Bushong: Radiologic Science for Technologists: Physics, Biology, and Protection, 8th Edition Chapter 22: Mammography MULTIPLE CHOICE 1. a. b. c. d. Soft tissue radiography requires special techniques because of the low image receptor contrast. subject contrast. part thickness. spatial resolution. ANS: B Soft tissue radiography is unique because of the low subject contrast. DIF: Moderate OBJ: Discuss the differences between soft tissue radiography and conventional radiography. 2. When doing soft tissue radiography, the differential absorption between ______ and ______ must be enhanced. a. bone, muscle b. muscle, fluid c. muscle, fat d. fat, air ANS: C When doing soft tissue radiography, the differential absorption between muscle and fat must be enhanced. DIF: Moderate OBJ: Discuss the differences between soft tissue radiography and conventional radiography. 3. a. b. c. d. In soft tissue radiography, all of the tissues being imaged have similar effective atomic numbers. mass densities. Compton interaction. All of the above. ANS: D In soft tissue radiography, all the tissues being imaged have similar effective atomic numbers, mass densities, and Compton interaction. DIF: Moderate OBJ: Discuss the differences between soft tissue radiography and conventional Copyright © 2004 Mosby, Inc. All Rights Reserved Chapter 22: Mammography 2 radiography. 4. a. b. c. d. The breast tissue tends to be increasingly ________ in older women. fatty dense glandular fibrous ANS: A The breast tissue tends to be increasingly fatty in older women. DIF: 5. a. b. c. d. Moderate OBJ: Describe the anatomy of the breast. About 80% of breast cancer occurs in ________ tissue. epidermal adipose ductal connective ANS: C About 80% of breast cancer occurs in ductal tissue. DIF: Moderate OBJ: Describe the anatomy of the breast. 6. A diagnostic mammogram must be able to demonstrate microcalcifications less than _______ in size. a. 5000 mm b. 3000 mm c. 1000 mm d. 500 mm ANS: D A diagnostic mammogram must be able to demonstrate microcalcifications less than 500 mm in size. DIF: Moderate OBJ: Describe the anatomy of the breast. 7. The American Cancer Society recommends that all women ____ years of age and older have an annual screening mammogram. a. 45 b. 50 c. 55 d. 60 ANS: B The American Cancer Society recommends that all women 50 years of age and older have an annual screening mammogram. Copyright © 2004 Mosby, Inc. All Rights Reserved Chapter 22: Mammography 3 DIF: Moderate OBJ: Identify the recommended intervals for self-examination and x-ray examination of the breast. 8. The American Cancer Society recommends biannual screening mammograms for all women a. over age 65. b. age 30–39. c. age 50–59. d. age 40–49. ANS: D The American Cancer Society recommends biannual screening mammograms for all women age 40–49. DIF: Moderate OBJ: Identify the recommended intervals for self-examination and x-ray examination of the breast. 9. It is recommended that women obtain their first baseline mammogram before the age of ______. a. 30 b. 40 c. 50 d. 60 ANS: C It is recommended that women obtain their first baseline mammogram before the age of 50. DIF: Moderate OBJ: Identify the recommended intervals for self-examination and x-ray examination of the breast. 10. A dedicated mammography unit should have an automatic adjustable ________ device. a. grid b. compression c. focal spot d. filter ANS: B A dedicated mammography unit should have an automatic adjustable compression device. DIF: Moderate OBJ: Describe the unique features of a mammographic imaging system. Copyright © 2004 Mosby, Inc. All Rights Reserved Chapter 22: Mammography 4 11. Every dedicated mammography unit is equipped with a ___________. a. low ratio grid b. high ratio grid c. three-phase voltage generator d. tungsten filter ANS: A Every dedicated mammography unit is equipped with a low ratio grid. DIF: Moderate OBJ: Describe the unique features of a mammographic imaging system. 12. A target of molybdenum or rhodium is preferable in mammography because it reduces the _______. a. resolution b. scatter c. contrast d. motion ANS: B A target of molybdenum or rhodium is preferable in mammography because it reduces the scatter. DIF: Moderate OBJ: Describe the unique features of a mammographic imaging system. 13. Breast compression has the advantage of lowering a. patient dose. b. motion blur. c. superimpositions. d. All of the above. ANS: D Breast compression has the advantage of lowering patient dose, motion blur, and superimpositions. DIF: Moderate OBJ: Discuss the requirement for compression in mammography. 14. Breast compression is used to _______ patient dose and _______ focal spot blur. a. lower, reduce b. lower, increase c. raise, reduce d. raise, increase ANS: A Breast compression is used to lower patient dose and reduce focal spot blur. DIF: Moderate OBJ: Discuss the requirement for compression in mammography. Copyright © 2004 Mosby, Inc. All Rights Reserved Chapter 22: Mammography 5 15. Breast compression increases a. contrast resolution. b. spatial resolution. c. patient dose. d. Both a and b. ANS: D Breast compression increases contrast resolution and spatial resolution. DIF: Moderate OBJ: Discuss the requirement for compression in mammography. 16. Mammograms are taken with _______ cassettes. a. double screen b. single screen c. non-screen d. Both a and b. ANS: B Mammograms are taken with single screen cassettes. DIF: Moderate OBJ: Describe the image receptors used in mammography and the spatial resolution obtained. 17. The spatial resolution is improved in mammography by always placing the emulsion side of the film ______ the screen and ______ the tube. a. away from, away from b. against, toward c. against, away from d. away from, toward ANS: C The spatial resolution is improved in mammography by always placing the emulsion side of the film against the screen and away from the tube. DIF: Difficult OBJ: Describe the image receptors used in mammography and the spatial resolution obtained. 18. Cassettes used in mammography are specially designed with a. tighter film-screen contact. b. high Z front covers. c. double screens. d. looser spring latches. ANS: A Cassettes used in mammography are specially designed with tighter film-screen contact. Copyright © 2004 Mosby, Inc. All Rights Reserved Chapter 22: Mammography DIF: Moderate OBJ: Describe the image receptors used in mammography and the spatial resolution obtained. 19. Mammography currently uses _______ film. a. direct exposure b. xeroradiography c. double-emulsion d. single-emulsion ANS: D Mammography currently uses single-emulsion film. DIF: Moderate OBJ: Explain the differences between diagnostic and screening mammography. 20. Screening mammography requires ___ view(s) of each breast, whereas diagnostic mammography requires _________ views. a. one, two or more b. two, two or more c. three, three or more d. four, four or more ANS: B Screening mammography requires two views of each breast, whereas diagnostic mammography requires two or more views. DIF: Difficult OBJ: Explain the differences between diagnostic and screening mammography. Bushong: Radiologic Science for Technologists: Physics, Biology, and Protection, 8th Edition Chapter 23: Mammography Quality Control MULTIPLE CHOICE 1. a. b. c. d. A quality assurance program includes measures of patient satisfaction. processor quality control. equipment function. All of the above. ANS: D A quality assurance program includes measures of patient satisfaction, processor quality control, and equipment function. Copyright © 2004 Mosby, Inc. All Rights Reserved 6 Chapter 22: Mammography DIF: Moderate assurance. 2. a. b. c. d. OBJ: Define quality control and its relationship to quality The ___________ is responsible for supervising quality assurance. chief radiologist mammographer department manager medical physicist ANS: A The chief radiologist is responsible for supervising quality assurance. DIF: Moderate assurance. OBJ: Define quality control and its relationship to quality 3. The purpose of a quality assurance program is to maintain maximum _________________ with minimum __________________. a. equipment function, department costs b. patient satisfaction, exam time c. quality mammograms, patient dose d. patient care, exam time ANS: C The purpose of a quality assurance program is to maintain quality mammograms with minimum patient dose. DIF: Moderate assurance. 4. a. b. c. d. OBJ: Define quality control and its relationship to quality The mammography quality control program is outlined by the radiologist department. Mammography Quality Standards Act. state governments. Bureau of Radiation Health. ANS: B The mammography quality control program is outlined by the Mammography Quality Standards Act. DIF: Moderate assurance. 5. a. b. c. d. OBJ: Define quality control and its relationship to quality The average glandular dose to mammography patients must be tested annually by the mammographer. radiologist. medical physicist. department manager. Copyright © 2004 Mosby, Inc. All Rights Reserved 7 Chapter 22: Mammography ANS: C The average glandular dose to mammography patients must be tested annually by the medical physicist. DIF: Moderate OBJ: Describe the role of the radiologist and the medical physicist in quality control. 6. The team of ________________________ is responsible for mammography quality control. a. mammographer and QC technologist b. mammographer, radiologist, and medical physicist c. medical physicist, staff manager, and chief radiologist d. staff manager and medical physicist ANS: B The team of mammographer, radiologist, and medical physicist is responsible for mammography quality control. DIF: Moderate OBJ: List the members of the quality control team in radiology. 7. The ___________ is responsible for selecting the medical physicist and mammographers responsible for quality control. a. radiologist b. department manager c. chief mammographer d. federal government ANS: A The radiologist is responsible for selecting the medical physicist and mammographers responsible for quality control. DIF: Moderate OBJ: Describe the role of the radiologist and the medical physicist in quality control. 8. The medical physicist is responsible for ______________ performance evaluation of the imaging equipment. a. quarterly b. semiannual c. biannual d. annual ANS: D The medical physicist is responsible for annual performance evaluation of the imaging equipment. DIF: Moderate OBJ: Describe the role of the radiologist and the medical physicist in quality control. Copyright © 2004 Mosby, Inc. All Rights Reserved 8 Chapter 22: Mammography 9 9. The _________________ is responsible for measurement of the mammogram viewing conditions. a. darkroom technologist b. mammographer c. medical physicist d. radiologist ANS: C The medical physicist is responsible for measurement of the mammogram viewing conditions. DIF: Moderate OBJ: Describe the role of the radiologist and the medical physicist in quality control. 10. When is the QC evaluation of the equipment performed? a. once a year b. when major components are replaced c. when repairs are needed d. Both a and b. ANS: D Equipment QC is done annually and when major components are replaced. DIF: Moderate OBJ: Describe the role of the radiologist and the medical physicist in quality control. 11. One responsibility of the radiologist is to track a. patient communications. b. film repeat analysis. c. darkroom conditions. d. equipment performance. ANS: A One responsibility of the radiologist is to track patient communications. DIF: Moderate OBJ: Describe the role of the radiologist and the medical physicist in quality control. 12. The medical physicist is responsible for the a. monthly equipment check. b. quarterly conference with the radiologist. c. annual artifact evaluation. d. semiannual compression check ANS: C The medical physicist is responsible for the annual artifact evaluation. Copyright © 2004 Mosby, Inc. All Rights Reserved Chapter 22: Mammography 10 DIF: Moderate OBJ: Describe the role of the radiologist and the medical physicist in quality control. 13. The role of medical physicist includes a. performing annual performance evaluations of equipment. b. consulting with the mammographers concerning QC. c. reviewing the QC records to check for compliance. d. All of the above. ANS: D The role of medical physicist includes performing annual performance evaluations of equipment, consulting with the mammographers concerning QC, and reviewing the QC records to check for compliance. DIF: Difficult OBJ: Describe the role of the radiologist and the medical physicist in quality control. 14. The mammographer should _____________________ on a monthly basis. a. do a repeat analysis b. complete a visual checklist c. perform processor quality control d. review phantom images ANS: B The mammographer should complete a visual checklist on a monthly basis. DIF: Difficult OBJ: Itemize the mammographer's quality control duties on a weekly, monthly, and annual basis. 15. How often should the mammographer perform the quality control test for screen-film contact? a. daily b. weekly c. monthly d. semiannually ANS: D The mammographer performs the quality control test for screen-film contact semiannually. DIF: Moderate OBJ: Itemize the mammographer's quality control duties on a weekly, monthly, and annual basis. 16. The first step in quality control is the daily a. darkroom cleaning. b. sensitometric strip. Copyright © 2004 Mosby, Inc. All Rights Reserved Chapter 22: Mammography 11 c. screen cleaning. d. phantom images. ANS: A The first step in quality control is the daily darkroom cleaning. DIF: Moderate OBJ: List the processor quality control steps. 17. Every daily sensitometry strip should be fed into the processor a. emulsion side down. b. on the same edge of the feed tray. c. with the least exposed end first. d. All of the above. ANS: D Every daily sensitometry strip should be fed into the processor under identical conditions each time. DIF: Moderate OBJ: List the processor quality control steps. 18. Once control values are set, the daily speed index (mid density) and contrast index (density difference) should not vary more than _____ from the control. a. 0.10 b. 0.15 c. 0.20 d. 0.25 ANS: B Once control values are set, the daily speed index (mid density) and contrast index (density difference) should not vary more than 0.15 from the control. DIF: Difficult OBJ: List the processor quality control steps. 19. The processor quality control begins with daily tests for a. developer temperature and darkroom fog. b. fixer retention and darkroom fog. c. developer temperature and sensitometric values. d. fixer retention and sensitometric values. ANS: C The processor quality control begins with daily tests for developer temperature and sensitometric values. DIF: Moderate OBJ: List the processor quality control steps. 20. The sensitometry strip step with the optical density closest to, but not less than, ____ is the speed index (mid density) step. a. 1.2 Copyright © 2004 Mosby, Inc. All Rights Reserved Chapter 22: Mammography b. 1.5 c. 2.2 d. 2.5 ANS: A The speed index (mid density) is the sensitometry strip step with the optical density closest to 1.2. DIF: Moderate OBJ: List the processor quality control steps. Copyright © 2004 Mosby, Inc. All Rights Reserved 12