Medical Dosimetry
Chapter Exam Questions
Course Introduction
Medical Dosimetry is a specialized course that focuses on the principles and practices of calculating, planning, and delivering radiation doses for cancer treatment. Students will explore foundational concepts such as radiation physics, dose calculations, and treatment planning systems, as well as the use of advanced technologies including intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). The course covers dose distribution assessment, normal tissue sparing techniques, and quality assurance protocols, preparing students to collaborate effectively with radiation oncologists and physicists in a clinical environment to optimize patient outcomes.
Recommended Textbook
Principles and Practice of Radiation Therapy 3rd Edition by Charles M. Washington
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Chapter 1: Cancer: An Overview
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Q1) Factors that may exclude a patient from having surgery include all of the following except:
A) preexisting medical conditions
B) tumor location
C) patient preference
D) classification
Answer: D
Q2) Which of the following make for an effective screening examination?
A) specific
B) sensitive
C) cost-effective
D) accurate
E) all of the above
Answer: E
Q3) Cancer is contagious.
A)True
B)False
Answer: False
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Chapter 2: The Ethics and Legal Considerations of Cancer Management
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Q1) Who is most closely associated with the stages of grief?
A) Nel Noddings
B) Elisabeth Kübler-Ross
C) John Mill
D) Immanuel Kant
Answer: B
Q2) According to the radiation therapist's Practice Standards,a radiation therapist should meet certain levels of ___________________.
A) clinical performance
B) quality performance
C) professional performance
D) all of the above
Answer: D
Q3) It is acceptable to skew the truth when discussing a cancer diagnosis with a patient.
A)True
B)False
Answer: False
Page 4
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Chapter 3: Principles of Pathology
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Q1) Etiology is defined as which of the following?
A) the study of the understanding of disease
B) the study of the socioeconomic facts of disease
C) the study of the cause of disease
D) the study of the stratification of disease
Answer: C
Q2) All of the following are organelles except:
A) mitochondria
B) endoplasmic reticulum
C) ribosomes
D) leukosomes
Answer: D
Q3) Extravasation is the accidental leakage of intramuscular administration of drugs.
A)True
B)False
Answer: False
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Chapter 4: Overview of Radiobiology
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Q1) What is the typical OER value for sparsely ionizing radiation?
A) 0.5 to 1.0
B) 1.0 to 2.0
C) 2.5 to 3.0
D) greater than 3.0
Q2) Organ dose can be measured directly.
A)True
B)False
Q3) The greatest amount of energy is deposited as a charged particle,such as a proton,comes to rest.
A)True
B)False
Q4) What does the term interphase death mean?
A) Cell dies prior to entering interphase.
B) Cell dies prior to leaving interphase.
C) Cell dies between mitotic phases.
D) The entire organism dies.
Q5) Tumors have more SLD repair capacity than normal tissues.
A)True
B)False
6
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Chapter 5: Detection and Diagnosis
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Q1) A normal white blood count is:
A) 3.90 to 5.40 million/mm<sup>3</sup>
B) 3,900 to 10,800/mm<sup>3</sup>
C) 12.0 to 16.0 million/mm<sup>3</sup>
D) 150,000 t0 425.000/mm<sup>3</sup>
Q2) An example of an exfoliative cytologic study could be demonstrative in which of the following?
I.cervix
II.lung
III.brain
A) I and II
B) II and III
C) I and III
D) I,II,and III
Q3) Research has been ongoing to develop and test a vaccine that would prevent infection with the most common high-risk subtypes of HPV,which may be connected to 70% of uterine cancers.
A)True
B)False
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Chapter 6: Medical Imaging
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Q1) Which of the following is responsible for transforming invisible x-ray into energy into visible light?
A) grids
B) glass envelop
C) densitometer
D) intensifying screens
Q2) The primary purpose of the anode is to emit liberated electrons in response to an applied current.
A)True
B)False
Q3) Which of the following modalities does not use radiation in image production and acquisition?
A) CT
B) nuclear medicine
C) MRI
D) mammography
Q4) Thermionic emission is the process by which electrons are liberated from the positively charged anode.
A)True
B)False
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Chapter 7: Treatment Delivery Equipment
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Q1) A Van de Graaff machine __________________. I.is an electrostatic generator
II.operates at 2 MV
III.operates a 200 kV
IV.uses a doughnut-shaped accelerator structure
A) I and II
B) II and IV
C) III and IV
D) I and IV
Q2) Inherent filtration is due to materials present in the x-ray tube itself that the beam must pass through.
A)True
B)False
Q3) The circulator in a linear accelerator:
A) mixes the hot and cold water to get the right temperature
B) spins the electrons in the right direction
C) conducts microwaves from the RF driver into the klystron
D) isolates the klystron from reflected microwave power
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Chapter 8: Treatment Procedures
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Q1) Methods of matching abutting fields include all of the following except:
A) penumbra method
B) gaps
C) feathering
D) use of nondivergent beam edges
Q2) A series of documentation and activities performed with the purpose of optimizing patient care is called:
A) quality control
B) quality auditing
C) quality assurance program
D) quality of life
Q3) In opposing field techniques specifically designed for treatment of breast might be:
A) AP/PA arrangement
B) tangential fields
C) box technique
D) right and left laterals
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Chapter 9: Radiation Therapy Education
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Q1) Only the radiation oncology nurse or patient educator is responsible for the education of cancer patients regarding their treatments.
A)True
B)False
Q2) Which professional organization is charged with administering the credentialing examination for graduates of radiation therapy educational programs?
A) ACR
B) JRCERT
C) ASRT
D) ARRT
Q3) Why are communication and education necessary to establish a positive relationship with the patient and/or other health care providers?
A) verifies consent
B) ensures accurate explanation of the procedure
C) provides an opportunity for questions
D) all of the above
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Chapter 10: Infection Control in Radiation Oncology
Facilities
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Q1) A person who is colonized but not ill is known as the:
A) host
B) carrier
C) vector
D) fomite
Q2) Five transmission routes that carry disease are:
A) airborne,vector-borne,contact,droplet,common vehicle
B) airborne,vector-borne,indirect,subdirect,droplet
C) airway,vector-borne,contact,blood-borne common vehicle
D) airway,vector-borne,contact,drippings,common vehicle
Q3) Disinfection is a process to eliminate all microbial life forms.
A)True
B)False
Q4) One way to screen for hepatitis B is to use Mantoux tuberculin skin test.
A)True
B)False
Q5) Flu shots can cause the flu in such a degree that it can be life threatening.
A)True
B)False
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Chapter 11: Patient Assessment
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Q1) Nonverbal communication is not important.
A)True
B)False
Q2) A multidimensional assessment tool to measure pain is:
A) The Brief Pain Inventory
B) Functional Assessment of Cancer Therapy
C) The Quality of Life Index
D) The Pain Free Forever Assessment
Q3) Hope is the key concept and essential ingredient in the religious and spiritual aspects of care and a major component in the healing process.
A)True
B)False
Q4) Cancer patients do not worry about pain.
A)True
B)False
Q5) All these sociocultural factors influence pain except:
A) spirituality
B) age
C) gender
D) hair and eye color
Page 13
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Chapter 12: Pharmacology and Drug Administration
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Q1) Select the organ most commonly used by the body to excrete drugs and their byproducts.
A) kidneys
B) lungs
C) sweat glands
D) all of the above
Q2) Select the type of medication administration that bypasses the gastrointestinal tract.
A) topical administration
B) parenteral administration
C) mucous membrane administration
D) administration via the rectum
Q3) Select the drugs that may be prescribed to relieve anxiety. I.Ativan
II.Valium
III.Librium
IV.Prozac
A) I,II,and IV
B) I,II,and III
C) II,III,and IV
D) I,II,III,and IV
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Chapter 13: Applied Mathematics Review
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Q1) Simplify 5(3b)<sup>2</sup>:
A) 15b<sup>2</sup>
B) 5(9b<sup>2</sup>)
C) 45b<sup>2</sup>
D) already simplified
Q2) Solve for x in the equation x<sup>8</sup>/x<sup>6</sup> = 100.
A) -10
B) ±10
C) 10
D) 1
Q3) Simplify (a<sup>2</sup>)<sup>5</sup>:
A) a<sup>10</sup>
B) a<sup>7</sup>
C) a<sup>32</sup>
D) a<sup>25</sup>
Q4) Solve for x in the equation x<sup>2</sup> - 1 = 0.
A) 0
B) 1
C) -1
D) ±1
Page 15
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Chapter 14: Introduction to Radiation Therapy Physics
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Q1) There are three major quantities that are important in radiation physics.They are radiation exposure,radiation absorbed dose,and radiation dose equivalent.
A)True
B)False
Q2) Wavelength is represented by:
A) Lambda
B) Hertz
C) inch
D) second
Q3) There are four photon interaction processes that occur in the energy range of concern in radiation therapy.
A)True
B)False
Q4) The unit for frequency is 1/sec,called the:
A) Lambda
B) Hertz
C) meter
D) Angstrom
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Chapter 15: Aspects of Brachytherapy
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Q1) Tandem and ovoids are used to treat which of the following?
A) prostate
B) bladder
C) cervix
D) esophagus
Q2) An autoradiograph is taken to:
A) determine the energy of the source
B) check source placement in the patient
C) verify uniformity of source
D) determine source strength
Q3) The half-life of radium is:
A) 1.6 years
B) 162 days
C) 1,622 years
D) 16 years
Q4) The radioisotope used to treat uveal melanoma of the eye is:
A) iridium 192
B) cesium 137
C) gold 198
D) iodine 125
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Chapter 16: Special Procedures
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Q1) The motion management method that defines an internal target volume is:
A) OBI
B) compression
C) conservative
D) MIP
Q2) Devices that are on the linear accelerator for imaging include all of the following except:
A) OBI
B) EPID
C) CT-on-rails
D) CBCT
Q3) IGRT is useful because it can: I.result in a more focused treatment
II.account for interfraction and intrafraction motion
III.compare in-room image set with treatment planning image set
A) I and II
B) II and III
C) I and III
D) I,II,and III
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Chapter 17: Intensity-Modulated Radiation Therapy
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Q1) Which of the following treatment planning systems or techniques is accomplished by selecting an optimal dose?
A) inverse treatment planning
B) forward treatment planning
C) direct treatment planning
D) indirect treatment planning
Q2) Conformal therapy treatment techniques and segmenting are both attributed to: A) 3D
B) MLCs
C) wedges and compensators
D) 3D CRT
Q3) The major advantage of IMRT over conventional 3D CRT treatment techniques is that:
A) IMRT delivers a higher dose to the surrounding structures.
B) IMRT delivers a uniform dose to both tumor volume and surrounding structures.
C) IMRT delivers a variable tumor dose from each treatment field.
D) IMRT delivers a conformal dose of varying beam intensities.
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Chapter 18: Radiation Safety and Protection
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Q1) The total gestational dose equivalent limit is ____ mSv.
A) 0.5
B) 1
C) 5
D) 50
Q2) Which particles are most closely associated with helium?
A) alpha particles
B) beta particles
C) x-rays
D) gamma-rays
Q3) Which particles can be electrons?
A) alpha particles
B) beta particles
C) x-rays
D) gamma-rays
Q4) Thermoluminescent dosimeters are composed of ____.
A) Ra
B) Al<sub>2</sub>O<sub>3</sub>
C) Ce
D) LiF
Page 20
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Chapter 19: Quality Improvement in Radiation Oncology
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Q1) A QI plan has a(n)_____________ that verifies that all aspects of the radiation oncology process meet national,state,institutional,and/or departmental quality standards and an mechanism to institute change if necessary:
A) audit mechanism
B) oversight committee
C) action plan
D) support staff
Q2) In the mid-1980s,OSHA mandated a policy on:
A) biohazard disposal procedures
B) preventing injuries
C) mold room procedures
D) bloodborne pathogens
Q3) This federal agency has as its scope of responsibility the regulation of nuclear reactors; medical,academic,and industrial uses of nuclear materials; and the transport,storage,and disposal of nuclear materials and waste.
A) NRC
B) EPA
C) DOT
D) FDA
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Chapter 20: Surface and Sectional Anatomy
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Q1) Which of the following structures or landmarks are associated with the bifurcation of the trachea?
A) the tip of the scapula
B) tip of the xiphoid process
C) the sternal angle
D) a and b
Q2) The bony structure that is located directly anterior to the second thoracic vertebra is the:
A) suprasternal notch
B) xiphoid process
C) hyoid bone
D) none of the above
Q3) If a cross section of the thorax is taken at about 10 cm inferior to the suprasternal notch (6 cm inferior to sternal angle),which structure(s)will not be visualized?
A) trachea
B) esophagus
C) scapula
D) a and c
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Chapter 21: Simulator Design
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Q1) When determining the shielding requirements for a simulation room,thicker shielding is needed in the _____________.
A) primary walls
B) secondary walls
C) tertiary walls
D) ceiling
Q2) Positioning lasers are located: I.side (lateral)
II.overhead
III.sagittal
IV.coronal
A) I and II
B) I,II,and III
C) II and III
D) all of the above
Q3) To reduce magnification during fluoroscopy,the image intensifier should be:
A) moved as close to the patient as possible
B) moved as far as possible from the patient
C) rotated in the direction of the central ray
D) centered
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Chapter
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Q1) Optical components of the simulator may include: I.the laser system
II.optical distance indicator (ODI)
III.field light indicator
IV.collimator movements
A) I and II
B) II and IV
C) III and IV
D) I,II,and III
Q2) State regulations may require the use of technique charts,which include guidelines for selecting the _______,_______,and _______ used in deciding radiographic exposure techniques. I.kVp
II.mA
III.time factors
IV.contrast factors
A) I,II,and IV
B) II,III,and IV
C) I,III and IV
D) I,II,and III
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Chapter 23: Computed Tomography Simulation
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Q1) Mechanical and image quality checks should be evaluated by using the guidelines set by the:
A) nuclear regulatory agency
B) AAPM Radiation Therapy Committee Task Group No.66
C) AAPM Radiation Therapy Committee Task Group No.40
D) individual state guidelines
Q2) What is a maximum intensity projection,or MIP?
A) measurement of table translation
B) result of noise on an image
C) relationship between the matrix size and the pixel size on an image
D) fused scan that shows the maximum amount of tumor movement during the respiratory cycle
Q3) The quality of the beam must be checked:
A) daily
B) weekly
C) yearly
D) biannually
Q4) Window level is the range of numbers displayed or the contrast on a CT image.
A)True
B)False
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Chapter 24: Photon Dosimetry Concepts and Calculations
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Q1) A TAR at the depth of Dmax used to correct for scatter of dose is called the
A) scatter-air ratio
B) tissue-phantom ratio
C) backscatter factor
D) Mayneord's F factor
Q2) Absorbed dose at depth x 100% = absorbed dose at Dmax is the definition of:
A) TAR
B) TMR
C) TPR
D) PDD
Q3) Dmax is defined as:
A) build-up region
B) depth of maximum equilibrium of occurs for photon beams
C) depth of dose deposited per unit of time
D) dose scatter to surface
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Chapter 25: Photon Dose Distributions
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Q1) Effective SSD and TAR methods of correcting for tissue heterogeneities result in accurate isodose distributions.
A)True
B)False
Q2) In the effective SSD method and TAR method of correcting isodose curves for oblique incidence,what does the factor h represent?
A) inverse square correction
B) depth
C) tissue deficit or excess
D) SSD,TAR,or TMR
Q3) At what point does the treatment planning process begin?
A) dose determination
B) bean delineation
C) organ segmentation
D) CT imaging
Q4) Which type of IMRT treatment involves the "sliding window" technique?
A) "step-and-shoot"
B) dynamic MLC
C) "tomotherapy"
D) robotic IMRT
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Chapter 26: Electron Beams in Radiation Therapy
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Q1) What thickness of lead is necessary to adequately shield a 9-MeV electron beam?
A) 3 cm
B) 3.6 cm
C) 4.5 cm
D) 5.4 cm
Q2) What is the practical range of a 25-MeV electron beam?
A) 12.5 cm
B) 12.5 mm
C) 50 cm
D) 50 mm
Q3) Which treatment energy for electrons is most likely to use a scanning beam technique rather than a scattering foil?
A) 4 MeV
B) 12 MeV
C) 20 MeV
D) 25 MeV
Q4) Unlike photons,electrons have a mass and a charge.
A)True
B)False
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Chapter 27: Electronic Charting,and Image Management
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Q1) HL7 is responsible for developing standards for:
A) exchanging clinical data
B) sharing image information
C) security and privacy
D) data entry
Q2) An information system designed for the collection,management,and analysis of data on a person with a malignant disease is called:
A) data gathering
B) DICOM
C) cancer registry
D) PACS
Q3) The most important step in the implementation of an electronic medical chart is:
A) staff education
B) configuration
C) problem-solving
D) data gathering
Q4) Computer-based patient record (CPR)systems improve cancer care outcomes.
A)True
B)False
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Chapter 28: Bone,Cartilage and Soft Tissue Sarcomas
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Q1) All of the following are examples of primary bone tumors except:
A) malignant histiocytoma
B) rhabdomyosarcoma
C) osteosarcoma
D) multiple myeloma
Q2) In which anatomical location are STSs most common?
A) head and neck
B) upper extremity
C) lower extremity
D) trunk
Q3) Preoperative radiation therapy for STS is performed to: I.kill the reactive rim of tumor cells before they are cut into
II.decrease the risk of implantation
III.attempt to preserve as much normal function as possible
A) I and II
B) I and III
C) II and III
D) I,II,and III
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Chapter 29: Lymphoreticular System Tumors
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Q1) The abdominal para-aortic treatment portal includes what organ(s)?
A) kidneys
B) spleen
C) pancreas
D) liver
Q2) NHLs are highly curable.
A)True
B)False
Q3) Which treatment field for HD includes the iliac lymph node chain?
A) mantle
B) inverted-Y (Abdominal portion)
C) inverted-Y (Pelvic portion)
D) all of the above
Q4) Which treatment field for HD includes the para-aortic lymph node chain?
A) mantle
B) inverted-Y (Abdominal portion)
C) inverted-Y (Pelvic portion)
D) all of the above
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Chapter 30: Leukemia
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Q1) TBI can used as part of the treatment of patients with leukemia.
A)True
B)False
Q2) Which of the following is not a symptom commonly associated with a diagnosis of leukemia?
A) fever
B) loss of appetite
C) dysphagia
D) weight loss
Q3) Radiation exposure is risk factor for leukemia.
A)True
B)False
Q4) Which chemotherapy agent can be used to reduce the leukemic cell load and impair the host's ability to reject the donor bone marrow?
A) dexamethasone
B) vincristine
C) L-asparaginase
D) cyclophosphamide
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Chapter 31: Endocrine System Tumors
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Q1) Parafollicular cells is another term used to describe the parathyroid glands.
A)True
B)False
Q2) The parathyroid glands are imbedded in the thyroid gland.
A)True
B)False
Q3) In which gland is epinephrine produced?
A) parathyroid
B) pituitary
C) thyroid
D) adrenal
Q4) What is the most common form of thyroid cancer seen in irradiated individuals?
A) follicular
B) papillary
C) medullary
D) lymphoma
Q5) The most common form of pituitary tumors is adenocarcinomas.
A)True
B)False
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Chapter 32: Respiratory System Tumors
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Q1) Cancer in which lobe of the lung will typically never include treatment of the contralateral hilar lymph nodes unless proved positive?
A) upper
B) middle
C) lower
D) none of the above
Q2) Which of the following syndromes is commonly associated with Pancoast tumors?
A) paraneoplastic syndrome
B) Down syndrome
C) Tourette syndrome
D) Horner syndrome
Q3) What is the 5-year survival rate for small cell and non-small cell lung cancers?
A) 0.5%
B) 15%
C) 60%
D) 85%
Q4) Mesotheliomas are more common in men than in women.
A)True
B)False
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Chapter 33: Head and Neck Cancers
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Sample Questions
Q1) Which anatomic structure contains the true vocal cords?
A) glottis
B) epiglottis
C) pharynx
D) larynx
Q2) What condition frequently develops in users of smokeless tobacco?
A) erythroplakia
B) leukoplakia
C) thrush
D) dysplasia
Q3) Which salivary gland is associated with the Stensen duct?
A) parotid
B) submandibular
C) sublingual
D) minor
Q4) Laser excision is the most common treatment for T3 laryngeal cancers.
A)True
B)False
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Page 35
Chapter 34: Central Nervous System Tumors
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Q1) Which of the following factors can limit the usefulness of surgery for CNS neoplasms?
A) tumor location and extent
B) patient status
C) risk of causing neurologic damage
D) all of the above
Q2) Which of the following is a late effect of brain irradiation in children?
A) leukemia
B) decreased IQ
C) gigantism
D) chronic fatigue
Q3) What grade are GBMs?
I.I/I
II.II/II
II.III/III
IV.IV/IV
A) I only
B) IV only
C) I and II
D) III and IV
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Page 36
Chapter 35: Digestive System Tumors
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Sample Questions
Q1) What condition is most closely associated to gastroesophageal reflux?
A) Barrett esophagus
B) Gardner syndrome
C) Plummer-Vinson syndrome
D) tenesmus
Q2) The treatment volume for colon cancers typically includes pelvic lymph nodes.
A)True
B)False
Q3) Which of the following methods may reduce the dose to the small bowel during radiation therapy?
I.supine positioning
II.prone positioning
III.full bladder
IV.empty bladder
A) I and III
B) I and IV
C) II and III
D) II and IV
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Chapter 36: Gynecological Tumors
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Sample Questions
Q1) The ovaries are retroperitoneal.
A)True
B)False
Q2) Who has the most significant risk of developing ovarian cancer?
A) 35-year-old woman with one child
B) 35-year-old woman with five children
C) 65-year-old woman with one child
D) 65-year-old woman with five children
Q3) The majority of cervical cancers are discovered early.
A)True
B)False
Q4) What is the most common histologic form of cervical cancer?
A) squamous cell
B) adenocarcinoma
C) epithelial
D) germ cell
Q5) Use of oral contraceptives reduces a woman's risk of developing ovarian cancer.
A)True
B)False
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Chapter 37: Male Reproductive and Genitourinary Tumors
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Sample Questions
Q1) What is the primary treatment option for kidney cancer?
A) surgery
B) chemotherapy
C) radiation therapy
D) immunotherapy
Q2) Scrotal irradiation is a commonly accepted practice for testicular cancer.
A)True
B)False
Q3) Kidney carcinoma can be attributed to the following. I.Cigarette use
II.Obesity
III.Betel nut chewing
A) I and II
B) I and III
C) II and III
D) I,II,and III
Q4) What is the most common form of testicular cancer?
A) squamous cell carcinoma
B) germ cell tumors
C) adenocarcinomas
D) stromal tumors
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Chapter 38: Breast Cancer
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Sample Questions
Q1) DCIS is classified as which stage?
A) stage 0
B) stage 1
C) stage 2
D) stage 3
Q2) What T stage is a breast cancer that is a 3-cm tumor invading the chest wall?
A) Tis
B) T1
C) T2
D) T3
E) T4
Q3) Breast cancer risk is influenced by hormonal variables; early menarche and late menopause increase the risk while oophorectomy before age 50 decreases the risk
A)True
B)False
Q4) What stage is a 6-cm breast cancer in the upper inner quadrant?
A) Tis
B) T1
C) T2
D) T3
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Chapter 39: Pediatric Solid Tumors
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Sample Questions
Q1) Trilateral retinoblastoma includes cancer of which other cranial structure?
A) pituitary gland
B) pineal gland
C) parotid gland
D) paranasal sinuses
Q2) Which pediatric cancer occurs in the sympathetic nervous system ganglia?
A) medulloblastoma
B) neuroblastoma
C) primary brain lesions
D) retinoblastoma
Q3) Which pediatric cancer has the best overall survival?
A) ALL
B) neuroblastoma
C) Wilms tumor
D) Hodgkin disease
Q4) Medulloblastomas typically begin in which area of the brain?
A) brain stem
B) cerebellum
C) cerebrum
D) hypothalamus
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Chapter 40: Skin Cancers and Melanoma
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Sample Questions
Q1) Malignant melanomas are extremely radiosensitive.
A)True
B)False
Q2) What is the most significant cause of skin cancer?
A) radiation exposure
B) sun exposure
C) arsenic exposure
D) human papillomavirus
Q3) Which of the following is the correct order to the layers of the skin from deep to superficial?
A) stratum granulosum,stratum spinosum,stratum lucidum,stratum basale,stratum corneum
B) stratum corneum,stratum lucidum,stratum granulosum,stratum spinosum,stratum basale
C) stratum basale,stratum granulosum,stratum spinosum,stratum corneum,stratum lucidum
D) stratum basale,stratum spinosum,stratum granulosum,stratum lucidum,stratum corneum
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