Part II (written exam) – Medical Health Physics

Contents

Exam Description

The Exam Panel seeks to determine the candidate’s practical experience, as well as his/her understanding of current radiation protection standards.  In  Part II we test the candidate’s level of knowledge on the following 9 topics.  The questions in each section test the candidate’s knowledge to the level appropriate for a radiation safety officer. The weighting factor for each topic is listed to the right.
 
Instrumentation 10%
Laboratory Design  5%
Standards and Regulations 15%
Structural Shielding 15%
Radiation Oncology 15%
Diagnostic Imaging 15%
Nuclear Medicine (molecular imaging) 15%
Radiation Biology  5%
Non-ionizing Radiation  5%

Instrumentation (10%)

  1. Characteristics and limitations of Portable ionization chambers
  2. Geiger-Mueller counters
  3. Scintillation counters
  4. Liquid Scintillation counting systems
  5. Multi-channel analyzers
  6. Gamma counting systems
  7. Uses of instrumentation in the field and in emergency situations

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Laboratory Design (5%)

  1. Ventilation systems
  2. Hood design
  3. Contamination control

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Standards and Regulations (15%)

  1. Risk Estimates
  2. Radiobiological basis for permissible doses
  3. Permissible Doses
  4. Familiarity with Regulatory Codes
  5. Familiarity with NRC/NCRP Guidelines

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Structural Shielding Design (15%)

  1. Radiation Oncology room design / shielding characteristics
  2. Diagnostic Radiology Shielding design / calculations

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Radiation Oncology (15%)

  1. Elements of Quality Management Program
  2. JCAHO Requirements
  3. Inventory Control-Brachytherapy
  4. Exposure Control
  5. Medical Events.
  6. Incident Investigation
  7. Quality Control Testing

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Diagnostic Imaging (15%)

  1. FDA Regulations
  2. Elements of Quality Management Program
  3. JCAHO Requirements
  4. Quality Control Testing

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Nuclear Medicine (molecular imaging) – (15%)

    1. I-131 Therapy
    2. Typical Doses
    3. Exposure Control
    4. Contamination Control
    5. Release Criteria
    6. Radioimmunotherapy

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Radiobiology (5%)

  1. BEIR Reports
  2. NCRP Recommendations

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Non-Ionizing Radiation (5%)

  1. Laser Safety Standards
  2. MRI Design and Hazard

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Sample Questions

1. A sealed source is considered to be leaking if the measured removable contamination (in μCi) is equal to or greater than:

A.  0.005
B. 0.010
C. 0.050
D. 0.100
E. 0.200

2. A patient has a series of diagnostic x-ray exams. Which one of the following contributes the highest dose to the gonads?

A. cardiac series
B. barium swallow
C. PA and lateral chest radiographs
D. thoracic spine series
E. lumbar sacral spine series

3. When evaluating a personnel monitor program for a hospital:

A. A monthly frequency is required.
B. The control badge must be kept outside of the radiology department.
C. A TLD is the preferred detector.
D. Two badges are required for females.
E. The control badge must be kept in a clearly non-radiation area.

4. You are informed by the radiation oncologist that I-125 seeds have been spilled on the floor of the operating room. Which of the instruments below would be the instrument(s) of choice to be taken to the O.R. in order to find the sources?
(1) ionization chamber survey meter
(2) Geiger-Mueller survey meter
(3) proportional counter
(4) scintillation survey meter

A. (1), (2), and (3) only are correct.
B. (1) and (3) only are correct.
C. (2) and (4) only are correct.
D. (4) only is correct.
E. All are correct.

ANSWERS:

1. A
2. E
3. E
4. C

Suggested References

Textbooks

  1. Allisy-Roberts, P., Williams, J., Farr’s Physics for Medical Imaging, Elsevier, 2nd edition, 2007, ISBN 978-0702028441
  2. Bushberg, Seibert, Leidholdt and Boone, The Essential Physics of Medical Imaging, Philadelphia: Lippincott Williams & Wilkins, 3rd Edition, 2013, ISBN: 978-0781780575
  3. Cherry, S.R., J.A. Sorenson, and M.E. Phelps, Physics in Nuclear Medicine, Philadelphia: Elsevier Saunders, 4th edition, 2012. ISBN 978-1416051985
  4. Huda, W., Review of Radiologic Physics, Philadelphia: Lippincott Williams & Wilkins, 4th edition, 2016, ISBN 978-1496325082

NATIONAL COUNCIL ON RADIATION PROTECTION & MEASUREMENTS (NCRP) REPORTS

  1. NCRP Report 116 – Limitation of Exposure to Ionizing Radiation, Bethesda, MD: NCRP (1993)
  2. NCRP Report 147 – Structural Shielding Design for Medical X-Ray Imaging Facilities, Bethesda, MD: NCRP,  (2004)
  3. NCRP Report 149 – A Guide to Mammography and Other Breast Imaging Procedures, Bethesda, MD: NCRP,  (2004)
  4. NCRP Report 155 – Management of Radionuclide Therapy Patients, Bethesda, MD: NCRP, (2006)
  5. NCRP Report 160 – Ionizing Radiation Exposure of the Population of the United States, Bethesda, MD: NCRP, (2009).
  6. NCRP Report168 – Radiation Dose Management for Fluoroscopically-Guided Interventional Medical Procedures, Bethesda, MD: NCRP, (2010)
  7. NCRP Report 174 –  Preconception and Prenatal Radiation Exposure: Health Effects and Protective Guidance, Bethesda, MD: NCRP, (2013)
  8. National Council on Radiation Protection and Measurements. Program Presentations No.43 – Advances in Radiation Protection in Medicine (2007). https://www.ncrppublications.org/index.cfm?fm=Product.ViewPDF&pdf=2007%20Annual%20Meeting%20Presentations.pdf&type=free
  9. National Council on Radiation Protection and Measurements. Program Presentations No. 48 – Emerging Issues in Radiation Protection in Medicine, Emergency Response, and the Nuclear Fuel Cycle (Medical Section only) (2012). https://www.ncrppublications.org/index.cfm?fm=Product.ViewPDF&pdf=2012%20Annual%20Meeting%20Presentations.pdf&type=free

OTHER REPORTS & GUIDANCE DOCUMENTS

  1. American College of Radiology, Disaster Preparedness for Radiology Professionals, Response to Radiological Terrorism: A Primer for Radiologists, Radiation Oncologists and Medical Physicists, version 3, 2006.  https://aapm.org/pubs/reports/DisasterPreparednessV3.pdf
  2. American College of Radiology, ACR Practice Guideline for Imaging Pregnant or Potentially Pregnant Adolescents and Women with Ionizing Radiation, 2013.  https://www.acr.org/-/media/ACR/Files/Practice-Parameters/pregnant-pts.pdf
  3. American Association of Physicists in Medicine. AAPM Report 181: The Selection, Use, Calibration, and Quality Assurance of Radionuclide Calibrators Used in Nuclear Medicine. College Park, MD: AAPM, 2012 . https://www.aapm.org/pubs/reports/RPT_181.pdf
  4. Applying Radiation Safety Standards in Nuclear Medicine.   http://www-pub.iaea.org/books/IAEABooks/7116/Applying-Radiation-Safety-Standards-in-Nuclear-Medicine
  5. Code of Federal Regulations (CFR): Title 10 CFR Parts 19, 20, 35   https://www.nrc.gov/reading-rm/doc-collections/cfr
  6. Communicating Radiation Risks in Pediatric Imaging: Information to Support Healthcare Discussions about Benefit and Risk –  http://www.who.int/ionizing_radiation/pub_meet/radiation-risks-paediatric-imaging/en/
  7. Diagnostic Radiology Physics: A Handbook for Teachers and Students (Chapters 1-3, 15.6, 20-22, 24) – http://www-pub.iaea.org/MTCD/Publications/PDF/Pub1564webNew-74666420.pdf
  8. Federal Guidance Report No. 14 Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures, November 2014.  https://www.epa.gov/sites/production/files/2015-05/documents/fgr14-2014.pdf
  9. Nuclear Medicine Physics: A Handbook for Teachers and Students (Chapters 1-6, 20)  – http://www-pub.iaea.org/MTCD/Publications/PDF/Pub1617web-1294055.pdf
  10. Radiation Protection in Medicine: Setting the Scene for the Next Decade –  http://www-pub.iaea.org/MTCD/publications/PDF/Pub1663_web.pdf
  11. US Nuclear Regulatory Commission, NUREG-1556. Consolidated Guidance about Materials Licenses. Volume 9, Program-Specific Guidance about Medical Use Licenses. Revision 2.   https://www.nrc.gov/docs/ML0734/ML073400289.pdf
  12. U.S. Nuclear Regulatory Commission, Washington, DC, January 2008.US Nuclear Regulatory Commission, Safety Culture Policy Statement, NUREG/BR-0500, March 2015.  https://www.nrc.gov/docs/ML1506/ML15062A478.pdf