QBASE 1 Radiology MCQs For The FRCR
QBASE 1 Radiology MCQs For The FRCR
QBASE 1 Radiology MCQs For The FRCR
QUESTION
QUESTION
Mammography
A. The radiological differentiation of normal and abnormal breast tissue is dependent upon
photoelectric attenuation in the normal breast
B. Maximum image contrast is obtained at photon energies of the order of 45 - 60 keV
C. The characteristic radiation of a molybdenum target occurs at 17.9 keV and 19.5 keV
D. For magnification mammography a focal spot of 0.5 mm diameter is normally used
E. A molybdenum filter attenuates the majority of characteristic radiation produced at a
molybdenum target
QUESTION
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Comparing gas filled ionization chambers and scintillating crystals used as detectors in CT
A. Ionization chambers are more sensitive
B. Scintillation crystals provide a linear response to different radiation intensities
C. Ionization chambers suffer from the phenomenon known as after-glow
D. Scintillation crystals are more reliable and stable
E. The efficiency of ionization chambers can be improved by using xenon at high pressure as
apposed to air
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Regarding MRI
A. Generally speaking. Tissues with a long T1 have a short T2
B. Generally speaking. Tissues with a long T1 also have a short T2
C. Spatial encoding: - slice selection is achieved by frequency encoding
D. Spatial encoding: - line selection is achieved by phase encoding
E. Spatial encoding: - point selection is achieved by phase encoding
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At the wrist
A. The pisiform is a scsamoid bone
B. The capitate articulates with the third and fourth metacarpals
C. The lunate is the second carpal bone to ossify
D. The triangular fibrocartilage is attached to the radial styloid process
E. The rediocarpal joint freely communicates with midcarpal joint
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36
The following types of screen can be used with film sensitive to the blue region of the light
spectrum
(a) Calcium tungstate screens
(b) Barium strontium sulphate screens
(c) Silver activated zinc sulphide screens
(d) Zinc cadmium sulphide screens
(e) Terbium activated screens
Answers: true true true false false
Explanation: The light emission from calcium tungstate, barium strontium sulphate and silver
activated zinc sulphide screens occurs in the blue region of the light spectrum
ZnCdS is used as the output phosphor in an image intensifier: It emits light in the yellow-green region
Terbium is an activator in rarer screens which emit light in the yellow-green region.
10 - Regarding the photoelectric effect
(a) The interacting photon disappears completely
(b) This involves the interaction between a photon and a free electron
(c) Characteristic radiation is produced
(d) Results in the production of an ionized atom
(e) As the photoelectron slows down and loses energy, no further ionization is produced
Answers: true false true true false
Explanation: In the photoelectric effect the interaction is between a photon and a bound electron
The photoelectron loses energy by interacting with matter resulting in further ionizations
11 - Regarding the interaction of x-rays with matter
(a) At 60 keV, the attenuation in fat is predominantly due to Compton interaction
(b) At 30 keV, attenuation in bone is predominantly due to the photoelectric affect
(c) In soft tissue, the majority of electrons may be considered as free electrons
(d) Regarding the Compton effect, the electron density is constant for all elements
(e) Scatter is more likely to occur in any direction with increase in photon energy
Answers: true true true false false
Explanation: At very low photon energies however, the photoelectric interaction becomes more
predominant
The electron density of hydrogen is about twice that of all other elements
With increasing photon energy, scatter is more likely to occur in a forward direction
12 - Patient dose may be reduced by
(a) The use of a bucky grid
(b) The use of tube filtration
(c) The use of a high kV
(d) The use of a lower mA
(e) The use of a larger focus to film distance
Answers: false true true false false
Explanation: The use of a secondary radiation grid requires an increase in exposure factors, and thus
increased dose to the patient
Filters remove the useless unwanted low energy photons which do not contribute to the useful image
The use of a lower mA will result in the need of a compensatory increase in exposure time. Thus the
total exposure will remain unchanged
The number of photons required to produce an x-ray image is independent of the focus to film
distance. Hence the dose is also independent of focus to film distance
(a) The filament is raised to incandescence to produce a space charge of protons around the filament
by the process of thermionic emission
(b) Tungsten is used as the filament material because it is relatively inexpensive
(c) A compound anode is usually made of copper and tin
(d) The mA is related to the filament current
(e) X-ray production is over 99% efficient
Answers: false false false true false
Explanation: A space charge of electrons is produced around the filament
Tungsten is used as the filament material because it is a good thermionic emitter and does not vaporize
easily
A compound anode is usually made of copper and tungsten
X-ray production is less than 1% efficient, the remaining energy is lost as heat
20 - Regarding the focal spot
(a) Focal spot size decreases with an increase in the tube current
(b) Focal spot size increases with an increase in kVp
(c) The modulation transfer function (MTF) worsens with an increase in the focal spot size
(d) A star test pattern imaging tool is useful for assessing focal spot sizes of less than 0.3 mm
(e) The star test pattern measures the actual focal spot size
Answers: false false true true false
Explanation: Focal spot size increases with an increase in the tube current. This effect is called
'blooming' and is more marked at low kVp and high mAs
The focal spot size decreases slightly with increasing kVp
The pinhole camera technique measures actual focal spot size, whereas the star test pattern measures
the resolving capacity of the focal spot
21 - The following are true of x-ray film
(a) In an unexposed film, base plus fog is approximately 0.5
(b) Film fogging is independent of the film age
(c) Film fogging is independent of the processor temperature
(d) The greater the film latitude the lower the film gamma
(e) The greater the film latitude the higher the film gamma
Answers: false false false true false
Explanation: Base plus fog is approximately 0.2
Fogging is increased with both the age of the film and with an increase in processor temperature
22 - Regarding the Geiger-Muller (GM) tube
(a) The outer cylinder is the anode
(b) Detection of ionising radiation occurs through the process of gas amplification
(c) The anode and the cathode are surrounded by hydrogen gas
(d) The tube is sensitive to the detection of high energy radiation
(e) A voltage of 25 kV is applied across the tube
Answers: false true false false false
Explanation: The outer case is the cathode
The tube is usually surrounded by an inert gas usually argon which is combined with either alcohol
vapour or a halogen gas, and maintained at low atmospheric pressure (10cmHg)
High energy radiation tends to pass through the tube and is thus less likely to be detected
A voltage of 900-1050 volts is applied across the tube when alcohol vapour is used. Alternatively a
voltage of 200-400 volts is applied when a halogen gas is used
(b) Above a threshold dose level, the severity of non-stochastic effects is proportional to the radiation
dose
(c) Lung fibrosis is an example of a non-stochastic effect
(d) Skin necrosis is an example of a non-stochastic effect
(e) Diarrhoea is an example of a non-stochastic effect
Answers: true true true true true,
29 - The air gap technique
(a) There is a significant degree of filtration within the air gap itself
(b) In the diagnostic energy range there is a strong bias towards forward scattering
(c) The results are equivalent to using a grid, but higher patient exposures are necessary
(d) To preserve image sharpness, focus to film distance should be increased in conjunction with
increase in object to film distance
(e) The ratio of scattered to primary radiation reaching the film for a given thickness of absorber
depends on the size of air gap present
Answers: false false false true true,
Explanation: The air gap technique is effective because scattered photons simply "miss" the film
No forward scattering bias exists. In the diagnostic energy range a photon is likely to be scattered
equally in any direction
Lower patient exposures are necessary than with a grid
A large air gap will reduce the ratio of scattered to primary radiation reaching the film
30 - Regarding modulation transfer function (MTF)
(a) Has units of line pairs per mm
(b) Is normally greater than one
(c) MTF is a ratio of the information recorded to the information available
(d) The MTF can be used to compare the resolving power of one imaging system versus another
(e) A 10% response on an MTF curve is the definition of the resolving power of an imaging system
Answers: false false true true true,
Explanation: Modulation transfer function has no units
As the recorded information can never exceed the available information, the MTF is always less than
one
32 - Types of radioactive emission
(a) Beta particles tend to be emitted from nuclides with an excess of protons
(b) Gamma rays have unit negative charge
(c) Alpha particles have an atomic number of 4 and an atomic mass of 2
(d) K-electron capture tends to happen with nuclei which have excess neutrons
(e) Occasionally, following emission of an alpha particle, daughter nucleus decays by isomeric
transition, with emission of a gamma ray
Answers: false false false false false
Explanation: Beta particles tend to be emitted from nuclides with an excess of neutrons
Gamma rays are uncharged rays
The atomic number can never be greater than the mass number. Alpha particles have an atomic mass
of 4 and an atomic number of 2
K-electron capture tends to happen with nuclei which have an excess number of protons
In isomeric transition a daughter nucleus does decay with the emission of a gamma ray. However the
daughter nucleus is formed by the emission of a Beta particle not an Alpha particle
33 - Regarding x-ray generating apparatus
(a) In the transformer assembly the filament circuit is supplied by a step-down transformer
(b) In the transformer assembly the potential difference across the step-up transformer is usually 50
kV
(c) The transformer assembly contains oil which acts to prevent electrical sparking between the
transformer assembly components
(d) In the filament circuit a potential difference of about 100 volts is applied across the filament
(e) In the filament circuit a current of 3-5 amps is usually produced through the filament
Answers: true false true false true,
Explanation: The potential difference across the step-up transformer may be as much as 150 kV
In the filament circuit, an incoming mains supply of 220 volts is stepped-down to provide a potential
difference of about 10 volts across the filament
34 - Regarding rectification
(a) Rectification refers to the process of changing direct current into alternating current
(b) Full wave rectification utilises the full potential of the electrical supply in the production of x-rays
(c) In a three phase generator, three separate voltage pulses in phase with each other are produced to
provide almost constant potential
(d) The ripple factor for a six pulse generator is 13%
(e) The ripple factor for a single phase generator is 3%
Answers: false true false true false
Explanation: Rectification refers to the process of changing alternating current into direct current
Three phase generators produce three separate voltages which are 120 degrees out of phase with each
other to produce almost constant potential
The variation in the voltage across an x-ray tube expressed as a percentage of the maximum value is
the ripple factor. For a six pulse generator this is 13%, and for a twelve pulse generator 3%. Single
phase generators have a ripple factor of 100%
35 - The following are ways in which x-ray interact with matter
(a) Coherent scattering
(b) Photoelectric effect
(c) Compton scattering
(d) Pair production
(e) Photodisintegration
Answers: true true true true true,
36 - Regarding scattered radiation
(a) Scattered radiation adds to the final image quality achieved
(b) Scatter makes up about 15% of the total number of photons emerging from a patient
(c) Apart from scattered radiation, the only other secondary radiation reaching the film arises from
contrast media such as barium
(d) Increasing scatter is produced with large fields of view
(e) Increasing scatter is produced when irradiating thick body parts
40 - Intensifying screens
(a) Calcium tungstate fluoresces blue light
(b) The efficiency of production of light with a calcium tungstate screen is 50%
(c) Lanthanum oxybromide emits green light
(d) Intensification factor is the ratio of exposure needed with the screen to the exposure needed
without the screen
(e) Film cassette containing double-sided emulsion film and 2 intensifying screens results in 2x
exposure speed and contrast
Answers: true false false false true,
Explanation: The efficiency of production of light in a calcium tunsgtate screen is only 5%, whereas
that in rare earth screens approaches 20%
Lanthanum oxybromide fluoresces blue light
Intensification factor is the ratio of the exposure needed without screens to exposure needed with the
screen
41 - Secondary radiation grids
Explanation: Autotomography is a technique which involves patient movement while keeping the xray tube and film stationary. Long exposure times, in the order of 5 seconds, are used for this
technique
The OPG machine needs to change its axis of rotation twice to allow for angulation of the jaw
45 - Regarding film copying
(a) Film copying utilises the principal of solarization
(b) With solarization film, an increase in exposure produces an increase in density
(c) The theory of solarization involves the re-bromination hypothesis
(d) Solarization emulsion is exposed with a red light source
(e) Copy film is processed in the same way as standard x-ray film
Answers: true false true false true,
Explanation: Solarization means that increased exposure actually destroys the developable state.
Hence an increase in exposure produces a decrease in density
Solarized film is exposed with an ultra violet light source. Low density areas in the original x-rays
allow more light through and are hence reproduced as areas of low density on the copy film
(b) In air, all forms of EMR obeys the inverse square law
(c) The wavelength and frequency of EMR are always inversely proportional to each other
(d) The intensity of EMR is the amount of energy passing through a unit area per unit time
(e) X-rays and Gamma rays are of lower photon energy than visible light
Answers: false false true true false
Explanation: All forms of EMR travel with the same velocity as light when in a vacuum. The velocity
is NOT significantly less in air
All forms of EMR obey the inverse square law only when in vacuuo.
Intensity = watts per square millimetre
The energy of X-rays and Gamma rays = MeV's. Visible light = eV's
73 - X-ray production
(a) In all forms of diagnostic radiology, 80% or more of the x-rays emitted are bremsstrahlung
radiation
(b) The photon energy of the K-radiation increases as the atomic number of the target increases
(c) Increasing the kV shifts the x-ray spectrum curve to the left
(d) Increasing the mA does not affect the shape of the x-ray spectrum
(e) The ripple factor for a 6 phase generator is less than that of a 12 phase generator
Answers: false true false true false
Explanation: In mammography, characteristic radiation forms the majority of the x-ray spectrum.
Increasing the kV shifts the x-ray spectrum curve to the right.
Increasing mA increases tube output.
Ripple factor: - 6 phase generator 13%; 12 phase generator - 3%
74 - The following are true
(a) Attenuation = absorption minus scatter
(b) Coherent scattering accounts for generally less than 5% of all x-ray interactions
(c) The photoelectric effect results in ionisation of an atom
(d) For pair production to occur, the incident radiation must have a minimum energy of at least 1.02
MeV
(e) Attenuation of polychromatic radiation is usually exponential
Answers: false true true true false
Explanation: Attenuation = absorption + scatter
Attenuation of monochromatic radiation is exponential
75 - Regarding filtration
(a) In a compound filter, the higher atomic number material should face the patient
(b) Aluminium and tin are the most commonly used compound filters
(c) Filters used in diagnostic radiology, reduce the exposure dose to a patient
(d) Filtration increases both the minimum and effective photon energies of an x-ray spectrum
(e) Excess filtration increases exposure times
Answers: false false true true true,
Explanation: In a compound filter the material with the higher atomic number should face the x-ray
tube.
A compound filter normally consists of aluminium and copper.
Filters however increase the exit dose to entry dose ratio.
Filtration does not affect the maximum photon energy. The area of the x-ray spectrum and the total
output of x-rays is reduced by filtration.
76 - The following are true
(a) The absorbed dose is the energy deposited per unit area of a material
(b) Kerma is the kinetic energy released per unit mass of an irradiated material
(c) A "thimble" chamber can be used to measure air kerma
(d) A standard free air chamber is commonly used in most departments to measure air kerma
(e) Silver bromide is used for dosimetry in thermoluminescent dosemeters (TLD)
Answers: false true true false false
Explanation: Absorbed dose is the energy deposited per unit mass (J/Kg)
Kerma and absorbed dose are more or less synonymous with each other and are measured in Grays (1
Gy = 1 J./Kg)
Standard free air chambers are 800 times larger than thimble chambers and are therefore impracticable
for use in most departments
Silver bromide is used in film badge dosimetry
77 - The following statements are true
(a) A material is relatively transparent to its own characteristic radiation
(b) Barium and iodine are suitable contrast agents as their "K-edges" are closely related to the mean
energy of the incident x-ray beam
(c) Total linear attenuation coefficient (LAC) = sum of LAC's of the contributions from elastic, photoelectric and Compton scattering
(d) In the diagnostic imaging range, the Compton effect predominates for air, water and soft tissue
(e) The SI units for mass attenuation coefficient are square centimetres per gram
Answers: true true true true true,
78 - The following are true
(a) The thicker the structure irradiated, the greater the subject contrast
(b) The greater the difference in linear attenuation coefficients (LAC) between 2 tissues the less the
subject contrast
(c) Increasing kV increases subject contrast
(d) Increasing filtration increases skin dose
(e) Reducing the field size irradiated decreases contrast
Answers: true false false false false
Explanation: Subject contrast, C, depends on a) the thickness, T, of the structure and b) the differences
in LAC's of the tissues involved. Hence C is proportional to (LAC 1 - LAC 2) x t.
Increasing kV decreases subject contrast.
Increasing filtration decreases skin dose.
Decreasing the field size reduces the amount of scatter radiation and thus improves contrast.
79 - Secondary radiation grids
(a) The line density of a moving grid is typically 25 lines per millimetre
(b) Grid lines reduce fine detail definition on an x-ray
(c) Crossed grids are more efficient at removing scattered radiation than uncrossed grids
(d) Decreased exposure doses are required when using a crossed grid as opposed to an uncrossed grid
(e) Moir fringes are typically seen with uncrossed grids
Answers: false true true false false
Explanation: Line density of a moving grid = 5 lines per millimetre
Increased exposure doses and careful centring are required with crossed grids
Moire fringes are a coarse interference pattern seen when the crossed grids are not at right angles to
each other
80 - The following are true:
(a) Magnification is reduced by using a shorter focus to film distance (FFD) or by increasing the
object to film distance (OFD)
(b) Distortion is increased by using a longer FFD
(c) Geometric unsharpness is reduced by using a smaller focal spot
(d) Geometric unsharpness is increased by increasing the OFD
(e) Movement unsharpness may be reduced by immobilisation
Answers: false false true true true,
Explanation: Magnification is reduced by increasing the FFD or decreasing the OFD
Distortion is increased when using a shorter FFD
81 - Regarding tomography
(a) The greater the tomographic angle of swing, the thinner the cut
(b) Only structures at right angles to the film are imaged sharply
(c) The further a structure is from the pivot plane, the greater the movement blur
(d) Tomography is most useful when imaging structures of high inherent contrast
(e) Larger tomographic angles are used in zonography as compared to tomography
Answers: true false true true false
Explanation: Structures parallel to the film are imaged sharply, those at right angles tend to be blurred
to a greater extent
Tomography is useful when imaging, for example, the inner ear and in pyelography
Zonography: 5-10 degrees, tomography: 30-50 degrees
82 - Regarding rotating anode tubes (RAT)
(a) RAT's cool by conduction of heat along the anode stem
(b) RAT's have a limited use in diagnostic radiology
(c) In routine diagnostic radiology RAT's rotate at approximately 15,000 rpm
(d) The target anode disc is usually made from pure Tungsten alone
(e) Heat dissipation from the anode assembly is proportional to the fourth power of the Kelvin
temperature of the anode
Answers: false false false false true,
Explanation: Cooling is via radiation of heat to the insulating oil and then conduction to the tube
housing
RAT's are widely used in diagnostic radiology
RAT's usually rotate at about 3,000 rpm. High speed RATs e.g. 15,000 rpm are used in angiography
The target is usually tungsten with about 10% rhenium. This has better thermal properties and is less
likely to roughen with use
(d) If 1% of light from a viewing box is transmitted through an xray film, then the optical density is
2.0
(e) If both front and rear emulsions of an x-ray film provide an optical density of 1.2, total optical
density = 1.44
Answers: true false false true false
Explanation: Optical density = Log to base 10 [incident light : transmitted light]
A log scale is used as the eye responds logarithmically to the brightness of light
Optical densities are additive therefore the total optical density = 2.4
87 - The following are true
(a) The speed of a film is the reciprocal of the exposure needed to produce an optical density of 1
above base + fog
(b) Inherent fog has typically an optical density; D = 0.12
(c) Storage conditions affect inherent fog
(d) Emulsions with rounded crystals are faster than those with flat crystals
(e) The speed of a film decreases with increasing average grain size
Answers: true true false false false
Explanation: Inherent fog arises from some silver halide crystals acquiring latent images during
manufacture, and also from the film base absorbing light when viewed. Storage conditions affect
additional fog.
Emulsion film with flat crystals are faster than those with rounded crystals
Film speed increases with increasing average grain size
88 - The following statements are true
(a) Increasing developer temperature increases speed of development and reduces fog
(b) Increasing the developer temperature may cause an initial increase in film gamma
(c) Developer concentration and developing time have little effect on the quality of film development
(d) Quality assurance (QA) of a processing unit may be carried out with a sensitometer
(e) In QA of a processing unit, a daily variation in densities of 30% is acceptable
Answers: false true false true false
Explanation: Speed of development is increased by increasing the developer temperature but there is
also an associated increase in fog
When the developer temperature rises above a temperature recommended by the manufacturer, there
is an increase in fog which reduces the average film gamma
Increasing developer concentration and increasing developing time have similar affects to those of
increasing developer temperature
QA involves measuring the density, following processing, of a film on which a step wedge image is
pre-exposed
In QA a 0-15% daily variation in densities are acceptable
89 - The following statements regarding exposure latitude are true
(a) Exposure latitude (EL) is the range of exposure factors which will give a correctly exposed image
of a subject
(b) EL is independent of subject contrast
(c) EL is dependent on film gamma
(d) EL can be increased by using a lower kV
(e) EL can be increased by using a film of lower gamma
Answers: true false true false true,
Explanation: With an increase in kV, with mAs reduced to compensate, subject contrast is reduced.
This results in some gain of exposure latitude.
90 - The following statements regarding intensification factor (IF) are true
(a) IF is defined as the ratio of :- [exposure required for a film + screen] : [exposure required for film
alone]
(b) Typical values for IF are 120-150
(c) IF decreases when the kV is increased
(d) IF is increased by using both smaller phosphor crystals and reducing the thickness of the phosphor
layer on a screen
(e) Tungstate screens have a larger IF than rare earth screens
Answers: false false false false false
Explanation: IF = [exposure required for film alone] : [exposure required for the film + screen]
A typical range for IF = 30-100
IF increases with increasing kV
IF is increased with larger crystals and increasing thickness of the phosphor layer
Rare earth screen have a larger IF than tungstate screens
91 - The following statements are true
(a) Poor film screen contact increases screen unsharpness
(b) Unsharpness due to parallax commonly occurs in single emulsion films
(c) Unsharpness due to crossover occurs most commonly in films with tabular grains
(d) Single emulsion films are used in nuclear medicine and digital imaging
(e) Single emulsion films are used when copying x-rays
Answers: true false false true true,
Explanation: Parallax is only seen with double emulsion films
Unsharpness due to crossover commonly occurs with granular / globular grains.
92 - Exposure factors
(a) A high mAs is generally desirable when selecting exposure factors
(b) The kV chosen should be as high as possible when selecting exposure factors
(c) Exposure times can be reduced by using a larger focal spot
(d) Exposure times can be reduced by using a single phase generator rather than a three phase
generator
(e) Exposure times can be reduced by using both a lower speed and smaller diameter anode disc
Answers: false true true false false
Explanation: The mAs should be kept as low as is needed in order to reduce exposure times
Increasing kV increases penetration and latitude of exposure. However the kV should not be so high
that insufficient contrast results.
Exposure times are reduced by using a three phase generator rather than a single phase generator
Exposure times can be reduced by using a higher speed and larger diameter anode disc
93 - The following statements are true
(a) Automatic exposure control (AEC) cannot be performed with a plate ionisation chamber
(b) AEC may be carried out using a phosphor coupled to a photomultiplier tube
(c) AEC devises are generally larger than the film cassette
(d) When measuring the kV for quality assurance, the actual tube kV should be within +/-5% of the set
value
(e) A penetrameter is not a suitable method for measuring tube kV
Answers: false true true true false
Explanation: The tube kV may be estimated indirectly by the penetrameter method
94 - The following statements are true
(a) Focal spot modulation transfer function (MTF) is reduced with macro-radiography
(b) Screen MTF is increased with macro-radiography
(c) In macro-radiography, screen unsharpness is also magnified
(d) In mammography, subject contrast is achieved primarily via photoelectric absorption
(e) In mammography, an appropriate operating kVp would be 28 kV
Answers: true true false true true,
Explanation: Screen unsharpness is not magnified although the image is
97 - The following statements regarding doses and dose rates are true
(a) Fluoroscopy: - dose rate at the input phosphor: 1 micro - Gy per second
(b) Cine-radiography: dose rate at the input prosper: 1 micro Gy per frame
(c) Digital imaging: - 1 micro Gy per frame
(d) Photospot film: - 10 micro - Gy per frame
(e) Skin doses may be up to 300 times greater than the dose to the input phosphor
Answers: true false false false true,
Explanation: Cine-radiography: 0.1 micro - Gy per frame
Digital imaging: 10 micro - Gy per frame
Photospot film: 1 micro - Gy per frame
98 - Digital subtraction angiography (DSA)
(a) The mask image is taken before the administration of contrast
(b) A small field image intensifier with good contrast resolution is required
(c) Following subtraction the signal to noise ratio is reduced
(d) In energy subtraction, a mask image is routinely taken
(e) In hybrid subtraction two energy subtracted (ES) pre-contrast & two ES post-contrast images are
temporally subtracted from each other
Answers: true false true false true,
Explanation: A large field intensifier (300mm) is needed
Following subtraction, the signals subtract but the noise is reinforced thereby reducing the SNR
With energy subtraction, rapid switching between a high kV e.g. 140 and a lower kV e.g. 65, avoids
the need for a mask image
In hybrid subtraction, the temporal subtraction would eliminate bone for example leaving the vessel
filled with contrast medium
99 - Regarding computed tomography (CT)
(a) The spatial resolution (SR) in CT is better than that in conventional radiography
(b) The contrast resolution in CT is better than that in conventional radiography
(c) The CT number for air is -100
(d) The CT number for water is 0
(e) The x-ray tube in a CT gantry is mounted with its axis parallel to the slice chosen
Answers: false true false true false
Explanation: The SR in CT is only 1 lp/mm whilst a detailed film-screen combination may have a SR
of 10 lp/mm
The improved contrast resolution of CT is visualised by the use of windowing
The CT number of air is -1000
The x-ray TUBE is mounted perpendicular to the slice chosen, in order to reduce any heel effect
100 - Regarding noise in computed tomography (CT)
(a) Noise may be reduced by decreasing the number of photons absorbed in each voxel
(b) Noise may be reduced by either decreasing slice thickness or reducing pixel size
(c) Noise may be reduced by either increasing mA or increasing the scan time
(d) Narrow windowing makes noise more noticeable
(e) Zoom enlargement of a CT display increases noise
Answers: false false true true true,
Explanation: Noise is reduced by increasing the number of photons absorbed in each voxel
Noise is decreased by either increasing slice thickness or increasing the pixel size
Increasing mA or increasing the scan time reduces noise at the expense of increased patient dose
Noise becomes more noticeable with narrow windowing as each grey scale covers a smaller range of
CT numbers, and hence there are fewer x-ray photons absorbed in each voxel
As the available information is spread more thinly over the pixel matrix with zoom enlargement
101 - Regarding CT artefacts
(a) Cardiac motion produces streak artefacts
(b) In fourth generation scanners, detector malfunction is manifest as ring artefacts
(c) Dental amalgam gives rise to star artefacts
(d) "Cupping" occurs as a consequence of beam hardening
(e) Aliasing may occur at sharp and high contrast boundaries
Answers: true true true true true,
Explanation: Ring artefacts usually signify detector malfunction in third generation scanners
Star artefacts may also occur with metal implants or high density contrast medium
102 - Regarding spiral helical scanning
(a) Partial volume artefacts are reduced compared to conventional axial scanning
(b) Slice to slice misregistration is exaggerated compared to conventional axial scanning
(c) 'Pitch' is the slice thickness (mm) divided by the distance (mm) moved by the table during one
rotation of the tube
(d) When a pitch of greater than 2:1 is used, artefacts may arise due to gaps in the volume data
acquisition
(e) Heat loading of the tube is greater with conventional axial scanning compared to helical scanning
Answers: true false false true false
Explanation: Partial volume artefacts are reduced since the volume acquisition data can be
reconstructed in small steps
As there is volume acquisition of data, the problem of slice to slice misregistration is overcome
especially in the region of the diaphragm
'Pitch' is defined as the distance moved by the table during one rotation divided by the slice thickness
As there is no cooling period between slices in helical scanning, heat loading of the tube is greater
than in conventional axial scanning
103 - Regarding radioactive decay
(a) In beta minus decay there is no change in the atomic number, but the mass number increases by
one
(b) In isomeric transition, the parent nucleus decays directly to the daughter nucleus by the emission
of a negative beta particle
(c) In beta plus decay, there is no change in the atomic number, but the mass number decreases by one
(d) In positron emission, two photons of annihilation radiation are emitted at right angles to each other
(e) The SI units of radioactive decay is the becquerel (Bq), where one Bq = the number of
disintegrations per minute
Answers: false false false false false
Explanation: Beta minus: there is no change in mass number, the atomic number increases by one
Isomeric transition: the daughter nucleus remains in a metastable state for a variable length of time,
prior to emitting a gamma ray and decaying to the ground state
Beta plus: there is no change in mass number, the atomic number decreases by one
Explanation: Only those persons whose presence is essential should remain in an xray room when
radiation is being generated; they should stand well away from the radiation beam and preferably
behind a protective screen.
For young persons and persons of reproductive capacity, gonad shields should be used in
examinations which are likely to give high gonad dose, unless these shields interfere with the
proposed examination.
A posteroanterior, rather than anteroposterior, projection can greatly reduce the dose to the breast
126 - The following statements are true
(a) Body aprons should be available with a protective equivalent of not less than 0.25mm lead for
xrays over 100 kV
(b) Gloves and aprons should be thoroughly examined at least once a month to ensure that no cracks
have developed
(c) During operation of a CT scanner, an operator should be present at the control panel while high
voltage is applied to the xray tube
(d) Gloves should be available with protective equivalent of not less than 0.35mm lead for x-rays up
to 150 kV
(e) Body aprons should not be folded
Answers: false false true false true,
Explanation: Body aprons with a protective equivalent of not less than 0.25mm lead for xrays up to
100 kV and not less than 0.3mm lead for xrays over 100 kV should be available.
Gloves and aprons should be examined thoroughly at least once a year to ensure that no cracks have
developed.
An operator should be at the control panel of a CT scanner while high voltage is applied to the xray
tube, since the equipment will not normally have an exposure switch which has to be pressed
continuously.
Gloves should be available with not less than 0.25mm lead for xrays up to 150 kV.
127 - Regarding quality assurance performed by a radiographer in mammography
(a) Processor performance and sensitometry should be assessed daily
(b) Automatic exposure control should be assessed weekly
(c) Xray kV accuracy and output should be assessed weekly
(d) Screen film contact should be assessed monthly
(e) A full change of chemicals and servicing of processor is suggested every 4 weeks for a screening
programme
Answers: true false true false true,
Explanation: Automatic exposure control: Exposure of a 4cm perspex phantom should yield a film
giving a consistent optical density from a consistent exposure mAs. This should be checked on a daily
basis.
Screen film contact should be assessed every 3 months.
128 - Regarding quality assurance as assessed by a physicist
(a) Focal spot measurement should be assessed annually
(b) Focal spot size is usually assessed by the pinhole method
(c) Beam alignment is usually assessed every 3 months
(d) The tolerance limits for beam alignment are +/- 2%
(e) Xray tube output and kilovoltage should be assessed every 3 months
129 - The National Radiation Protection Board (NRPB) recommend that the following views
should not be part of a "routine" x-ray examination
(a) Lateral chest view
(b) Coned view of the pituitary fossa
(c) Oblique views of the cervical spine
(d) Post micturition film of an IVU
(e) A post evacuation film after a barium enema
Answers: true true true true true,
Explanation: The NRPB also recommends that the following views should not be performed as part of
"routine" radiography:
1) Flexion and extension views of the cervical spine
2) Coned L5/S1 and obliques of the lumbar spine
3) Skyline and tunnel views of the knees
4) 1 minute film from an IVU.
The NRPB also recommends the following:
i) The occipito-mental view should be the only view performed when examining the sinuses
ii) The submento-vertical view should not be routinely performed when examining the skull iii) An
AP odontoid peg view should not be taken unless there is a history of trauma.
Ref: Report by the Royal College of Radiologists and the National Radiation Protection Board (1990).
Patient Dose Reduction in Diagnostic Radiology. National Radiation Protection Board.
RRM 02/99
Radiation Protection
2 - Regarding atoms and their structure
(a) The mass number defines the number of nucleons within an atom
(b) The L shell contains a maximum of 18 electrons
(c) Isotopes of an element have different physical properties
(d) An alpha particle is four times heavier than an electron
(e) An isobar is any nucleus which has the same atomic mass number as another nucleus
Regarding the metallic replacement method of silver recovery
A. This can be used in conjunction with an automated processor
B. Requires electric power
C. Uses steel wool
D. It is possible to reuse the fixer after silver recovery with this method