nmtradioexam2

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nmtradioexam2
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2011-11-07 00:07:54
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  1. List the steps in preparing a unit
    dose of radiopharmaceutical
    • 1) Choosing the correct RP
    • 2) Determining the activity to be
    • administered
    • 3) Calculating the unit dose volume
    • 4) Withdrawing the unit dose into a
    • syringe
    • 5) Assaying the unit dose
  2. Define total volume
  3. Define total activity
  4. Define RP
  5. Define specific activity
  6. Define concentration
  7. Define assay (calibration)
  8. Define lot number

  9. Convert units of radioactivity between the CGS and MKS(SI) systems.
  10. If appropriate, calculate the RP
    activity to be administered based on the patient’s body weight
  11. calculate pediatric RP doses
  12. Define aseptic technique as it
    relates to unit dose preparation and identify common breaks in aseptic
    technique
    • Wear disposable plastic gloves
    • Wipe
    • vial rubber closures with fresh 70% isopropyl alcohol
    • Puncture
    • rubber closures properly to prevent coring
    • Do not force air into vials and
    • create positive pressure
    • Enter vials only with a new syringe
    • & needle
    • Use
    • fresh needles on syringes before injecting patients
    • Keep all openings in sterile
    • set-ups protected before use

    • Inspect all materials, devices, and
    • solutions carefully – be observant at all times

    • No
    • eating, drinking, smoking, or pipetting by mouth is allowed
  13. Identify specific radiation
    protection techniques to be used during RP dose preparation
    • work behind L block
    • plan ahead
    • use inverse square law
  14. Explain the appropriate choice of
    needle and syringe when preparing individual patient doses from
    multidose vials
  15. Define a medical event according to the NRC, and intrepret the NRC regulations regarding
    medical events and reports.
    • A
    • dose that differs from the prescribed dose or dose that would have resulted
    • from the prescribed dosage by more than 0.05 Sv (5 rem) effective dose equivalent,
    • 0.5 Sv (50 rem) to an organ or tissue, or 0.5 Sv (50 rem) shallow dose equivalent
    • to the skin; AND
    • The
    • total dose delivered differs from the prescribed dose by 20 percent or more
  16. The
    most accurate estimate of required imaging dose for pediatric patients
    Area rule (m1)^2/3 / (m2)^2/3 *adult dose
  17. Agrees
    with Area Rule until age 11 or 12
    websters rule age +1 / Age +7 * adult dose
  18. does not do a great job of accounting for variability in body weight at a
    given age.
    • Webster’s Rule and Young’s Rule
    • youngs = age / age +12 * adult
  19. Differentiate the terms “diluted
    to” and “added to”.
  20. Define
    working standard and stock standard
  21. Dilution:
    • The
    • ratio of the quantity of a desired solute (serum, urine, chemical solution,
    • etc.) contained in a solvent (diluents such as water or saline).
  22. Added To
    • Refers
    • to the volume of the solute added to a specified volume of solvent
  23. Diluted To:
    • The
    • same as “dilution”. If 1ml is diluted to 10 ml, enough diluent is added to the
    • original volume to yield a final, total volume of 10 ml.
  24. Serial Dilution:
    • Refers
    • to multiple dilutions. An initial dilution is made and then this dilution is
    • used to make a second dilution, and so on
  25. Stock Standard:
    • A concentrated standard, usually made up in large volume; used for the
    • preparation of a working standard
  26. Working Standard:
    A dilute standard solution made from a stock standard.
  27. Compare
    I-123 and I-131 based on decay characteristics,
    • I-123 has 13.2hr t1/2 159keV
    • I-131 8day t1/2 364keV
  28. Compare
    I-123 and I-131 based on mode
    of production
    • I-123 is cyclotron produced
    • I-131 is reactor produced
  29. Compare
    I-123 and I-131 based on radionuclidic impurities
    • I-123: 124, 125, 126, 130 ,131
    • I-131: I-127
  30. Compare
    I-123 and I-131 based on absorbed
    dose
    I-131 about 100x higher ... to thyroid.
  31. safety procedures to be followed
    when working with iodine liquid radionuclides.
    use fume hood, refrigerate
  32. , identify mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose:Ga-67 citrate
    • Cyclotron
    • t1/2=78hrs
    • 93 kev (38%), 185 keV (24%)
    • critical organ= GI-tract
  33. , identify their mode ofproduction, decay characteristics, photon energy(ies), and organs receiving thegreatest absorbed radiation dose: In-111 oxine (wbc)
    • t1/2 =2.8days
    • cyclotron
    • 171keV, 245 keV
    • crit organ= spleen
  34. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: P-32 chromic phosphate
    • t1/2= 14.3 days
    • reactor produced ( NEUTRON activation)
    • intracavitary use only
    • Critical organ = pleural surface
  35. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: P-32 sodium phosphate
    • t1/2 14.3days
    • pure beta 1710keV
    • Reactor (neutron activation)
    • critical organ = bone marrow
    • clear, colorless, iv use only.
  36. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Tl-201 thallous chloride
    • t1/2 73 hrs
    • xrays 68-80kev (95%)
    • gamma mainly 135 keV
    • cyclotron
    • critical organ=kidney
  37. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Xe-133 xenon gas
    • t1/2 5.3 days
    • 81keV
    • critical organ = lung
    • absorbs readily onto plasic
  38. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: I-131 MIBG
    • t1/2 8 days
    • y = 364 keV
    • b= 192 keV
    • pheochromocytomas and neuroblastomas
    • reactor
    • critical= liver and bladder wall
  39. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: I-123 MIBG
    • t1/2 =13.3hrs
    • cyclotron
    • y=159keV
    • critical organ = bladder
  40. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Cr-51 sodium chromate RBCs
    • t1/2= 27.7days
    • reactor
    • 320keV
    • critical organ= 2.64
  41. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Sr-89 chloride
    • t1/2 = 50.5days
    • reactor
    • critical organ -= bone surface
    • 100% beta emitter 1492keV
  42. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Sm-153 lexidronam
    • t1/2 = 46.3hrs
    • reactor
    • critical organ = bone surface 25 rad/mci
    • y=103kev
    • b= 710, 640, 810
  43. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Re-186
    • t1/2 = 9hrs
    • reactor
    • critical organ = bone marrow
    • b= 1.071 Mev, 835 kev
    • y = 137
  44. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Y-90 microspheres
    • t1/2 = 64.2hrs
    • reactor
    • critical dose= liver
    • pure beta 937
  45. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose:Dy-165
    • treatment of Rheumatoid arthritis
    • radio-synovectomy
    • t1/2 2.33hr
    • reactor
    • beta 1.29Mev
    • y=95
  46. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Ho-166
    • Radio-synovectomy
    • t1/2= 26.4hrs
    • reactor
    • b=1.85Mev
    • y= 184
  47. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: 1-123MIBG
    • t1/2 13.3hrs
    • cyclotron
    • bladder
  48. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: C-14 urea
    • t1/2 = 5730 yrs
    • reactor
    • critical = bladder wall
  49. , identify their mode of production, decay characteristics, photon energy(ies), and organs receiving the greatest absorbed radiation dose: Y-90 ibritumomab tiuxetan
    • t1/2 64.2
    • reactor
    • critical= liver
    • 100% beta 937kev
  50. Differentiate P-32 chromic
    phosphate and P-32 sodium phosphate
    • chromic is used intracavitary only, blue-gree collodial suspension, treats cancer
    • sodium is clear , colorless solution iv use only (bone marrow) bone pain palliation.
  51. Describe
    when to use appropriate interventional drugs associated with different Nuclear
    Medicine studies
  52. recommended diluent for iodine radioisotopes
    purified water containing .2% sodium thiosulfate
  53. to reduce volatility if iodine radioisotopes
    refrigerate
  54. List the order reagents should be
    mixed for optimum Tc-99m radiolabeling.
    • reconstitute kit with concentrated Tc04-
    • then dilute after incubation
  55. Identify 3 methods used to minimize
    oxidation and to prolong stability in RP kits and/or preparations.
    • use only preservative free saline
    • N2 purged vials
    • cold storage
    • seal integrity
  56. Identify
    3 problems associated with
    radionuclidic contamination
    • increased dose to patient
    • errors in dose calibration
    • image degradation
  57. List
    4 methods used to decrease volatility
    • use buffers
    • add chelating agent
    • maintain at room temp
    • encapsulation
  58. Discuss 3 factors to be considered
    when using heat during RP preparation.
    • temperature
    • duration: too short=poor labeling efficiency, too long= increased particle size.
    • volume: smaller=more uniform heating
  59. What happens with AL+3 breakthrough with
    sulfur colloid, Diphosphonates (bone), TcO4-
    • Sulfur colliod- lung localization b/c of larger particle size
    • Diphosphonates= forms radiocolloid , liver/spleen activity
    • pertechnetate= soft tissue uptake
  60. particle size is affected by
    • Al concentration
    • extended heating times
    • aggregation over time
  61. Explain the effects encapsulation
    of labeled tracers may have on quantitative test results.
    may alter biodistribution if capsule does not dissolve rapidly, or does not dissolve in stomach fluids
  62. for Tc-SC kit prep order
    • Tc-O4, acid and thiosulfate must be combined before heating,
    • gelatin, helps maintain particle size
    • EDTA , removes AL

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