American Board of Internal Medicine (ABIM) Certification Practice Exam

Technetium-labeled nuclear scans are most useful in patients who are?

1. Asymptomatic and in follow-up

2. Transfusion dependent and hospitalized with active bleeding

3. Outpatient with a history of gastrointestinal disease

4. Undergoing routine screening

The correct answer is: Transfusion dependent and hospitalized with active bleeding

Technetium-labeled nuclear scans, commonly used in various diagnostic imaging techniques such as technetium-99m scans, are particularly valuable in assessing active bleeding situations. In patients who are transfusion-dependent and hospitalized due to active bleeding, rapid and accurate identification of the source of bleeding is crucial for appropriate management. These scans provide essential information about perfusion and can pinpoint areas of active hemorrhage, assisting clinicians in determining whether an intervention, such as endoscopy or surgical intervention, is necessary. The technology's ability to evaluate dynamic processes in real-time makes it especially pertinent in acute settings where timely decision-making is critical. In contrast, while patients in different scenarios might benefit from imaging, they may not require the immediacy and precision that technetium-labeled nuclear scans offer in the context of ongoing hemorrhage. For example, asymptomatic patients in follow-up or those undergoing routine screening may not have pressing medical needs that necessitate such a targeted imaging approach. Similarly, outpatient individuals with a history of gastrointestinal issues might be managed through less invasive methods unless they are presenting with acute symptoms. Hence, the context of active bleeding in a transfusion-dependent patient underscores the importance and utility of technetium-labeled nuclear scans.