AMERICAN BOARD OF MEDICAL PHYSICS, INC.

STUDY GUIDE 2007

"Part I - General Medical Physics"

Contents

• Forward
• Radiological Physics
• Radiation Detection and Measurement
• Biology and Radiobiology
• Radiation Protection
• Statistics
• Imaging and Other Diagnostic Studies
• Principles of Therapy
• Medical Electronics
• Medical Applications of Lasers
• Anatomy, Physiology and Medical Science
• Computers
• Sample Questions

back to the American Board of Medical Physics page

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%

Back to "Contents"

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.

Back to "Contents"

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.

Back to "Contents"

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.

Back to "Contents"

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.

Back to "Contents"

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.

Back to "Contents"

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.

Back to "Contents"

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.

Back to "Contents"

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.

Back to "Contents"

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.

Back to "Contents"

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:

• Blood

physical characteristics	hemostasis
functions	interstitial fluid and lymph
components

· Vessels:

arteries	venous
cappillary	lymph

• The Heart

pericardium	valves
wall	conduction systems
cardiac cycles	chambers
vessels	cardiac output

• Lymphatic System

lymphatic vessels	lymphatic tissue
immunity	non-specific resistance to disease
reticuloendothelial system

· Respiratory System:

• Organs

nose	pharynx
larynx	trachea
bronchea	lungs

• Respiration and its Control

pulmonary ventilation air volumes and capacities

gas exchange and transport

· Digestive System and Metabolism:

• Digestive Processes

Characteristics of alimentary canal: wall structure, tube movements, enervation

• Mouth

tongue	teeth
salivary glands

• Pharynx and Esophagus

structure

deglutition

• Stomach

parts	gastric secrections and absorptions
mixing and emptying actions

• Supporting Organs

pancreas	liver
gall bladder	small and large intestines

• Metabolism

anabolism and catabolism	enzymes
carbohydrates	lipids and protiens
body heat and temperature regulations

· Urinary System; Water, Electrolyte, Acid/Base Balance:

• Kidneys

external and internal anatomy	blood and nerve supply
nephrons	urine formation

• Elimination of urine

ureters	urethra
bladder

• Body Fluids

compartments	compositions
balance	movements

• Electrolyte and Acid/Base balance

electrolyte and acid/base balance

· Reproductive System; Development and Inheritance:

• Male Reproductive System

anatomy and physiology

spermatogenesis

• Female Reproductive System

anatomy and physiology

menstrual and ovarian cycles

• The Breast

structure	function of mammary glands
pathology

• Pregnancy

fertilization and implantation	embryonic development
fetal growth and birth

• Human Genetics

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.

Back to "Contents"

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.

Back to "Contents"

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

Back to "Contents"

back to the American Board of Medical Physics page