AMERICAN BOARD OF MEDICAL PHYSICS, INC.
STUDY GUIDE 2010
"Part I - General Medical Physics"
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FOREWARD
Part I of the ABMP examination is intended to test the general knowledge of the basic principles of medical physics. These are the principles with which all medical physicists should be familiar, regardless of their specialization. Questions will be restricted to basic principles only. Detailed questions appear in the appropriate Part II examinations.
The questions in the examination are apportioned by topic as follows.
| Radiological Physics | 20% |
| Radiation Detection and Measurement | 15% |
| Biology and Radiobiology | 5% |
| Radiation Protection | 15% |
| Imaging and Other Diagnostic Studies | 17% |
| Principles of Therapy | 15% |
| Anatomy, Physiology, and Medical Science | 7% |
| Computers | 6% |
RADIOLOGICAL PHYSICS
UNITS:
| fundamental units | electrical units |
| derived units | radiation units |
ATOMIC AND NUCLEAR STRUCTURE:
| Bohr model | elementary particles |
| shell structure | nuclear structure |
| periodic table | nuclear binding energy |
| electron binding energy | mass-energy equivalence |
| ionization and excitation |
ELECTROMAGNETIC RADIATION:
| frequency | energy |
| properties of non-ionizing radiation | wavelength |
| properties of ionizing radiation | LASER's |
| infrared radiation | microwaves |
ULTRASOUND:
| speed in different media | properties |
RADIOACTIVITY:
| decay constant | modes of decay |
| half life | - alpha |
| mathematics of decay | - beta +/beta - |
| equilibrium | - electron capture |
| exposure rate constant | internal conversion |
| dose rate near a point source | isometric conversion |
| isotope production | fission |
PRODUCTION OF X-RAYS:
| basic x-ray circuit | spectra |
| factors affecting spectra | anode |
| cathode | filtration |
| rectification | quality |
| transformers | HVL |
| Characteristic and Bremsstralung X-rays | angular distribution vs. energy |
INTERACTION OF PHOTONS WITH MATTER:
| attenuation | Compton scatter |
| absorption | pair production |
| attenuation coefficients | relative importance of different |
| photoelectric absorption | interactions at different energies and in different media |
| coherent scatter |
INTERACTION OF CHARGED PARTICLES WITH MATTER:
| collisional | stopping power |
| radiative | LET |
| range | Bragg peak |
NEUTRON INTERACTION:
| elastic | inelastic |
REFERENCES
Attix, F.H. "Introduction to Radiological Physics and Radiation Dosimetry", John Wiley & Sons, 1986.
Bushberg J.T., et al. "The Essential Physics of Medical Imaging," 2nd Ed. Lippencott Williams & Wilkins, 2002.
Dendy PP & Heaton B. "Physics for Diagnostic Radiology", 2nd Edition. Insitute of Physics, 1999.
Johns, H.E. and Cunningham, J.R. "The Physics of Radiology," 4th Ed., Thomas, Springfield, 1983.
Knoll G.F. "Radiation Detection and Measurement," 3rd Edition. John Wiley & Sons, 2000.
Podgorsak, E.B. "Radiation Physics for Medical Physicists", Springer, 2006.
Turner, J.E. "Atoms, Radiation and Radiation Protection", 2nd Edition. John Wiley & Sons, 1995.
Tsoulfanaids N. "Measurement and Detection of Radiation", 2nd Edition,
Taylor & Francis, 1995.
RADIATION DETECTION AND MEASUREMENT
DOSIMETRY FUNDAMENTALS:
| exposure | absorbed dose |
| radiation detection (photons, neutrons) | Kerma |
IONIZATION CHAMBERS:
| general principles and composition | ion collection efficiency |
| recombination | survey meters |
| pancake chambers | thimble chambers |
| well chambers |
DOSE MEASUREMENTS:
| general Bragg-Gray Theory and Principles | stopping power ratio principles |
DOSIMETERS:
| photographic | TLD |
| basic principles of chemical (FeSO4) dosimeters | semiconductors |
| calorimetry |
DETECTORS:
| Geiger-Mueller | scintillation |
| proportional | PM tubes |
INTERNAL DOSIMETRY:
| gamma and beta radiations | effective half life |
| beta particles | mean life |
REFERENCES
Attix, F.H. "Introduction to Radiological Physics and Radiation Dosimetry", John Wiley & Sons, 1986.
Johns, H.E. and Cunningham, J.R. "The Physics of Radiology," 4th Ed., Thomas, Springfield, 1983.
Knoll G.F. "Radiation Detection and Measurement," 3rd Edition. John Wiley & Sons, 2000.
Podgorsak, E.B. "Radiation Physics for Medical Physicists", Springer, 2006.
Tsoulfanaids N. "Measurement and Detection of Radiation", 2nd Edition, Taylor & Francis, 1995.
Turner, J.E. "Atoms, Radiation and Radiation Protection", 2nd Edition. John Wiley & Sons, 1995.
BIOLOGY AND RADIATION BIOLOGY
THE CELL:
| basic structure | function |
CELL PROLIFERATION:
| phases of cell cycle | cell cycle time |
| enzymes | sensitivity |
CHROMOSOMES:
| DNA and replication | chromosome aberrations |
BASIC GENETICS:
| genes | genetic mutations |
RADIATION CHEMISTRY:
| direct/indirect actions | protectors and sensitizers |
CELL SURVIVAL CURVES:
| basic target and L-Q theories |
DOSE RESPONSE:
| statistical nature of dose-response curves | sublethal damage and repair |
ACUTE RADIATION SYNDROME:
| hematopoietic | LD50 |
| gastrointestinal | latent period |
| CNS syndrome |
RADIATION CARCINOGENESIS:
| human data | relative and absolute risk models |
| latent period | BEIR reports |
RADIATION CATARACTOGENESIS:
| ocular lens | dose response |
| cataracts | threshold |
RADIATION EMBRYOLOGY:
| human and animal data | effect of age |
| occupational exposure | patients |
RISK VERSUS BENEFITS:
| typical doses | relative risks |
| sources of human exposure |
REFERENCES
Bushberg J.T., et al. "The Essential Physics of Medical Imaging," 2nd Ed. Lippencott Williams & Wilkins, 2002.
Hall, E.J. "Radiobiology For the Radiobiologist," 6th Edition, Lippincott Williams & Wilkins, 2005.
Johns, H.E. and Cunningham, J.R. "The Physics of Radiology," 4th Ed., Thomas, Springfield, 1983.
Steel G.G. "Basic Clinical Radiobiology", Arnold (Hodder Headline Group), 2002.
Turner, J.E. "Atoms, Radiation and Radiation Protection", 2nd Edition. John Wiley & Sons, 1995.
RADIATION PROTECTION
UNITS:
| dose equivalent | Sievert |
| quality factor |
SOURCES OF HUMAN EXPOSURE:
| medical and other sources | natural |
REGULATORY AGENCIES:
| federal | state |
| local |
DOSE EQUIVALENT LIMITS:
| protection (ALARA) | maximum possible dose (MPD) |
| philosophy of radiation | radiation protection guides |
| stochastic and non-stochastic considerations | occupational and non-occupational exposures |
RADIOACTIVE SOURCES:
| radionuclides | storage |
| transportation | wipe testing |
SURVEYS:
| basic methodology and instrumentation |
PERSONNEL MONITORING:
| films | TLD |
| pocket dosimeters | filters |
EXTERNAL RADIATION PROTECTION:
| time | distance |
| shielding | WUT |
| basic protection design |
INTERNAL RADIATION PROTECTION:
| internal radiation hazards | contamination |
| assessment of hazards | waste management |
| principles of control |
HAZARDS OF NON-IONIZING RADIATION:
| lasers | microwaves |
| ultrasound | magnetic resonance power and energy |
| biological effects |
REFERENCES
Blater S. "Interventional Fluoroscopy: Physics, Technology & Safety", Wiley-Liss, 2001.
Bushong, S.C. "Radiologic Science For Technologists," 3rd Ed., Mosby, ST. Louis, 1984.
Cember H. "Introduction to Health Physics", 3rd Edition. McGraw-Hill, 1996.
Dendy PP & Heaton B. "Physics for Diagnostic Radiology", 2nd Edition. Insitute of Physics, 1999.
Johns, H.E. and Cunningham, J.R. "The Physics of Radiology," 4th Ed., Thomas, Springfield, 1983.
Khan, F.M. "The Physics of Radiation Therapy," 3rd Edition. Lippincott Williams and Wilkins, 2003.
NCRP Report No. 119, " A Practical Guide to the Determination of Human Exposure to Radiofrequency Fields" (1993).
NCRP Report No. 122, "Use of Personal Monitors to Estimate Effective Dose Equivalent and Effective Dose to Workers For External Exposure to Low-LET Radiation" (1995)
NCRP Report No. 124, "Sources and Magnitude of Occupational and Public Exposures from Nuclear Medicine Procedures" (1996)
NCRP Report No. 125, "Deposition, Retention and Dosimetry of Inhaled Radioactive Substances" (1997)
NCRP Report No. 126, "Uncertainties in Fatal Cancer Risk Estimates Used in Radiation Protection" (1997)
NCRP Report No. 128, "Radionuclide Exposure of the Embryo/Fetus" (1998)
NCRP Report No. 133, "Radiation Protection for Procedures Performed Outside the Radiology Department" (2000)
NCRP Report No. 134, "Operational Radiation Safety Training" (2000)
NCRP Report No. 136, "Evaluation of the Linear-Nonthreshold Dose-Response Model for Ionizing Radiation" (2001)
NCRP Report No. 140, "Exposure Criteria for Medical Diagnostic Ultrasound" (2002)
NCRP Report No. 144, "Radiation Protection for Particle Accelerator Facilities" (2003)
NCRP Report No. 145, "Radiation Protection in Dentistry" (2003)
NCRP Report No. 147, "Structural Shielding Design for Medical X-Ray Imaging Facilities" (2004)
NCRP Report No. 149, "A Guide to Mammography and Other Breast Imaging Procedures" (2004)
NCRP Report No.151, " Structural Shielding Design and Evaluation for Megavoltage X- and Gamma-Ray Radiotherapy Facilities" (2005).
Tsoulfanaids N. "Measurement and Detection of Radiation", 2nd Edition, Taylor & Francis, 1995.
Turner, J.E. "Atoms, Radiation and Radiation Protection", 2nd Edition.
John Wiley & Sons, 1995.
STATISTICS
SAMPLES, OBSERVATIONS:
| sample surveys | random sampling |
FREQUENCY DISTRIBUTIONS:
| histograms | cumulative frequency |
| distributions | probability distributions |
MEANS AND STANDARD DEVIATIONS:
| arithmetic and population means | degrees of freedom |
| sandard deviations | mean values |
| variance | modal values |
| coefficient of variation |
NORMAL (OR GAUSSIAN) DISTRIBUTIONS:
| standard errors | sample sizes |
| confidence limits |
TEST OF HYPOTHESIS:
| null hypothesis | confidence intervals |
| statistical significance | chi-square test |
BINOMIAL AND POISSON DISTRIBUTIONS:
| relationship to normal distributions | propagation of errors |
| applications |
REGRESSIONS:
| linear regression | correlation coefficient |
| least squares estimate |
REFERENCES
Glantz, S.A. "Primer of Biostatistics", McGraw-Hill, 6th Ed., 2002.
Evans, R.D. "The Atomic Nucleus", Reprint Edition, Krieger, Malabar, Florida, pp 746-818, 1985.
Mould, R.F. "Introductory Medical Statistics", IOPP, Bristol, 1989.
Tsoulfanaids N. "Measurement and Detection of Radiation", 2nd Edition, Taylor & Francis, 1995.
IMAGING AND OTHER DIAGNOSTIC STUDIES
THE PHOTOGRAPHIC PROCESS:
| latent image production | film processing and chemistry |
| electrostatic imaging -Xerography | photographic emulsions and chemistry |
SENSITOMETRY:
· Characteristic curves
| density | reciprocity failure |
| contrast | fog |
| latitude | reversal |
| gamma | solarization |
| energy dependence | effect of processing |
| speed conditions |
· Resolution and Contrast
| modulation transfer function | line spread function |
| film contrast | line pairs |
| basic principles of MTF & LSF |
· Screens
| phosphors | resolution |
| modification of H & D curves | effect on image quality and dose |
| mottle |
· Noise
| signal to noise ratio | model structured and statistical grids |
| scatter |
FLUOROSCOPY:
| basic principles of digital systems | basic principles of luminescence |
· Image Intensification
| design | brightness |
| flux gain and minification | dose |
RADIOGRAPHY:
| general equipment and imaging considerations |
· Basic principles of
| angiography | CT |
| tomography | mammography |
IMAGE FORMATION:
| subject contrast as related to density, atomic number, and energy spectrum |
PHYSICS OF NUCLEAR MEDICINE:
· Basic concepts
| applications | uptake |
| scanning | cameras |
| emission tomography | basic performance checks |
| instrumentation and radio nuclides | hazards |
PHYSICS OF MAGNETIC RESONANCE IMAGING (AND SPECTROSCOPY):
· Basic concepts
| NMR | instrumentation |
| relaxation times | application |
| hazards | chemical shifts |
PHYSICS OF CLINICAL ULTRASOUND:
· Basic principles
| propagation of sound | generation and detection |
| interactions in tissues | modes of operation |
| hazards | Doppler techniques |
REFERENCES
American College of Radiology, "Mammography Quality Control Manual," ACR, 1999.
Blater S. "Interventional Fluoroscopy: Physics, Technology & Safety", Wiley-Liss, 2001.
Bushberg J.T., et al. "The Essential Physics of Medical Imaging," 2nd Ed. Lippencott Williams & Wilkins, 2002.
Curry, T.S.et al. "Christensen's Introduction to the Physics of Diagnostic Radiology", 4th Ed., Lea & Febiger, 1990.
Dendy PP & Heaton B. "Physics for Diagnostic Radiology", 2nd Edition. Insitute of Physics, 1999.
Johns, H.E. and Cunningham, J.R. "The Physics of Radiology," 4th Ed., Thomas, Springfield, 1983.
Papp J. "Quality Management in the Imaging Sciences," 3rd Edition. Mosby/Elsevier, 2006.
Waggener, R.G., Kereiakes, J.G., and Shalek, R.J. "Handbook of Medical Physics, Volume II", CRC Press, Boca Raton, 1984.
PRINCIPLES OF THERAPY
PHOTONS:
| phantoms | depth dose distribution |
| percent depth dose | parameters affecting depth dose |
| scatter | isodose curves |
PARTICLES:
· Electrons
| depth dose and isodose distributions |
· Heavy Particles
| protons | neutrons |
| pions | stripped nuclei |
| Bragg peaks |
BRACHYTHERAPY:
| activity | radioactive sources |
| exposure rate constant | sealed sources |
| dose calculation principles |
HYPERTHERMIA:
| basic principles of application and monitoring |
REFERENCES
Bentel G.C. "Radiation Therapy Planning", 2nd Edition, 1996.
Johns, H.E. and Cunningham, J.R. "The Physics of Radiology," 4th Ed., Thomas, Springfield, 1983.
Khan, F.M. "The Physics of Radiation Therapy," 3rd Edition. Lippincott Williams and Wilkins, 2003.
Kerieakes, J.F., Elson, H.R., and Born, C.G. "Radiation Oncology Physics - 1986", AAPM Monograph No. 15, AIP, New York, 1987.
MEDICAL ELECTRONICS
BASIC PRINCIPLES OF DC CIRCUITS:
| potential difference | batteries |
| current | power |
| Ohm's Law | series and parallel circuits |
| resistance | Kirchoff's Laws |
| voltage dividers |
BASIC PRINCIPLES OF AC CIRCUITS:
| sinusoidal waveforms | inductive reactance |
| capacitors | RL circuits |
| capacitance | transformers |
| RC circuits | impedance matching |
| capcitative reactance | resonant circuits |
| rise and fall times | complex wave forms |
| Fourier analysis | inductors and inductance |
MEASURING INSTRUMENTS:
| moving-coil meters | Wheatstone bridge |
| moving iron meters | AC bridges |
| dynamometers | potentiometers |
| AC and DC measurements | capacitance and inductance meters |
| RMS values | practical applications |
| digital voltmeters and multimeters | analog multimeters |
| electrometers |
OSCILLOSCOPES:
| triggering | basic principles and components |
| storage and sampling scopes | dual beam/ dual trace scopes |
DIODES:
| p-n junction | Zener diodes |
| RC filters | vaccuum and semiconductor diodes |
| half-wave and full-wave rectification | voltage doubler rectification |
TRANSISTORS:
| bipolar junction | field-effect transistor (FET) |
| applications |
AMPLIFIER CIRCUITS:
| types and applications | basic principles and properties |
OP-AMPS
| properties | inout and output impedance |
| gain | applications |
DIGITAL BASICS:
| basic principles | Boolean algebra |
| logic gates | flip flops |
| gate construction | numbering systems |
| positive/negative logic | digital displays |
DIGITAL CIRCUITRY:
| counters and registers | D/A and A/D conversions |
| voltage to frequency conversions |
NOISE:
| origins | reduction techniques |
GROUNDING AND SHIELDING:
| principles and methods | coax cables |
| RF shielding | isolation |
| guard shields | ground loops |
REFERENCES
Carr J.J., "Introduction to Biomedical Equipment Technology," 4th Edition, Prentice-Hall Career & Technology, 2000.
Khandpur R.S., "Biomedical Instrumentation: Technology and Applications", McGraw-Hill, 2005.
Tsoulfanaids N. "Measurement and Detection of Radiation", 2nd Edition, Taylor & Francis, 1995.
Webster J.G. , "Medical Instrumentation: Application and Design",
John Wiley & Sons, 1998.
MEDICAL APPLICATIONS OF LASERS
BASIC THEORIES:
| stimulated emission | metastable atomic states |
TYPES:
| Nd-YAG | He-Ne alignment device |
| argon | ruby |
| krypton | CO2 |
USES:
| retinal detachment | surgery |
| endobronchial stenosis | dermatology |
| photocoagulation | laser angioplasty |
SAFTEY:
| types of injuries | standards |
| protection |
REFERENCES
Niemz M.H., "Laser-Tissue Interactions: Fundamentals and Applications ", Springer-Verlag, 2004.
Vij D.R. & Mahesh K. "Medical Applications of Lasers ", Kluwer Academic Publishers, 2002.
Webster J.G. , "Medical Instrumentation: Application and Design",
John Wiley & Sons, 1998.
ANATOMY, PHYSIOLOGY, AND MEDICAL SCIENCE
ORGANIZATION OF THE HUMAN BODY:
| anatomical nomenclature | body plans |
| anatomical position | body cavities |
| regional names | their subdivisions and contents |
| directional terms |
· Levels of Structural Organization:
| chemical | tissue |
| system | cellular |
| organ |
PRINCIPLE SYSTEMS OF THE HUMAN BODY:
| structure | function |
| principle methods of diagnosis and therapy | medical terminology |
| pathology |
· Skeletal, Muscular, and Integumentary Systems:
| skeletal tissue | muscle tissue |
| axial and appendicular skeletons | muscular systems |
| articulations | skin and its derivatives |
· Nervous System:
| nervous tissue | brain and its principle parts |
| the nerve impulse | sensory and motor systems |
| spinal cord and nerves | autonomic nervous systems |
· Special Senses:
| structure of the outer, middle, and inner ear |
| physiology of hearing , equilibrium |
| structure of eyeball; visual physiology |
· Endocrine System:
| endocrine glands; identity, location, function |
| other endocrine tissues |
| mechanism of hormonal action |
· Cardiovascular System:
| physical characteristics | hemostasis |
| functions | interstitial fluid and lymph |
| components |
· Vessels:
| arteries | venous |
| cappillary | lymph |
| pericardium | valves |
| wall | conduction systems |
| cardiac cycles | chambers |
| vessels | cardiac output |
| lymphatic vessels | lymphatic tissue |
| immunity | non-specific resistance to disease |
| reticuloendothelial system |
· Respiratory System:
| nose | pharynx |
| larynx | trachea |
| bronchea | lungs |
| pulmonary ventilation air volumes and capacities |
| gas exchange and transport |
· Digestive System and Metabolism:
| Characteristics of alimentary canal: wall structure, tube movements, enervation |
| tongue | teeth |
| salivary glands |
| structure | deglutition |
| parts | gastric secrections and absorptions |
| mixing and emptying actions |
| pancreas | liver |
| gall bladder | small and large intestines |
| anabolism and catabolism | enzymes |
| carbohydrates | lipids and protiens |
| body heat and temperature regulations |
· Urinary System; Water, Electrolyte, Acid/Base Balance:
| external and internal anatomy | blood and nerve supply |
| nephrons | urine formation |
| ureters | urethra |
| bladder |
| compartments | compositions |
| balance | movements |
| electrolyte and acid/base balance |
· Reproductive System; Development and Inheritance:
| anatomy and physiology | spermatogenesis |
| anatomy and physiology | menstrual and ovarian cycles |
| structure | function of mammary glands |
| pathology |
| fertilization and implantation | embryonic development |
| fetal growth and birth |
| chromosomes | dominant and recessive genes |
| meiosis |
ANATOMICAL PRESENTATION BY IMAGING SYSTEMS:
| conventional radiographic anatomy | transverse and topographic anatomy |
· physical and chemical features affecting appearance in images produced by:
| X-rays | radiopharmaceuticals |
| magnetic resonance | ultrasound |
REFERENCES
Belanger A.C. , "Vascular Anatomy and Physiology: An Introductory Text", Davies Publishing, 1990.
Butler P., Mitchell A.W.M., Ellis H. "Applied Radiological Anatomy", Cambridge University Press, 1999.
Elllis H., "Clinical Anatomy: A Revision and Applied Anatomy for Clinical Students", Blackwell Publishers, 2002.
Marieb E.N., Hoehn K. "Human Anatomy & Physiology", 7th Edition, Benjamin Cummings, 2006.
Rice J., "Medical Terminology with Human Anatomy", 5th Edition, Prentice Hall, 2004.
COMPUTERS
FUNDAMENTAL CONCEPTS
| analog | digital |
| hardware | computer |
| peripheral devices | micro, mini, mainframe computers |
HARDWARE
| CPU | speed |
| capacity | bus |
· Memory
| bits, bytes | RAM |
| ROM |
· Storage Devices
| floppy disks | hard disks |
| optical disks |
· Input Devices
| keyboards | digital pad |
| joystick | light pen |
| trackball | voice control |
| mouse | touch screen |
· Printers
| laser | thermal |
| ink jet | color |
SOFTWARE
| operating systems | single user |
| time sharing | batch processing |
| programming basics |
· Languages
| Assembly | C |
| COBOL | FORTRAN |
| BASIC | Pascal |
APPLICATIONS
| nuclear medicine | ultrasound |
| diagnostic radiology | therapy |
| CT | MRI |
| PAC's | health physics |
REFERENCES
Blater S. "Interventional Fluoroscopy: Physics, Technology & Safety", Wiley-Liss, 2001.
Bushberg J.T., et al. "The Essential Physics of Medical Imaging," 2nd Ed. Lippencott Williams & Wilkins, 2002.
Joos I., "Introduction to Computers for Healthcare Professionals", 4th Edition, Jones and Bartlett Publishers, Inc., 2005.
Olifer N, Olifer V. "Computer Networks: Principles, Technologies and Protocols for Network Design", John Wiley & Sons, 2006.
Umbaugh S.E., "Computer Imaging: Digital Image Analysis and Processing",
CRC, 2005.
APPENDIX
Sample Questions of Types A, B, K, and S.
TYPE A
The average annual collective dose equivalent in mSv from natural sources (excluding radon) to the population in the USA is about:
A. 0.1
B. 0.5
C. 1.0
D. 2.0
E. 3.0
TYPE B
Match the property (1-4) with the appropriate particle (A-E):
A. Proton
B. Neutron
C. Electron
D. Neutrino
E. Pion
(B) 1. Has the greatest mass
(E) 2. Has rest mass of 140 MeV
(B) 3. Has no charge and rest mass of 939 MeV
(A) 4. Electron capture reduces the number of these in the nucleus
TYPE K
Within hours of receiving a nearly lethal whole body dose of radiation an individual is likely to experience acute radiation syndrome symptoms which include:
1. nausea and diarrhea
2. convulsive seizures
3. severe fatigue
4. loss of hair
A. (1,2,3 only)
B. (1,3 only)
C. (2,4 only)
D. (4 only)
E. (All are correct)
TYPE S
A variable X is determined by making a series of measurements of two independent variables Y and Z with variances 10 and 5 and mean values 100 and 50, respectively.
1. If X=Y+Z, then the variance of X is:
A. 5
B. 7.5
C. 15
D. 75
E. 125
2. If X=Y-Z, then the variance of X is:
A. 5
B. 7.5
C. 15
D. 75
E. 125
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