1. Which of the following statements about radioactivity is NOT correct?

A. some of the atoms in our body are radioactive.

B. radioactivity occurs naturally in the environment.

C. radioactivity is associated with the nucleus of an atom.

D. radioactivity is involved in diagnostic x-rays.

Answer is D: Diagnostic x-rays are not associated with radioactivity.

2. If a patient who has been administered a radiopharmaceutical containing technetium 99m (halflife = 6
hours), is allowed to go home 36 hours after the administration, what fraction of the original
radioactivity is left in the patient (ignoring excretion from the body)?

A. 1/216

B. 1/64

C. 1/36

D. 1/6

Answer is B: After every 6 hours, the amount of technetium 99m that remains

is one half of the amount that was present 6 hours ago. 36/6 = 6, so six half-lives

will elapse over 36 hours, thus the amount remaining is: ½ × ½ × ½ × ½ × ½ ×

½ = (½)6
= 1/64

In radiotherapy, why is the patient’s irradiation treatment “fractionated”, that is, consist of (say) 20
sessions and spread over (say) 4 weeks – rather than given all at 1 session?

A.
Fractionation allows time for the normal healthy tissue that is also irradiated, to recover in between
irradiations.

B. Extremely high energy electrons bombard the target of a linear accelerator, fractionation is necessary
to allow the x-ray target to cool.

C. In order to irradiate the tumor over a period of time that it is growing.

D.
Irradiating in a single session takes too long, people cannot remain immobile for the time it would
require.

Answer is A: Radiotherapy also damages the healthy tissue through which it passes. By choosing a
different path for the radiotherapy beam through the body for the next “fraction”, whilst at the same
time ensuring that the tumor is always in the beam, allows the healthy tissue time to recover.

Which of the following statements about radioactivity is correct?

A.
X-rays can be produced by radioactivity.

B. The spontaneous emission of microwaves from the nucleus of an atom is one form of radioactivity.
C. Radioactivity is the spontaneous emission of particles or photons from the nucleus of an atom

D. Radioactivity is involved in the FM radio frequency band but not the AM

radio band.

Answer is C: Radioactivity involves the nucleus of an atom. Microwaves are not produced by
radioactivity. While radiation from a nucleus could remove an inner shell electron from another atom,
and when this electron is replaced by another “falling” into its place while emitting an x-ray photon, this
is not classed as radioactivity.

Given that a radiopharmaceutical containing the radionuclide technetium 99m

(4399mTc) has an activity of 4 MBq immediately prior to injection into a patient.
About 12 hours later the patient is measured to have an activity of about 1 MBq.
How long is the half-life of technetium 99m?

A.
6 hours

B. 12 hours

C. 24 hours

D.
48 hours

Answer is A: After one half life, half of the radioactive atoms have decayed, so only half remain. One
quarter (= ½ × ½) remains after 4 hours, so two half-lives have elapsed in the 12 hour period. 12/2 = 6
hours.
Why are radioisotopes that emit low energy (100–250 keV) gamma rays preferred for the diagnostic
procedures of nuclear medicine? Because:

A. high energy gamma rays are too easily stopped by body tissue.

B. radioisotopes that emit gammas within this energy range have a half-life that is ideal for diagnostic
procedures.

C. photons of this energy are sufficiently penetrating to escape from the body but are able to be
detected.

D. charged particles are too difficult to shield against.

Answer is C: There is a trade off where the photons should be penetrating

enough so that they are not stopped within the body, but not so penetrating that too few are stopped
by the detector placed next to the body. This energy range satisfies both needs.

7. Given the statement: “Your exposure to radiation varies inversely with the

square of your distance from the source of radiation”, what is the correct way

to finish the sentence? “If you increased the distance between you and a patient

with a radioactive implant, from 1 to 3 m, your exposure would”:

A. increase by a factor of nine.

B. decrease by a factor of one ninth.

C. decrease by a factor of one third.

D. increase by a factor of three.

Answer is B: If you triple your distance, your exposure would" be one third of

a third of your exposure while closer. (1/3)2

= 1/9

*Why is radiotherapy using high energy x-rays, an effective way of treating some cancer? Because*

A. if enough energy is deposited in tumor cells, they can be killed.

B. most of the x-rays pass through the body without harming healthy tissue.

C. the dose to the skin surface is lower than with low energy x-rays.

D.
high energy x-rays do not kill healthy cells.

Answer is A: The ability of x-rays to be switched off and on and to deposit

enough energy within a cell to kill it, makes it suitable for treatment of cancer tumors.

Which of the following pairs of nuclides are isotopes?

A. 2760Co and 2860Ni

B. 4399Tc and 4298Mo

C. 1940K and 4019K

D. 1940K and 1939K

Answer is D: Isotopes are two forms of the same element that have different

numbers of neutrons in the nucleus. This means same symbol, and same atomic

number (subscript), but different mass number (superscript).

*What may the term “radioactive” be correctly used to describe?*

A. a diagnostic x-ray machine used to produce radiographs.

B. a linear accelerator used to produce x-rays for radiotherapy.

C. a patient undergoing a nuclear medicine scan.

D. a patient undergoing a CT (computed tomography) examination.

Answer is C: A patient who has been prepared for a NM scan has had a radioisotope incorporated into
their body, so are themselves (temporarily)

radioactive.
*What may the term radioactivity correctly used to refer to?*

A.
The spontaneous emission of electromagnetic radiation from the nucleus of an atom.

B. The particles or photons emitted from an unstable nucleus.

C. The emission of particulate radiation from a radionuclide.

D.
The alpha, beta or X-radiation which emanates from some atomic nuclei.

Answer is B: Unstable nucleus = radioactive. Choices A & C also describe

radioactivity but not in as general terms as choice B.

*What does the physical half-life of a pure sample of radioactive material refer to?*

A.the amount of time taken for half of the radioactive atoms to decay.

B. half of the time that it would take for all of the radioactive atoms to decay

C. the average time taken for any particular radioactive atom to decay.

D.
the time it takes for half of a sample of ingested radioisotope to be cleared from the body.

Answer is A: The half-life of a particular radionuclide is the time it takes for half of the remaining atoms
of that particular radionuclide to decay. Choice B is not the same thing.
*The radionuclide technetium 99m (43/99mTc) is often incorporated into radiopharmaceuticals. When it
decays by gamma emission the daughter nucleus may be represented as 43/99X (X is not the real
chemical symbol for the daughter nucleus!). Which of the following statements is correct?*

A. The daughter nucleus displays chemical behaviour identical to 43/99mTc.

B. X is the symbol of a chemical element different from technetium.

C. The daughter nucleus detaches from the radiopharmaceutical and is

excreted.

D. The daughter nuclide is not radioactive.

Answer is A: “X” is still technetium as the atomic number (43) has not changed. Consequently, the
chemical behaviour of the two nuclides is the same. A daughter nucleus may or may not be radioactive
(In this case it is).

*If the halflife of technetium 99 m is 6 hours. After five half-lives what fraction of the original amount of
technetium would remain?*

A.
1/5

B. 1/10

C. 1/30
D.
1/32

Answer is D: The half-life of a particular radionuclide is the time it takes for half of the remaining atoms
of that particular radionuclide to decay. (½)⁵ = 1/32

Why is increasing the distance between yourself and a source of radiation is an effective way of
reducing your exposure? Because:

A.
the amount of exposure to radiation is inversely proportional to distance.

B. the intensity of radiation decreases as the square of the distance.

C. the intensity of radiation decreases exponentially with distance.

D. an expanse of air is an effective shield for gamma and x radiation.

Answer is B: As radiation leaves a point source it diverges and spreads equally in all directions over an
ever expanding spherical surface. A spherical surface area is proportional to the radius squared, so
exposure to radiation diminishes as it spreads more thinly in space.

Why should the use of staff of child-bearing age to nurse patients with implanted radioactive sources be
avoided?

A. Because such sources are highly radioactive.

B. Because there is a risk of damage to the gametes of the staff.

C. Because younger people are more at risk of developing radiation induced cancers.

D. Because implanted sources cannot be adequately shielded.

Answer is B: If it is possible to reduce risk to staff by assigning them to other duties, then it should be
done.

The lead aprons that are used for protection of staff in diagnostic radiography procedures do not
provide protection against the ionising radiation used in nuclear medicine or radiotherapy. Why is
this? Because

A. charged particles are much easier to stop (are less penetrating) than l are.

B. gamma rays are more penetrating than x-rays even if both have the same energy.

C. such aprons do not cover the arms, feet, head and neck.

D.
the shielding provided by the aprons is not sufficient to stop photons with energies above about
100 keV.

Answer is D: Diagnostic radiography uses x-rays with an average energy of 70 keV or less, which can
be stopped by relatively thin amounts of lead (or leadlike) material. In order to stop the gamma
rays used in nuclear medicine imaging, the thickness of the “aprons” would make them
prohibitively heavy to wear.

When compared to visible light, which is not very penetrating, why can radiation such as x-rays
and gamma rays pass right through the human body? Because:

A. the density of the human body is relatively low.

B. they have no mass and no charge.

C. atoms in the body are mostly empty space.

D.
they have very high energy.

Answer is D: X and gamma rays are high energy radiation, which means high frequency, which
means short wavelength, which means that many of the photons will pass through the body
without interacting with any atoms. The other three choices do not distinguish between different
types of radiation.

Which of the following is true?*

A.
A patient exposed to diagnostic x-rays will emit x-rays for a short time after the procedure.

B. A cancer patient treated with a megavoltage beam of x-rays will emit x-rays for a short time after
the treatment.

C. For a short time after having a bone scan using the radionuclide technetium 99 m, the patient
will emit gamma rays.

D. The human body does not contain any radioactive material unless it has

been exposed to man-made radioactive material.

Answer is C: A bone scan (any nuclear medicine scan) involves taking some radioactive material
into the body which then emits gamma rays to be detected outside the body. The body takes some
time to excrete the material (and much of it decays) so until that happens, the body is more
radioactive than is usually the case.
What does the term Ionising radiation refer to?*

A. the radiation that is emitted by ionised atoms.

B. that part of the electromagnetic spectrum with wavelengths less than 300 nm which has enough
energy to produce ions.

C. alpha, beta and gamma rays spontaneously emitted from radionuclides.

D. radiation with enough energy to produce ionisation in the material which

absorbs it.

Answer is D: If the radiation produces ions when it interacts with any substance, then it is ionising
radiation. Choice B is true but does not include particulate radiation. Choice C is true but does not
include x-rays or cosmic rays.

Which of the following is a correct use of the unit known as the “electron volt” (eV)?*

A. One electron volt is the amount of radioactivity that results in one disintegration per second.

B. Radiopharmaceuticals contain gamma photon emitting radionuclides whose energy is usually in

the range 100–250 keV

C. One electron volt is equal to 1.9 × 1016 joules of energy.

D.
A photon of visible light has energy of about 1.5 MeV.

Answer is B: The eV is a unit of energy (not radioactivity). It is equal to 1.9 × 10−16 joules of energy.
Visible photons have energy of 1.5 eV or less.

Which one of the statements about the penetrating ability of radiation is true?

A.
750 keV gamma rays are more penetrating than 750 keV x-rays.

B. 140 keV gamma rays are more penetrating than 60 keV x-rays.

C. 2 MeV beta-rays (electrons) are more penetrating than 1 MeV gamma rays

D. 1 MeV gamma rays are more penetrating than 2 MeV x-rays.

Answer is B: gamma rays and x-rays are indistinguishable, once they have

travelled away from their site of production. So a 140 keV gamma or x-ray is more penetrating than
a lower energy one.

What may the term “ionising radiation” be applied to?

A.
all electromagnetic radiation

B. radiation that produces ions when it interacts with matter

C. infra-red radiation

D.
radiation that is emitted by ions

Answer is B: The production of ions (i.e. removal of electrons from an atom), is the sign of ionising
radiation. Such a change in the medium through which radiation passes is significant.

What does it mean when an x-ray tube is operated at an accelerating voltage of 120 kV?

A.
the maximum energy that an x-ray photon can have will be 120 keV

B. the characteristic x-rays will have energy 120 keV

C. all of the x-ray photons will have an energy of 120 keV

D.
the x-ray beam will contain photons with every energy from 0 keV up to

120 keV

Answer is A: X-rays are emitted from the tube with a range of energies (a spectrum) which will
range from mid-teens to low twenties of keV (depending on
the amount of “filtration” that the photons pass through) up to the maximum value which will
equal the accelerating voltage.
Why do some x-ray photons will pass through the human body without deflection? Because:

A. carbon, hydrogen and oxygen atoms are transparent to x-rays.

B. the energy of diagnostic x-rays is too low to produce interactions

C. the wavelength of x-rays is too long to interact with an object with the

dimensions of the human body.

D.
the interior of atoms is mostly empty space

Answer is D: Apart from the positions where electrons and the nuclei are

located, the rest of the body is empty space through which photons can travel unimpeded. They
will interact only if they “hit” these sub-atomic particles. The other answers contain errors.

How will increasing the filtration of an x-ray beam reduce the intensity of the x-ray spectrum?

A.
equally at all frequencies

B. more at lower frequencies than at higher frequencies

C. more at higher frequencies than at lower frequencies

D.
only at lower frequencies

Answer is B: Lower frequency radiation is less penetrating than higher frequency radiation, so the
low frequency are preferentially absorbed compared to high frequency radiation.

What is a difference between x-rays and gamma rays?

A. x-rays are ionising radiation and gamma rays are not

B. gamma rays have higher energies than x-rays

C. gamma rays can be turned off by switching the power supply off.

D.
x-rays are produced in an electrical machine whereas gamma rays emerge from an atomic nucleus.

Answer is D: Apart from the difference in how they are produced, x-rays and gamma rays are the
same phenomenon.

To what energy can an x-ray tube that is operated at 110 kV accelerate

electrons?*
A. 110 eV

B. 110 keV

C. 110 joules

D. 110,000 keV

Answer is B: An electron volt is the amount of energy gained by an electron

when it is accelerated by a potential difference of 1 volt. 110 keV is the amount
of energy gained by an electron when it is accelerated by a potential difference of 110 kilovolt.

*Which statement about the differences between medical imaging using x-rays and a nuclear
medicine scan using gamma rays is correct?*

A. an x-ray procedure leaves the patient with residual radioactivity while

nuclear medicine does not.

B. a gamma ray source can be switched off after which no gamma radiation is produced while an x-
ray source will continue to produce radiation until the source decays.

C. x-rays produce an image of internal anatomy while a nuclear medicine scan provides
information about the functioning of an organ or tissue.

D.
a beam of gamma rays is fired at the patient and detected on the other side, while x-rays are
produced by the nucleus of a radionuclide incorporated in the patient’s body.
Answer is C: X-rays that pass through the body without being absorbed by the body are used to
produce an image of internal structure. In nuclear medicine, a radioactive material is incorporated
into the body, travels to certain organs from
where a gamma ray is emitted. If physiology is altered sufficiently to affect the way the radioactive
material moves about the body, the resulting image provides information about how much
alteration there has been.

*Which of the following imaging modalities does NOT involve the use of “ionising radiation”?*

A. mammography

B. ultrasound

C. a scintigram using technetium

D.
a chest x-ray

Answer is B: Ultrasound produces an oscillation in the particles of the body, but does not use
ionising electromagnetic radiation.

*When inspecting an x-ray image, the order of densities from blackest to whitest is:*

A. Bone, water, fat, air

B. Air, fat, water, bone

C. Air, water, fat, bone

D.
Bone, air, water, fat

Answer is B: The blackest part on an x-ray image is air, while the whitest is

bone.

*Which of the following imaging modalities uses x-rays?*

A.
computed tomography (CT).

B. single photon emission computed tomography (SPECT).

C. positron emission tomography (PET).

D. nuclear medicine scan (scintigram).

Answer is A: CT machines generate x-rays. The others are all nuclear medicine procedures.

*Radiation which is “ionising” includes which of the following?*

A. x-rays and gamma rays

B. infra-red radiation

C. radiation emitted by mobile phones

D. microwaves

Answer is A: The other three choices, while also being forms of electromagnetic radiation, do not
utilise energies that are sufficient to remove electrons from their atoms.

*What is the purpose of adding filtration to an x-ray beam? To:*

A. Prevent high energy photons entering the patient

B. Increase the mean energy of the beam.

C. Decrease the scattered radiation

D. Increase the ratio of low energy photons to high energy photons.

Answer is B: X-rays are produced in an x-ray tube with a range of energies.

Filtration will absorb the lowest energy photons more than higher energy ones. This will result in
the average energy of the remaining spectrum increasing.
*One difference between the x-radiation in the primary beam and the scattered radiation is that:*

A. Photons in the primary beam degrade contrast in radiographic images.

B. Scattered radiation is more penetrating than the primary beam.

C. Scattered radiation may be absorbed in the imager.

D. Scattered radiation is travelling at an angle to the main beam.

Answer is D: “Scattered” radiation has interacted with an atom in the medium so is diverted from
the direction of the primary beam.

*The advantage of Computed Tomography (CT) over conventional radiography is:*

A. CT delivers lower doses than conventional radiography.

B. CT images are faster to acquire than conventional radiographs.

C. CT produces a cross-sectional image that is not obscured by overlying anatomical structures.

D. CT projects a 3D structure onto a 2D image.

Answer is C: It is the ability to image internal structures without having them partially obscured by
the tissue on either side as is the case for “conventional” radiography, that makes CT such a useful
diagnostic tool. (Also there is no need to cut the person open to see what is inside!)

*The contrast of a CT image displayed on a monitor may be increased by*

A. increasing the window width

B. increasing the window level

C. decreasing the window width

D.
decreasing the window level

Answer is C: Decreasing the width of the “window” means restricting the range of gray scale
displayed on the monitor screen (0 to 255), to a more limited range of the available Hounsfield
numbers (−1000 for air, to 3000 for dense bone). A lung window may be −1250 to +250; a soft tissue
window may be −160 to +240; a bone window may be −650 to +1350.

*Which one of the following beams is the most penetrating?*

A.
2 MeV gamma rays
B. 2 MeV x-rays

C. 4 MeV x-rays

D.
8 MeV x-rays

Answer is D: Penetrating ability of electromagnetic radiation increases as

energy does.

*What time does the half-life of a radioactive sample refer to? The time for the*

A. activity to halve.

B. count rate to double

C. parent nuclei to decay

D. number of nuclei to halve

_Answer is A: This is the best answer, although the daughter nuclei may themselves also be
radioactive and so contribute to the radioactivity of the sample. When a nucleus decays, it (or the
daughter nucleus) is still there, so choice D is wrong._

*‘Half-life’ when applied to atoms of a radioactive isotope refers to the:*

A. midpoint of the time span for which the isotope will emit its radiation

B. effective time for which the isotope is considered to be dangerous.

C. length of time taken for half of the isotope to emit its radiation.

D. time after which the radioactivity of the sample is half of its original value.

_Answer is C: This is the best answer. Half-life refers to the atoms of an isotope of the one element.
The daughter nuclei may themselves also be radioactive and so contribute to the radioactivity of
the sample now containing a mixture of original isotope atoms and daughter atoms._

*In an experiment to determine the half-life of a particular radionuclide, measurements of the

mass of that nuclide are made. If masses of 8 micrograms and 2 micrograms are recorded at
intervals 8 days apart, what is the half-life of the nuclide?*

A. 8 days

B. 6 days

C. 4 days

D. 2 days

_Answer is C: If we start with 8 μg of a radionuclide and when it decays it

becomes another nuclide, then after one half-life there will be 4 μg remaining and after another
half-life, there will be 2 μg. Hence two half-lives have elapsed during the 8 day period. This means
one half life is 8 ÷ 2 = 4 days._

*A particular radionuclide has a half-life of six hours. When first measured, its activity is 10,000 Bq.
Twelve hours later, what will its activity be?*

A.
0 Bq

B. 1250 Bq

C. 2500 Bq

D.
5000 Bq

_Answer is C: After one half-life the starting activity of 10,00 Bq will be halved to 5000 Bq. After
another half-life the activity will be halved again from 5000 to 2500 Bq_

*What is a radionuclide with a short half-life (say 5 hours) said to be?*

A. highly radioactive.

B. weakly radioactive.
C. of high penetrating ability.

D. of low penetrating ability.

_Answer is A: A radionuclide with a short half-life must be emitting a lot of

radiation in that time as half of the nuclei present will have emitted their radiation. Hence it may
be termed “highly radioactive”, albeit for a short time._

*Which of the following does NOT contribute to the background radiation?*

A. cosmic rays

B. fluorescent lights

C. radon gas

D.
uranium

_Answer is B: Fluorescent lights contain mercury vapour at low pressure which emits ultraviolet
light when excited by the passage of electrons through the tube. The UV photons are absorbed by
the phosphor that coats the inside of the tube which re-emits the energy as visible light. No
ionising radiation is emitted._
*Which one of the following sources contributes to the background radiation?*

A. medical x-rays of bones.

B. potassium 40 and carbon 14 in our bodies.

C. ultraviolet B radiation from the sun.

D. microwave radiation.

_Answer is B: Background radiation is that radiation that is impossible to avoid as it is part of our
natural environment. Potassium 40 and carbon 14 are two naturally occurring radionuclides that
form part of the background radiation._

*Which one of the following radiations, all of 1 MeV energy, is the least
penetrating?*

A.
alpha rays

B. beta rays

C. gamma rays

D. x-rays
_Answer is A: Alpha rays are doubly ionised helium nuclei, which, because of their large mass and
double charge interact strongly with any matter through which they pass. They are able to travel a
mere few centimetres in air and a fraction of a millimetre in solid matter._

*Which is the most penetrating nuclear radiation?*

A.
alpha particles of energy 7 MeV.

B. beta particles of 0.5 MeV energy

C. x-rays with energy of 5 MeV.

D. gamma rays with 140 keV of energy.

_Answer is C: X-rays are photons so have no mass or charge. Hence they interact
only weakly with the matter through which they pass. In addition, 5 MeV are very energetic x-rays
so are more penetrating than gamma ray photons with less energy._

*Suppose a gamma source is placed 10 cm from a radiation detector and in succession, a 1 cm thick
slab of each of the following materials is used to shield the source. For which one would the count
rate be lowest?*
A. lead

B. wood

C. aluminium

D.
cardboard

_Answer is A: Shielding material with the highest density is able to absorb the
greatest amount of gamma photons. Lead has the highest density so would reduce the count rate
the most._

*Why is a shield made of lead effective in reducing the exposure to gamma rays? Because the*

A. lead shield absorbs all of the gamma rays.

B. number of gamma rays absorbed increases exponentially with the thickness of the shield.

C. number of gamma rays absorbed increases in an inverse square fashion with thickness.

D.
lead shield reflects all the gamma rays.

_Answer is B: The number of gamma photons that can pass through a medium is described by an
exponential relationship. Their number decreases exponentially as the thickness increases._
*Why are gamma rays are able to penetrate “solid” walls but alpha or beta rays cannot? Because*

A. the speed of gamma rays (3 × 10⁸ m/s) is very much faster than either alpha or beta radiation.

B. gamma rays do not have an electric charge whereas alpha is charged +2 and beta -1.

C. to a gamma ray, the atoms of the wall appear to be mostly empty space.

D.
gamma rays possess much more energy than either alpha or beta rays

_Answer is B: It is the absence of an electrical charge that allows photons to pass by electrons and
atomic nuclei with being attracted or repelled by them. This means that photons are undeflected
unless they suffer a direct hit._