PROVISIONAL ANSWER KEY
Question Paper Code: 39/2024/OL
Category Code: 342/2023
Exam: Assistant Professor in Nuclear Medicine
Date of Test 06-04-2024
Department Medical Education
Question1:-Coordination number of a metal ligand complex is
A:-the number of ligands in the complex
B:-the number of metal ions in the complex
C:-the number of unshared electron pairs
D:-the number of oxygen atoms in the complex
Correct Answer:- Option-A
Question2:-Nucleon numbers called magic numbers are
A:-2, 4, 20, 60, 82 or 126
B:-2, 10, 20, 50, 80 or 126
C:-2, 8, 20, 50, 82 or 126
D:-2, 10, 20, 50, 80 or 120
Correct Answer:- Option-C
Question3:-In alpha decay, the atomic number of the parent nuclide and the mass number is reduced by
A:-4 and 2
B:-2 and 4
C:-2 and 2
D:-4 and 4
Correct Answer:- Option-B
Question4:-In a Technetium radiopharmaceutical the number of states that Technetium can exist is
A:-1
B:-2
C:-3
D:-4
Correct Answer:- Option-C
Question5:-The radiopharmaceuticals requiring one solvent chromatography are all except
A:-Tc-99m DMSA
B:-Tc-99m MAA
C:-Tc-99m Sulphur Colloid
D:-Tc-99m DTPA
Correct Answer:- Option-D
Question6:-What instrument will you use if you have a spill of 2 mCi of I-131 in your lab?
A:-Cutie Pie
B:-Survey Meter
C:-Well Counter
D:-TLD
Correct Answer:- Option-B
Question7:-The type of collimator used in thyroid probe is
A:-Pinhole collimator
B:-Parallel hole collimator
C:-Converging collimator
D:-Flatfield collimator
Correct Answer:- Option-D
Question8:-Thermal neutrons are absorbed by
A:-Graphite
B:-Cadmium
C:-Beryllium
D:-Heavy water
Correct Answer:- Option-B
Question9:-For a radiopharmaceutical if Tp is < Tb, then the Te will be
A:-Less than Tp
B:-Less than Tb
C:-No relation
D:-Equal to Tp
Correct Answer:- Option-A
Question10:-A kit preparation of Tc-99m which involves a transchelation reaction is
A:-Tc-99m DMSA
B:-Tc-99m DTPA
C:-Tc-99m Mebrofenin
D:-Tc-99m ECD
Correct Answer:- Option-D
Question11:-The precision of measured counts is indicated by
A:-Mean
B:-Standard deviation
C:-Median
D:-Confidence interval
Correct Answer:- Option-B
Question12:-For a count of 10,000, calculate the % uncertainity
A:-1%
B:-0.1%
C:-0.01%
D:-.02%
Correct Answer:- Option-A
Question13:-How closely a measurement agrees with the "True" value is called its?
A:-Precision
B:-Real value
C:-Accuracy
D:-Sensitivity
Correct Answer:- Option-C
Question14:-Radioactive disintegration follows a
A:-Gaussian distribution
B:-Poisson distribution
C:-Random distribution
D:-Log distribution
Correct Answer:- Option-B
Question15:-Interater agreement for categorical items is measured using
A:-Pearson correlation
B:-Mann Whitney U Test
C:-Wicoxon signed rank test
D:-Cohens Kappa
Correct Answer:- Option-D
Question16:-What statistical test will you apply to determine the significance of difference between the means of two sets of data obtained from the same set of patients following a normal distribution and whether positive or negative?
A:-One-sided Unpaired t test
B:-Two-sided Unpaired t test
C:-One-sided Paired t test
D:-Two-sided Paired t test
Correct Answer:- Option-D
Question17:-For a first order process rate constant k X concentration of substance in the compartment determines
A:-mean transit time
B:-flux
C:-turnover time
D:-steady state
Correct Answer:- Option-B
Question18:-The technique that averages local pixel values to reduce the effect of pixel-to-pixel variation is
A:-Normalizing
B:-Segmentation
C:-Smoothing
D:-Windowing
Correct Answer:- Option-C
Question19:-Nominal data from independent groups is analyzed using
A:-Mc Nemar Test
B:-Chi Square Test
C:-Wilcoxon signed rank test
D:-Friedman test
Correct Answer:- Option-B
Question20:-A useful approach to determine causes of artifacts in PET and SPECT images is
A:-MIP image
B:-Cine image
C:-Sinogram
D:-Back projection image
Correct Answer:- Option-C
Question21:-Identify this structure(arrow)
A:-Right lung upper lobe
B:-Right lung apex
C:-Azygous lobe
D:-Azygous vein
Correct Answer:- Option-C
Question22:-Identify this structure
A:-Caudate
B:-Putamen
C:-Thalamus
D:-Globus Pallidus
Correct Answer:- Option-B
Question23:- Identify the pathology on I-131 MIBG planar scan
A:-Pheochromocytoma
B:-Paraganglioma
C:-NET
D:-Normal Adrenal
Correct Answer:- Option-A
Question24:-Identify the pathology on Tc-99m Mebrofenin scan
A:-Gall bladder
B:-Choledochal cyst
C:-Bilioma
D:-Hydatid cyst
Correct Answer:- Option-B
Question25:-Identify the structure with increased FDG uptake on PET/CT
A:-None
B:-Duodenum
C:-Stomach
D:-Pancreas
Correct Answer:- Option-D
Question26:-At the cellular level, the following components have been implicate in promoting elevated FDG uptake in the malignant cells compared to host cells except
A:-Increased vascular flow-more tracer is available for the uptake
B:-Increased GLUT-1 on the cellular membrane-more FDG movement into the cell
C:-More HK 11-more FDG-6-P Production
D:-Increased dephosphorylation of FDG-6-P and less egress of FDG activity out of the malignant cell
Correct Answer:- Option-D
Question27:-An imaging radiopharmaceutical for tumor Apoptosis
A:-18 F-MISO
B:-11C-Co2
C:-99mTc-Annexin
D:-62Cu ATSM
Correct Answer:- Option-C
Question28:-Which of the following mechanism justifies the increased uptake of 11C methionine in cancer cells?
A:-Phosphorylation
B:-Decarboxylation
C:-Hexokinase activity
D:-Trans methylation
Correct Answer:- Option-D
Question29:-99 Tc RBC scintigraphy for the diagnosis of hepatic cavernous hemangioma
A:-Is the most sensitive noninvasive method
B:-Is the most specific noninvasive method
C:-Its sensitivity does not depend upon the size of the lesion
D:-It cannot differentiate hepatic cavernous hemangioma from matastasis
Correct Answer:- Option-B
Question30:-Critical organ for 201 Thallium is
A:-Gal bladder
B:-Kidneys
C:-Small intestine
D:-Large intestine
Correct Answer:- Option-B
Question31:-Which of the following radioisotope is recommended for the labeling of monoclonal antibodies for PET imaging?
A:-68 Ga
B:-124 I
C:-18 F
D:-11 C
Correct Answer:- Option-B
Question32:-On myocardial perfusion scan which of the following factors can be considered an advantage of 99m Tc tetrofosmin over 99m Tc Sestamibi?
A:-Higher myocardial uptake
B:-Rapid hepatic clearance
C:-Lower pulmonary uptake
D:-Lower price
Correct Answer:- Option-B
Question33:-What is the most appropriate radiopharmaceutical for myocardial perfusion with PET?
A:-18F FDG
B:-13 N Ammonia
C:-82 Rb
D:-11C Palmitate
Correct Answer:- Option-B
Question34:-Which brain SPECT imaging has the poorest resolution quality?
A:-99m Tc HMPAO
B:-99m Tc ECD
C:-123 I IMP
D:-133 Xe
Correct Answer:- Option-D
Question35:-Which among the following is radiochemical impurity?
A:-Presence of free 99m Tc in radiopharmaceutical preparation
B:-The presence of 99Mo in 99m Tc04-Solution
C:-The presence of alumina in 99m Tc04-Solution
D:-None of the above
Correct Answer:- Option-A
Question36:-Argon is the choice of gas filled in dose calibrator due to
A:-It being non-radioactive in most physical conditions
B:-It being the cheapest among all noble gases
C:-It has relatively higher Z and lower first ionization potential
D:-All of the above
Correct Answer:- Option-D
Question37:-The major interactions in soft tissues for 100 Kev to 10 Mev energy range is
A:-Photoelectric effect
B:-Compton Scattering
C:-Pair production
D:-Both 2 and 3
Correct Answer:- Option-B
Question38:-It is called for an investigation of Over Exposure if a person is receiving exposure more than 10 mSv during
A:-One month
B:-One year
C:-Monitoring period
D:-None of the above
Correct Answer:- Option-C
Question39:-Organ absorbed dose is
A:-Directly proportional to the effective half-life of the radionuclide
B:-Inversely proportional to the effective half-life of the radionuclide
C:-Not related to the effective half-life of the radionuclide
D:-Four times less than the effective half-life of the radionuclide
Correct Answer:- Option-A
Question40:-131 Iodine sealed in the capsule for the treatment of thyroid disorder is termed as
A:-Normal form of radioactive material
B:-Special form of radioactive material
C:-Depends on the activity of 131I in the capsule
D:-None of the above
Correct Answer:- Option-B
Question41:-In case of spillage of very high radionuclide activity, the steps taken are
i. Information to RSO
ii. Decontaminate the area
iii. Inform others about the incidence
iv. Control the spread of contamination
A:-i, ii, iii, iv
B:-ii, iii, iv, i
C:-iii, iv, i, ii
D:-iv, ii, iii
Correct Answer:- Option-D
Question42:-Sensitivity to radiation carcinogenesis is maximum for
A:-Senior Citizen > 60 yrs
B:-Children < 20 yrs
C:-Adult females
D:-Adult males in the age group of 20-60yrs
Correct Answer:- Option-B
Question43:-If the physical half-life of a radionuclide is 2 days and the biological half-life is 4 days, the effective half life of the radionuclide is
A:-6 days
B:-13 days
C:-1.33 days
D:-4 days
Correct Answer:- Option-C
Question44:-Basic principle of radiation protection is to
A:-Completely avoid deterministic effects and minimize stochastic effects well below the detectable levels
B:-Only avoid deterministic effects
C:-Set dose limits based on actual epidemiological observations of occupational workers
D:-None of the above
Correct Answer:- Option-A
Question45:-Doubling dose for genetic effects is
A:-Dose needed to achieve double the mutation rate compared to the natural mutation rate
B:-The dose needed to double the total mutations
C:-The dose needed to observe double the frequency of recessive disorders in a human population
D:-The dose needed to achieve half the mutation rate compared to the natural mutation rate
Correct Answer:- Option-A
Question46:-Tissue weighting factor is based on
A:-Fractional contribution of a tissue based on relative detriment towards stochastic risk
B:-Total weight of the concerned tissue
C:-Related to the total surface area of the patient
D:-Threshold of the deterministic effect associated with the tissue
Correct Answer:- Option-A
Question47:-Which of the following is the principle of medical ethics?
A:-Autonomy
B:-Beneficence
C:-Confidentiality
D:-All of the above
Correct Answer:- Option-D
Question48:-Which of the following are types of consent?
A:-Informed consent
B:-Express consent
C:-Proxy consent
D:-All of the above
Correct Answer:- Option-D
Question49:-Which instrument is used for locating radioactive contamination?
A:-Well Counter
B:-Gas Ion Chamber
C:-Geiger Counter
D:-Proportional Counter
Correct Answer:- Option-C
Question50:-True incidence counts in PET imaging correspond to the number of __________ that occur between a pair of PET detector crystals.
A:-Positron - electron annihilation
B:-Annihilation gamma rays
C:-Nuclear decays
D:-Positrons emitted
Correct Answer:- Option-A
Question51:-What is the minimum volume of gastrointesinal (GI) bleed that can be detected by RBC scintigraphy?
A:-0.1 mL
B:-0.5 mL
C:-1 mL
D:-5 mL
Correct Answer:- Option-B
Question52:-PSMA therapy most common side effects is
A:-Drop in GFR
B:-Drop in Blood parameters
C:-Sialadenitis
D:-Diarrhea
Correct Answer:- Option-C
Question53:-What is the mechanism of choline uptake in parathyroid adenoma on Choline PET/CT?
A:-Chief cells
B:-Oxyphil cells
C:-Both Chief cells and Oxyphil cells
D:-None of the above
Correct Answer:- Option-C
Question54:-Therasphere/Sirsphere is contraindicated if right to left shunt is more than
A:-5%
B:-10%
C:-20%
D:-30%
Correct Answer:- Option-C
Question55:-PET/MR is best indicated in
A:-Lung metastasis
B:-Lymph metastasis
C:-Bone metastasis
D:-Liver metastasis
Correct Answer:- Option-D
Question56:-Radiotherapy is indicated in patients with thyroid cancer
A:-Brain metastasis
B:-Lung metastasis
C:-Spinal metastasis
D:-Lymph node metastasis
Correct Answer:- Option-C
Question57:-Dose limiting factor in pediatric thyroid cancer patients is with following site of metastasis
A:-Brain metastasis
B:-Lung metastasis
C:-Spinal metastasis
D:-Lymph node metastasis
Correct Answer:- Option-B
Question58:-During a lung perfusion study, activity is noted in the head and in the area of the kidneys. This represents
A:-Incorrect particle size
B:-Right to left shunt
C:-Probable metastasis
D:-Free technetium in the MAA
Correct Answer:- Option-B
Question59:-When activity is noted in the head and in the area of the kidneys, minimum right to left shunt is
A:-4
B:-8
C:-16
D:-20
Correct Answer:- Option-B
Question60:-FAPI PET/CT has advantage over FDG PET/CT in patients with
A:-GI malignancy
B:-Lymphoma
C:-Breast Cancer
D:-Genital malignancies
Correct Answer:- Option-A
Question61:-In TENIS patients of thyroid cancer FDF PRY/CT is indicated when minimum Tg level is
A:-More than 5
B:-More than 80
C:-More than 120
D:-More than 20
Correct Answer:- Option-D
Question62:-Sandwich protocol in neuroendrocrine tumor therapy is
A:-Chemotherapy followed by Radiotherapy followed by Chemotherapy
B:-DOTATATE therapy followed by chemotherapy followed by DOTATATE therapy
C:-DOTATATE therpay followed by radiotherapy followed by DOTATATE therapy
D:-DOTATATE therapy followed by surgery followed by DOTATATE therapy
Correct Answer:- Option-B
Question63:-CXCR for PET/CT is based on
A:-Chemokine receptors
B:-SS receptors
C:-Estrogen receptors
D:-Progesterone receptors
Correct Answer:- Option-A
Question64:-Ga-68 trivhexine PET/CT imaging is based on
A:-Integrin expression receptor
B:-Chemokine expression receptor
C:-Somatostatin receptor
D:-HER2 receptor
Correct Answer:- Option-A
Question65:-F-18 Tetrafluoroborate PET/CT imaging is based on
A:-Integrin expression receptor
B:-HER2 receptor
C:-Chemokine expression receptor
D:-Sodium/iodide symporter
Correct Answer:- Option-D
Question66:-In 3D PET acquisition, what determines the optimum amount of administered activity?
A:-True count rate
B:-Noise equivalent count rate
C:-External radiation exposure
D:-Internal radiation exposure
Correct Answer:- Option-B
Question67:-What is the recommended approach to optimize radiation dose to patients in PET examinations?
A:-Administer the maximum possible radioactivity to ensure clear images
B:-Administer an amount of radioactivity sufficient for good images of diagnostic information
C:-Administer radioactivity beyond the required levels for better count rates
D:-Administer a fixed amount of radioactivity regardless of imaging requirements
Correct Answer:- Option-B
Question68:-What is the half-value thickness of lead material for 511 keV photons compared to 140 keV photons?
A:-4.1 mm vs 0.3 mm
B:-0.3 mm vs 4.1 mm
C:-2.5 mm vs 1.0 mm
D:-0.5 mm vs 2.0 mm
Correct Answer:- Option-A
Question69:-What is the primary concern regarding radiation exposure for staff in nuclear medicine compared to radiology and teletherapy?
A:-Internal contamination from unsealed sources
B:-External irradiation during procedures
C:-Exposure to radioactive aerosols
D:-Handling of volatile radiopharmaceuticals
Correct Answer:- Option-A
Question70:-Which areas in nuclear medicine facility are typically classified as controlled areas?
A:-Patients waiting rooms
B:-Examination rooms
C:-Storage and preparation rooms for radiopharmaceuticals
D:-Counting and imaging departments
Correct Answer:- Option-C
Question71:-What is the purpose of the Annual Limit on Intake (ALI)?
A:-To determine the maximum amount of radiation a person can receive in a year
B:-To calculate the amount radiation required for medical imaging
C:-To estimate the dose resulting from internal contamination
D:-To regulate the disposal of radioactive materials
Correct Answer:- Option-C
Question72:-Which method is typically used to remove loose contamination from surfaces in nuclear medicine facilities?
A:-Dry wiping
B:-Acid treatment
C:-Wet swabbing
D:-Air blowing
Correct Answer:- Option-C
Question73:-What action should be taken if fixed contamination emits high-energy gamma radiation and has a long half-life?
A:-Dispose of the contaminated object
B:-Use mild acids for cleaning
C:-Apply a thick coat of paint
D:-Use soap-EDTA mixture
Correct Answer:- Option-A
Question74:-Which of the following factors is NOT typically considered when planning the layout of a Nuclear Medicine department?
A:-Accessibility for patients with disabilities
B:-Proximity to the emergency room
C:-Adequate shielding for radiation safety
D:-Workflow efficiency for staff
Correct Answer:- Option-B
Question75:-How does the gamma ray constant of PET radionuclides compare to that of Tc-99m?
A:-The same
B:-7 times more
C:-Half as much
D:-One tenth as much
Correct Answer:- Option-B
Question76:-Which of the following radionuclides used for pain palliation works by Auger electron emission?
A:-Sr89
B:-117mSn
C:-153Sm
D:-186Re
Correct Answer:- Option-B
Question77:-Most common toxicity of therapy is
A:-Thrombocytopenia
B:-Deterioration of renal function
C:-Hypothyroidism
D:-Hypertension
Correct Answer:- Option-A
Question78:-Physiological sites for DMSA concentration are all of the following except
A:-Kidney
B:-Nasal mucosa
C:-Female breasts
D:-Skull bones
Correct Answer:- Option-D
Question79:-All of the following are PET agents except
A:-F18
B:-Ga-68
C:-Rb-82
D:-N-14
Correct Answer:- Option-D
Question80:-Octreotide is preferred over Somatisation because
A:-It has a shorter half-life than the latter
B:-It has a longer half-life than the latter
C:-It shows greater tumour uptake than the latter
D:-It is less expensive
Correct Answer:- Option-B
Question81:-All of the following tumors take up Octreotide except
A:-Medullary Carcinoma
B:-Neuroblastoma
C:-Pheochromocytoma
D:-Glioblastoma multiforme
Correct Answer:- Option-D
Question82:-The T1/2 of Carbon-11, Fluorine-18, Oxygen-15 and Nitrogen-13 are respectively
A:-20 min, 110 mins, 2 mins and 10 mins
B:-10 min, 110 mins, 2 mins and 20 mins
C:-110 min, 10 mins, 20 mins and 2 mins
D:-2 min, 110 mins, 20 mins and 10 mins
Correct Answer:- Option-A
Question83:-Which among the following drugs with not interfere with MIB uptake?
A:-Tricyclic antidepressents
B:-Deriphylline
C:-Reserpina
D:-Dopamine
Correct Answer:- Option-B
Question84:-The Fu radionuclide used for large joint synoveitomy is
A:-Re 186
B:-Elb 169
C:-Y-90
D:-None of the above
Correct Answer:- Option-C
Question85:-Which among the following radio isotope is not used for palliation of bone pain?
A:-P-32
B:-Sr 89
C:-Re 186
D:-Re 188
Correct Answer:- Option-D
Question86:-Which among the following radio isotope is not used for imaging
medullary carcinoma thyroid?
A:- 68Ga-DOTA-
B:- 99mTc(V)DMSA
C:- 131I NaI
D:- 18F-FDG
Correct Answer:- Option-C
Question87:-131I therapy is not indicated in
A:-Papillary carcinoma thyroid
B:-Follicular carcinoma thyroid
C:-Insular carcinoma thyroid
D:-Anaplastic carcinoma thyroid
Correct Answer:- Option-D
Question88:-Among neuroendocrine tumors which has the good prognosis?
A:- 68Ga DOTA negative and 18 FDG scan positive
B:- 68Ga DOTA positive and 18 FDG scan positive
C:- 68Ga DOTA positive and 18 FDG scan negative
D:- 68Ga DOTA scan negative and 18 FDG scan negative
Correct Answer:- Option-C
Question89:-Which radioisotope is ideal for whole body imaging in well differentiated thyroid tumor after thyroidectomy?
A:-131I
B:-123I
C:-124I
D:-125I
Correct Answer:- Option-B
Question90:-Which one of the following drugs interfere with the uptake of 131 I in the thyroid gland/metastasis?
A:-Alpha blockers
B:-Beta-blockers
C:-Verapamil
D:-Amiodarone
Correct Answer:- Option-D
Question91:-Which one of the following is the proper way of validating the data?
A:-Repetition of full data collection in the same population
B:-Data collection in new population
C:-Repetition of data collection in a randomly selected subset in the same population
D:-Repeat data collection is not required
Correct Answer:- Option-C
Question92:-To describe the study population characteristics we need to
A:-Calculate the frequency of distribution
B:-Calculate measures of association
C:-Look for correlation between variables
D:-Perform multivariable regression
Correct Answer:- Option-A
Question93:-Which of the following is TRUE for a "Descriptive Research Question"?
A:-Involves observation to measure a quantity
B:-Involves comparison groups
C:-Tests the efficacy of interventions
D:-Require hypothesis testing
Correct Answer:- Option-A
Question94:-The ability to apply the principles of analysis to identify those studies which are unbiased and valid is called as
A:-Critical appraisal
B:-Information seeking
C:-Information management
D:-Systematic review
Correct Answer:- Option-A
Question95:-The purpose of a double-blinding in a clinical trial is to
A:-Achieve comparability of all arms of a clinical trial
B:-Avoid observer and participant bias
C:-Avoid observer bias and sampling variation
D:-Avoid subject bias and sampling variation
Correct Answer:- Option-B
Question96:-In a clinical trial, what is the main purpose of randomization?
A:-To get more power for data analysis
B:-To reduce investigator bias
C:-To get groups with comparable baseline characteristics
D:-To ensure optimum number of participants in each trial arm
Correct Answer:- Option-C
Question97:-Statistical power is defined as the probability of
A:-Accepting a null hypothesis when it is false
B:-Rejecting a null hypothesis when it is true
C:-Rejecting a null hypothesis when it is false
D:-Failing to reject a null hypothesis when it is false
Correct Answer:- Option-C
Question98:-Ability of a study to detect correctly the presence of an association is known as
A:-Precision
B:-Power
C:-Confidence
D:-Significance
Correct Answer:- Option-B
Question99:-A study design that randomly assigns participation into an experimental group or control group is called as
A:-Cohort Study
B:-Case - Control Study
C:-Randomized Controlled Trials
D:-Cross Sectional Study
Correct Answer:- Option-C
Question100:-Difference between the minimum value and the maximum value of the observations
A:-Variance
B:-Inter-quartile range
C:-Range
D:-Standard deviation
Correct Answer:- Option-C
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