Radiation Therapy Mock Exam 1

Which of the following types of treatments is normally accomplished using a source to skin distance of 50 cm or more:

1. Superficial

2. Supervoltage

3. Orthovoltage

4. Megavoltage

A. 1 & 3

B. 2 & 4

C. 1, 2, and 3

D. All choices

B. 2 & 4

The most common solid tumor in children is:

A. Retinoblastoma

B. ALL

C. Ewings Sarcoma

D. Medulloblastoma

D. Medulloblastoma

Which of the following methods can be used for calibration?

A. Ionization

B. Photographic

C. Thermoluminescent dosimetry

D. All choices

D. All choices

All are true regarding the location of the spleen EXCEPT:

A. Between T11-L3

B. Close to the 9th-11th ribs

C. End 5 cm to the midline

D. Lies posteriorly in the left hypochondrium

A. Between T11-L3

Primary CNS Tumors use the following staging system:

A. Ann Arbor Staging

B. FIGO

C. French American British staging

D. Grade staging

D. Grade staging

Malfunction of radiation monitoring devices may occur due to:

1. Power failure

2. Humidity

3. Damage to probe

4. Meter failure

A. 1 only

B. 2 only

C. 1 & 3

D. 1, 3, and 4 only

D. 1, 3, and 4 only

When calibrating ionization chambers, which of the following correction factors is NOT needed?

A. Barometric pressure

B. Elevation

C. Temperature

D. Beam energy

D. Beam energy

The most common metastatic site from head and neck cancer is:

A. Brain

B. Bone

C. Lung

D. Liver

C. Lung

Which radiation monitoring device is composed of ferrous sulfate, sodium chloride, and sulfuric acid?

A. TLD

B. OSL

C. Fricke dosimeter

D. Ionization chamber

E. Cutie Pie

C. Fricke dosimeter

The instrument used for recording higher energy gamma and x-radiation and beta particles specifically for contamination and measurement of radioactivity is the:

A. Geiger-Mueller counter

B. Cutie Pie

C. Ionization chamber

D. None of these

B. Cutie Pie

The most common histopathology for head neck cancers is:

A. Adenocarcinoma

B. Squamous cell carcinoma

C. Transitional cell carcinoma

D. Clear cell carcinoma

B. Squamous cell carcinoma

A 42 year old male who has been working in the field for 10 years would have a lifetime exposure of:

A. 4.2 rem

B. 42 rem

C. .05 rem

D. 5 rem

B. 42 rem

* 1 rem per year in age is allowed

Which of the following are required on the personnel monitoring report:

1. Birth date

2. Cumulative lifetime exposure

3. Cumulative annual skin dose

A. 1 & 2

B. 1 & 3

C. 2 & 3

D. All choices

A. 1 & 2

The most common cancer in children is:

A. Retinoblastoma

B. ALL

C. Ewings Sarcoma

D. Medulloblastoma

B. ALL

The annual dose limit for occupational exposure to the hands is ____ annually.

50 rem or 500 mSv

If distance is doubled, the intensity of the radiation will be:

A. Reduced by half

B. Increased by a factor of 2

C. Reduced by a factor of 4

D. Increased by a factor of 4

C. Reduced by a factor of 4

An area where the radiation level could reach 60 mrem/hr would be classified as:

A. Radiation area

B. High radiation area

C. Very high radiation area

D. Dangerous radiation area

A. Radiation area

Notice should be posted where radiation exposure has potential. An area above 100 mrem/hr must have a sign saying "Caution: High radiation area". Exposure below that can just read "radiation area."

When a patient is treated with radioactive Iodine 131, the room should have a label that reads:

A. "High Radiation-Grave Danger"

B. "Caution: Radioactive Materials"

C. "Caution: High Dose Radiation"

D. "Do Not Enter: Radiation at Excessive Levels"

B. "Caution: Radioactive Materials"

Where sources of radiation are stored and used, there should always be warning signs posted saying, "Caution: Radioactive Materials."

When calibrating ion chambers, which of the following correction favors are needed?

A. Barometric pressure

B. Volume of the chamber

C. Temperature

D. Beam energy

E. A & B

F. B & D

G. A, B, and C

D. A, B, C, and D

G. A, B, and C

For a controlled area, the shielding must be sufficient to reduce exposure to no more than:

A. 1 mrem/hr

B. 10 mrem/hr

C. 1 mrem/week

D. 100 mrem/week

D. 100 mrem/week

For sufficient shielding, exposure has to be be reduced to 100 mrem/week (.1 rem/week) for a controlled area.

A stochastic effect is best defined as one in which:

A. Severity is easily predicted

B. Severity is dose dependent

C. Probability is dose dependent

D. Severity has a threshold

C. Probability is dose dependent

For stochastic effects, the probability of a latent effect is dose dependent.

The primary function of area control activities, personnel monitoring, and proper radioactive material disposal is for the:

A. Prevention of unnecessary exposure from background radiation

B. A determination of the degree of penetration of x-Rays

C. A determination of the variation of traditional units used to measure radiation

D. Determination of appropriate ALARA procedures and process

D. Determination of appropriate ALARA procedures and process

The energy of an electromagnetic radiation is inversely proportional to its:

A. Frequency

B. Mass

C. Speed

D. Wavelength

D. Wavelength

The basic types of interaction between X-radiation and matter include all of the following EXCEPT:

A. Compton scattering

B. Radiative bremsstrahlung production

C. Photoelectric absorption

D. Pair production

B. Radiative bremsstrahlung production

Bremsstrahlung radiation is a product of electron interaction with matter.

The traditional unit of exposure is the roentgen, while the SI unit is the:

A. Coulomb/kg or air

B. Rad

C. Rem

D. Curie

A. Coulomb/kg or air

The SI unit for absorbed dose is the Gray, while the traditional unit of exposure is the:

A. Joule

B. Calorie

C. Rad

D. Rem

C. Rad

An example of a non stochastic effect from radiation exposure is:

A. Cancer

B. Genetic abnormalities

C. Shortened life span

D. Erythema

D. Erythema

A non stochastic effect is an early effect. Erythema or skins reddening is an example of early response to radiation exposure.

The SI unit for activity is the:

A. Becquerel

B. Curie

C. Hertz

D. Roentgen

A. Becquerel

Two or more chemicals with the same chemical formulas but having different nuclear states are known as:

A. Isotopes

B. Isomers

C. Isobars

D. Isotones

B. Isomers

Two elements with the same formula in different nuclear states are called isomers.

The wavelengths of X-rays are measured in:

A. Millimeters

B. Centimeters

C. Roentgens

D. Angstroms

D. Angstroms

Ionizing radiation can disrupt chemical ____ in biological materials.

A. Balance

B. Distribution

C. Energy

D. Bonds

D. Bonds

Dose received from terrestrial radiation varies according to:

A. Thickness of the atmosphere

B. The magnetic distribution of the earth

C. The number of diagnostic x-rays received

D. The composition of soil or rock in nearby areas

D. The composition of soil or rock in nearby areas

Dose received from terrestrial radiation comes from radioactive elements in the soil or rock of the earth. Some geographic regions have higher concentrations of radioactive elements in the earth.

The process of cellular growth and development is called:

A. Mitosis

B. Meiosis

C. Differentiation

D. Proliferation

D. Proliferation

Germ cells proliferate during:

A. Mitosis

B. Meiosis

C. Osmosis

D. Organogenesis

B. Meiosis

Which of the following cells have the highest sensitivity:

A. Neurons

B. Chondrocytes

C. Osteoblasts

D. Lymphocytes

C. Osteoblasts

Osteoblasts are the most sensitive because they are young and immature. They are still dividing making them the most sensitive.

Linear energy transfer is measured in units of:

A. J/Kg

B. keV/micrometer

C. J/KeV

D. J/C

E. C/Kg

B. keV/micrometer

All naturally occurring radioactive sources ultimately decay to a stable form of:

A. Bismuth

B. Carbon

C. Lead

D. Tungsten

C. Lead

A joule is a unit of:

A. Absorbed dose

B. Charge

C. Mass

D. Energy

D. Energy

The half life of iodine 125 is:

A. 74.1 days

B. 60.2 years

C. 30 days

D. 60.2 days

D. 60.2 days

Beam symmetry and flatness are defined over what percentage of the field?

A. 30%

B. 50%

C. 80%

D. 100%

C. 80%

Radon is a natural reactive gas with a half life of:

A. 4 minutes

B. 4 hours

C. 4 days

D. 4 months

C. 4 days

As the overall time of treatment is altered, with fraction size and total dose remaining the same, the biological effect:

A. Increases as time is shortened

B. Decreases as time is shortened

C. Increases as time is prolonged

D. Remains unchanged

A. Increases as time is shortened

How many joules are in 1 electron volt?

A. 1.6 x 10 ^ -13 J

B. 1.6 x 10 ^ -19 J

C. 1.6 x 10 ^ 13 J

D. 1.6 x 10 ^ 19 J

B. 1.6 x 10 ^ -19 J

Which theory of radiation is illustrated by the operating principles of an ionization chamber?

A. Bragg-Gray cavity theory

B. Spencer-Attix theory

C. Burlin cavity theory

D. Compton theory

A. Bragg-Gray cavity theory

Which of the following radiation interactions with matter occur independently of atomic number?

A. Pair production

B. Photoelectric effect

C. Coherent scattering

D. Compton effect

D. Compton effect

The incident photon has a higher energy compared to the binding energy of an orbital electron. Thus the photons interact with essentially free electrons.

Which of the following equipment produces extra nuclear indirectly ionizing radiation?

A. A cobalt-60 unit

B. Linear accelerator

C. Ir-192 high-dose afterloader

D. None of the above

B. Linear accelerator

Photons are produced by a linear accelerator through the bremsstrahlung interaction that occurs when electrons impinge on the target. Bremsstrahlung occurs outside of the nucleus.

1 roentgen in air is equal to;

A. 25.8 x 10 ^ 4 C/Kg

B. 2.58 x 10 ^ -4 C/Kg

C. 2.58 x 10 ^ -4 J/Kg

D. None of the above

B. 2.58 x 10 ^ -4 C/Kg

The mathematical correction for the effect of temperature and pressure on ionization is based on a standardized barometric pressure of:

A. 273.2 mmHg

B. 295.2 mmHg

C. 727 mmHg

D. 760 mmHg

D. 760 mmHg

In a SAD setup, the field size is defined:

A. On the skin surface

B. At the isocenter

C. At the depth of Dmax

D. None of the above

B. At the isocenter

The physical field size is defined at the:

A. 90% isodose line

B. 100% isodose line

C. 80% isodose line

D. 50% isodose line

D. 50% isodose line

Which isotope is most commonly used in High Dose Rate (HDR) afterloading brachytherapy?

A. I-131

B. I-125

C. Cs-137

D. Ir-192

D. Ir-192

The radionuclide Tc-99m is an example of an:

A. Isotope

B. Isomer

C. Isobar

D. Isotone

B. Isomer

Tc-99m has the same number of protons and neutrons as Tc-99 but it is in a metastable nuclear energy state.

Which of the following isotopes are most commonly used in Low Dose Rate (LDR) afterloading brachytherapy for the treatment of Prostate cancer?

A. I-131

B. I-125

C. Cs-137

D. Ir-192

B. I-125

Which of the following is the energy of a photon detected by a Postitron Emission Tomography (PET)?

A. 5.11 MV

B. 1.022 MV

C. 0.511 kV

D. 511 kV

D. 511 kV

A positron will combine with an at rest electron resulting in annihilation reaction that emits two 511 kV photons.

Which of the following is an example of indirectly ionizing radiation?

A. Electrons

B. Protons

C. Alpha particles

D. Neutrons

D. Neutrons

Neutrons interact by recoil nuclei and are indirectly ionizing.

The tail of the pancreas is located:

A. In the curve of the duodenum

B. In the Hilum of the spleen

C. At the level of L4

D. In the right Hypogastric region

B. In the Hilum of the spleen

The chemotherapy related side effect characterized by a decrease in many cellular components of the blood is known as:

A. Pancytopenia

B. Neutrophilia

C. Neutropenia

D. Erythropenia

A. Pancytopenia

Pancytopenia is a drop in several blood components. This is a common side effect of cytotoxic chemotherapy.

The adrenal glands are located at the level of the thoracic vertebrae number:

A. 12

B. 10

C. 8

D. 6

A. 12

Landmarks around the mouth are generally not very accurate due to:

A. Extreme flexibility in the area

B. Daily variations in texture in the area

C. Extreme Hyperpigmentation in the area

D. Occasional occurrence of contagious mouth sores

A. Extreme flexibility in the area

A triangular shaped surface landmark often used in radiation therapy that partially covers the External Auditory Meatus (EAM) is known as the:

A. Helix

B. Glabella

C. Canthus

D. Tragus

D. Tragus

The French-American-British (FAB) system is used to classify:

A. Chronic leukemia

B. Acute leukemia

C. Non-Hodgkin's lymphoma

D. Hodgkin's lymphoma

B. Acute leukemia

Clubbing of the distal phalanges may be a clinical sign of:

A. Basal cell carcinoma

B. Metastatic melanoma

C. Upper extremity lymphedema

D. Chronic obstructive pulmonary disease

D. Chronic obstructive pulmonary disease

The tolerance dose (TD 5/5) for the optic chiasm is:

A. 10 Gy

B. 45 Gy

C. 50 Gy

D. 60 Gy

C. 50 Gy

The rectum is located in which of the following regions?

A. Epigastric

B. Inguinal

C. Lumbar

D. Pubic

D. Pubic

Which of the following tumors originates in osseous tissue?

A. Ewing's sarcoma

B. Chondrosarcoma

C. Fibrosarcoma

D. Chordoma

B. Chondrosarcoma

Osseous tumors originate in hard bone, spongy bone and cartilage. Chondrosarcoma originates in cartilage tissue.

Which of the following techniques is used to treat early-precancers of the cervix?

A. Hysterectomy

B. Brachytherapy

C. External beam radiation

D. A loop electrosurgical excision

D. A loop electrosurgical excision

LEEP, A loop electrosurgical excision, is a suitable technique to remove precancerous tissues of the cervix.

Machine dose rate constancy is most commonly checked using (a)n ____.

Ion chamber

The central panel for mega voltage therapy treatment must have a visual display of:

1. Operating voltage

2. Interlock status

3. Patient set up parameters

A. 1 only

B. 2 only

C. 1 & 3

D. 2 & 3

E. All choices

A. 1 only

A protective device on a fluoro simulator to prevent tube and tabletop impact is called a ____.

Collision ring

Daily or weekly safety checks should be performed for:

A. Door interlocks

B. Monitor system

C. Protective barrier

D. Laser lights

E. A only

F. A & B

G. A, B, and D

H. B, C, and D

E. A only

Radiation high energy rooms should have "emergency off" buttons are installed:

A. In the treatment room

B. On the control console

C. A & B

C. A & B

"CAUTION RADIATION: This equipment produces radiation when energized" signs must be placed:

A. In the treatment room

B. On the control console

C. A & B

B. On the control console

Advantages of film badges include all EXCEPT:

A. Provide permanent record

B. Exposure to interpretation delay

C. Measure dose over large area

D. Radiation type can be determined

B. Exposure to interpretation delay

The verification of an isocentric unit requires that the final location of the images of the cross wires shall pass through a sphere not exceeding ____ in diameter.

4 mm

The _____ is responsible for bending the electron stream to direct it into the target.

Beam transport system

Put the following in order from how it exits the linac from 1st to last:

A. Xray collimator

B. Scattering foil

C. Ion chamber

Scattering foil, ion chamber, x-ray collimator

Full recalibration of gamma beam therapy should be done:

A. Daily

B. Weekly

C. Monthly

D. Annually

D. Annually

Monitor units of the linac is located within the _____.

Collimator

Orthovoltage unit operates at a tube current of:

10-2o Ma and 150-200 KVp

The procedure to check alignment of the field light should be performed:

A. Daily

B. Weekly

C. Monthly

D. Annually

C. Monthly

Possible sources of light field incongruence include:

1. Mirror misalignment

2. Gantry angulation

3. Collimator misalignment

A. 1 only

B. 2 only

C. 3 only

D. B & C

E. A, B, and C

A. 1 only

Depth dose increases when SSD ______.

Increases

Calculate the Dmax for a 300 cGy dose if the depth dose percent is 96%.

300/.96 = 312.5 cGy

The daily treatment record should be checked:

A. Daily

B. Weekly

C. Monthly

D. Annually

B. Weekly

SSD's of the patient's AP and Lateral measurements are needed to check:

Accuracy of contour taking

The basic method of determining the absorbed dose in a medium due to the production of heat is termed _____.

Calorimetry

Which of the following are used to measure isodose charts:

A. Radiographic films

B. Ion chambers

C. Solid state detectors

D. A only

E. B & C

F. All choices

F. All choices

All of the following might account for beam flatness drifting outside of specifications except:

A. Flattening filter shift

B. Target position shift

C. Incorrect mirror angulation

D. Fluctuation of current to bending magnet

C. Incorrect mirror angulation

Scatter air ratio is most often used for the scatter dose produced in _____ fields.

Irregular

During a 4 MV treatment, a sloping skin surface is corrected by a ______ shift toward the skin surface of the isodose curve.

A. 1/4

B. 1/2

C. 2/3

D. 3/4

C. 2/3

The dosimetric physical field is the distance intercepted by a given _____ on a plane perpendicular to the beam axis at the stated source distance.

A. 30% isodose curve

B. 50% isodose curve

C. 80% isodose curve

D. 100% isodose curve

B. 50% isodose curve

Nephropathy occurs at a dose of ___.

2000 cGy

Whole abdominal radiation is effective for ____.

Radiosensitive tumors

What is the most sensitive organ to whole organ irradiation?

Spinal cord

The TD 50/5 for whole brain irradiation is approximately ____.

6000 rads

The principal difference from modified radical and radical mastectomy is the extent of the ____ removal.

A. Breast

B. Tumor

C. Lymph node

D. Muscle

E. A & B

F. C & D

G. All choices

F. C & D

The principal advantage of TAR is its ability to remove dependence upon:

A. Target skin distance

B. Field size

C. PDD

D. Backscatter radiation

A. Target skin distance

The PDD for a 15 x 15 cm field size, 10 MV beam, @ 5 cm depth and 80 cm SSD is 88%. Calculate the PDD for the same field size and depth for 100 cm SSD.

89.0

The spleen is:

A. Close to the 9-11th ribs

B. Ends 5 cm from the midline

C. Lies in the left hypochondrium posteriorly

D. All choices

D. All choices

The PDD for a 12 x 12 cm field size, 4 MV beam, 5 cm depth, @ 80 SSSD is 82.8. Calculate the PDD for the same F.S. And depth at 100 cm SSD.

84.3%