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Pheochromocytomas arise from what type of cells?
Chromaffin cells
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The organ receiving the most radiation burden from either 123 MIBG or 131 MIBG is:
Thyroid (unblocked)
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The most common extracranial solid malignant tumor found in infants and children is:
Neuroblastoma
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The standard dose for a voiding cystogram is:
1.0 mCi of 99m Tc O4
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Testicular torsion is:
A surgical emergency
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It is important to tape the penis cephalic when doing a testicular scan because:
It is very vascular
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A testicular scan that show a horseshoe or half-moon shaped area of photopenia surrounding the testicle is like a (an):
Hydrocele
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The best radiopharmaceutical for diagnosing glomerular filtration abnormalities is:
99m Tc DTPA
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The best radiopharmaceutical for imaging a renal space occupying lesion is:
99m Tc DMSA
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The DTST for a renogram is:
Immediate
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The kidneys span the distance b/n the:
12th thoracic vertebrae and 3rd lumbar vertebrae
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The best view for demonstrating a horseshoe kidney is the:
Anterior view
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When imaging a patient with a ptotic kidney, the technologist should take images in the:
Supine and upright position
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On a renal scan, the right kidney is slightly lower than the left kidney. Because of this, the technologist should:
Continue the scan bc this is normal
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With planar scintigraphy, the kidney may appear smaller than its normal size if:
The long axis is not parallel to the surface of the camera crystal
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A neobladder made from a portion of the small bowel is called:
Ileal loop
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The most accurate nuclear medicine technique for measuring renal size is:
SPECT imaging with morphologic agent DMSA
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If normal resting cardiac output is 5 L/min; the total renal blood flow would be approximately:
1.2 L/min
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If normal effective renal plasma flow is about 600 ml/min, normal glomerular filtration rate is:
120 mL/min
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ACEI augmented renal studies are performed in patients suspected to have:
RAS- related hypertension
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A morphologic renal tracer is noted for its:
Retention in the renal parenchyma for a prolonged period of time
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The two most common agents used for morphologic renal imaging are:
99m Tc DMSA and 99m Tc Glucoheptonate
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Two common agents used for functional renal imaging are:
99m Tc MAG3 and 99m Tc DTPA
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Absolute renal function typically refers to the:
ERPF and GFR
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Common cortical imaging agents include:`
99m Tc DMSA and 99m Tc Glucoheptonate
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A patient is scheduled for a diuretic renal imaging study. The technologist prepares the radiopharmaceutical and:
Furosemid (Lasix)
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A diuretic renal imaging study is most helpful in differentiating:
A dilated from an obstructed renal collecting system
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A renogram (time-activity curve) shows prompt uptake of the tracer, with activity in the kidney peaking at 3-5 minutes after injection to less than 50% of peak value by 20 minutes. The technologist should:
Suspect this to be normal
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After the injection of furosemide in a diuretic renal imaging study, the washout activity from the collecting system has a clearance half- time of less than 10 minutes. this is most likely indicative of a(n):
Dilated but unobstructed kidney
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Morphologic renal imaging can be used to document:
Global and regional changes in renal function
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A patient is scheduled for an indirect cystogram. The technologist should:
Prepare the tracer dose for intravenous injection
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Patient preparation for testicular scintigraphy includes:
The taping of the penis over the pubis
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The most common radiopharmaceutical used in testicular scintigraphy is:
99m Tc Pertechnetate
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What are 2 reasons for doing a morphologic renal scan?
- Dx of acute/ chronic polynephritis
- Determine which kidney is doing more work
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What are the three most common radiopharmaceuticals used in renal imaging (functional and morphologic), and what are the standard doses?
- 99m Tc MAG 3 (Mercaptoacetyltriglycine 3mCi)
- 99m Tc DTPA (Diethylenetriamine-pentaacetic acid 10mCi)
- 99m Tc DMSA (Dimercaptosuccinic acid 5mCi)
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Explain what happens during a normal renogram
PERFUSION: 99m Tc MAG3 goes through glomerulla and is uptaken by the tubules
EXTRACTION: 99m Tc MAG3 is uptake by proximal renal tubule; urine is being made
EXCRETION: After lasix is administered, urine output is increased causing patient to void and lasix to washout.
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List 4 indications for doing a functional renogram
- - Evaluate renal blood flow and function
- - Evaluate renal trauma
- - Dx of renovascular hypertension
- - Detect and evaluate renal collecting system obstruction
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Explain the rule of ten in regards to pheochromocytoma imaging.
- 10% pediatric
- 10% malignant
- 10% bilateral
- 10% are extra-adrenal
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What is Captopril and how does it relate to renal imaging?
Captopril is an ace inhibitor used to determine whether a patient has renal stenosis contributing to renovascular HTN
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MIBG is primarily used to image what type of tumors?
Pheochromocytomas and neuroblastomas
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MIBG resembles what two chemicals?
Norepinephrine and guanethidine
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What are some drugs that interfere with MIBG uptake?
- Cocaine- stop 2 weeks prior to scan
- Tricyclic antidepressants- stop 6 weeks prior to scan
- Adrenergic blockers (beta blockers) - stop 2 weeks prior to scan
- Phenylpropanolamine (Sudafed and other OTC cold drugs)- stop 2 weeks prior
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How do you calculate GFR?
GFR=(UV)/P
- U= urine concentration (cpm/ml)
- V= timed urine collection (ml/min)
- P= plasma concentration (cpm/ml)
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Define hydronephrosis
Dilation of the renal pelvis and ureters
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What are the 4 major functions of the kidney?
- Excretion of waste
- Resorption of important body constituents
- Maintenance of acid-base balance
- Maintenance of body fluid
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What is the basic unit of the kidney?
Nephron
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