Examination Two: Questions

1.  The technique used to minimise motion blur includes

(A)  increasing the mA.
(B)  increasing the exposure time.
(C)  using a fast film-screen combination.
(D)  image magnification.
(E)  using a breath-hold technique.

2.  Geiger-Muller counter used for radiation survey

(A)  has a thick window to detect alpha particle.
(B)  has low efficiency in detecting gamma radiation.
(C)  is a dosimeter-type detector.
(D)  distinguishes beta particle from alpha particle.
(E) requires a multichannel analyser to read out the signal from radiation
interaction.

3.  Regarding quality assurance of a dose calibrator:

(A)  Accuracy test is done on installation.
(B)  Constancy test is done annually.
(C) Measurement of high-energy gamma emitters is affected by changes in
the sample volume.
(D) Sealed 60Co is used in quality assurance test.
(E)  Linearity test result is accepted if the calculated activity exceeded 10%.

4.  Carbon-12 and carbon-11 have the same

(A)  chemical properties.
(B)  physical properties.
(C)  number of protons.

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12 Examination Two: Questions

(D)  number of neutrons.

(E) half-life.

5.  X-ray tube

(A)  consists of a small coil of wire cathode.
(B)  is a gas-filled tube.
(C)  has 100% efficiency in producing X-rays.
(D)  has a glass envelope.
(E)  is located within a CT scanner.

6.  Regarding bremsstrahlung X-rays produced in an X-ray tube:

(A) It is produced from the interaction of electrons with the nucleus of the
target atom.
(B)  The energy spectrum is discrete.
(C)  The lower-energy photons are absorbed by the tube.
(D)  The maximum energy of the photons is equal to the tube kVp.
(E)  It is the major component of photons produced from a tungsten target.

7.  Beam attenuation

(A)  is caused by scatter.
(B)  is caused by absorption.
(C)  is caused by penetration.
(D)  increases patient dose.
(E)  is caused by photoelectric interaction.

8.  The device used to measure radiation dose includes

(A)  film badge.
(B)  optically stimulated luminescence detector.
(C) TLD.
(D)  lonisation chamber.
(E)  geiger counter.

9.  The radiation weighting factor

(A)  for gamma is 5.
(B)  for proton and X-ray is the same.
(C)  for alpha is 20.
(D)  for neutron is dependent on energy.
(E)  affects the absorbed dose value.

10.  Regarding X-ray production:

(A)  A large focal spot produces sharper images.
(B)  Tungsten is used in cathode filament.
Examination Two: Questions 13

(C)  The cathode filament is heated to 200 °C for it to emit electrons.

(D)  The quantity of X-ray produced increases linearly with mAs.
(E) The quantity of X-ray produced increases linearly with filtration
thickness.

11.  Regarding digital image receptor in direct digital radiography:

(A)  It converts X-rays to electric signals.
(B)  Thin-film transistor collects electrical charge.
(C) Charge-coupled device (CCD) is used to collect electrical charge in
direct digital image receptor.
(D)  The caesium iodide (CsI) crystal is use to convert X-rays to lights.
(E) Lights are produced following the interactions of X-rays with amor-
phous selenium.

12.  Regarding resolution of an image intensifier:

(A) The output phosphor liberates light when bombarded by light photons.
(B)  The input screen liberates visible lights when stimulated by X-rays.
(C)  Resolution improves by using a thicker input phosphor.
(D)  It is superior to conventional film.
(E)  It is measured in pixels.

13.  Regarding fluoroscopic image quality:

(A) Vignetting is a reduction in brightness of the fluoroscopic image at the
periphery.
(B) Brightness gain is defined as the ability of the image intensifier to
increase the illumination level of the image.
(C)  S-distortion is due to maladjustment of the electron focusing system.
(D) Flux gain is defined as the ratio of the light photons at output phosphor
to the number of X-rays at input phosphor.
(E) Low quantum detection efficiency in input phosphor causes pincushion
distortion.

14.  Regarding personal radiation monitoring device:

(A)  It is used at waist level during pregnancy.
(B)  Film badges contain various types of filters.
(C)  Ring dosimeter is used on the hand closest to radiation source.
(D)  It is placed at location that can represent whole-body exposure.
(E)  It is used whenever working with radionuclide.

15.  The purpose of using personal monitoring device is to

(A)  protect the radiologist from radiation.
(B)  calculate the total of radiation delivered to the patient.
(C) calculate the number of radiation procedures conducted by the radiologist.
14 Examination Two: Questions

(D)  indicate an occupational exposure.

(E)  recognise the type of radiation received by personnel.

16.  Regarding radioactive decay:

(A)  Alpha particle is identical to a helium nucleus.
(B)  Positron decay occurs when a neutron is converted into a proton.
(C)  Beta minus decay emits an electron.
(D)  An antineutrino is emitted in a positron decay.
(E)  Electron capture results in a production of Auger electron.

17.  Regarding choice of collimators in planar radionuclide imaging:

(A)  It is a trade-off between specificity and resolution.
(B) A collimator with small holes will provide better resolution but has
lower sensitivity.
(C) The best spatial resolution is achieved with a collimator with long holes
of a small diameter.
(D) Lung ventilation and perfusion scans are acquired using a low-energy
general purpose collimator.
(E) Bone scans are best done with a low-energy high-resolution collimator.

18. Concerning 57Co flood source:

(A)  The half-life is 5.2 years.
(B)  The photon energy is 122 keV.
(C)  It is used for intrinsic uniformity.
(D) A 99mTc flood source is used to replace it for the same uniformity test.
(E)  The uniformity test is performed on daily basis.

19.  Regarding UK radiation legislation:

(A) A radiation protection supervisor is responsible for ensuring that patient
doses are kept as low as reasonably practicable.
(B) Classified workers require an annual medical report by an appointed
doctor to be certified fit.
(C) An area in which doses are greater than 30% of the annual dose limit is
classified as controlled area.
(D) There are no dose limits for patients undergoing medical exposures
under IRR 1999.
(E)  A diagnostic dose reference level is the dose limit.

20. The Ionising Radiations Regulations (IRR) 1999 states the following dose
limits
(A) the annual whole-body effective dose for a member of the public is
6 mSv.
(B)  equivalent dose of 150 mSv to the lens of the eye of a radiologist.
Examination Two: Questions 15

(C) 10  mSv during any consecutive 3-month period to the abdomen of a

woman of reproductive capacity.
(D)  50 mSv to the individual organs or tissues of a radiographer.
(E) radiation exposure resulting from medical exposure for a member of the
public is limited to 5 mSv in any five consecutive calendar years.

21. The circumstance where the Health and Safety Executive (HSE) must be
notified includes
(A)  loss or theft of a radioactive source.
(B)  dose exceeding investigation level.
(C)  radioactive spillage leading to significant contamination.
(D)  medical exposure much greater than intended.
(E)  failure to follow local rules.

22.  Regarding tomographic reconstruction:

(A)  Filtered backprojection is referred to as the convolution method.
(B) The convolution method allows image to be reconstructed, while X-ray
transmission data are being collected.
(C)  A low-frequency convolution filter makes the image appear smoother.
(D)  A low-frequency filter is referred to as a low-pass filter.
(E)  Serial expansion is also known as iterative reconstruction technique.

23.  Concerning simple backprojection:

(A) Each X-ray emission path through the body is divided into equally space
elements.
(B) It is formed by smearing each view back through the image in the direc-
tion it was originally acquired.
(C) A final summed attenuation coefficient is determined by summing the
attenuation for each element at different distances.
(D) A composite image of attenuation coefficients is obtained when the
coefficient for all elements is combined in the anatomic section.
(E)  It produces blurred images of sharp features in the object.

24.  In CT imaging
(A) the images are presented as a greyscale display of linear attenuation
coefficients of tissues.
(B) the linear attenuation coefficients are related to the physical density of
tissues.
(C) rectilinear pencil-beam scanning is the second generation of CT
scanners.
(D) the beam hardening artefact results in reduced attenuation coefficients
in the centre compared with the periphery.
(E)  higher CT numbers produce darker CT image.
16 Examination Two: Questions

25.  Advantages of spiral compared with conventional CT include

(A)  slower image acquisition.
(B)  quicker response to contrast media.
(C)  less partial volume artefact.
(D)  more motion artefacts.
(E)  improved two-axis resolution.

26.  Regarding SPECT:

(A) The advantage of multiple heads in SPECT system is an improvement in
count-rate sensitivity.
(B) The centre of rotation QC test for SPECT cameras is performed on
monthly basis.
(C)  A 180° acquisition arc is recommended for cardiac imaging.
(D) The bull’s-eye artefact in SPECT images is due to field non-uniformity.
(E) The continuous data acquisition is better than “step-and-shoot” acquisi-
tion as it reduces blurred images due to camera head motion.

27.  Concerning SPECT:

(A) The usual collimator used for 99mTc-pertechnetate thyroid imaging is
pinhole collimator.
(B) 99m
Tc-labelled aerosol is preferable for use in pulmonary ventilation
imaging as it provides better distribution of radioactivity in lungs.
(C)  Cold area in SPECT images indicates the area of no activity.
(D)  Any discontinuities in the sinogram indicate the patient motion.
(E) In filtered backprojection algorithm, selecting higher cut-off frequency
yields a blurry reconstruction.

28.  Regarding positron emission tomography (PET):

(A)  Radionuclides are produced in a cyclotron.
(B) The distribution of radioactivity is estimated by Fourier transform
method.
(C) The radiation detected is annihilation radiation released due to photon
interaction with electron.
(D) The PET image reveals the number of decays occurring in each of the
voxels.
(E)  Collimators are needed in imaging.

29.  Concerning nuclear magnetic resonance (NMR):

(A)  The nuclei of many elemental isotopes have a characteristic spin.
(B)  Nuclei of 12C have an integral spin.
(C)  Some nuclei have integral spin.
(D)  A spinning charge generates a magnetic field.
(E) The resulting spin-magnet has a magnetic moment proportional to the spin.
Examination Two: Questions 17

30.  Regarding NMR:

(A) A magnetic dipole moment in a magnetic field has a potential energy
related to its orientation with respect to that field.
(B) The photon spin tends to precess around the magnetic field with a fre-
quency called the Larmor frequency.
(C) It allows imaging of soft tissues of the body by distinguishing between
hydrogen atoms in different environments.
(D) In vivo NMR provides a window to the metabolic states of different
cells.
(E) The NMR allows the measurement of chemical shifts in the properties.

31.  Regarding MRI:

(A)  FLAIR stands for fluid-attenuated inversion recovery.
(B)  The rephasing pulse is 180°.
(C)  A narrow bandwidth allows for thinner slices.
(D)  Positron is imaged using MRI.
(E) The longitudinal relaxation time is longer than the transverse relaxation
time.

32.  Regarding T1-weighted image in MRI:

(A)  The TR used is long.
(B)  Large flip angle is used in gradient echo pulse sequences.
(C)  Cerebrospinal fluid is hypointense.
(D)  Grey matter is hyperintense compared to white matter.
(E) It provides the contrast for paramagnetic contrast agents such as
gadolinium.

33.  Safety of MR imaging in patients with cardiovascular devices involves

(A) a careful initial patient screening.
(B) accurate determination of the permanent implanted cardiovascular
device and its properties.
(C)  a thoughtful analysis of the risks of performing the examination.
(D)  physician management and supervision.
(E) clarification of safety issues in regard to the performance of MR
examinations.

34.  Regarding medical ultrasound:

(A)  The velocity of ultrasound in fat is equal to that in muscle.
(B)  High-frequency probes are used in endoscopic ultrasound.
(C)  The absorption coefficient for fat is higher than water.
(D) A caesium iodide crystal is used to produce diagnostic range ultrasound
waves.
(E) Setting the focus at the depth of interest improves the resolution at this level.
18 Examination Two: Questions

35.  As an ultrasound pulse moves through tissue, it undergoes a change in

(A) frequency.
(B) amplitude.
(C) wavelength.
(D) intensity.
(E) velocity.

36. Determining blood flow velocity using Doppler function requires for the
operator to adjust for
(A)  transducer frequency.
(B)  depth of vessel.
(C)  direction of vessel.
(D)  size of transducer.
(E)  direction of blood flow.

37.  Concerning safety in ultrasound imaging:

(A) For obstetric examination, the recommended maximum scanning time
for thermal indices (TI) of 1.5 is less than 30 min.
(B) The thermal index for cranial bone (TIC) is used for any foetal scan
more than 10 weeks after the last menstrual period.
(C) The raised tissue temperature due to probe self-heating is greater for
endo-cavitary probes than for surface probes.
(D)  The eye is particularly vulnerable to thermal hazard of the ultrasound.
(E) For neonatal cardiac imaging, the recommended exposure time for TI of
2.5 is less than 15 min.

38.  The key element of a fluorescent imaging system includes

(A)  helium neon laser.
(B) lenses.
(C)  optical filters.
(D)  light scintillator.
(E)  photomultiplier tube.

39.  Regarding functional and molecular imaging (FMI):

(A) Molecular imaging is defined as the ability to visualise the function of
cellular processes in vivo.
(B) CT images provide an attenuation map for scatter correction in PET/CT.
(C) Molecularly targeted microbubbles in ultrasound imaging are used in
FMI.
(D) Sodium iodide (NaI) crystals are preferred for PET imaging over
­bismuth germanate (BGO).
(E) The limitation of MRI as a molecular imaging tool is the size of the
contrast agents.
Examination Two: Questions 19

40.  Concerning FMI:

(A) Cellular MRI is based on tracking of migration of cells labelled with an
MR contrast agent.
(B)  Cerebral glucose metabolism is decreased during seizures.
(C) The clinical application of in  vivo optical imaging is for imaging of
atherosclerosis.
(D) 18
FDG is used to measure the local cerebral metabolic rate in SPECT
imaging.
(E)  Cervical carcinoma has low uptake of FDG in PET.
Examination Three: Questions

1. Overall detection efficiency of a detector in nuclear medicine department

is affected by
(A)  quantum detection efficiency.
(B)  intrinsic efficiency.
(C)  photopeak efficiency.
(D)  geometric design of the detector.
(E)  distance of the source from the detector.

2.  Regarding scintillation detector in an imaging detector:

(A)  It emits visible light after the interaction with ionising radiation.
(B) The two bands of the scintillator material are the valence and conduction
bands.
(C) Dopants are introduced in the scintillator material to create the electron
traps.
(D)  Phosphorescence occurs without the electron trap.
(C)  It exists in liquid form.

3.  Regarding dead time of a detector system:

(A) It is determined by the electronic component of the systems.
(B) Geiger-Muller counter has the shortest dead time.
(C) Paralysable system causes longer dead time compared to a non-­paralysable
system.
(D) It affects sensor running in current mode.
(E) It causes loss of signal.

4.  Gamma ray

(A)  is emitted from a nuclide in a metastable state.
(B)  has a lifetime of several years.

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22 Examination Three: Questions

(C)  results in an increase of the mass number of the daughter nuclide.

(D)  is emitted after alpha decay.
(E)  is produced from an X-ray tube.

5.  Interaction of electrons with the anode in an X-ray tube results in

(A)  production of thermal energy.
(B)  emission of bremsstrahlung X-ray.
(C)  increase kinetic energy of the electron.
(D)  production of discrete energy X-rays.
(E)  generation of a spectrum of X-rays.

6.  Regarding characteristic X-ray produced in an X-ray tube:

(A)  It is the maximum energy photon from a tungsten target.
(B)  It results in a ramp-shaped spectrum.
(C)  It has several discrete energies.
(D) It is produced from interaction of electrons with the nucleus of the target
atom.
(E) The energy of the incoming electron is higher than the K-shell binding
energy of the anode.

7.  Beam attenuation

(A)  is the attenuation of photons due to scatter and absorption.
(B)  affects the image contrast.
(C)  is contributed from photoelectric interaction.
(D)  is contributed from Compton interaction.
(E)    is contributed from coherent scatter.

8.  Regarding radiation measurement and its unit:

(A)  Absorbed dose is measured in J/kg.
(B)  Equivalent dose is measured in Gy.
(C)  Dose limits are given in Gy.
(D)  Effective dose is measured in Sv.
(E)  Dose area product is measured in Gy/cm2.

9.  Regarding the tissue weighting factor:

(A)  The gonads have the highest weighting factor.
(B)  The stomach and colon have the same weighting factor.
(C)  The skin has a lower weighting factor than bone surface.
(D)  The factor indicates the radiosensitivity of various tissues.
(E)   The values are derived from atomic bomb survivors in Japan in 1945.