Test: Cardiovascular quiz (3/3) (employee training


Cardiovascular quiz (3/3)Versión en línea Multiple choice por Joshua Liberty 1 During exercise the heart is displaced downward against the diaphragm as the thorax expands. During recovery, the heart "creeps" back up in the thorax leading to reversible defects in the inferoseptal wall. This is called? a Infarction b Ischemia c Attenuation d Upward creep 2 The ideal solution for upward creep is? a Patient should be NPO. b By processing study with a lower cutoff frequency, these artifacts maybe reduced. c By waiting 45-55 minutes after exercise, before beginning imaging, these artifacts may be reduced. d By waiting 10-15 minutes after exercise, before beginning imaging, these artifacts may be reduced. 3 Adenosine dosing is? a 0.80 mg/kg/minute for 5 minutes rphx is injected at 4 min mark b 0.4 mg/5 mL in a ready, prefilled syringe; 5 mL saline flush and then rphx 10-20 sec later. c 0.140 mg/kg/minute for 6 minutes; rphx is injected at 3 minute mark; or infuse 4 minutes, inject tracer at 2 minute. d 0.56 mg/kg over four minutes; rphx is injected at 3-5 minutes post infusion 4 Regadenoson dosing is? a 0.80 mg/kg/minute for 5 minutes rphx is injected at 4 min mark b 0.4 mg/5 mL in a ready, prefilled syringe; 5 mL saline flush and then rphx 10-20 sec later. c 0.140 mg/kg/minute for 6 minutes; rphx is injected at 3 minute mark d 0.56 mg/kg over four minutes; rphx is injected at 3-5 minutes post infusion 5 Dipyridamole dosing is? a 0.80 mg/kg/minute for 5 minutes rphx is injected at 4 min mark b 0.4 mg/5 mL in a ready, prefilled syringe; 5 mL saline flush and then rphx 10-20 sec later. c 0.140 mg/kg/minute for 6 minutes; rphx is injected at 3 minute mark d 0.56 mg/kg over four minutes or 142 ug/kg/minute over 4 minutes; rphx is injected at 3-5 minutes post infusion 6 Dobutamine dosing is? a 5-10 ug/kg/minute and increases every 3 minutes to 20, 30, 40 ug/kg/minute until 85% of max HR acheived; inject rphx at peak HR and continue stress infusion for 2 minutes after tracer injection. b 0.4 mg/5 mL in a ready, prefilled syringe; 5 mL saline flush and then rphx 10-20 sec later. c 0.140 mg/kg/minute for 6 minutes; rphx is injected at 3 minute mark d 0.56 mg/kg over four minutes or 142 ug/kg/minute over 4 minutes; rphx is injected at 3-5 minutes post infusion 7 The 1rst deflection is the ____ and represents depolarization of atrial muscle cells? a QRS complex b P wave c T wave d PR interval e ST segment 8 The ____ represents depolarization of ventricular muscle cells and triggers main pumping contraction. a QRS complex b P wave c T wave d PR interval e ST interval 9 ____ is a delay of AV node to allow filling of ventricles; this interval represents the time between the onset of atrial depolarization and the onset of ventricular depolarization. a QRS complex b P wave c ST segment d PR interval e ST interval 10 The ___ is the initial upward deflection in the _____. a QRS complex; T wave b Q portion; QRS complex c R portion; QRS complex d S portion; QRS complex 11 The assumption is that contraction will commence at the peak of the ____ of the complex. a T wave b Q portion c R portion d S portion 12 The assumption is that the SA node fires at the start of the ____ and atrial contraction begins at the peak of? a QRS complex; P wave b P wave; P wave c P wave; T wave d PR interval; QRS complex e ST segment; T wave 13 The duration of the QRS complex should not exceed? a 0.300 seconds b 0.62 seconds c 0.12 minutes d 0.12 seconds 14 Occaisionally an extra impulse is fired from within the ____ and creates a ____ QRS complex; this is called a _____? a Ventricle; wide; premature ventricular contraction (PVC) b Ventricle; narrow; premature ventricular contraction (PVC) c Ventricle; wide; ventricular tachycardia d Ventricle; wide; fibrillation 15 In patients with heart failure, ____ is an early mechanism to compensate for decreased myocardial function. a Cappilary compensation b Decreased respiration c Decreases in BP d Activation of the sympathetic nervous system 16 The concentration of ____ over several hours after injection of the agent is a potential marker of sympathetic neuronal activity and may correlate with the severity of heart failure. a Tc99m Tetrofosmin b Tc99m Sestamibi c 123-Iodine meta-iodobenzylgaunidine d Tl-201 17 Before administering I-123 MIBG for cardiac imaging, patient prep includes? a Blocking thyroid with 500 mg potassium perchlorate or 10 drops potassium iodide in water. b Patient should be NPO c Low glucose diet d Low carb diet 18 I-123 MIBG cardiac dose is usually? a 100-450 uCi b 20 mCi c 10 mCi d 100 uCi 19 A cardiac MIBG patient has a HMR of <1.4. This is? a Abnormal b Normal c Indicative that the test must be repeated d None of the above 20 Cardiac 90 mode is preferable because? a The study can be done faster. b Less GB would be seen on a sestamibi scan. c Less upward creep occurs. d Detectors are closer to the heart. 21 _____ artery supplies oxygen and nutrition to the interventricular septum and the anterior wall of the LV. a Right circumflex b Left circumflex c Left anterior descending (LAD) d Right coronary artery 22 The target HR is not reached on a dobutamine study with max dose. ____ should be used next. a Xanthine b Atropine c Caffeine d More dobutamine 23 A ______ is obtained by drawing ROIs over the mediastinum and myocardium in the ____ view in cardiac MIBG imaging. a Heart to mediastinum ratio (HMR); ANT b Heart to mediastinum ratio (HMR); POST c Heart to mediastinum ratio (HMR); LAO d Heart to mediastinum ratio (HMR); Lt LAT 24 N-13 ammonia is used for? a SPECT MPI b PET viability c PET perfusion d Adrenergic innervation in ischemic heart disease 25 Patient prep for a vasodilator MPI study includes? a Patient should be NPO at least 4 hours. b Avoid food or beverages containing caffeine for at least 12-24 hours. c Discontinue all xanthine type medications for 12 hours prior to the test. d All of these. 26 Regarding left to right cardiac shunts, which are true? a The 1rst pass study is best, as far as NM studies. b ROI analysis is done with ROI over a lung area. c Early pulmonary recirculation will show a variation in the normal curve. d The variation is a small 2nd peak proportional to the size of the shunt. e All of the above. 27 Tetrofosmin is being used for MPI: rest images are done __ min post injection, exercise stress imaging ______ min post injection, and pharmacological stress imaging ___ post injection. a 10-15; 30-45; 45 b 30-45; 10-15; 45 c 20; 30-40; 45 d 45-60; 15-20; 60 e 30-45; 10-15; 20 28 The best study to evaluate cardiotoxicity from chemotherapy is? a Sestamibi or Tetrofosmin MPI b N-13 ammonia c FDG PET d Multiple gated acquisition e I-123 MIBG study 29 RBC tagging is being done with in vitro method using Ultratag Kit: to vial containing Sn2+ compound, add 3-5 mL of anticoagulated blood; Incubate 15 minutes; add 25 mCi Tc99m pertechnetate; the next step is? a Add Citrate Buffer b Inject tagged RBC blood into patient c Incubate for 20 minutes d Add Na hypochlorite (NaCIO) to destroy extracellular Sn2+ ion 30 The best study to assess regional changes in myocardial adrenergic and cholinergic innervation in ischemic heart disease is a or an? a Sestamibi or Tetrofosmin MPI b N-13 ammonia cardiac study c FDG PET study d I-131 MIBG study e I-123 MIBG study f Tl-201 MPI study 31 Circular target regions of interest (ROI) are drawn over the heart on the planar images and are mirrored over the contralateral chest to account for background and ribs. Total and absolute mean counts are measured in each ROI. A heart to contralateral (H/CL) ratio is calculated as the fraction of heart ROI mean counts to contralateral chest ROI mean counts. The study being processed is? a Tc99m MPI b I-123 MIBG cardiac c MUGA d Rb-82 cardiac PET e Cardiac amyloidosis using Tc99m PYP 32 10 patients have a new NM scan; 2 patients have the disease the scan is supposed to detect; the scan shows the disease in 8 patients. The scan has? a Poor sensitivity b Good specificity c Good accuracy d Poor specificity 33 The best study to assess cardiac amyloidosis is? a Sestamibi or Tetrofosmin MPI b N-13 ammonia cardiac study c FDG PET study d Tc99m PYP study e I-123 MIBG study 34 The dose for cardiac amyloidosis imaging is? a Tc99m MAA; 5 mCi b Tc99m Tetrofosmin; 10-30 mCi c Tc99m PYP; dose = 10-20 mCi d I-123 MIBG; 5 mCi e Tc99m PYP; dose = 5-10 mCi 35 On an FDG Cardiac study, regions of decreased blood flow but increased uptake of FDG indicate? a Ischemic with cardiomyopathy b Ischemic without viable tissue c Ischemic but viable tissue d MI without viable tissue

1

During exercise the heart is displaced downward against the diaphragm as the thorax expands. During recovery, the heart "creeps" back up in the thorax leading to reversible defects in the inferoseptal wall. This is called?

a

Infarction

b

Ischemia

c

Attenuation

d

Upward creep

2

The ideal solution for upward creep is?

a

Patient should be NPO.

b

By processing study with a lower cutoff frequency, these artifacts maybe reduced.

c

By waiting 45-55 minutes after exercise, before beginning imaging, these artifacts may be reduced.

d

By waiting 10-15 minutes after exercise, before beginning imaging, these artifacts may be reduced.

3

Adenosine dosing is?

a

0.80 mg/kg/minute for 5 minutes rphx is injected at 4 min mark

b

0.4 mg/5 mL in a ready, prefilled syringe; 5 mL saline flush and then rphx 10-20 sec later.

c

0.140 mg/kg/minute for 6 minutes; rphx is injected at 3 minute mark; or infuse 4 minutes, inject tracer at 2 minute.

d

0.56 mg/kg over four minutes; rphx is injected at 3-5 minutes post infusion

4

Regadenoson dosing is?

a

0.80 mg/kg/minute for 5 minutes rphx is injected at 4 min mark

b

0.4 mg/5 mL in a ready, prefilled syringe; 5 mL saline flush and then rphx 10-20 sec later.

c

0.140 mg/kg/minute for 6 minutes; rphx is injected at 3 minute mark

d

0.56 mg/kg over four minutes; rphx is injected at 3-5 minutes post infusion

5

Dipyridamole dosing is?

a

0.80 mg/kg/minute for 5 minutes rphx is injected at 4 min mark

b

0.4 mg/5 mL in a ready, prefilled syringe; 5 mL saline flush and then rphx 10-20 sec later.

c

0.140 mg/kg/minute for 6 minutes; rphx is injected at 3 minute mark

d

0.56 mg/kg over four minutes or 142 ug/kg/minute over 4 minutes; rphx is injected at 3-5 minutes post infusion

6

Dobutamine dosing is?

a

5-10 ug/kg/minute and increases every 3 minutes to 20, 30, 40 ug/kg/minute until 85% of max HR acheived; inject rphx at peak HR and continue stress infusion for 2 minutes after tracer injection.

b

0.4 mg/5 mL in a ready, prefilled syringe; 5 mL saline flush and then rphx 10-20 sec later.

c

0.140 mg/kg/minute for 6 minutes; rphx is injected at 3 minute mark

d

0.56 mg/kg over four minutes or 142 ug/kg/minute over 4 minutes; rphx is injected at 3-5 minutes post infusion

7

The 1rst deflection is the ____ and represents depolarization of atrial muscle cells?

a

QRS complex

b

P wave

c

T wave

d

PR interval

e

ST segment

8

The ____ represents depolarization of ventricular muscle cells and triggers main pumping contraction.

a

QRS complex

b

P wave

c

T wave

d

PR interval

e

ST interval

9

____ is a delay of AV node to allow filling of ventricles; this interval represents the time between the onset of atrial depolarization and the onset of ventricular depolarization.

a

QRS complex

b

P wave

c

ST segment

d

PR interval

e

ST interval

10

The _ is the initial upward deflection in the ___.

a

QRS complex; T wave

b

Q portion; QRS complex

c

R portion; QRS complex

d

S portion; QRS complex

11

The assumption is that contraction will commence at the peak of the ____ of the complex.

a

T wave

b

Q portion

c

R portion

d

S portion

12

The assumption is that the SA node fires at the start of the ____ and atrial contraction begins at the peak of?

a

QRS complex; P wave

b

P wave; P wave

c

P wave; T wave

d

PR interval; QRS complex

e

ST segment; T wave

13

The duration of the QRS complex should not exceed?

a

0.300 seconds

b

0.62 seconds

c

0.12 minutes

d

0.12 seconds

14

Occaisionally an extra impulse is fired from within the and creates a QRS complex; this is called a _?

a

Ventricle; wide; premature ventricular contraction (PVC)

b

Ventricle; narrow; premature ventricular contraction (PVC)

c

Ventricle; wide; ventricular tachycardia

d

Ventricle; wide; fibrillation

15

In patients with heart failure, ____ is an early mechanism to compensate for decreased myocardial function.

a

Cappilary compensation

b

Decreased respiration

c

Decreases in BP

d

Activation of the sympathetic nervous system

16

The concentration of ____ over several hours after injection of the agent is a potential marker of sympathetic neuronal activity and may correlate with the severity of heart failure.

a

Tc99m Tetrofosmin

b

Tc99m Sestamibi

c

123-Iodine meta-iodobenzylgaunidine

d

Tl-201

17

Before administering I-123 MIBG for cardiac imaging, patient prep includes?

a

Blocking thyroid with 500 mg potassium perchlorate or 10 drops potassium iodide in water.

b

Patient should be NPO

c

Low glucose diet

d

Low carb diet

18

I-123 MIBG cardiac dose is usually?

a

100-450 uCi

b

20 mCi

c

10 mCi

d

100 uCi

19

A cardiac MIBG patient has a HMR of <1.4. This is?

a

Abnormal

b

Normal

c

Indicative that the test must be repeated

d

None of the above

20

Cardiac 90 mode is preferable because?

a

The study can be done faster.

b

Less GB would be seen on a sestamibi scan.

c

Less upward creep occurs.

d

Detectors are closer to the heart.

21

_____ artery supplies oxygen and nutrition to the interventricular septum and the anterior wall of the LV.

a

Right circumflex

b

Left circumflex

c

Left anterior descending (LAD)

d

Right coronary artery

22

The target HR is not reached on a dobutamine study with max dose. ____ should be used next.

a

Xanthine

b

Atropine

c

Caffeine

d

More dobutamine

23

A __ is obtained by drawing ROIs over the mediastinum and myocardium in the view in cardiac MIBG imaging.

a

Heart to mediastinum ratio (HMR); ANT

b

Heart to mediastinum ratio (HMR); POST

c

Heart to mediastinum ratio (HMR); LAO

d

Heart to mediastinum ratio (HMR); Lt LAT

24

N-13 ammonia is used for?

a

SPECT MPI

b

PET viability

c

PET perfusion

d

Adrenergic innervation in ischemic heart disease

25

Patient prep for a vasodilator MPI study includes?

a

Patient should be NPO at least 4 hours.

b

Avoid food or beverages containing caffeine for at least 12-24 hours.

c

Discontinue all xanthine type medications for 12 hours prior to the test.

d

All of these.

26

Regarding left to right cardiac shunts, which are true?

a

The 1rst pass study is best, as far as NM studies.

b

ROI analysis is done with ROI over a lung area.

c

Early pulmonary recirculation will show a variation in the normal curve.

d

The variation is a small 2nd peak proportional to the size of the shunt.

e

All of the above.

27

Tetrofosmin is being used for MPI: rest images are done min post injection, exercise stress imaging __ min post injection, and pharmacological stress imaging _ post injection.

a

10-15; 30-45; 45

b

30-45; 10-15; 45

c

20; 30-40; 45

d

45-60; 15-20; 60

e

30-45; 10-15; 20

28

The best study to evaluate cardiotoxicity from chemotherapy is?

a

Sestamibi or Tetrofosmin MPI

b

N-13 ammonia

c

FDG PET

d

Multiple gated acquisition

e

I-123 MIBG study

29

RBC tagging is being done with in vitro method using Ultratag Kit: to vial containing Sn2+ compound, add 3-5 mL of anticoagulated blood; Incubate 15 minutes; add 25 mCi Tc99m pertechnetate; the next step is?

a

Add Citrate Buffer

b

Inject tagged RBC blood into patient

c

Incubate for 20 minutes

d

Add Na hypochlorite (NaCIO) to destroy extracellular Sn2+ ion

30

The best study to assess regional changes in myocardial adrenergic and cholinergic innervation in ischemic heart disease is a or an?

a

Sestamibi or Tetrofosmin MPI

b

N-13 ammonia cardiac study

c

FDG PET study

d

I-131 MIBG study

e

I-123 MIBG study

f

Tl-201 MPI study

31

Circular target regions of interest (ROI) are drawn over the heart on the planar images and are mirrored over the contralateral chest to account for background and ribs. Total and absolute mean counts are measured in each ROI. A heart to contralateral (H/CL) ratio is calculated as the fraction of heart ROI mean counts to contralateral chest ROI mean counts. The study being processed is?

a

Tc99m MPI

b

I-123 MIBG cardiac

c

MUGA

d

Rb-82 cardiac PET

e

Cardiac amyloidosis using Tc99m PYP

32

10 patients have a new NM scan; 2 patients have the disease the scan is supposed to detect; the scan shows the disease in 8 patients. The scan has?

a

Poor sensitivity

b

Good specificity

c

Good accuracy

d

Poor specificity

33

The best study to assess cardiac amyloidosis is?

a

Sestamibi or Tetrofosmin MPI

b

N-13 ammonia cardiac study

c

FDG PET study

d

Tc99m PYP study

e

I-123 MIBG study

34

The dose for cardiac amyloidosis imaging is?

a

Tc99m MAA; 5 mCi

b

Tc99m Tetrofosmin; 10-30 mCi

c

Tc99m PYP; dose = 10-20 mCi

d

I-123 MIBG; 5 mCi

e

Tc99m PYP; dose = 5-10 mCi

35

On an FDG Cardiac study, regions of decreased blood flow but increased uptake of FDG indicate?

a

Ischemic with cardiomyopathy

b

Ischemic without viable tissue

c

Ischemic but viable tissue

d

MI without viable tissue

Cardiovascular quiz (3/3)

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