Physics Recalls September 2006

1. A CR photostimulable phosphor cassette was mistakenly opened in the exam room. What is the risk to the study?
a) Increased noise
b) Too dark
c) Dust in the cassette
d) Damaged film
2. Radiation kills cells by:
a) DNA damage
b) RNA damage
c) Mitochondria damage
3. What is the direct mechanism of cell damage by radiation?
a) Nucleic acid pair dissociation
b) Free radical production
c) Deionization
d) Changes in pH
4. Why is the quoted size of the NaI crystal small than actuality?
a) Edge packing artifact
b) Pulse pile-up
c) Photomultiplier tube insensitivity
5. An image intensifier is moved from 12 inches away to 4.5 inches away from the patient. What happens?
a) Dose increases by a factor of 7
b) Dose increases by a factor of 3.5
c) Dose remains the same
d) Dose decreases by a factor of 3.5
e) Dose decreases by a factor of 7
6. A 5 MHz beam has 3dB/cm attenuation in fat. What is the decreased ratio of original intensity of the beam through fat 5 cm
beneath the surface?
a) 1:25
b) 1:75
c) 1:1000
d) 1:3000
7. The greatest source of manmade radiation is:
a) Dental and medical radiographic examinations.
b) Radon in soil.
c) High-altitude flight.
d) Nuclear power plants
8. Long-term storage and quick retrieval of information is achieved with
a) Ethernet
b) RAID
c) Magnetic tape drive
d) RAM
9. Acoustic noise in MR imaging comes from
a) Gradient magnetic fields switching on and off
b) RF transmitter
c) Main magnet solenoid
d) Cooling system
10. Scatter at approximately 1 meter from the patient is
a) 10% of incident energy
b) 1% of incident energy
c) 0.1% of incident energy
d) 1% of incident energy

11. What is the spatial resolution in lp/mm of a 26 cm tube over a 512 x 512 pixel matrix?
a) 1 lp/cm
b) 5 lp/cm
c) 1 lp/mm
d) 5 lp/cm
12. Regarding radiation pneumonitis, which is true?
a) Usually occurs in a segmental distribution
b) There is usually an associated pleural effusion
c) There is usually no associated fever or cough
d) Usually occurs 3-16 weeks after therapy
13. An ultrasound beam travels through fat into liver. Visualization of the boundary is due to:
a) Specular reflections
b) Nonspecular reflections
c) Change in frequency
14. T2* represents
a) Spin-lattice relaxation
b) Spin dephasing
c) Spin dephasing and field inhomogeneity
d) Dephasing due to field inhomogeneity
15. An abdominal film is acquired at 80 kVp. What is the approximate skin dose?
a) 0.5 mGy
b) 3 mGy
c) 20 mGy
d) 100 mGy
16. For radiation protection purposes, a fetus is considered:
a) A radiation worker
b) More resistant to radiation effects than an adult
c) A member of the general public
17. X-ray is shown of a pediatric patient which appears very mottled. What is wrong?
a) keV too high
b) keV too low
c) mAs too high
d) mAs too low
18. What is the effect of increasing the SOD while keeping the SID constant?
a) magnification = SID/SOD
b) magnification = SOD/SID
c) magnification = (SID - SOD)/SID
d) magnification = SOD/(SID-SOD)
19. You are given a diagram of gradients and RF pulses switching on and off. You can see that TR = 2000, TE = 20, 80. This
sequence would result in:
a) T2 and proton density images
b) high T1 contrast
c) time of flight angio sequence
20. Which is the fastest imaging sequence?
a) 3D spoiled gradient recalled echo
b) fast spin echo
c) echo planar imaging
d) inversion recovery sequence
21. How can you decrease the dose from fluoroscopy in a pediatric patient?
a) remove the grid

b) decrease the keV

c) remove collimation
22. 1.2 cGy is administered. How much dose is delivered over 2 half lives?
a) 0.3 cGy
b) 0.6 cGy
c) 0.9 cGy
d) 1.1 cGy
e) 1.2 cGy
23. Which has the highest signal-to-noise ratio?
a) Time of flight
b) Inversion recovery
c) Gradient recalled echo
d) Proton density
24. Picture of an ultrasound image. Values of MI and TI are in the right upper corner of the image. What do these represent?
a) wavelength and power
b) heat and cavitation
c) frequency and amplitude
d) penetrance and velocity
25. A grid is off center of an image. What is the effect?
a) More loss of primary x-rays with increased grid ratio.
b) Increased image contrast
c) Increased blur
d) Overexposure of the film
26. Why use a Mo filter in mammography?
a) It is more transparent to the Mo characteristic x-rays.
b) It provides more linear attenuation than Aluminum.
c) It has a higher atomic number than Aluminum.
d) It adds more Mo characteristic x-rays.
27. An MR image is shown. There are extra lines around edges of sharp transition from high signal to low. What is the name of the
artifact?
a) Chemical shift artifact
b) Gibbs artifact
c) Magnetic susceptibility artifact
d) Pulsation artifact
28. The visual distortion that makes you think there is an odontoid fracture on an open mouth view is known as:
a) Motion artifact
b) Beam-hardening artifact
c) Truncation artifact
d) Mach band artifact
e) Gibbs artifact
29. An object being fluoroscopically imaged is 4 inches long, and its projection is 12 inches long. 1 foot is between the object and
its projection. What is the source to object distance?
a) 3 inches
b) 4 inches
c) 6 inches
d) 8 inches
e) 18 inches
30. What is the lifetime effective dose limit of a 65 year old radiologist?
a) 0.3 Sv
b) 1.8 Sv
c) 10 Sv
d) 16 Sv
e) 30 Sv

31. The dose limit of a fetus in a pregnant patient is:

a) 0.5 mSv/month
b) 1.0 mSv/month
c) 2.0 mSv/month
d) 5.0 mSv/month
32. Which population doesnt have an NRCP dose limit?
a) General public.
b) Over 65 person.
c) Radiation worker.
33. What is the greatest source of quality control problems in mammography?
a) The developer
b) Technician error
c) Automatic exposure control error
34. Graph is shown. A move to the right along the ROC curve does what?
a) Increases true positive rate and specificity
b) Decreases true positive rate and increases specificity
c) Increases true positive rate and decreases specificity
d) Decreases true positive rate and specificity
35. A good picture and a really grainy picture of a V/Q scan are shown. Why are these different?
a) PMT malfunction
b) Incorrect energy window setting
c) No collimation
d) Low number of counts
36. Which of the following statements about radon is true?
a) It is an important source of manmade radiation
b) It decays to produce radium
c) The gas is found in higher concentration in basements.
d) It decays via beta decay
37. Regarding PACS and HIS, what does HL7 do?
a) Allows for improved data storage and retreival
b) Serves the same purpose as the RIS
c) It is a set of standards which interfaces PACS with HIS
d) Patient registration and tracking
38. What is the effect of overexposure of a digital film?
a) Decreased noise
b) Decreased dose
c) Increased contrast
d) Burnout of the film
39. What is the purpose of the pulse height analyzer?
a) Increase total counts
b) Decrease the scatter counted in an image
c) Allows for multiplanar SPECT imaging
40. A CT protocol yields 50 studies which demonstrate masses suspicious for renal cell carcinoma and 250 negative studies. Forty
of the patients with positive scans are taken to surgery, and 25 of these have pathologically proven cancer. The positive predictive
value is:
a) 80%
b) 63%
c) 50%
d) 25%
e) 16%

41. If the linear attenuation coefficient of a material is twice that of water, what would be the materials Hounsfield units?
a) 2000
b) 1000
c) 500
d) 0
e) -500
42. What causes chemical shift artifact?
a) Acid-base interactions
b) Local magnetic field inhomogeneity
c) The difference in resonance frequency between lipids and water
d) Fast gradient switching
43. The result of compression in mammography:
a) Decreased sharpness
b) Increased scatter
c) Increased film speed
d) Decreased noise
44. A fetus is exposed to some dose > 0.1 Gy. What period is most likely to result in decreased IQ without without any frank
evidence of mental retardation?
a) 0-8 weeks
b) 8-15 weeks
c) 15-20 weeks
d) 20+ weeks
45. Which is used to measure limiting spatial resolution?
a) SNR
b) MTF
c) MTC
d) DWI
46. Harmonic imaging does what?
a) Increases axial resolution
b) Decreases lateral resolution
c) Increases reverberation
47. A very dense object with an abrupt margin shows intermediate attenuation artifact around the transition on a CT-helical scan.
How do you fix this problem?
a) Increase the keV
b) Increase the mAs
c) Decrease the keV
d) Decrease the pitch
48. What is the benefit of giving KI in radioactive material exposure?
a) Prevents DNA damage
b) Decreases thyroid uptake
c) Shields cardiac potassium pump
d) Prevents free radical formation
49. When an ultrasound wave strikes an interface, which of the following is refracted?
a) Incident waves
b) Reflected waves
c) Transmitted waves
d) Reverberated waves
50. Imaging with which radioisotope requires a high-energy collimator?
a) Tl201
b) I131
c) I123

d) Tc99m
51. Graph is given. Which has the deepest tissue penetrance?
a) Gamma
b) Alpha
c) Proton
d) Neutron
52. How do you increase the sensitivity of an ionization chamber?
a) Increase the pressure.
b) Filters chosen to absorb the scattered radiation
c) Decrease quenching gases
53. What determines multislice CT slice thickness?
a) Width of the detector.
b) Width of collimator after patient
c) Width of collimator before patient
54. What does decreasing the field of view in an MR image do?
a) Decreases the signal to noise ratio.
b) Decreases resolution
c) Increase imaging time
d) Eliminates truncation artifact
55. Which of the following diagrams depicts the lowest dose?

56. Which tissue has parenchyma more sensitive than its connective tissue?
a) Brain
b) Liver
c) Muscle
d) Skin
57. A point density located 2 cm out of the plane of a conventional tomogram will look:
a) Like a line
b) Like a star
c) Like a ring
58. Multiple ring artifacts present in a SPECT image result from:
a) A non uniform crystal.
b) PMT failure
c) cracked crystal
d) patient motion
59. 1 Gy will cause what?
a) Decreased lymphocyte count.
b) Erythema.
c) Diarrhea in 50% of people.
d) Nausea in 95% of people.
60. What is the advantage of filtered back projection versus straight back projection?
a) Decreased ring artifact.
b) faster computation
c) increased noise
61. What kVp should be used for a carotid angiogram?
a) 32
b) 48

c) 75
62. 18-F degrades to O with 1.67 MeV transition. What is the maximum kinetic energy of a positron?
a) 1.67 MeV
b) 1.67 KeV
c) 1.16 MeV
d) 0.83 MeV
63. What is the reported exposure for workers?
a) Equivalent dose
b) Effective dose
c) Whole body dose
64. Leakage radiation is most significant in:
a) X-ray angiography
b) Nuclear radiography
c) Ultrasound
d) MRI
65. OD of 2.0 on a viewbox with 2000 Cd/m2. What is the resultant luminance?
a) 1000
b) 500
c) 20
d) 12.5
66. Use factor considers all of the following except:
a) Number of people occupying adjacent room
b) Hours a day the x-ray machine is in use
c) Direction of radiation source
d) whether Punj "lead-foot" Gupta is at helm
67. A filter is added to a beam. Which of the following graphs depicts the resultant spectrum?

68. What is the main advantage of a dual head SPECT camera?

a) Increased spatial resolution.
b) Decreased time for examination.
c) Decreased noise
d) Can give lower dose of radiopharmaceutical
69. In CT fluoroscopy how do you improve the temporal resolution?
a) Decrease from 360 to 180 image reconstruction.
b) Decrease from 360 to 180 Z axis
c) Increase the slice thickness.
d) Increase the pitch.
70. How do you correct for attenuation in PET scanning?
a) Time of coincidence from injection and attenuation correction factor.
b) Use a collimator
c) Use straight back projection
71. Highest skin dose results from which?
a) TIPS procedure.
b) Barium enema.
c) PET/CT
72. You need to clear 40 MB on a hard drive. How many 512x512 at 2 bytes pixel depth CT images do you need to delete?
a) 80
b) 72

c) 50
73. Using a parallel collimator in a nuclear medicine study, there is significant scatter from adjacent tissue giving counts not of
interest. What can you do?
a) Place lead over the tissue to decrease scatter.
b) Switch to converging collimator
c) Switch to diverging collimator
d) Decrease size of the the energy window
74. Why is the kVp of a chest film 120?
a) To minimize visualization of the ribs.
b) Maximize contrast
c) Decreased exposure time
75. A patient receives 30 minutes of fluoroscopy and develops itching on the skin of their right posterior thorax. Why is this so?
a) Radiation burn.
b) Defibrillator burn.
c) Irritation from debrillation adhesive pad
76. What is the most likely effect of diagnostic radiology on genetic mutation?
a) Negligible
b) Mutation in first generation after exposure.
c) Mutation in second generation after exposure.
77. Risk of carcinogenesis in humans is:
a) Based on data from humans
b) Not related to the rate of exposure
c) Based on animal experiments
78. Chemical properties are based upon:
a) Orbital electrons.
b) Proton to neutron ratio
c) van der Walls interactions
d) Hydrogen bonds
79. In photoelectric interaction, the energy of the incident photon must be:
a) More than the energy to remove a k-shell electron
b) Less than the L orbital binding energy
c) 511 KeV
80. In use of AEC phototimers how can you get a film that is too light?
a) Selection of wrong location for AEC timer
b) Too much time in developer
c) Too small a focal spot
81. Post processing of a digital image includes all of the following except:
a) Histogram equalization.
b) Low pass spatial filtering.
c) Unsharp masking
d) Window levels
82. The purpose of measuring radioactivity at the thigh on an Iodine nuclear medicine study is:
a) To check circulating background activity in the bloodstream.
b) Measure total patient dose
c) Measure non target organ dose
83. What is the most likely result of a single strand DNA break?
a) Base degradation
b) Repair
c) Lethal mutation

84. Which area below would show lamellar flow?

85. Picture of aliasing Doppler. Which should you adjust to correct this?
a. Decreasing gain
b. Decreasing transducer angle
c. Increasing transducer frequency

d. Increasing PRF