M. Babar Imran, PINUM · M. Babar Imran, PINUM Use True and False method for negatively worded questions. Which one of the following statements is not a common finding on a conventional

M. Babar Imran, PINUM


An Art to attempt MCQs!

Dr M Babar Imran

MBBS, MSc, MS, PhD, FRCP

Director

PINUM Cancer Hospital

Faisalabad, Pakistan

For ABNM Candidates


Examination

What is an examination?

A test to see how good somebody is at

something

meant to determine suitability and to test

the required knowledge for the given job /title


Exam, Lecture and Black Bitter Coffee

One Common Feeling

.


Exam, Lecture and Black Bitter Coffee

One Common Feeling

It is always pleasure when one finishes


MCQs

Know the subject

Know how to attempt


When I will finish my talk

Understanding Instructions

Understanding the Stem

Selection Correct Answer

If you really don’t know the answer

Solved Questions with explanations


Which of the following is used for

skeletal scintigraphy?

a-MIBI

b-DTPA

c-MDP

d-HMPAO

Stem

Options

*

* Distractors

* Distractor

Anatomy of MCQ


Stem

requires analysis of a problem

requires application of principles

requires evaluation of alternatives

to combine several concepts or ideas

to test higher order thinking


Stem

What, Why, How statement ?

Incomplete statement !

Calculation !

Which one correct / incorrect

Interpretation of images


Thoroughly understand the exam pattern. Know all the

sections of the exam

Understand yourself i.e. know your strengths and

weaknesses.

Strength lies where you had been able to answer the

question in half of the allocated time (eg 30 sec) and

weakness where you had to spend more than

allocated time

Before Exam


Instructions Read Carefully

Instructions

Any error in understanding the instructions is fatal

Questions

Common errors occur when students fail to accurately

or thoroughly read the question. Understand what is

being emphasized / what is being asked before

starting to read the answer


Read the Stem

What is being asked?

If one or more options are correct

If assertion is on Negative or Positive

Underline the important words


Which one of the following statements about

Radioactive Iodine is TRUE?

a.Radioactive Iodine-131 is used for only treatment

purpose in benign and malignant thyroid diseases.

b.Radioactive Iodine-125 is used for imaging and

treatment purpose in benign and malignant thyroid

diseases

c. Radioactive Iodine-131 is used for imaging and


diseases.

d. Radioactive Iodine-125 is used for treatment




Radioactive Iodine is TRUE?

a.Radioactive Iodine-131 is used for only treatment


b.Radioactive Iodine-125 is used for imaging and


diseases

c. Radioactive Iodine-131 is used for imaging and


diseases.

d. Radioactive Iodine-125 is used for treatment




Radioactive Iodine is False?

a. Radioactive Iodine-131 is used for treatment

purpose in benign and malignant thyroid

diseases.

b. Radioactive Iodine-125 is used for imaging and

treatment purpose in benign and malignant

thyroid diseases

c. Radioactive Iodine-123 is used for imaging of

benign and malignant thyroid diseases.

d. None of the above



Radioactive Iodine is False?

a. Radioactive Iodine-131 is used for treatment

purpose in benign and malignant thyroid

diseases.

b. Radioactive Iodine-125 is used for imaging and

treatment purpose in benign and malignant

thyroid diseases

c. Radioactive Iodine-123 is used for imaging of

benign and malignant thyroid diseases.

d. None of the above correct


If Stem long---

If Stem is long, carefully read the last

sentence/last part, it may include the

main target


A 60 yr old woman, known case of spinal stenosis and

hypertension, presented with atypical chest pain. Her

physical mobility is limited to slow pace 200 meters

walk only. She is referred for adenosine stress MPS.

Her BP= 130/70 mm Hg and pulse is 70 b/m. Her

baseline ECG is without any significant abnormality.

Because she is capable of performing some exercise,

administering adenosine infusion in combination with

low level exercise is recommended . As compared with

adenosine infusion alone, what should be expected

when combining adenosine infusion with low level

exercise?


A 60 yr old woman, known case of spinal stenosis and hypertension,

presented with atypical chest pain. Her physical mobility is limited to slow

pace 200 meters walk only. She is referred for adenosine stress MPS. Her

BP= 130/70 mm Hg and pulse is 70 b/m. Her baseline ECG is without any

significant abnormality. Because she is capable of performing some exercise,

administering adenosine infusion in combination with low level exercise is

recommended . As compared with adenosine infusion alone, what should

be expected when combining adenosine infusion with low level

exercise?

a. Relatively Less adenosine related adverse effects

b. To avoid artifacts in patients with LBBB

c. Higher radiopharmaceutical activity in spleen

d. Long delay for data acquisition is needed after stress


Starting with the answer (1)

Think if you can answer without looking at options

MDP, HEDP

HMDP, HDP

NaF


A 40 year old male underwent 201Tl stress redistribution study for

evaluation of chest pain. How do you interpret this study?

Norm, Isch

Inf. Artfct

1. Reversible perfusion defect

involving apex

2. Reverse Redistribution involving

apex

3. Motion artifact during SPECT

acquisition

4. Abnormal Tracer uptake in RV

free wall.


1. Reversible perfusion defect

involving apex

2. Reverse Redistribution involving

apex

3. Motion artifact during SPECT

acquisition

4. Abnormal Tracer uptake in RV

free wall.










Eliminate the answers which you know are wrong








Use True and False method for negatively worded

questions.

Which one of the following statements is not a common

finding on a conventional bone scan in a patient with

renal osteodystrophy?

a. Decreased uptake in the calvaria




questions.




a. Decreased uptake in the calvaria is not a common

finding on bone scan in renal osteodystrophy




questions.




a. Decreased uptake in the calvaria T




questions.





b. High-bone to soft tissue uptake ratio




questions.





b. High-bone to soft tissue uptake ratio is not a common





questions.





b. High-bone to soft tissue uptake ratio F




questions.






c. Minimal or no evidence of urinary activity




questions.






c. Minimal or no evidence of urinary activity is not a

common finding on bone scan in renal osteodystrophy




questions.






c. Minimal or no evidence of urinary activity F




questions.







d. Increased uptake in the axial skeleton




questions.







d. Increased uptake in the axial skeleton is not a common





questions.







d. Increased uptake in the ax ial skeleton F



Generally a positive choice is more likely to be true

than a negative choice

Usually a correct answer is with maximum information

Even if you are unfamiliar with the question, use

common sense and a good guess to respond

When guessing ask why it is right, does it make a

sense



Research indicate that your first selected answer is

correct. Changing an answer should be under good

reasons

While dealing with a question, if your logic differs with

your knowledge, go for your knowledge.



Do not stop reading all of options merely because you

are 100% sure about the correct choice else you will fail

to understand the tricks

All of the above

None of the above

2/4 Correct

2/4 incorrrect



Notice words

“Always”, “Every”, “All”

Less likely correct than

“Some”, “many”, “few”

these give more room for exceptions



Indicate which statement about regional cerebral blood

flow SPECT is false

a. It is useful in the differential diagnosis of dementia

b. It provides very specific pattern for each type of

dementia

c. It is useful for localization of the epileptogenic focus

before surgical

d. treatment of refractory epilepsy

e. Images reflect the regional cerebral blood flow at the

time of injection


Indicate which statement about regional cerebral blood

flow SPECT is false

a. It is useful in the differential diagnosis of dementia

b. It provides very specific pattern for each type of

dementia

c. It is useful for localization of the epileptogenic focus

before surgical

d. treatment of refractory epilepsy

e. Images reflect the regional cerebral blood flow at the

time of injection


Difficult Question (unseen info)

Eliminate

True / False test to each option

Grammatically not fitting

Absolute words “Always”, “All”, “every”

All /None options

For “number” answers, consider the middle one



Two similar options, choose the best one

Two opposite options, one of them might be correct

Remember you looking for the best answer (not only

correct answer)

Totally Correct Least Correct

Difficult Question (unseen info)



Try to attempt maximum questions (No Negative

Scores). Never leave a question un-answered.


Guessing

If there is no penalty…

Use hints from those question you know the answer for

those you don’t

While guessing once selected don’t change the answer,

usually your first answer is correct unless you mis-read

the question

Only change if you are sure about the correction

Option “C” -----


Fix response or response C

FEBNM, Solved Paper

Research has

shown that C

more frequently

correct than other

options

Guessing


Guessing

If there is no penalty…

Use hints from those question you know the answer for

those you don’t

While guessing once selected don’t change the answer,

usually your first answer is correct unless you mis-read

the question

Only change if you are sure about the correction

Option “C” has more than 25% chance being correct


Optimize the art of speed------

Old remains gold or at least like gold. Try to solve past

years paper to understand the exam format and to

build speed, correctness (if available)


Time Management

Do not stick to one question only

Try to keep time for review at the end – you could have

mis-read some questions

It is never a good idea to leave the hall earlier, unless

you are sure you have attempted all the questions

correctly.

At the end, left out questions may be tried with “Guess”


If you have studied sufficiently

and have good knowledge only

then these tips can help you to

gain reasonable scores


If you have studied sufficiently

and have good knowledge only

then these tips can help you to

gain reasonable scores


Spillage in hot lab and notification to radiation

safety officer

Major Spillage in hot lab

needs notification to RSO


After access restriction, which of the following

spillage in hot lab requires immediate notification

to radiation safety officer

a. I-123 8 mCi

b. Tl-201 90 mCi

c. Tc-99m MDP 110 mCi

d. Tc-99m MIBI 50 mCi

Major Spillage in hot lab

needs notification to RSO


After access restriction, which of the following

spillage in hot lab requires immediate notification

to radiation safety officer

a. I-123 8 mCi

b. Tl-201 90 mCi

c. Tc-99m MDP 110 mCi

d. Tc-99m MIBI 50 mCi Major Spillage in hot lab needs

notification to RSO

Spillage of more than 10 mCi of

I-123 or more than 100 mCi of

Tl-201/Tc99m NUREG 1556 Volum 9


Which of the following factors is essential in the

calculation of standardized uptake value (SUV)?

a. Time activity curve

b. Serum insulin level

c. Injected dose

d. Arterial radioactivity concentration


Which of the following factors is essential in the

calculation of standardized uptake value (SUV)?

a. Time activity curve

b. Serum insulin level

c. Injected dose

d. Arterial radioactivity concentration


In a crystal scintillation detector the size or amplitude of the

electrical pulse is generally proportional to the:

a. Activity

b. Gamma photon energy

c. Number of gamma photons

d. Number of electrons


If a low-energy collimator is (incorrectly) used with a high-

energy radionuclide the results would be:

a. A reduced camera sensitivity (counting efficiency)

b. A blurred image

c. A reduced field of view

d. Increased image detail


A collimator designed for use with radionuclides with relatively

low photon energies, such as technetium, has relatively thin

septa between the holes. High energy photons will produce

significant septal penetration which results in a blurring of the

image and reduced image detail.


In Nuclear Medicine departments chemical impurity of Alumina

in the Mo-99/Tc-99m generator elute is evaluated through

which of the following test:

a. Thin-layer chromatography

b. HPLC

c. Colorimetric qualitative spot test

d. Paper chromatography


In Nuclear Medicine departments chemical impurity of Alumina

in the Mo-99/Tc-99m generator elute is evaluated through

which of the following test:

a. Thin-layer chromatography

b. HPLC

c. Colorimetric qualitative spot test

d. Paper chromatography

The

quantified


Nuclear binding energies are usually expressed in units of:

a. keV

b. Watts

c. Joules

d. Newtons


Nuclear binding energy

is the minimum energy that would be required to

disassemble the nucleus of an atom into its

component parts. These component parts

are neutrons and protons, which are collectively

called nucleons.

Nuclear binding energy = Δmc2

The most commonly used unit is the MeV.

1 electron volt = 1eV = 1.6 x 10-19 joules

1 MeV = 106 eV; 1 GeV = 109 eV; 1 TeV = 1012 eV

http://hyperphysics.phy-astr.gsu.edu/hbase/electric/ev.html


Which combination is false?

a. Bremsstrahlung – electromagnetic radiation

b. Orbital electron capture – alpha decay

c. Isomer transition – gamma decay

d. Positron – annihilation radiation


One curie is equal to

a. 3.7 X 1010 dps

b. 3.7 X 1012 dpm

c. 3.7 X 107 dps

d. 2.2 X 109 dpm

Curie is a unit of radioactivity = 3.7 ×1010 disintegrations per second.

It is quantity of radioactive substance that emits one curie of activity.

"a curie of any radioactive element disintegrates at the same rate as 1

gram of natural radium”

1MBq = 2.7 uCi


Mode of decay by electron

capture occurs in all except:

a. Cr 51

b. Co 57

c. Ga 67

d. I 124

Iodine-124 is a positron

emitter with a half-life of

4.2 days and appropriate

chemical properties.

Measurements made

under realistic conditions

on several different PET

scanners have shown that

satisfactory imaging and

quantitation can be

achieved.


Stochastic effects. Effects that

occur by chance and which may

occur without a threshold level

of dose, whose probability is

proportional to the dose and

whose severity is independent

of the dose.

Stochastic effects in a mammal :

a. Cancer

b. Cataract

c. Radiation sickness

d. Sterility


Which of the following is not a PET radio-

pharmaceutical for imaging of neuroendocrine

tumors

a. 68 Ga-DOTANOC

b. 18 F-Fluorodopa

c. 177 Lu-DOTATATE

d. 18 F-FDG


Which of the following is not a PET radio-

pharmaceutical for imaging of neuroendocrine

tumors

a. 68 Ga-DOTANOC

b. 18 F-Fluorodopa

c. 177 Lu-DOTATATE

d. 18 F-FDG


A 60-year-old female with a history of gastroesophageal reflux,

attended the hospital complaining of chest pain at rest. Her

ECG and echocardiography were normal. She underwent MPI

which revealed reversible perfusion defects in the apex and

the inferior wall; LVEF was 59%. The expected perfusion scan

finding is:

a. Scan within normal limits

b. Moderate defect in the LAD territory

c. Large defect in the LAD territory

d. Large defect in the RCA territory




The given ECG shows

a. First degree AV Block

b. Right Bundle Branch Block

c. Left Bundle Branch Block

d. Interventricular Conduction



Which is useful for the evaluation of myocardial

sympathetic innervation?

a. I-123 BMIPP

b. I-123 MIBG

c. Tc-99m MIBI

d. Tl-201


MIBG is analog of norepinephrine (NE)

MIBG diffuses into the synaptic cleft

Taken up into pre-synaptic sympathetic

terminals via the NE transporter-1

(NET1) (energy dependent )

MIBG is not metabolized

MIBG & ITS MECHANISM OF ACTION

123I-MIBG imaging depicts integrity of re-uptake function, thus

the integrity and health of cardiac sympathetic innervation.


MIBG is not metabolized

It accumulates in the presynaptic

terminal.

123I-MIBG imaging depicts function

of the uptake-1 process, and thus

the integrity and health of cardiac

sympathetic innervation.


• Scintigraphic assessment of sympathetic

innervation of the myocardium in patients with

New York Heart Association [NYHA] class II or

class III HF and left ventricular ejection fraction

[LVEF] < 35%

• Help identify patients with lower one and two-

year mortality risks, as indicated by an [HMR]

ratio >1.6

Indications of Cardiac 123I-MIBG Imaging



Given the myocardial perfusion scan (MPS) of a 50-year-

old female (see below) with a TID of 1.1 which of the

following statements is true for the image below:

a. Normal MPI

b. Balanced ischemia

c. Transient ischemic dilatation

d. Suspected triple-vessel disease

TID : 1.1


Transient ischemic dilation (TID)

Stress-induced apparent increase in the size of the left

ventricle visualized by MPS

TID ratio is calculated dividing stress by rest LV

volumes; this is usually done on the non-gated images

defining the endocardial limits of the LV but also can

be done on the gated, end-diastolic images


• Transient ischemic dilation (TID) of the left ventricle (LV) is a

marker for severe and extensive CAD, which has been shown to

be of prognostic value.

• Although TID is usually higher in patients with LAD ischemia or

multivessel disease (MVD), it can also be found in patients with

LVH or diabetes.

• However, TID in the absence of evident perfusion abnormalities

should always raise the question of balanced myocardial ischemia

in the first place, which is more common in MVD.


A 47 year old female presented with progressive exertional dyspnea

for the last 3 months. There is no H/O angina. Adenosine stress Tc

99m MIBI gated cardiac scan is performed. LV EDV is 138 and 140

ml during rest and stress study. What is the most likely diagnosis


A 47 year old female presented with progressive exertional dyspnea

for the last 3 months. There is no H/O angina. Adenosine stress Tc

99m MIBI gated cardiac scan is performed. LV EDV is 138 and 140

ml during rest and stress study. What is the most likely diagnosis

1. LV infarct leading to dilated LV

2. Ischemic Heart Disease

3. Non Ischemic Cardiomyopathy

4. Infarct with peri infarct ischemia

Uniform perfusion with dilated LV and symptoms of LV

Failure strongly suggestive of dilated cardiomyopathy of

non ischemic origin


Which of the following examination is appropriate for the

early diagnosis of Alzheimer’s dementia?

a. Brain MRI

b. Brain 18F-FDG PET

c. Brain amyloid plaque imaging PET

d. CSF tau protein analysis


The characteristic features of Alzheimer’s disease (AD)

are the appearance of extracellular amyloid-beta (Aβ)

plaques and neurofibrillary tangles in the intracellular

environment, neuronal death and the loss of synapses, all

of which contribute to cognitive decline in a progressive

manner.


In Alzheimer’s disease, regional blood flow is decreased

except in the:

a. Temporal cortex

b. Posterior cingulate gyrus

c. Precuneus

d. Cerebellum


rCBF is an indirect measure for brain functional activity. Reduction in activity of

neurons or number of neurons leads to reduced rCBF

In AD there is decrease in flow (at single photon emission computed tomography) or

metabolism (at positron emission tomography [PET]) in the temporoparietal regions


Single Photon Emission Tomography

• The most widely used tracer is 99mTcHMPAO.

• Neuroreceptor studies using 123I-ioflupane(IFP)-CIT

(DAT-scan) which allows visualization of the

degeneration of the nigrostriatal dopaminergic neurons

• A 123IIBZM-SPECT shows the integrity of the

postsynaptic dopamine receptor.


Brain perfusion SPECT shows increase in CBF in the

following states except in:

a. Epileptic foci

b. Reperfusion after ischemia

c. Parkinson’s disease

d. Encephalitis


Which one of the following is normally used to explore the

cerebral vasodilatory flow reserve by means of CBF SPECT

a. Captopril

b. Acetazolamide

c. Dobutamine

d. Furosemide


An 80-year-old woman with recent onset of fever and

headache without any previous medical problems had CT,

MRI and SPECT scans performed. What is the possible

diagnosis?

a. Seizure

b. Herpes simplex encephalitis

c. Glioblastoma multiforme

d. Cerebral infarction


A 45-year-old female with diffuse large B-cell lymphoma

received 6 courses of R-CHOP therapy. F-18 FDG PET

images before and after treatment are shown. Which of the

following statement is the most likely interpretation of the F-

18 FDG uptake indicated by arrows in post therapy image?

a. Relapse of malignant lymphoma

b. Supraclavicular Lymph nodes

metastasis

c. Activation of brown adipose tissue

d. Neurolymphomatosis


Brown Fat

One of two types of adipose tissue (white and brown)

Contains smaller fat vacuoles, higher number of mitochondria, more capillaries than white fat

Richly innervated by sympathetic nerves (b1, b2, b3)

Uncoupling protein-1 (UCP-1, thermogenin) in inner mitochondrial membrane uncouples oxidative phosphorylation producing heat energy (non-shivering thermogenesis) with ATP provided by glycolysis

Present in newborns (5% body mass) and hibernating animals; most disappear in adulthood (not in mice)

Contribution to evolutionary success of mammals Cannon B et al. Physiol Rev 2004 (Sweden)


Kaposi’s Sarcoma is

1. Ga 67 negative and Tl 201 positive

2. Ga 67 positive and Tl 201 positive

3. Ga 67 negative and Tl 201 negative

4. Ga 67 positive and Tl 201 negative

Sensitivity of Tl-Ga combination

reduces in the presence of

opportunistic infections


Metastatic medullary thyroid carcinoma can

be localized with all except

a. 123I-MIBG

b. 131I-anti AFP antibodies

c. 18F-FDG

d. 111In-octreotide

Imaging Medullary Thyroid Carcinoma . J Clin Endocrinol Metab. 2007; 92: 4185-4190 Occult Medullary Carcinoma. HORMONES 2012, 11(2):210-214

AFP related with Liver

testis and ovarian tumor

/ congenital abnormalities


Bilaterally increased renal visualization on MDP

bone scanning can be found in the following

conditions except

a) Renal metastases

b) Hypercalcaemia

c) Recent chemotherpy

d) Renal vein thrombosis




conditions except

a) Renal metastases

b) Hypercalcaemia



Hyperparathyroidism,

hypercalcaemia, iron

overload, cirrhosis and

sickle cell disease. Post

chemotherapy (cisplatin)




conditions except

a) Renal metastases

b) Hypercalcaemia



Conventional NM agents,

uptake is always less in

tumour tissue

However, it is known not to

correlate with any specific

malignancy or the presence

of metastasis World J Nuc Med2005;4:104–7


Which of the following statements is true?

a. The mechanism of uptake of Tc-99m IDA is by Kupffer cell

extraction

b. Tc-99m mebrofenin has better hepatic extraction than Tc-

99m HIDA

c. The chemical structure of IDA radiopharmaceuticals is

similar to the diphosphonates

d. With hepatic insufficiency, the alternate elimination route

for IDA radiopharmaceuticals is via the bowel


Physiologic functions of the liver can be evaluated

1. 99mTc-Labeled IDA Derivatives used to evaluate the

functional status of the hepatocytes and the patency of the

biliary duct

2. Lipophilic compounds(99mTc-Sulfur Colloid) labeled with

radionuclides for RE system (Kupffer cells)

Hepatobiliary radiopharmaceuticals


A Two-month-old baby girl presented with jaundice since

birth with frequent vomiting and pale stools. Her bilirubin

level was 4.6 mg/dl. A Tc-99m DISIDA scan was done. What

is your most probable diagnosis?

a. Choledochal cyst

b. Biliary obstruction

c. Acute cholecystitis

d. Delayed biliary to bowel transit


High-grade common bile duct obstruction

Usually prompt liver uptake & function

No secretion of the radiotracer into biliary ducts.

Delayed images, even up to 24 h, often show only a

persistent hepatogram.


True statement regarding cholescintigraphy is

a.Chronic cholecystitis may cause non-visualization of

gallbladder even at 60 minutes

a.The common bile duct is usually seen starting at 60 min

b.Transit from the biliary ducts to small intestine normally

occurs in less than 5 minutes

c. In the arterial blood flow phase normally liver is seen

before the spleen and kidneys


True statement regarding cholescintigraphy is

a.Chronic cholecystitis may cause non-visualization of

gallbladder even at 60 minutes

a.The common bile duct is usually seen starting at 60 min

b.Transit from the biliary ducts to small intestine normally

occurs in less than 5 minutes

c. In the arterial blood flow phase normally liver is seen

before the spleen and kidneys


The gall bladder is usually not visualized on hepatobiliary

imaging in the following cases except:

a.acute cholecystitis

b.chronic cholecystitis

c. congenital biliary atresia

d.severe hyperbilirubinemia


In Meckel's diverticulum study; which statement is not correct

a. Tc-99m SC is used as radiopharmaceutical agent

b. The diagnostic sensitivity/PPV is high in children

c. The ectopic gastric mucosa is identified

d. Sequential views are obtained

PPV

Sensitivity


It is indicated primarily for overt mid or lower

gastrointestinal bleeding, specifically when an upper

gastrointestinal bleed has been excluded

Labeled RBCs & Tc-99m SC

Colloids can be used for acute bleeding only. RBCs for

intermittent as well

Diagnostic Criteria

1. The appearance of activity outside the expected anatomic

blood pool structures,

2. Change in the intensity of activity on consecutive images,

3. Movement of activity in a pattern consistent with bowel.

Gastrointestinal bleeding scintigraphy


Advantages of RBC scintigraphy

1. 10-fold greater sensitivity for detection of slow bleeding

rates or chronic bleeding

2. The ability to examine the entire lower GI tract

simultaneously and continuously over an extended period

of time (60 to 90 minutes)

3. The ability for repeat imaging up to 24 hours.

GI Bleed Scintigraphy Vs Angiography


A 2-year-old girl presents with lower GI bleeding episodes and anemia. A

Meckel’s scan is performed. A focus of ectopic tracer uptake is identified.

Which scinitigraphic findings would suggest that this focus represents a

Meckel’s diverticulum?

a. The focus appears simultaneously with the normal uptake in the gastric

mucosa and gradually fades away

b. The focus appears simultaneously with the normal uptake in the gastric

mucosa and intensifies during the study

c. The focus first appears 10 minutes post tracer injection and persists

throughout the remainder of the study

d. The focus first appears at an early stage in the right upper abdominal

quadrant, fades away and reappears towards the end of the study.


Which of the following is true regarding Tc-99m sulfur colloid

for the detection of GI bleed?

a. It has higher sensitivity than angiography

b. It is best for upper GI bleed

c. It is good for detecting intermittent bleeds

d. It requires labelling of RBCs


Exam

Subject

Practice Technique

Know

Succ

ess


Thank you very much for being with me

.

Documents

M. Babar Imran, PINUM · M. Babar Imran, PINUM Use True and False method for negatively worded questions. Which one of the following statements is not a common finding on a conventional