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GENERAL INFORMATION:
The ANMB examinations consist of two (2) parts: Theoretical and Practical.
The Theoretical part will be assessed through questions answerable by True or False, Multiple
Choice, or based on scintigraphic/radiographic images. Samples of these questions are presented
in this paper.
The Practical part will be evaluated through reporting of cases containing needed clinical
information and scintigraphic/radiologic images. These given data shall be formatted into a
Report to be made as you would in your own environment. A Panel of Examiners can ask
questions based on the Report and the discussion/interview could cover both clinical and
technical aspects of the case. Additional cases may be presented to you for further discussion
within the time frame.
True –False Questions
A child presents with recurrent pulmonary infections. Recurrent aspiration pneumonia is
suspected and can be confirmed by:
Q1. Thyroid scans for lingual thyroids
Q2. Milk scan
Q3. Radionuclide salivagram
Q4. Gastroesophageal reflux scintigraphy
False positive PET cancer screening studies are seen with
Q5. Active tuberculosis
Q6. Carcinoid tumors
Q7. Sarcoidosis
Q8. Abscess
False positive PET cancer screening studies are seen with
Q9. Active tuberculosis
Q10. Carcinoid tumors
Q11. Sarcoidosis
Q12. Abscess
Multiple Choice Question.
Choose the correct answer.
Indicate the LETTER corresponding to the correct answer.
Q. 13. What should you do if you see lung activity in the I-131 (5 mCi) study?
A. Low dose (30 mCi) I-131 therapy
B. High dose (150 mCi) I-131 therapy
C. High dose (200 mCi) I-131 therapy
D. External radiotherapy
Q. 14. What nuclear medicine imaging studies can be used in the serum Tg positive and I-131 wh
ole body scan negative patients? (5)
A. FDG PET/CT
B. Tl-201
C. I-131 MIBG
D. Tc-99m DMSA(V)
Q. 15. What is the TNM staging of the thyroid papillary cancer patient (40-year-old) with 3 cm-si
zed primary tumor without extrathyroidal extension, 2 central lymph nodes metastases, and pu
lmonary micrometastasis?
A. T2N1M1, stage II
B. T2N1M1, stage IV
C. T3N1M1, stage II
D. T3N1M1, stage IV
Q. 16. A 48-yer-old woman with 2 cm-sized thyroid nodule in the right lobe underwent right thyr
oid lobectomy. The pathology revealed follicular thyroid carcinoma with extrathyroidal inva
sion. Which of the following management would be most appropriate?
A. TSH suppression
B. I-131 remnant ablation + TSH suppression
C. Completion thyroidectomy + I-131 remnant ablation + TSH suppression
D. Completion thyroidectomy + chemotherapy + TSH suppression
Q. 17. You are reading a FDG PET scan of healthy volunteer and you note symmetric diffuse FD
G activity in both the vocal cords. It means.
A. Bilateral cancer of the vocal cords
B. Inflammation
C. Physiologic uptake
D. Benign tumor
Q. 18. You are reading a FDG PET/CT scan of a prostate cancer patient who have undergone pro
statectomy. And you note a focal FDG accumulation in the liver. CBC shows hemoglobin of 1
5.5 mg/dL and white blood cell (WBC) count of 5900 /mm3 (neutrophil 44.9%, lymphocyte 3
7.7%, eosionophil 11.8 %, monocyte 5.1%). What is the next step?
A. Chemotherapy; it is because of liver metastasis
B. Chemotherapy; even though the serum PSA is negative
C. Wedge resection; because the lesion is a hepatocellular carcinoma
D. Observation; because it is a benign lesions that show variable FDG uptake
Q. 19. What is the common mutation of the differentiated thyroid cancer?
A. Follicular – BRAF
B. Follicular - RET
C. Hurthle cell – RET
D. Papillary – BRAF
Q. 20. The application of nitrates in myocardial perfusion study is useful because nitrates:
A. Can be used as a pharmacologic stress agent
B. Nitrates reduce collateral flow into ischaemic zone
C. Decrease myocardial blood flow in areas of resting ischaemia
D. Enhances the detection of myocardial viability by Tc-99m radiopharmaceuticals
Q. 21. Which are included in the system components of conventional gamma camera for single
photon imaging?
A. Scintillation crystal
B. Collimator
C. Pulse height analyser
D. All of the above
No “All of the above” answers, please! By having 4 choices, the examinee gives 25% probabilit
y to each of the choices. Having “All of the above” confers on each choice 33% probability. Th
e Index of Difficulty vs the Index of Discrimination becomes altered vis-à-vis the other questions
with 4 distinct choices.
Q. 22. Which are the scintillation crystals used in nuclear medicine imaging devices?
A. LSO(Ce)
B. NaI(Tl)
C. CdZnTe
D. A and B
Q. 23. What is the commonly used reducing agent for Tc99m radiolabeling?
A. SnCl2
B. ZnCl2
C. GaCl3
D. DTT
Q. 24. The followings are positron emitting radionuclides. Which one is the generator produced
radionuclide?
A. C11
B. F18
C. Cu64
D. Ga68
Q. 25. Regarding Tc99m -tetrofosmine all are true EXCEPT:
A. They are monovalent cations
B. They are lipophilic
C. They are inhibitors of Na+, K+ and Ca2+ transport
D. Following intravenous injection they are primarily cleared from blood by the liver
Q. 26. Which one can be used as the substrate sodium/iodide symporter (NIS)?
A. I-131 MIBG
B. Ga-67 citrate
C. In-111 octreotide
D. Re-188 perrhenate
Q. 27. Which size of radiolabeled particles is most used in lymphoscintigraphy?
A. 5 nm or less
B. 10 – 80 nm
C. 200 – 400 nm
D. 500 – 1,000 nm
Q. 28. Please interpret this MUGA study
A. Normal LV systolic and diastolic function
B. Moderate LV systolic function with global hypokinesia
C. Moderate LV systolic function with septal and apical hypokinesia
D. Moderate LV systolic function with septal akinesia and apical dyskinesia