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47 Cards in this Set
- Front
- Back
- 3rd side (hint)
Which of the following is a malignant bone disease?
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Paget's Disease
Ewing's Disease osteomyelitis osteoid osteoma |
Ewing's Disease
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A three phase bone scan is often referred to differentiate
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osteoporosis vs. cellulitis
osteomyelitis vs. diskitis osteomyelitis vs. cellulitis osteoporosis vs. septic arthritis |
osteomyelitis vs. cellulitis
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The presence of gastric and thyroid activity on a bone scan signals the presence of
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metastatic disease
free pertechnetate radionucloide impurity reducing agent |
free pertechnetate
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What is the purpose of the reducing agent in a 99Tc disphosphonate kit?
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to oxidize technetium
to lower the valence state of technetium to improve the tag efficiency |
both b & c
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What is the dose of 99mTc-MDP most often for a planar bone scan?
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1-3 mCi
5-10mCi 10-30mCi 30-35mCi |
10-30mCi
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Which of the following is least likely to cause an artifact on a bone scan?
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snap on trousers
colostomy bag skin contaminated by urine injection site |
colostomy bag
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What is not an indication for a bone scan?
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metastatic disease
osteoporosis cellulitis avascular necrosis |
osteoporosis
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The presence of free pertechnetate on a bone scan may be the result of
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-using a radiopharmaceutical which was prepared too long ago
-introduction of air into the kit vial while adding technetium -increased blood flow to the bones |
both a & b
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What is the purpose of hydration and voiding after an injection for a bone scan?
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- to block the update of unlabeled technetium by the stomach
- to reduce the possibility of urine contamination - to obtain a superscan - to reduce the radiation dose to the bladder |
to reduce the radiation dose to the bladder
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What could be the cause of generalized, diffuse activity in the abdomen on a bone scan?
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free Tc
malignant ascities pacemaker bone cyst |
malignant ascities
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What timing protocol best describes a 4 phase bone scan?
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during injection, immediately following injection, 2-4 hours after, and 18-24 hours
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A focal hot spot near the left femur shows up on a bone scan. What is/are the best ways to proceed?
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-change to pinhole collimator and image
- perform SPECT imaging - have patient remove clothing from that area - ask patient to wash the skin in that area with soap and water |
both c & d
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A bone scan showing relatively uniformly increased skeletal uptake of the radiopharmaceutical with almost absent renal and bladder activity is usually
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flare phenomenon
superscan renal failure suprascan |
superscan
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The glove phenomenon is usally the result of
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reactive arthritis
intravenous injection arterial injection subcutaneous injection |
arterial injection
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What are common sites of bony metastasis?
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pelvis
spine ribs all of the above |
all of the above = pelvis, ribs and spine
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What is the purpose of a stannous ion in a diphosphonate kit?
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- act as a reducing agent
- act as an oxidizing agent - provide stabilizing force - maintain particle size |
Act as a reducing agent
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appendicular skeleton
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lower
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Axial skeleton
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upper
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The appendicular skeleton includes the following bones except?
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the femurs
the skull the phalanges the radius |
the skull
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The axial skeleton contains
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the ribs
the skull the vertebral column all of the above a,b,c only |
a,b,c, only
the ribs the skull the vertebral column |
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By what mechanism do diphosphonates localize in the bone?
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capillary blockade
active transport ion exchange phagocytosis |
ion exchange
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epiphyseal plates
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The epiphyseal plate (or epiphysial plate, physis, or growth plate) is a hyaline cartilage plate in the metaphysis at each end of a long bone. The plate is found in children and adolescents; in adults, who have stopped growing, the plate is replaced by an epiphyseal line.
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|
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Which of the following describes a pediatric bone scan?
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- increased uptake in long bones
- decreased uptake along the epiphyeal plates - increased uptake along the epiphyseal plates - overall decreased uptake in bone |
increased uptake along the epiphyseal plates
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The first phase of a three phase bone scan is best performed by
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-bolus injection, followed by dynamic 2 second images for 60 seconds
- bolus injection followed by dynamic 20 second images for 3 minutes -bolus injection followed by a static 500-600k count image - bolus injection followed by dynamic 1 second images for 30 seconds |
bolus injection, followed by dynamic 2 second images for 60 seconds
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What radiopharmaceuticals may be used for bone marrow imaging:
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99mTc albumin colloid
99mTc sulfur colloid 99mTc PYP |
a & b
99mTc albumin colloid 99mTc sulfur colloid |
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Splenic uptake on a bone scan is often associated with
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liver failure
sickle cell disease splenic abscess Paget's Disease |
sickle cell disease
|
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Bone is made up of
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hydrogen peroxide
hydroxyapatite mineral collagen |
b & c only
hydroxyapatite mineral collagen |
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Osteoblastic activity refers to
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-bone marrow biopsy
- destruction and re-absorption of bone - bone compression - new bone formation |
new bone formation
|
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Osteoclastic activity refers to
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-bone marrow biopsy
- destruction and re-absorption of bone - bone compression - new bone formation |
destruction and re-absorption of bone
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What is often used in imaging suspected avascular necrosis of the hip
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- SPECT imaging
- PET imaging - pinhole collimator - diverging collimator both a & c |
pinhole collimator
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The function of the skeleton is
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- to provide support
- to protect organs - production of blood cells - all of the above |
- all of the above
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Which group shows the highest rate of primary bone tumors?
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-the elderly
- children - males - females |
children
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The radiation dose from a bone scan is highest to the
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bone marrow
chest bladder brain |
bladder
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When performing a bolus injection for a 3-phase bone scan, why would the tourniquet be released and injection delayed for one minute?
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- to minimize pain during injection
- to reduce transient hyperemia resulting from vasodilation - to double check dynamic sequence - to obtain a better bolus |
to reduce transient hypermia resulting from vasiodilation
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32
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page 55
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Which of the following is not in the pelvis?
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the ileum
the ischium the iridium none of the above |
the iridium
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Which of the following would be a reason not to inject in the right antecubital fossa?
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- the patient had blood drawn from the back of the right hand that same day
- the patient was injected on the right for a previous bone scan - there is a suspicion of osseous abnormality in the right distal humerus - the patient is left handed |
there is a suspicion of osseous abnormality in the right distal humerus
|
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The preparation for a bone scan is
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NPO from midnight
cleansing edema patient must be off thyroid medication 4 weeks none of the above |
none of the above
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Metastaases usually affects the axial skeleton before the appendicular skeleton?
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true
false |
true
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The mechanism of localization for bone marrow scanning is
|
active transport
ion exchange phagocytosis capillary blockade |
phagocytosis
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A large amount of diffuse soft tissue activity present on a bone scan at 4 hours means
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- increased cardiac output
- renal insufficiency -metastatic disease -infection |
renal insufficiency
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What imaging agent can be used for the skeleton as well as myocardial infarction?
|
MDP
HDP PYP TL Chloride |
PYP
|
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Rib fractures often show up as
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-multiple, focal hot spots located in consecutive ribs
- a linear distribution along the axis of the rib - diffuse activity in the chest cavity - cold spots |
-multiple, focal hot spots located in consecutive ribs
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The advantage of bone scanning over plain radiography
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- bone must lose only a minimum of calcium content before lesions are visible on bone scintigraphy
- time - efficient for multifocal trauma such as child abuse none of the above |
efficient for multifocal trauma such as child abuse
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number 42
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page 58
|
|
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Bone Marrow imaging
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sulfur or albumin colloid particles are phagocytized by the reticuloendothelial cells in the bone marrow
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Rib fractures are often found in consecutive ribs
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Bone metastasis is more likely to appear as linear uptake along the rib
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