ABNM Nuclear Medicine study plan

Derive the radioactive decay law and compute remaining activity, decay constants, and half-lives for Tc-99m, F-18, I-131, Lu-177, and Ga-68 without a calculator aid sheet.

Distinguish the five principal photon-matter interactions and predict which dominates across the 20 keV to 511 keV range relevant to nuclear medicine imaging.

Calculate absorbed dose, effective dose, and attenuation half-value layers for representative staff and patient exposure scenarios.

Build a personal reference sheet of decay factors at 1, 2, 4, 6, 12, and 24 hours for the eight most common clinical radionuclides.

Trace the signal path from scintillation crystal through photomultiplier tube, pulse-height analysis, and position logic to a planar image.

Compare collimator designs (parallel-hole, pinhole, fan-beam, slant-hole) and select the appropriate collimator for stated clinical tasks.

Design a weekly, monthly, and annual quality-control schedule for a gamma camera and a SPECT/CT system, naming the acceptance limits for each test.

Apply ALARA principles and compute expected exposure rates and shielding requirements from a stated source strength and distance.

Explain the regulatory framework for written directives, authorized user responsibilities, and medical event reporting.

Compare reactor-produced, cyclotron-produced, and generator-derived radionuclides and justify the production route for five clinically used agents.

Diagram the Mo-99/Tc-99m generator elution process and calculate elution yield, breakthrough limits, and the effect of prior elution time on activity.

Explain the chemistry of Tc-99m labeling via stannous reduction, including the roles of ligand, reducing agent, pH, and radiochemical impurities.

Describe the mechanism and biodistribution of the ten highest-volume clinical radiopharmaceuticals, including normal and abnormal distribution patterns.

Summarize the indications, preparation, and imaging parameters for F-18 FDG, Ga-68 DOTATATE, and F-18 NaF.

Perform radiochemical purity testing calculations for paper, thin-layer, and column chromatography and interpret a stated chromatogram.

Evaluate sterility, pyrogenicity, pH, particle size, and radionuclidic purity acceptance criteria for an in-house prepared kit.

Diagnose causes of a failed radiochemical purity result and propose corrective action for a stated kit preparation.

Explain the regulatory and documentation requirements for PET radiopharmacy under USP general chapters and cGMP expectations.

Interpret adverse reactions and interference scenarios involving radiopharmaceuticals and concurrent medications.

Formulate a systematic search pattern and structured reporting template for planar bone, renal, hepatobiliary, thyroid, and V/Q studies.

Interpret stated planar case vignettes and commit to a most-likely diagnosis with supporting and refuting features.

Explain SPECT reconstruction choices (filtered back projection versus iterative, filter selection, attenuation and scatter correction) and their effect on image quality.

Identify and correct common artifacts including motion, truncation, collimator damage, center-of-rotation error, and patient-related attenuation.

Select appropriate camera settings, collimators, and acquisition parameters for a stated clinical question on a given study type.

Compare PET detector designs (LSO, LYSO, GSO, BGO) and explain how time-of-flight capability and coincidence timing resolution affect image quality.

Calculate SUV from stated patient weight, injected dose, decay-corrected time, and ROI activity, and explain sources of SUV error.

Interpret stated PET/CT vignettes across oncology, cardiac, and neurologic indications, distinguishing benign from malignant uptake patterns.

Integrate CT findings with PET uptake to characterize incidentally detected lesions in stated cases.

Review advanced SPECT applications, including quantitative SPECT, myocardial perfusion, and DaTscan interpretation.

Evaluate the roles of FDG, Ga-68 DOTATATE, PSMA-targeted agents, and amyloid tracers in stated clinical scenarios and justify the agent choice.

Explain therapy dosimetry methods (MIRD schema, organ-level versus voxel-level dosimetry) and compute a stated absorbed dose to a target organ.

Compare I-131, Lu-177 DOTATATE, Lu-177 PSMA, Y-90 microsphere, and Ra-223 therapies by mechanism, indication, dosing basis, and critical organ.

Apply radiation safety precautions for therapy patients, including release criteria, household instructions, and waste handling.

Design a monitoring plan for therapy-related toxicity across hematologic, renal, and salivary endpoints.

Manage stated thyroid cancer and hyperthyroidism therapy scenarios, including activity selection, stunning, and post-therapy imaging interpretation.

Integrate prior learning by answering mixed questions across all five domains under timed conditions.

Diagnose and correct the top recurring error patterns identified in the week 4 and week 8 mock exams.

Rehearse high-yield safety and regulatory facts, including pregnancy screening, breastfeeding interruption, and medical event definitions.

Construct a final one-page synthesis sheet linking physics principles to imaging artifacts and therapy dosimetry.