| Question 1: In compliance with the dose limit in 10 CFR 35.75(a), licensees may release patients who have received radioactive iodine therapy from licensee control if the dose rate at 1 meter is at or below: |
| Reference: | Appendix U, Table U.1 of NUREG-1556, volume 9, revision 2, “Program-Specific Guidance About Medical Use Licensees” (https://www.nrc.gov/docs/ML0734/ML073400289.pdf). |
| Choice A: | 0.21 mSv/hr |
| Choice B: | 0.14 mSv/hr |
| Choice C: | 0.07 mSv/hr |
| Choice D: | 0.03 mSv/hr |
| Question 2: Lead is often used for shielding therapy rooms for use with iodine-131. What is the half value layer for lead when shielding for iodine-131? |
| Reference: | Nuclide Safety Data Sheet, Iodine-131 (http://www.hpschapters.org/northcarolina/NSDS/131IPDF.pdf) |
| Choice A: | 0.60 cm |
| Choice B: | 0.45 cm |
| Choice C: | 0.30 cm |
| Choice D: | 0.15 cm |
| Question 3: In compliance with the dose limit in 10 CFR 20.1301(c), a licensee may permit visitors to an individual who cannot be released, under 10 CFR 35.75, to receive a radiation dose greater than 1.0 mSv but less than or equal to: |
| Reference: | 10 CFR20.1301, Dose limits for individual members of the public. (https://www.nrc.gov/reading-rm/doc-collections/cfr/part020/part020-1301.html |
| Choice A: | 7.5 mSv |
| Choice B: | 5.0 mSv |
| Choice C: | 2.5 mSv |
| Choice D: | 1.0 mSv |
| Question 4: In NCRP Report No. 116, “Limitation of Exposure to Ionizing Radiation,” for occupational situations the NCRP recommends a monthly equivalent dose limit (excluding medical and natural background radiation) for the embryo-fetus once the pregnancy is known. This dose limit is: |
| Reference: | NCRP Report No. 116, Limitation of Exposure to Ionizing Radiation. |
| Choice A: | 0.75 mSv |
| Choice B: | 0.50 mSv |
| Choice C: | 0.25 mSv |
| Choice D: | 0.10 mSv |
| Question 5: The derived equation to calculate Patient-specific red bone marrow (RBM) dose is based on all of the following terms EXCEPT: |
| Reference: | Shen et al. JNM 1999, 40:2102-2106 |
| Choice A: | Patient’s weight. |
| Choice B: | Cumulated radioactive concentration of blood (Cblood). |
| Choice C: | Cumulated radioactive of whole body (A ̃). |
| Choice D: | Biological half-life of the therapeutic radionuclide (Tb). |
| Question 6: What percent lung shunt fraction results in excluding the patient from a Y-90 Sir-sphere procedure? |
| Reference: | Murthy R. et al. RadioGraphics 25(1) 2005; https://doi.org/10.1148/rg.25si055515 |
| Choice A: | <10% |
| Choice B: | 10-15% |
| Choice C: | 15-20% |
| Choice D: | >20% |
| Question 7: Amino Acid infusion begins 30 mins prior to the [Lu-177] Lutathera infusion, and continues another 3 hours post therapy infusion. The amino acid infusion is ordered to protect which organ from the high therapeutic radiation dose? |
| Reference: | Bailey et al. EJNMMI Physics (2015) 2:20; DOI 10.1186/s40658-015-0123-2 |
| Choice A: | Liver. |
| Choice B: | Spleen. |
| Choice C: | Kidneys. |
| Choice D: | Bladder. |
| Question 8: According to current NRC regulations, the limit on total effective dose equivalent (TEDE) that a minor sibling of a released NM therapy pediatric patient may receive is: |
| Reference: | 10 CFR 35.75. Release of individuals containing unsealed byproduct material or implants containing byproduct material (https://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-0075.html) |
| Choice A: | 50 mSv |
| Choice B: | 5 mSv |
| Choice C: | 20 mSv |
| Choice D: | 1 mSv |
| Question 9: What application must an institution file with the U.S. Food & Drug Administration (FDA), if it wishes to treat a pediatric patient outside of a clinical trial, with a radiopharmaceutical approved for investigational use in adults? |
| Reference: | U.S. Food & Drug Administration: Expanded Access (Compassionate Use) (https://www.fda.gov/newsevents/publichealthfocus/expandedaccesscompassionateuse/default.htm) |
| Choice A: | Investigational New Drug (IND) |
| Choice B: | Humanitarian Device Exemption (HDE) |
| Choice C: | Compassionate Use IND (CIND) |
| Choice D: | Institutional Review Board (IRB) |
| Question 10: The so-called “80 mCi at 48 hour” limit for radioiodine therapy in patients with lung metastases is based on a study of adult females. Given a clearance half-life of 24 hours, and 800 g adult female and 290 g five-year-old reference lung masses, a more conservative limit on administered activity for a five year old using the rule, adjusting for lung mass, would be: |
| Reference: | Sgouros G, Song H, Ladenson PW, Wahl RL, Lung toxicity in radioiodine therapy of thyroid carcinoma: development of a dose-rate method and dosimetric implications of the 80-mCi rule. J Nucl Med. 2006; 47(12):1977-84. |
| Choice A: | 116 mCi |
| Choice B: | 221 mCi |
| Choice C: | 58 mCi |
| Choice D: | 320 mCi |
