Study Guide for Your Final Exam
Study Guide and Objectives InVitro

  1. Understand the following procedures: Red Cell Volume/Survival and Schillings I - III.
  2. Identify"cause and effect" issues with the above procedures. If you alter the procedure, how does it effect your results? Does it make it falsely high, falsely low, or does it have no effect?
  3. Consider the following aspects of a Red Cell Volume/Survival procedure:
    1. ACD solution
    2. Ascorbic acid
    3. Preparation and dilution of standard
    4. Plastic vs. glass test tubes
    5. Receiving a blood transfusion prior to the end of the test
  4. Schillings I - III
    1. What''s the difference between 1, 2, and 3?
    2. Intrinsic factor
    3. Stable B12 injection
    4. Collection of a 24 hour urine
    5. Antibody therapy
  5. Describe99mTcO4- distribution in the human system.
  6. Related to PET imaging
    1. How does false HU values effect PET attenuated images?
    2. Note the uptake of FDG when
      1. There is muscle activity
      2. Infection/inflammation
      3. Chemotherapy
      4. Excessive activity in the bladder
      5. Lung movement (respiration) at the base with CT/PET
      6. The difference between attenuated (CT) and non-attenuated images
      7. Thymus uptake
      8. Menstration occurs
    3. Results that cause truncation
    4. The effects of glucose levels and myocardial uptake of FDG
    5. Identify a which image has CT attenuation and which one does not

From Exam II - MoAbs and 99mTc

  1. What is a Moab?
    1. How do they differ?
    2. What makes them work?
    3. What is the process of creating a Moab?
    4. What are the difference between fragmented and whole MoAbs?
    5. Why is there so much liver uptake in most procedures?
    6. From a diagnostic and therapeutic standpoints, what type of radionuclide would you label these MoAbs to?
    7. Consider the following terms:
      1. Mono vs Poly Clonal
      2. IgG and its structure
      3. HAMA and its response
      4. Affinity and Avidity
      5. Immunoreactive fraction and immunospecificity
  2. Identify and discuss the basic biodistribution of the MoAbs covered in this class
    1. CEA
    2. NeutroSpec
    3. Verluma
  3. Related to MoAb imaging know the following
    1. Gleason score/sum
    2. PSA levels, density, TRUS, and velocity
    3. CEA levels and Duke's Classification
  4. Given a mCi values determine the correction factor of a pure beta emitter when applying a dose calibrator
  5. Evaluate the ProstaScint procedure (detail) and discuss its relationship to other diagnostic procedures in imaging
  6. Evalute the different treatment options available for prostate cancer
  7. Regarding Bexxar and Zevalin
    1. Discuss the B-lymphocyte life cycle and where Ca enters into it
    2. How does a slow vs. fast clearance effect the dose administered?
    3. What is the role of the pre-dosing (prior to the administration of any radiomoAb)?
    4. Understand the complete dosing regiment/time line
    5. When imaging these agents, what abnormalities prevents the therapy from being administered?
    6. How would you imagine these agents (131I and 111In)
    7. How effective are they in treating disease?
    8. Understand the pathophysiology of 99mTcO4-
      1. VP vs. IF
      2. Distribution in the GI track, kidney. thyroid, sweat glands, and brain
      3. How does the body reduce the biological half-life of this agent?

From Exam I - A Little Bit of This and a Little Bit of That

  1. Understand the basic procedures from the following: vascular analysis of disease, lymphoscintigraphy, bone palliation, infectious imaging with labeled WBCs/Ga67, mammoscintigraphy, testicular, La Veen Shunt, CSF Shunt, Salivary, La Veen Shunt, Dacro imaging, H. Pylori Breath Test, Bone Marrow Imaging, Pulmonary aspiration
  2. From question 1, know the pathophysiology associated with the appropriate radiopharmaceutical
  3. From question 1, know the diagnostic potential for each procedure and what is considered normal/abnormal
  4. From question 1, know the diseases associated with each procedure
  5. Special applications should be understood with certain procedures
    1. Using a lemon
    2. Clapper Bell vs. Epididymitis vs. Varicocele vs. Hydrocele
    3. Digital massage
    4. Uptake and washout are the two predictors
    5. Shunt patency and organ uptake
    6. Compare Ga67 to In111/Tc99mWBCs
    7. How are In111WBCs images normalized with Tc99mMDP images
    8. Compare Sr89 to Sm153
    9. How are dynamic nuclear medicine procedures used to diagnose disease
    10. The cause of epiphora
    11. Who gets H. Pylori and how is it detected
    12. Imaging the marrow with Fe, In, or SC
    13. Aspiration in kids and adults

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