distortion that resembles the National Weather Service symbol for a hurricane.

d)

It is an artifact caused by radioactive decay of the radiotracer, leading to a pattern of image distortion that resembles a hurricane.

112.

What is the potential consequence of a center of rotation (COR) offset error in SPECT imaging?

a)

It can result in a pattern of distortion that resembles a hurricane, reducing image contrast and spatial resolution.

b)

It can cause significant image artifacts, particularly at the apex, resulting in a characteristic "doughnut" or "tuning fork" artifact in the transverse images.

c)

It can lead to an altered distribution of the radiotracers, resulting in visualization of lymph nodes and potentially causing an investigation for malignancy.

d)

It can reduce the amount of radiotracer available for uptake by the myocardium, leading to lower counting statistics and decreased study quality.

113.

What portion of an EKG wave represents the depolarization of the ventricles?

a)

QRS Complex

b)

P wave

c)

ST Segment

d)

T wave

114.

What is the rate of infusion for regadenoson?

a)

140 ug/kg/min

b)

0.57 mg/kg body weight – correct

c)

5 mg/kg/min for 3 minutes followed by 10, 20, 30, and 40 mg/kg/min each consecutive 3 minute period

d)

No dose adjustment is required for body weight

115.

What is the rate of infusion for dobutamine?

a)

140 ug/kg/min

b)

0.57 mg/kg body weight

c)

5 mg/kg/min for 3 minutes followed by 10, 20, 30, and 40 mg/kg/min each consecutive 3 minute period

d)

No dose adjustment is required for body weight

116.

What is the rate of infusion for dipyridamole?

a)

140 ug/kg/min

b)

0.57 mg/kg body weight

c)

5 mg/kg/min for 3 minutes followed by 10, 20, 30, and 40 mg/kg/min each consecutive 3 minute period

d)

No dose adjustment is required for body weight

117.

What is the rate of infusion for adenosine?

a)

No dose adjustment is required for body weight

b)

5 mg/kg/min for 3 minutes followed by 10, 20, 30, and 40 mg/kg/min each consecutive 3 minute period"

c)

140 ug/kg/min

d)

0.57 mg/kg body weight

118.

Stunned myocardium is a phenomena that:

a)

refers to the state of delayed recovery of the left ventricle after a transient period of ischemia

b)

can only be seen at stress

c)

can be demonstrated by looking at both the stress and rest, where the stress EF is 5% than the rest EF

"

d)

there is no phenomena called stunned myocardium in nuclear medicine

119.

I-123 MIBG can be used to diagnose and measure:

a)

ischemic memory or acute myocardial ischemia

b)

congestive heart failure

c)

left-to-right shunt

d)

right-to-left shunt

120.

A technologist injects a patient with 1 mg of unlabeled stannous phosphate. After 20 minutes, 20 mCi of 99mTc pertechnetate is administered. This is:"

a)

an in vivo labeling procedure

b)

an in vitro labeling procedure

c)

a modified in vivo labeling procedures

d)

none of the choices

121.

During a MUGA study, data collection is stopped when:

a)

a preset time has been reached

b)

a preset number of cardiac cycles has been reached

c)

a preset number of counts has been acquired

d)

when either a preset number of counts or a preset number of cardiac cycles has been reached

122.

False negative stress myocardial perfusion studies are usually caused by:

a)

thallium is contained in too large a volume

b)

failure of the myocardium to extract 201Tl chloride from the bloodstream

c)

failure of the patient to reach maximal stress

d)

electrocardiogram leads

123.

When performing a dual isotope myocardial perfusion rest/stress study, which isotope should be injected first?

a)

either can be injected first without any consequence

b)

201thallium chloride

c)

99mTc

d)

it doesn't matter which is injected first, as long as 99mTc is used for the stress study

124.

Soft tissue attenuation is less problematic in:

a)

SPECT myocardial imaging with 201Thallium chloride than with planar imaging with 99mTc sestamibi

b)

SPECT myocardial imaging with 201Thallium chloride than with planar imaging with 201Thallium chloride

c)

SPECT myocardial imaging with 99mTc-sestamibi than with planar imaging with 99mTc sestamibi

d)

myocardial imaging with 99mTc sestamibi than with 201Thallium chloride

125.

Choose the correct order in which the structures appear during a first pass study.

a)

"right ventricle, pulmonary artery, lungs, pulmonary veins, left atrium"

b)

"right ventricle, pulmonary artery, lungs pulmonary veins, left ventricle"

c)

"right ventricle, pulmonary veins, lungs, pulmonary artery, left atrium"

d)

"left ventricle, pulmonary artery, lungs, pulmonary veins, left atrium"

126.

A patient who cannot exercise and who has asthma can undergo a stress myocardial perfusion study through the use of:

a)

adenosine

b)

dipyridamole

c)

the Bruce protocol

d)

Dobutamine

127.

Set up for a SPECT imaging of myocardial perfusion with 99mTc-sestamibi includes all of the following EXCEPT:

a)

ensuring that COR correction for high sensitivity collimator is selected.

b)

moving the patient's arm over his or her head

c)

ensuring that the detector head will not snag IV lines or oxygen tubing

d)

setting a 10 degree caudal tilt to differentiate left atrium and left ventricle

128.

Gated blood pool ventriculography (MUGA) is often used to:

a)

detect hematologic spread of metastases

b)

diagnose arrhythmia

c)

determine effect of chemotherapy on cardiac function

d)

obtain a baseline measurement of cardiac output in potential radiation therapy patients

129.

Which of the following does not describe the correct preparation for an exercise myocardial study?

a)

catheter placement for injection of radiopharmaceutical during exercise

b)

halt all medication 24 hours before the study.

c)

NPO at least 4 hours prior to radiopharmaceutical administration.

d)

none of the choices

130.

All of the following will negatively affect a myocardial perfusion study with 201Thallium chloride EXCEPT:

a)

Arrhythmia

b)

Wrong collimator

c)

Incorrect COR

d)

Increased patient to detector distance

131.

Which of the following classes of drugs inhibits lower arteriolar resistance and increases venous capacitance, thereby increasing cardiac output, stroke work, and stroke volume?

a)

Angiotensin-converting enzyme inhibitors

b)

Acetylsalicylic acids

c)

Antiarrhythmic drugs

d)

Anticoagulants

132.

Which of the following drugs frequently induces ST segments depression in the ECG, which can lead to false-positive treadmill tests or mask ischemia if not taken into consideration? Toxic levels of this drug can lead to heart block and almost any arrhythmia, as well as weakness, depression, and anorexia."

a)

Warfarin

b)

Digoxin

c)

Aspirin

d)

Niacin

133.

Which class of drugs may affect exercise and the EKG by decreasing heart rate and blood pressure at rest and during exercise, decreasing cardiac contractility, and decreasing work capacity?"

a)

Vasodilators

b)

ACE Inhibitors

c)

Beta-blockers

d)

Sympathomimetic Drugs

134.

Low doses of which drug may be given immediately after a heart attack to reduce the risk of another heart attack or the death of cardiac tissue?

a)

Aminophylline

b)

Diltiazem

c)

Digoxin

d)

Aspirin

135.

Which group of drugs is often the drug of choice to treat hypertension and congestive heart failure?

a)

ACE inhibitors

b)

Calcium channel blockers

c)

Antiarrhythmics

d)

Anticoagulants

136.

When using 99mTc-sestamibi, according to both textbooks what is the recommended dose range used for both stress and rest combined?

a)

10 to 30 mCi

b)

8 to 10 mCi

c)

20 mCi

d)

22 to 25 mCi

137.

Increased carrier TC in the eluent is caused by:

a)

prolonged generator in-growth

b)

too much anticoagulant used

c)

too much tin used

d)

the patient being on dextrose

138.

The amount of tin needed to pretreat RBCs for labeling is approximately ____________mg or ug/kg body weight.

a)

2.0 to 2.5; 30

b)

1.5 to 2.0; 25

c)

1.0 to 1.5; 20

d)

0.5 to 1.0; 15

139.

An early bone imaging agent now used to identify acutely infarcted myocardium:

a)

99mTc-tetrofosmin

b)

99Tc-PYP

c)

99mTc-RBCs

d)

99mTc-Tebroxime

140.

The T wave represents

a)

repolarization of the ventricular myocardial cells and occurs during the last part of the ventricles systole

b)

depolarization of the interventricular septum

c)

atrial depolarization

d)

the rest period between depolarization and repolarization of the right and left ventricles

141.

The ST segment represents:

a)

repolarization of the ventricular myocardial cells and occurs during the last part of the ventricles systole.

b)

atrial depolarization

c)

depolarization of the interventricular septum

d)

the rest period between depolarization and repolarization of the right and left ventricles

142.

Sympathetic activity can slow the heart rate.

a)

True

b)

False

143.

Parasympathetic activity can slow the heart rate.

a)

True

b)

False

144.

Which factors influence heart rate?

a)

pain

b)

temperature

c)

hydration status

d)

all of these factors

145.

If the end-diastolic volume is 135 liters and the end systolic volume is 60 liters, what is the Stroke Volume for this patient?

a)

8,100 liters

b)

2.25 liters

c)

195 liters

d)

75 liters

146.

Cardiac Index is defined as:

a)

the amount of blood ejected from the ventricles each time they contract.

b)

the percentage of blood forced out of the heart with each heartbeat.

c)

the amount of blood that is ejected from the left ventricle into the systemic circulation or the right ventricle into the pulmonary circulation per minute.

d)

a physiologic measurement used to adjust for individual differences in body size.

147.

Cardiac Output is defined as:

a)

a physiologic measurement used to adjust for individual differences in body size.

b)

the amount of blood ejected from the ventricles each time they contract.

c)

the percentage of blood forced out of the heart with each heartbeat.

d)

the amount of blood that is ejected from the left ventricle into the systemic circulation or the right ventricle into the pulmonary circulation per minute.

148.

1.       Ejection Fraction is defined as:

a)

the amount of blood ejected from the ventricles each time they contract.

b)

the percentage of blood forced out of the heart with each heartbeat.

c)

the amount of blood that is ejected from the left ventricle into the systemic circulation or the right ventricle into the pulmonary circulation per minute.

d)

a physiologic measurement used to adjust for individual differences in body size.

149.

Stroke volume is defined as:

a)

the percentage of blood forced out of the heart with each heartbeat.

b)

the amount of blood ejected from the ventricles each time they contract.

c)

the amount of blood that is ejected from the left ventricle into the systemic circulation or the right ventricle into the pulmonary circulation per minute.

d)

a physiologic measurement used to adjust for individual differences in body size.

150.

Cardiac Output can be determined by multiplying the heart rate by the stroke volume.

a)

True

b)

False

151.

     Parasympathetic function is dominated by the vagus or 9th cranial nerve.

a)

True

b)

False

152.

If the SA node fails, then the AV node takes over at a slower rate of 40 - 60 beats/min.

a)

True

b)

False

153.

What is the normal rate for sinus rhythm?

a)

60 - 100 beats/mint

b)

40 - 60 beats/min

c)

100 - 140 beats/min

d)

140 - 180 beats/min

154.

When labeling RBCs with 99mTc for imaging, the highest labeling efficiency will be obtained by:

a)

Modified in vivo/in vitro method

b)

In-viva method

c)

In-vitro method

d)

In-vivo method

155.

Cardiac contraction is initiated in the:

a)

Bundle of His

b)

AV node

c)

SA node

d)

P wave

156.

Which of the following radiopharmaceuticals is used to study the heart?

a)

99mTc-MAA

b)

99mTc-sestamibi

c)

99mTc-WBC

d)

99mTc-DTPA

157.

What will reverse the effects of dipyridamole?

a)

Aminophylline

b)

Dobutamine

c)

Adenosine

d)

Thallium

158.

Given the data below, calculate the left ventricular ejection fraction. ED = 58,219 and ES = 15,317. Is the ejection fraction within the normal range?"

a)

TRUE

b)

FALSE

159.

Given the data below, calculate the left ventricular ejection fraction. ED = 62,145 and ES = 40,258

a)

60%

b)

43%

c)

16%

d)

35%

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