Nuclear Medicine Quiz

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Quiz on Nuclear Medicine

1. Purpose of radioimmune assay is all, except :
(1) Detection of target protein
(2) Quantification of drug levels in blood
(3) Detection of malignant cells
(4) Quantification of hormone levels

2. Platelet survival study can be done following radioisotope/s :
(1) Chromium-51 sodium chromate
(2) Indium-111 oxine
(3) Both (1) & (2)
(4) lodine-125

3. What is the normal Ⴀ1/2, of Cr-51 labelled red blood cells ?
(1) 28 days
(2) 40 days
(3) 9 days
(4) 14 days

4. Chromium-51 is used for assessment of
(1) RBC survival study
(2) Plasma volume estimation
(3) Detection of E-pylori infection
(4) Both (1) & (2)

5. What is the biological basis for peptide receptor radionuclide therapy in Neuroendocrine tumors ?
(1) SSTR 2-mediated internalization and intracellular retention of the radiopeptide
(2) SSRT 3-mediated internalization and intracellular retention of the radiopeptide
(3) Binding with SSTR 2 without internationalization and intracellular retention of the radiopeptide
(4) Binding with SSTR 3 without internalization and intracellular retention of the radiopeptide

6. Binding of certain antibody to an antigen involves
(1) Concentration and localization
(2) Enhanced affinity and low avidity
(3) Enhanced avidity and low affinity
(4) Enhanced affinity and avidity

7. Ideal properties for therapeutic radionuclide are all, EXCEPT :
(1) high absorbed dose rate
(2) low non-penetrating equilibrium does constant
(3) high target to non-target ratio
(4) high specific activity

8. False statement about bone pain palliation therapy with radionuclide is
(1) Patient should have life expectancy of at-least 3 months.
(2) Preferable to delay bone pain palliation therapy for 2-3 months post large field radiotherapy.
(3) Bisphosphonates can be used concomitantly.
(4) Pain relief start early with Sr89 chloride compared to Sm-153-EDTMP.

9. Which of the following its contraindication for bone pain palliation therapy with radionuclide ?
(1) Hemoglobin 100 g/L
(2) Platelets counts < 90 x 109/L
(3) WBC counts 5 x 107/L
(4) Metastatic bone marrow involvement

10. What is true about relation of LET, OER and RBE ?
(1) OER decreases with increase in LET.
(2) RBI decreases with increases in LET.
(3) Both OER and RBE increases with LET.
(4) Both OER and RBE decreases with LET.

11. Amifostine is a
(1) Radio protector
(2) Radiation sensitizer
(3) Radiation modifier
(4) No effect on radiation effects.

12. ________ is added to reduce the volatile nature of Na131I
(1) Sodium bicarbonate
(2) Sodium triphosphate
(3) Sodium polyphosphate
(4) Sodium thiosulphate

13. What is the estimated cancer risk per Sievert for radiation worker after acute radiation exposure ?
(1) 10%
(2) 8%
(3) 5%
(4) 4%

14. A medical physicist working in the department of Nuclear Medicine observed that his TLD badge readings for the given monitoring period is 8 mSv. He is apprehensive about his readings. What is the most appropriate action required in this situation ?
(1) Report RSO and AERB about the overexposure
(2) Report RSO and AERB about the overexposure and perform chromosome aberration test.
(3) Report the incidence to AERB and refrain him from working in radiation working area.
(4) No active intervention required. Monitor exposure readings for rest of the year. Ask him to practice ALARA principle strictly.

15. What is the radiation unit used to represent deterministic effect for radiation ?
(1) Gray
(2) Sievert
(3) Barendsen
(4) Roentgen

16. Which dose response model is used to determine stochastic effects by regulatory body ?
(1) Linear no threshold
(2) Linear quadratic dose response
(3) Linear threshold model
(4) Both (1) & (2)

17. The radiation exposure rate a distance of 12 inches from radioactive source is 12.5 mR/h. How many feet away should the technologist stand to reduce the exposure level to 3.0 mR/h ?
(1) 2 ft.
(2) 4.2 ft.
(3) 24.5 ft.
(4) 60 ft.

18. In Nuclear Medicine Physician wants to plan an isolation ward with facility for 2 patients. According to area available maximum single isolation room of size of 3 x 5 sq. metres is possible. For a maximum dose of 250 mCi 131, what should be the minimum thickness of concrete wall for this isolation room according to ALRB guidelines ?
(1) 20cm
(2) 9cm
(3) 14cm
(4) 30cm

19. According to AERB guidelines, what should be the capacity of delay tank for effective collection and storage of efficient waste in high dose radioisotope therapy isolation ward with facility for 2 patients ?
(1) Dual delay tank system with capacity of 3000 litres each
(2) Dual delay tank system with capacity of 6000 litres each
(3) Single delay tank system with capacity of 6000 litres
(4) Dual delay tank system with total capacity of 6000 litres.

20. According to AERB, what should be the I-131 concentration in the effluent waste at the time of discharge into public sewerage system ?
(1) <0.6 µC/L
(2) <0.06 µC/L
(3) <0.7 µC/L
(4) <0.07 µC/L

21. During administration of Sm-153 EDTMP for metastatic carcinoma prostate patient, physician noticed extravasation. What should be the immediate action ?
(1) No intervention required continue remaining infusion.
(2) Terminate the procedure and reschedule the patient.
(3) Stop the administration and try to withdrawn radiopharmaceutical as much as possible.
(4) Inject another radiopharmaceutical dose.

22. According to AERB guidelines, what is the maximum exposure limit for the radiation worker in the given monitoring period ?
(1) 10 mSv
(2) 20 mSv
(3) 30 mSv
(4) 8mSv

23. Radiation safety officer after wipe test from fume hood founds a reading of 32 Bq/cm2. What is correct statement regarding above situation ?
(1) ALARA principles are not followed in the laboratory practices properly.
(2) Report the incidence to regulatory body immediately.
(3) Reading is well within the prescribed limits of contamination for given area.
(4) Seal the area for 24 hours.

24. Determine the transmission factor of an allenuating material that reduced the count rate from 1600kct to 400kct ?
(1) 0.55
(2) 0.45
(3) 0.25
(4) 0.35

25. Selumetinib is a
(1) MEK inhibitor
(2) DNA methylase inhibitor
(3) PPAR-gamma Agonists
(4) Demethylation and histone Deacetylase inhibitor

26. Which of the following bone pain palliation agent showed improvement in overall survival ?
(1) Ra-223
(2) Sm-153
(3) Sr-89
(4) Leu-177 EDTMP

27. Ra-223 has a half-life of
(1) 10.4 days
(2) 11.4 days
(3) 12.4 days
(4) 13.4 days

28. Which of the following radionuclides can be used in radioactive patches for skin therapies ?
(1) P-32
(2) Y-90
(3) Re-188
(4) Leu-177

29. Incorrect statement about Nephrotoxicity with Leu-177/Y-90 PRRT therapy for NET.
(1) It is due to glomerular filtration, reabsorption and retention of small sized radiopeptides in proximal tubules.
(2) It is more common with Leu-177 than Yttrium 90 therapy.
(3) Positively charged molecules L-lysine and/or L-arginine competitively inhibit the proximal tubular reabsorption of the radiopeptide.
(4) 4% succinylated gelatine infusion helps in inhibiting proximal tubular resorption of radiopeptides.

30. Which of the following is not a theragnostic radionuclide ?
(1) Copper 67
(2) Scandium 87
(3) Samarium 153
(4) Zirconium 89

31. Which is not the indication for radiosynoviorthesis ?
(1) Rheumatoid Arthritis (RA)
(2) Seronegative spondyloarthropathy
(3) Haemophilic arthritis
(4) Osteoarthrosis

32. Which method/s are useful for dosimetry after Yttrium-90 therapy of neuroendocrine tumors ?
(1) Bremsstrahlung imaging
(2) Imaging with Yttrium 86
(3) Both (1) & (2)
(4) Gamma ray imaging

33. What are the advantages of radiosynoviorthesis for haemophilic arthritis ?
(1) Reduces the requirement of clotting factor replacement
(2) It can be done in severely unstable joints.
(3) Prevents joint deformity
(4) Less Factor VIII or LX requirement

34. I-131 tositumomab (Bexxar) is radiommune therapy directed against the
(1) CD20 antigen
(2) CD37 antigen
(3) CD19 antigen
(4) CD22 antigen

35. Cu-64 produced in cyclotron by following reaction :
(1) (n, p)
(2) (2n, p)
(3) (3n, p)
(4) (2d, n)

36. A 60 years old male patient with castrate resistant prostate cancer underwent Ga68 PSMA PET CT scan, which showed multiple PSMA avid metastases to liver, retroperitoneal & pelvic lymph nodes and skeletal sites. PSA levels > 600ng/ml. What should be the best possible treatment option for this patient ?
(1) Radium-233 therapy
(2) Lutetium-177 PSMA therapy
(3) Lutetium-177 EDTA therapy
(4) None of these

37. 35 years old male patient was diagnosed with rhematoid arthritis of metacarcophalangeal joint. Which is the ideal radionuclide for radiosynoviorthesis ?
(1) Yttrium 90
(2) Erbium 169
(3) Rhenium 188
(4) Rhenium 186

38. A 56 years old female patient presented with neck swelling since 2 yrs. NAC suggestive of papillary carcinoma thyroid. She underwent total thyroidectomy and neck dissection. Final histopathology showed 4.3 cm tumor confined to right lobe of thyroid with 4/6 N1 group of lymph nodes showing metastatic deposits. I-131 whole body scan did not show any distant metastasis. What will be the staging according to AJCC 8?
(1) Stage I
(2) Stage II
(3) Stage III
(4) Stage IV

39. According to AJCC 8; the cut off age for staging well differentiated Thyroid cancer is
(1) 35 years
(2) 45 years
(3) 55 years
(4) 60 years

40. NETTER I trials is related to which of the following ?
(1) Metastatic Prostate carcinoma
(2) Midgut NET
(3) Undifferentiated Thyroid cancer
(4) Bone pain palliation

41. According to latest ATA guidelines, minimum dose required for thyroid remnant ablation post total thyroidectomy in a patient with thyroid carcinoma is —
(1) 40 mCi
(2) 30 mCi
(3) 20 mCi
(4) 50 mCi

42. Redifferentiation therapy for thyroid cancer includes all of the following, EXCEPT :
(1) Retinoic acid
(2) Radiotherapy
(3) Satins
(4) Sorafenib

43. False statement regarding Sm-153 EDTMFP is
(1) Maximum beta particles energy is 0.8 MeV.
(2) Skeletal uptake is upto 48% of administered radioactivity.
(3) Pain relief starts earlier compared to Sr89 chloride.
(4) Emits gamma rays of 113 keV.

44. Terbium-161 :
(1) Alpha emitter
(2) Emits both beta and gamma radiation
(3) Emits low-energy conversion and Auger electrons
(4) Both (2) & (3)

45. All the following radiopharmaceuticals can be used for evaluation of metastatic medullary carcinoma, except :
(1) I-131 MIBG
(2) I-131 antiFFP antibody
(3) F-18 FDG
(4) In-111 octreotide