Quiz: Infection, Tumor imaging, and Therapy study quiz (3/4) (employee training


Infection, Tumor imaging, and Therapy study quiz (3/4)Online version 22-30 slides by Joshua Liberty 1 Lu-177 Dotatate causes myelosuppression. a True b False 2 What is the MOL of Lu-177 Dotatate? a Synthetic amino acid transported across mammalian cell membranes by amino acid transporters, such as LAT-1 and ASCT2, which are upregulated in prostate cancer cells b Upon binding to somatostatin receptor expressing cells, including malignant somatostatin receptor-positive tumors, the compound is internalized. c Unknown, thought to be increased blood flow and metabolic rate in abnormal cells d Migration via chemotaxis, it is lipophilic and enters leukocyte cell membrane. 3 The beta emission from Lu-177 induces cellular damage by formation of _____ in somatostatin receptor-positive cells and in neighboring cells. a Antioxidants b Citrate buffer c Free radicals d Cold rituximab 4 Within ____ of administration, distributes in kidneys, tumor lesions, liver, spleen, and in some patients, pituitary gland and thyroid. a 1 b 2 c 3 d 4 5 Within four hours of administration, distributes in kidneys, tumor lesions, liver, spleen, and in some patients, pituitary gland and thyroid. a Kidneys b Tumor lesions c Liver d Spleen e Pituitary gland and thyroid f Kidneys, tumor lesions, Liver, spleen, pituitary gland, and thyroid 6 How much does the co-administration of amino acids reduce the median radiation dose to the kidneys by? a 25% b 47% c 50% d 67% e 33% 7 Yttrium-Ibritumomab tiuxetan is used to treat HL a True b False 8 What is the MOL of Y-90-Ibritumomab tiuxetan? a Targets the CD20 antigen on surface of normal/malignant B lymphocytes b Synthetic amino acid transported across mammalian cell membranes by amino acid transporters, such as LAT-1 and ASCT2, which are upregulated in prostate cancer cells c Upon binding to somatostatin receptor expressing cells, including malignant somatostatin receptor-positive tumors, the compound is internalized. d Unknown, thought to be increased blood flow and metabolic rate in abnormal cells 9 Tp of Y-90 a 64 hours b 78 hours c 73 hours d 66 hours 10 Y-90 decays by? a B-decay b EC c Annihilation reaction d B+ decay 11 Y-90 has different doses depending on lab levels. a True b False 12 If platelet counts are between _____ and ______ the dose should be? a 150,000; 0.3 mCi b 100,000-149000; 0.4 mCi c 100,000-149000; 0.3 mCi d 150,000; 0.4 mCi 13 If platelet counts are less than _________ the dose should be? a >150,000; 0.4 mCi b 100,000-149000; 0.4 mCi c 100,000-149000; 0.3 mCi d <150,000; 0.3 mCi 14 Max dose should not exceed _____ for Y-90 therapy. a 32 uCi b 20-30 mCi c 5-10 mCi d 0.032 Curie 15 Day 1 of Y-90 therapy; ??? a Give IV rituximab (do not bolus), which is cold antibody; this blocks CD20 sites in peripheral circulation and RES uptake; pretreat with acetaminophen and diphenhydramine for fever/chills b Prep patient by drawing injection markers on the skill just about center on each tumor site. c Give 2nd infusion IV cold rituimab; within 4 hours: the give therapeutic dose d Patient must discontinue taking Thyroid replacement hormones as it can cause artifacts within the scan 16 Day 7, 8, 9 of Y-90 therapy; ??? a Give 2nd infusion IV cold rituimab; within 4 hours: the give therapeutic dose b Give IV rituximab (do not bolus), which is cold antibody; this blocks CD20 sites in peripheral circulation and RES uptake; pretreat with acetaminophen and diphenhydramine for fever/chills c Prep patient by drawing injection markers on the skill just about center on each tumor site. d Patient must discontinue taking Thyroid replacement hormones as it can cause artifacts within the scan 17 What is the Therapeutic dose of Y-90. a 0.3 or 0.4 uCi/kg (<34) mCi b 0.2 or 0.3 mCi/kg (<32) mCi c 0.3 or 0.4 uCi/kg (<32) uCi d 0.3 or 0.4 mCi/kg (<32) mCi 18 Y-90 is a ____ emitter. a Alpha b Gamma c Beta d Photometric effect. 19 What is the most common energy range for Y-90? a 750-935 KeV b 300-600 KeV c 566-827 KeV d 105-318 KeV 20 Which one of the side effects of Y-90 therapy is not a serious side effect? a Cytopenia b Thrombocytopenia c Asthenia d Secondary malignancies e Anemia f Lymphopenia 21 Which one of the side effects of Y-90 therapy is not a minor side effect? a Fatigue b Anemia c Nausea d Abdominal pain e Cough f Pyrexia 22 Thera-spheres are made of resin. a True b False 23 Thera-spheres are made of glass microspheres. a True b False 24 Sir-spheres are made of resin. a True b False 25 Sir-spheres are made of glass microspheres. a True b False 26 How much of all cancers ultimately spread to the liver. a 1/2 b 1/4 c 1/3 d 3/4 27 Thera-spheres are used for the treatment of? a Lung nodules b Primary liver tumor c Adrenal adenoma d Unresectable liver Mets from colorectal cancer 28 Sir-spheres are used for the treatment of? a Lung nodules b Primary liver tumor c Adrenal adenoma d Unresectable liver Mets from colorectal cancer 29 What is the dose for Thera-spheres? a 80-150 mCi b 80-150 uCi c 80-150 Gys d 80-150 Rads 30 What is the dose for Sir-spheres a >50% liver involvement, 3 GBq b 25-50% liver involvement, 2.5 GBq c <25% liver involvement, 2 GBq d <50% liver involvement, 3 GBq e None of these f >50% liver involvement, 3 GBq, 25-50% liver involvement, 2.5 GBq,<25% liver involvement, 2 GBq 31 Prior to the administration of Y-90 labeled Glass microspheres, the patient should undergo? a Hepatic arterial catherization b V/Q scan c GE study d Bone scan 32 Y-90 labeled Glass microspheres is contradicted in patients with? a Tc99m MAA deposition to the GI tract b Shunting of blood to the lungs that could lead to greater than 16.5 mCi of yttrium-90 to the lungs. c COPD d Heart failure e Tc99m MAA deposition to the GI tract, Shunting of blood to the lungs that could lead to greater than 16.5 mCi of yttrium-90 to the lungs. 33 When doing the pre-Y-90 what is the dose? a 2-4 mCi Tc99m DTPA b 5-10 mCi Tc99m Mebrofenin c 5-10 mCi Tc99m MAA d 2-4 mCi Tc99m MAA 34 Y-90 Glass microspheres uses MAA to determine the extent of A-V shunting to the lungs and to confirm the absence of? a Duodenal flow b Gastric flow c Pooling in the cardiac ventricles d In the ureters of the kidneys e Duodenal flow and Gastric flow 35 When is radiation pneumonitis seen in patients? a Pts receiving dose greater than 30 Gy in a single treatment b Pts receiving dose greater than 60 Gy in a single treatment c Pts receiving dose greater than 20 Gy in a single treatment d Pts receiving dose greater than 30 mCi in a single treatment e Pts who already have pneumonia before receiving treatment 36 Microspheres are trapped into liver tumors by embolizing small arterial vessels; use hepatic artery for infusion. a True b False 37 We cannot take pictures using Y-90 spheres. a True b False 38 When are Sir-spheres contradicted? a All of these b Had previous external beam radiation therapy to the liver. c Ascites or are in clinical liver failure d Markedly abnormal synthetic and excretory liver function tests e 20% lung shunting of the hepatic artery blood flow, or >30Gy RAD to the lungs, as estimated by MAA scan 39 I-125 half-life is? a 64 days b 59.6 days c 13.2 hours d 8 days 40 Which of the following statements about I-125 is true? a Decays by EC, 27.4 and 31 keV x-rays and a 35.5 keV gamma. b Decays by EC, 27.4 and 31 keV gamma rays and a 35.5 keV x-ray. c Decays by B-, 27.4 and 31 keV x-rays and a 35.5 keV gamma. d Decays by EC, 27.4 keV x-ray and a 35.5 keV gamma. 41 I-125 implant seeds are used for? a Permanent interstitial treatment of selected localized tumors. b Castrate resistant Prostate cancer c Primary liver tumor d Unresectable liver mets from colorectal cancer 42 Implants may be used in ? a Head b Neck c Lung d Pancreas e Early stage prostate f All of these 43 Implants are administered? a Superficial b Intra-abdominal c Intra thoracic d All these locations e None of these locations 44 Seeds do not have to be sterile. a True b False 45 Seeds are strictly controlled and are stored in a cabinet in the hot lab. a True b False Feedback 7 NHL 37 Bremsstrahlung radiation can be used to form a crude picture of Y-90 liver distribution by SPECT. 44 They start non sterile but for administration they have to be sterilized. 45 False they are stored in a hot lab but in a locked safe.

1

Lu-177 Dotatate causes myelosuppression.

a

True

b

False

2

What is the MOL of Lu-177 Dotatate?

a

Synthetic amino acid transported across mammalian cell membranes by amino acid transporters, such as LAT-1 and ASCT2, which are upregulated in prostate cancer cells

b

Upon binding to somatostatin receptor expressing cells, including malignant somatostatin receptor-positive tumors, the compound is internalized.

c

Unknown, thought to be increased blood flow and metabolic rate in abnormal cells

d

Migration via chemotaxis, it is lipophilic and enters leukocyte cell membrane.

3

The beta emission from Lu-177 induces cellular damage by formation of _____ in somatostatin receptor-positive cells and in neighboring cells.

a

Antioxidants

b

Citrate buffer

c

Free radicals

d

Cold rituximab

4

Within ____ of administration, distributes in kidneys, tumor lesions, liver, spleen, and in some patients, pituitary gland and thyroid.

a

1

b

2

c

3

d

4

5

Within four hours of administration, distributes in kidneys, tumor lesions, liver, spleen, and in some patients, pituitary gland and thyroid.

a

Kidneys

b

Tumor lesions

c

Liver

d

Spleen

e

Pituitary gland and thyroid

f

Kidneys, tumor lesions, Liver, spleen, pituitary gland, and thyroid

6

How much does the co-administration of amino acids reduce the median radiation dose to the kidneys by?

a

25%

b

47%

c

50%

d

67%

e

33%

7

Yttrium-Ibritumomab tiuxetan is used to treat HL

a

True

b

False

8

What is the MOL of Y-90-Ibritumomab tiuxetan?

a

Targets the CD20 antigen on surface of normal/malignant B lymphocytes

b

Synthetic amino acid transported across mammalian cell membranes by amino acid transporters, such as LAT-1 and ASCT2, which are upregulated in prostate cancer cells

c

Upon binding to somatostatin receptor expressing cells, including malignant somatostatin receptor-positive tumors, the compound is internalized.

d

Unknown, thought to be increased blood flow and metabolic rate in abnormal cells

9

Tp of Y-90

a

64 hours

b

78 hours

c

73 hours

d

66 hours

10

Y-90 decays by?

a

B-decay

b

EC

c

Annihilation reaction

d

B+ decay

11

Y-90 has different doses depending on lab levels.

a

True

b

False

12

If platelet counts are between _ and __ the dose should be?

a

150,000; 0.3 mCi

b

100,000-149000; 0.4 mCi

c

100,000-149000; 0.3 mCi

d

150,000; 0.4 mCi

13

If platelet counts are less than _________ the dose should be?

a

>150,000; 0.4 mCi

b

100,000-149000; 0.4 mCi

c

100,000-149000; 0.3 mCi

d

<150,000; 0.3 mCi

14

Max dose should not exceed _____ for Y-90 therapy.

a

32 uCi

b

20-30 mCi

c

5-10 mCi

d

0.032 Curie

15

Day 1 of Y-90 therapy; ???

a

Give IV rituximab (do not bolus), which is cold antibody; this blocks CD20 sites in peripheral circulation and RES uptake; pretreat with acetaminophen and diphenhydramine for fever/chills

b

Prep patient by drawing injection markers on the skill just about center on each tumor site.

c

Give 2nd infusion IV cold rituimab; within 4 hours: the give therapeutic dose

d

Patient must discontinue taking Thyroid replacement hormones as it can cause artifacts within the scan

16

Day 7, 8, 9 of Y-90 therapy; ???

a

Give 2nd infusion IV cold rituimab; within 4 hours: the give therapeutic dose

b

Give IV rituximab (do not bolus), which is cold antibody; this blocks CD20 sites in peripheral circulation and RES uptake; pretreat with acetaminophen and diphenhydramine for fever/chills

c

Prep patient by drawing injection markers on the skill just about center on each tumor site.

d

Patient must discontinue taking Thyroid replacement hormones as it can cause artifacts within the scan

17

What is the Therapeutic dose of Y-90.

a

0.3 or 0.4 uCi/kg (<34) mCi

b

0.2 or 0.3 mCi/kg (<32) mCi

c

0.3 or 0.4 uCi/kg (<32) uCi

d

0.3 or 0.4 mCi/kg (<32) mCi

18

Y-90 is a ____ emitter.

a

Alpha

b

Gamma

c

Beta

d

Photometric effect.

19

What is the most common energy range for Y-90?

a

750-935 KeV

b

300-600 KeV

c

566-827 KeV

d

105-318 KeV

20

Which one of the side effects of Y-90 therapy is not a serious side effect?

a

Cytopenia

b

Thrombocytopenia

c

Asthenia

d

Secondary malignancies

e

Anemia

f

Lymphopenia

21

Which one of the side effects of Y-90 therapy is not a minor side effect?

a

Fatigue

b

Anemia

c

Nausea

d

Abdominal pain

e

Cough

f

Pyrexia

22

Thera-spheres are made of resin.

a

True

b

False

23

Thera-spheres are made of glass microspheres.

a

True

b

False

24

Sir-spheres are made of resin.

a

True

b

False

25

Sir-spheres are made of glass microspheres.

a

True

b

False

26

How much of all cancers ultimately spread to the liver.

a

1/2

b

1/4

c

1/3

d

3/4

27

Thera-spheres are used for the treatment of?

a

Lung nodules

b

Primary liver tumor

c

Adrenal adenoma

d

Unresectable liver Mets from colorectal cancer

28

Sir-spheres are used for the treatment of?

a

Lung nodules

b

Primary liver tumor

c

Adrenal adenoma

d

Unresectable liver Mets from colorectal cancer

29

What is the dose for Thera-spheres?

a

80-150 mCi

b

80-150 uCi

c

80-150 Gys

d

80-150 Rads

30

What is the dose for Sir-spheres

a

>50% liver involvement, 3 GBq

b

25-50% liver involvement, 2.5 GBq

c

<25% liver involvement, 2 GBq

d

<50% liver involvement, 3 GBq

e

None of these

f

>50% liver involvement, 3 GBq, 25-50% liver involvement, 2.5 GBq,<25% liver involvement, 2 GBq

31

Prior to the administration of Y-90 labeled Glass microspheres, the patient should undergo?

a

Hepatic arterial catherization

b

V/Q scan

c

GE study

d

Bone scan

32

Y-90 labeled Glass microspheres is contradicted in patients with?

a

Tc99m MAA deposition to the GI tract

b

Shunting of blood to the lungs that could lead to greater than 16.5 mCi of yttrium-90 to the lungs.

c

COPD

d

Heart failure

e

Tc99m MAA deposition to the GI tract, Shunting of blood to the lungs that could lead to greater than 16.5 mCi of yttrium-90 to the lungs.

33

When doing the pre-Y-90 what is the dose?

a

2-4 mCi Tc99m DTPA

b

5-10 mCi Tc99m Mebrofenin

c

5-10 mCi Tc99m MAA

d

2-4 mCi Tc99m MAA

34

Y-90 Glass microspheres uses MAA to determine the extent of A-V shunting to the lungs and to confirm the absence of?

a

Duodenal flow

b

Gastric flow

c

Pooling in the cardiac ventricles

d

In the ureters of the kidneys

e

Duodenal flow and Gastric flow

35

When is radiation pneumonitis seen in patients?

a

Pts receiving dose greater than 30 Gy in a single treatment

b

Pts receiving dose greater than 60 Gy in a single treatment

c

Pts receiving dose greater than 20 Gy in a single treatment

d

Pts receiving dose greater than 30 mCi in a single treatment

e

Pts who already have pneumonia before receiving treatment

36

Microspheres are trapped into liver tumors by embolizing small arterial vessels; use hepatic artery for infusion.

a

True

b

False

37

We cannot take pictures using Y-90 spheres.

a

True

b

False

38

When are Sir-spheres contradicted?

a

All of these

b

Had previous external beam radiation therapy to the liver.

c

Ascites or are in clinical liver failure

d

Markedly abnormal synthetic and excretory liver function tests

e

20% lung shunting of the hepatic artery blood flow, or >30Gy RAD to the lungs, as estimated by MAA scan

39

I-125 half-life is?

a

64 days

b

59.6 days

c

13.2 hours

d

8 days

40

Which of the following statements about I-125 is true?

a

Decays by EC, 27.4 and 31 keV x-rays and a 35.5 keV gamma.

b

Decays by EC, 27.4 and 31 keV gamma rays and a 35.5 keV x-ray.

c

Decays by B-, 27.4 and 31 keV x-rays and a 35.5 keV gamma.

d

Decays by EC, 27.4 keV x-ray and a 35.5 keV gamma.

41

I-125 implant seeds are used for?

a

Permanent interstitial treatment of selected localized tumors.

b

Castrate resistant Prostate cancer

c

Primary liver tumor

d

Unresectable liver mets from colorectal cancer

42

Implants may be used in ?

a

Head

b

Neck

c

Lung

d

Pancreas

e

Early stage prostate

f

All of these

43

Implants are administered?

a

Superficial

b

Intra-abdominal

c

Intra thoracic

d

All these locations

e

None of these locations

44

Seeds do not have to be sterile.

a

True

b

False

45

Seeds are strictly controlled and are stored in a cabinet in the hot lab.

a

True

b

False

Feedback

7

NHL

37

Bremsstrahlung radiation can be used to form a crude picture of Y-90 liver distribution by SPECT.

44

They start non sterile but for administration they have to be sterilized.

45

False they are stored in a hot lab but in a locked safe.

Infection, Tumor imaging, and Therapy study quiz (3/4)

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