Download Item bank of Nuclear Medicine for MBBS Single choice questions

Item bank of Nuclear Medicine for MBBS
1. Single choice questions (please choose the best answer for each of the following
questions).
Q 1. The principle of lung perfusion imaging is that the radio-tracers can ( ).
A . block the pulmonary capillaries B. block the pulmonary arteries C. block the
pulmonary veins D. be up-taken by capillary endothelials E. deposit on the
pulmonary arteries
Q 2. The most frequently used radiopharmaceutical for lung perfusion imaging is
( ).
A. 99mTc-MIBI B. 99mTc-MDP C. 99mTc-MAA D. 99mTc-RBC E. 99mTc-DTPA
Q 3. The rationale of lung ventilation imaging is that the radio-tracer can ( ).
A. temporarily occlude the pulmonary capillary
B. swallowed and cleared by alveolar reticulocytes
C.diffuse freely into alveolar membrane
D.diffuse into blood through alveolar wall
E.deposit on the walls of larynx, trachea, bronchus,bronchioles and alveolar .
Q4. Among the conditions below mentioned, which can cause the dilation of brain
vessels?(
)
A. decrease of pappenheimer CO2(PCO2)
B.decrease of pappenheimer O2(PO2)
C.increase of the density of hydrogen ions
D.temperature change of local brain
E. inrease of pappenheimer O2(PO2)
Q5. The typical features of epilepsy of SPECT CBF imaging is that the perfusion in the
lesions is (
).
A. Increased both in ictal and interictal
B. Decreased both in ictal and interictal
C. Decreased in ictal and increased interictal
D. Increased in ictal and decreased interictal
E. Decreased in ictal and normal interictal
Q6. The most common status of metabolism of glucose in Alzheimer’s disease(AD)
patients is( ).
A. hypometabolism in frontal lobe
B. hypometabolism in brain stem
C. posterior parietal lobe
D. parietotemporal lobe
E. cerebellium
Q7. Nowadays, the most sensitive and specific imaging strategy is(
).
A. SPECT cerebral blood flow tomography
B.
18F-FDG
C. MRI
PET brain glucose metabolism imaging
D. CT
E. Angiography
Q8. The highest risk of cerebral infarction in the near future of TIA patient is (
).
A. no obvious abnormality of CBF imaging
B.Low perfusion local area in CBF imaging, but the lesion zone recover to
normality within 24 hrs.
C.multiple decrease or defect areas in CBF imaging
D.continuous local low perfusion zone in CBF imaging after the attack of TIA.
E. hyper perfusion region in CBF.
Q9. 4,Compared to X-CT, the SPECT rCBF imaging can display the cerebral infarction
( ).
A.Earlier and with larger border
B. Earlier with smaller border
C. Later with larger border
D.Later with smaller border
E. Earlier with the same border
Q10. The widely used radiotracer for SPECT myocardial perfusion imaging is (
).
99mTc-Tetrofosmin (99mTc-P53)
A.thallium-201(201Tl)
B. 99mTc-MIBI
C.
D.18F-FDG E. 99mTc-RBC
Q11. Among the following tracers ,which can be used in first pass radionuclide
ventriculography ?( )
A. 99mTc-DTPA
B. 99mTc-Technegas C. 99mTc-RBC
D. 99mTc-MDP E.
99mTc-ECD
Q12. Among the following tracers ,which can be used in equilibrium radionuclide
ventriculography ?()
99mTc-RBC
A. 99mTc-DTPA
B. 99mTc-IDA C.
D. 99mTc-MDP
E.
99mTc-MIBI
Q13. When use equilibrium radionuclide ventriculography(ERNV) to diagnose stress
–induced myocardial ischemia ,the diagnostic criteria of ischemia is that the left ventricle
ejection fraction (LVEF) at stress test (
).
A. Increase ＞5% or more
B. Increase ＜5% or even decrease
C. Decrease ＞15%
or even worse
D. Increase ＜15% or even worse
E. Without obvious increase
Q14. Among the following radio tracers ,which can be used for myocardial infarction
imaging(
).
99mTc-RBC
A. 99mTc-DTPA
B. 99mTc-PYP C.
D. 99mTc-MDP
E.
99mTc-MIBI
Q15. Meckel’s diverticulum is often found on the distal end of ileum ,the
location is about (
) from ileocecal valve.
A . 0.5-1.0 m
B. 1.0-1.5 m C. 1.5-2.0m D.2.5-3.0 m
E. 3.5-4.0 m
99m
Q16. . Tc-RBC GI bleeding can detect the bleeding with a minimum rate of (
).
A. 0.05ml/min
B.0.5 ml/min C. 0.01 ml /min D. 0.1 ml /min E. 1ml/min
Q17. The lesion that manifests radioactive defect in liver colloid imaging with high
radioactive condense in blood pool imaging is ( ).
A. liver cysts B. hepatic abscess
C. focal nodular hyperplasia (FNH) D.
hepatic hemangioma E. hepatic cell cancer (HCC)
Q18. Among the following cells in liver ,which can phagocytize the 99mTc-SC ( ).
A.hepatic cells B. vascular endothelial cells
C.Kupffer cells D. stellate cells E.biliary duct endothelial cells
Q19. In hepatobiliary scintigraphy, the radio tracer can be up taken by ( ).
A.hepatic cells B. vascular endothelial cells
C.Kupffer cells D. stellate cells E.biliary duct endothelial cells
Q20. Among the following modalities, which can be used to differentiate biliary atresia
from neonatal hepatitis syndrome?( )
A. 99mTc-MIBI hepatobiliary scintigraphy
B.
99mTc-RBC
C.
99mTc-SC
D.
99mTc-pertechnetate
E.
99mTc-DTPA esophageal
liver blood pool scintigraphy
liver colloid scintigraphy
gastrointestinal scintigraphy
motility scintigraphy
Q21. As for gastrointestinal bleeding scintigraphy, which radio tracer can be used for
intermittent bleeding(
).
99m
A.
Tc-DPTA
B.
99mTc-RBC
C.
99mTc-SC
D.
99mTc-pertechnetate
E.
99mTc-MIBI
Q22. The reason that 99mTc labeled phosphate compounds can be used as tracer for
skeletal scintigraphy is ( ).
A. 99mTc labeled phosphate compounds can exchange with calcium. in the
hydroxyapatitie.
B. 99mTc labeled phosphate compounds can exchange with hydroxyl ion in the
hydroxyapatitie.
C. 99mTc labeled phosphate compounds can exchange with collagen in the organic of
bones.
D. 99mTc labeled phosphate compounds can be obsorbed onto the surface of
hydroxyapatitie.
E. 99mTc labeled phosphate compounds can be obsorbed onto inorganic matter of bones.
Q23. Among the following states, which is the feature of bone necrosis(
)?
A. new necrosis manifests intensive uptake of tracer.
B. new necrosis manifests defected uptake of tracer.
C. in the healing of stage of necrosis , the images display radioactive defect.
D. when necrosis occurs, intensive radioactivity appears then convert into
radio-defect.
E. radioactive defect is showed in either the new necrosis or the healing stage
Q24.When osteogenic activity appears in lesions, the main feature of bone scan is ( ).
A. increased uptake of 99mTc-MDP
B. decreased uptake of 99mTc-MDP
C.normal uptake of 99mTc-MDP
D.no obvious intensive radioactivity
E.all of the above
Q25. The most commonly used tracer for skeletal scintigrphy is (
).
99m
99m
99m
A. Tc-MDP
B. . Tc-PYP
C. . Tc-IDA
99m
99m
D. . Tc-RBC E. . Tc-DTPA
Q26. When osteolytic lesions occur in skeleton, what is the main feature of bone
scintigraphy( )?
A. increased uptake of 99mTc-MDP
B. decreased uptake of 99mTc-MDP
C.normal uptake of 99mTc-MDP
D.no obvious intensive radioactivity
E.all of the above
Q27.How to distingusih osteomyelitis from cellulitis with skeletal scintigraphy?(
)
A. whole bone scan
B. regional bone scan
C.bone tomographic scan
D. dynamic bone scan
E.static bone imaging
Q28. T main features of acute osteomyelitis in three phases bone scan (TPBS) are ( ).
A. enhanced arterial flow, normal blood pool activity and intensive activity in
delayed scan
B. enhanced arterial flow,increased blood pool activity and intensive activity in
delayed scan
C. enhanced arterial flow, increased blood pool activity and decreased activity in
delayed scan
D. enhanced arterial flow, increased blood pool activity and normal activity in
delayed scan
E. enhanced arterial flow, decreased blood pool activity and decreased activity in
delayed scan
Q29. In the reaction system of radioimmunoassay, which of the reagents was labeled ?
(
)
A. The antibodies.
B. The antigens.
C. The antibodies and antigens
D. The antibody-antigen complex
E. Either antibody or antigen
Q30. Among the following radioactive isotopes, which is the most extensively used one in
radioimmunoassay ? ( )
A. 131I B. 123I C. 14C .D. 3H . E. 125I
2. Multiple choice questions (please choose the answers that suit each of the following
questions).
Q 1. Among the following radiopharmaceuticals ,which can be used as radio-tracer
in lung ventilation imaging (
).
A. 99mTc-DTPA aerosol
99mTc-MDP E. 99mTc-ECD
B. 99mTc-Technegas
C.
Xenon-133(133Xe)
D.
Q 2. Within the following ventilation/perfusion (V/Q) imaging interpretation criteria,
which has or have the high possibility(＞80%) of diagnosing pulmonary embolism (PE)
( ABD).
A. ≥ 2 large (＞75% of a segment) perfusion defect (PD) without corresponding V or chest
radiograph(CXR) abnormalities.
B. 1 large segment PD and 2 moderate (25-75% of a segment) segmental PD without
corresponding V or CXR abnormalities.
C. 1 moderate to ＜2 large segmental PD without corresponding V of CXR abnormalities.
D. ≥4 moderate segmental PD without corresponding V or CXR abnormalities.
E. ＞ 3 small (＜25% of a segment) segmental PDs with a normal CXR.
Q 3. Among the following examinations, which can help to make a diagnosis of pulmonary
).
embolism( PE) (
A. Radionuclide lung ventilation/perfusion imaging.
B. Spiral computed tomography and electron beam computed tomography
angiography.
C. Magnetic Resonance angiography (MRA) of pulmonary artery.
D. X-ray angiography of pulmonary artery.
E. Electrocardiogram.
Q 4. In the process of lung perfusion imaging, which type of patients should receive a
reduced number of particles. (
)
A. Patients with severe pulmonary hypertension B. Patients with severe
right-to-left shunts
C. Children D. Patients with chronic obstructive pulmonary
disease(COPD) E. Patients with high blood pressure.
Q5. The reasons that 99mTc-ECD can be used as a radio-tracer for cerebral blood
flow tomography are (
).
A. ECD is lipophilic B. ECD is water-soluble
C. ECD has small molecular size
D. ECD is neutral charged E. ECD can be converted into water-soluble complex in
the brain cells.
Q6. Among the following radiotracers, which can be used for myocardial perfusion or
metabolism imaging are(
).
201
99mTc-Tetrofosmin (99mTc-P53)
A.thallium-201( Tl)
B. 99mTc-MIBI
C.
D.18F-FDG E. 99mTc-PYP
Q7. ‘Reversible defect ’ in the myocardial perfusion imaging commonly shows ().
A. Decrease or defect of radio distribution at regional myocardial segment at
stress imaging.
B. Decrease or defect of radio distribution at regional myocardial segment at
rest imaging.
C. The defect is filled obviously or completely at rest imaging.
D. Increased distribution at regional myocardial segment at stress imaging.
E. Normal distribution at regional myocardial segment at stress imaging.
Q8. When injected intravenously, the 99mTc-Sulfer colloid can be phagocyized by( ).
A. Kupffer Cells B. Spleen C. Bone marrow D. Leukocytes
E. Erythrocytes
Q9. Within the space-occupying lesions of liver, which can manifest decreased or
defected of radiodistribution in the liver colloid scintigraphy (
).
A. liver cysts B. hepatic abscess
C. focal nodular hyperplasia (FNH) D.
hepatic hemangioma E. hepatic cell cancer (HCC)
Q10. Among the following radioactive tracers, which can be used for hepatobiliary
scintigraphy?
A.99mTc-IDA B. 99mTc-DTPA C. 99mTc-MIBI
D. 99mTc-HMPAO
E.
99mTc-IMP
Q11. In the gastrointestinal bleeding scintigraphy, specific criteria for accurate
diagnosis of the bledding site include(s) (
)
A. Radioactivity is seen in the abdomen where none was initially.
B. The radioactivity increases over time.
C. The radiotracer moves in a pattern that conforms anatomically to small or large
intestines.
D. The presence of radioactivity on delayed images.
E. A female of reproductive age with the presence of pelvic activity.
Q12. In the skeletal scintigraphy , “hot -spots” can be caused by (
).
A. Increased blood supply
B. Decreased bone metabolism
C. Increased skeleton metabolism
D. High osteogenetic activity
E. Increase osteoclasts activity
Q13. In the skeletal scintigraphy , “cold -spots” can be caused by (
).
A. Decreased blood supply
B. Decreased osteoblasts activity
C. Decreased bone metabolism
D. Low osteogenetic activity
E. Increased
sympathetic nerve activity
Q14. The skeleton dynamic imaging consists of (
).
A. Blood flow images
B. Blood pool images
C. Delayed static bone scan
D. Planer scan
E. Local bone scan
Q15. What are the features of normal images of skeletal scintigraphy? ( )
A. The left and right halves of the skeleton should be virtually mirror images of each
other.
B. Flat bones (vertebra, ilium,ribs, skull lamina) have higher radioactivity than long
-bone diaphysis.
C. Long- bone metaphysis has higher radioactivity than long-bone diaphysis.
D. Major joints have higher radioactivity than facets.
E. Kidneys and bladder are clearly visualized.
Q16. “Spuer bone scan” or “super bone imaging” are commonly seen in patients
with ( ).
A. Breast carcinoma
B. Lung cancer
C. Prostate cancer
D. Primary hyperparathyroidism
E. Secondary hpyerparathyroidism
Q17. The characteristics of bone metastasis in skeletal scintigraphy are(
A. Multiple increased or decreased radiodistribution lesions
).
B. Asymmetrical lesions with increased uptake of radiotracer
C. Lesions distribute at random in skeleton
D. Lesions with different size,morphology and radiotracer accumulation
E. ‘Super bone scan’ or ‘doughnut or ring like’ distribution of radioactivity
Q18. The “parallel track or double –stripe” sign of scintigraphy can occur in patients
with ( ).
A. COPD
B. Lung cancer
C. Other malignant tumor with lung metastasis
D. Pulmonary embolism
E. Pulmonary tuberculosis
Q19. The basic requirements of radioimmunoassay are (
A. Specific antibodies
B. Labeled antigens
C. Calibration standard
D. Separation technique
).
E. Radio- counter
Q20. The typical features of “doughnut” sign and their pathologic changes are
A. Photopenia or photon-deficient lesion at the site of bone necrosis.
( ).
B. Photon-lesion or photopenia around the site of bone necrosis.
C. Increased radioactivity at the site of bone repairing and revascularizting area
area surrounding the necrosis center.
D. Increased radioactivity at the site of bone necrosis.
E. Decreased radioactivity at the site of bone repairing and revascularizting area
surrounding the necrosis center.
Q21. In the reaction system of radioimmunoassay, which of the statement is
correct ? ( )
A. *Ag and Ab are in constant quanity
B. The total dose of Ag and *Ag exceed the effective binding site of Ab.
C. The formation of
*Ag-Ab would decrease as
the dose of Ag increases.
D. The free *Ag will increase as the concentration of Ag increases.
E. The free Ag will increase as the concentration of *Ag increases.
Q22. Currently ,which of the following radioactive isotopes that can be used to
labeled for radioimmunoassay? ( )
A.131I B. 125I. C. 14C D. 3H E. 11C
Q 23. Disorders that can cause excessive production of lymphatic fluid are ( ).
A. obstruction of the capillary vessels.
B. obstruction of the venious system
C. excessive fluid migration from the vascular space
D. a link in the lymphatic system
E. a link in the venous system
Q24. The reasons that can cause lymphedema are ( ).
A. Excessive production of lymph fluid
B. Obstruction of lymphatic drainage.
C. Disruption of the integrity of the lymphatic system.
D. Heart failure
E. Chronic renal failure
Q25. The characteristics of abnormal lymphoscintigraphy may include ( ).
A. delayed, asymmetric or absent visualization of regional lymph nodes
B. the “dermal back flow”
C. asymmetric lymphatic channels
D. collateral channels
E. interrupted lymphatic trunks and deep lymph nodes imaging
Q 26. The following radio-tracers that can be used
scintigraphy are (
).
99m
A. Tc-human serum albumin
B. 99mTc-sulfur colloid
C. 99mTc-antimony colloid
D. 99mTc-dextran
E. 99mTc-MAA
for sentinel lymph node
3. True or false questions (if the statement is true please write ‘T’, otherwise write ‘F’ in
the bracket following each item).
Q 1. In the process of 99mTc-MAA lung perfusion imaging, the injected particles
(100,000 to 700,000) can occlude 1% of the peripheral pulmonary arterial trees
（F）.(0.1%)
Q 2. No perfusion defect and perfusion outlines the shapes of lung seen on chest
radiography (CXR) in ventilation/perfusion (V/Q) imaging criteria means normal ( ).
Q3. The typical features of epilepsy of SPECT CBF imaging is that the perfusion in
the lesions are increased radioactivity in ictal and decreased interictal ( )
Q4. The feature of SPECT cerebral blood flow tomography of Alzhemer’s disease(AD)
is hypoperfusion often seen in basal ganglia and cerebellum.( )
Q5. The feature of SPECT cerebral blood flow tomography of Parkinson’s disease(PD)
is hypoperfusion often seen in basal ganglia and brain cortex.( )
Q6. If the radio defect of the 18FDG myocardial metabolism imaging matches with
that of 99mTc-MIBI myocardial perfusion imaging, it means the lesion has no viable
myocardial cells.( )
Q7. If the normal or near normal 18FDG myocardial metabolism imaging dismatches
with the radio defect of 99mTc-MIBI myocardial perfusion imaging, it means the lesion
has viable myocardial cells.( )
Q8. In the process of electrocardiogram acquisition, usually,the R wave was used as
the trigger for the start of the data acquisition sequence.( )
Q9. 99mTc-RBC can be used for firs pass radionuclide ventriclography.(
)
Q10. In the liver blood pool scintigraphy, the liver hemagioma often manifests
‘perfusion-blood pool mismatch’.( )
Q11. Most symptomatic patients with Meckel’s diverticulum are children, often
under 2 years of age.(
)
Q12. In the imaging of heterotopic gastric mucosa, Meckel’s diverticulum appears as
focal areas of radio uptake,usually in the right upper quadrant.(
)
Q13.18F can exchange with the calcium(Ca2+) ion in the hydroxyapatite of bone.(
)
Q14. 85Sr can can exchange with the calcium(Ca2+) ion in the hydroxyapatite of
bone.( )
Q15. 89Sr can can exchange with the calcium(Ca2+) ion in the hydroxyapatite of
bone.( )
Q16.
bone( ).
18F
can exchange with the hydroxyl (OH+) ion in the hydroxyapatite of
Q17. When ‘Flare phenomenon’ occurs in patient with bone metastasis, it represents
a favorable response to therapy ( ).
Q18. When ‘Flare phenomenon’ occurs in patient with bone metastasis, it represents
the worsening of metastatic lesions (
).
Q19. When the findings on a bone scan are positive, there is very poor prognosis
among patients with lung carcinoma.(
)
Q20. The presence of ＞ 2 areas of abnormal uptake on a bone scan of a patient
with lung carcinoma often represents a significant poor prognostic factor.( )
Q21. Patients with only 1or 2 abnormal areas in bone scans did not have a change in
overall survival rate.(
)
Q22. Breast carcinoma cells are rare to spread to the ribs and sternum.(
)
Q23. In the skeletal scintigraphy, the “avascular necrosis of the femoral head” can
manifest ‘doughnut’ sign.(
)
Q24.As for skeletal diseases, skeletal scintigraphy can detect the lesions 3-6 months
earlier than plain-film radiography.(
)
Q25. Bone scintigraphy for lung cancer can show evidence of hypertrophic
pulmonary osteoarthropathy(HPO) (
).
Q26. Sentinel lymph node is the first filter that metastatic cells encounter. (
)
Q27. Sentinel lymph node is the first lymph node in a lymph node bed drainage from
a tumour (
).
4. Definitions (please describe each of the following items).
Q1. Crossed cerebellar diaschisis: In the cerebral blood flow tomography, the sign
shows decreased uptake of radio-tracers in the contralateral cerebellum of the infarction
lesion is called Crossed cerebellar diaschisis.
Q2.aneurysm :An aneurysm is difined as a break in the contour of the diastolic
outline of the ventricle.
5. Long questions.( please answer the following questions clearly and correctly)
Q1. What are the clinical applications of SPECT
Q2.
Please describe the four types of
myocardial perfusion imaging.
cerebral blood flow tomography?
abnormal image in
99mTc-MIBI
SPECT