FRCR Physics MCQs in Clinical Radiology Ibrahim Lutfi Shuaib Hafiz M. Zin Mohd Zahri Abdul Aziz Noor Diyana Osman Rafidah Zainon 123 FRCR Physics MCQs in Clinical Radiology Ibrahim Lutfi Shuaib Hafiz M. Zin • Mohd Zahri Abdul Aziz Noor Diyana Osman • Rafidah Zainon FRCR Physics MCQs in Clinical Radiology Ibrahim Lutfi Shuaib Hafiz M. Zin Advanced Medical & Dental Institute Advanced Medical & Dental Institute Universiti Sains Malaysia Universiti Sains Malaysia Penang Penang Malaysia Malaysia Mohd Zahri Abdul Aziz Noor Diyana Osman Advanced Medical & Dental Institute Advanced Medical & Dental Institute Universiti Sains Malaysia Universiti Sains Malaysia Penang Penang Malaysia Malaysia Rafidah Zainon Advanced Medical & Dental Institute Universiti Sains Malaysia Penang Malaysia ISBN 978-981-13-0910-6 ISBN 978-981-13-0911-3 (eBook) https://doi.org/10.1007/978-981-13-0911-3 Library of Congress Control Number: 2018951071 © Springer Nature Singapore Pte Ltd. 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore Preface The book is a collection of specimen multiple choice questions (MCQs) for the First FRCR Examination in Clinical Radiology (Physics Module). The content follows the updated Royal College of Radiology (RCR) UK syllabus (November 2016) on scientific basis of medical imaging that now covers topics in molecular imaging. This book will assist the candidate in preparing for the First FRCR Examination and other postgraduate examinations. The questions are arranged in nine sets of 40 MCQs following the examination format. In addition, explanations to all the answers are provided to improve under- standing of the topics. In each practice set, the questions are arranged in the order of the syllabus from the basis of medical imaging and radiation physics to the principles of specific modalities and safety issues. The candidate can also attempt the questions according to the topics in the syllabus by referring to the table below. Content Question number 4.1 Principles of medical diagnostic imaging 1, 2, 3 4.2 Common themes for all imaging modalities 4.3 Matter and radiation 4, 5, 6, 7 4.4 Ionising radiation dose 8, 9 4.5 Radiography 10, 11 4.6 Fluoroscopy 12, 13 4.7 Safety in radiography and fluoroscopy 14, 15 4.8 Radioactivity 16 4.9 Planar radionuclide imaging 17 4.10 Safety in planar radionuclide imaging 18 4.11 UK framework for ionising radiation protection 19, 20, 21 4.12 Tomographic reconstruction 22, 23 4.13 Computed tomography 24, 25 4.14 Single-photon emission computed tomography 26, 27, 28 4.15 Positron emission tomography 4.16 Nuclear magnetic resonance 29, 30 4.17 Magnetic resonance imaging 31, 32 4.18 Safety in magnetic resonance imaging 33 v vi Preface Content Question number 4.19 Physics of ultrasound 34, 35, 36 4.20 Ultrasound imaging 4.21 Safety in ultrasound imaging 37 4.22 Optical imaging 38 4.23 Functional and molecular imaging 39 4.24 The principles of biological processes that can be 40 probed with functional and molecular imaging Kepala Batas, Penang, Malaysia Ibrahim Lutfi Shuaib Hafiz M. Zin Mohd Zahri Abdul Aziz Noor Diyana Osman Rafidah Zainon Contents Part I Questions Examination One: Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Examination Two: Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Examination Three: Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Examination Four: Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Examination Five: Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Examination Six: Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Examination Seven; Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Examination Eight: Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Examination Nine: Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Part II Answers Examination One: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Examination Two: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Examination Three: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Examination Four: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Examination Five: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Examination Six: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 Examination Seven: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 Examination Eight: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Examination Nine: Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 vii About the Authors Ibrahim Lutfi Shuaib (FRCR) graduated from the University of Malaya, Kuala Lumpur, Malaysia. He is a professor of radiology and senior consultant radiologist at the Advanced Medical and Dental Institute, Malaysia. He has many peer-reviewed international publications and delivered numerous oral and poster presentations in national and international meetings. He is involved in post-graduate radiology teaching and has been an examiner in the local master of radiology program. He has been actively involved in formulating the curriculum of the program and organises the mock anatomy and physics FRCR examination every year in Malaysia. Professor Ibrahim is the chairman of the committee for post-graduate teachings in the College of Radiology, Malaysia. Hafiz M. Zin obtained his PhD from the joint physics department, Institute of Cancer Research, London and Royal Marsden NHS, UK. He is a senior lecturer in medical physics at Advanced Medical and Dental Institute at Universiti Sains Malaysia (University of Science, Malaysia). He is involved in teaching physics module for the master of medicine program, FRCR short courses and mock exams at the institute. His research interest is to improve targeted radiotherapy treatment of cancer using optimised image guidance modalities. He has presented his research in several international conferences and has published papers in international journals. He is the vice president of Malaysian Association of Medical Physics and a member of Institute of Physics UK and the Malaysian Institute of Physics. Mohd Zahri Abdul Aziz is a senior lecturer in oncological and radiological sci- ences cluster in charge of teaching physics module for the Master of Medicine pro- gram and FRCR short courses at the Advanced Medical and Dental Institute, Universiti Sains Malaysia (University of Science, Malaysia). Dr. Aziz completed a BSc. in medical radiation, MSc. in medical physics and PhD in medical radiation physics. He is an active researcher in the field of medical physics, has published articles and received innovation awards. Besides that, he also supported the brachy- therapy clinical group in the oncology unit at the institute. Previously in 2006, until 2007, he was a lecturer at MAHSA University and Ministry of Health College, Malaysia before joining Universiti Sains Malaysia. ix x About the Authors Noor Diyana Osman is a senior lecturer and medical physicist at the Advanced Medical and Dental Institute at Universiti Sains Malaysia (University of Science, Malaysia). She completed her bachelor’s in medical radiation, M.Sc. in medical physics from Universiti Sains Malaysia and PhD in medical radiation physics at Universiti Teknologi MARA, Malaysia. She is involved in undergraduate and post- graduate teaching, physics FRCR course and Radiology mock exam. Her research interests are medical image processing and radiation dosimetry that primarily focus on the diagnostic imaging field. She has published several journal articles and con- ference papers. Rafidah Zainon is a senior lecturer in Medical Physics at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. She received her PhD degree in Medical Physics from the University of Canterbury, New Zealand in 2012. She is a member of academic accreditation committee in Universiti Sains Malaysia. She is involved in teaching medical physics module for the Master of Science (Medical Physics), Master of Medicine (Radiology) and Master of Medicine (Nuclear Medicine) programmes. She is also an invited speaker and facilitator in anatomy and physics FRCR mock examination in Malaysia. Her research interests are imag- ing and nuclear medicine physics. She is a Secretary of Malaysian Association of Medical Physics and a member of Malaysian Institute of Physics and IEEE Society. Part I Questions