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Mammography

A diagnostic imaging technique that uses low-dose X-rays to detect and diagnose breast abnormalities, aiding in the early detection of breast cancer.

mammography

breast

screening

imaging

x-ray

radiology

cancer

diagnosis

early detection

mammogram

radiologist

biopsy

dense breasts

tumor

abnormalities

A broken parallel set of calcifications will most likely be located in:

  • Areola
  • Arteries
  • Cystic walls
  • The skin

Indicate the projection described by the following positioning instructions: The tube assembly is vertical (x-ray beam perpendicular to the floor) and the tube is angled 5 degree in a lateral to medial direction. The erect atient faces the image receptor and is slightly rotated medially. The inferior aspect of the breast is on the image receptor. The central is directed to the midpoint of the image receptor (may be slightly lateral to the nipple).

  • Mediolateral oblique (MLO)
  • Oblique Craniocaudal
  • Craniocaudal with medial exaggeration
  • Craniocaudal with lateral exaggeration

The film for the weekly phantom test is taken from

  • Clinical bin
  • QC box
  • Either bin
  • Neither the QC box or the clinical film bin

Output for a FFDM system includes: (choose all correct answers)

  • Soft copy display
  • Soft copy display
  • Laser camera
  • Display monitor
  • Hard copy

The x-ray interaction that provides the contrast for the radiograph is:

  • Photoelectric
  • Compton
  • Pair production
  • Coherent

To improve the appearance of the specimen on film, one can:

  • Magnify the specimen
  • Use kVp settings below 25 (molybdenum)
  • Compress the specimen
  • All of the above

What brightness is recommended by the ACR for mammographic film illuminators?

  • 2000 cd/m2
  • 2500 cd/m2
  • 3000 cd/m2
  • 3500 cd/m2

Which view would be most useful in determining whether calcification are within the skin rather than within the breast parenchyma?

  • Rolled (RL or ML)
  • Tangential (TAN)
  • Axillary Tail (AT)
  • Cleavage (CV)

Stereotactic guided core needle biopsy:

  • Is less expensive than wire localization and open surgical biopsy
  • Is faster than wire localization and open surgical biopsy
  • Leaves a smaller scar than open surgical biopsy
  • All of the above

Image

  • Retromammary space/fat
  • Pectoralis Major Muscle
  • Rib
  • Lactiferous duct
  • Inframammary fold/crease

Which view would best demonstrate the deep medial aspect of the beast?

  • Axillary tail
  • Cleavage ((CV)
  • Medial lateral
  • Rolled

Repeat rate will decrease with FFDM mainly because of:

  • Digitization
  • Wide exposure latitude
  • Lower dose
  • High frequency generator

A predisposition to breast cancer is inherited in ____.

  • Men only
  • Women only
  • Both men and women
  • Neither men nor women

To increase exposure slightly when the AEC’s tracking ability is sub-optimum:

  • The backup time should be increased
  • The sensing chamber should be moved to its most anterior position
  • The minimum reaction time should be decreased
  • The density control should be increased

Which of the following determines the level of radiographic contrast displayed on mammograms?

  • Quantity of fibrous tissue compared with glandular and adipose
  • Quantity of adipose tissue compared with fibrous and glandular
  • Quantity of glandular tissue compared with adipose and fibrous
  • Type of breast tissue has no influence on contrast

The spread of malignant cancer cells from the primary tumor to distant an area of the body is termed:

  • Idiopathy
  • Carcinogenesis
  • malignancy
  • Metastasis

Thepatient’s ____ is likely to obstruct the X-ray beam when the obese patient ispositioned for theCaudo-Cranial(FB) view.

  • Abdomen
  • Shoulder
  • Head
  • Opposite breast

How does increasing the radiation dose affect the image noise?

  • It increases
  • It decreases
  • It stays the same

The most commonly used magnification factor for mammography is:

  • 1.5 times
  • 3.0 times
  • 2.3 times
  • 2.5 times

Current treatment for localized breast carcinoma with minimal disfiguration includes:

  • Radical mastectomy
  • Modified radical mastectomy
  • Lumpectomy
  • Needle localization

Compared to open surgical biopsy, ultrasound-guided core needle biopsy:

  • Is faster
  • Is less expensive
  • Leaves a smaller scar
  • All of the above

All mammography films, no matter the manufacturer are

  • Most sensitive to green light
  • Most sensitive to blue light
  • Equally sensitive to blue or green light
  • None of the above

If WW = 500 and WL = 500, what image pixel values are displayed?

  • 0-1000
  • 250-750
  • 0-500
  • 500-1000

What is the correct height of the image receptor in relation to the breast for routine CC projection?

  • 2 inches below the inframammary fold (IMF)
  • 2 inches above the IMF
  • At level of IMF with breast at 45 degree angle to chest
  • At level of IMF with breast at 90 degree angle to chest

In mammography facilities in the United States, ACR accreditation is applied for every

  • Year
  • 2 years
  • 3 years
  • 5 years

Removal of unwanted, unexposed silver bromide on film happens in the:

  • Developer cycle
  • Fixer cycle
  • Wash cycle

The storage conditions of processed films should have a relative humidity of

  • 30 – 50%
  • 40 – 60%
  • 50 – 70%
  • 30 – 40%

Which of the following may be achieved with magnification views of the breast?

  • Decreased patient dose
  • Improved visualization of suspicious areas
  • Shorter exposure times
  • Ability to improve contrast by using lower kilovoltage

Fibroadenomas:

  • Are benign
  • Can calcify
  • Can involute
  • All of the above

A mammographic image that appears to be properly penetrated but slightly underexposed should be corrected by altering which variable?

  • MAs
  • KVp
  • FFD

The base of the breast is considered to:

  • Include the nipple
  • Include the IMP
  • Include the axilla
  • Be the area closest to the chest wall

Which of the following positions is/are most helpful in demonstrating tissue in the 12:00 or 6:00 position?

  • Cleavage (CV)
  • Exaggerated CC lateral
  • ML 90 degree or LM 90 degree
  • Axillary Tail

Which projection would best demonstrate fluid levels in the erect patient?

  • Mediolateral oblique (MLO)
  • Medial lateral (ML)
  • Craniocaudal (CC)
  • Tangential (TAN)

Mammography films show breast calcifications better than chest x-rays because of:

  • More photoelectric effect
  • Smaller focal spot
  • Single rather than double emulsion film
  • All of the above

Compared with routine mammographic imaging, what effect will magnification studies have on patient dose?

  • Increased dose
  • Decreased dose
  • No effect

When performing BSE, which of the following should be done?

  • Gently survey the breast using a light touch
  • Apply firm pressure to breast using the pads of the fingers
  • Apply firm pressure using the dorsal aspect of the fingers
  • Use pressing motion with the heel of the hand

For the mediolateral oblique (MLO) projection, the technologist should place the image receptor:

  • Perpendicular to the breast
  • Perpendicular to the pectoral muscle
  • Parallel to the breast
  • Parallel to the pectoral muscle

Choose the correct equation:

  • Pixel size = FOV / matrix size
  • Pixel size = FOV x matrix size
  • Pixel size = matrix size / FOV
  • Pixel size = FOV + matrix size

50% of all breast cancers occur in which quadrant?

  • LIQ
  • LOQ
  • UOQ
  • UIQ

The projection that best demonstrates the posterior portion of the breast, including the axillary tail, is the:

  • Craniocaudal (CC)
  • Craniocaudal (CC) with lateral exaggeration (XCCL)
  • Mediolateral oblique (MLO)
  • Lateral medial (LM)

Any electrical charge remaining in the detector after image data readout is referred to as:

  • Image noise
  • Charge saturation
  • Post-processing
  • Ghost image

in the correct order with largest number of pixels to the smallest:

  • Acquisition workstation monitor, laser film, diagnostic workstation monitor
  • Acquisition workstation monitor, diagnostic workstation monitor, laser film
  • Laser film, diagnostic workstation monitor, acquisition workstation monitor
  • Diagnostic workstation monitor, laser film, acquisition workstation monitor

During pre-operative needle localizations, the amount of compression used should be equal to that of the routine mammogram.

  • True
  • False

Forthe Cranio-caudal projection, the mammographer should stand on ____.

  • The medial side of the breast being examined
  • The lateral side of the breast being examined
  • Either side of the breast being examined
  • The patient’s right side

The ACS does not recommend routine mammograms for women below the age of:

  • 40
  • 35
  • 30
  • 25

Processor roller marks that show up as artifacts running perpendicular to the direction of film travel are called

  • Guide shoe marks
  • Chatter
  • Wet pressure
  • Delay streaks

A smaller anode angle results in a _____ field size and is used with the _____ focal spot.

  • Larger, small
  • Medium, small
  • Smaller, small
  • Smaller, large

Reciprocity failure occurs when:

  • Very long or very short exposure times are used
  • D-max is exceeded
  • Developer becomes depleted
  • Film is used beyond the expiration date

Which of the following should influence the length of the time between screening examinations on asymptomatic patients?1. If the patient performs BSE 2. If the patient drinks coffee3. Age of the patient 4. Positive family history

  • 1 & 2
  • 1 & 3
  • 2 & 3
  • 3 & 4

The purpose of adding starter to fresh chemicals is:

  • To increase the temperature of the developer
  • To season the developer
  • Minimize developer artifacts

Ideally, when is the best time to perform processor sensitometry?

  • At the start of the work period (shift) before patient examinations have begun
  • About 2 hours after examinations have begun, which allows processor warm-up
  • At mid-shift, when technologists have a break
  • At the end of the work period (shift)

Which anatomical structures typically develop in the male breast?

  • Ductal structures
  • Complex lobular structures
  • Terminal ductal lobular units
  • Lobular units and acini

Which TWO materials are used as anode target materials in mammography?1. Aluminum 2. Rhodium 3. Beryllium 4. Molybdenum

  • 1 and 3
  • 2 and 4
  • 1 and 4
  • 2 and 3

Radiation dose with a screen is about ___ times the dose of direct film mammography.

  • 1/10
  • 1/100
  • 10
  • 100

Proper compression of the breast is indicated by which of the following?

  • The breast will feel soft
  • The breast will feel taut
  • The breast will have both tight and soft areas
  • The patient will experience extreme discomfort

How many years do mammography films need to be kept for if the woman is a returning patient?

  • 2 years
  • 5 years
  • 10 years
  • Indefinitely

Abasic rule in male breast radiography is ____.

  • Nipple markers should always be used
  • The position of the nipple is not important
  • As long as maximum breast tissue is included, the position of the nipple is not a concern
  • The nipple should always be projected in profile

The crossover procedure is:

  • Done to establish new operating levels for a new box of film
  • Performed over 2 days
  • Performed over 5 days
  • Performed after a P.M. with fresh chemicals

Male breast carcinoma accounts for approximately what portion of all breast carcinomas?

  • 25%
  • 10%
  • 5%
  • Less than 2%

The typical placement of the intensifying screen, when a single screen is employed, is with the:

  • Back screen facing the x-ray source
  • Front screen facing the x-ray source
  • Front screen facing away from the x-ray source

Ductal carcinoma can present with findings of:

  • Masses
  • Speculated lesions
  • Microcalcifications
  • All of the above

In order to perform successful magnification mammography, what criteria must be met?

  • Decreased FFD
  • Increased FFD
  • Small focal spot
  • Large focal spot

The maximum MQSA-allowed radiation dose per exposure for a 4.2 cm average breast is:

  • 165 mrad
  • 5000 mrad
  • 300 rad
  • 300 mrad

"Camel's nose" refers to a mammogram which:

  • Is too light
  • Has a skin fold in the axilla on the MLO view
  • Is too dark
  • Shows sagging of the breast on the MLO view

What is the condition of the detector if the radiation exposure is too high:

  • Charge saturation
  • Wide latitude
  • High dark current
  • Super-charged

Plus density artifact bands running parallel to the direction of film travel are caused by:

  • The build-up of developer on the processor rollers
  • Improper cleaning of the crossover rack assembly
  • Uneven roller pressure in the developer tank
  • All of the above

Which combination of procedures is most effective for early detection of breast cancer?1. breast self-examination 2. physical examination 3. mammography

  • 1 and 2
  • 2 and 3
  • 1 and 3
  • 1, 2, and 3

Typically, the breast is situated on the thorax between the levels of the:

  • 1st and 4th ribs
  • 2nd and 6th ribs
  • 1st and 6th thoracic vertebrae
  • 2nd and 10th thoracic vertebrae

For magnification mammography, what is the maximum size the focal spot should be?

  • 1.2 mm
  • 0.6 mm
  • 0.2 mm
  • 0.1 mm

Characteristics of calcifications associated with benign growths include which of the following?1. Smooth borders 2. Presence in clusters 3. Round shape 4. Numerous microcalcifications

  • 1, 2, & 4
  • 1, 3, & 4
  • 1 & 3
  • 2 & 4

What is the typical SID for mammographic imaging?

  • 60-65 cm
  • 45-50 cm
  • 27-57 cm
  • 70-100 cm

How frequently should breast self-examination be performed?

  • Weekly
  • Monthly
  • Bimonthly
  • Quarterly

The physical boundaries of the breast include superior to the clavicle, medial to the sternum, inferior to the inframammary crease, and lateral to the midaxillary line.

  • True
  • False

How should the patient’s arm on the side being examined be positioned for the CC projection?

  • Down and slightly pulled back
  • Abducted 90 degree to body
  • Raised directly overhead
  • Shoulder height and reaching forward for handlebar

The area of the breast that is not visualized on the CC view is:

  • Posterior - inferior
  • Posterior - superior
  • Anterior - inferior
  • Anterior - superior

Which of the following would be the greatest risk factor for breast cancer?

  • Obesity
  • Numerous full-term pregnancies
  • Advanced age
  • Late menopause

The primary purpose for using grids in mammography is to:

  • Increase record detail (sharpness)
  • Increase contrast
  • Decrease dose
  • Decrease production of scatter

MQSA stands for:

  • Medical Quality Site Accreditation
  • Mammography Quantity Select Aid
  • Medical Query System Association
  • Mammography Quality Standards Act

The main advantage of half-field geometry is:

  • Lower dose
  • Increased contrast
  • Better compression
  • Improved positioning

Which additional position/s should be performed to determine milk of calcium?1. Tangential 2. Roll (RL or RM) 3. ML 90 or LM 90

  • 1 only
  • 2 only
  • 3 only
  • 1, 2, & 3

Which of the following primary signs of breast cancer, evident on a mammographic image, would indicate the disease at the earliest possible time?

  • Dense mass with spiculations
  • Numerous clustered microcalcifications
  • Skin retraction
  • Enlargement of focal veins

What quadrant is 5:00 in the right breast

  • UOQ
  • UIQ
  • LOQ
  • LIQ

A man's likelihood of developing breast cancer is increased by ____.(1) Klinefelter syndrome (2) childhood radiation of the chest(3) family history of breast cancer

  • 1 & 2
  • 1 & 3
  • 2 & 3
  • 1, 2 & 3

Which of the following breast conditions is considered malignant:

  • Dermal calcifications
  • Accessory nipple
  • Fibroadenoma
  • None of the above

Stereotactic imaging implies the use of:

  • A digital monitor
  • Optical storage media
  • Core needle biopsy
  • Two angled images

Use of a grid _____ contrast and ______ radiation dose.

  • Decreases, decreases
  • Increases, decreases
  • Decreases, increases
  • Increases, increases

check viewboxes and viewing conditions

  • Daily
  • Weekly
  • quarterly
  • Semi-annually

On which projection would the technologist check the medial and lateral aspects of the breast for the proper amount of compression?

  • CC
  • ML
  • MLO
  • Axillary

Which of the following positions are recommended for a complete study of the augmented breast?1. Routine CC & MLO 2. Modified CC & MLO (push back, Eklund) 3. 30 degree oblique

  • 1 & 2 only
  • 1 & 3 only
  • 2 & 3 only
  • 1, 2, & 3

Correct placement of the breast onto the image receptor for CC projection requires:

  • The patient to lift and place the breast as instructed by the technologist
  • The image receptor to be below the breast and then raised with the breast
  • The technologist to gently lift and pull the breast into position on the receptor
  • The image receptor to be lower than the breast to allow the breast lie in its natural position

The control limits on a phantom chart for the density difference (DD) are which of the following

  • +/- .05
  • +/- .10
  • +/- .15
  • +/- .20

Extended processing involves:

  • Increased developer temperature
  • Increased fixer temperature
  • Shorter development time
  • Warmer wash water

Which of the following minimum requirements applies to the Phantom test in order to pass the evaluation

  • Visualization of 4 fibers, 4 speck groups, 4 masses
  • Visualization of 5 fibers 3 speck groups and 3 masses
  • Visualization of 4 fibers 3 speck groups and 2 masses
  • Visualization of 4 fibers, 3 speck groups and 3 masses

Which of the following is the most serious citation a facility can obtain upon an FDA annual inspection

  • Level 1
  • Level 2
  • Level 3
  • Level 4

The digital detector can also function as the AEC.

  • True
  • False

Which of the following would be considered major risk factors for breast cancer?1. Family history (mother, sister) of breast disease2. First of three pregnancies at age 223. Previous treatment for breast disease

  • 1 & 2
  • 2 & 3
  • 1 & 3
  • 1, 2 & 3

The Mid-density (MD) on the processor quality control chart is chosen by the step closest in density to

  • .45
  • 1.20
  • 1.50
  • 2.20

A simple cyst will show on ultrasound:

  • Smooth walls
  • Good acoustic enhancement
  • No internal echoes (anechoic)
  • All of the above

DCIS is an acronym for:

  • Direct collimation in system
  • Digital core in stereotactic
  • Ductal carcinoma in situ
  • None of the above

What material is used in the x-ray tube's window allow photons to pass through?

  • Aluminum
  • Rhodium
  • Beryllium
  • Molybdenum

What should be done first if the nipple is rotated up or down instead of in profile?

  • Mark on the history sheet could not get nipple
  • Discontinue the attempt on that view and try again
  • Angle the tube medially
  • Build up the nipple area

The majority of glandular tissue exists in groups known as:

  • Terminal ductal units
  • Lobules
  • Lobes
  • Lactiferous ducts

Artifacts oriented parallel between 2 films after processing that have been run perpendicular and parallel to the direction of film travel are caused by problems in

  • Processor tank
  • Fixer tank
  • Wash tank
  • X-Ray equipment or cassette

Which of the following conditions is most likely to be associated with an abnormal galactogram?

  • A unilateral greenish nipple discharge
  • Retroareolar pain with monthly variation
  • A unilateral dark or bloody nipple discharge
  • A bilateral white or creamy nipple discharge

Low contrast detectability can be improved by ________ the image.

  • Masking
  • Shielding
  • Bending
  • Squinting at

Where should identified markers be placed on the image receptor for the MLO and 90 lateral projection?

  • Mid-film near nipple
  • Inferior aspect of film near abdomen
  • Superior aspect of the film near axilla
  • Wherever they fit

The reason(s) for performing BSE include:

  • To compensate for the inaccuracy in mammograms (up to 20%)
  • To detect cancers which are not, even in retrospect, visible on the mammogram
  • To involve women who do not have mammograms
  • All of the above

A malignant breast lesion can appear on a mammogram:

  • As a spiculated mass
  • As microcalcification clustering
  • As a neodensity
  • All of the above

A Mammotome is:

  • A scalpel
  • A densitometer
  • Prone table
  • Core biopsy needle

The amount of obliquity (rotation of the C-arm) used to perform the mediolateral oblique projection varies from patient to patient. However, the average degree of obliquity is:

  • 25 degree
  • 30 degree
  • 45 degree

BSE should be done in a random pattern using the fingertips.

  • True
  • False

When processor sensitometry falls out of limits, what should be done first?

  • Shut down and restart the processor
  • Increase developer temperature
  • Increase replenishment rates
  • Repeat the sensitometric strip

A common temporary benign enlargement of the male breast is ____.

  • Paget’s disease
  • Infiltrating ductal carcinoma
  • Gynecomastia
  • Fibroadenoma

To reduce the patient's radiation dose during pre-operative needle localizations, which of the following can be done:

  • Increase the kVp setting
  • Use a faster screen/film system
  • Exposes only that area of the breast immediately surrounding the area in question
  • All of the above

The word "orthogonal" is best described as:

  • Two planes
  • At a 45 degree angle
  • At a right angle
  • Multi-sided

Lobular carcinoma accounts for approximately what portion of all breasts carcinomas?

  • 50%
  • 25%
  • 10%
  • Less than 2%

The breast attenuates what percentage of incident x-rays.

  • 0.9
  • 9
  • 59
  • 99

A characteristic associated with gynecomastia is ____.

  • A well-defined tender mass
  • Irregular edges and hardness on palpation
  • An area fixed in place with nipple retraction
  • A painless lump

perform processor QC

  • Daily
  • Weekly
  • quarterly
  • Semi-annually

Aluminum filters are not used in mammography because of:

  • Cost
  • Weight
  • Rarity
  • Lack of k-edge attenuation

Which is NOT an advantage of compression?

  • Decreased tissue thickness
  • Decreases patient motion
  • Increases exposure to breast tissues
  • Spreads tissues

A grid is not required during magnification mammography because of:

  • Decreased patient dose
  • Influence of the air gap
  • Lower kilovoltage used
  • Larger field size used

In order to minimize patient discomfort, how should compression be applied?

  • Compress very quickly
  • Compress a little, then stop to allow patient time to adjust
  • Compress slowly and steadily
  • Allow the patient to apply compression

The phosphors most commonly used for mammography screens emit light in what color?

  • Yellow
  • Blue
  • Red

If processing artifacts are more severe when the film is run emulsion side up, the artifacts may be caused by:

  • Inner rollers of the developer rack
  • Outer rollers of the developer rack
  • Crossover assembly of the fix to wash tank
  • Turnaround assembly of the fixer tank

What quadrant is 1:00 in the left breast

  • UOQ
  • UIQ
  • LOQ
  • LIQ

All chemical reactions depend on all of the following EXCEPT:

  • Time
  • Temperature
  • Chemical strength
  • Pressure

The core specimens should be radiographed when the biopsied lesion:

  • Has speculations
  • Is solid
  • Is cystic
  • Has calcifications

According to MQSA guidelines, how many continuing education credits are necessary for a mammography technologist to obtain in mammography

  • 15 credits every 3 years
  • 15 credits every year
  • 24 credits every 2 years
  • 5 credits every 2 years

BSE should be performed monthly by all women beginning in their 20's

  • True
  • False

Architectural distortion is most often found in cases of:

  • Fibroadenoma
  • Invasive breast carcinoma
  • Papillomatosis
  • Intramammary lymph node

The incidence of breast cancer in men ____.

  • Increases with age
  • Decreases with age
  • Is not influenced by age
  • Is still undetermined in its relationship to

Mild cases of gynecomastia will be visualized on the mammogram as a small circumscribed density ____.

  • In the upper outer quadrant of the breast
  • Posterior to the nipple in the subareolar area
  • In the tail of the breast
  • In the axilla

The tissue type that attenuates the x-ray beam the least is:

  • Adipose tissue
  • Fibro-glandular tissue
  • Fibrous tissue
  • Fibro-fatty tissue

The “preferred” limits on a Processor Quality Control Chart for MD (mid density) are which of the following:

  • +/- .05 from reference operating level
  • +/- .10 from reference operating level
  • +/- .15 from reference operating level
  • +/- .20 from reference operating level

During a mammographic evaluation the radiographer does not have a responsibility to:

  • Obtain a high quality examination
  • To perform a clinical breast examination
  • Reduce the anxiety level of the patient
  • Coordinate clinical history with the radiologist

About _____% of male breast cancer patients are treated by mastectomy.

  • 60
  • 80
  • 90
  • 95

The actual focal spot is always _______ the projected focal spot.

  • Larger than
  • Smaller than
  • The same size as

In flooded replenishment, the starter is added to:

  • Developer tank
  • Replenishment tank
  • Both

A pneumocystogram starts with aspiration of most or all of the fluid from a cystic lesion. Which of the following is then injected into the lesion just before the pneumocystogram films are done?

  • Betadine and air
  • Saline
  • Air and methylene blue dye
  • Air

Why is the breast specimen radiographed?

  • To provide the technologist with an opportunity to prefect exposure factors
  • To determine if the suspicious area was successfully excised
  • To determine finally the benign or malignant status of the tissue sample
  • To validate the radiologist’s skill in performing needle localization procedures

The advantage of the molybdenum target over the tungsten target for Mammography is its ability to produce:

  • More characteristic photons of approximately 20 keV
  • More characteristic photons of approximately 10 keV
  • More bremsstrahlung photons of approximately 20 keV
  • More bremsstrahlung photons of approximately 10 keV

The developer temperature should be kept within how many degrees of the processor manufacturer’s recommendation?

  • +/- 5 degrees
  • +/- 2 degrees
  • +/- 1 degree
  • +/- 0.5 degrees

Which of the following is the primary reason for breast compression?

  • To void the need for more than one view per breast.
  • To uniformly reduce the thickness of the breast tissue
  • To avoid need for a grid
  • To allow use of a faster screen/film system

What age group is at the greatest risk for radiation-induced breast cancer?

  • Less than 20 years old
  • Between 20 & 35 years old
  • Between 35 & 50 years old
  • After 50 years old

A grid may be used when performing magnification.

  • True
  • False

Which of the following is NOT required on the Medical Report?

  • Name of the lead interpreting physician
  • Name of the technologist who performed the mammogram
  • Additional patient qualifier
  • Name of the facility

Possible causes of poor film screen contact include which of the following?1. Trapped air 2. Warped cassettes 3. Foreign bodies with-in cassettes

  • 1 & 2
  • 2 & 3
  • 1 & 3
  • 1, 2, & 3

Which of the following positions may be required for a complete mammographic study of a patient after a mastectomy?1. MLO of skin of affected breast 2. CC and MLO of uneffective breast3. Axillary view of affected breast 4. Spot view of any area of concern

  • 1 & 2 only
  • 1 & 3 only
  • All of the above

Which link in the mammographic imaging chain is the Phantom Image test monitoring?

  • Processor
  • Mammography equipment
  • Film/screen combination
  • Entire imaging chain

The following are all breast interventional procedures except:

  • Pneumocystography
  • Stereotactic core needle biopsy
  • Myelography
  • Galactography

If microcalcification clustering is present on routine screening views what is the best next step?

  • Biopsy
  • Ultrasound
  • Magnification views
  • One year follow-up

What is (are) the benefit(s) of a high frequency generator in mammography?

  • Accuracy of exposure technique
  • Reduce voltage ripple
  • More compact size
  • All of the above

To decrease image noise you should do what to the radiation dose?

  • Increase
  • Noise does not depend on dose

The size of the effective focal spot to the actual focal spot is related to

  • Anode angle
  • Ripple effect
  • Characteristic cascade
  • Manufacturer

Implant displaced views:

  • Visualize tissue anteriorly and inferiorly to the implant
  • May be difficult to obtain if implant is encapsulated
  • May be phototimed if enough tissue is displaced
  • All of the above

The effective focal spot is always largest on the _____ side of the field.

  • Cathode
  • Anode

When using a phototimer, if a plus density setting is used, which of the following will occur?1. reduction focal spot size2. increase in mA3. increase in exposure time

  • 1 and 2
  • 1, 2 and 3
  • 2 and 3
  • 3 only

What is the approximate increased likelihood of developing breast cancer for the woman with a family history of breast cancer?

  • 5 times
  • 10 times
  • 20 times
  • 50 times

Match the following description with the correct projection: The tube assembly is rotated to a 90 degree position from vertical (x-ray beam is parallel to the floor). The patient is erect and the arm on the side being examined is at the right angle to the body. The edge of the image receptor is along the sternum and central ray is directed perpendicular to the image receptor from lateral to medial.

  • Mediolateral oblique (MLO)
  • Medial lateral (ML)
  • Lateral medial (LM)
  • Reverse oblique (LMO)

Lymph node enlargement, nipple inversion, nipple discharge, skin thickening, and breast lumps are ALWAYS a sign of breast cancer.

  • True
  • False

Where is beam limitation most critical?

  • Nearest to the technologist
  • The edges of the film
  • The chest wall of the patient

The most common type of breast cancer in the male is ____.

  • Ductal carcinoma in situ (DCIS)
  • Lymphoma
  • Infiltrating ductal carcinoma (IDC)
  • Lobular carcinoma in situ (LCIS)

When a combination of single emulsion film and single screen is used, how should the screen and film be aligned?

  • Film emulsion in contact with back of screen
  • Film emulsion in contact with front of screen
  • Non-emulsion side of film in contact with back of screen
  • Non-emulsion side of film in contact with front of screen

For the MLO view, the best angle of the tube is:

  • Standard 50 degree for all patients
  • Standard 60 degree for all patients
  • Standard 70 degree for all patients
  • Determined by the anatomy of each patient

What is the average focal film distance (FFD) available on dedicated Mammography units?

  • 20 to 25 cm
  • 40 to 45 cm
  • 60 to 65 cm
  • 80 to 85 cm

The most important factor influencing prognosis in male breast cancer ____.

  • Histologic features
  • Size of the tumor
  • Status of the axillary lymph nodes
  • Stage of the disease

Analog-to-digital (A to D) conversion occurs _________ image processing.

  • Before
  • After
  • Sometimes before and sometimes after
  • At the same time as

If a facility receives a Level 2 citation upon an annual FDA inspection, how many days does the facility have to correct the problem?

  • 5 days
  • 10 days
  • 15 days
  • 30 days

Currently what are the statistics of how many women will develop breast cancer over their lifetimes

  • 1 in 5
  • 1 in 8
  • 1 in 10
  • 1 in 12

darkroom cleanliness

  • Daily
  • Weekly
  • quarterly
  • Semi-annually

The ____ view is an alternative for the Cranio-caudal view and may be substituted.

  • Caudo-cranial (From Below FB)
  • Rolled
  • Latero-Medial Oblique
  • 90 degree Medio-Lateral

The base of the breast and the inframammary crease are one and the same.

  • True
  • False

Core biopsies of the breast are performed with a ____ gauge needle?

  • 14 gauge
  • 18 gauge
  • 20 gauge
  • 22 gauge

Good breast compression is important because it:

  • Upper and medial
  • Lower and lateral
  • Between sternum and clavicle
  • Axillary and medial

During pregnancy and throughout lactation, the breast has an increased amount of:

  • Adipose
  • Glandular tissue
  • Coopers ligaments
  • Sebaceous glands

Radiation dose for FFDM will always be lower than for screen-film mammography:

  • True
  • False

It is necessary for the technologist to diagram which of the following:

  • Scars
  • Tattoos
  • Moles
  • All of the above

Which of the following are primary signs of breast cancer?1. numerous microcalcifications2. skin thickening and retraction3. dense mass of irregular shape

  • 1 & 2
  • 2 & 3
  • 1 only

Using a 5M-pixel monitor to display 100 micron (0.1 mm) pixels, what is the FOV?

  • 20 cm x 25 cm
  • 20 cm x 20 cm
  • 25 cm x 25 cm
  • 50 cm x 50 cm

The maximum amount of automated compression allowed by the ACR is:

  • 40 lbs
  • 45 lbs
  • 50 lbs
  • 55 lbs

What effect does beam restriction have on the quality of the mammography image?

  • Less background density
  • Better penetration of breast
  • Magnification of small structures
  • Improved contrast

Which of the following should the technologist complete before obtaining the mammogram images?1. Record the exposure factors to be used on the patient’s film file2. Review the patient’s personal history form with the patient3. Review the patient’s previous mammogram images, (if available)

  • 1 & 2
  • 2 & 3
  • 1 & 3
  • 1, 2 & 3

The principle reason for the use of mammography in male patients is to distinguish ____.

  • Gynecomastia from simple cysts
  • Gynecomastia from male breast cancer
  • Pubertal hypertrophy from senescent hypertrophy
  • Gynecomastia from benign breast enlargement

The most common characteristic symptom of a male with breast cancer is ____.

  • Breast tenderness
  • A painless subareolar lump
  • Nipple ulceration
  • Axillary pain

The only task NOT required of the RT is:

  • Validation of the Doctor's requisition with the clinical history given by the patient.
  • Diagramming lumps, scars, large moles on the breast.
  • Diagnosing the patient's condition
  • Choice of technical factors used - determined by patient age, density of breast tissue, equipment characteristics.

The tissue type that attenuates the x-ray beam the most is:

  • Adipose tissue
  • Fibro-glandular tissue
  • Fibrous tissue
  • Fibro-fatty tissue

Correct use of vigorous compression will lower patient dose because of decreased:

  • Focal film distance (FFD)
  • Film distance
  • Patient motion
  • Tissue thickness

The anatomic structures that support the breast are the:

  • Submammary muscles
  • Cruciate ligaments
  • Axillary ligaments
  • Cooper’s ligaments

check compression device

  • Daily
  • Weekly
  • Quarterly
  • Semi-annually

The breasts are separated from the pectoral muscle by a layer of retromammary:

  • Adipose tissue
  • Dense connective tissue
  • Lactiferous tissue
  • Epithelial tissue

Magnification views have __________ exposure times than/as routine mammography.

  • Longer
  • Shorter
  • The same

Which two items are used in mammography to reduce scattered radiation?1. Stationary grid 2. Air gap 3. Moving grid 4. Lead shielding

  • 1 and 4
  • 2 and 3
  • 3 and 4
  • 4 and 2

Spot compression/coned-down views can:

  • Helps separate superimposed tissue
  • Increase contrast by reducing scatter
  • Help identify subtle findings in dense breasts
  • All of the above

What is the typical range of kVp used in mammography?

  • 10-18
  • 22-32
  • 45-55
  • 62-72

A mammography technologist may not count which of the following toward her MQSA performance requirement of 200 mammograms every 2 years

  • Spot compression view
  • Magnification view
  • Additional views
  • Needle localizations

Extended cycle processing vs. Standard cycle processing:

  • Increases speed of the film being processed
  • Increases contrast of the film being processed
  • Is determined by the amount of time spent in the developer tank
  • All of the above

Under MQSA guidelines, which of the following represents the minimum number of mammograms a mammography technologist must perform in a 2 year period?

  • 100
  • 200
  • 300
  • 400

Changing from the moly to the rhodium filter ______ the x-ray beam energy.

  • Decreases
  • Increases
  • Does not change
  • None of the above

Which detector type converts x-ray energy directly into electrical charge?

  • CR
  • Scintillator-photodiode
  • Phosphor screen-CCD
  • Selenium

When a lesion has been entirely removed (resected) as seen on the post core needle biopsy stereotactic images, what must be done before the patient is released from the stereotactic unit?

  • Complete the pathology requisition form
  • Place a microclip
  • Gives the patient post-biopsy instructions
  • Gets a specimen radiograph

Recommended film storage conditions are: ___ relative humidity and ___ degrees F.

  • 30-40, 50-60
  • 35-55, 45-65
  • 30-50, 50-70
  • 25-50, 50-75

If films are requested on a mastectomy patient (one side affected). What views would you take?1. Routine projections - CC and MLO 2. MLO of the skin over the mastectomy site3. Spot view of any area of concern 4. AP view of Axillary

  • 1 & 2
  • 2, 3 & 4
  • 1 & 3
  • None - mammography is no longer required

The automatic exposure control (AEC) may be used for all of the following EXCEPT:

  • Needle localization
  • Specimen radiography
  • A patient with breast implants in-place
  • A male breast with enlarged breast

What quadrant is 2:00 in the right breast

  • UOQ
  • UIQ
  • LOQ
  • LIQ

The overall advantage of using automatic exposure control (phototimer, AEC’s) is the ability to automatically compensate for:

  • Change in screen speed
  • Inconsistent processing methods
  • Poor positioning of the breast
  • Variations in breast thickness

The characteristics of microcalcifications associated with malignancy include which of the following?1. Fine size 2. Clustered appearance3. Round shape 4. Very numerous calcifications

  • 1, 2, & 3
  • 2, 3, & 4
  • 1, 3, & 4
  • 1, 2, & 4

Image processing that smoothes the image will have what effect on image noise and detail?

  • Decrease, decrease
  • Decrease, increase
  • Increase, decrease
  • Increase, increase

Breast cancers arise in which type of tissue?

  • Ducts
  • Lobules
  • Adipose tissue
  • A + B

Breast cancer accounts for ____% of malignancies in men.

  • Less than 1
  • 8
  • 24
  • 73

What percentage of mammographic images of malignant disease present microcalcifications?

  • 100 %
  • 75 %
  • 40 - 60 %
  • 10 %

What is an adequate range of force for a compression device?

  • 50 to 85 pounds
  • 25 to 45 pounds
  • 15 to 30 pounds
  • 05 to 20 pounds

Artifacts oriented perpendicular between 2 films after processing that have been run perpendicular and parallel to the direction of film travel are caused by problems in

  • Processor tank
  • Fixer tank
  • Wash tank
  • X-ray equipment or cassette

The final MQSA regulations went into effect

  • October 1992
  • October 1994
  • April 1994
  • April 1999

An adult male with a suspicious mammogram and a firm unilateral nodule will be advised by his physician to ____.

  • Undergo a biopsy
  • Wait to further observe nodule
  • Switch medications
  • Reduce cholesterol levels

____ is a characteristic most likely associated with carcinoma.

  • An area which is tender and smooth on palpation
  • An area centrally located beneath the areola and well defined
  • An area with irregular margins and hard on palpation
  • Breast tenderness, unilaterally or bilaterally,

What percent voltage ripple occurs with a high frequency generator?

  • 25%
  • 5%
  • 15%
  • 10%

Of the tissues types that make up the breast, which is the most radiosensitive?

  • Adipose
  • Connective
  • Areolar

In order to improve positioning capability for the Craniocaudal projection on a kyphotic patient, which alternate projection should be performed?

  • Axillary tail (AT)
  • Rolled (RM or RL)
  • Exaggerated medial craniocaudal (XCCM)
  • Caudalcranial (FB)

The area between the breast and the pectoral muscle is the:

  • Retromanmmary space
  • Axillary prolongation
  • Inframammary fold
  • Mammary apex

According to standards, where are the view markers placed when doing a mammogram?

  • As close to the medial breast as the position allows
  • Anywhere not obscuring breast tissue
  • As close to the axilla as the position allows
  • Next to the ID flash

What is the primary reason for performing magnification mammography?

  • Evaluation of fatty tissue
  • Increased image contrast
  • Reduce patient dose
  • Increase detail of calcifications

When using automatic exposure control (AEC) for mammography, which of the following must be applied?

  • Use all three sensing chambers simultaneously
  • Place the most dense portion of the breast over the sensing chamber (photocell)
  • Use the AEC only on the CC projection

Subjecting processed films to high temperatures and low humidity (below 30%) can result in which of the following

  • Wet, tacky films
  • Films with plus density, parallel artifacts
  • Emulsion cracking
  • Films with minus density perpendicular artifacts

Infiltrating ductal carcinoma accounts for ____% of male breast cancer.

  • 1
  • 8
  • 24
  • 85

When should breast self-examination performed?

  • Five to seven days after the menstrual cycle
  • At the beginning of the menstrual cycle
  • Three days following onset of the menstrual cycle
  • Anytime during the menstrual cycle

What portion of the breast is best demonstrated on the Axially Tail view

  • Medial breast tissue
  • Tail of the breast
  • Nipple area
  • Inframammary region

Which is NOT considered curative breast surgery?

  • Core sample biopsy
  • lumpectomy
  • Quadectomy
  • Modified radical mastectomy

In which of the following life stages would the breast contain the LEAST amount of adipose (fat)tissue?

  • Post puberty
  • Middle age
  • Mature adulthood
  • Post menopause

Which of the following positions or techniques is used to demonstrate tissue that has been superimposed on another position?

  • Axillary Tail (AT)
  • Coat hanger
  • Roll (RM or RL)
  • Tangential

Choose all of the correct functions of a digital detector:

  • Converts x-ray energy into electrical charge
  • Converts x-ray energy into electrical charge
  • Produces dark current
  • Transmit x-ray energy
  • Absorb x-ray energy

How many days does a facility have to notify a woman of her screening mammogram results following her screening mammogram?

  • 10 days
  • 20 days
  • 30 days
  • No notification is necessary if the results are normal

Blurring of a mammogram image can be caused by:

  • Patient motion
  • Too long exposure
  • Defective equipment
  • All of the above
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