100+ Free TEMN Medicina Nuclear Practice Questions

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Practice Questions100 questions

2026 Statistics

Key Facts: TEMN Medicina Nuclear Exam

100 Items

High-yield four-option MCQs in this OpenExamPrep study adaptation

OpenExamPrep Curricular Framework

6–8 Hours

Total multi-session examination duration across official theoretical and practical stages

Edital Oficial SBMN / AMB

R$ 2.000,00

Registration fee benchmark for affiliated SBMN/AMB members (R$ 4.000 for non-members)

Edital SBMN / AMB

6.0 / 10.0

Minimum Passing Grade Benchmark (60% composite score)

Regulamento Oficial TEMN / SBMN

RQE Medicina Nuclear

Specialist Registration Credential Conferred with CFM

Conselho Federal de Medicina (CFM) / AMB

CNEN RT Requirement

Mandatory specialist qualification for Nuclear Medicine Technical Responsibility under CNEN-NN-3.05

Norma CNEN-NN-3.05

The TEMN (Título de Especialista em Medicina Nuclear) is Brazil's premier nuclear medicine board certification awarded by SBMN and AMB. The examination tests radiation physics, radiopharmacy, CNEN radiation protection regulations, diagnostic PET/CT and SPECT/CT, and cutting-edge targeted radionuclide therapies (theranostics).

Sample TEMN Medicina Nuclear Practice Questions

Try these sample questions to test your TEMN Medicina Nuclear exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A nuclear medicine department elutes a technetium-99m (99mTc) generator at 08:00 AM, obtaining an activity of 740 MBq (20 mCi) in a radiopharmaceutical preparation vial. If the physical half-life of 99mTc is 6.0 hours and no further elution occurs, what is the remaining radioactivity in the vial at 02:00 PM (14:00) on the same day, assuming negligible chemical degradation?

A.185 MBq (5 mCi)

B.370 MBq (10 mCi)

C.555 MBq (15 mCi)

D.92.5 MBq (2.5 mCi)

Explanation: Radioactive decay follows the exponential formula A(t) = A0 * (0.5)^(t / T1/2). The elapsed time between 08:00 AM and 02:00 PM is exactly 6.0 hours, which represents one physical half-life of technetium-99m (T1/2 = 6.0 hours). Therefore, the initial activity of 740 MBq is halved to 370 MBq (10 mCi).

2A therapeutic radiopharmaceutical has a radionuclide physical half-life (Tp) of 8.0 days and a biological clearance half-life (Tb) from the target tumor tissue of 2.0 days. What is the effective half-life (Te) of the radiopharmaceutical in the tumor?

A.1.6 days (38.4 hours)

B.2.7 days (64.8 hours)

C.5.0 days (120 hours)

D.10.0 days (240 hours)

Explanation: The effective half-life (Te) is calculated using the reciprocal relationship 1/Te = 1/Tp + 1/Tb, which simplifies to Te = (Tp * Tb) / (Tp + Tb). Substituting the values yields Te = (8.0 * 2.0) / (8.0 + 2.0) = 16.0 / 10.0 = 1.6 days (38.4 hours). The effective half-life is always shorter than both the physical and biological half-lives.

3In a clinical molybdenum-99 / technetium-99m (99Mo/99mTc) generator system, the parent radionuclide 99Mo has a physical half-life of 66.0 hours and the daughter 99mTc has a half-life of 6.0 hours. What type of radioactive equilibrium is established, and approximately how many hours after elution does maximum 99mTc activity occur?

A.Secular equilibrium; maximum daughter activity is reached at 48 to 72 hours.

B.Transient equilibrium; maximum daughter activity is reached at approximately 23 hours.

C.Transient equilibrium; maximum daughter activity is reached at exactly 6 hours.

D.No equilibrium; daughter activity decreases continuously without reaching a maximum.

Explanation: Transient equilibrium occurs when the parent half-life is longer than the daughter half-life by a factor of roughly 10 to 100 (here, 66.0 hours vs 6.0 hours). Maximum daughter 99mTc activity in the generator column accumulates at approximately 22.9 hours (~23 hours) post-elution, at which point the rate of 99mTc decay equals its rate of production from 99Mo.

4In a germanium-68 / gallium-68 (68Ge/68Ga) generator used for PET radiopharmacy, 68Ge has a half-life of 271 days and 68Ga has a half-life of 67.7 minutes. Which type of radioactive equilibrium governs this system, and how quickly after elution does 68Ga activity regenerate to approximately 50% of its maximum yield?

A.Secular equilibrium; 68Ga regenerates to 50% of maximum yield in approximately 68 minutes (1 half-life).

B.Transient equilibrium; 68Ga regenerates to 50% of maximum yield in approximately 4.5 hours (4 half-lives).

C.Secular equilibrium; 68Ga requires 271 days to regenerate to 50% capacity.

D.Dynamic non-equilibrium; 68Ga yield cannot be predicted by physical decay equations.

Explanation: Because the parent half-life (68Ge: 271 days) is thousands of times longer than the daughter half-life (68Ga: 67.7 minutes), the system operates under secular equilibrium (T1/2_parent >> T1/2_daughter). Daughter activity regrows according to the factor (1 - e^(-lambda_d * t)), reaching 50% capacity in 1 daughter half-life (~68 minutes) and >93% of full capacity within 4 half-lives (~4.5 hours).

5According to Brazilian regulatory standards (CNEN-NN-3.05) and the United States Pharmacopeia (USP), what is the maximum permissible limit for molybdenum-99 (99Mo) breakthrough (radionuclidic impurity) in a 99mTc generator eluate at the time of patient administration?

A.0.15 kBq of 99Mo per 1 MBq of 99mTc (0.15 uCi 99Mo / mCi 99mTc)

B.1.5 kBq of 99Mo per 1 MBq of 99mTc (1.5 uCi 99Mo / mCi 99mTc)

C.0.015 kBq of 99Mo per 1 MBq of 99mTc (0.015 uCi 99Mo / mCi 99mTc)

D.15.0 kBq of 99Mo per 1 MBq of 99mTc (15.0 uCi 99Mo / mCi 99mTc)

Explanation: The statutory radionuclidic purity threshold established by CNEN-NN-3.05, Brazilian Pharmacopoeia, and USP is 0.15 uCi of 99Mo per 1.0 mCi of 99mTc (equivalent to 0.15 kBq 99Mo per 1.0 MBq 99mTc) at the time of patient administration. Because 99Mo has a much longer half-life (66h) than 99mTc (6h), the 99Mo/99mTc activity ratio increases over time, requiring calculation to ensure compliance at the end of the vial's shelf life.

6Aluminum ion (Al3+) breakthrough in a 99mTc generator eluate is a chemical impurity resulting from the acidic alumina (Al2O3) column. What is the maximum acceptable concentration of Al3+ in generator eluates, and what adverse in vivo imaging artifact can excess Al3+ cause?

A.Less than 10 ug/mL; excess Al3+ causes colloid formation leading to abnormal liver and spleen uptake during bone scintigraphy.

B.Less than 50 ug/mL; excess Al3+ causes rapid renal tubular precipitation and acute nephrotoxicity.

C.Less than 1 ug/mL; excess Al3+ causes cross-reactivity with thyroid peroxidase and false-positive thyroid uptake.

D.Less than 100 ug/mL; excess Al3+ results in microembolization in pulmonary capillaries during brain SPECT.

Explanation: The pharmacopeial limit for chemical aluminum breakthrough in generator eluates is <10 ug Al3+/mL, routinely tested using colorimetric aurintricarboxylic acid spot paper. Excess aluminum ions interact with radiopharmaceutical compounds (such as 99mTc-MDP or 99mTc-pyrophosphate) to form colloidal aggregates that are phagocytosed by the reticuloendothelial system, causing unwanted liver and splenic visualization on bone scans.

7A radiopharmacist performs quality control on a freshly prepared kit of 99mTc-sestamibi using Instant Thin-Layer Chromatography (ITLC). In the test system, intact 99mTc-sestamibi migrates to the solvent front (top half: 9,600 counts), while hydrolyzed-reduced technetium (99mTcO2) and free pertechnetate (99mTcO4-) remain at the origin (bottom half: 400 counts). What is the calculated radiochemical purity (RCP), and does it meet minimum release specifications?

A.RCP = 96.0%; meets release specifications (minimum required RCP >= 90.0%).

B.RCP = 92.0%; fails release specifications (minimum required RCP >= 95.0%).

C.RCP = 88.5%; fails release specifications (minimum required RCP >= 90.0%).

D.RCP = 98.4%; meets release specifications (minimum required RCP >= 99.0%).

Explanation: Radiochemical purity is calculated as RCP (%) = (Counts at target fraction / Total counts) * 100%. Here, RCP = (9,600 / [9,600 + 400]) * 100% = (9,600 / 10,000) * 100% = 96.0%. Because the standard pharmacopeial release specification for 99mTc-sestamibi requires an RCP of at least 90.0%, this preparation easily passes quality control.

8Which gamma camera collimator design is optimal for imaging indium-111 (111In; primary gamma photopeaks at 171 keV and 245 keV) and gallium-67 (67Ga; photopeaks at 93, 185, and 300 keV) to prevent high-energy septal penetration while preserving spatial resolution?

A.Low-Energy High-Resolution (LEHR) parallel-hole collimator

B.Medium-Energy General-Purpose (MEGP) parallel-hole collimator

C.Low-Energy All-Purpose (LEAP) parallel-hole collimator

D.Ultra-High-Resolution Pinhole collimator with 0.5 mm aperture

Explanation: Medium-Energy General-Purpose (MEGP) collimators have thicker lead septa designed to attenuate gamma photons up to 300 keV without allowing septal penetration. Low-energy collimators (LEHR/LEAP) are rated only up to 140–160 keV; when used with 111In (245 keV) or 67Ga (300 keV), high-energy photons penetrate the thin septa, causing starburst artifacts, severe image degradation, and loss of contrast.

9In Positron Emission Tomography (PET) coincidence detection, which type of coincidence event occurs when two 511-keV annihilation photons originating from unrelated positron annihilations are detected within the same coincidence timing window (tau)?

A.True coincidence

B.Scatter coincidence

C.Random (accidental) coincidence

D.Multiple coincidence

Explanation: A random (accidental) coincidence occurs when two independent 511-keV photons from two completely separate positron annihilation events strike opposing detector elements within the coincidence timing window (typically 3–5 nanoseconds). Random coincidences add uniform background noise and degrade image contrast, and their rate increases with the square of the administered radioactivity.

10Time-of-Flight (TOF) PET technology measures the difference in arrival times (delta-t) between paired 511-keV annihilation photons. What is the fundamental clinical and physical advantage of TOF-PET compared to non-TOF PET?

A.It restricts the position of the annihilation event along the Line of Response (LOR), significantly increasing the Signal-to-Noise Ratio (SNR), especially in large or obese patients.

B.It eliminates the necessity for CT attenuation correction maps by recalculating tissue electron density from photon speed.

C.It completely eliminates positron range blurring, achieving sub-millimeter spatial resolution regardless of the positron isotope.

D.It shortens the physical half-life of positron-emitting radionuclides through quantum entanglement.

Explanation: TOF-PET measures the arrival time difference (delta-t) with picosecond precision (e.g., 200–400 ps), constraining the annihilation position along the LOR according to delta-x = (c * delta-t) / 2. This reduces noise propagation during iterative reconstruction, resulting in a substantial gain in Signal-to-Noise Ratio proportional to sqrt(2D / c*delta-t), which markedly improves lesion detectability and contrast in large/obese patients.

About the TEMN Medicina Nuclear Exam

The Título de Especialista em Medicina Nuclear (TEMN) is the official medical board certification for nuclear medicine physicians in Brazil, conferred by the Sociedade Brasileira de Medicina Nuclear e Imagem Molecular (SBMN) in conjunction with the Associação Médica Brasileira (AMB) and recognized by the Conselho Federal de Medicina (CFM). Passing the TEMN examination is mandatory to obtain the Registro de Qualificação de Especialista (RQE) in Nuclear Medicine and is a statutory requirement under CNEN-NN-3.05 for physicians serving as Technical Managers (Responsáveis Técnicos) of nuclear medicine departments and theranostic centers throughout Brazil.

Assessment

Multi-stage examination administered by SBMN and AMB: (1) Prova Teórica de Clínica (Clinical MCQs), (2) Prova Teórica de Física Médica e Proteção Radiológica (Physics and CNEN Radiation Safety MCQs), (3) Prova Teórico-Prática (Clinical and Imaging Case Vignettes), and Análise Curricular.

Time Limit

6 to 8 hours across multiple examination sessions on official test dates

Passing Score

Minimum composite grade of 6.0 / 10.0 (or 60%) across theoretical clinical, radiation physics/safety, and practical case interpretation stages

Exam Fee

R$ 2.000,00 (sócios adimplentes da SBMN/AMB) / R$ 4.000,00 (não sócios ou inadimplentes) (Sociedade Brasileira de Medicina Nuclear e Imagem Molecular (SBMN) — Associação Médica Brasileira (AMB))

TEMN Medicina Nuclear Exam Content Outline

15%

Física das Radiações, Instrumentação e Controle de Qualidade

Radiation physics, decay kinematics, photon interactions, gamma cameras, SPECT reconstruction, PET coincidence and TOF, dose calibrators, and equipment quality control (uniformity, COR, spatial resolution, linearity).

10%

Radiofarmácia e Princípios de Imagem Molecular

Radionuclide production (cyclotron, reactor, generators), Mo-99/Tc-99m and Ge-68/Ga-68 generator physics, radiochemical synthesis, radiochemical purity (ITLC), radionuclidic and chemical impurities, and sterility/endotoxin testing.

12%

Proteção Radiológica, Dosimetria e Normas CNEN

Radiation protection principles (ALARA, justification, optimization, dose limits), CNEN-NN-3.01 and CNEN-NN-3.05 standards, internal/external dosimetry (MIRD schema), radioactive waste management, contamination surveys, and therapeutic discharge criteria.

18%

PET/CT e Imagem Molecular em Oncologia

18F-FDG PET/CT in oncology, standard uptake value (SUV), Lugano/Deauville response in lymphoma, PERCIST criteria, 68Ga/18F-PSMA PET/CT for prostate cancer, 68Ga-DOTA somatostatin receptor PET/CT in NETs, 18F-FES, and 18F-DOPA.

15%

Teranóstica e Terapia com Radionuclídeos

I-131 therapy for hyperthyroidism and differentiated thyroid cancer (ablation, dosimetry, ATA risk), 177Lu-PSMA-617 radioligand therapy, 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT), Ra-223 for mCRPC bone metastases, and Y-90 radioembolization (SIRT).

12%

Cardiologia Nuclear

Myocardial perfusion SPECT (sestamibi/tetrofosmin/thallium), physical and pharmacological stress protocols (adenosine, dipyridamole, regadenoson, dobutamine), gated SPECT parameters, myocardial viability (18F-FDG PET), 99mTc-PYP cardiac amyloidosis scintigraphy, and cardiac sarcoidosis.

10%

Nefrourologia, Gastroenterologia e Pediatria Nuclear

Dynamic renal scintigraphy (99mTc-MAG3, DTPA, diuretic protocol), static renal scintigraphy (99mTc-DMSA), gastric emptying, GI bleeding, Meckel diverticulum, hepatobiliary scintigraphy (HIDA), and pediatric dosage card protocols.

Neurologia, Endocrinologia Diagnóstica e Sistema Músculo-Esquelético

Brain 18F-FDG PET (dementia patterns), 123I-FP-CIT DaTscan in movement disorders, brain death confirmation, parathyroid scintigraphy (dual-phase sestamibi, SPECT/CT), diagnostic thyroid uptake/scintigraphy, 123I/131I-MIBG imaging, and 3-phase bone scintigraphy.

How to Pass the TEMN Medicina Nuclear Exam

What You Need to Know

Passing score: Minimum composite grade of 6.0 / 10.0 (or 60%) across theoretical clinical, radiation physics/safety, and practical case interpretation stages
Assessment: Multi-stage examination administered by SBMN and AMB: (1) Prova Teórica de Clínica (Clinical MCQs), (2) Prova Teórica de Física Médica e Proteção Radiológica (Physics and CNEN Radiation Safety MCQs), (3) Prova Teórico-Prática (Clinical and Imaging Case Vignettes), and Análise Curricular.
Time limit: 6 to 8 hours across multiple examination sessions on official test dates
Exam fee: R$ 2.000,00 (sócios adimplentes da SBMN/AMB) / R$ 4.000,00 (não sócios ou inadimplentes)

Keys to Passing

Work through all 100 available questions
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TEMN Medicina Nuclear Study Tips from Top Performers

1Master CNEN Radiation Safety Directives: Memorize exact dose limits from CNEN-NN-3.01 (IOE: 20 mSv/year averaged over 5 years with a max of 50 mSv in any single year; eye lens: 20 mSv/year; extremities/skin: 500 mSv/year; public: 1 mSv/year; embryo/fetus of pregnant IOE: 1 mSv during gestation) and facility requirements from CNEN-NN-3.05.

2Internalize Radiopharmacy QC Cutoffs: Master Mo-99 breakthrough limits (<0.15 uCi Mo-99 per mCi Tc-99m at administration), radiochemical purity testing using Instant Thin Layer Chromatography (ITLC), aluminum breakthrough limits in generator eluates (<10 ug/mL), and LAL endotoxin thresholds.

3Calculate Decay and Dosimetry Rapidly: Practice calculating physical, biological, and effective half-lives (1/Te = 1/Tp + 1/Tb), radioactive decay law equations (A = A0 * e^(-lambda*t)), dose rate attenuation by Half-Value Layers (HVL), and inverse square law calculations for radiation protection.

4Standardize PET/CT Oncologic Interpretation: Master criteria for 18F-FDG PET/CT (Deauville 5-point scale for lymphoma, PERCIST 1.1 for metabolic tumor response, Brown adipose tissue mitigation), 68Ga/18F-PSMA PET/CT reporting (PROMISE / miTNM classification), and 68Ga-DOTATATE (Krenning score) for neuroendocrine tumors.

5Memorize Theranostics Protocols and Toxicity Profiles: Review clinical trial evidence and management protocols for 177Lu-PSMA-617 (VISION trial, salivary/renal/marrow monitoring), 177Lu-DOTATATE (NETTER-1 trial, amino acid co-infusion for nephroprotection), Ra-223 dichloride (ALSYMPCA trial, contraindication with abiraterone), and I-131 for differentiated thyroid cancer (ATA risk stratification, rhTSH vs withdrawal).

6Correlate Dynamic Renal and Cardiac Scintigraphy: Understand 99mTc-MAG3 vs DTPA vs DMSA mechanisms, diuretic renography (furosemide T1/2 <10 min normal, >20 min obstruction), captopril challenge criteria, and myocardial perfusion SPECT stress protocols (adenosine/dipyridamole vs regadenoson vs dobutamine) and cardiac amyloidosis 99mTc-PYP grading.

Frequently Asked Questions

What is the TEMN and why is it essential for physicians in Brazil?

The Título de Especialista em Medicina Nuclear (TEMN) is the official medical specialist certification awarded by the Sociedade Brasileira de Medicina Nuclear e Imagem Molecular (SBMN) and the Associação Médica Brasileira (AMB). Passing the TEMN examination allows physicians to register their specialized qualification (Registro de Qualificação de Especialista - RQE) in Nuclear Medicine with Regional Medical Councils (CRMs) and the CFM. Furthermore, under CNEN standard CNEN-NN-3.05, holding the TEMN is a statutory requirement to serve as the Technical Responsible Physician (Responsável Técnico) of any clinical nuclear medicine service in Brazil.

What are the eligibility requirements to register for the TEMN exam?

Candidates must be licensed physicians in good standing with their CRM and fulfill one of three pathways: (1) Completion of an accredited Medical Residency Program (CNRM/MEC) in Nuclear Medicine; (2) Completion of an SBMN-accredited Nuclear Medicine Specialization Program; or (3) Proven documented clinical practice in Nuclear Medicine for at least double the standard residency duration (6 years), combined with curricular point qualification as specified in the annual SBMN/AMB Edital.

How is the TEMN examination structured?

The examination is divided into distinct eliminatory stages: (1) Prova Teórica de Clínica (Clinical MCQs covering diagnostic imaging, oncology, cardiology, nephrology, pediatrics, and theranostics); (2) Prova Teórica de Física e Proteção Radiológica (MCQs focusing on radiation physics, instrumentation, radiopharmacy, and CNEN regulatory standards); (3) Prova Teórico-Prática (clinical vignettes with image interpretation of PET/CT, SPECT/CT, planar scans, and quantitative curve analysis); and (4) Análise Curricular (academic and professional portfolio evaluation).

What role do CNEN regulations play in the TEMN examination?

Knowledge of Comissão Nacional de Energia Nuclear (CNEN) regulations is heavily tested. Key standards include CNEN-NN-3.01 (Basic Radiation Protection Directives: dose limits, ALARA principles, radiation worker monitoring), CNEN-NN-3.05 (Radiation Safety and Protection Requirements for Nuclear Medicine Services: licensing, facility shielding, waste management, radioactive release criteria), and CNEN-NN-6.01 (Transport of Radioactive Materials).

Why is this OpenExamPrep question bank presented in English?

This practice bank is an English-language MCQ study adaptation crafted with 4-choice items to facilitate structured practice and self-assessment for Brazilian candidates and international nuclear medicine trainees. All authentic Brazilian regulatory standards (CNEN), SBMN recommendations, and international consensus guidelines (SNMMI/EANM) are integrated throughout the clinical rationales.