Quiz
Cardiac - Myocardial Perfusion Imaging
Questions in this quiz (54)
1Why is it necessary to inject two doses of 99mTc-MIBI for a myocardial perfusion study under both rest and stress conditions?
- Athe physical half-life of 99mTc is too short to obtain both image sets from one injection
- Bthe effective half-life of 99mTc is too short to obtain both image sets from one injection
- Cthere is no redistribution of 99mTc-MIBI within the myocardium
- DSestamibi is not retained by the myocardium for a sufficient amount of time
- EImages would be degraded on stress images after exercise
2To help clear the thyroid, liver, and bowel when performing a cardiac perfusion study with sestamibi, a technologist may give what before imaging?
- Aa high carb meal
- Bdobutamine
- Cdextrose intravenously
- Dadenosine
- Ea glass of cold water
3Which of the following is an advantage of 99mTc-tetrofosmin over 99mTc-sestamibi?
- Ait redistributes
- Bone-day stress-rest protocol can be used
- Cfaster tracer clearance from the GI system
- Dstress and rest images can be acquired with one tracer dose
- Ehigher activities may be administered
4Which of the following would NOT be a characteristic of an ideal myocardial perfusion agent?
- Ahigh first-pass myocardial extraction proportional to blood flow
- Badequate imaging window
- Chigh target:non-target ratio
- Dability to complete both rest and stress imaging in 2 days
- Ehalf-life sufficient to complete the cardiac study
5Why is it necessary to wait 45-90 minutes between the stress injection with Myoview and imaging?
- Ato allow for respiratory motion to decrease
- Bto allow for liver and lung activity to decrease
- Cto allow time for uptake in the myocardium
- Dto allow time to monitor the patient
- Eto give the patient time to eat a fatty meal
6In the 1-day protocol for myocardial perfusion imaging with a 99mTc-labelled tracer, the larger amount of activity is administered:
- Afor the rest study
- Bfor the study performed second
- Cfor the study performed first
- Dfor the stress study
- Efor the study performed third
7Advantages of using 99mTc-sestamibi for myocardial perfusion imaging include all of the following except:
- Ano redistribution of tracer
- Bacquisition of ventricular function information
- Ccompletion of stress and rest imaging on the same day
- Dflexibility in the time of imaging following tracer administration
- Eacquisition of stress and rest images with one tracer dose
8A contraindication for performing a myocardial perfusion rest study is:
- Afasting 4-12 hours before the study
- Bdrinking cold water before the study
- Chaving a normal sinus rhythm
- Dbeing NPO 4-12 hours before the study
- Ehaving a nitroglycerin drip
9Which of the following agents used for pharmacologic stress testing remain in the plasma for the greatest length of time?
- Adobutamine
- Badenosine
- Cnitroglycerin
- Ddipyridamole
- Eregadenoson
10Persantine 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?
- A7.9 mL
- B8.7 mL
- C17.4 mL
- D39.5 mL
- E5.3 mL
11Which of the following pharmacologic stress agents indirectly affects adenosine receptor sites on cell membranes?
- Adobutamine
- Badenosine
- Catropine
- Desmolol
- Edipyridamole
12Which of the following agents used for pharmacologic stress testing has the longest plasma half life?
- Aadenosine
- Bdipyridamole
- Cdobutamine
- Dnitroglycerin
- Eatropine
13Which of the following pharmacologic stressing agents should NOT be administered to a patient with asthma or bronchospastic disease?
- Aboth adenosine and dipyridamole
- Bboth atropine and adenosine
- Cdobutamine
- Dadenosine
- Eatropine
14Treatment of the adverse effects induced by dipyridamole involves the adminstration of:
- Aaminophylline
- Badenosine
- Cacetazolamide
- Dnitroglycerin
- Easpirin
15What is an advantage of performing exercise stress testing over pharmaceutical stress?
- Ait is safer
- Bimaging can begin sooner after tracer injection
- Cit is less technically challenging
- Da cardiologist does not need to be present
- Epatients tolerate it better
16Dobutamine is contraindicated for stress testing in patients with all of the following conditions except:
- Asevere aortic stenosis
- Bblood glucose level above 200 mg/dL
- Cejection fraction below 15%
- Dunstable angina
- Esevere hypertension
17Caffeine is a contraindication for which of the following interventional pharmacologic agents?
- ACCK
- Badenosine
- Cinsulin
- Dfurosemide
- Ecaptopril
18The recommended dose of adenosine is:
- A140 mcg/kg/min
- B14 mcg/kg/min
- C1.4 mcg/kg/min
- D1400 mcg/kg/min
- E14,000 mcg/kg/min
19Which of the following must be discontinued for at least 24 hours before administration of dipyridamole?
- Awater
- Btheophylline
- Cinsulin
- DLasix
- Easpirin
20Adenosine is contraindicated for patients with which of the following conditions?
- Aasthma
- Bstress-induced myocardial ischemia
- Cdiabetes
- Dperipheral vascular disease
- Estroke
21Which of the following diagrams is a correctly labelled representative slice of the horizontal long axis of the left ventricular myocardium?
- AA
- BB
- CC
- DD
22Which tomographic plane of the heart displays all walls of the left ventricle?
- Ahorizontal long axis
- Bshort axis
- Ctransaxial
- Dvertical long axis
- Esagittal
23Mr. 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?
- ANegative for coronary artery disease
- BPositive for coronary artery disease
- CPotentially a false negative for coronary artery disease due to inadequate stress
- DPotentially a false positive for coronary artery disease due to inadequate stress
- EUnequivocal for coronary artery disease
24Which of the following functional images represents the magnitude of ventricular contraction?
- Anon-phase image
- Bparadox image
- Cphase image
- Dstroke-volume image
- Eamplitude image
25In 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?
- Ahorizontal long axis
- Btransaxial
- Cvertical long axis
- Dshort axis
- Ehorizontal short axis
26A 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?
- AInform the cardiologist that it will be impossible to perform the test
- BUse CT for attenuation correction
- CPerform only the rest study only today
- DImage the patient in the prone position for both rest and stress studies
- EPerform the emission imaging as normal and eliminate the transmission imaging for today's studies
27Diaphragmatic attenuation may be reduced by:
- A360 degree acquisition
- Bsupine acquisition
- Cdelayed imaging
- Dprone acquisition
- Egiving a bolus injection
28Which vessels are affected based on these images?
- Aright coronary artery and left anterior descending
- Bleft anterior descending only
- Cleft circumflex artery and right coronary artery
- Dleft circumflex artery only
- Eright coronary artery only
29Perfusion of the ventricular septum in the heart is provided by which coronary artery?
- Aright coronary
- Bleft circumflex
- Cleft anterior descending
- Dleft coronary
- Eright circumflex
30Which SPECT cardiac slice is used to generate a polar plot?
- Atransverse
- BHLA
- CVLA
- DSA
- Esagittal
31A disadvantage of using the polar map display to assess myocardial perfusion data is:
- Aperfusion defects at the base of the heart tend to be underrepresented
- Bperfusion defects at the apex tend to be underrepresented
- Cthe polar map display does not provide accurate quantitative information and should only be used as a visual representation of perfusion
- Dstress and rest datasets cannot be accurately compared
- Ethe polar map display can provide information on reversible defects but not fixed defects
32When 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:
- Aa processing-induced septal wall defect
- Ba processing-induced inferior wall defect
- Cmyocardial ischemia
- Dmyocardial infarction
- Epatient motion
33Delayed improvement of perfusion after coronary artery revascularization is referred to as:
- Ahibernating myocardium
- Binfarcted myocardium
- Cstunned myocardium
- Dnecrosed myocardium
- Emyocarditis
34Which 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- A1, 2, 3, 4, and 5
- B1, 2, 3, and 4
- C1 only
- D2 and 5
- E2, 3, and 4
35Functional cardiac studies may be performed to evaluate wall-motion abnormalities caused by all of the following except:
- Aaneurysm
- Bmyocardial infarction
- Cmyocardial perfusion patency
- Dmyocardial ischemia
- Emyocarditis
36Which of the following will NOT give information on left ventricular function?
- Agated equilibrium radionuclide angiography
- Bgated myocardial perfusion imaging
- Cungated first-pass study
- Dgated myocardial PET
- Eungated myocardial SPECT
37Ischemia means:
- Anecrotic tissue
- Binfarction
- Cdecreased blood flow
- Dthe superior portion of the pelvis
- Escar tissue
38A 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?
- AMyocardial perfusion to the inferior wall will be mostly unchanged between rest and stress
- BMyocardial perfusion to the inferior wall will increase following administration of Persantine
- CMyocardial perfusion to the inferior wall will decrease following administration of Persantine
- DIt is impossible to predict how myocardial perfusion to the inferior wall will be affected by Persantine
39When 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?
- Aapparent dyskinesia
- Bfalsely elevated lung:heart ratio
- Cfalsely low summed difference score
- Dno effect
- Efalsely elevated TID
40Which of the following is the most likely cause of false anterior or lateral wall defects on myocardial perfusion imaging?
- Acentre of rotation error
- Brespiratory motion
- Ctoo few projections
- Dattenuation by breast tissue or implant
- Emultiple pulmonary emboli
41Which of the following may result in a false positive result on a myocardial perfusion scan?
- Atriple vessel disease
- Bexercise stressing a patient with LBBB
- Cradiopharmaceutical injected before the target heart rate is achieved
- Dpatient motion of 1 pixel
- Enon-transmural infarction
42Which of the following may be indicated by a reversible defect?
1. Ischemia
2. Hibernating myocardium
3. Stunned myocardium
4. Infarction- A1 only
- B1 and 3
- C1 and 4
- D2, 3, and 4
- E4 only
43Which of the following patients would benefit most from coronary revascularization?
- AA 52 year old male whose rest and stress perfusion studies show matched defects and whose gated data indicate paradoxical motion
- BA 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
- CA 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
- DA 40 year old male whose rest images appear normal but with a large inferior wall defect on stress images and a LVEF of 65%.
44Which of the following may result in a false negative myocardial perfusion imaging result?
- AA 75 year old female achieving a maximum heart rate of 124 bpm before tracer injection
- BA 46 year old patient with hypertensive myocardial hypertrophy
- CA 72 year old male patient with a left bundle-branch block
- DA 58 year old patient with balanced myocardial ischemia
- EA 60 year old female patient with aortic regurgitation
45An advantage of 201Tl-thallium chloride is that it:
- Ahas a high photon flux at a high-energy window
- Bis a calcium analogue
- Chas a short half-life
- Dredistributes
- Ehas a high first-pass extraction and stays fixed in the myocardium
46In preparation for a Tl-201 stress test, patients are instructed to fast to:
- Aprevent gastrointestinal upsets during exercise
- Bminimize tracer uptake in the gastrointestinal tract
- Cenhance myocardial tracer uptake
- Dstandardize test conditions among patients
- Eprevent redistribution of the tracer
47After stress myocardial imaging with 201Tl-thallous chloride, 37-55 MBq of 201Tl-thallous chloride may be administered before rest imaging to:
- Aimprove patient throughput
- Bdemonstrate reversible ischemia more readily
- Cdemonstrate infarct size more precisely
- Dminimize visualization of attenuation artifacts
- Emaximize visualization of attenuation artifacts
48Which 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- A1, 2, 3, and 4
- B2 & 4
- C3 & 4
- D1 & 3
- E3 only
49Which of the following protocols would be most appropriate for dual-isotope myocardial perfusion imaging?
- ARest first: 111MBq 201Tl-chloride
Stress second: 925 MBq 99mTc-MIBI - BRest first: 925MBq 99mTc-MIBI
Stress second: 111 MBq 201Tl-chloride - CStress first: 925MBq 99mTc-MIBI
Rest second: 111MBq 201Tl-chloride - DStress first: 111MBq 201Tl-chloride
Rest second: 925MBq 99mTc-MIBI - ERest first: 925MBq 99mTc-MIBI
Stress second: 925MBq 99mTc-tetrofosmin
- ARest first: 111MBq 201Tl-chloride
50Myocardial perfusion imaging is a relatively high radiation dose nuclear medicine procedure. All of the following are useful methods to reduce patient doses EXCEPT:
- AUsing PET/CT imaging techniques
- BUsing a stress-only protocol in low-risk patients with normal post-stress images
- CEncouraging the patient to stay hydrated and to empty their bladder frequently
- DUsing a dedicated cardiac camera that enables shorter imaging times
- EUsing a longer imaging time so that a smaller dose can be administered
51What is the most likely diagnosis?
- Adilated cardiomyopathy
- Bnormal myocardium
- Clateral wall ischemia
- Dmulti-vessel ischemia
- Ehibernating septal wall myocardium
52A patient presents with the following quantitative results on a 99mTc-sestamibi myocardial perfusion study:
SSS = 31; SRS = 30
What is the most likely diagnosis?- Anegative for coronary artery disease
- Bhibernating myocardium
- Cmyocardial infarction
- Dmyocardial ischemia
- Edilated cardiomyopathy
53What is the purpose of glucose loading when assessing myocardial viability with 18FDG?
- ATo decrease the absorbed dose from radiation delivered to the myocardium
- BTo prevent patients with diabetes from having a reaction during the procedure
- CSo that the heart switches from fatty acid to glucose utilization, increasing uptake of FDG
- DA loading dose of glucose should not be administered for myocardial viability imaging with 18F-FDG
- ETo reduce extracardiac uptake of 18FDG.
54What is the most likely diagnosis?
- Adextrocardia
- Bbreast attenuation artifact
- Cdiaphragmatic attenuation artifact
- Dlarge anterior-apical infarct
- Eischemic dilatation
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- CAMRT Nuclear Medicine Technology (Clinical) Quiz on Cardiac - Myocardial Perfusion Imaging, created by Siobhan Pett on 20/06/2020.
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- Siobhan Pett
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