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MCQ on Nuclear Medicine
1. Macromolecules in comparison to colloids have
(1) Slower clearance via lymphatics
(2) Are not used for lymphoscintigraphy
(3) Same clearance rate as colloids
(4) Faster clearance via lymphatics
2. Specific activity is
(1) Radioactivity per unit mass
(2) Radioactivity per unit volume
(3) Radioactivity per unit time
(4) None of these
3. Choose incorrect statement about Tc-99m — Ubiquicidin.
(1) It is synthetic antimicrobial peptide fragment.
(2) It can differentiate between sterile inflammation and infection
(3) It can detect both gram positive and gram negative bacterial infection
(4) It is not useful in detection of fungal infection
4. When the half-life of daughter radionuclide is higher than parents it is
(1) Transient equilibrium
(2) Secular equilibrium
(3) There is no equilibrium.
(4) None of these
5. What is the oxidation state of chemical form of 79mTcO4, eluted from a generator ?
6. Radiopharmaceuticals with technetium 99m odixation state 7 is
(1) Tc-99m-macroaggergated albumin
(2) Tc-99m-sulphur collide
7. Choose what is correct about Thallium 201.
(1) Predominantly emits 167 keV gamma rays
(2) Decays by internal conversion
(3) Excreted predominantly through hepatobiliary system
(4) Half-life is 68 hours.
8. IMP is a
(1) Renal agent
(2) Brain agent
(3) Hepatobiliary agent
(4) Cardiac agent
9. Which of the following drugs does not interfere with MIBG uptake ?
(1) Beta blockers
(3) Tricyclic antidepressants
(4) Calcium channel blockers
10. What is incorrect about Tc-99m Mebrofenin ?
(1) It is bromotriethyl iminodiacetic acid.
(2) It has hepatic extraction of 98% and biological half-life of 25 minutes.
(3) < 1% is excreted by kidney.
(4) Bilirubin levels upto 20-30 mg/dl doesn’t interfere with hepatic uptake.
11. Which of the following is false regarding optimal Imaging time for Infection-Seeking Radiopharmaceuticals ?
(1) Ga-67:48 hr
(2) In-111 leulocytes : 24 hr
(3) Technetium-9m HMPAO leukocyte 1-4 hr
(4) Antigranulocyte monoclonal antibodies : 24 hr
12. What would be the correct scintigraphy description for AVN on bone marrow scan and Tc-99m MDP bone scan ?
(1) Hypoactivity on bone marrow scan in area of hypoactivity on bone scan consistent with chronic/reparative phase AVN.
(2) Hyperactivity on bone marrow scan in area of hyperactivity on bone scan consistent with chronic/reparative phase AVN.
(3) Hypoactivity on bone marrow scan in area of hyperactivity on bone scan consistent with chronic/reparative phase AVN.
(4) Hyperactivity on bone marrow scan in area of hypoactivity on bone scan consistent with chronic/reparative phase AVN.
13. In hypertrophic osteoarthropathy, all of the following statement are true, except :
(1) There is periosteal reaction of long bones of extremities.
(2) It involves diaphysis and metadiaphysis.
(3) It is consequence of underlying bone metastasis.
(4) It shows tram track appearance in long bones on Tc-99m-MDP bone scan.
14. A 35 years old male patient presented with pain in abdomen, lethargy and generalized bodyache. His abdomen ultrasound showed bilateral renal calculi. His calcium was 11.6 mg/dl, TSH-1.2 µlU/ml and PTH was 73 ng/ml, what Nuclear Medicine procedure could be considered in this patient for further evaluation ?
(1) Tc-99m Thyroid scan
(2) Parathyroid scan with Tc-99m Sestamibi scan
(3) Tc-99m DTPA renal dynamic study
(4) Tc-99m Bone scane
15. Tc-99m MDP Bone scan has limited sensitivity for detection of skeletal metastasis form which of the following malignancy ?
(1) Thyroid cancer
(2) Breast cancer
(3) Prostate cancer
(4) Lung cancer
16. A 49 years old female patient underwent renal transplantation. On day 5 post transplantation her Tc-99m-DIPA dynamic renal study showed normal perfusion, cortical radiotracer uptake and clearance. On Day 11, she presented with raised creatinine levels and decrease in urine output. She was again referred for Tc-99m-DTPA study. It showed preserved perfusion with delayed cortical uptake and clearance. What could be the likely possibility ?
(1) Acute rejection
(3) Cyclosporine toxicity
(4) Cortical necrosis
17. A 56 years old male patient presented with neck swelling. Ile was diagnosed as carcinoma thyroid. His preoperative evaluation with ECG showed wide QRS complex, absence of Q wave in lateral leads, dominant S wave in VI and notched R wave in V6. His surgeon wants cardiac clearance before the surgery. Which myocardial Stress study he should undergo ?
(1) Myocardial perfusion study with dobutamine stress
(2) Myocardial perfusion study with Adenosine stress
(3) Myocardial perfusion with exercise stress test
(4) Patient not suitable for stress test
18. Which of the following is TRUE about the pattern of Glucose metabolism in different types of Dementia ?
(1) Alzheimer’s disease involves hypermetabolims in temporal and posterior parietal lobes.
(2) Limbic system metabolism is preserved in Alzheimer’s disease.
(3) Lewy body dementia shows hypometabolism in occipital cortex plus temporal and parietal cerebral cortex and the posterior cingulate cortex.
(4) The precentral gyrus and occipital lobe is typically spared in Alzheimer’s disease.
19. Idiopathic Parkinson’s disease initially involves
(2) Pre-central gyrus
(3) Hippocampus Caudate nucleus
20. All of the following are TRUE about captopril renogram study, EXCEPT –
(1) It is indicated for patients with hypertension resistant to medical therapy, abrupt or recent onset hypertension and if onset of hypertension under the age of 30 years.
(2) In adults, Captopril 25-50 mg is administered orally 1 hr before the study.
(3) Primary finding in renovascular hypertension MAG3 captopril study is slower uptake and delayed peak.
(4) Decreases in GFR by > 10% over baseline study in considered high probability for renovascular hypertension.
21. A 45 years old hypertensive man with history of 20 pack years of smoking, presents with frequent episodes of chest pain. Resting ECG during his visit. to office appears normal. Treadmill shows mild ST-T changes during fourth stage at 12 mets. His cholesterol and triglycerides are elevated and is on statins. Ile was put on secondary preventive measures for hypertension and lifestyle modification regimen. He comes back to OPD with similar complaints. Which of the following non-invasive imaging modalities would be ideal to investigate his chest pain ?
(1) Ammonia PET and CFR estimation
(2) FDG PET-CT and viability assessment
(3) Stress FDG
(4) 1231 BMIPP imaging and resting perfusion imaging
22. Thyroid nodule in Marine-Lenhart syndrome is
(2) Responsive to TSH but not TSI
(3) Responsive to TSI not TSH
(4) Not responsive to either
23. Choose the correct statement for Dopamine transporter imaging.
(1) It can differentiate IPD from Parkinson plus syndromes.
(2) It can differentiate Parkinsons from essential tremor.
(3) It can differentiate between Parkinonian plus syndromes.
(4) It can differentiate vascular from drug induced Parkinsons.
24. Tissue SUV in obese patients is
(3) No relation to weight
(4) Depends on height
25. In multigated acquisition study, Ejection fraction is given by
(1) (End diastolic — End systolic volume) / End diastolic volume
(2) (End systolic — End diastolic volume) / End diastolic volume
(3) (End diastolic -— End systolic volume) / End systolic volume
(4) (End systolic — End diastolic volume) / End diastolic volume
26. Cardiac PET quantification of Myocardial Blood Flow (MBF) and Coronary Flow Reserve (CFR) may be useful for detection and evaluation of all of the following, EXCLPT :
(1) left ventricle ejection fraction
(2) Balanced ischemia on qualitative images
(3) Evaluation of collateral flow
(4) Identification of endothelial dysfunction
27. According to the PERCIST — PET Response Criteria in Solid Tumors criteria for treatment response evaluation, the changes in SUVs should be assessed as :
(1) Percentage change in the same lesion
(2) Percentage change in the “hottest” lesion
(3) Value change in the same lesion
(4) Value change in the “hottest” lesion
28. The tumor’s Total Glycolytic Volume (TGV) is defined as :
(1) SUV x Injected activity
(2) SUV x Tumor volume
(3) Tumor volume x Glucose level
(4) Injected activity x Glucose level
29. Dementia with Lewy Bodies (DLB) has pattern of FDG uptake similar to that present in patients with Alzheimer’s Disease (AD) but in addition it also involves :
(1) The frontal lobe
(2) The occipital lobe
(3) The cerebellum
(4) The basal ganglia
30. All of the following passes through NAI symporter except ?
31. First step in the ischemic cascade is
(1) Flow heterogeneity
(2) Metabolic shift
(3) Diastolic dysfunction
(4) Wall motion abnormality
32. Diastolic dysfunction is evaluated in all, except :
(2) gates SPECT MPS
(3) First pass duty
(4) Gates stress FDG MPS
33. All are true ischemic memory zone, except :
(1) Normal perfusion
(2) Hot spot on FDG
(3) Cold spot on BMIPP
(4) Hot spot on BMIPP
34. What is the accurate description for ATN in renal transplant evaluation with Tc-99m EC renography ?
(1) Poor perfusion, slow but good uptake, slow progressive excretion
(2) Poor perfusion, poor uptake, slow progressive excretion
(3) Good perfusion, slow but good uptake, little or no excretion
(4) Good perfusion, good uptake, little or no excretion
35. GI bleeding study using Tc-99m labeled RBC
(1) Less sensitive than CT angiography
(2) Can detect intermittent GI bleed
(3) Minimum bleeding rate is 1ml/minute for detection of Tc-99m labeled RBC scintigraphy
(4) Tc-99m labeled RBC scintigraphy can locate exact bleeding site
36. What is true about Meckel’s diverticulum ?
(1) Most Meckel’s diverticula become symptomatic during adolescence.
(2) Gastric mucosa is found in approximately 50% Meckel’s diverticulum.
(3) More than 90% bleeding Meckel’s diverticula shows ectopic gastric mucosa.
(4) Patient preparation with potassium perchlorate is required before 99m-pertechnatate study.
37. All of the following malignant tumors has less sensitivity on F-18-FDG PET-CT, EXCEPT :
(1) Primary cutaneous T cell lymphoma
(2) NSCLC Bronchioloalveolar carcinoma
(3) Low grade carcinoma prostate
(4) Neuroendocrine carcinoma
38. A 60 years old male patient was found to have spiculated solid pulmonary nodule of size 9 mm in might lung upper lobe on contrast enhanced CT scan. He gives history of smoking for 10 years. His father died due to carcinoma lung. He is apprehensive about this nodules. According to Fleischner Society guidelines, what should be further plan of management in this patient ?
(1) No intervention required
(2) F-18-FDG PET-CT
(3) CT scan thorax after 6 months
(4) CT scan thorax and MRI brain
39. 28 years old female patient diagnosed as DLBCL. She had involvement of mediastinal and cervical lymph nodes on baseline F-18 FDG PET-CT. She received 3 cycles of chemotherapy. Her interim F-18-FDG PET-CT showed intense FDG avid cervical and mediastinal lymph nodes (uptake 2-3 limes greater than liver uptake). However, corresponding CT images showed 50% reduction in SPD. There was no new lesions compared to : baseline F-18-FDG PET-CT. According to Lugano criteria, these PET-CT findings could be summarised as
(1) Partial response to treatment
(2) Stable disease
(3) Progressive disease
(4) Minimal response to treatment
40. False negative results with C-14 urea breath test can be seen with all, except :
(3) Proton pump inhibitors
41. Positive results with C-14 urea breathe test for H-pylori infection can be interpreted as
(1) >50 DPM at 10 minutes
(2) > 100 DPM at 10 minutes
(3) > 150 DPM at 10 minutes
(4) >200 DPM at 10 minutes
42. Choose best method for estimation of measured GFR.
(1) lodine-125 — lothalamate
(2) Cr-51-EDTA renal clearance
(3) Cr-51-EDTA plasma clearance
(4) DTPA renal clearance
43. 35 years male patient was diagnosed with megaloblastic anaemia. Which In-vitro Nuclear Medicine test could be useful in diagnosis of this clinical condition ?
(1) Co-57 labelled Vitamin B12
(2) Co-58 labelled Vitamin B12 plus Intrinsic factor
(3) Chromium-51-RBC survival study
(4) Both (1) and (2)
44. Radiosotope used for estimation of plasma volume is
45. Radioimmune assay was discovered by
(1) Chals & Wastone
(2) Berson & Yalow
(3) Vector & Logan
(4) Watson & Crick