Question 1

Angiotensin-converting enzyme inhibitor (ACEI) augments renal studies in patients with

Accepted Answer

Patients with hypertension may be classified into three groups: (1) those with hypertension and no significant RAS, (2) those with hypertension in whom RAS is a major contributor to the hypertension, and (3) those with hypertension in whom RAS is an insignificant contributor to the hypertension. Renal imaging with and without an ACE inhibitor is intended to identify patients in whom RAS is a major contributor to the hypertension (group 2).

Question 2

It is important to position the crystal of the camera parallel to the surface when performing renal imaging to prevent the artifact of

Accepted Answer

With planar scintigraphy, the kidney may appear smaller than its actual size if the long axis is not parallel to the surface of the crystal of the gamma camera. This artifact is called foreshortening.

Question 3

If normal resting cardiac output is 5 L/min; the total renal blood flow would be approximately

Accepted Answer

Approximately 20% to 25% of the cardiac output goes to normally functioning kidneys. Because the resting cardiac output is 5 L/min, total renal blood flow is about 1.2 L/min.

Question 4

The kidneys span the distance between the

Accepted Answer

The top of each kidney is located just below the ribs in the back, spanning the distance between the 12th thoracic vertebra and the 3rd lumbar vertebra.

Question 5

The most accurate nuclear medicine technique for measuring renal size is

Accepted Answer

With planar scintigraphy, the kidney may appear smaller than its actual size if the long axis is not parallel to the surface of the crystal of the gamma camera. This artifact is called foreshortening. SPECT imaging using a morphologic renal imaging agent such as dimercaptosuccinic acid (DMSA) is a more accurate technique for measuring renal size.

Question 6

Absolute renal function typically refers to the

Accepted Answer

Most medical centers do not measure absolute renal function (ERPF or the GFR) because the most accurate methods are time-consuming and cumbersome, requiring several timed blood samples.

Question 7

A patient is scheduled for a diuretic renal imaging study. The technologist prepares the radiopharmaceutical and

Accepted Answer

At 20 minutes after injection of the radiopharmaceutical, intravenous injection of furosemide (Lasix) is very useful.

Question 8

If normal effective renal plasma flow (ERPF) is about 600 mL/min, normal glomerular filtration rate (GFR) is

Accepted Answer

Approximately 20% of the plasma passes through the glomerulus into the renal tubules, resulting in a GFR of 120 mL/min.

Question 9

The two most common agents used for morphologic renal imaging are

Accepted Answer

^99mTc-DMSA and ^99mTc-glucoheptonate are considered morphologic imaging agents, because accumulation in the kidney is the result of a complex interaction of blood flow, the GFR, tubular secretion, and tubular resorption.

Question 10

The best view for demonstrating a horseshoe kidney is the

Accepted Answer

Because the spine attenuates the activity coming from the thin band of tissue connecting the lower poles of the kidneys, this congenital abnormality may be missed if only posterior views are obtained. An anterior view often clearly shows the band of functioning tissue that connects the lower poles of the kidney.

Question 11

A diuretic renal imaging study is most helpful in differentiating

Accepted Answer

A diuretic renal imaging study is most helpful in differentiating a dilated renal collecting system from an obstructed renal collecting system.

Question 12

On a renal scan, the right kidney is slightly lower than the left kidney. Because of this, the technologist should

Accepted Answer

The right kidney is slightly lower than the left because it is displaced by the liver.

Question 13

A neobladder made from a portion of the small bowel is called

Accepted Answer

Sometimes a patient's bladder is removed to treat bladder cancer. A new "bladder" (neobladder) can be fashioned from the patient's gastrointestinal tract and is most commonly made from a portion of the small bowel (ileum), thus being called an ileal loop. Less commonly, a small portion of the colon can be used to construct a neobladder.

Question 14

Morphologic renal imaging can be used to document

Accepted Answer

Morphologic renal imaging can be used to document global and regional changes in renal function (e.g., acute pyelonephritis, areas of decreased function, cortical defects).

Question 15

Common morphologic imaging agents include

Accepted Answer

Morphological renal imaging after injection of ^99mTc-glucoheptonate or ^99mTc-DMSA can be used to document global and regional changes in renal function.

Question 16

With planar scintigraphy, the kidney may appear smaller than its normal size if the

Accepted Answer

With planar scintigraphy, the kidney may appear smaller than its actual size if the long axis is not parallel to the surface of the crystal of the gamma camera. This artifact is called foreshortening.

Question 17

After the injection of furosemide in a diuretic renal imaging study, the washout activity from the collecting system has a clearance half-time of less than 10 minutes. This is most likely indicative of a(n)

Accepted Answer

A dilated but unobstructed kidney can increase its urine flow rate in response to furosemide; therefore the washout of activity from the collecting system is in the normal range (t _1/2 <10 minutes).

Question 18

A renogram (time-activity curve) shows prompt uptake of the tracer, with activity in the kidney peaking at 3 to 5 minutes after injection and decreasing to less than 50% of peak value by 20 minutes. The technologist should

Accepted Answer

The time-activity curve (renogram) from a normal MAG3 study shows prompt uptake of the tracer, with the activity in the kidney peaking at 3 to 5 minutes after injection (when radioactivity is primarily in the parenchyma (functioning tissue)) and decreasing to less than 50% of peak value by 20 minutes. Abnormal curves can result from abnormal renal function, retention of activity in the collecting system, or patient movement. The cause of an abnormal curve usually can be easily determined from visual inspection of the images, with careful attention paid to the fate of activity seen in the peripheral parenchyma (cortex) of the kidney.

Question 19

A morphologic renal tracer is noted for its

Accepted Answer

The hallmark of a morphologic renal tracer is its retention in the renal parenchyma for a prolonged period of time, thereby making possible relatively high-resolution imaging of the renal parenchyma.

Question 20

Two common agents used for functional renal imaging are

Accepted Answer

Functional renal imaging using ^99mTc-MAG3 or ^99mTc-DTPA is the most common radionuclide renal imaging study performed at most medical centers.

Quiz 21: Genitourinary System

Angiotensin-converting enzyme inhibitor (ACEI) augments renal studies in patients with

It is important to position the crystal of the camera parallel to the surface when performing renal imaging to prevent the artifact of

If normal resting cardiac output is 5 L/min; the total renal blood flow would be approximately

The kidneys span the distance between the

The most accurate nuclear medicine technique for measuring renal size is

Absolute renal function typically refers to the

A patient is scheduled for a diuretic renal imaging study. The technologist prepares the radiopharmaceutical and

If normal effective renal plasma flow (ERPF) is about 600 mL/min, normal glomerular filtration rate (GFR) is

The two most common agents used for morphologic renal imaging are

The best view for demonstrating a horseshoe kidney is the

A diuretic renal imaging study is most helpful in differentiating

On a renal scan, the right kidney is slightly lower than the left kidney. Because of this, the technologist should

A neobladder made from a portion of the small bowel is called

Morphologic renal imaging can be used to document

Common morphologic imaging agents include

With planar scintigraphy, the kidney may appear smaller than its normal size if the

After the injection of furosemide in a diuretic renal imaging study, the washout activity from the collecting system has a clearance half-time of less than 10 minutes. This is most likely indicative of a(n)

A renogram (time-activity curve) shows prompt uptake of the tracer, with activity in the kidney peaking at 3 to 5 minutes after injection and decreasing to less than 50% of peak value by 20 minutes. The technologist should

A morphologic renal tracer is noted for its

Two common agents used for functional renal imaging are