Radiation Physics Exam
Review
Course Introduction
Radiation Physics explores the fundamental principles and applications of ionizing and non-ionizing radiation, emphasizing their interactions with matter. The course covers topics such as atomic and nuclear structure, types of radiation, mechanisms of energy transfer, detection and measurement methods, and biological effects. Students gain an understanding of practical considerations in radiation safety, dosimetry, medical imaging, and radiotherapy, preparing them for roles in physics, engineering, health sciences, and related fields where radiation plays a critical role.
Recommended Textbook Principles and Practice of Radiation Therapy 3rd Edition by Charles M. Washington
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Page 2
Chapter 1: Cancer: An Overview
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Q1) Which of the following is not a term for genes involved in the cancer process?
A) antioncogenes
B) oncogenes
C) protooncogenes
D) somatooncogenes
Answer: D
Q2) In which phase of the mammalian cell cycle does DNA synthesis occur?
A) G0
B) G1
C) G2
D) S
E) M
Answer: D
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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Q1) The ARRT Code of Ethics is the mandatory minimum acceptable standards of professional conduct.
A)True
B)False
Answer: False
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) Fidelity is about being faithful or loyal.
A)True
B)False
Answer: True
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Page 4
Chapter 3: Principles of Pathology
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Sample Questions
Q1) Hodgkin's disease is a neoplasm that typically involves the _________.
A) brain
B) lung
C) lymph nodes
D) liver
Answer: C
Q2) A malignant tumor of fat would be called a(n):
A) chondrosarcoma
B) Ewing's tumor
C) seminoma
D) liposarcoma
Answer: D
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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Q1) In order to produce the same biologic effect as a single fraction of 5,000 cGy,the total dose of a fractionated treatment regimen will be greater than 5,000 cGy.
A)True
B)False
Q2) Populations that do not divide are generally radiosensitive.
A)True
B)False
Q3) Organ dose can be measured directly.
A)True
B)False
Q4) Carbohydrates contain enzymes.
A)True
B)False
Q5) RBE relates to the ability of different radiation doses,energies,or types to produce a specific biologic response.
A)True
B)False
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Chapter 5: Detection and Diagnosis
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Q1) A very healthy 40-year old woman has a hematocrit of 30.0%.This is within normal limits.
A)True
B)False
Q2) Lymphadenopathy in the axilla area could be an indication of cancer spread from the breast.
A)True
B)False
Q3) 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>
Q4) A more widely accepted procedure for assessing axillary node status once the primary breast tumor has been identified is:
A) specificity testing
B) predictive value testing
C) sentinel lymph node
D) axillary node surgery
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Chapter 6: Medical Imaging
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Q1) Components of a modern x-ray tube include:
A) cathode filament
B) rotating anode
C) glass envelope
D) all of the above
Q2) The predominant x-ray interaction in the diagnostic range is:
A) Compton scatter
B) photoelectric absorption
C) coherent scatter
D) none of the above
Q3) Therapeutically,x-rays in the 40 to 300 kVp range are used for:
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
Q4) The quantity of photons in an x-ray beam is directly proportional to:
A) kVp
B) anode temperature rating
C) tube current
D) filtration
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Chapter 7: Treatment Delivery Equipment
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Sample Questions
Q1) 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
Q2) Electron beams __________________.
A) require a flattening filter to make the electron beam profile symmetric and flat
B) require a scattering foil to make the electron beam profile symmetric and flat
C) interact with the transmission target before leaving the exit window
D) a,b,and c are true
E) b and c are true
Q3) A betatron produces megavoltage:
A) electrons
B) photons
C) protons
D) a and b
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Chapter 8: Treatment Procedures
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Q1) Which of the following is not considered a part of the radiation oncology team responsible for the department's quality assurance?
A) radiation therapist
B) dosimetrist
C) radiation oncologist
D) medical oncologist
Q2) The goal of radiation therapy planning is to deliver an evenly distributed radiation dose to the ________ while minimizing the dose to the normal surrounding tissue.
A) isodose lines
B) target volume
C) hinge angle
D) penumbra
Q3) Cones are a form of secondary collimation systems for use with electron beam therapy.These cones prevent the increase interaction electrons in air upon leaving the beam.
A)True
B)False
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Chapter 9: Radiation Therapy Education
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Q1) 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
Q2) Only the radiation oncology nurse or patient educator is responsible for the education of cancer patients regarding their treatments.
A)True
B)False
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Chapter 10: Infection Control in Radiation Oncology
Facilities
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Q1) The person to whom the infectious agent is passed is:
A) fomite
B) a host
C) a pathogenic
D) an iatrogenic
Q2) Which of the following chemical methods of asepsis is applied topically?
A) disinfectant
B) antiseptic
C) a and b
D) all of the above
Q3) Nosocomial infections affect:
A) patients
B) health care workers
C) the public
D) a and b
E) all of the above
Q4) One way to screen for hepatitis B is to use Mantoux tuberculin skin test.
A)True
B)False
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Chapter 11: Patient Assessment
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Q1) General Health Assessment can include all except:
A) an interview
B) taking medical history past and present
C) a self-report
D) asking when the person last attended church
Q2) Thrombocytopenia is a reduction in:
A) platelets
B) white blood cells
C) red blood cells
D) all blood counts
Q3) Skin reactions include all except:
A) erythema
B) alopecia
C) dry desquamation
D) moist desquamation
Q4) Anemia is a decrease in white blood cell count.
A)True
B)False
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Chapter 12: Pharmacology and Drug Administration
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Q1) 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
Q2) Select potential symptoms of an anaphylactic reaction to a drug. I.Nausea and vomiting
II.Diarrhea
III.Uriticaria
IV.Symptoms of vascular shock
A) I,II,and III
B) I,III,and IV
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) Convert 2 Gy into rad.
A) 2 rad
B) 20 rad
C) 200 rad
D) 2000 rad
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) 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
Q4) Solve for x in the equation 4x - 4 = 12.
A) 6
B) ± 6
C) 4
D) ± 4
Page 15
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Chapter 14: Introduction to Radiation Therapy Physics
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Q1) Who proposed the first model of the atom?
A) Bohr
B) Thomson
C) Rutherford
D) Planck
Q2) Ground state is the lowest energy state for an atom.
A)True
B)False
Q3) Nuclear binding energy is measured in:
A) KeV
B) Amu
C) MeV
D) Coulombs
Q4) There are four photon interaction processes that occur in the energy range of concern in radiation therapy.
A)True
B)False
Q5) Radiation can be considered both as waves and particles.
A)True
B)False
Page 16
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Chapter 15: Aspects of Brachytherapy
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Q1) Which of the following has the shortest half-life?
A) gold 198 - 2.7 days
B) iodine 125 - 59.4 days
C) cesium 137 - 30 years
D) cobalt 60 - 5.27 years
Q2) Decay constant is expressed as:
A) 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 an advantage of HDR over LDR?
A) HDR is noninvasive.
B) HDR dosimetry is simpler.
C) Treatment time is decreased from 72 hours to 24 hours.
D) HDR can be given on an outpatient basis.
Q4) Of the following,which radionuclide is used for permanent prostate implants?
A) gold 198
B) cobalt 60
C) cesium 137
D) iridium 192
Page 17
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Chapter 16: Special Procedures
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Q1) The only approach to managing motion that allows for real-time feedback is:
A) 4DCT
B) gated treatment
C) RPM system
D) electromagnetic transponder
Q2) A single fraction of radiation to a brain metastasis would be what kind of stereotactic treatment?
A) stereotactic radiation therapy (SRT)
B) stereotactic body radiation therapy (SBRT)
C) stereotactic radiosurgery (SRS)
Q3) Deformable image registration is easier than rigid body registration.
A)True
B)False
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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Page 18
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) The two most common approaches in treatment planning are:
A) IMRT with multileaf collimators (MLCs)
B) forward and inverse planning
C) dose escalation and dose histograms
D) PET scans and beam's-eye view treatment plans
Q3) The major key to the precision delivery of radiation to the exact tumor volume begins with:
A) accurate CT images
B) simulation process
C) accurate dose escalation measurements
D) proper sequencing of multileaf collimators (MLCs)
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19
Chapter 18: Radiation Safety and Protection
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Q1) 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
Q2) The annual dose equivalent limit to the whole body for occupationally exposed individuals is _____ mSv.
A) 50
B) 100
C) 150
D) 500
Q3) Which particles can be electrons?
A) alpha particles
B) beta particles
C) x-rays
D) gamma-rays
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Page 20
Chapter 19: Quality Improvement in Radiation Oncology
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Q1) 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
Q2) 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
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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Q1) MRI (magnetic resonance imaging)
A) 1 and 2
B) 3 and 4
C) 5 and 6
D) none of the above
Q2) The largest of the paranasal sinuses is the:
A) frontal
B) ethmoid
C) maxillary
D) sphenoid
Q3) The diaphragm divides the anterior cavity into the thoracic cavity and the abdominopelvic cavity.
A)True
B)False
Q4) The sinuses that are located directly inferior to and form the floor of the orbit are the:
A) maxillary sinus
B) sphenoidal sinus
C) frontal sinus
D) ethmoidal sinus
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Chapter 21: Simulator Design
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Q1) Digital fluoroscopy is similar to conventional fluoroscopy; however,there is a ________________ to transmit the electrical charge.
A) charge capture device
B) computer capture detector
C) computer coupled detector
D) charge coupled device
Q2) 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
Q3) Conventional simulators are designed to simulate the ____________,geometric,and optical properties of a variety of treatment units.
A) x-ray
B) mechanical
C) comfort
D) linear design
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Chapter 22: Conventional Fluoroscopy-Basedsimulation Procedures
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Q1) Which body plane displays axial anatomic information obtained from CT and MRI images?
A) coronal
B) sagittal
C) transverse
D) proximal
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
Q3) Presimulation planning includes the localization of disease using radiography and fluoroscopy.
A)True
B)False
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Chapter 23: Computed Tomography Simulation
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Q1) Of the following list of contrast agents,which is not water soluble and therefore should not be used in the gastrointestinal tract if there is an increased risk of perforation?
A) high-osmolality contrast
B) low-osmolality contrast
C) Gastrograffin
D) barium sulfate
Q2) Forward planning uses all of the following techniques except:
A) The planner selects the number of the beams.
B) It begins the plan with the end in mind.
C) The planner selects the direction and shape of the beams.
D) It uses conventional and conformal treatments.
Q3) The reconstructed field of view that is displayed on the computer monitor should be large enough to display: I.the entire contour
II.the immobilization device
III.pertinent anatomy only
A) I
B) II
C) III
D) I and II
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Chapter 24: Photon Dosimetry Concepts and Calculations
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Q1) Find the skin gap necessary to match two symmetric ports at midline that are 21 and 37 cm in length.Assume the midline depth is 13 cm and both ports are treated at 100 cm SAD.
A) 1.53
B) 3.6
C) 2.5
D) 3.77
Q2) As a field size increases from the standard established,the output factor for a treatment machine will _______________.
A) increase
B) decrease C) remain the same
Q3) As the energy increases,the PDD: A) increases B) decreases C) remains the same D) there is no effect
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Chapter 25: Photon Dose Distributions
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Q1) 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
Q2) Critical structures are contoured for intensity modulated radiation therapy (IMRT)planning but not for 3DCRT planning.
A)True
B)False
Q3) Which of the following imitates a radiograph by reconstructing the diverge-corrected patient anatomy from the CT data set?
A) BEV
B) DVH
C) DRR
D) REV
Q4) The 3DCRT method uses conventional inverse planning.
A)True
B)False
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Chapter 26: Electron Beams in Radiation Therapy
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Q1) Which electron beam energy is most likely to underdose at the surface?
A) 9 MeV
B) 12 MeV
C) 16 MeV
D) 20 MeV
Q2) What will be the energy of an electron beam at a depth of 4 cm that had a surface energy of 16 MeV?
A) 4 MeV
B) 12 MeV
C) 14 MeV
D) 16 MeV
Q3) 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
Q4) A 12-MeV electron beam lacks skin sparing.
A)True
B)False
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Chapter 27: Electronic Charting,and Image Management
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Q1) Who is responsible for the quality of the EMR?
A) patients
B) hospital administrators
C) information systems personnel
D) caregivers
Q2) Which of the following does not describe EMR?
A) digital
B) paperless
C) easy accessibility
D) requires little or no training
Q3) 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
Q4) Errors and poor documentation are potential sources of harm for patients.
A)True
B)False
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Chapter 28: Bone,Cartilage and Soft Tissue Sarcomas
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Q1) Bone scans are used to evaluate the:
A) histology of the specimen
B) spread of metastatic disease
C) extent of soft tissue involvement
D) none of the above
Q2) Which of the following is an acceptable radiation therapy treatment technique for STS?
I.external beam
II.brachytherapy
III.intraoperative
A) I and II
B) I and III
C) II and III
D) I,II,and III
Q3) Which of the following has the highest incidence of bone tumors?
A) Ewing sarcoma
B) chondrosarcoma
C) metastatic bone lesions
D) multiple myeloma
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Page 30
Chapter 29: Lymphoreticular System Tumors
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Q1) The thymus 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) NHLs are adequately staged using the Ann Arbor staging system.
A)True
B)False
Q3) Which lymph node chain is more likely to be the original site of Hodgkin lymphoma?
A) pelvic
B) inguinal
C) para-aortic
D) axillary
Q4) What is the most common presenting symptom of HD?
A) painless mass
B) headache
C) persistent cough
D) dysphagia
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Chapter 30: Leukemia
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Q1) CML and CLL occur more frequently in children than in adults.
A)True
B)False
Q2) Which of the following is not one of the stages in the natural history of CML?
A) plague
B) chronic
C) accelerated
D) acute
Q3) Children are most likely to develop which type of leukemia?
A) ALL
B) AML
C) CLL
D) CML
Q4) Patients needing TBI can be treated with either an AP/PA or opposed lateral treatment arrangement.
A)True
B)False
Q5) TBI can used as part of the treatment of patients with leukemia.
A)True
B)False
Page 32
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Chapter 31: Endocrine System Tumors
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Q1) What is the most common form of thyroid cancer seen in irradiated individuals?
A) follicular
B) papillary
C) medullary
D) lymphoma
Q2) Cancer of which of the following endocrine glands is the most deadly?
A) thyroid
B) adrenal
C) pituitary
D) parathyroid
Q3) In which gland is T<sub>4</sub> produced?
A) parathyroid
B) pituitary
C) thyroid
D) adrenal
Q4) Parafollicular cells is another term used to describe the parathyroid glands.
A)True
B)False
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Page 33
Chapter 32: Respiratory System Tumors
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Q1) What performance status score is assigned to patients with disabilities who require special care and assistance but not hospitalization?
A) 20
B) 30
C) 40
D) 50
E) 60
Q2) Assume the initial treatment portals are AP/PA; after about how many fractions does the typical lung cancer patient start receiving oblique boost treatments?
A) 10
B) 20
C) 30
D) 40
Q3) What is the most effective single-agent chemotherapy drug?
A) cisplatin
B) paclitaxel
C) vinorelbine
D) gemcitabine
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34
Chapter 33: Head and Neck Cancers
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Q1) What is commonly referred to as the voice box?
A) vestibular folds
B) epiglottis
C) pharynx
D) larynx
Q2) Most salivary gland cancers are squamous cell carcinomas.
A)True
B)False
Q3) Xerostomia is a common side effect associated with traditional radiation therapy for early larynx cancer.
A)True
B)False
Q4) Which of the following is not considered a risk factor for larynx cancer?
A) Epstein-Barr virus
B) poor nutrition
C) alcohol abuse
D) human papillomavirus
Q5) Chemotherapy is an effective treatment for salivary gland tumors.
A)True
B)False
35
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Chapter 34: Central Nervous System Tumors
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Metastatic brain lesions are more common in children than are primary brain tumors.
A)True
B)False
Q2) In which portion of the CNS do most CNS tumors occur?
A) cerebrum
B) cerebellum
C) brain stem
D) thalamus
Q3) Primary brain tumors rarely metastasize.
A)True
B)False
Q4) What is the most common type of brain tumor?
A) GBM
B) astrocytoma
C) meninegioma
D) metastatic brain lesions
Q5) T2 lesions are the most common stage of primary brain tumors.
A)True
B)False
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Chapter 35: Digestive System Tumors
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Sample Questions
Q1) The Whipple is a surgical procedure associated with cancer of which organ?
A) pancreas
B) esophagus
C) stomach
D) colon
Q2) The treatment volume for colon cancers typically includes pelvic lymph nodes.
A)True
B)False
Q3) Most esophageal cancers are discovered in early stages.
A)True
B)False
Q4) What is the dose-limiting structure of most concern for radiation treatments of colorectal cancers?
A) spinal cord
B) bladder
C) normal colon
D) small bowel
Q5) Men are more at risk of developing anal cancer than women.
A)True
B)False
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Chapter 36: Gynecological Tumors
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Sample Questions
Q1) What is the most common histologic form of endometrial cancer?
A) squamous cell
B) adenocarcinoma
C) epithelial
D) germ cell
Q2) Use of oral contraceptives reduces a woman's risk of developing ovarian cancer.
A)True
B)False
Q3) Which of the following cancers is treated with the patient in the "frog leg" position?
A) ovarian
B) cervical
C) vaginal
D) vulvar
Q4) Pap testing is a screening tool used to detect which cancer?
A) ovarian
B) cervical
C) vaginal
D) vulvar
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Chapter 37: Male Reproductive and Genitourinary Tumors
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Sample Questions
Q1) 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
Q2) What is the most common form of bladder cancer?
A) adenocarcinoma
B) transitional cell carcinoma
C) squamous cell carcinoma
D) renal cell carcinoma
Q3) What is the most common form of testicular cancer?
A) squamous cell carcinoma
B) germ cell tumors
C) adenocarcinomas
D) stromal tumors
Q4) Topical chemotherapy is often used when treating low staged penile cancers.
A)True
B)False
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Chapter 38: Breast Cancer
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Sample Questions
Q1) What is the medial treatment border when the internal mammary lymph nodes are to be included in the tangential field?
A) midline
B) 1 cm beyond midline to the contralateral side
C) 3 cm beyond midline to the contralateral side
D) 3 cm beyond midline to the ispalateral side
Q2) What T stage is a breast cancer that is a 1.5-cm tumor near the nipple?
A) Tis
B) T1
C) T2
D) T3
E) T4
Q3) DCIS is classified as which stage?
A) stage 0
B) stage 1
C) stage 2
D) stage 3
Q4) Breast cancer is the most common cancer in women.
A)True
B)False
Page 40
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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) Children are most likely to develop which type of leukemia?
A) ALL
B) AML
C) CLL
D) CML
Q3) Which area is least likely to develop rhabdomyosarcoma?
A) testis
B) head and neck
C) lower extremity
D) upper extremity
Q4) Wilms tumors are cancers of which organ?
A) kidney
B) bone
C) skeletal muscle
D) smooth muscle
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Chapter 40: Skin Cancers and Melanoma
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Sample Questions
Q1) The incidence of skin cancer has declined over the past two decades.
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) What is the most widely used staging system for melanoma?
A) TNM
B) Breslow
C) Clarke
D) ATCG
Q4) Which cancer is commonly associated with HIV?
A) rhabdomyosarcoma
B) mycosis fungoides
C) melanoma
D) Kaposi sarcoma
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