Cardiac - Myocardial Perfusion Imaging

Pregunta 1 de 54

1

Why is it necessary to inject two doses of 99mTc-MIBI for a myocardial perfusion study under both rest and stress conditions?

Selecciona una de las siguientes respuestas posibles:

the physical half-life of 99mTc is too short to obtain both image sets from one injection
the effective half-life of 99mTc is too short to obtain both image sets from one injection
there is no redistribution of 99mTc-MIBI within the myocardium
Sestamibi is not retained by the myocardium for a sufficient amount of time
Images would be degraded on stress images after exercise

Explicación

Pregunta 2 de 54

1

To help clear the thyroid, liver, and bowel when performing a cardiac perfusion study with sestamibi, a technologist may give what before imaging?

Selecciona una de las siguientes respuestas posibles:

a high carb meal
dobutamine
dextrose intravenously
adenosine
a glass of cold water

Explicación

Pregunta 3 de 54

1

Which of the following is an advantage of 99mTc-tetrofosmin over 99mTc-sestamibi?

Selecciona una de las siguientes respuestas posibles:

it redistributes
one-day stress-rest protocol can be used
faster tracer clearance from the GI system
stress and rest images can be acquired with one tracer dose
higher activities may be administered

Explicación

Pregunta 4 de 54

1

Which of the following would NOT be a characteristic of an ideal myocardial perfusion agent?

Selecciona una de las siguientes respuestas posibles:

high first-pass myocardial extraction proportional to blood flow
adequate imaging window
high target:non-target ratio
ability to complete both rest and stress imaging in 2 days
half-life sufficient to complete the cardiac study

Explicación

Pregunta 5 de 54

1

Why is it necessary to wait 45-90 minutes between the stress injection with Myoview and imaging?

Selecciona una de las siguientes respuestas posibles:

to allow for respiratory motion to decrease
to allow for liver and lung activity to decrease
to allow time for uptake in the myocardium
to allow time to monitor the patient
to give the patient time to eat a fatty meal

Explicación

Pregunta 6 de 54

1

In the 1-day protocol for myocardial perfusion imaging with a 99mTc-labelled tracer, the larger amount of activity is administered:

Selecciona una de las siguientes respuestas posibles:

for the rest study
for the study performed second
for the study performed first
for the stress study
for the study performed third

Explicación

Pregunta 7 de 54

1

Advantages of using 99mTc-sestamibi for myocardial perfusion imaging include all of the following except:

Selecciona una de las siguientes respuestas posibles:

no redistribution of tracer
acquisition of ventricular function information
completion of stress and rest imaging on the same day
flexibility in the time of imaging following tracer administration
acquisition of stress and rest images with one tracer dose

Explicación

Pregunta 8 de 54

1

A contraindication for performing a myocardial perfusion rest study is:

Selecciona una de las siguientes respuestas posibles:

fasting 4-12 hours before the study
drinking cold water before the study
having a normal sinus rhythm
being NPO 4-12 hours before the study
having a nitroglycerin drip

Explicación

Pregunta 9 de 54

1

Which of the following agents used for pharmacologic stress testing remain in the plasma for the greatest length of time?

Selecciona una de las siguientes respuestas posibles:

dobutamine
adenosine
nitroglycerin
dipyridamole
regadenoson

Explicación

Pregunta 10 de 54

1

Persantine is supplied to a nuclear medicine department in 10 mL vials, each containing 50 mg. If a patient weighs 155 lbs, how many mL must be injected for the patient to receive 0.56 mg/kg?

Selecciona una de las siguientes respuestas posibles:

7.9 mL
8.7 mL
17.4 mL
39.5 mL
5.3 mL

Explicación

Pregunta 11 de 54

1

Which of the following pharmacologic stress agents indirectly affects adenosine receptor sites on cell membranes?

Selecciona una de las siguientes respuestas posibles:

dobutamine
adenosine
atropine
esmolol
dipyridamole

Explicación

Pregunta 12 de 54

1

Which of the following agents used for pharmacologic stress testing has the longest plasma half life?

Selecciona una de las siguientes respuestas posibles:

adenosine
dipyridamole
dobutamine
nitroglycerin
atropine

Explicación

Pregunta 13 de 54

1

Which of the following pharmacologic stressing agents should NOT be administered to a patient with asthma or bronchospastic disease?

Selecciona una de las siguientes respuestas posibles:

both adenosine and dipyridamole
both atropine and adenosine
dobutamine
adenosine
atropine

Explicación

Pregunta 14 de 54

1

Treatment of the adverse effects induced by dipyridamole involves the adminstration of:

Selecciona una de las siguientes respuestas posibles:

aminophylline
adenosine
acetazolamide
nitroglycerin
aspirin

Explicación

Pregunta 15 de 54

1

What is an advantage of performing exercise stress testing over pharmaceutical stress?

Selecciona una de las siguientes respuestas posibles:

it is safer
imaging can begin sooner after tracer injection
it is less technically challenging
a cardiologist does not need to be present
patients tolerate it better

Explicación

Pregunta 16 de 54

1

Dobutamine is contraindicated for stress testing in patients with all of the following conditions except:

Selecciona una de las siguientes respuestas posibles:

severe aortic stenosis
blood glucose level above 200 mg/dL
ejection fraction below 15%
unstable angina
severe hypertension

Explicación

Pregunta 17 de 54

1

Caffeine is a contraindication for which of the following interventional pharmacologic agents?

Selecciona una de las siguientes respuestas posibles:

CCK
adenosine
insulin
furosemide
captopril

Explicación

Pregunta 18 de 54

1

The recommended dose of adenosine is:

Selecciona una de las siguientes respuestas posibles:

140 mcg/kg/min
14 mcg/kg/min
1.4 mcg/kg/min
1400 mcg/kg/min
14,000 mcg/kg/min

Explicación

Pregunta 19 de 54

1

Which of the following must be discontinued for at least 24 hours before administration of dipyridamole?

Selecciona una de las siguientes respuestas posibles:

water
theophylline
insulin
Lasix
aspirin

Explicación

Pregunta 20 de 54

1

Adenosine is contraindicated for patients with which of the following conditions?

Selecciona una de las siguientes respuestas posibles:

asthma
stress-induced myocardial ischemia
diabetes
peripheral vascular disease
stroke

Explicación

Pregunta 21 de 54

1

Which of the following diagrams is a correctly labelled representative slice of the horizontal long axis of the left ventricular myocardium?

Selecciona una de las siguientes respuestas posibles:

A
B
C
D

Explicación

Pregunta 22 de 54

1

Which tomographic plane of the heart displays all walls of the left ventricle?

Selecciona una de las siguientes respuestas posibles:

horizontal long axis
short axis
transaxial
vertical long axis
sagittal

Explicación

Pregunta 23 de 54

1

Mr. Brown is 65 year old man in the nuclear medicine department for a myocardial perfusion scan with 99mTc-sestamibi. During exercise stress testing he reached a heartrate of 125 bpm. His rest and stress images showed no apparent perfusion defects. How may this scan be reported?

Selecciona una de las siguientes respuestas posibles:

Negative for coronary artery disease
Positive for coronary artery disease
Potentially a false negative for coronary artery disease due to inadequate stress
Potentially a false positive for coronary artery disease due to inadequate stress
Unequivocal for coronary artery disease

Explicación

Pregunta 24 de 54

1

Which of the following functional images represents the magnitude of ventricular contraction?

Selecciona una de las siguientes respuestas posibles:

non-phase image
paradox image
phase image
stroke-volume image
amplitude image

Explicación

Pregunta 25 de 54

1

In processing a myocardial perfusion study, a slice from which body axis is used to identify the degree to which the heart points to the left and to construct slices in the three opposing cardiac planes?

Selecciona una de las siguientes respuestas posibles:

horizontal long axis
transaxial
vertical long axis
short axis
horizontal short axis

Explicación

Pregunta 26 de 54

1

A patient is booked for a 1 day rest-stress myocardial perfusion study, and the hybrid CT scanner is failing quality control. The cardiologist insists that the test be performed today. As the technologist, what do you do?

Selecciona una de las siguientes respuestas posibles:

Inform the cardiologist that it will be impossible to perform the test
Use CT for attenuation correction
Perform only the rest study only today
Image the patient in the prone position for both rest and stress studies
Perform the emission imaging as normal and eliminate the transmission imaging for today's studies

Explicación

Pregunta 27 de 54

1

Diaphragmatic attenuation may be reduced by:

Selecciona una de las siguientes respuestas posibles:

360 degree acquisition
supine acquisition
delayed imaging
prone acquisition
giving a bolus injection

Explicación

Pregunta 28 de 54

1

Which vessels are affected based on these images?

Selecciona una de las siguientes respuestas posibles:

right coronary artery and left anterior descending
left anterior descending only
left circumflex artery and right coronary artery
left circumflex artery only
right coronary artery only

Explicación

Pregunta 29 de 54

1

Perfusion of the ventricular septum in the heart is provided by which coronary artery?

Selecciona una de las siguientes respuestas posibles:

right coronary
left circumflex
left anterior descending
left coronary
right circumflex

Explicación

Pregunta 30 de 54

1

Which SPECT cardiac slice is used to generate a polar plot?

Selecciona una de las siguientes respuestas posibles:

transverse
HLA
VLA
SA
sagittal

Explicación

Pregunta 31 de 54

1

A disadvantage of using the polar map display to assess myocardial perfusion data is:

Selecciona una de las siguientes respuestas posibles:

perfusion defects at the base of the heart tend to be underrepresented
perfusion defects at the apex tend to be underrepresented
the polar map display does not provide accurate quantitative information and should only be used as a visual representation of perfusion
stress and rest datasets cannot be accurately compared
the polar map display can provide information on reversible defects but not fixed defects

Explicación

Pregunta 32 de 54

1

When assessing a myocardial perfusion study that has been processed using filtered back projection, it may be useful to compare the filtered images to the unfiltered images to rule out:

Selecciona una de las siguientes respuestas posibles:

a processing-induced septal wall defect
a processing-induced inferior wall defect
myocardial ischemia
myocardial infarction
patient motion

Explicación

Pregunta 33 de 54

1

Delayed improvement of perfusion after coronary artery revascularization is referred to as:

Selecciona una de las siguientes respuestas posibles:

hibernating myocardium
infarcted myocardium
stunned myocardium
necrosed myocardium
myocarditis

Explicación

Pregunta 34 de 54

1

Which of the following is/are advantages of G-SPECT?

1. Identification of suspected attenuation artifacts
2. Enhanced detection of multivessel CAD
3. Assessment of myocardial viability
4. Distinguishing ischemic from nonischemic cardiomyopathy
5. Simpler procedure than non-gated SPECT

Selecciona una de las siguientes respuestas posibles:

1, 2, 3, 4, and 5
1, 2, 3, and 4
1 only
2 and 5
2, 3, and 4

Explicación

Pregunta 35 de 54

1

Functional cardiac studies may be performed to evaluate wall-motion abnormalities caused by all of the following except:

Selecciona una de las siguientes respuestas posibles:

aneurysm
myocardial infarction
myocardial perfusion patency
myocardial ischemia
myocarditis

Explicación

Pregunta 36 de 54

1

Which of the following will NOT give information on left ventricular function?

Selecciona una de las siguientes respuestas posibles:

gated equilibrium radionuclide angiography
gated myocardial perfusion imaging
ungated first-pass study
gated myocardial PET
ungated myocardial SPECT

Explicación

Pregunta 37 de 54

1

Ischemia means:

Selecciona una de las siguientes respuestas posibles:

necrotic tissue
infarction
decreased blood flow
the superior portion of the pelvis
scar tissue

Explicación

Pregunta 38 de 54

1

A patient with known myocardial ischemia affecting the right coronary artery undergoes a 2 day rest-stress myocardial imaging procedure using 99mTc-sestamibi and pharmacological stressing with Persantine. How will perfusion to the inferior wall of the left ventricular myocardium differ between the rest and Persantine stress images?

Selecciona una de las siguientes respuestas posibles:

Myocardial perfusion to the inferior wall will be mostly unchanged between rest and stress
Myocardial perfusion to the inferior wall will increase following administration of Persantine
Myocardial perfusion to the inferior wall will decrease following administration of Persantine
It is impossible to predict how myocardial perfusion to the inferior wall will be affected by Persantine

Explicación

Pregunta 39 de 54

1

When processing a myocardial perfusion study using automatic edge detection software, part of the adjacent bowel is included in the inferior contour of the rest images only. What effect may this have on the results?

Selecciona una de las siguientes respuestas posibles:

apparent dyskinesia
falsely elevated lung:heart ratio
falsely low summed difference score
no effect
falsely elevated TID

Explicación

Pregunta 40 de 54

1

Which of the following is the most likely cause of false anterior or lateral wall defects on myocardial perfusion imaging?

Selecciona una de las siguientes respuestas posibles:

centre of rotation error
respiratory motion
too few projections
attenuation by breast tissue or implant
multiple pulmonary emboli

Explicación

Pregunta 41 de 54

1

Which of the following may result in a false positive result on a myocardial perfusion scan?

Selecciona una de las siguientes respuestas posibles:

triple vessel disease
exercise stressing a patient with LBBB
radiopharmaceutical injected before the target heart rate is achieved
patient motion of 1 pixel
non-transmural infarction

Explicación

Pregunta 42 de 54

1

Which of the following may be indicated by a reversible defect?

1. Ischemia
2. Hibernating myocardium
3. Stunned myocardium
4. Infarction

Selecciona una de las siguientes respuestas posibles:

1 only
1 and 3
1 and 4
2, 3, and 4
4 only

Explicación

Pregunta 43 de 54

1

Which of the following patients would benefit most from coronary revascularization?

Selecciona una de las siguientes respuestas posibles:

A 52 year old male whose rest and stress perfusion studies show matched defects and whose gated data indicate paradoxical motion
A 36 year old female who demonstrates normal perfusion on both stress and rest images, but whose gated data indicate akinesis of the anterior, septal, and apical walls
A 64 year old female patient whose rest images appear normal but with anterior, apical, and septal defects on the stress images with matching mild hypokinesis
A 40 year old male whose rest images appear normal but with a large inferior wall defect on stress images and a LVEF of 65%.

Explicación

Pregunta 44 de 54

1

Which of the following may result in a false negative myocardial perfusion imaging result?

Selecciona una de las siguientes respuestas posibles:

A 75 year old female achieving a maximum heart rate of 124 bpm before tracer injection
A 46 year old patient with hypertensive myocardial hypertrophy
A 72 year old male patient with a left bundle-branch block
A 58 year old patient with balanced myocardial ischemia
A 60 year old female patient with aortic regurgitation

Explicación

Pregunta 45 de 54

1

An advantage of 201Tl-thallium chloride is that it:

Selecciona una de las siguientes respuestas posibles:

has a high photon flux at a high-energy window
is a calcium analogue
has a short half-life
redistributes
has a high first-pass extraction and stays fixed in the myocardium

Explicación

Pregunta 46 de 54

1

In preparation for a Tl-201 stress test, patients are instructed to fast to:

Selecciona una de las siguientes respuestas posibles:

prevent gastrointestinal upsets during exercise
minimize tracer uptake in the gastrointestinal tract
enhance myocardial tracer uptake
standardize test conditions among patients
prevent redistribution of the tracer

Explicación

Pregunta 47 de 54

1

After stress myocardial imaging with 201Tl-thallous chloride, 37-55 MBq of 201Tl-thallous chloride may be administered before rest imaging to:

Selecciona una de las siguientes respuestas posibles:

improve patient throughput
demonstrate reversible ischemia more readily
demonstrate infarct size more precisely
minimize visualization of attenuation artifacts
maximize visualization of attenuation artifacts

Explicación

Pregunta 48 de 54

1

Which of the following are differences between myocardial perfusion imaging with 201Tl-chloride versus 99mTc-sestamibi?

1. A high resolution collimator should be used with 201Tl-chloride
2. There is less soft tissue attenuation with 201Tl-chloride
3. 99mTc-sestamibi results in higher photon flux
4. There is less respiratory motion with 201Tl-chloride

Selecciona una de las siguientes respuestas posibles:

1, 2, 3, and 4
2 & 4
3 & 4
1 & 3
3 only

Explicación

Pregunta 49 de 54

1

Which of the following protocols would be most appropriate for dual-isotope myocardial perfusion imaging?

Selecciona una de las siguientes respuestas posibles:

Rest first: 111MBq 201Tl-chloride
Stress second: 925 MBq 99mTc-MIBI
Rest first: 925MBq 99mTc-MIBI
Stress second: 111 MBq 201Tl-chloride
Stress first: 925MBq 99mTc-MIBI
Rest second: 111MBq 201Tl-chloride
Stress first: 111MBq 201Tl-chloride
Rest second: 925MBq 99mTc-MIBI
Rest first: 925MBq 99mTc-MIBI
Stress second: 925MBq 99mTc-tetrofosmin

Explicación

Pregunta 50 de 54

1

Myocardial perfusion imaging is a relatively high radiation dose nuclear medicine procedure. All of the following are useful methods to reduce patient doses EXCEPT:

Selecciona una de las siguientes respuestas posibles:

Using PET/CT imaging techniques
Using a stress-only protocol in low-risk patients with normal post-stress images
Encouraging the patient to stay hydrated and to empty their bladder frequently
Using a dedicated cardiac camera that enables shorter imaging times
Using a longer imaging time so that a smaller dose can be administered

Explicación

Pregunta 51 de 54

1

What is the most likely diagnosis?

Selecciona una de las siguientes respuestas posibles:

dilated cardiomyopathy
normal myocardium
lateral wall ischemia
multi-vessel ischemia
hibernating septal wall myocardium

Explicación

Pregunta 52 de 54

1

A patient presents with the following quantitative results on a 99mTc-sestamibi myocardial perfusion study:

SSS = 31; SRS = 30

What is the most likely diagnosis?

Selecciona una de las siguientes respuestas posibles:

negative for coronary artery disease
hibernating myocardium
myocardial infarction
myocardial ischemia
dilated cardiomyopathy

Explicación

Pregunta 53 de 54

1

What is the purpose of glucose loading when assessing myocardial viability with 18FDG?

Selecciona una de las siguientes respuestas posibles:

To decrease the absorbed dose from radiation delivered to the myocardium
To prevent patients with diabetes from having a reaction during the procedure
So that the heart switches from fatty acid to glucose utilization, increasing uptake of FDG
A loading dose of glucose should not be administered for myocardial viability imaging with 18F-FDG
To reduce extracardiac uptake of 18FDG.

Explicación

Pregunta 54 de 54

1

What is the most likely diagnosis?

Selecciona una de las siguientes respuestas posibles:

dextrocardia
breast attenuation artifact
diaphragmatic attenuation artifact
large anterior-apical infarct
ischemic dilatation

	Creado por Siobhan Pett hace casi 6 años

CAMRT (Clinical) Nuclear Medicine Technology Test sobre Cardiac - Myocardial Perfusion Imaging, creado por Siobhan Pett el 20/06/2020.

Cardiac - Myocardial Perfusion Imaging

Cardiac - Myocardial Perfusion Imaging

Pregunta 1 de 54

Why is it necessary to inject two doses of 99mTc-MIBI for a myocardial perfusion study under both rest and stress conditions?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 2 de 54

To help clear the thyroid, liver, and bowel when performing a cardiac perfusion study with sestamibi, a technologist may give what before imaging?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 3 de 54

Which of the following is an advantage of 99mTc-tetrofosmin over 99mTc-sestamibi?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 4 de 54

Which of the following would NOT be a characteristic of an ideal myocardial perfusion agent?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 5 de 54

Why is it necessary to wait 45-90 minutes between the stress injection with Myoview and imaging?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 6 de 54

In the 1-day protocol for myocardial perfusion imaging with a 99mTc-labelled tracer, the larger amount of activity is administered:

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 7 de 54

Advantages of using 99mTc-sestamibi for myocardial perfusion imaging include all of the following except:

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 8 de 54

A contraindication for performing a myocardial perfusion rest study is:

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 9 de 54

Which of the following agents used for pharmacologic stress testing remain in the plasma for the greatest length of time?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 10 de 54

Persantine is supplied to a nuclear medicine department in 10 mL vials, each containing 50 mg. If a patient weighs 155 lbs, how many mL must be injected for the patient to receive 0.56 mg/kg?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 11 de 54

Which of the following pharmacologic stress agents indirectly affects adenosine receptor sites on cell membranes?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 12 de 54

Which of the following agents used for pharmacologic stress testing has the longest plasma half life?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 13 de 54

Which of the following pharmacologic stressing agents should NOT be administered to a patient with asthma or bronchospastic disease?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 14 de 54

Treatment of the adverse effects induced by dipyridamole involves the adminstration of:

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 15 de 54

What is an advantage of performing exercise stress testing over pharmaceutical stress?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 16 de 54

Dobutamine is contraindicated for stress testing in patients with all of the following conditions except:

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 17 de 54

Caffeine is a contraindication for which of the following interventional pharmacologic agents?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 18 de 54

The recommended dose of adenosine is:

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 19 de 54

Which of the following must be discontinued for at least 24 hours before administration of dipyridamole?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 20 de 54

Which of the following is/are advantages of G-SPECT?

1. Identification of suspected attenuation artifacts
2. Enhanced detection of multivessel CAD
3. Assessment of myocardial viability
4. Distinguishing ischemic from nonischemic cardiomyopathy
5. Simpler procedure than non-gated SPECT