Medical Physics
Exam Answer Key
Course Introduction
Medical Physics is an interdisciplinary field that applies principles of physics to medicine, particularly in the diagnosis and treatment of human diseases. This course explores the physical foundations of medical imaging techniques such as X-ray, CT, MRI, and ultrasound, as well as the principles behind radiation therapy for cancer treatment. Students will learn about radiation dosimetry, radiation safety, and the interaction of various forms of energy with biological tissues. Emphasis is placed on both theoretical understanding and practical applications, preparing students to contribute to advancements in medical technology and patient care.
Recommended Textbook Principles and Practice of Radiation Therapy 3rd Edition by Charles M. Washington
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1191 Verified Questions
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Page 2
Chapter 1: Cancer: An Overview
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Sample Questions
Q1) Which of the following is not used for brachytherapy treatments?
A) cesium
B) cobalt
C) iodine
D) iridium
Answer: B
Q2) A T<sub>1</sub>N<sub>0</sub>M<sub>X</sub> tumor has how many positive lymph nodes?
A) 0
B) 1
C) 2
D) unknown
Answer: A
Q3) Preoperative radiation therapy and chemotherapy use lower doses than postoperative doses.
A)True
B)False
Answer: True
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Chapter 2: The Ethics and Legal Considerations of Cancer Management
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Sample Questions
Q1) What occurs when the obvious solution to a problem is prohibited by institutional constraints?
A) ethical dilemma
B) ethical dilemma of justice
C) ethical distress
D) locus of authority
Answer: C
Q2) What is the study of ethical issues in medicine?
A) biometrics
B) bioethics
C) macroethics
D) microethics
Answer: B
Q3) Veracity is about keeping secrets.
A)True
B)False
Answer: False
Page 4
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Chapter 3: Principles of Pathology
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Sample Questions
Q1) A malignant tumor of epithelial origin would be called a(n):
A) rhabdomyosarcoma
B) squamous cell carcinoma
C) osteoma
D) malignant angiosarcoma
Answer: B
Q2) Which of the following is the most invasive procedure used to make a diagnosis of cancer?
A) recovery of exfoliating cells
B) fine needle aspiration of malignant cells
C) open biopsy of the tumor
D) retinoscopy
Answer: C
Q3) The hallmark of reversible cell damage is cellular swelling.
A)True
B)False
Answer: True
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Page 5
Chapter 4: Overview of Radiobiology
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Sample Questions
Q1) What is the term describing certain chemicals or drugs that enhance the response of cells to radiation?
A) free radicals
B) radiosensitizers
C) radioprotectors
D) NSAIDs
Q2) BUDR is a radioprotector.
A)True
B)False
Q3) D<sub>0</sub> is a good measure of SLD repair capacity.
A)True
B)False
Q4) When cells are sensitized by oxygen,the resulting survival curve has a reduced extrapolation number.
A)True
B)False
Q5) Tumors that have a PO<sub>2</sub> less than 10 mm Hg have a poor prognosis.
A)True
B)False
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Chapter 5: Detection and Diagnosis
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Sample Questions
Q1) Making a fist and pounding gently onto the posterior abdomen,over a kidney area,is an example of which of the following physician's exam?
A) percussion
B) auscultation
C) palpation
D) inspection
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) A very healthy 40-year old woman has a hematocrit of 30.0%.This is within normal limits.
A)True
B)False
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Page 7
Chapter 6: Medical Imaging
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Sample Questions
Q1) A quality radiograph taken 100 cm using 20 mAs could be replicated at 50 cm using:
A) 15 mAs
B) 10 mAs
C) 7 mAs
D) 5 mAs
Q2) Because of the mobility of the prostate,this imaging modality is often used at the time of treatment to identify the position of the prostate.
A) fluoroscopy
B) ultrasound
C) MRI
D) nuclear medicine
Q3) Additive pathologies affect tissue density such that the affected anatomy may appear _________ on the radiograph.
A) lighter than normal
B) darker than normal
C) unchanged
D) hypoechoic
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Chapter 7: Treatment Delivery Equipment
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Sample Questions
Q1) The energy of a cobalt unit is:
A) 1.36 and 1.01 MeV
B) .662 and 1.5 MeV
C) 1.00 and 1.5 MeV
D) 1.17 and 1.33 MeV
Q2) Image-guided radiation therapy can be accomplished with: I.ultrasound units
II.CT scanner
III.kV imager
IV.cone beam
V.simulator
A) I,III,and IV
B) II,III,and V
C) I,II,III,and IV
D) III,IV,and V
Q3) The rate of decay per month on a cobalt 60 unit is:
A) 1% per month
B) 2% per month
C) 3% per month
D) 5% per month
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Page 9
Chapter 8: Treatment Procedures
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Sample
Questions
Q1) Record and verify (RV)provides a therapist with a check system against those most recently prescribed for a particular field and can prevent the action of a treatment error.
A)True
B)False
Q2) Based partially on historical studies showing a reduction in treatment error associated with increased portal imaging,________ portal imaging for radical cases has become an accepted but not universally implemented standard.
A) twice-daily
B) weekly
C) monthly
D) initial and final
Q3) Wedge systems used include which of the following?
I.global wedge
II.universal
III.virtual
A) I and II
B) I and III
C) II and III
D) I,II,and III
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Page 10
Chapter 9: Radiation Therapy Education
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Sample Questions
Q1) When the radiation therapist is deciding what educational material to use,which of the following factors must be taken into consideration?
A) skill or knowledge is needed
B) intrinsic and extrinsic incentives
C) both a and b
D) neither a nor b
Q2) What are the three domains of student learning?
I.affective
II.cognitive
III.effective
IV.psychomotor
V.psychosocial
VI.physiologic
A) I,II,and III
B) I,II,and IV
C) I,III,and VI
D) II,VI,and V
E) IV,V,and VI
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11
Chapter 10: Infection Control in Radiation Oncology
Facilities
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Sample Questions
Q1) Which of the following describes sources of nosocomial infections?
A) carpet in a radiation oncology department
B) fresh or dried flowers
C) pen used to apply marks used on all patients
D) b and c
E) all of the above
Q2) Fomites include food,water,medications,and medical equipment and supplies.
A)True
B)False
Q3) Hepatitis B is an example of a virus transmitted as a blood-borne pathogen.
A)True
B)False
Q4) The term used to indicate the number of antibodies present in a blood sample is:
A) vaccine
B) titers
C) pathogens
D) antibiotics
Q5) At the turn of the century,tuberculosis was the leading cause of death.
A)True
B)False
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Chapter 11: Patient Assessment
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Sample Questions
Q1) Cachexia is the loss of appetite.
A)True
B)False
Q2) All these sociocultural factors influence pain except:
A) spirituality
B) age
C) gender
D) hair and eye color
Q3) Epilation occurs at doses around 2,000 cGy.
A)True
B)False
Q4) Tools to assess pain should be very detailed and long and take the patients about 2 days to complete.
A)True
B)False
Q5) Marasmus is:
A) calorie malnutrition
B) protein malnutrition
C) fat malnutrition
D) carbohydrate malnutrition
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Chapter 12: Pharmacology and Drug Administration
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Sample Questions
Q1) Select the most serious allergic reaction to a drug.
A) light rash
B) hives
C) nausea
D) cardiac or respiratory arrest
Q2) A drug is any substance that alters physical function,while a medication has a therapeutic goal.
A)True
B)False
Q3) What is the first duty of a therapist if a patient has an adverse reaction to a drug?
A) Locate emergency supplies.
B) Begin CPR.
C) Call a code.
D) Observe the patient carefully.
Q4) In which part of the body is barium sulfate is used as a contrast agent?
A) gastrointestinal tract
B) bronchography
C) myelography
D) cardiovascular
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Chapter 13: Applied Mathematics Review
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Sample Questions
Q1) Transposition of numbers in a patient's chart is an example of which type of error?
A) systematic
B) random
C) blunder
D) None of the above
Q2) Simplify 5x<sup>4</sup> * x.
A) 6x<sup>4</sup>
B) 5x<sup>5</sup>
C) 5x<sup>3</sup>
D) already simplified
Q3) How many significant figures are there in 6,800?
A) 2
B) 3
C) 4
D) unable to determine
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15
Chapter 14: Introduction to Radiation Therapy Physics
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Sample Questions
Q1) A mCi (millicurie)equals:
A) 10<sup>3 </sup>Ci
B) 10<sup>-3 </sup>Ci
C) 10<sup>-6 </sup>Ci
D) 10<sup>6 </sup>Ci
Q2) Ground state is the minimum amount of energy needed to keep the nucleons together.
A)True
B)False
Q3) The speed of light is:
A) 3 x 10<sup>10 </sup>m/sec
B) 3 x 10<sup>8 </sup>m/min
C) 3 x 10<sup>10 </sup>m/min
D) 3 x 10<sup>8 </sup>m/sec
Q4) The thickness of some added material required to reduce beam intensity to half its original value is called the:
A) half-life
B) inverse square factor
C) half-value layer
D) intensity coefficient
Page 16
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Chapter 15: Aspects of Brachytherapy
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Sample Questions
Q1) The term radium substitute in brachytherapy indicates:
A) an isotope whose dosimetry is based on original radium work
B) an isotope whose dosimetry is more accurate than that of radium
C) any source implemented when radium is unavailable
D) a source that has a greater average energy than radium
Q2) Permanent implants involve: I.sources packaged as tiny seeds
II.sources with long half-lives
III.sources implanted with needles in surgery
IV.tumors that cannot be reached surgically
A) I and II
B) I and III
C) II and III
D) I,II,and III
Q3) The purpose of intravascular brachytherapy is to:
A) eliminate arterial plaque
B) treat cancers of the heart
C) prevent heart disease
D) inhibit restenosis in coronary arteries
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Chapter 16: Special Procedures
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Sample Questions
Q1) The kV images are preferred by radiation therapists and radiation oncologists because the:
A) contrast is better
B) metal artifacts are reduced
C) timing is more efficient
D) resolution is not an issue
Q2) Cranial stereotactic treatments began with the:
A) CyberKnife
B) proton accelerator
C) Gamma Knife
D) SBRT
Q3) Respiratory motion can be managed by: I.rapid CT scanning
II.4DCT
III.two-breath-hold CT
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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Sample Questions
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) Advances in 3D imaging have contributed greatly to the treatment planning process due to:
A) more sophisticated 3D imaging data
B) the improved precision of 3D imaging
C) the reformatting of digital data from CT and MRI
D) none of the above
Q3) Some institutions use forward IMRT treatment planning frequently for radiation therapy treatments of the:
A) lung
B) liver
C) prostate
D) colon
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Chapter 18: Radiation Safety and Protection
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Sample Questions
Q1) The average annual dose received by the general public from radon is ____ mSv.
A) 3
B) 2
C) 1
D) 0.5
Q2) X-rays have a quality factor of what?
A) 1
B) 5
C) 10
D) 20
Q3) Which particles can be electrons?
A) alpha particles
B) beta particles
C) x-rays
D) gamma-rays
Q4) It is recommended that gestational dose be unequally shifted to the third trimester.
A)True
B)False
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Page 20
Chapter 19: Quality Improvement in Radiation Oncology
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Sample Questions
Q1) Among continuous improvement methods,the system of Six Sigma is one that focuses on improving processes by:
A) emphasizing quality control procedures that are routinely performed,documented,and evaluated
B) emphasizing speed and efficiency
C) the elimination of defects in the process through precision and accuracy
D) continuous statistical assessment of date being collected
Q2) Peer review plays a part in several QA programs in radiation oncology.Select the programs listed below that incorporate peer review as part of QA.
A) weekly chart review
B) weekly film review
C) current patient case review
D) new patient planning conference
E) all of the above
Q3) TJC's indicator measurement system (IM system)focuses primarily on:
A) acute inpatient care
B) quality indicators
C) electronic data
D) peer review
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Page 21
Chapter 20: Surface and Sectional Anatomy
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Sample Questions
Q1) The diaphragm is located between T12 and L1.
A)True
B)False
Q2) "Deep" means movement toward the surface.
A)True
B)False
Q3) The base of the penis may be used as an anatomical landmark on the anterior pelvis.
A)True
B)False
Q4) 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
Q5) Lymph consists of water,plasma proteins,and all other formed elements of the blood.
A)True
B)False
Page 22
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Chapter 21: Simulator Design
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Sample Questions
Q1) Light photons are produced and transmitted electronically through to a video image at the:
A) output phosphor
B) tube housing
C) photocathode
D) focusing lenses
Q2) The ___________________ in the image intensifier emits electrons when it is stimulated by light photons.
A) input phosphor
B) output phosphor
C) photocathode
D) electrostatic lenses
Q3) The matrix size is determined by the number of:
A) voxels
B) Hounsfield units
C) detectors on the scanner
D) pixels
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Page 23
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Sample Questions
Q1) Generally,which term would describe the largest volume of tissue in the patient planning process according to ICRU Report 50?
A) gross tumor volume (GTV)
B) clinical target volume (CTV)
C) verification tumor volume (VTV)
D) planning target volume (PTV)
Q2) _________________complex immobilization devices,such as thermoplastic immobilization devices and foaming agent devices,to the treatment couch will provide for "tighter" tolerance settings.
A) Indexing
B) Radiographing
C) Taping
D) Recycling
Q3) A patient's separation (IFD)= 14.5 cm.If the posterior SSD = 94 cm,what will the anterior SSD measurement be?
A) 86 cm
B) 90 cm
C) 91.5 cm
D) 94 cm
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Chapter 23: Computed Tomography Simulation
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Sample Questions
Q1) Which of the following are common artifacts in CT scanning?
I.partial volume artifacts
II.ring and star artifacts
III.motion artifacts
A) I and II
B) I and III
C) II and III
D) I,II,and III
Q2) The window level on a CT image is:
A) the range of numbers displayed on a CT image
B) the number of columns and rows of pixels demonstrated on an image
C) an unwanted image characteristic
D) the central Hounsfield unit of all the CT numbers displayed on an image
Q3) Prior to the use of computed tomography (CT)in the simulation process,contouring was performed by use of solder wire or plaster.
A)True
B)False
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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Sample Questions
Q1) A tray holding custom blocks is measured as 97 cGy and the dose without the tray is 100 cGy.What is the tray transmission factor?
A) 103
B) 97
C) 100
D) not enough information to determine
Q2) The equivalent square of rectangular field of 20 x 10
A) 12 x 12
B) 15 x 15
C) 11.5 x 11.5
D) 13.3 x 13.3
Q3) A wedge filter is used to alter the isodose distribution on an anterior chest field.The MU setting must be ________________ to account for the wedge filter in the field.
A) increased
B) decreased
C) unchanged
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Chapter 25: Photon Dose Distributions
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Q1) The 3DCRT method uses conventional inverse planning.
A)True
B)False
Q2) Organ segmentation is the process of identifying structures,target volumes,or normal tissues,by creating contours around them.
A)True
B)False
Q3) Which of the following is the palpable,visible,and/or demonstrable extent and location of malignant growth and is the volume of known disease?
A) GTV
B) CTV
C) PTV
D) treated volume
Q4) The Bentley-Milan algorithm is an example of which type of treatment planning algorithm?
A) data-driven algorithms
B) scatter integration algorithms
C) model-driven algorithms
D) convolution algorithms
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Chapter 26: Electron Beams in Radiation Therapy
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Q1) According to the AAPM Task Group 25 report,what distance is considered an extended SSD for electron beams?
A) greater than 100 cm SSD
B) greater than 110 cm SSD
C) greater than 115 cm SSD
D) greater than 130 cm SSD
Q2) What are electrons scattered with enough energy to cause further ionization and excitations in other atoms?
A) alpha particles
B) beta particles
C) delta rays
D) gamma rays
Q3) What thickness of Lipowitz alloy 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
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28
Chapter 27: Electronic Charting,and Image Management
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Q1) ________ can be defined as an assembly of tasks performed to accomplish a goal.
A) Input methods
B) Workflow
C) Medical record
D) Decision making
Q2) _______ is a computer network covering a small geographic area:
A) LAN
B) WAN
C) PACS
D) DICOM
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) Quality and accuracy in documenting medical records are governed by:
A) professional guidelines
B) hospital guidelines
C) regulatory boards
D) health department
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Chapter 28: Bone,Cartilage and Soft Tissue Sarcomas
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Q1) The main shaft of a typical long bone is termed the:
A) periosteum
B) diaphysis
C) epiphysis
D) shaftosis
Q2) Most STSs generally spread through: I.the lymphatic system
II.direct invasion and extension
III.hematogenous spread
A) I and II
B) I and III
C) II and III
D) I,II,and III
Q3) Pain is the most common presenting symptom of soft tissue sarcoma (STS).
A)True
B)False
Q4) In which anatomical location are STSs most common?
A) head and neck
B) upper extremity
C) lower extremity
D) trunk
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Chapter 29: Lymphoreticular System Tumors
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Q1) What stage is a Hodgkin lymphoma affecting the hilar nodes and the periaortic nodes?
A) stage I
B) stage II
C) stage III
D) stage IV
Q2) 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
Q3) What stage is a Hodgkin lymphoma affecting only the right cervical lymph nodes?
A) stage I
B) stage II
C) stage III
D) stage IV
Q4) Follicular lymphoma is the most common form of NHL.
A)True
B)False
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Chapter 30: Leukemia
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Q1) Which of the following stages in the natural history of CML is also known as blast crisis?
A) plague
B) chronic
C) accelerated
D) acute
Q2) Children are most likely to develop which type of leukemia?
A) ALL
B) AML
C) CLL
D) CML
Q3) 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
Q4) A lower than normal dose rate is used to treat total-body irradiation (TBI).
A)True
B)False
Page 32
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Chapter 31: Endocrine System Tumors
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Q1) Tumors of which of the following endocrine glands are treated using arc radiation therapy?
A) adrenal
B) pancreas
C) pituitary
D) thyroid
Q2) In children,somatophen-secreting pituitary tumors can present as which of the following conditions?
A) Cushing's syndrome
B) gigantism
C) acromegaly
D) diabetes insipidus
Q3) What is the most common form of thyroid cancer?
A) follicular
B) papillary
C) medullary
D) lymphoma
Q4) 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) Lung cancer is the most common cancer in both men and women.
A)True
B)False
Q2) Which of the following is not a common acute side effect a patient may experience during the course of radiation treatments for lung cancer?
A) dermatitis
B) erythemia
C) esophagitis
D) diarrhea
Q3) What is the leading cause of non-small cell carcinoma of the lung?
A) smoking
B) asbestos
C) radiation
D) genetics
Q4) Which of the following terms is used to describe the surgical removal of an entire lung?
A) lobectomy
B) segmentectomy
C) pneumonectomy
D) wedge resection
Page 34
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Chapter 33: Head and Neck Cancers
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Q1) What defines the posterior radiation field border for the treatment of a low staged larynx cancer?
A) posterior aspect of the hyoid
B) anterior aspect of the vertebral body
C) mid-vertebral body
D) posterior aspect of the vertebral body
Q2) What defines the inferior radiation field border for the treatment of a low staged larynx cancer?
A) superior aspect of the hyoid
B) cricoid cartilage
C) clavicles
D) C7-T1 intervertebral space
Q3) Xerostomia is a common side effect associated with traditional radiation therapy for early larynx cancer.
A)True
B)False
Q4) Most salivary gland cancers are squamous cell carcinomas.
A)True
B)False
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Chapter 34: Central Nervous System Tumors
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Q1) Metastatic brain lesions are more common in children than are primary brain tumors.
A)True
B)False
Q2) From which cells to medulloblastomas arise?
A) primitive neuroectodermal tumor (PNET)
B) primitive neuroectodermal cells
C) astrocytes
D) lymphocytes
Q3) What is the standard dose delivered to the tumor of a patient with a low grade astrocytoma?
A) 3000 to 3500 cGy
B) 4000 to 4500 cGy
C) 5000 to 5500 cGy
D) 6000 to 6500 cGy
Q4) Primary brain tumors rarely metastasize.
A)True
B)False
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Chapter 35: Digestive System Tumors
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Q1) The treatment volume for colon cancers typically includes pelvic lymph nodes.
A)True
B)False
Q2) At what age should a person of average risk have his or her first screening colonoscopy?
A) 30
B) 40
C) 50
D) 60
Q3) The Whipple is a surgical procedure associated with cancer of which organ?
A) pancreas
B) esophagus
C) stomach
D) colon
Q4) Which of the following cancers has the highest incidence of cancer-related deaths in the United States?
A) esophagus
B) stomach
C) colorectal
D) anal
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Chapter 36: Gynecological Tumors
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Q1) What is the most common histologic form of ovarian cancer?
A) squamous cell
B) adenocarcinoma
C) epithelial
D) germ cell
Q2) Pap testing is a screening tool used to detect which cancer?
A) ovarian
B) cervical
C) vaginal
D) vulvar
Q3) The ovaries are retroperitoneal.
A)True
B)False
Q4) The majority of cervical cancers are discovered early.
A)True
B)False
Q5) Bladder and rectal doses are more important to gynecologic radiation therapy planning than kidney doses.
A)True
B)False
Page 38
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Chapter 37: Male Reproductive and Genitourinary Tumors
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Q1) Cancer of which urinary organ is most common?
A) kidney
B) ureter
C) bladder
D) urethra
Q2) PSA is only useful in diagnosing prostate cancer.
A)True
B)False
Q3) What is the treatment of choice for testicular cancers?
A) surgery
B) chemotherapy
C) radiation therapy
D) watchful waiting
Q4) What is the most common form of penile 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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Q1) The lower border of the breast extends to which rib?
A) 5th
B) 6th
C) 7th
D) 8th
Q2) What T stage is a breast cancer that is a 3.5-cm tumor near the nipple?
A) Tis
B) T1
C) T2
D) T3
E) T4
Q3) What is the standard dose delivered to the SCV field?
A) 4000 to 4600 cGy
B) 4500 to 5000 cGy
C) 5000 to 5600 cGy
D) 6000 to 6600 cGy
Q4) Breast implants at an early age increase a woman's risk of developing breast cancer.
A)True
B)False
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Chapter 39: Pediatric Solid Tumors
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Q1) To what dose are medulloblastomas traditionally treated?
A) 2600 cGy
B) 3600 cGy
C) 4600 cGy
D) 5600 cGy
E) 6600 cGy
Q2) Treatment of rhabdomyosarcoma with radiation therapy is most effective when the cancer is located where?
A) orbit
B) bladder
C) skeletal muscle
D) kidney
Q3) What is the most common presenting symptom of a soft tissue sarcoma of the extremity?
A) pain
B) mass
C) loss of mobility
D) headache
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Chapter 40: Skin Cancers and Melanoma
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Q1) What is the most significant cause of skin cancer?
A) radiation exposure
B) sun exposure
C) arsenic exposure
D) human papillomavirus
Q2) What do the ABCDs of melanoma represent?
A) adenocarcinoma,basal cell carcinoma,carcinoma in situ,dermatoma
B) abrasion,bruise,cut,dimpling
C) asymmetry,border,color,diameter
D) appearance,blackness,contour,depth
Q3) The skin is the largest organ of the human body.
A)True
B)False
Q4) Basal cell carcinoma (BCC)is a slow-growing form of skin cancer that does not tend to metastasize.
A)True
B)False
Q5) The incidence of skin cancer has declined over the past two decades.
A)True
B)False
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