Radionuclide Therapy for Palliation of Bony Metastases

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Test: Radionuclide Therapy in Palliation of Bony Metastases

1.  Consider the following list of radiopharmaceuticals. Which three are approved for palliation of pain caused by bony metastases?
  1. 89Sr strontium chloride
  2. 153Sm-EDTMP
  3. 32P-Na phosphate
  4. 85Sr strontium chloride
  5. 131I Na iodide

        a, b and c

        a, b and d

        b, d and e

        c, d and e

2.  Which ONE of the following statements is FALSE...?:

        Use of Sr-89 chloride for treating pain from bony metastases is palliative but 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 chloride for treating pain from bony metastases confers a bone surface radiation dose of ~25 R

3.  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

4.    Which ONE of the following 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

5.     Typical injected doses of Sr-89 chloride and Sm-153 EDTMP, respectively, are...:

        0.4 mCi, 1 mCi/kg

        4 mCi, 1 mCi

        1 mCi/kg, 0.4 mCi

        1 mCi/kg , 4 mCi
 

6.   Which ONE of the following statements is TRUE?:

        Sm-153 EDTMP has a more rapid onset of relief than Sr-89 chloride, but a shorter mean duration of effect.

        Sr-89 chloride has a more rapid onset of relief than Sm-153 EDTMP, but a shorter mean duration of effect

        There is no difference in time onset of relief and duration of effect

        Both radioisotopes are pure b- emitters and neither emits gamma rays.

7.   The radioisotope with the longest physical half-life is...?:

        Sm-153

        Sr-89       

        P-32

        Tc-99m

8.   In patients with Stage IV breast and prostate cancer, what % of patients have bone disease at the time of diagnosis?:

        10%

        20%

        50%

        90%

9.    Which one of the following approaches to treatment of pain from bony metastases is the most effective...: 

        NSAIDs

        Chemotherapy

        Hormonal Therapy

        External Beam Radiation

10. Consider the following list of patients. Which one patient meets the eligibility criteria for undergoing radionuclide therapy for palliation of pain from bony metastases?:

        Male patient with WBC Count = 4,000 and platelet count = 150,000; life expectancy 1 years

        Pregnant female patient with WBC Count = 4,000 and platelet count = 150,000; life expectancy 3 years

        Male patient with WBC Count = 1,000 and platelet count = 50,000; life expectancy 3 years

        Male patient with WBC Count = 4,000 and platelet count = 150,000; life expectancy 1 month

11.    The critical organ (organ receiving highest radiation dose) for all three palliative therapeutic radiopharmaceuticals is...:

        Bone surface

        Gonads

        Liver

        Bone marrow

12.    Which ONE of the following is TRUE?:

        A flare phenomenon indicates a good probability that the treatment will not be successful

        Range of relief is typically 1 month to 3 years

        Gonadal dose from this type of therapy is > 50 Rems

        Treatment of Osteosarcoma with Sr-89 is usually not successful

13.    The critical organ (organ receiving highest radiation dose) for all three palliative therapeutic radiopharmaceuticals is...:

        Bone Surface

        Gonads

        Liver

        Bone Marrow

14.    A good method of assessing effectiveness of therapy is...:

        To ask the patient how he feels

        To check vital signs, especially body temperature

        To review pain and medication diaries

        To perform a CBC monthly

15.    The range of penetration through human tissue for P-32, Sr-89, and Sm-153 is approximately...:

        5-8 nm

        5.8 mm

        5-8 mm

        5-8 cm

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