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Radionuclide Therapy in Nuclear Medicine
Name: Address1: Address2: City/State/Zipcode: Email Address: Voice #: Work Phone #: Work Fax #: Student (Nuclear Medicine) Yes No Special Needs:
TEST: Radionuclide Therapy
1. Which one of the following statements is NOT true?:
The ideal effective half-life of a therapeutic radiopharmaceutical is 1.5 x procedure length
In a beta/gamma emitter like I-131, the ratio of tissue damage is ~ 90% beta/10% gamma
Target-to-non target ratio is more critical therapeutically than diagnostically
Particulate emission is preferable to photon emission for therapy
2. Which one of the following radioisotopes has no current applications in therapeutic Nuclear Medicine?:
Y-90
I-131
P-32
Sr-85
3. NRC Group 5 Radiopharmaceuticals include:
Generators
Diagnostic Radiopharmaceuticals
Therapeutic Radiopharmaceuticals not requiring hospitalization
Therapeutic Radiopharmaceuticals requiring hospitalization
4. Of the four types of thyroid cancer,:
Follicular and anaplastic are treatable, the others are not
Follicular and papillary are treatable, the others are not
Papillary and medullary are treatable, the others are not
Papillary and anaplastic are treatable, the others are not
5. For a hyperthyroid patient with a 50% uptake, treatment with 10 mCi of I-131 NaI solution results in a thyroid dose of approximately:
10 Rads
100 Rads
1,000 Rads
10000 Rads
6. For a hyperthyroid patient undergoing treatment with 10 mCi of I-131 NaI solution for hyperthyroidism, the patient is advised that it will take ____ weeks to begin to observe beneficial effects and ____ weeks to reach the maximum beneficial effect.:
2, 6
1, 12
4-6, 12
12-24
7. The long-term side effect following a successful treatment of hyperthyroidism with I-131 NaI solution is:
thyroid carcinoma
hypothyroidism
aplastic anemia Hashimoto’s thyroiditis
8. According to the current NRC and Agreement State regulations, If it is necessary to hospitalize a patient; the release criterion for a patient hospitalized for treatment of a thyroid cancer patient with I-131 NaI solution is a reading of:
5 mR/hr and 5 mR/hr at 1 m from patient’s chest
5 mR/hr and 7 mR/hr at 1 m from patient’s chest
7 mR/hr and 5 mR/hr at 1 m from patient’s chest
7 mR/hr and 7 mR/hr at 1 m from patient’s chest
9. Which one of the following statements is NOT true?:
Use of Sr-89 chloride for treating pain from bony metastases is palliative and not curative
Use of Sr-89 chloride for treating pain from bony metastases has an overall response rate of ~ 80%
Sr-89 chloride for treating pain from bony metastases may cause pain to flare up before a positive response is obtained.
Use of 4 mci of Sr-89 for treating pain from bony metastases confers a bone marrow radiation dose of ~25 R
10. Which ONE of the following statements regarding successful treatment of polycythemia vera with P-32 is FALSE?:
Increases median survival time 8-fold
Often requires two 4-mCi doses for effective treatment
The pharmaceutical used is P-32 chromic phosphate colloid
Bone marrow dose exceeds 200 R for a 4 mCi dose
11% of successfully treated patients eventually develop leukemia
11. Which of the following therapies involves use of an unsealed source in the body?
Brachytherapy
Teletherapy
Radiopharmaceutical Therapy Neutron irradiation
12. Which of the following therapeutic radioisotopes places the dose administrator at greatest risk?
Sr-89 Y-90
13. Typical prescribed doses for treating Graves Disease and Plummer’s Disease are, respectively,
8 mCi and 25 mCi
25 mCi and 8 mCi
15 mCi and 50 mCi 8 mCi and 100 mCi
25 mCi and 25 mCi
14. If the first dose of I-131 NaI administered for treating hyperthyroidism or thyroid carcinoma fails to adequately treat the patient, the second dose should be equal to...
50% of the first dose
100% of the first dose
150% of the first dose 200% of the first dose
Same as the first dose
15. In the decay scheme of I-131 printed below, the gamma ray used for imaging is...
gamma 3 gamma 3
gamma 9
gamma 13 gamma 14
16. Since the decay scheme displayed above indicates that there are 14 gamma rays and 6 beta particles emitted by I-131, then the ratio of tissue damage caused by beta particles compared to gamma rays is:
6/14
6/20
14/20 None of the above
17. Which ONE of the following statements is TRUE?
Women are more likely to develop hyperthyroidism and are more difficult to treat than men
Women are more likely to develop hyperthyroidism and are less difficult to treat than men
Women are less likely to develop hyperthyroidism and are more difficult to treat than men Women are less likely to develop hyperthyroidism and are less difficult to treat than men
18. Which one of the following statements describes the FDA approved indication for palliation of bone pain with Sr-89 chloride?
Patient presents with bone pain and requests Sr-89 therapy
Patient with bone pain caused by bony metastases from breast or prostate cancer but no other primary malignancy
Patient with bone pain caused by bony metastases from osteosarcoma but no other primary malignancy Patient with bone pain caused by bony metastases from any primary malignancy
19. Which ONE of the following statements is FALSE?
The biological distribution of Sr-89 is essentially identical to that of Tc-99m MDP
Sr is a Ca analog
Therapy with Sr-89 is both palliative and curative One reason that Sr-89 therapy is effective while minimizing bone and bone marrow dose is that it is retained in metastases longer than in normal bone tissue
20. Typical injected dose of Sr-89 chloride is:
0.4 mCi
4 mCi
40 mCi 400 mCi
21. Typical injected dose of P-32 Na phosphate for treating Polycythemia Vera is:
22. P-32 CrPO4 colloid is suitable for treating malignant effusions in women with ovarian carcinoma. The route of injection is:
intravenous
intracavitary
intraarterial intradermal
subcutaneous
23. Which one of the following is NOT required for a high dose therapy for thyroid cancer?:
After patient is released, the room must be surveyed by Radiation Safety before being occupied by the next patient
Everyone involved in the patient’s care must wear a film badge
Everyone involved in the patient’s care must provide a urine specimen to check for I-131 excretion Patient must be in a private room
24. Which ONE of the following statements regarding both Sr-89 and I-131 is TRUE?
Both decay by b+ emission
Both decay by b- emission
Both emit g photons along with the b particles
The radiation risk to the person administering the dose would be approximately the same for both isotopes
25. Which one of the following protocols is used for Bexxar and Zevalin in the radioimmunotherapy of non-Hodgkins Lymphoma?
5 mCi dosimetric dose on day 1, therapeutic dose on day 3
5 mCi dosimetric dose on day 1, therapeutic dose on day 8
5 mCi dosimetric dose on day 1, therapeutic dose on day 21 5 mCi dosimetric dose on day 1, therapeutic dose on day 30
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