Rad Review for ARRT
A star pattern is used to measure 1. focal spot resolution. 2. intensifying-screen resolution. 3. SID resolution.
1 Only
Which of the following statements is (are) correct with respect to evaluation criteria for a PA projection of the chest for lungs? 1 Sternal extremities of clavicles are equidistant from vertebral borders. 2 Ten posterior ribs are demonstrated above the diaphragm. 3 The esophagus is visible in the midline.
1 and 2 only The air-filled trachea should be seen midline; the esophagus is unlikely to be visualized without a contrast agent
In general, as the intensification factor increases, 1 radiographic density increases 2 screen resolution increases 3 recorded detail increases
1 only Factors that contribute to an increase in the intensification factor generally function to reduce resolution. As intensification factor increases, radiographic density generally increases.
Which of the following pathologic conditions require(s) a decrease in exposure factors? 1 Pneumothorax 2 Emphysema 3Multiple myeloma
1,2 and 3
In which of the following procedures is quiet, shallow breathing recommended during the exposure to obliterate prominent pulmonary vascular markings? 1RAO sternum 2Lateral thoracic spine 3AP scapula
1,2, and 3
Patient's Bill of Rights
1. The right to considerate and respectful care 2. The right to be informed completely and understandably 3. The right to refuse treatment 4. The right to have an advance directive (e.g., a living will or health care proxy) 5. The right to privacy 6. The right to confidentiality 7. The right to review one's records 8. The right to request appropriate and medically indicated care and services 9. The right to know about institutional business relationships that could influence treatment and care 10. The right to be informed of, consent to, or decline participation in proposed research studies 11. The right to continuity of care 12. The right to be informed of hospital policies and procedures relating to patient care, treatment, and responsibilities
Stochastic effects of radiation are those that 1 have a threshold 2 may be described as "all-or-nothing" effects 3 are late effects A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
2 and 3 only Most late effects do not have a threshold dose; that is, any dose, however small, theoretically can induce an effect. Increasing that dose will increase the likelihood of the occurrence but will not affect its severity; these effects are termed stochastic. Nonstochastic effects are those that will not occur below a particular threshold dose and that increase in severity as the dose increases.
Which of the following statements is (are) true regarding the radiograph shown in Figure 6-16? The part is rotated. The patient is not shielded correctly. There is excessive density.
2 only
Backscatter on a digital image can cause an artifact called a A Phantom image artifact B Moiré artifact C Static artifact D Grid cutoff artifact
A Phantom image artifact
In which type of equipment does kilovoltage decrease during the actual length of the exposure? 1 Condenser-discharge mobile equipment 2 Battery-operated mobile equipment 3 Fixed x-ray equipment A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
A 1 only Condenser-discharge mobile x-ray units do not use batteries; this type of mobile unit requires that it be charged before each exposure. A condenser (or capacitor) is a device that stores electrical energy. The stored energy is used to operate the x-ray tube only. Because this machine does not carry many batteries, it is much lighter and does not need a motor to drive or brake it. The major disadvantage of the capacitor/condenser-discharge unit is that as the capacitor discharges its electrical charge, the kilovoltage gradually decreases throughout the length of the exposure—therefore limiting tube output and requiring recharging between exposures.
Deposition of vaporized tungsten on the inner surface of the x-ray tube glass window 1 acts as additional filtration 2 results in increased tube output 3 results in anode pitting A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
A 1 only Through the action of thermionic emission, as the tungsten filament continually gives up electrons, it gradually becomes thinner with age. This evaporated tungsten frequently is deposited on the inner surface of the glass envelope at the tube window. When this happens, it acts as an additional filter of the x-ray beam, thereby reducing tube output. Also, the tungsten deposit actually may attract electrons from the filament, creating a tube current and causing puncture of the glass envelope.
If a patient's zygomatic arch has been traumatically depressed or the patient has flat cheekbones, the arch may be demonstrated by modifying the SMV projection and rotating the patient's head A 15 degrees toward the side being examined B 15 degrees away from the side being examined C 30 degrees toward the side being examined D 30 degrees away from the side being examined
A 15 degrees toward the side being examined When one cheekbone is depressed, a tangential projection is required to "open up" the zygomatic arch and draw it away from the overlying cranial bones. This is accomplished by placing the patient in the SMV position, rotating the head 15 degrees toward the affected side, and centering to the zygomatic arch. A 30-degree rotation places the mandibular shadow over the zygomatic arch. (Frank, Long, and Smith, 11th ed., vol. 2, pp. 364-365)
What structure can be located midway between the anterosuperior iliac spine (ASIS) and pubic symphysis? A Dome of the acetabulum B Femoral neck C Greater trochanter D Iliac crest
A Dome of the acetabulum
A type of cancerous bone tumor occurring in children and young adults and arising from bone marrow is A Ewing sarcoma B multiple myeloma C enchondroma D osteochondroma
A Ewing sarcoma
Which of the following interactions between x-ray photons and matter is most responsible for patient dose? A The photoelectric effect B Compton scatter C Classic scatter D Thompson scatter
A The photoelectric effect As radiation passes through tissue, different types of ionization processes can take place depending on the photon energy and the type of material being irradiated. In the photoelectric effect, a relatively low-energy photon uses all its energy to eject an inner-shell electron from the target atom, leaving a vacancy in that shell. An electron from the shell beyond drops down to fill the vacancy and in so doing emits a characteristic ray. This type of interaction contributes most to patient dose because all the x-ray photon energy is being transferred to tissue. In Compton scatter, a high-energy-incident photon uses some of its energy to eject an outer-shell electron. In so doing the incident photon is deflected with reduced energy but usually retains most of its original energy and exits the body as an energetic scattered photon. In Compton scatter, the scattered radiation will either contribute to image fog or pose a radiation hazard to personnel depending on its direction of exit. In classic scatter, a low-energy photon interacts with an atom but causes no ionization; the incident photon disappears in the atom and then immediately reappears and is released as a photon of identical energy but with changed direction. Thompson scatter is another name for classic scatter. (Selman, 9th ed., pp. 125-128)
The medical term used to describe the vomiting of blood is A hematemesis B hemoptysis C hematuria D epistaxis
A hematemesis Hematemesis refers to vomiting blood. If the blood is dark in color, it is probably gastric in origin; if it is bright red, it is most likely pharyngeal in origin. Expectoration (coughing or spitting up) of blood is called hemoptysis. Blood is originating from the mouth, larynx, or respiratory structure. Hematuria is the condition of blood in the urine. Epistaxis is the medical term for nosebleed. (Taber, p. 954)
In fluoroscopy, the automatic brightness control is used to adjust the A kVp and mA B backup timer C milliamperage (mA) and time D kilovoltage (kV) and time
A kVp and mA As body areas of different thicknesses and densities are scanned with the image intensifier, image brightness and contrast require adjustment. The ABC functions to maintain constant brightness and contrast of the output screen image, correcting for fluctuations in x-ray beam attenuation with adjustments in kilovoltage and/or milliamperage. There are also brightness and contrast controls on the monitor that the radiographer can regulate. (Bushong, 10th ed., p. 402)
Tracheotomy is an effective technique most commonly used to restore breathing when there is A respiratory pathway obstruction above the larynx B crushed tracheal rings owing to trauma. C respiratory pathway closure owing to inflammation and swelling D all the above
A respiratory pathway obstruction above the larynx If obstruction of the breathing passageways occurs in the upper respiratory tract, above the larynx (i.e., in the nose or pharynx), tracheotomy may be performed to restore breathing.
The movement of the IP through the transport system of a CR reader is referred to as the: A Slow-scan direction B Charge-coupled direction C Nyquist direction D Fast-scan direction
A slow scan direction The IP moves slowly through the transport system of a CR reader and this movement is considered the slow-scan direction.This light moves back and forth very rapidly to scan the PSP transversely, in a raster pattern, and this movement of the laser beam across the PSP is therefore called the fast-scan direction (D).
The contraction and expansion of arterial walls in accordance with forceful contraction and relaxation of the heart are called A hypertension B elasticity C pulse D pressure
C pulse
RADIATION DOSE EQUIVALENT LIMIT
According to the NCRP, the annual occupational whole-body dose-equivalent limit is 50 mSv (5 rem or 5,000 mrem). The annual occupational whole-body dose-equivalent limit for students under the age of 18 years is 1 mSv (100 mrem or 0.1 rem). The annual occupational dose-equivalent limit for the lens of the eye, a particularly radiosensitive organ, is 150 mSv (15 rem). The annual occupational dose-equivalent limit for the thyroid, skin, and extremities is 500 mSv (50 rem). The total gestational dose-equivalent limit for the embryo/fetus of a pregnant radiographer is 5 mSv (500 mrem), not to exceed 0.5 mSv in 1 month.
What is the relationship between kV and HVL? A As kV increases, the HVL increases. B As kV increases, HVL decreases C If the kV is doubled, the HVL doubles. D If the kV is doubled, the HVL is squared
As kV increases, the HVL increases The HVL of a particular beam is defined as that thickness of a material that will reduce the exposure rate to one-half of its original value. The more energetic the beam (the higher the kilovoltage), the greater is the HVL thickness required to cut its intensity in half. Therefore, it may be stated that kilovoltage and HVL have a direct relationship: As kilovoltage increases, HVL increases.
Adverse reactions to high osmolality water-soluble contrast media that are classified as mild, include 1. nausea. 2. pallor. 3. dyspnea. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
B. 1 and 2 only Mild effects include warmth, itching, flushing, nausea, pallor, hives, anxiety, chills. Moderate adverse effects include hypertension, dyspnea, hypotension, bronchospasm. Severe reactions include arrhythmia, cardiopulmonary arrest, laryngeal edema.
Which of the following factors can contribute to hypertension? 1 Obesity 2 Smoking 3 Stress A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
D 1,2, and 3
According to NCRP regulations, leakage radiation from the x-ray tube must not exceed A 10 mR/h B 100 mR/h C 10 mR/min D 100 mR/min
B
Which of the following artifacts is occasionally associated with the use of grids in digital imaging? A Incomplete erasure B Aliasing C Image fading D Vignetting
B An artifact associated with digital imaging and grids is "aliasing" or the "moiré effect."
A three-phase timer can be tested for accuracy using a synchronous spinning top. The resulting image looks like a A series of dots or dashes, each representative of a radiation pulse B solid arc, with the angle (in degrees) representative of the exposure time C series of gray tones, from white to black D multitude of small, mesh-like squares of uniform sharpness
B solid arc, with the angle (in degrees) representative of the exposure time
The right posterior oblique position (Judet method) of the right acetabulum will demonstrate the 1 anterior rim of the right acetabulum 2 right iliac wing 3 right anterior iliopubic column A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
B 1 and 2 only
Types of inflammatory bowel disease include 1 ulcerative colitis. 2 Crohn's disease. 3 intussusception. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
B 1 and 2 only
Which of the following will have an effect on radiographic contrast? 1. Beam restriction 2. Grids 3. Focal spot size A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
B 1 and 2 only
The effect that differential absorption has on radiographic contrast of a high-subject-contrast part can be minimized by 1 using a compensating filter. 2 using high-kilovoltage exposure factors. 3 increased collimation. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
B 1 and 2 only This effect can be minimized by the use of a compensating filter or by the use of high kilovoltage (for more uniform penetration). Increased collimation is important in the control of patient dose and scattered radiation, not differential absorption.
Structures involved in blowout fractures include the 1 orbital floor 2 inferior rectus muscle 3 zygoma A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
B 1 and 2 only The zygoma usually is not involved with a blowout fracture but rather with a tripod fracture.
The advantages of collimators over aperture diaphragms and flare cones include 1 the variety of field sizes available 2 more efficient beam restriction 3 better cleanup of scattered radiation A 1 only B 1 and 2 only C 1 and 3 only D 2 and 3 only
B 1 and 2 only Although the collimator assembly contributes approximately 1.0 mm Al equivalent to the added filtration of the x-ray tube (because of the plastic exit portal and silver-coated reflective mirror), its functions are unrelated to the cleanup of scattered radiation. This is so because the patient is the principal scatterer, and grids function to clean up scattered radiation generated by the patient.
Which of the following anomalies is (are) possible if an exposure dose of 40 rad (400 mGy) were delivered to a pregnant uterus in the third week of pregnancy? 1 Skeletal anomaly 2 Organ anomaly 3 Neurologic anomaly A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
B 1 and 2 only During the first trimester, specifically the 2nd to 10th weeks of pregnancy (i.e., during major organogenesis), if the radiation dose is sufficient, fetal anomalies can be produced. Skeletal and/or organ anomalies can appear if irradiation occurs in the early part of this time period, and neurologic anomalies can be formed in the latter part; mental retardation and childhood malignant diseases, such as cancers or leukemia, and retarded growth/development also can result from irradiation during the first trimester.
Types of inflammatory bowel disease include 1 ulcerative colitis. 2 Crohn's disease. 3 intussusception. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
B 1 and 2 only The two most common types of chronic inflammation of the intestines are ulcerative colitis and Crohn's disease. The latter can attack any part of the GI tract and extends through all layers of the intestinal wall (therefore the possibility of forming fistulous tracks to contiguous structures). Ulcerative colitis attacks only the large bowel and only the mucosal layer of the intestinal wall. Curiously, cigarette smoking increases the risk for Crohn's disease and decreases the risk for ulcerative colitis. Intussusception is an obstructive disorder. (Tortora and Derrickson, 11th ed., p. 944)
When radiographing young children, it is helpful to 1. let them bring a toy. 2. tell them it will not hurt. 3. be cheerful and unhurried. A 1 only B 1 and 3 only C 2 and 3 only D 1, 2, and 3
B 1 and 3 only Children are often fearful of leaving familiar surroundings, and being able to take along a familiar toy is helpful. A calm and cheerful radiographer can be reassuring to the anxious child. Honesty is essential, and false reassurances, such as telling the child it will not hurt, not only do more harm than good, but also focus the child's attention on pain
Which interaction between x-ray photons and matter involves partial transfer of the incident photon energy to the involved atom? A Photoelectric effect B Compton scattering C Coherent scattering D Pair production
B Compton In Compton scatter, the high-energy incident photon uses only part of its energy to eject an outer-shell electron. It retains most of its original energy in the form of a scattered x-ray. Compton scatter is the interaction between x-ray photons and matter that occurs most frequently in diagnostic x-ray and is the major contributor of scattered radiation fog.
Patient dose increases as fluoroscopic A FOV increases B FOV decreases C FSS increases D FSS decreases
B FOV decreases During fluoroscopic procedures, as field of view (FOV) decreases, magnification of the output screen image increases, and contrast and resolution improve. The focal point on an image intensifier's 6-in. field/mode is further away from the output phosphor than the focal point on the normal mode; therefore, the output image is magnified. Because less minification takes place, the image is not as bright. Exposure factors are increased automatically to compensate for the loss in brightness with smaller FOVs. Focal spot size (FSS) is unrelated to patient dose. (Fosbinder, p. 285)
Patient dose increases as fluoroscopic A FOV increases B FOV decreases C FSS increases D FSS decreases
B FOV decreases Exposure factors are increased automatically to compensate for the loss in brightness with smaller FOVs. Focal spot size (FSS) is unrelated to patient dose
An important feature of the pixel in a flat-panel TFT digital detector active matrix array is the: A Nyquist frequency B Fill factor C Image lag D Modulation transfer function
B Fill Factor The fill factor (B) is defined as the ratio of the sensing area of the pixel to the area of the pixel itself. The sensing area of the pixel receives the data from the layer above it, which captures X-rays that are subsequently converted to light (indirect flat-panel detectors) or electrical charges (direct flat-panel detectors).
Which of the following structures is located at the level of the interspace between the second and third thoracic vertebrae? A Manubrium B Jugular notch C Sternal angle D Xiphoid process
B Jugular Notch Sternal angle is located opposite the T4-T5 interspace
Which of the following will be demonstrated best in the 45-degree right anterior oblique (RAO) position? A Right axillary ribs B Left axillary ribs C Sternum in the heart shadow D Left scapular Y
B Left Axillary Ribs In order to place the axillary portions parallel to the image receptor (IR), the affected side is away from the IR in the PA oblique (RAO and LAO) positions and toward the IR in the AP oblique (RPO and LPO) positions
Late or long-term effects of radiation exposure are generally represented by which of the following dose-response curves? A Linear threshold B Linear nonthreshold C Nonlinear threshold D Nonlinear nonthreshold
B Linear nonthreshold
Which of the following radiographic procedures requires an intrathecal injection? A IV pyelogram B Myelogram C Lymphangiogram D Computed tomography (CT)
B Myelogram A myelogram, or radiographic examination of the spinal canal, requires an intrathecal (intraspinal) injection. Intrathecal administration of contrast medium is usually at the level of L2/3 or L3/4
With milliamperage adjusted to produce equal exposures, all the following statements are true except A a single-phase examination done at 10 mAs can be duplicated with three-phase, 12-pulse at 5 mAs. B There is greater patient dose with three-phase equipment than with single-phase equipment. C Three-phase equipment can produce comparable radiographs with less heat unit (HU) buildup. D Three-phase equipment produces lower-contrast radiographs than single-phase equipment.
B There is greater patient dose with three-phase equipment than with single-phase equipment. If the same kilovoltage is used with single-phase and three-phase equipment, the three-phase unit will require about 50% fewer milliampere-seconds to produce similar radiographs. Because three-phase equipment has much higher effective voltage than single-phase equipment, the three-phase radiograph will have lower contrast. A lower milliampere-seconds value can be used with three-phase equipment, so heat units are not built up as quickly. When technical factors are adjusted to obtain the same density and contrast, there is no difference in patient dose. (Selman, 9th ed., pp. 162-164)
A MRI procedure is contraindicated for a patient who has A a herniated disk. B aneurysm clips. C dental fillings. D subdural bleeding
B aneurysm clips The presence of aneurysm clips is contraindication for magnetic resonance imaging (MRI); even a slight shift can cause damage. MRI can be performed for a herniated disk and subdural bleeding. Dental fillings do not contraindicate MRI.
The relationship between the ends of fractured long bones is referred to as A angulation B apposition C luxation D sprain
B apposition Various terms are used to describe the position of fractured ends of long bones. The term apposition is used to describe the alignment, or misalignment, between the ends of fractured long bones. The term angulation describes the direction of misalignment. The term luxation refers to a dislocation. A sprain refers to a wrenched articulation with ligament injury.
The part of a CT imaging system made of thousands of solid-state photodiodes is the A gantry. B detector array. C collimator assembly. D x-ray tube.
B detector array.
Medical and dental radiation accounts for what percentage of the general public's exposure to human-made radiation? A 10% B 50% C 80% D 95%
C 80%
Occupational radiation monitoring is required when it is likely that an individual will receive more than what fraction of the annual dose limit? A ½ B ¼ C 1/10 D 1/40
C
Which of the following structures should be visualized through the foramen magnum in an AP axial projection (Towne method) of the skull for occipital bone? 1 Posterior clinoid processes 2 Dorsum sella 3 Posterior arch of C1 A 1 only B 2 only C 1 and 2 only D 2 and 3 only
C
Which of the following statements would be true regarding tracheostomy patients? 1 Tracheostomy patients have difficulty speaking. 2 A routine chest x-ray requires the tracheostomy tubing to be rotated out of view. 3 Audible rattling sounds indicate a need for suction. A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3
C 1 and 3 only
The AP axial projection of the chest for pulmonary apices requires 15 to 20 degrees of cephalad angulation projects the apices above the clavicles should demonstrate the medial ends of the clavicles equidistant from the vertebral column
C 1 and 3 only The AP axial projection is used to prevent the clavicles from superimposition on the pulmonary apices. A 15- to 20-degree cephalad angle projects the clavicles above the apices
Which of the following statements regarding dual x-ray absorptiometry is (are) true? 1 Radiation dose is low. 2 Only low-energy photons are used. 3 Photon attenuation by bone is calculated. A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3
C 1 and 3 only Dual x-ray absorptiometry (DXA) imaging is used to evaluate bone mineral density (BMD). It is the most widely used method of bone densitometry—it is low-dose, precise, and uncomplicated to use/perform. DXA uses two photon energies—one for soft tissue and one for bone. Since bone is denser and attenuates x-ray photons more readily, photon attenuation is calculated to represent the degree of bone density. Bone densitometry DXA can be used to evaluate bone mineral content of the body, or part of it, to diagnose osteoporosis or to evaluate the effectiveness of treatments for osteoporosis
Which of the following statements regarding myelography is (are) correct? 1 Spinal puncture may be performed in the prone or flexed lateral position. 2 Contrast medium distribution is regulated through x-ray tube angulation. 3 The patient's neck must be in extension during Trendelenburg positions. A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3
C 1 and 3 only Following injection, the contrast medium is distributed to the vertebral region of interest by gravity;
Capacitor-discharge mobile x-ray units 1 use a grid-controlled x-ray tube 2 are typically charged before the day's work 3 provide a direct-current output A 1 only B 2 only C 1 and 3 only D 1, 2, and 3
C 1 and 3 only There are two main types of mobile x-ray units—capacitor-discharge and battery-powered. The capacitor-discharge units consist of a capacitor, or condenser, which is given a charge and then stores energy until the x-ray tube uses it to produce x-rays. The charge may not be stored for extended periods, however, because it tends to "leak" away; the capacitor must be charged just before the exposure is made. Its x-ray tube is grid-controlled, permitting very fast (short) exposure times.
Facsimile transmission of health information is 1 not permitted. 2 permitted for urgently needed patient care. 3 permitted for third-party payer hospitaliza-tion certification. A 1 only B 2 only C 2 and 3 only D 1, 2, and 3
C 2 and 3 Facsimile transmission of health information is convenient but should be used only to address immediate and urgent patient needs—and every precaution must be taken to ensure its confidentiality. It should be used only with prior patient authorization, when urgently needed for patient care, or when required for third-party payer ongoing hospitalization certification. These recommendations are made by the American Health Information Management Association (AHIMA). (Adler and Carlton, 4th ed., p. 368)
Myelography is a diagnostic examination used to demonstrate 1 internal disk lesions. 2 posttraumatic swelling of the spinal cord. 3 posterior disk herniation. A 1 only B 2 only C 2 and 3 only D 1, 2, and 3
C 2 and 3 only
Which of the following will reduce patient dose during fluoroscopy? 1. Decreasing the source-skin distance (SSD) 2. Using 2.5 mm Al filtration 3. Restricting tabletop intensity to less than 10 R/min A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
C 2 and 3 only
Which of the following statements regarding film badges is (are) correct? 1. Film badges should be read quarterly. 2. Film badges must not leave the workplace. 3. Film badges measure quantity and quality of radiation exposure. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
C 2 and 3 only Film within the badges is usually changed monthly. The sensitive film emulsion is susceptible to deterioration and false readings if the badges are worn for longer periods, or if they are damaged by water, heat, light, and so on.
Which of the following positions can be used to demonstrate the axillary ribs of the right thorax? 1 RAO 2 LAO 3 RPO A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
C 2 and 3 only the right axillary ribs would be demonstrated in the RPO (AP oblique with affected side adjacent to the IR) and LAO (PA oblique with affected side away from the IR) positions.
Which of the following positions will demonstrate the lumbosacral apophyseal articulation? A AP B Lateral C 30-degree RPO D 45-degree LPO
C 30-degree RPO The articular facets (apophyseal joints) of the L5-S1 articulation form a 30-degree angle with the MSP; they are, therefore, well demonstrated in a 30-degree oblique position. The 45-degree oblique position demonstrates the apophyseal joints of L1-4. (Frank, Long, and Smith, 11th ed., vol. 1, p. 432)
The luminescent light emitted by the PSP is transformed into the image seen on the CRT by the A PSP B scanner-reader C ADC D helium-neon laser
C ADC The exposed IP is placed into the CR scanner/reader, where the PSP/SPS is removed automatically. The latent image appears as the PSP is scanned by a narrow, high-intensity helium-neon laser to obtain the pixel data. As the PSP plate is scanned in the CR reader, it releases a violet light—a process referred to as photostimulated luminescence (PSL). The luminescent light is converted to electrical energy representing the analog image. The electrical energy is sent to an analog-to-digital converter (ADC), where it is digitized and becomes the digital image that is displayed eventually (after a short delay) on a high-resolution monitor and/or printed out by a laser printer. The digitized images can also be manipulated in postprocessing, transmitted electronically, and stored/archived. (Carlton and Adler, 4th ed., pp. 357-358; Bushong 9th ed., p. 421, p. 443)
What is the first treatment for extravasation of contrast media during an IV injection? A Apply a hot compress. B Apply a cold compress. C Apply pressure to the vein until bleeding stops. D Remove the needle and locate a sturdier vein immediately.
C Apply pressure to the vein until bleeding stops the needle should be removed and the extravasation cared for immediately (before looking for another vein). First, pressure should be applied to the vein until bleeding stops. Application of moist heat to the affected area helps to relieve pain. (Adler and Carlton, 5th ed., p. 283)
Quality Control (QC) testing is used to evaluate digital display monitors in all of the following ways, except A Display luminance response B Display resolution C Display matrix size D Display noise
C Display matrix size
Which of the following is another name for an intermittent injection port? A Hypodermic needle B Butterfly needle C Heparin lock D Intravenous (IV) infusion
C Heparin Lock
Which of the following modes of a trifield image intensifier will result in the highest patient dose? A Its 25-cm. mode B Its 17-cm. mode C Its 12-cm. mode D Diameter does not affect patient dose
C Its 12-cm. mode
A thermoluminescent dosimetry system would use which of the following crystals? A Silver halide B Sodium thiosulfate C Lithium fluoride D Aluminum oxide
C Lithium fluoride TLDs are personnel radiation monitors that use lithium fluoride crystals. Once exposed to ionizing radiation and then heated, these crystals give off light proportional to the amount of radiation received. TLDs are very accurate personal monitors. Even more accurate are optically stimulated luminescence (OSL) dosimeters. OSL dosimeters use aluminum oxide as their sensitive crystal. Silver halide is in film emulsion and sodium thiosulfate is in fixer solution. (Bushong, 8th ed., p. 593)
All of the following are advantages of digital fluoroscopic imaging systems over conventional fluoroscopic imaging systems, except: A Post-processing capability to enhance image contrast B Increased image acquisition speed C No need for pulsed or continuous radiation exposure D Higher milliamperage settings can be used
C No need for pulsed or continuous radiation exposure All fluoroscopic imaging (conventional and digital) requires either pulsed or continuous X-ray exposure (C) to provide a dynamic image of the anatomical area of interest. In digital fluoroscopic units, the X-ray tube actually operates in the radiographic mode.
Geometric blur can be evaluated using all the following devices except A star pattern B slit camera C penetrometer D pinhole camera
C Penetrometer Focal-spot size accuracy is related to the degree of geometric blur, that is, edge gradient or penumbra. Manufacturer tolerance for new focal spots is 50%; that is, a 0.3-mm focal spot actually may be 0.45 mm. Additionally, the focal spot can increase in size as the x-ray tube ages—hence the importance of testing newly arrived focal spots and periodic testing to monitor focal-spot changes. Focal-spot size can be measured with a pinhole camera, slit camera, or star-pattern-type resolution device.
Which of the following is a condition in which an occluded blood vessel stops blood flow to a portion of the lungs? A Pneumothorax B Atelectasis C Pulmonary embolism D Hypoxia
C Pulmonary embolism Blood pressure in the pulmonary circulation is relatively low, and therefore, pulmonary vessels can easily become blocked by blood clots, air bubbles, or fatty masses, resulting in a pulmonary embolism. If the blockage stays in place, it results in an extra strain on the right ventricle, which is now unable to pump blood. This can result in congestive heart failure
Recently, dual-sided reading technology has become available in more modern CR readers, in which two sets of photodetectors are used to capture light released from the front and back sides of the phosphor storage plate, or PSP (photostimulable phosphor). This technology enables improved: A Slow-scan direction speed B Modulation transfer function C Signal-to-noise ratio D Fast-scan direction speed
C Signal-to-noise ratio By incorporating two sets of light guides and photodetectors on either side of the IP as it travels through the CR reader, a single laser beam can effectively stimulate release of stored energy from both sides of the phosphor plate. This increases the amount of energy that may be released and used in the form of light to be converted by the photodetectors to an electrical (analog) signal. Therefore, the higher signal intensity increases the SNR, i.e. signal-to-noise ratio
The pain experienced by an individual whose coronary arteries are not conveying sufficient blood to the heart is called A tachycardia. B bradycardia. C angina pectoris. D syncope.
C angina pectoris
With the patient in the PA position and the OML and CR perpendicular to the IR, the resulting radiograph will demonstrate the petrous pyramids A below the orbits B in the lower third of the orbits C completely within the orbits D above the orbits
C completely within the orbits
The apophyseal articulations of the thoracic spine are demonstrated with the A coronal plane 45° to the IR. B midsagittal plane 45° to the IR. C coronal plane 70° to the IR. D midsagittal plane 70° to the IR.
C coronal plane 70 degrees to the IR The thoracic apophyseal joints are demonstrated by placing the patient in an oblique position with the coronal plane 70° to the IR (MSP 20° to the IR). This may be accomplished by first placing the patient lateral, then obliquing the patient 20° "off lateral." The apophyseal joints closest to the IR are demonstrated in the PA oblique, and those remote from the IR in the AP oblique. Comparable detail is obtained using either method, because the OID is about the same.
The most radiosensitive portion of the GI tract is the A upper esophagus B stomach C small bowel D cecum and ascending colon
C small bowel The most radiosensitive portion of the GI tract is the small bowel. Projecting from the lining of the small bowel are villi, from the intestinal crypt cells of Lieberkühn, which are responsible for the absorption of nutrients into the bloodstream. Because the cells of the villi are continually being cast off, new cells must continually arise from the crypts of Lieberkühn. Being highly mitotic undifferentiated stem cells, they are very radiosensitive. Thus, the small bowel is the most radiosensitive portion of the GI tract. (Dowd and Tilson, 2nd ed., p. 155)
All the following x-ray circuit devices are located between the incoming power supply and the primary coil of the high-voltage transformer except A the timer B the kilovoltage meter C the milliamperage meter D the autotransformer
C the milliamperage meter
Improper support of a patient's fractured lower leg (tibia/fibula) while performing radiography could result in 1 movement of fracture fragments. 2 tearing of soft tissue, nerves, and blood vessels. 3 initiation of muscle spasm. A 1 and 2 only B 1 and 3 only C 2 and 3 only D 1, 2, and 3
D 1 2 and 3
Moderate hypertension can produce damage to which of the following organ(s) 1. Lungs 2. Kidneys 3. Brain A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
D 1 2 and 3
Types of secondary radiation barriers include 1 the control booth 2 lead aprons 3 the x-ray tube housing A 2 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
D 1, 2 and 3 Secondary radiation includes leakage and scattered radiation. The control booth wall is a secondary barrier; therefore, the primary beam must never be directed toward it. The x-ray tube housing must reduce leakage radiation to less than 100 mR/h at a distance of 1 m from the housing. Lead aprons, lead gloves, portable x-ray barriers, and so on are also designed to protect the user from exposure to scattered radiation and will not protect her or him from the primary beam. (Selman, 9th ed., p. 403)
Which of the following is (are) essential to high-quality mammographic examinations? Small-focal-spot x-ray tube Short-scale contrast Use of a compression device A 1 only B 1 and 2 only C 1 and 3 only D 1, 2, and 3
D 1, 2, and 3 short scale.. low kVp
A radiologic technologist can be found guilty of a tort in which of the following situations? 1 Failure to shield a patient of childbearing age from unnecessary radiation 2 Performing an examination on a patient who has refused the examination 3 Discussing a patient's condition with a third party A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
D 1,2 and 3
The total number of x-ray photons produced at the target is contingent on the 1 tube current 2 target material 3 square of the kilovoltage A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
D 1,2 and 3 Although kilovoltage usually is associated with the energy of the x-ray photons because a greater number of more energetic electrons will produce more x-ray photons, an increase in kilovoltage will also increase the number of photons produced.
Reducing the number of repeat images is an important way to decrease patient exposure and can be accomplished by 1. good patient communication. 2. accurate positioning skills. 3. using AEC. A 1 only B 1 and 2 only C 2 and 3 only D 1, 2, and 3
D 1,2, and 3
Using the PA projection, which of the following tube angle and direction combinations is correct for an axial projection of the clavicle? A 5 to 15 degrees caudad B 5 to 15 degrees cephalad C 15 to 30 degrees cephalad D 15 to 30 degrees caudad
D 15 to 30 degrees caudad
In what order should the following examinations be performed? 1 Upper GI series 2 IVU 3 BE A 3, 1, 2 B 1, 3, 2 C 2, 1, 3 D 2, 3, 1
D 2,3,1
One advantage of a battery-powered mobile radiographic unit is: A It requires less kilovoltage to penetrate the anatomical part of interest B It produces radiographic images of much better image quality C It is much lighter than other mobile units D Electrical power is available to drive itself
D Electrical power is available to drive itself
Too much edge enhancement of the image in digital systems can cause an unwanted artifact called the: A Photoelectric effect artifact B Scaling artifact C Hounsfield artifact D Halo effect artifact
D Halo effect artifact
How is the intensity of an x-ray photon affected after each time it scatters? A Its intensity increases 4 times. B Its intensity increases 1000 times. C Its intensity decreases 4 times. D Its intensity decreases 1000 times.
D Its intensity decreases 1000 times.
The trend in spot filming in conventional fluoroscopy is to use a: A Cassette-loaded spot film B Flat panel image receptor C Cine film D Photospot camera film
D Photospot camera film Photospot camera film (D) is similar to that used in a movie camera except only one frame is exposed when activated. This film receives its light image from the output phosphor of the image intensifier tube. The photospot camera provides adequate image quality without interruption of the fluoroscopic examination, and can produce up to twelve exposures in one second. A cassette-loaded spot film (A) is positioned in a lead-lined compartment between the patient and the image intensifier. When a spot-film exposure is desired, the radiologist must actuate a control that properly positions the cassette in the X-ray beam and changes the operation of the X-ray tube from low fluoroscopic milliamperes (mA) to high radiographic mA, at which time the rotating anode is energized to a higher rotation speed. A flat panel image receptor (FPIR) (B) composed of cesium iodide and amorphous silicon pixel detectors can be used in place of an image intensifier in digital fluoroscopy for real-time imaging. Images created from this device are digitized and, therefore, can be stored in a PACS, but this device is not considered a recording system in itself. It only generates the image to be recorded. Cine film (C) is almost exclusively used in cardiac catheterization fluoroscopic procedures. Cine film typically comes in 35 mm rolls of 100 and 500 feet in length and is exposed by the light from the output phosphor of the image intensifier tube, similar to that of the photospot camera film, but while rapidly moving to expose each frame of the film strip. The exposed frames can then be played back as a continuous strip of images to produce a dynamic reproduction of the fluoroscopic images, similar to how one would draw various, slightly different images, on the same spot on multiple blank pieces of paper, and then flip these pieces of paper rapidly to produce what appears to be a moving image. Because of the rapid transition to digital imaging, the use of cine film is rapidly declining. (Bushong, 10 th ed., p. 413).
Which part of an induction motor is located within the x-ray tube glass envelope? A Filament B Focusing cup C Stator D Rotor
D Rotor he anode is made to rotate through the use of an induction motor. An induction motor has two main parts, a stator and a rotor. The stator is the part located outside the glass envelope and consists of a series of electromagnets occupying positions around the stem of the anode. The stator's electromagnets are supplied with current, and the associated magnetic fields function to exert a drag or pull on the rotor within the glass envelope. The anode is a 2- to 5-in.-diameter molybdenum or graphite disk with a beveled edge. The beveled surface has a focal track of tungsten and rhenium alloy. The anode rotates at about 3,600 rpm (high-speed anode rotation is about 10,000 rpm) so that heat generated during x-ray production is distributed evenly over the entire track. Rotating anodes can withstand delivery of a greater amount of heat for a longer period of time than stationary anodes. (Carlton and Adler, 4th ed., p. 73)
Using an AEC system, how will the mAs be adjusted as the film-screen speed combination is decreased? A The mAs will increase as film-screen speed decreases. B Both the mAs and the kV will increase as film-screen speed decreases. C The milliamperage will decrease as film-screen speed decreases. D The mAs remains unchanged as film-screen speed decreases.
D The mAs remains unchanged as film-screen speed decreases.
All of the following statements regarding the RAO position of the sternum are true, except A the sternum is generally projected to the left of the vertebral column. B shallow breathing during the exposure can obliterate prominent pulmonary markings. C it is helpful to project the sternum over the heart. D a thin thorax requires a lesser degree of obliquity than a thicker thorax
D a thin thorax requires a lesser degree of obliquity than a thicker thorax A thin chest would require a greater degree of obliquity to separate the vertebrae and sternum from superimposition than would a thick chest
The AP axial projection, or "frog leg" position, of the femoral neck places the patient in a supine position with the affected thigh A adducted 25 degrees from the horizontal B abducted 25 degrees from the vertical C adducted 40 degrees from the horizontal D abducted 40 degrees from the vertical
D abducted 40 degrees from the vertical
All the following radiation-exposure responses exhibit a nonlinear threshold dose-response relationship except A skin erythema B hematologic depression C radiation lethality D leukemia
D leukemia The genetic effects of radiation and some somatic effects, such as leukemia, are plotted on a linear dose-response curve. The linear dose-response curve has no threshold; that is, there is no dose below which radiation is absolutely safe. The nonlinear/sigmoidal dose-response curve has a threshold and is thought to be generally correct for most somatic effects—such as skin erythema, epilation, hematologic depression, and radiation lethality (death)
For medicolegal reasons, radiographic images are required to include what 4 things
Every radiographic image must include (1) the patient's name or ID number, (2) the side marker, right or left; (3) the date of the examination; and (4) the identity of the institution or office.
If the exposure rate to an individual standing 4.0 m from a source of radiation is 10 mR/h, what will be the dose received after 20 minutes at a distance of 6 m from the source? A 22.5 mR B 7.5 mR C 4.44 mR D 1.48 mR
The relationship between x-ray intensity and distance from the source is expressed in the inverse-square law of radiation. The formula is I1/I2=(d2)^2-(d1)^2 Substituting known values: Thus, x = 4.44 mR in 60 minutes and, therefore, 1.48 mR in 20 minutes. Distance has a profound effect on dose received and, therefore, is one of the cardinal rules of radiation protection. As distance from the source increases, dose received decreases. (Bushong, 8th ed., pp. 68-70)
What are symptoms of inadequate oxygen supply
dyspnea, cyanosis, diaphoresis, retraction of intercostal spaces, dilated nostrils, and distension of the veins of the neck.
Radiation-induced cancer, leukemia, and genetic effects follow what type of relationship
linear nonthreshold
