| Question 1: The ACR requires annual review of all of the following protocols EXCEPT: |
| Reference: | ACR CT Quality Control Manual, page 54. |
| Choice A: | Adult Head |
| Choice B: | Adult Abdomen |
| Choice C: | Pediatric Head (1 Year Old) |
| Choice D: | Cardiac CTA |
| Choice E: | High Resolution Chest |
| Question 2: MPPG 1a recommends the following members for a Protocol Review team EXCEPT: |
| Reference: | Cody, DD, et.al., AAPM Medical Physics Practice Guideline 1.a: CT Protocol Management and Review Practice Guideline. J Appl Clin Med Phys 14(5):3-12, 2013. |
| Choice A: | Radiologist |
| Choice B: | Qualified Medical Physicist |
| Choice C: | Lead CT Technologist |
| Choice D: | Senior Member of Administration |
| Choice E: | Manufacturer’s Applications Specialist |
| Question 3: Which of the following individuals is responsible for the commissioning of treatment planning systems in a clinical setting? |
| Reference: | Smilowitz, JB, et.al., AAPM Medical Physics Practice Guideline 5.a.: Commissioning and QA of Treatment Planning Dose Calculations - Megavoltage Photon and Electron Beams. J Appl Clin Med Phys 16(5): 14-34, 2015. |
| Choice A: | Dosimetrists |
| Choice B: | Qualified Medical Physicist (QMP) |
| Choice C: | Vendor service engineer |
| Choice D: | Radiation Oncologist |
| Question 4: What is the process for modeling the parameters of the treatment beam in a treatment planning system? |
| Reference: | MPPG 5a |
| Choice A: | One-time process. |
| Choice B: | Iterative process, accepting compromises considering the expected scope of clinical use . |
| Choice C: | Use the parameters from a similar model system. |
| Choice D: | Make two measurements and average. |
| Question 5: When validating the treatment beam modeled in the TPS, measured points should be compared to calculated points at multiple depths, and within the: |
| Reference: | MPPG 5a. |
| Choice A: | High-dose region. |
| Choice B: | Penumbra. |
| Choice C: | Low-dose tail regions. |
| Choice D: | All of the above. |
| Question 6: Considering that diagnostic medical procedures result in effective doses that are typically lower than 100 mSv, which of the following statements are TRUE: |
| Reference: | AAPM PP 25-B: AAPM Position Statement on Radiation Risks from Medical Imaging procedures. |
| Choice A: | Describing potential radiation risks using predictions of hypothetical cancer incidence and deaths can lead some patients to fear or refuse appropriate medical imaging. |
| Choice B: | When the procedures are appropriate, the anticipated benefits to the patient are highly likely to outweigh any small potential risks. |
| Choice C: | If a patient refuses a diagnostic procedure due to concerns of radiation dose, it is sufficient to say the dose is very low without explaining the medical benefit of the procedure. |
| Choice D: | d. A and B |
| Choice E: | e. All of the above |
| Question 7: The air kerma-area product (PKA) and reference incident air kerma (Ka,r) are useful dose metrics in fluoroscopically-guided procedures. Indicate which of the following is FALSE: |
| Reference: | NCRP Report 168. Radiation Dose Management for Fluoroscopically-guided Interventional Procedures. 2010. pp 89-93. |
| Choice A: | PKA is a measure of the total x-ray energy absorbed by the patient. It is therefore an indicator of stochastic risk from fluoroscopically-guided interventional procedures. |
| Choice B: | The relationship between displayed Ka,r and peak skin dose depends on the clinical procedure and how the physician maneuvers the x-ray equipment during the case. |
| Choice C: | PKA can be used as an indicator of how often the beam projection angle was changed during the procedure to spread the dose over larger areas of the skin. |
| Choice D: | Measures that reduce total radiation dose (PKA) will also reduce peak skin dose. |
| Question 8: Regarding Reference Levels (RLs) and Achievable Administered Activity (AAA) in Nuclear Medicine, indicate which of the following is FALSE: |
| Reference: | ACR–AAPM Practice Parameter for Reference Levels and Achievable Administered Activity for Nuclear Medicine and Molecular Imaging. |
| Choice A: | A RL is an investigational (action) level that identifies higher than typical administered activities for routine nuclear medicine and molecular imaging procedures. |
| Choice B: | If a facility or practice consistently exceeds an RL, it should review its procedures and equipment to determine if acceptable image quality can be achieved with a lower administered activity. |
| Choice C: | For pediatric procedures, manufacturers recommend a standard administered activity based on a standard 5 year-old or 45 pound child in their package insert as required by the US Food and Drug Administration. |
| Choice D: | When modifying administered activity, image quality must be maintained at an appropriate level as administered activity is decreased. |
| Question 9: Which of the following TG-142 tests were not included in the minimum set of recommended tests because of a low RPN score? |
| Reference: | Smith, K, et. al., AAPM Medical Physics Practice Guideline 8.a: Linear accelerator performance tests, J Appl Clin Med Phys 18(4):23-39, 2017. |
| Choice A: | ODI |
| Choice B: | Field-size/cone specific output factors |
| Choice C: | Photon output vs. dose rate |
| Choice D: | Electron beam energy |
| Question 10: Which of the following statements is NOT true regarding MPPG 8.a: |
| Reference: | MPPG 8a |
| Choice A: | It does not require specialized equipment beyond what is typically used for “traditional” QA. |
| Choice B: | Though MMPG 8 attempts generate a set of tests in the spirit of TG-100 for the “every clinic,” the authors encourage each clinic create their own set of tests based on TG-100. |
| Choice C: | MPPG8a is not an exhaustive list of tests one should perform in his clinic. |
| Choice D: | Vendor QA and safety tests are generally a complete and comprehensive set of tests. |
