FRCR 2A Nuclear Medicine Radiology SBA

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FRCR 2A Nuclear Medicine Radiology SBA

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An 8-year-old patient with suspected lower extremity osteomyelitis presents with normal plain radiographs. Which one of the following is the MOST appropriate next imaging study?

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Which of the following factors contributes MOST to the specificity of Tc-99m sestamibi scintigraphy for the detection of parathyroid adenomas?

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What is the basic principle underlying the C-14 urea breath test for Helicobacter pylori infection in patients with peptic ulcer disease?

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"You are shown representative coronal, transaxial and sagittal tomographic radionuclide images. Which one of the following radiotracers was MOST likely utilized for this study?

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"You are shown representative coronal, transaxial and sagittal images from an F-18 FDG (fluorodeoxyglucose) PET scan. What is the MOST likely diagnosis?

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"You are shown anterior whole body Tc-99m MDP bone scan in an 84-year-old woman with head and neck pain and a history of papillary thyroid carcinoma. What is the MOST likely explanation for the scintigraphic findings?

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"You are shown serial dynamic static images from a radionuclide hepatobiliary scan performed in a 63-year-old man presenting with abdominal pain and fever. Given the findings demonstrated, which of the following clinical complications is MOST likely present?

    

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Regarding Tc-99m sulfur colloid scintigraphy in focal nodular hyperplasia, which cell line is responsible for radiotracer uptake by this lesion?

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A 43-year-old male patient who is HIV positive presents with fever and back pain, with point tenderness in the thoracic spine on physical examination. Radiographs of the thoracic spine (not shown) are negative. Which of the following is the MOST appropriate scintigraphic workup for suspected osteomyelitis?

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"You are shown multiple 48 hour planar images obtained in a 56 year-old male presenting with recurrent tachycardia after prior right hepatectomy for tumor resection. Which one of the following medications needs to be discontinued prior to this study?

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"Based upon these static images from a Tc-99m macroaggregated albumin (MAA) pulmonary perfusion scintigram, what is the MOST likely explanation for the image findings?

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"You are shown maximum intensity projection (MIPS) coronal, transaxial and sagittal F-18-fluorodeoxyglucose (FDG) PET images obtained in an adult patient (Figure 6). What is the MOST LIKELY diagnosis?

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"You are shown 24 hour anterior and posterior whole-body In-111 Ibritumomab Tiuxetan (Zevalin) images obtained prior to Y-90 Ibritumomab Tiuxetan (Zevalin) therapy. Based on the findings demonstrated, which of the following statements regarding Zevalin radioimmunotherapy for this patient is correct?

19 / 170

Regarding the C-14 urea breath test for the detection of Helicobacter pylori (H. pylori) infection, which of the following medications will LEAST likely affect the results?

20 / 170

"A 58 year-old man is scheduled to undergo radioactive immunotherapy with Yttrium-90 ibritumomab tiuxetan (Zevalin). You are shown anterior and posterior 48 hour Indium-111 Zevalin images. What is the correct interpretation?

  

21 / 170

Concerning stress myocardial perfusion imaging in patients with left bundle branch block, which ONE of the following statements is correct?

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Which of the following findings on an In-111 Zevalin® scan would constitute a CONTRAINDICATION to radioimmunotherapy with Y-90 Zevalin®?

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A Tc-99m sulfur colloid scan performed in a 25-year-old woman reveals an incidental round, hyperintense area of activity within the liver. Which of the following is the MOST likely etiology for this finding?

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"You are shown a posterior Tc-99m MDP bone scintigram obtained in a 58-year-old man with back pain. What is the MOST likely diagnosis?

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Analysis of an equilibrium multigated-acquisition (MUGA) radionuclide cardiac study is performed, with the background region of interest placed over the spleen. The resulting calculated left ventricular ejection fraction will be:

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Which of the following is the MOST appropriate pharmacologic stress agent for patients undergoing myocardial perfusion imaging who have severe bronchospasm?

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Concerning the use of extremity radiation badges in Nuclear Medicine procedures, which one of the following describes the correct placement of a ring badge?

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What is the MOST commonly cited threshold for the diagnosis of malignancy using standardized uptake value (SUV) on PET imaging for a solitary pulmonary nodule?

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Reduced occipital lobe glucose metabolism on F-18 FDG (fluorodeoxyglucose) cerebral PET imaging is MOST common in which one of the following progressive dementias?

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A post-menopausal woman with osteoporosis undergoes dual-energy x-ray absorptiometry (DEXA. scanning, demonstrating marked osteopenia of the lumbar spine and hip, but normal bone density of the distal forearm. What is the BEST explanation for these findings?

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"You are shown serial images from a Tc-99m diethylene-triamine-pentaacetic acid (DTPA) radionuclide CNS shunt study. Which one of the following statements is CORRECT?

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Which ONE of the following sets of I-123 thyroid scintigraphy findings and history of radiation exposure is associated with the LOWEST relative risk for thyroid carcinoma?

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You are shown serial 3 minute posterior static images and renogram curves from a Tc-99m mercaptoacetyltriglycine (MAG3) renal scan performed in an adult with left hydronephrosis. Repeat images and curves obtained after intravenous administration of 40mg of furosemide (LasixR) are also shown. Which one of the following statements is CORRECT?

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You are shown flow, immediate and delayed static spot images and delayed whole body images from a three-phase Tc-99m MDP (methylene diphosphonate) bone scan in a previously healthy 11 year-old boy, presenting with worsening knee pain and fever. Which of the following diagnoses is MOST consistent with the imaging findings?

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Concerning radionuclide myocardial perfusion imaging, which one of the following is NOT associated with an inferior wall perfusion defect on a stress Tc-99m sestamibi SPECT study?

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Concerning the presence of multiple focal hotspots on a Tc-99m macroaggregated albumin (MAA) scan, which one of the following is CORRECT?

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You are shown stress and rest vertical long-axis images from a SPECT myocardial perfusion scan in a 50-year-old woman with chest discomfort. During treadmill exercise, the patient achieved 70% of the maximum predicted heart rate. What is the MOST likely explanation of the findings?

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You are shown transaxial, sagittal and coronal Tc-99m RBC SPECT images obtained in a patient with a solitary right hepatic lobe mass with indeterminant enhancement characteristics on CT (not shown). Based on the images provided, which ONE of the following statements is correct?

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Which of the following characteristics of F-18 FDG (fluorodeoxyglucose) PET imaging is most responsible for its efficacy in oncology imaging?

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Which of the following organs is NOT normally visualized 20-30 minutes after intravenous administration of Tc-99m pertechnetate?

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Based on the PIOPED II criteria for the interpretation of ventilation-perfusion scintigraphy studies in suspected pulmonary embolism, the presence of a ""stripe sign"" is best categorized as which ONE of the following?

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Regarding evaluation of a hip prosthesis with bone scintigraphy, which of the following statements about periprosthetic activity is CORRECT?

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The parallel-hole collimator is the MOST common type of collimator used in nuclear medicine studies. For an object imaged with a gamma camera with a parallel-hole collimator, how does the image size relate to the object size?

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Regarding patient preparation for F-18 FDG PET tumor imaging, which of the following medications should be withheld for several hours prior to radiopharmaceutical injection?

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A radiopharmaceutical using 99mTc has a biological half-life of ½ hour in the liver, and a biological half-life of 6 hours in the heart. How do the effective half-lives compare for imaging the liver and the heart?

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A patient with high-risk coronary artery disease undergoing a Tl-201 chloride stress myocardial perfusion exam would likely have a lung-heart activity ratio of which of the following?

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A nuclear medicine department is planning to install a PET-CT scanner. Which of the following radiation safety issues is critical and must be addressed during the preplanning stages?

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Which of the following is the maximum acceptable dose limit for the spouse of a patient sitting in a Nuclear Medicine waiting room for 1 hour?

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Following radioiodine therapy for Graves disease, how long can signs and symptoms persist before one can conclude that therapy was unsuccessful?

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Following radioiodine therapy for Graves disease, how long can signs and symptoms persist before one can conclude that therapy was unsuccessful?

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"You are shown images from an Rb-82 PET study of the heart performed in a 62-year-old woman with a history of previous coronary bypass surgery several years ago. She is now presenting with recurrent exertional chest discomfort. Based on these images, which of the following is the MOST LIKELY diagnosis?

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"You are shown flow images, serial static images and renogram curves from a Tc-99m MAG3 renal scintigraphy study performed on a 48-year-old man presenting with renal insufficiency. What is the MOST LIKELY diagnosis?

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"You are shown an AP MIPS image and corresponding CT and FDG PET images at two levels obtained in a 63-year-old man with palpable left-sided neck nodules. What is the MOST LIKELY diagnosis?

    

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"You are shown an image from a dual-energy x-ray absorptiometry (DEXA. study of the lumbar spine performed on a 72-year-old man. The bone mineral density at levels L1-L4 is 1.29 g/cm2, corresponding to 108% of the peak reference value and 119% of age-matched controls, with a T-score of 0.8. Based on these findings, which of  the following is MOST LIKELY?

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"You are shown images from three-phase bone and radiolabeled leukocyte scintigrams of a patient with a painful knee prosthesis that was placed 2 years earlier. What is the MOST LIKELY diagnosis?

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"You are shown anterior and posterior whole-body images from a Tc-99m MDP bone scan. Which of the following is the MOST LIKELY diagnosis?

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"You are shown a photograph of the floor after a Nuclear Medicine technologist dropped a syringe containing a radiopharmaceutical intended for patient injection. This occurrence would constitute a major radioactive spill if which of the following had been in the syringe?

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"You are shown selected planar and SPECT images from an In-111 pentetreotide (Octreoscan) study performed in a 55-year-old patient. What is the MOST LIKELY diagnosis?

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Regarding hepatobiliary scintigraphy in suspected biliary atresia in the neonatal period, imaging should be carried out for at least:

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Which one of the following is MOST LIKELY to produce a whole-lung ventilation-perfusion (V/Q) mismatch on a ventilation-perfusion lung scan?

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Which of the following statements about the clinical evaluation of bone mineral density using dual-energy x-ray absorptiometry (DEXA) and dual-photon absorptiometry (DPA) is TRUE?

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"You are shown images from a ventilation-perfusion (V/Q) scintigraphy study performed in an adult patient. Which of the following is the MOST LIKELY diagnosis?

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"You are shown radionuclide images of the abdomen obtained prior to the therapeutic administration of Y-90-labeled microspheres for treatment of hepatic malignancy. The patient has not undergone prior surgery. Which one of the following procedures was MOST LIKELY performed?

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"You are shown baseline posterior images and renogram curves from a Tc-99m MAG3 renal scan and further images and curves obtained following an intervention in a patient presenting with left flank pain. Which of the following is the MOST LIKELY diagnosis?

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"You are shown stress and rest images from a TI-201 chloride/Tc-99m sestamibi dual-isotope myocardial perfusion study performed in a thin 50-year-old woman presenting with atypical chest pain. Which of the following is the MOST LIKELY etiology for the findings demonstrated?

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"You are shown anterior and posterior whole-body images and right and left lateral delayed static images of the chest from a Tc-99m bone scan performed in a middle-aged woman. Based on the findings demonstrated, what is the MOST LIKELY diagnosis?

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"You are shown multiple planar images from an In-111 DTPA radionuclide cisternogram. Which of the following statements is MOST consistent with the findings demonstrated in the images?

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"You are shown an anterior maximum intensity projection (MIP) image from an F-18 FDG PET scan performed in a patient with a history of previous total thyroidectomy for thyroid carcinoma. Which of the following is the MOST LIKELY clinical setting in which this study was performed?

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What is the optimal time for post-therapy whole-body I-131 scintigraphy following I-131 therapy for well-differentiated thyroid carcinoma?

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According to Nuclear Regulatory Commission (NRC) regulations, what is the maximum total effective dose equivalent (TEDE) exposure allowed to other individuals to safely release a patient immediately following radioiodine therapy?

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Regarding Ga-67 citrate and In-111 WBC scintigraphy in suspected spinal infections, which one of the following statements is CORRECT?

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For a whole-body PET/CT scan performed with 15 mCi of F-18 FDG and a CT scan done from the base of the brain to mid-thigh (100 mAs @ 120 kVp, pitch of 1), what is the approximate effective radiation dose considering both internal and external radiation sources?

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Regarding ventilation-perfusion scintigraphy, which of the following findings is associated with the HIGHEST likelihood of acute pulmonary embolism?

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Which of the following radionuclide imaging modalities is the MOST effective in preventing artifactual myocardial perfusion defects due to soft tissue attenuation?

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According to the World Health Organization (WHO) recommendations, which of the following bone densitometry findings is diagnostic for osteoporosis?

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Regarding radionuclide imaging in patients with intractable seizures, which of the following findings is MOST LIKELY to be observed during the interictal phase?

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A 35-year-old patient who is clinically hyperthyroid with an autonomously functioning thyroid adenoma is referred for radioiodine therapy. Which of the following therapeutic doses of I-131 would be MOST appropriate?

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A woman received a single dose of 10 mCi of I-131 for treatment of Graves’ disease 3 weeks ago. Today, she calls to tell you she discovered she was pregnant at the time of the test and is now about 7 weeks pregnant. You should:

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Concerning In-111 pentetreotide (OctreoScan), which one of the following receptors serves as the basis for its uptake by neuroendocrine tumors?

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Concerning patients with well-differentiated papillary thyroid cancer, which one of the following serum assays is the MOST useful in conjunction with I-131 whole-body scintigraphy for the detection of recurrent disease following thyroidectomy and high-dose I-131 ablation?

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Which of the following radiopharmaceuticals is the MOST appropriate agent for imaging renal parenchymal scarring due to pyelonephritis?

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Regarding the mechanism of captopril-enhanced renal scintigraphy in unilateral renovascular hypertension, which one of the following statements is CORRECT?

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Regarding the use of ventilation-perfusion (V/Q) scintigraphy in suspected pulmonary embolism, the primary role of the ventilation portion of the study is to increase scan:

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According to Nuclear Regulatory Commission (NRC) regulations, which one of the following radionuclide administrations requires a written directive signed by the authorized user?

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Regarding F-18 fluorodeoxyglucose (FDG) PET imaging, which one of the following lesions is MOST LIKELY to result in a focal area of increased tracer uptake within the lung?

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Which of the following radiopharmaceuticals is MOST appropriate for imaging of a 60-year-old man presenting with progressive dementia, gait disturbance, and incontinence?

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"You are shown I-123 thyroid images obtained from a 54-year-old woman with signs and symptoms of hyperthyroidism. Which of the following is the MOST LIKELY 24-hour I-123 thyroid uptake value for this patient?

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"You are shown serial dynamic images from a Tc-99m-tagged RBC scan obtained from a 55-year-old man presenting with bright red blood per rectum. Based on the findings demonstrated, which major branch vessel of the aorta is MOST LIKELY involved?

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"You are shown serial posterior images of the abdomen and pelvis obtained in a young child. Which of the following is the MOST LIKELY diagnosis?

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In which one of the following clinical settings would ventilation-perfusion (V/Q) lung scintigraphy be preferable to multidetector spiral CT imaging for assessment of suspected pulmonary thromboembolism?

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Which of the following procedures is MOST sensitive for initial staging of axillary lymph node involvement in breast carcinoma?

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Gallium-67 citrate is preferred over Indium-111-labeled white blood cells in the evaluation of inflammatory processes in which one of the following clinical settings?

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Regarding the use of Technetium-99m-labeled red blood cells for the evaluation of gastrointestinal bleeding, which one of the following is TRUE?

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For radioactive waste generated in a nuclear medicine department (other than human excreta), disposal typically occurs by which one of the following?

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"You are shown anterior and posterior whole-body images obtained from an elderly man presenting with severe back and extremity pain that is unresponsive to analgesics. Based on these findings, which one of the following radionuclides MOST LIKELY would be beneficial in treating the patient’s pain?

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"You are shown serial anterior images of the abdomen obtained between 30 and 60 minutes postinjection from a Tc-99m DISIDA hepatobiliary scintigram and 4-hour delayed anterior and right lateral images. What is the BEST diagnosis?

  

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"You are shown (clockwise from lower left) transaxial, sagittal, and coronal SPECT images of the abdomen. What is the MOST LIKELY diagnosis based on the findings demonstrated in this study?

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"You are shown a coronal image and a maximum intensity projection (MIP) image from an F-18 fluorodeoxyglucose (FDG) PET scan performed on a patient with recently diagnosed left upper lobe bronchogenic carcinoma. Which of the following is the CORRECT stage of the patient’s neoplasm?

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"You are shown serial posterior images of the abdomen obtained from a normal adult who is a potential renal transplant donor to assess the patient’s glomerular filtration rate preoperatively. Which of the following radiopharmaceuticals was MOST LIKELY used for this study?

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"You are shown anterior and posterior images of the head, chest, abdomen, and pelvis. Which one of the following is the MOST LIKELY diagnosis?

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For the man-made radiation contributions to the background radiation in the United States, which of the following represents the MOST significant source of exposure to the U.S. population?

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In nuclear medicine, what is the main difference between an intrinsic uniformity and extrinsic uniformity quality control test?

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"You are shown stress and rest SPECT images from a Tc-99m sestamibi myocardial perfusion study obtained from a 56-year-old woman. Which of the following is the MOST LIKELY coronary artery territory involved?

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"You are shown 15- and 30-minute anterior images of the chest from a lymphoscintigraphy study performed on a patient with a melanoma of the anterior chest. Which one of the following is demonstrated in this case?

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"You are shown corresponding transaxial, sagittal, and coronal F-18 fluorodeoxyglucose (FDG) PET images obtained from a young adult patient, status post chemotherapy for Hodgkin's disease. Based on the imaging findings demonstrated, which one of the following is the MOST appropriate patient management?

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"You are shown posterior whole-body Tc-99m MDP bone scans performed 2 years apart in a 65-year-old male with prostate carcinoma status post prostatectomy. What is the MOST LIKELY diagnosis?

 

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"You are shown serial anterior images of the abdomen obtained in a 3-year-old boy being evaluated for recurrent episodes of painless gastrointestinal bleeding. Based on the imaging findings, which one of the following statements is CORRECT?

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In a multigated acquisition (MUGA) ventricular function study, the phase analysis MOST commonly reveals that the dyskinetic segments are out of phase by approximately:

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Which of the following collimators produces an image in the scintillation camera crystal that is the same size as the object being imaged?