FINALS-RADPRO

Question 1

Sources of radiation exposure

Answer 1

1. OCCUPATIONAL EXPOSURE
2. PUBLIC EXPOSURE
3. MEDICAL EXPOSURE
4. POTENTIAL EXPOSURE

Question 1

The main precautions required in dealing with external irradiation depend on the
? of the emitted radiation and the activity as reflected by the
specific dose rate constant as well as the ? of the radionuclide.

Answer 1

physical characteristics,
half-life

Question 2

When a radionuclide enters the body, the internal exposure will depend on factors such
as the ? and ? of the radionuclide, the ? and ?

Answer 2

physical and chemical properties
activity and the biokinetics

Question 3

Every type of work performed in a nuclear medicine facility will make a contribution to
the external exposure of the worker: .

Answer 3

-unpacking radioactive material,
-activity measurements,
-storage of sources,
-preparation of radiopharmaceuticals,
-administration of radiopharmaceuticals,
-patient handling and examination,
-care of the radioactive
patient and
-handling of radioactive waste

Question 4

Generally, the yearly effective dose to staff working full time in nuclear medicine with
optimized protection should be well below ?

Answer 4

5 mSv.

Question 5

 Among the different tasks involved, the highest effective dose is received from the
patient at ? and ?
The dose rate close to the patient can be quite high.

High equivalent dose to the ? can be received in preparation and administration of radiopharmaceuticals, even if proper shielding is used.

Answer 5

injection and imaging,
fingers

Question 6

Injecting eight patients per day with 400 MBq of 99mTc per patient has been reported
to give a mean and maximum equivalent dose to the fingers of ?and ? mSv/a, respectively, even if syringe shields are used. Without shielding, the maximum
equivalent dose will be about
?mSv/a.

Answer 6

80 and 330 mSv/a
2500 mSv/a.

Question 7

Higher risk of internal exposure due to contamination is associated with:

Answer 7

-radioactive spills,
-animal experiments,
-emergency surgery of a therapy patient and
-autopsy of a
therapy patient.

Question 8

Whole body measurements of workers have revealed an equilibrium internal
contamination of up to ? of 99mTc, which will result in an effective dose of ~?
mSv/annual.
Although this is a small fraction of the external exposure, every precaution must be taken to avoid contamination of the facility.

Answer 8

10 kBq,
0.05
mSv/annual

Question 9

The risks in radiation work should not be greater than for any other similar work.
The upper limit of a tolerable risk for the individual is determined by the ?
However, through optimized protection, the incurred effective dose should be further
reduced.

Answer 9

dose limits

Question 10

? is also achieved through education and
training, resulting in awareness and involvement in radiation protection.

Besides ?, ?, ?as well as ? are important in the optimization of occupational radiation protection.

Answer 10

Optimization

facility and equipment design,
shielding of sources, handling of sources, personal protective equipment

Question 11

The principal parties responsible for occupational exposure are ? and ? and they should ensure that the exposure is limited, and that protection is optimized.
The worker also has responsibilities and must follow the rules and procedures as well as using the devices for monitoring and the protective equipment and tools provided, and in all aspects cooperate with the employer in order to improve
the protection standard in the workplace.

Answer 11

licensees and employers

Question 12

It is generally accepted that the unborn child should be afforded the same protection
level as a member of the general public, meaning that a dose limit of ? mSv should be
applied once pregnancy is declared.

Answer 12

1 mSv

Question 13

Previous personal monitoring results can help guide any decisions, noting that the dose to the fetus fromexternal radiation is not likely to exceed ?% of the personal dosimeter measurement.

no person under the age of ?years is to be subjected to occupational exposure, and
no person under the age of ?years is to be allowed to work in a controlled area unless
supervised and then only for the purpose of training.

Answer 13

25%
16
18

Question 14

Suitable personal ? should be provided for the use of all persons employed in work in controlled areas.

 The? should be adequate to prevent any contamination of the body of the worker for whom it is provided and should include ? (6) for aseptic work.

Answer 14

protective clothing

-gloves,
-laboratory coats,
-safety glasses and
-shoes or overshoes, as well as
-caps and
-masks

Question 15

Wearing a ? at all times will reduce the effective dose by a factor of about two.
 It is, therefore, a matter of judgement whether this dose reduction compensates for the
effort of wearing it.
In some hospitals, ?are used in the case of prolonged injections and high activity.

Answer 15

lead apron

Question 15

 The safety of the work in nuclear medicine is based on ? as well as on the use of? and the use of ? and ?.
 These measures together with working procedures aimed to minimize external exposure, risk of contamination and spread of contamination, will optimize protection of workers.

Answer 15

facility design,
protective clothing,
protective equipment and tools

Question 16

In order to minimize external exposure, the three fundamental measures of protection
should be applied:

Answer 16

time, distance and shielding.

Question 16

 ?or? should be used to reduce the radiation exposure by increasing the distance between the source and the hands. Properly designed vial and syringe shields must be used wherever practicable.

In cases where unshielded sources are handled or the exposure time is prolonged, the
work should be performed behind a properly designed? or similar type
of protective barrier.  Radioactive waste should

Answer 16

Forceps or tongs
lead glass shield

Question 16

For preparation and dispensing of radiopharmaceuticals, working behind a ? and using shielded ? and ?
 — For administration of radiopharmaceuticals to patients, using ? in the case
of prolonged injection and high activity, and using a syringe shield;
 — During examinations, when the distance to the patient is short, using a ?

Answer 16

lead glass bench shield,
vials and syringes;
lead aprons
movable transparent shield

Question 18

The ? and ? have the joint responsibility to ensure that appropriate
personal monitoring is provided to staff.

Answer 18

licensee and employer

Question 19

This normally means that the would specify which workers need to be monitored routinely, the type of monitoring device to
be used and the body position where the monitor should be worn, bearing in mind that
some countries may have specific regulatory requirements on these issues. Further, the
regulatory body is likely to have specified the monitoring period and the time frame for
reporting monitoring results.

Answer 19

RPO - Radiation Protection Officer

Question 20

 ? should be carried out occasionally on staff that regularly prepare and
administer radioactive substances to patients, and also when setting up an operation
which requires the routine handling of large quantities of radionuclides.  After handling unsealed radionuclides, the ? should be monitored.
It may, therefore, be convenient to mount a suitable ? near the sink where hands are
washed.

Answer 20

Finger monitoring
hands
contamination monitor

Question 21

These local rules should include all working procedures involving unsealed sources in the facility such as:

Answer 21

 — Ordering radionuclides;  — Unpacking and checking the shipment;  — Storage of radionuclides;  — General rules for work in controlled and supervised areas;  — Preparation of radiopharmaceuticals;  — Personal and workplace monitoring;  — In-house transport of radionuclides  — Management of radioactive waste;  — Administration of radiopharmaceuticals to the patients;  — Protection issues in patient examinations and treatments;  — Routine cleaning of facilities;  — Decontamination procedures;  — Care of radioactive patients.

Question 22

The ? is responsible for controlling public exposure arising from a nuclear medicine facility. The presence of members of the public in or near the nuclear medicine facility needs to be considered when designing the shielding and flow of persons in the facility.

Answer 22

licensee

Question 23

For example, the room for preparation and dispensing of radiopharmaceuticals and the room for administration should be ? and connected by a pass through.  Areas where significant activities of radionuclides are present must be appropriately shielded. Access must be restricted so that members of the public are not allowed into controlled areas.

Answer 23

adjacent

Question 24

For almost all diagnostic procedures, the maximum dose that could be received by another person due to external exposure from the patient is a fraction of the annual public dose limit and it should not normally be necessary to issue any special radiation protection advice to the patient. One exception is restrictions on ?. Another exception is an intensive use of ? which may require structural shielding ased on the exposure of the public.

Answer 24

breast-feeding a baby positron emitters

Question 25

 One possible source of exposure of the general public is ? of sources. It is performed both inside and outside the nuclear medicine facility.

Answer 25

transport

Question 26

In general, the package is built in several parts. It should be ? safe and reduce the effect of potential ? and ? damage. 

Answer 26

mechanically fire and water

Question 27

The radiation package should be labelled with a sign. There are three

Answer 27

I–White, II– Yellow and III–Yellow.

Question 28

color of label I in radiation package

Answer 28

white

Question 29

color of label II in radiation package

Answer 29

yellow

Question 30

Category I–White D ≤ ? mSv/h

Answer 30

0.005 mSv/h

Question 31

Category II–Yellow ? < D ≤ ? mSv/h

Answer 31

0.005 < D ≤ 0.5 mSv/h

Question 31

A more exact figure of the radiation around the package is given by the ? which is the maximum dose rate (mSv/h) at a distance ? m from the surface of the package multiplied by a hundred.

Answer 31

transport index 1 m

Question 31

Category III–Yellow ? < D ≤ ? mSv/h

Answer 31

0.5 < D ≤ 2 mSv/h

Question 32

BSS meaning

Answer 32

The Basic Safety Standards

Question 33

The ?,state that: “Medical exposures shall be justified by weighing the expected diagnostic or therapeutic benefits...that they yield against the radiation detriment that they might cause, with account taken of the benefits and the risks of available alternative techniques that do not involve medical exposure.”

Answer 33

Basic Safety Standards (BSS)

Question 34

The principle of justification of medical exposure should not only be applied to nuclear medicine practice in general but also on a case by case basis, meaning that any examination should be based upon a :  The nuclear medicine

Answer 34

-correct assessment of the indications for the examination, -the actual clinical situation, -the expected diagnostic and therapeutic yields, and -the way in which the results are likely to influence the diagnosis and the medical care of the patient.

Question 34

For diagnostic nuclear medicine procedures, the patient exposure should be the minimum necessary to achieve the clinical purpose of the procedure, taking into account relevant norms of acceptable image quality established by appropriate professional bodies and relevant diagnostic reference levels (DRLs)

Question 34

The ? has the ultimate responsibility for the control of all aspects of the conduct and extent of nuclear medicine examinations, including the justification of the given procedure for a patient.  they should advise and make decisions on the appropriateness of examinations and determine the techniques to be used. In justifying a given diagnostic nuclear medicine procedure, relevant international or national guidelines should be taken into account.

Answer 34

nuclear medicine specialist

Question 35

For diagnostic nuclear medicine procedures, the patient exposure should be the minimum necessary to achieve the clinical purpose of the procedure, taking into account relevant norms of acceptable image quality established by appropriate ? and relevant ?

Answer 35

professional bodies diagnostic reference levels (DRLs).

Question 35

For therapeutic nuclear medicine procedures, the appropriate radiopharmaceutical and activity are selected and administered so that the activity is primarily localized in the ? while the activity in the rest of the body is kept ?.

Answer 35

organ(s) of interest, ALARA

Question 36

 The implementation of optimization of protection for patients in nuclear medicine is quite complex and includes: (7)

Answer 36

-equipment design, -choice of radiopharmaceutical and activity, -procedure considerations, -DRLs, -calibration, -clinical dosimetry and -QA, as well as special considerations for children, pregnant women and lactating women.

Question 37

For diagnostic procedures, it is necessary for the ? in cooperation with the ? to determine the optimum activity to administer in a certain type of examination, taking the relevant ? into account.

Answer 37

nuclear medicine specialist medical physicist DRL

Question 38

For any given procedure used on an individual patient, the optimum activity will depend on the (5)

Answer 38

-body build and weight of the patient, -the patient’s metabolic characteristics and clinical condition, -the type of equipment used, -the type of study (static, dynamic, tomographic)and the -examination time.

Question 39

The nuclear medicine procedure starts with the ? for an examination or treatment. It should be written and contain basic information about the patient’s condition. This information should help the nuclear medicine specialist to decide about the most appropriate method to use and to decide how urgent the examination is. The patient should then be scheduled for the examination or treatment and be informed about when and where it will take place.

Answer 39

request

Question 40

? in an examination means that equipment should be operated within the conditions established in the technical specifications, thus ensuring that it will operate satisfactorily at all times, in terms of both the tasks to be accomplished and radiation safety. -in radionuclide therapy means that a correctly calculated and measured activity should be administered to the patient in order to achieve the prescribed absorbed dose in the organ(s) of interest, while the radioactivity in the rest of the body is kept as low as reasonably achievable. -also means using routines to avoid accidental exposures of the patient, the staff and members of the general public.

Answer 40

Optimization of protection

Question 41

radiopharmaceuticals in breast The dose to the baby depends on various factors such as

Answer 41

-the radiopharmaceutical, -the amount of milk and -the time between the administration of the radiopharmaceutical to the mother and the feeding of the child.

Question 42

The baby is a member of the public and a typical constraint on the dose from a single source of exposure (in this case, per episode) is ? mSv

Answer 42

0.3 mSv

Question 43

the average adult body weight is ? kg.

Answer 43

70 kg

Question 44

The licensee of a nuclear medicine facility needs to ensure that a ? or ? is available for measuring activity in syringes or vials. The validity of measurements should be ensured by regular quality control of the instrument, including periodic reassessment of its calibration, traceable to secondary standards

Answer 44

dose calibrator or activity meter

Question 45

The ? of a nuclear medicine facility should ensure that appropriate clinical dosimetry by a medical physicist is performed and documented.  For diagnostic nuclear medicine, this should include representative typical patient doses for common procedures.

Answer 45

licensee

Question 46

 The BSS require the licensee of the nuclear medicine facility to have a comprehensive program of ? for medical exposures

Answer 46

QA Quality Assurance

Question 46

The QA program needs to have the active participation of the ?(5), and needs to take into account principles established by international organizations.

Answer 46

-medical physicists, -nuclear medicine specialists, -nuclear medicine technologists -radiopharmacists

Question 47

The program of QA for medical exposures should include:

Answer 47

-Measurements -Implementation of corrective actions -Verification of the appropriate physical and clinical factors -Records of relevant procedures and results; -Periodic checks of the appropriate calibration and conditions of operation of dosimetry and monitoring of equipment.

Question 48

Unintended and accidental exposure may occur due to ? , or a combination of both. Although such events can be identified by a careful safety assessment, their details and the time of occurrence cannot be predicted.  These exposures are called ?

Answer 48

equipment failure, human error potential exposures

Question 49

According to the BSS, the licensee needs to conduct a ? applied to all stages of the design and operation of the nuclear medicine facility and present the report to the regulatory body if required. - it needs to include, as appropriate, a systematic critical review of identification of possible events leading to unintended or accidental exposure. In practice, this means that all procedures in which unsealed sources are involved in the work should be listed and for every procedure it should be asked what can go wrong.

Answer 49

safety assessment