Course Introduction
Radiation Biology
Final Exam Questions
Radiation Biology explores the interactions between ionizing and non-ionizing radiation and living organisms at the molecular, cellular, and whole-body levels. The course covers the fundamental principles of radiation physics, the mechanisms of radiation-induced biological damage, cellular response and repair mechanisms, and the effects of radiation on DNA and other cellular components. Students will study dose-response relationships, radiation carcinogenesis, genetic effects, and the principles of radiation protection. The course also examines applications in medicine, such as radiation therapy, as well as environmental and occupational radiation exposure, providing a foundation for safe and effective practices in various scientific and healthcare settings.
Recommended Textbook
Principles and Practice of Radiation Therapy 4th Edition by Washington
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954 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 a radiosensitizing chemotherapy agent?
A) Cyclophosphamide
B) 5-Fluorouracil
C) Doxorubicin
D) Cisplatin
Answer: C
Q2) Which of the following routes of administration is used when treating bladder cancer with chemotherapy?
A) Oral
B) Intra-arterial
C) Intracavitary
D) Intrathecal
Answer: C
Q3) Pancreatic cancer may be treated using which technique?
A) Intraluminal
B) Intravascular
C) Intracavitary
D) Intraoperative
Answer: D
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Page 3
Chapter 2: The Ethics and Legal Considerations of Cancer Management
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Q1) Which group is responsible for producing the rules of ethics for radiation therapists?
A) American Registry of Radiologic Technologists (ARRT)
B) American Society of Radiologic Technologists (ASRT)
C) American Medical Association (AMA)
D) American Hospital Association (AHA)
Answer: A
Q2) What legal document designates an individual as decision maker for a patient who is no longer capable of making decisions?
A) Scope of practice
B) Informed consent
C) Durable power of attorney
D) Living will
Answer: C
Q3) Which of the following is not a source from which values are derived?
A) Money
B) Experience
C) Religion
D) Science
Answer: A
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Chapter 3: Principles of Pathology
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Sample Questions
Q1) The three most common procedures used to make a diagnosis of cancer are all except which of the following?
A) Incisional
B) Excisional
C) Sputum cytology
D) Needle aspiration
Answer: C
Q2) A(n)______________ is a term used to describe a gene that accelerates growth.
A) oncogene
B) tumor-suppressor gene
C) nucleoside
D) nucleotide
Answer: A
Q3) 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
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Chapter 4: Overview of Radiobiology
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Q1) Which of the following is not an early response to radiation?
A) Breast cancer
B) Erythema
C) Diarrhea
D) Chromosome aberrations
Q2) What is the typical oxygen enhancement ratio (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
Q3) To produce the same biological effects seen after a single dose of 5,000 cGy, the total dose of a fractionated dose would be _________.
A) less
B) greater
C) equivalent
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Chapter 5: Detection and Diagnosis
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Q1) One part of the staging by the American Joint Committee on Cancer (AJCC)is called histologic type; this refers to which of the following?
A) Staging of the cell
B) Cell type
C) Differentiation of the cell
D) Grading of the cell
Q2) Vital signs include all except which of the following?
A) Temperature
B) Pulse
C) Oxygen analysis
D) Blood pressure
Q3) A subjective indication of a disease or a change in condition as perceived by the patient is a ________.
A) sign
B) symptom
C) syndrome
D) screening
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Chapter 6: Medical Imaging
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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) Which technical factor has the most effect on radiographic density?
A) mAs
B) kVp
C) Distance
D) All of the above
Q3) Therapeutically, x-rays in the 40 to 300 kVp range are used for which of the following?
A) Treatment of skin cancers and other superficial tumors
B) The planning of a patient's treatment on the simulator
C) Both of the above
D) None of the above
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Page 8
Chapter 7: Treatment Delivery Equipment
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Q1) When using multileaf collimation, which concerns need to be evaluated?
A) Penumbra between the leaves and the transmission of the leaves
B) Movement of MLCs during the treatment give variations in dose that need to be evaluated along with penumbra between the leaves
C) Movement of MLCs during treatment and interleaf transmission leakage
D) Penumbra at the end of the leaves and interleaf transmission leakage
Q2) Depth of maximum dose for a 6-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) When treating with electrons, the carousel rotates to place a _________________ in the beam to spread it out.
A) collimator
B) cone
C) scattering foil
D) flattening filter
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9
Chapter 8: Treatment Procedures
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Sample Questions
Q1) Patients are monitored during treatment delivery with megavoltage treatment units by using which of the following?
I.Direct visual
II.Closed-circuit television
III.Two-way audio
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) Bolus comes in many forms and has many applications.Which of the following is not a material that bolus would be made from?
A) Vaseline gauze
B) Water-filled balloon
C) Superflab
D) Aluminum covered with paraffin wax
Q3) What is the melting point of Cerrobend?
A) 74° F
B) 100° F
C) 165° F
D) 212° F
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Chapter 9: Infection Control in Radiation Oncology Facilities
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Sample Questions
Q1) Recommended vaccines for health care workers include all except which of the following?
A) Hepatitis B
B) Varicella
C) Measles, mumps, rubella
D) Annual influenza
E) All of the above vaccines are recommended.
Q2) An OSHA-approved respiratory mask is required for use by health care workers at high risk of being exposed to which of the following?
A) Hepatitis B
B) Hepatitis C
C) Methicillin-resistant Staphylococcus aureus (MRSA)
D) Tuberculosis (TB)
Q3) All of the following statements describe the use of Standard Precautions except which of the following?
A) Wear gloves when touching blood and body fluids.
B) No hand washing is necessary if using gloves.
C) Use mouthpieces when performing cardiopulmonary resuscitation (CPR).
D) Never recap used needles.
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Page 11
Chapter 10: Patient Assessment
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Q1) A general health assessment can include all except which of the following?
A) An interview
B) Taking medical history past and present
C) A self-report
D) Asking when the person last attended church
Q2) Skin reactions include all except which of the following?
A) Erythema
B) Alopecia
C) Dry desquamation
D) Moist desquamation
Q3) Marasmus is ____________ malnutrition.
A) calorie
B) protein
C) fat
D) carbohydrate
Q4) Thrombocytopenia is a reduction in which of the following?
A) Platelets
B) White blood cells
C) Red blood cells
D) All blood counts
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Chapter 11: Pharmacology and Drug Administration
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Q1) Which of the following are included in the "six rights" of drug safety?
I.Identify the right patient.
II.Identify the right medication and right dose.
III.Identify the right time.
IV.Identify the route.
A) I, II, and III
B) I, III, and IV
C) II, III, and IV
D) I, II, III, and IV
Q2) Which of the following routes of drug administration is not considered a parenteral route?
A) Oral
B) Intradermal
C) Subcutaneous
D) Intrathecal
Q3) Which of the following radioactive isotopes is used in radiation therapy?
A) Strontium 89
B) Technetium 99
C) Fluorine 18
D) Hydrogen 3
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Chapter 12: Applied Mathematics Review
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Sample Questions
Q1) Which of the following numeric expressions is written in scientific notation?
A) 1222 × 10<sup>1</sup>
B) 122.2 × 10<sup>2</sup>
C) 12.22 × 10<sup>3</sup>
D) 1.222 × 10<sup>4</sup>
Q2) How many significant figures are there in 6,800?
A) Two
B) Three
C) Four
D) Unable to determine
Q3) Which of the following is an example of a random error?
A) Inaccuracies in the laser positioning system
B) Patient movement
C) Human error
D) Difference in cushioning capacity of couch materials between simulator and treatment table
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Chapter 13: Introduction to Radiation Therapy Physics
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Q1) 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
Q2) The condition in which the half-life of the parent isotope is much greater than the half-life of the daughter isotope is called __________________.
A) transient equilibrium
B) transient attenuation
C) secular attenuation
D) secular equilibrium
Q3) 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
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15
Chapter 14: Aspects of Brachytherapy
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Q1) Permanent implants involve which of the following?
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
Q2) Decay constant is expressed as which of the following?
A) The time it takes for activity to decay to half its original value
B) Total number of atoms that decay per unit time
C) Average lifetime for the decay of radioactive atoms
D) Total number of atoms that decay
Q3) Which of the following is the radionuclide with the largest average photon energy?
A) Cobalt 60
B) Cesium 137
C) Iridium 192
D) Radium 226
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Page 16
Chapter 15: Special Procedures
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Q1) Heavy charged particles like protons have a(n)__________ fall-off in tissue that is desirable.
A) continuous
B) sharp
C) shortened
D) absent
Q2) Protons are ________________.
A) highly imaged
B) heavy charged particles
C) extended range
D) electrons
Q3) Which of the following is a process that aligns multiple data sets into a single coordinate system so that the spatial locations of corresponding points coincide?
A) Registration
B) Recombination
C) IGRT
D) MIP
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Page 17
Chapter 16: Particle Therapy
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Q1) What do the results of a clinical study completed at MD Anderson indicate regarding when adaptive planning is strongly indicated?
A) The first week of therapy is completed.
B) The first day of therapy is completed.
C) The patient loses significant weight.
D) A high Z prosthesis is in the beam path.
Q2) What are the typical therapeutic proton beam energies?
A) 6 to 25 MeV
B) 10 to 50 MeV
C) 50 to 250 MeV
D) 300 to 500 MeV
Q3) Internal target motion can be accounted for by _____________ the compensator used in proton therapy.
A) smearing
B) shaving
C) rotating
D) waxing
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Chapter 17: Radiation Safety and Protection
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Q1) The annual dose equivalent limit to the lens of the eye for nonoccupationally exposed individuals is ____ mSv.
A) 0.5
B) 1
C) 5
D) 50
Q2) Which of the following would not be helpful in a personnel radiation-monitoring program?
A) Film badges
B) Routine blood examinations
C) Pocket ionization chambers
D) TLDs
Q3) What is the radiation weighting factor for alpha particles?
A) 1
B) 5
C) 10
D) 20
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Page 19
Chapter 18: Patient Safety in Radiation Oncology
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Q1) 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
Q2) Transformational leadership focuses on which of the following?
A) Interactions between leaders and followers
B) Relationship between leaders and followers
C) Rewards for positive behaviors and punishment for negative behaviors
D) Relationship and interactions between leaders and followers
Q3) Which of the following would be a key driving force for the development of staff exhibiting "initiating" and "enhancing" behaviors during culture change efforts?
A) Positive feedback
B) Low staff levels
C) Burdensome reporting system
D) Limited access to training
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20
Chapter 19: Quality Improvement in Radiation Oncology
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Q1) Components of a quality improvement (QI)plan in radiation oncology incorporate evaluation, assessment, identification, data collection, and annual review of items ultimately affecting patient care.Which of the following is the key player in the QI plan?
A) QI officer
B) QI committee
C) Medical director
D) Radiation oncology team
Q2) Which of the following regulatory agencies is dedicated to improving the quality of care in health care settings and also requires every radiation oncology department to have its own dedicated QI plan?
A) ANSI
B) TJC
C) NCQA
D) NRC
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Chapter 20: Surface and Sectional Anatomy
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Q1) The movement of lymph through the lymphatic system is caused by which of the following?
A) The motion of the adjacent muscles
B) A primitive two-chamber heart located in the posterior portion of the mediastinum
C) Hydrostatic and osmotic pressure differences in the body
D) Both a and c
Q2) The lambdoidal suture is formed by which bones?
I.Frontal
II.Sphenoid
III.Parietal
IV.Temporal
V.Occipital
A) I, III
B) I, III.
C) V, III
D) IV, V
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Chapter 21: Simulator Design
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Q1) A(n)_________ ring allows the CT x-ray tube to rotate in a continuous motion without the concern of cables becoming tangled.
A) spiral
B) slip
C) aperture
D) electrical power
Q2) The CT number for dense bone is _________.
A) -1000
B) -100
C) 0
D) 1000
Q3) The CT number for water is _____________.
A) -1000
B) -100
C) 0
D) 1000
Q4) CT numbers are also known as which of the following?
A) Hounsfield units
B) Godfrey units
C) Attenuation coefficient units
Page 23
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Chapter 22: Computed Tomography Simulation
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Q1) Which of the following are benefits of CT simulation?
I.The ability to outline critical structures and view these structures in three dimensions
II.Machine setup parameters and treatment accessories unable to be verified on the CT scanner
III.Virtual simulation allows for construction of digitally reconstructed radiographs DRRs without the patient being present
A) I and II
B) I and III
C) II and III
D) I, II, and III
Q2) When using intravenous (IV)contrast to enhance the anatomy of the brain, the best interval for contrast administration should be before the scan by _____________.
A) 30 seconds
B) 60 seconds
C) 30 minutes
D) 60 minutes
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Chapter 23: Photon Dosimetry Concepts and Calculations
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Q1) Mayneord F factor is used in which of the following?
A) Isocentric setups when distance is increased
B) Isocentric setups when field size changes
C) SSD setups when field size changes
D) SSD setups when distance increases
Q2) As a field size increases from the standard established, the output factor for a treatment machine will do what?
A) Increase
B) Decrease
C) Remain the same
Q3) 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
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Chapter 24: Photon Dose Distributions
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Q1) What determines the wedge angle?
A) The angle of the 100% isodose line with a line perpendicular to the central axis
B) The actual measurements of the wedge
C) The angle of the 80% isodose line with a line perpendicular to the central axis
D) Two times the hinge angle
Q2) What determines the hinge angle?
A) The angle between two beams' central axes that share an isocenter
B) The angle of the 80% isodose line with a line perpendicular to the central axis of a wedges field
C) The angle of the 100% isodose line with a line perpendicular to the central axis of a wedges field
D) The wedge angle divided by 2
Q3) What is (are)spatial representation(s)of the magnitude of the dose produced by a source of radiation?
A) Treatment planning
B) Dose distributions
C) Dose calculation matrix
D) Dose-volume histogram (DVH)
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Chapter 25: Electron Beams in Radiation Therapy
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Q1) Which of the following is one very important consideration during the use of internal shields when administering electron therapy?
A) Shielding materials become radioactive
B) Dose to tissues directly in front of the shield is increased
C) Internal shields need to be secured by suturing
D) Shielding material thickness is found by MeV/3
Q2) Surface dose values for electron beams in the 6- to 20-MeV range vary from
A) 100% to 105%
B) 95% to 100%
C) 80% to 90%
D) 70% to 80%
Q3) Which electron beam energy is most likely to under-dose at the surface?
A) 9 MeV
B) 12 MeV
C) 16 MeV
D) 20 MeV
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Chapter 26: Electronic Charting and Image Management
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Q1) Centralization of patient medical history in the EMR does which of the following?
A) Enhances patient privacy
B) Improves safety and efficiency
C) Improves the decision-making process
D) Both b and c
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) _______ is a computer network covering a small geographic area.
A) A local area network (LAN)
B) WAN
C) PACS
D) DICOM
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28
Chapter 27: Bone, Cartilage, and Soft Tissue Sarcomas
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Q1) Which of the following bone malignancies has the highest incidence?
A) Osteosarcoma
B) Chondrosarcoma
C) Ewing's sarcoma
D) Metastatic bone disease
Q2) Which of the following has the highest incidence of bone tumors?
A) Ewing sarcoma
B) Chondrosarcoma
C) Metastatic bone lesions
D) Multiple myeloma
Q3) The main shaft of a typical long bone is termed the __________.
A) periosteum
B) diaphysis
C) epiphysis
D) shaftosis
Q4) Primary bone tumors comprise approximately ___ of all tumors.
A) 1%
B) 5%
C) 10%
D) 15%
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Chapter 28: Lymphoreticular System Tumors
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Q1) The spleen is commonly associated with which of the following blood cell types?
A) Red blood cells
B) B-cell lymphocytes
C) T-cell lymphocytes
D) Macrophages
Q2) What is the most common presenting symptom of HD?
A) Painless mass
B) Headache
C) Persistent cough
D) Dysphagia
Q3) What is the standard dose delivered for the treatment of NHL?
A) 1600 to 2000 cGy
B) 2600 to 3000 cGy
C) 3000 to 4500 cGy
D) 4600 to 5000 cGy
Q4) In what general anatomical location is Waldeyer ring located?
A) Mouth
B) Anus
C) Small intestine
D) Axilla
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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) Which of the following is the primary thyroid tumor with the worst prognosis?
A) Follicular
B) Papillary
C) Medullary
D) Anaplastic
Q3) In which gland is oxytocin produced?
A) Pancreas
B) Pituitary
C) Thyroid
D) Adrenal
Q4) Which of the following is the most common type of functioning pituitary adenoma?
A) Prolactin secreting
B) Growth hormone secreting
C) TSH secreting
D) Chromophobe adenoma
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Chapter 30: Respiratory System Tumors
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Q1) One symptom associated with superior vena cava syndrome is orthopnea.Orthopnea is ____________________.
A) difficulty breathing
B) a bluish color of the skin
C) difficulty swallowing
D) inability to lie flat
Q2) Mesothelioma is a cancer of which respiratory system component?
A) Pleura
B) Primary bronchi
C) Carina
D) Alveoli
Q3) At what anatomical location does the trachea bifurcate into the right and left main stem bronchi?
A) Pleura
B) Primary bronchi
C) Carina
D) Alveoli
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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 is commonly referred to as the voice box?
A) Vestibular folds
B) Epiglottis
C) Pharynx
D) Larynx
Q3) Which of the following is not a division of the pharynx?
A) Parapharynx
B) Nasopharynx
C) Oropharynx
D) Laryngopharynx
Q4) What is the most common histologic type of head and neck cancer?
A) Adenocarcinoma
B) Transitional cell carcinoma
C) Squamous cell carcinoma
D) Renal cell carcinoma
Page 33
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Chapter 32: Central Nervous System Tumors
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Q1) Which of the following cells is responsible for myelin production?
A) Neurons
B) Schwann cells
C) Astrocytes
D) Ependymal cells
Q2) What defines the inferior radiation field border for the treatment of the whole brain for palliation?
A) 1-cm flash
B) Superior orbital ridge
C) External auditory meatus
D) Both b and c
Q3) Which of the following conditions is a contraindication for stereotactic radiosurgery (SRS)?
A) Spherical tumor
B) 2-cm tumor
C) Brain metastases
D) Five lesions
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Chapter 33: Digestive System Tumors
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Q1) What condition is most closely associated with adenomatous polyposis?
A) Barrett esophagus
B) Gardner syndrome
C) Plummer-Vinson syndrome
D) Tenesmus
Q2) Radiation treatment fields for the distal esophagus typically include which of the following lymph nodes?
A) Supraclavicular
B) Celiac axis
C) Common iliac
D) Hypogastric
Q3) Familial adenomatous polyposis (FAP)and hereditary nonpolyposis colorectal syndrome (HNPCC)are most closely associated with which type of cancer?
A) Esophageal
B) Pancreatic
C) Colorectal
D) Anal
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35
Chapter 34: Gynecological Tumors
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Q1) 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
Q2) Radiation therapy to the peritoneum for ovarian cancer would extend from which of the following?
A) Diaphragm to the 5th lumbar vertebrae
B) 5th lumbar vertebrae to the ischial tuberosities
C) Diaphragm to the floor of the pelvis
D) Tenth thoracic vertebrae to the symphysis pubis
Q3) Which female reproductive organ is most likely to develop cancer?
A) Ovarian
B) Uterus (endometrium)
C) Vaginal
D) Vulvar
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Chapter 35: Male Reproductive and Genitourinary Tumors
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Q1) A total dose of 7200 cGy in fractions of 180 cGy is used to treat which male reproductive cancer?
A) Prostate
B) Testicle
C) Penis
D) All of the above
Q2) What is the 5-year survival of all stages of testicular cancer combined?
A) 50%
B) 70%
C) 90%
D) 100%
Q3) What is the 5-year survival of all stages of prostate cancer combined?
A) 39%
B) 59%
C) 79%
D) 99%
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Chapter 36: Breast Cancer
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Q1) What T stage is a breast cancer that is a 9-cm tumor with skin invasion?
A) Tis
B) T1
C) T2
D) T3
E) T4
Q2) Which treatment field arrangement is used to increase the midaxillary dose to the prescribed level in some patients?
A) Intact breast tangents
B) Chest wall tangents
C) Supraclavicular (SCV)field
D) Posterior axillary boost field (PAB)
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
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Chapter 37: Pediatric Solid Tumors
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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) Pituitary adenomas in children that are not successfully managed by surgery and hormonal suppression may be treated with radiation using which of the following?
A) Single-field electrons
B) Multiple-field photons
C) HDR brachytherapy
D) Multiple-field electrons
Q3) Wilms' tumors are cancers of which organ?
A) Kidney
B) Bone
C) Skeletal muscle
D) Smooth muscle
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Chapter 38: Skin Cancers and Melanoma
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Q1) Pigmentation following therapeutic doses of radiation is caused by which of the following?
A) Dwelling of capillaries of the dermal layer
B) Shedding of the epidermis
C) Increased production of melanin
D) Destruction of cells at the basal layer
Q2) What form of skin cancer has the highest mortality rate?
A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Melanoma
D) Kaposi sarcoma
Q3) 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
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