Quiz: Cardiovascular quiz (2/3) (employee training


Cardiovascular quiz (2/3)Online version Multiple choice questions by Joshua Liberty 1 Gated SPECT uses ___ leads ECG at ___? a 3; RA, LA, LL b 12; same leads used for treadmill test c 3; RA, V1, V2 d 3; RA, V5, V6 2 ____ are used to assess ____ ventricular function and are based upon acquiring data (20 to 50 ms per frame) with patient's ECG correlated to images, during the ____ passage of the radiopharmaceutical through the heart. a MUGA studies; right; first b First pass studies; right; first c First pass studies; left; first d First pass studies; right; repeated 3 Tc99m DTPA (pentate) commonly used for 1rst pass studies because it? a Allows LVEF also b A faster rphx to reach heart c Rapidly cleared=multiple studies possible d Has increased uptake in heart 4 On a MUGA, subtraction of too little background results in a falsely ___ EF. a High b Low c No effect d None of these 5 A MUGA patient has arrythmias: >10% variation in R-R interval in >10% of beats; the solution is to? a Do a stress MUGA b Switch to an MPI study c Cancel the study d Open up acceptance window 6 The advantages of 180 degree limited imaging in cardiac studies is/are? a Brings out inferior wall in images. b Is more comfortable for the patient. c Reduces imaging time. d Reduces both the noise that comes from detecting mostly attenuated data from the patient's back which distant from the heart, and the attenuation artifacts due to the spine. 7 When performing myocardial perfusion imaging using Technetium agents? a Redistribution is minimal b Redistribution occurs at a faster rate with Thallium c A patient must undergo a two day protocol d They are lost quickly from the myocardium in less than 2 hours 8 Regarding Tc99m pyrophosphate (PYP) for MI imaging, which are true? a It was used to diagnose infarction b After cell death in MI, an influx of calcium occurs and calcium phosphate complexes are formed c These deposits act as sites for bone tracer uptake d All fo the above 9 Which are vasodilators? a Adenosine b Regadenoson c Dipyridamole d Dobutamine e Adenosine, Regadenoson, and Dipyridamole 10 When performing a pharmacological stress test using adenosine, the counteragent drug that must be available if needed to treat the adverse effects of adenosine is? a Xanthine b Atropine c Morphine d Aminophylline 11 An asthmatic patient arrives for a pharmacological stress test, the technologist will most likely perform the study using? a Excercise stress b Dipyridamole c Adenosine d Dobutamine 12 A bull's-eye or polar plot display of myocardial perfusion data is constructed by:? a Stacking reconstrcuted slices of all axis images b Stacking reconstrcuted vertical long-axis slices c Stacking reconstrcuted horizontal long-axis slices d Stacking reconstrcuted short-axis slices 13 Indications for a MUGA study include? a Evaluation of wall motion b Evaluation of heart after chemotherapy c Evaluation of ischemia of myocardium d Evaluation of wall motion and Evaluation of heart after chemotherapy e All of these 14 Systole represents: ? a The period of ventricular relaxation b The period of ventricular contraction c The period of atrial contraction d The cardiac output 15 Describe both the image results seen on a stress/rest MPI study indicative of infarct or scar. a Normal stress/abnormal gating b Abnormal stress/normal rest c Normal stress/abnormal rest d Abnormal stress/abnormal rest 16 Tertofosmin and sestamibi are used instead of Tl-201 for cardiac MPI imaging; the advantages include? a Lower radiation doses b Better counts c Less attenuation d All of these 17 Tl-201 begins however washes back in to myocardium from bloodstream; 4-24 hours after injection, the relative concentration of thallium in the two areas (normal vs. ischemic) may appear similar. This is called? a Ischemia b Redistribution c Osmolality d Upward or myocardial creep 18 The Tl-201 only protocol includes giving the patient? a 2.5-4 mCi of Tl-201 stress injection is given first with redistribution/rest imaging at 3-4 hours later; may give an additional 1-1.5 mCi at rest b 1 mCi of Tl-201 stress injection is given first with redistribution/rest imaging at 3-4 hours later; may give an additional 2.5-4 mCi at rest c 30 mCi of Tl-201 stress injection is given first with redistribution/rest imaging at 3-4 hours later; may give an additional 10 mCi at rest d 10 mCi of Tl-201 stress injection is given first with redistribution/rest imaging at 3-4 hours later; may give an additional 30 mCi at rest 19 The 2nd additional Tl-201 dose at rest may help diagnose _____? a Myocardial or upward creep b Chest pain c Hibernating myocaridum: chronically ischemic but viable (not scar) heart tissue d Infarct 20 Tl-201 imaging should begin 10-15 minutes after stress because of? a Myocardial or upward creep b Redistribution c Gut activity d GB activity 21 Tl-201 MOL is ? a Passive diffusion b Antigen reaction c Chemisorption d AT similar to K, distributes with Na/K pump 22 In the two-day Tc99m protocol, the rest and stress scans done on separate days, each using? a 10-15 mCi b 24-36 mCi c 30-40 mCi d 5-10 mCi 23 The two-day protocol is ideal for? a Females with potentially significant breast attenuation b >250 lb patients or BMI >30 c Patients who cannot walk on a treadmill d Females with potentially significant breast attenuation and >250 lb patients or BMI >30 24 The Optimal cardiac stress test on the treadmill would involve? a 85% of the (maximum heart rate which = 120-the pts age in years) b 120 bpm c 45% of the (maximum heart rate which = 220-the pts age in years) d 85% of the (maximum heart rate which = 220-the pts age in years) 25 The Bruce cardiac stress test treadmill protocol involves? a 9 stages, each 1 min in duration with incresing speed and grade. b 7 stages, each 2 min in duration with incresing speed and grade. c 7 stages, each 3 min in duration with incresing speed and grade. d 5 stages, each 3 min in duration with incresing speed and grade. 26 Regarding Rubidium-82 chloride which is true? a It is used for PET myocardial perfusion and MOL =analog of K b Available from a Sr-82 generator c Tp= 75 seconds d Dose = use 30-50 mCi for rest and pharmacological stress e All of these 27 The heart uses ____ first for energy; when blood flow is reduced and ischemia results, ____ becomes the preferred energy source. a Glucose; fatty acids b Fatty acids; protiens c Fatty acids; glucose d Glucose; glycogen 28 PET utilizing ___ is a well-recognized method to asses myocardial viability ( is tissue still function post MI) and hibernating myocardium. a 18- flurodeoxyglucose (FDG) b N-13 ammonia c Tl-201 d Rb-82 chloride 29 Direct evaluation of radioactivity inside the heart cavity between diastole and systole allows visualization and quantization of EF and wall motion; this study is called? a MUGA b Radionuclide ventriculography c Equilibrium gated blood pool imaging d MUGA and Radionuclide ventriculography e All of these 30 Gated stress blood pool imaging uses? a Bicycle ergometer b Increments every 3 minutes in exercise c Planar LAO imaging during last 2 minutes of each stage d Dobutamine is an option e All of these 31 The dose for a MUGA is ? a 20-30 mCi Tc99m labeled RBC's b 20-30 mCi Tc99m labeled sestamibi c 5-10 mCi Tc99m labeled RBC's d 3-4 mCi Tl-201 32 The % of total volume of blood ejected with ventricular contraction is called? a Stroke volume b Cardiac output c End diastolic volume d End systolic volume e Ejection fraction 33 Describe completely the dual isotope cardiac protocol including rphxs, doses used, and order of studies. a Usually 1 mCi Tl-201 rest 1rst and 10-20 mCi sestamibi or tetrofosmin stress 2nd. b Usually 5-10 mCi Tl-201 rest 1rst and 25 mCi sestamibi or tetrofosmin stress 2nd. c Usually 3 mCi Tl-201 rest 1rst and 25 mCi sestamibi or tetrofosmin stress 2nd. d 25 mCi sestamibi or tetrofosmin stress 1rst; 3 mCi Tl-201 rest 2nd. 34 The one day rest/stress (not common) sestamibi or tetrofosmin protocol involves? a Inject 8-12 mCi at rest and 24-36 mCi at peak stress. b Inject 24-36 mCi at rest and 8-12 mCi at peak stress. c Inject 24-36 mCi for both studies d Inject 8-12 mCi at rest and 8-12 mCi at peak stress. 35 The one day stress/rest (not common) sestamibi or tetrofosmin protocol involves? a Inject 8-12 mCi at stress and 24-36 at rest. b Inject 24-36 mCi at stress and 8-12 mCi at rest. c Inject 24-36 mCi for both. d Inject 8-12 mCi at stress and 8-12 mCi at rest. Feedback 4 Too little = too low 18 TL-201 has a long half-life so use very little of it during study! 35 Doesnt matter if rest or stress first as long as rule of 1:3 is followed

1

Gated SPECT uses _ leads ECG at _?

a

3; RA, LA, LL

b

12; same leads used for treadmill test

c

3; RA, V1, V2

d

3; RA, V5, V6

2

are used to assess ventricular function and are based upon acquiring data (20 to 50 ms per frame) with patient's ECG correlated to images, during the passage of the radiopharmaceutical through the heart.

a

MUGA studies; right; first

b

First pass studies; right; first

c

First pass studies; left; first

d

First pass studies; right; repeated

3

Tc99m DTPA (pentate) commonly used for 1rst pass studies because it?

a

Allows LVEF also

b

A faster rphx to reach heart

c

Rapidly cleared=multiple studies possible

d

Has increased uptake in heart

4

On a MUGA, subtraction of too little background results in a falsely ___ EF.

a

High

b

Low

c

No effect

d

None of these

5

A MUGA patient has arrythmias: >10% variation in R-R interval in >10% of beats; the solution is to?

a

Do a stress MUGA

b

Switch to an MPI study

c

Cancel the study

d

Open up acceptance window

6

The advantages of 180 degree limited imaging in cardiac studies is/are?

a

Brings out inferior wall in images.

b

Is more comfortable for the patient.

c

Reduces imaging time.

d

Reduces both the noise that comes from detecting mostly attenuated data from the patient's back which distant from the heart, and the attenuation artifacts due to the spine.

7

When performing myocardial perfusion imaging using Technetium agents?

a

Redistribution is minimal

b

Redistribution occurs at a faster rate with Thallium

c

A patient must undergo a two day protocol

d

They are lost quickly from the myocardium in less than 2 hours

8

Regarding Tc99m pyrophosphate (PYP) for MI imaging, which are true?

a

It was used to diagnose infarction

b

After cell death in MI, an influx of calcium occurs and calcium phosphate complexes are formed

c

These deposits act as sites for bone tracer uptake

d

All fo the above

9

Which are vasodilators?

a

Adenosine

b

Regadenoson

c

Dipyridamole

d

Dobutamine

e

Adenosine, Regadenoson, and Dipyridamole

10

When performing a pharmacological stress test using adenosine, the counteragent drug that must be available if needed to treat the adverse effects of adenosine is?

a

Xanthine

b

Atropine

c

Morphine

d

Aminophylline

11

An asthmatic patient arrives for a pharmacological stress test, the technologist will most likely perform the study using?

a

Excercise stress

b

Dipyridamole

c

Adenosine

d

Dobutamine

12

A bull's-eye or polar plot display of myocardial perfusion data is constructed by:?

a

Stacking reconstrcuted slices of all axis images

b

Stacking reconstrcuted vertical long-axis slices

c

Stacking reconstrcuted horizontal long-axis slices

d

Stacking reconstrcuted short-axis slices

13

Indications for a MUGA study include?

a

Evaluation of wall motion

b

Evaluation of heart after chemotherapy

c

Evaluation of ischemia of myocardium

d

Evaluation of wall motion and Evaluation of heart after chemotherapy

e

All of these

14

Systole represents: ?

a

The period of ventricular relaxation

b

The period of ventricular contraction

c

The period of atrial contraction

d

The cardiac output

15

Describe both the image results seen on a stress/rest MPI study indicative of infarct or scar.

a

Normal stress/abnormal gating

b

Abnormal stress/normal rest

c

Normal stress/abnormal rest

d

Abnormal stress/abnormal rest

16

Tertofosmin and sestamibi are used instead of Tl-201 for cardiac MPI imaging; the advantages include?

a

Lower radiation doses

b

Better counts

c

Less attenuation

d

All of these

17

Tl-201 begins however washes back in to myocardium from bloodstream; 4-24 hours after injection, the relative concentration of thallium in the two areas (normal vs. ischemic) may appear similar. This is called?

a

Ischemia

b

Redistribution

c

Osmolality

d

Upward or myocardial creep

18

The Tl-201 only protocol includes giving the patient?

a

2.5-4 mCi of Tl-201 stress injection is given first with redistribution/rest imaging at 3-4 hours later; may give an additional 1-1.5 mCi at rest

b

1 mCi of Tl-201 stress injection is given first with redistribution/rest imaging at 3-4 hours later; may give an additional 2.5-4 mCi at rest

c

30 mCi of Tl-201 stress injection is given first with redistribution/rest imaging at 3-4 hours later; may give an additional 10 mCi at rest

d

10 mCi of Tl-201 stress injection is given first with redistribution/rest imaging at 3-4 hours later; may give an additional 30 mCi at rest

19

The 2nd additional Tl-201 dose at rest may help diagnose _____?

a

Myocardial or upward creep

b

Chest pain

c

Hibernating myocaridum: chronically ischemic but viable (not scar) heart tissue

d

Infarct

20

Tl-201 imaging should begin 10-15 minutes after stress because of?

a

Myocardial or upward creep

b

Redistribution

c

Gut activity

d

GB activity

21

Tl-201 MOL is ?

a

Passive diffusion

b

Antigen reaction

c

Chemisorption

d

AT similar to K, distributes with Na/K pump

22

In the two-day Tc99m protocol, the rest and stress scans done on separate days, each using?

a

10-15 mCi

b

24-36 mCi

c

30-40 mCi

d

5-10 mCi

23

The two-day protocol is ideal for?

a

Females with potentially significant breast attenuation

b

>250 lb patients or BMI >30

c

Patients who cannot walk on a treadmill

d

Females with potentially significant breast attenuation and >250 lb patients or BMI >30

24

The Optimal cardiac stress test on the treadmill would involve?

a

85% of the (maximum heart rate which = 120-the pts age in years)

b

120 bpm

c

45% of the (maximum heart rate which = 220-the pts age in years)

d

85% of the (maximum heart rate which = 220-the pts age in years)

25

The Bruce cardiac stress test treadmill protocol involves?

a

9 stages, each 1 min in duration with incresing speed and grade.

b

7 stages, each 2 min in duration with incresing speed and grade.

c

7 stages, each 3 min in duration with incresing speed and grade.

d

5 stages, each 3 min in duration with incresing speed and grade.

26

Regarding Rubidium-82 chloride which is true?

a

It is used for PET myocardial perfusion and MOL =analog of K

b

Available from a Sr-82 generator

c

Tp= 75 seconds

d

Dose = use 30-50 mCi for rest and pharmacological stress

e

All of these

27

The heart uses first for energy; when blood flow is reduced and ischemia results, becomes the preferred energy source.

a

Glucose; fatty acids

b

Fatty acids; protiens

c

Fatty acids; glucose

d

Glucose; glycogen

28

PET utilizing ___ is a well-recognized method to asses myocardial viability ( is tissue still function post MI) and hibernating myocardium.

a

18- flurodeoxyglucose (FDG)

b

N-13 ammonia

c

Tl-201

d

Rb-82 chloride

29

Direct evaluation of radioactivity inside the heart cavity between diastole and systole allows visualization and quantization of EF and wall motion; this study is called?

a

MUGA

b

Radionuclide ventriculography

c

Equilibrium gated blood pool imaging

d

MUGA and Radionuclide ventriculography

e

All of these

30

Gated stress blood pool imaging uses?

a

Bicycle ergometer

b

Increments every 3 minutes in exercise

c

Planar LAO imaging during last 2 minutes of each stage

d

Dobutamine is an option

e

All of these

31

The dose for a MUGA is ?

a

20-30 mCi Tc99m labeled RBC's

b

20-30 mCi Tc99m labeled sestamibi

c

5-10 mCi Tc99m labeled RBC's

d

3-4 mCi Tl-201

32

The % of total volume of blood ejected with ventricular contraction is called?

a

Stroke volume

b

Cardiac output

c

End diastolic volume

d

End systolic volume

e

Ejection fraction

33

Describe completely the dual isotope cardiac protocol including rphxs, doses used, and order of studies.

a

Usually 1 mCi Tl-201 rest 1rst and 10-20 mCi sestamibi or tetrofosmin stress 2nd.

b

Usually 5-10 mCi Tl-201 rest 1rst and 25 mCi sestamibi or tetrofosmin stress 2nd.

c

Usually 3 mCi Tl-201 rest 1rst and 25 mCi sestamibi or tetrofosmin stress 2nd.

d

25 mCi sestamibi or tetrofosmin stress 1rst; 3 mCi Tl-201 rest 2nd.

34

The one day rest/stress (not common) sestamibi or tetrofosmin protocol involves?

a

Inject 8-12 mCi at rest and 24-36 mCi at peak stress.

b

Inject 24-36 mCi at rest and 8-12 mCi at peak stress.

c

Inject 24-36 mCi for both studies

d

Inject 8-12 mCi at rest and 8-12 mCi at peak stress.

35

The one day stress/rest (not common) sestamibi or tetrofosmin protocol involves?

a

Inject 8-12 mCi at stress and 24-36 at rest.

b

Inject 24-36 mCi at stress and 8-12 mCi at rest.

c

Inject 24-36 mCi for both.

d

Inject 8-12 mCi at stress and 8-12 mCi at rest.

Feedback

4

Too little = too low

18

TL-201 has a long half-life so use very little of it during study!

35

Doesnt matter if rest or stress first as long as rule of 1:3 is followed

Cardiovascular quiz (2/3)

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