

Medical Physics
Pre-Test Questions

Course Introduction
Medical Physics is an interdisciplinary course that explores the application of physics principles and methods to the diagnosis and treatment of human diseases. The curriculum covers fundamental topics such as radiation physics, medical imaging techniques (including X-ray, CT, MRI, and ultrasound), radiation dosimetry, and the principles behind therapeutic modalities like radiotherapy. Students will gain insight into the design and operation of medical devices, the safe use of ionizing and non-ionizing radiation in medicine, and the regulatory and ethical considerations in clinical practice. The course equips learners with the knowledge required for effective collaboration between physicists, clinicians, and engineers in healthcare settings, emphasizing both theoretical understanding and practical problem-solving in the context of modern medicine.
Recommended Textbook Principles and Practice of Radiation Therapy 4th Edition by Washington
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38 Chapters
954 Verified Questions
954 Flashcards
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Page 2

Chapter 1: Cancer: An Overview
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Sample Questions
Q1) Pancreatic cancer may be treated using which technique?
A) Intraluminal
B) Intravascular
C) Intracavitary
D) Intraoperative
Answer: D
Q2) Which of the following is an example of an etiologic factor?
A) Gender
B) Sex
C) Race
D) Social habits
Answer: D
Q3) Which of the following is a radiosensitizing chemotherapy agent?
A) Cyclophosphamide
B) 5-Fluorouracil
C) Doxorubicin
D) Cisplatin
Answer: C
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Chapter 2: The Ethics and Legal Considerations of Cancer Management
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Sample Questions
Q1) Which of the following is not a recognized exception to patient confidentiality?
A) Genetic disease
B) Abuse
C) Communicable disease
D) Automobile accident
Answer: A
Q2) Which of the following is not a sanctionable offence by the American Registry of Radiologic Technologists (ARRT)?
A) Failure to participate in professional activities, share knowledge with colleagues, and investigate new aspects of professional practice
B) Impersonation of a candidate for the examination
C) Failure to perform radiation therapy procedures with reasonable skill and safety
D) Knowingly assisting, aiding, or allowing a person without a current certificate of registration with the ARRT to engage in the practice of radiologic technology, in a jurisdiction that requires such registration
Answer: A
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Chapter 3: Principles of Pathology
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Sample Questions
Q1) All except which of the following are organelles?
A) Mitochondria
B) Endoplasmic reticulum
C) Ribosomes
D) Plasma membrane
Answer: D
Q2) Which of the following describes the cell membrane?
A) Contains genetic DNA
B) Contains organelles
C) Is a permeable structure
D) Is the powerhouse of the cell
Answer: C
Q3) Characteristics of malignant tumors include all except which of the following?
A) They have rapid growth.
B) They are encapsulated.
C) They metastasize frequently.
D) There is frequent vessel invasion.
Answer: B
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Chapter 4: Overview of Radiobiology
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Sample Questions
Q1) To calculate the nominal standard dose (NSD), what factors must be known?
I.Total dose
II.Fraction size
III.Elapsed days
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) What does the term interphase death mean?
A) The cell dies prior to entering interphase.
B) The cell dies prior to leaving interphase.
C) The cell dies between mitotic phases.
D) The entire organism dies.
Q3) A whole-body radiation dose given in a period of seconds to minutes produces a clinical pattern called what?
A) Delayed effects
B) Mortality rates
C) Acute radiation syndromes
D) Clinical body dose
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Chapter 5: Detection and Diagnosis
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Sample Questions
Q1) Examples of facilitating verbal responses include all except which of the following?
A) "I understand."
B) "This is just part of the aging process."
C) "How much did it hurt?"
D) "I see you are very angry."
Q2) What is the leading site of cancer resulting in deaths in males and females from studies in 2013?
A) Lung and bronchus
B) Colon and rectum
C) Brain
D) Head and neck
Q3) Which of the following is not considered one of the four senses?
A) Sight
B) Touch
C) Taste
D) Smell
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Chapter 6: Medical Imaging
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Sample Questions
Q1) Which of the following describes the predominant x-ray interaction in the diagnostic range?
A) Compton scatter
B) Photoelectric absorption
C) Coherent scatter
D) None of the above
Q2) Components of a modern x-ray tube include which of the following?
A) Cathode filament
B) Rotating anode
C) Glass envelope
D) All of the above
Q3) Which of the following imaging receptors do not use light in capturing the latent image?
A) Flat panel detectors (FPDs)
B) TFTs
C) Film and screen
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Chapter 7: Treatment Delivery Equipment
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Sample Questions
Q1) Lipowitz metal is composed of which of the following?
A) Tin, bismuth, lead, and cadmium
B) Lead, tungsten, and tin
C) Tin, bismuth, tungsten, and lead
D) Bismuth, cadmium, and lead
Q2) Depth of maximum dose for a 10-MV machine is how far below the skin surface?
A) 0.5 cm
B) 1.5 cm
C) 2.5 cm
D) 5 cm
Q3) Which of the following best describes the major components of a linear accelerator?
A) Power supply, modulator, electron gun, accelerating waveguide, head, beryllium target
B) Power supply, modulator, klystron, electron gun, "D"s, beryllium target
C) Power supply, electron gun, accelerating waveguide, head, doughnut accelerator structure
D) Modulator, klystron, electron gun, accelerator structure, waveguide, bending magnet
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9

Chapter 8: Treatment Procedures
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Sample Questions
Q1) Where would the radiation therapist find the information regarding the status of the treatment unit?
A) Console
B) Interlock system of the unit
C) Patient record
D) Cameras in the room
Q2) Which of the following is a series of documentation and activities performed with the purpose of optimizing patient care?
A) Quality control
B) Quality auditing
C) Quality assurance (QA)program
D) Quality of life
Q3) Which of the following is the measurement of the angle between central rays of two intersecting treatment beams?
A) Wedge angle
B) Hinge angle
C) Isodose angle
D) Central axis angle
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Chapter 9: Infection Control in Radiation Oncology Facilities
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Sample Questions
Q1) What are the five transmission routes that carry disease?
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
Q2) CDC stands for the _________________________.
A) Cancer Diagnostic Centers
B) Center for Diagnosis of Cancer
C) Cancer Domain Center
D) Centers for Disease Control and Prevention
Q3) A person who is colonized but not ill is known as a ________________.
A) host
B) carrier
C) vector
D) fomite
Q4) When should Standard Precautions be used?
A) When exposure to blood is likely
B) When exposure to saliva is likely
C) During all patient care procedures
D) During patient procedures requiring sterile asepsis
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Chapter 10: Patient Assessment
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Sample Questions
Q1) The affective responses that occur most commonly among cancer patients are ________________.
A) anxiety and depression
B) anxiety and coping strategies
C) depression and coping
Q2) The dynamic process directed toward the goal of enabling persons to function at their maximum level within the limitations of their disease or disability in terms of physical, mental, emotional, social, and economic potential is ________________.
A) rehabilitation
B) coping strategy
C) reflecting
D) therapeutic relationship
Q3) Which of the following is a multidimensional assessment tool to measure pain?
A) Brief Pain Inventory
B) Functional Assessment of Cancer Therapy
C) Quality of Life Index
D) Pain Free Forever Assessment
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Page 12

Chapter 11: Pharmacology and Drug Administration
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Sample Questions
Q1) What type of medication administration bypasses the gastrointestinal tract?
A) Topical administration
B) Parenteral administration
C) Mucous membrane administration
D) Administration via the rectum
Q2) Select potential reasons why a patient may be unable to take oral preparations of a drug.
A) The patient is experiencing nausea and vomiting.
B) The patient has difficulty in swallowing.
C) The patient refuses to swallow medication.
D) All of the above apply.
Q3) Radiolucent contrast agents are those that ______________________.
A) appear dark on x-ray
B) appear white on x-ray
C) have high atomic numbers
D) absorb x-ray photons easily
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Chapter 12: Applied Mathematics Review
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Sample Questions
Q1) How many significant figures are there in 0.0068?
A) Two
B) Three
C) Four
D) Five
Q2) 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
Q3) Simplify (a²)<sup>5</sup>.
A) a<sup>10</sup>
B) a<sup>7</sup>
C) a<sup>32</sup>
D) a<sup>25</sup>
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Chapter 13: Introduction to Radiation Therapy Physics
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Sample Questions
Q1) Rest mass refers to the _______ of a particle when it is not moving.
A) energy
B) charge
C) force
D) weight
Q2) 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 (HVL)
D) intensity coefficient
Q3) The force responsible for interaction between particles with a nonzero mass and having infinite range is _________________.
A) electromagnetic
B) gravity
C) weak force
D) strong force
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Chapter 14: Aspects of Brachytherapy
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Sample Questions
Q1) What is the average energy of iridium 192?
A) 170 keV
B) 730 keV
C) 450 keV
D) 380 keV
Q2) Areas commonly treated with external applicators include which of the following?
I.Hard palate
II.Skin
III.Orbital cavity
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q3) What is the purpose of dummy sources used for temporary implants?
A) Localize the tumor in surgery
B) Enable visualization of source placement
C) Give physics residents experience with loading sources
D) Determine dose to the bladder and rectum
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16

Chapter 15: Special Procedures
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Sample Questions
Q1) The typical width of the spread-out proton Bragg's peak (SOBP)is _____________.
A) 2 to 16 mm
B) 2 to 16 cm
C) 1 to 25 mm
D) 1 to 25 cm
Q2) The cyber knife can treat anywhere in the body because it uses a(n)___________ technique.
A) nonisocentric
B) repetitive
C) real-time
D) isocentric
Q3) Cone beam CT, TomoTherapy, and CT-on rails correct for _________ motion.
A) interfraction
B) intrafraction
Q4) Cone beam CT _______________________.
A) uses a fan beam
B) has a 3D extended digital array
C) has an area detector with 2D extended digital array
D) has multiple rotational speeds
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Chapter 16: Particle Therapy
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Sample Questions
Q1) In an SOBP proton beam, as depth increases, linear energy transfer (LET)does what?
A) Decreases
B) Increases
C) Remains unchanged
Q2) What is the shape of the proton beam as it passes through the transport system?
A) Divergent
B) Conical
C) Fan-shaped
D) Pencil thin
Q3) What is one disadvantage of today's synchrocyclotron over the cyclotron?
A) It needs energy degraders.
B) It can generate variable beam energies.
C) It has less current producing longer treatment times.
D) It needs a complex system to extract the beam energy needed.
Q4) The proton beam is focused and shaped by devices in which of the following?
A) Magnet
B) Nozzle
C) Compensator
D) Accelerator
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Chapter 17: Radiation Safety and Protection
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Sample Questions
Q1) Thermoluminescent dosimeters are composed of ____.
A) Ra
B) Al<sub>2</sub>O<sub>3</sub>
C) Ce
D) LiF
Q2) The average annual dose received by the general public from naturally occurring internal radiation is ____ mSv.
A) 0.2
B) 0.11
C) 13
D) 11
Q3) Which of the following describes why filters are used in film badges?
A) To discriminate different directions of radiation
B) To discriminate different radiation energies and types
C) To correct for film fogging due to exposure
D) To increase the sensitivity of the measuring device
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Chapter 18: Patient Safety in Radiation Oncology
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Sample Questions
Q1) Which of the following characteristics is least reflective of a good leader?
A) Readily receives criticism
B) Listens well
C) Inspires others
D) Promotes standardization
Q2) One tool used to show problem areas leading to potential solutions is a graph showing the range of data collected.Data would be displayed in a _____________________.
A) fishbone graph
B) Pareto graph
C) histogram
D) control chart
Q3) Regular safety rounds may be instituted by a department in order to do which of the following?
A) Discuss items needed to perform tasks successfully.
B) Improve interpersonal and organizational communication.
C) Report various issues noticed during the day.
D) Evaluate the quality of work by others.
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20

Chapter 19: Quality Improvement in Radiation Oncology
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Sample Questions
Q1) The recommended frequency for checking the audio-visual system in the treatment room is _______________.
A) daily
B) weekly
C) monthly
D) yearly
Q2) 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
Q3) The tolerance for light/radiation field coincidence on the linear accelerator is _____ mm.
A) 1
B) 2
C) 3
D) 4
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Page 21

Chapter 20: Surface and Sectional Anatomy
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Sample Questions
Q1) Which of the following structures is located in the anterior portion of the neck; directly inferior to the thyroid cartilage and superior to the suprasternal notch?
A) Mandible
B) Hyoid bone
C) Tip of the xiphoid process
D) Cricoid cartilage
Q2) Which of the following structures is not located at the level of the fourth thoracic vertebrae?
I.Angle of Louis
II.Medial aspect of the clavicle
III.Carina
IV.Inferior tip of the scapula
A) I and II
B) II and I
C) I and III
D) I and IV
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Chapter 21: Simulator Design
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Sample Questions
Q1) In the conventional simulator, the _____________ represent(s)the radiation field.
A) blades
B) wires
C) OID
D) collimator assembly
Q2) The Hounsfield unit for fat would be _________________.
A) +1000
B) -500
C) -100
D) 100
Q3) CT numbers are also known as which of the following?
A) Hounsfield units
B) Godfrey units
C) Attenuation coefficient units
Q4) The CT number for water is _____________.
A) -1000
B) -100
C) 0
D) 1000
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Chapter 22: Computed Tomography Simulation
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Sample Questions
Q1) A contraindication for administering barium-based contrast to a patient with a history of long-term steroid therapy would be an increased risk of _______________.
A) aspiration
B) colon perforation
C) difficulty in holding an enema
D) allergic reaction
Q2) The reconstructed field of view that is displayed on the computer monitor should be large enough to display which of the following?
I.Entire contour
II.Immobilization device
III.Pertinent anatomy only
A) I
B) II
C) III
D) I and II
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24
Chapter 23: Photon Dosimetry Concepts and Calculations
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Sample Questions
Q1) What is the depth from the PA if the SAD is 100 cm and the SSD is 89 cm?
A) 8 cm
B) 9 cm
C) 10 cm
D) 11 cm
Q2) Absorbed dose at depth × 100% = absorbed dose at Dmax is the definition of which of the following?
A) TAR
B) TMR
C) TPR
D) PDD
Q3) Calculate the PDD of depth (d)if the dose at Dmax is 180 cGy and the dose at d is 127 cGy.
A) 47%
B) 70.6%
C) 56%
D) 75%
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25
Chapter 24: Photon Dose Distributions
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Sample Questions
Q1) The process of identifying structures, target volumes, or normal tissues, by creating contours around them, is often called _____________________.
A) organ segmentation
B) virtual simulation
C) intensity modulation
D) heterogeneity correction
Q2) Which of the following factors can be corrected to adjust the isodose lines of beams with oblique incidences?
I.PDD
II.TAR
III.TMR
A) I and II
B) I and III
C) II and III
D) I, II, and III
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26

Chapter 25: Electron Beams in Radiation Therapy
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Sample Questions
Q1) Which technique is most likely to result in photon contamination of the electron beam?
A) Use of an electron gun
B) Use of a bending magnet
C) Use of a scattering foil
D) Use of a scanning beam
Q2) What effect will an increase in the energy of an electron beam have on the lateral bulge of the 80% isodose line?
A) Increase
B) Decrease
C) Remain the same
D) Dose dependence
Q3) What is the depth of the 90% isodose line of a 9-MeV electron beam?
A) 2.25 cm
B) 3 cm
C) 4.5 cm
D) 9 cm
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Chapter 26: Electronic Charting and Image Management
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Q1) _______ facilitate the use of wireless PDAs, laptops, and other pervasive computing devices at the point of care.
A) LANs
B) WLANs
C) ASPs
D) Mans
Q2) What series of events does a patient referred to radiation oncology typically follow?
I.Consultation
II.Treatment delivery
III.Simulation
A) I and II
B) I, III, and II
C) I, II, and III
D) I and III
Q3) HL7 is responsible for developing standards for which of the following?
A) Exchanging clinical data
B) Sharing image information
C) Security and privacy
D) Data entry
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Chapter 27: Bone, Cartilage, and Soft Tissue Sarcomas
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Q1) What type of bone marrow is contained in the diaphysis of long bones?
A) Red
B) White
C) Blue
D) Yellow
Q2) What is the most common form of primary bone cancer?
A) Osteosarcoma
B) Chondrosarcoma
C) Fibrosarcoma
D) Chordoma
Q3) What is the most common site of metastasis from a primary bone cancer?
A) Brain
B) Bowel
C) Lung
D) Bone
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 28: Lymphoreticular System Tumors
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Q1) Which lymphoma is most common in young African males?
A) T-cell lymphoma
B) Burkitt lymphoma
C) HD
D) Follicular lymphoma
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) Which treatment field for HD includes the axillary lymph node chain?
A) Mantle
B) Inverted-Y (abdominal portion)
C) Inverted-Y (pelvic portion)
D) All of the above
Q4) A mantle field is used to treat which type of cancer?
A) Mycosis fungoides
B) Multiple myeloma
C) Non-Hodgkin lymphoma (NHL)
D) Hodgkin's disease (HD)
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Chapter 29: Endocrine System Tumors
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Q1) In which gland is prolactin (PRL)produced?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
Q2) In which gland is epinephrine produced?
A) Parathyroid
B) Pituitary
C) Thyroid
D) Adrenal
Q3) In which gland is cortisol produced?
A) Parathyroid
B) Pituitary
C) Thyroid
D) Adrenal
Q4) Which endocrine gland contains a medulla and a cortex?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
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Chapter 30: Respiratory System Tumors
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Sample Questions
Q1) What is the leading cause of non-small cell carcinoma of the lung?
A) Smoking
B) Asbestos
C) Radiation
D) Genetics
Q2) What is the most effective single-agent chemotherapy drug?
A) Cisplatin
B) Paclitaxel
C) Vinorelbine
D) Gemcitabine
Q3) 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) Erythema
C) Esophagitis
D) Diarrhea
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Chapter 31: Head and Neck Cancers
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Q1) In which salivary gland do most salivary cancers occur?
A) Parotid
B) Submandibular
C) Sublingual
D) Minor
Q2) 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) Midvertebral body
D) Posterior aspect of the vertebral body
Q3) Which salivary gland is associated with the Stensen duct?
A) Parotid
B) Submandibular
C) Sublingual
D) Minor
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Chapter 32: Central Nervous System Tumors
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Q1) Which of the following beam arrangements is most typical for treatment of a malignant primary brain tumor?
A) Parallel opposed whole brain fields
B) Small fields with 1 to 3 cm margins
C) Oblique fields to include the supraorbital ridge
D) Large fields with 5 to 10 cm margins
Q2) Epilation may be permanent when the cranium is treated beyond the threshold dose of ______ cGy.
A) 1000
B) 2000
C) 3000
D) 4000
Q3) What is the most common source of brain metastases among the following?
A) Colon
B) Lung
C) Breast
D) Melanoma
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Page 34

Chapter 33: Digestive System Tumors
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Sample Questions
Q1) What condition is most closely associated with adenomatous polyposis?
A) Barrett esophagus
B) Gardner syndrome
C) Plummer-Vinson syndrome
D) Tenesmus
Q2) A dose-limiting organ of concern when planning treatment of the pancreas is the liver.The tolerance dose (TD 5/5)for the liver is ______ Gy.
A) 23
B) 35
C) 45
D) 55
Q3) What is the dose-limiting structure of most concern for radiation treatments of the esophagus?
A) Normal esophagus
B) Heart
C) Spinal cord
D) Trachea
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Chapter 34: Gynecological Tumors
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Sample Questions
Q1) The prescription point A can be measured from the cervical os ______________.
A) 2 cm superior and 2 cm lateral
B) 2 cm inferior and 2 cm lateral
C) 3 cm superior and 5 cm lateral
D) 3 cm inferior and 5 cm lateral
Q2) Primary peritoneal carcinomas are most closely associated with which cancer?
A) Ovarian
B) Cervical
C) Vaginal
D) Vulvar
Q3) What is the common name for the female external genitalia?
A) Vulva
B) Mons pubis
C) Labia
D) Perineum
Q4) 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
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Chapter 35: Male Reproductive and Genitourinary Tumors
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Sample Questions
Q1) What is the most common form of kidney cancer?
A) Adenocarcinoma
B) Transitional cell carcinoma
C) Squamous cell carcinoma
D) Renal cell carcinoma
Q2) What is the treatment of choice for testicular cancers?
A) Surgery
B) Chemotherapy
C) Radiation therapy
D) Watchful waiting
Q3) Which of the following treatment techniques can be used to treat the prostate?
A) 4-field box
B) IMRT
C) Brachytherapy
D) All of the above
Q4) Who has the most significant risk of developing prostate cancer?
A) 45-year-old black male
B) 50-year-old white male
C) 70-year-old black male
D) 81-year-old black female
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Chapter 36: Breast Cancer
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Sample Questions
Q1) What is the standard dose delivered to the tumor bed following tangential treatments?
A) 4500 to 5000 cGy
B) 5000 to 5600 cGy
C) 6000 to 6600 cGy
D) 7000 to 7600 cGy
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) At what age should women of normal risk begin having regular annual screening mammograms?
A) 20
B) 30
C) 40
D) 50
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38

Chapter 37: Pediatric Solid Tumors
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Sample Questions
Q1) Successful treatment of Langerhans cell histiocytosis requires what dose?
A) 200 to 400 cGy
B) 400 to 1200 cGy
C) 1500 to 2500 cGy
D) Greater than 4000 cGy
Q2) Ewing sarcomas are cancers of which organ?
A) Kidney
B) Bone
C) Skeletal muscle
D) Smooth muscle
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 38: Skin Cancers and Melanoma
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Sample Questions
Q1) In instances where malignant melanoma is treated with radiation, delivering one fraction per day, which of the following is the most effective fraction size?
A) 100 to 150 cGy
B) 150 to 180 cGy
C) 180 to 200 cGy
D) 200 to 400 cGy
Q2) What primary skin cancer (other than malignant melanoma)is aggressive and has a tendency to spread through the lymphatics and bloodstream?
A) Adenocarcinoma
B) Basal cell
C) Squamous cell
D) Merkel cell
Q3) What is the technique in which the tumor is removed and examined one layer at a time?
A) Curettage and electrodessication
B) Mohs surgery
C) Cryosurgery
D) Laser surgery
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