Welcome to your Mammography Name: Email: [If, after examining a phantom image, the number of visualized fibers or masses has changed significantly, the next step is to] record the new values call the medical physicist call the equipment service personnel check the mammography unit or the image processor None . [In conventional imaging, overexposure is sometimes called the recoverable error because] it can be corrected during developing high illumination and masking can overcome it magnification can overcome it the use of small focal spot sizes will reduce it None . [Which projection gives a mirror image of the MLO?] ML LM LMO AT None . [MRI can be used to 1. map the extent of a tumor 2. image patients with implants 3. evaluate patients with dense breast] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The half-value layer (HVL) of the x-ray beam is measured with a] star pattern slit camera pinhole camera quality-control dosimeter None . [If too much upper axilla and shoulder are under the compression paddle when imaging for the MLO, the effect is to] inhibit proper compression of the upper breast inhibit proper compression of the lower breast ensure equal compression of the upper and lower breast ensure proper compression of the lower breast None . [The same mammographer should view the phantom images because] subjective judgment about images is always difficult it is not wise to have different individuals handling the phantom not all mammographers know the MQSA regulations given set values, different mammographers will calculate the densities differently None . [The operating level density difference (DD) for the phantom should be at least] 0.40 0.80 0.02 1.20 None . [Variation in compression levels causes 1. inadequate exposure on one portion of the breast 2. over- or underexposure in other portions of the breast 3. adequate exposure throughout the breast] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 only None . [MRI could be used 1. as a primary breast cancer detection tool 2. to image patients with breast implants to evaluate ruptures 3. to determine tumor margins and the extent of tumor spread] 1 only 1 and 2 only 2 and 3 only 1 and 3 only None . [In the rolled medial (RM) position, the lower surface of the breast is rolled in which direction?] laterally medially inferiorly superiorly None . [Which of the following is (are) considered a first-degree relative? 1. mother 2. aunt 3. sister] 1 only 1 and 2 only 2 and 3 only 1 and 3 only None . [When positioning for the right CC, where is the patient’s left arm placed?] Brought back. This action rotates the shoulder to remove it from the imaging area. Brought forward. The patient can hold the handle bar of the unit. Brought forward. The patient can hold the IR. Remains at the patient’s side. None . [Involution of the breast describes a process by which] milk is removed from the breast by suckling breast epithelium proliferates during menstruation breast epithelium decreases because of postmenopausal changes estrogen causes an overall density decrease in the breast None . [Why is the MLO preferred to the ML as a routine projection?] The MLO visualizes the medial breast. The ML does not visualize the medial breast. The ML poorly visualizes the posterior and lateral breast. The MLO does not distort the anterior structure of the breast. None . [The Mammography Quality Standards Act (MQSA) requires that the maximum compression for the initial power drive not exceed] 100 newtons 200 newtons 400 newtons 500 newtons None . [The projection best used to demonstrate the true representation of medial breast structures in relation to the nipple is the] LM AT ML TAN None . [If an artifact is noted on some mammographic images, which appropriate MQSA regulation will identify the dirty cassette/ image receptor quickly and easily?] processor QC test screen cleanliness visual checklist standardized image labeling None . [A hamartoma is] a malignant tumor of the breast a benign tumor of the breast associated with trauma of the breast associated with nursing None . [If the nipple is not imaged in profile on the four projection series, indications to take additional projections with the nipple in profile include 1. the nipple cannot be differentiated from a mass 2. the patient has a possible retroareolar mass 3. the patient is male] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [What immediate action is used to reduce motion unsharpness in mammography?] compression low mAs (milliamperes per second) low kVp (kilovoltage peak) small focal spot size None . [there is an upward drift in the operating data levels there is a change in the types of chemical used there is a change in film brand or type a mammographer notices dust artifacts on the image] check the developer temperature be sure the view boxes are clean clean the cassette screens with screen cleaner check the cassettes for dirt or lint None . [Which projection best shows the extreme medial aspect of the breast?] CC MLO ML CV None . [The inframammary crease is located at approximately the level of the] second to third rib third to fourth rib fourth to fifth rib sixth to seventh rib None . [The MLO projection demonstrates a large encapsulated lesion occupying almost the entire breast. The contour is sharp and the lesion is radiolucent. This lesion is most likely to be a(an)] oil cyst hematoma fibroadenoma lipoma None . [Which of the following hormones has the most influence on the normal physiological changes of the breast? 1. prolactin 2. estrogen 3. progesterone] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [MRI imaging involves the use of] radiation to detect breast lesions sound waves in the imaging of the breast magnetic properties plus radio waves to image the breast strong sound and radio waves in imaging the breast None . [After a four-projection mammogram, calcifications are visualized superior to the nipple but only on the MLO projection. What additional projection would best be used to locate the position of the lesion?] exaggerated craniocaudal (XCCL) cleavage (CV) ML AT None . [In the CC projection of the breast, the IR is positioned] at the level of the raised inframammary crease below the level of the raised inframammary crease at the level of the inframammary crease just below the level of the inframammary crease None . [The radial scar or sclerosing duct hyperplasia 1. can sometimes be mistaken for carcinoma 2. sometimes has a solid dense central tumor 3. is usually not associated with skin thickening or dimpling over the lesion] 1 only 1 and 2 only 2 and 3 only 1 and 3 only None . [Visual inspection done during CBE involves] feeling for changes in the breast looking for changes in the breast palpating the breast examining areas under the armpit None . [In general, when imaging tall, thin patients the angulation is adjusted to] below 30 degrees between 30 and 40 degrees close to 60 degrees almost 70 degrees None . [An MQSA certificate is issued when a mammography facility has been accredited. This certification is valued for] 1 year 2 years 3 years 4 years None . [The portion of the breast that holds the milkproducing element is the] ampulla segmental duct lobule lactiferous sinus None . [Which projection is used to prove breast calcifications are benign (teacup type)?] CC XCCL FB ML None . [In positioning for the superior-inferior oblique (SIO), the _________ of the breast will rest on the image receptor.] lateral surface superior surface medial surface inferior aspect None . [The clinical breast examination (CBE) should be performed] at or near the time of the annual mammogram only by the radiologist monthly, preferable at the same time of the month at least twice a year None . [Identify the projection shown in Figure.] MLO CV LM ML None Comment . [One of the minor risk factors for breast cancer could include] gender aging genetic risk factors not breast-feeding None . [A radiopaque implant used in breast reconstruction that easily adjusts for cup size after placement is the] silicone gel implant transverse rectus abdominis muscle (TRAM) flap implant silicone liquid implant saline implant None . [Ductography can be used to determine 1. the location of the lesions in the ducts 2. if a lesion is benign or malignant 3. changes or abnormalities associated with the ducts] 1 only 1 and 2 only 1 and 3 only 2 and 3 only None . [The mammogram of a woman age 50 who has recently started estrogen replacement therapy is likely to be] more fibroglandular than her past mammographic study more fatty that her previous mammogram less fibrous and less glandular than her previous studies unchanged from her previous mammograms None . [Quantum mottle on the image is reduced by] high kVp high mAs motion fast intensifying screens None . [Proper compression of the breast is indicated when the] patient is in pain compression paddle stops breast is taut breast feels soft None . [Stereotactic breast localization is used to] obtain two-dimensional information on palpable breast lesions calculate the vertical position of nonpalpable lesions obtain a three-dimensional image of the breast calculate the horizontal, vertical, and depth position of nonpalpable lesions None . [Identify the projection shown in Figure.] MLO CV LM ML None Comment . [Scattered radiation is reduced during magnification mammography by] using a small focal spot size using a grid using the air-gap technique increasing the source-to-image receptor distance (SID) None . [Increasing the kVp by two points will] force a doubling of exposure time reduce the exposure time by half have no effect on the exposure time increase the subject contrast None . [Antiestrogen drugs such as tamoxifen can be used to 1. slow or stop the cancer’s growth 2. prevent breast cancer in high-risk women 3. prevent the recurrence of breast cancer] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The major difference between the general radiography grid and the grid used in mammography is that the] grid used in general radiography causes an increase in exposure grids used in general radiography have higher ratios use of a grid in mammography increases patient dose grids in mammography improve the radiographic image contrast None . [The function of the filter in mammography is to remove 1. low-energy x-rays not needed to produce the breast image 2. high-energy x-rays that cause a reduction of subject contrast 3. low-energy x-rays that increase patient dose] 1 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [It may be necessary to use manual technique with small breast because the] multiple detectors can be moved according to breast size automatic exposure control (AEC) detector may not cover the small breast tissue area AEC detector cannot compensate for breast size AEC cannot compensate for varying breast tissue types None . [Manual compression in mammography] must be between 25 and 45 lb depends solely on breast size depends on breast size and the patient’s pain tolerance generally depends on the patient’s pain tolerance None . [In addition to the patient’s name, all mammographic reports should have the 1. final assessment of findings 2. hospital number or additional patient identifier 3. name of the radiologist] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [Lumpectomy describes the process of] removing the entire breast including the nipple removal of the breast cancer tumor and surrounding margins of normal breast making a small incision over or near the site of breast lesion removing benign lumps from the breast None . [Breast tissue can extend medially to the] latissimus dorsi muscle midsternum retromammary space inframammary crease None . [Digital images can be viewed on a computer monitor or printed using] dry laser technology single emulsion mammography film single emulsion laser film double emulsion film, sensitive to the red-light spectrum emitted by lasers None . [In mammography imaging, exposure factors used depends on all of the following except] the patient target material screen/film combination viewing conditions None . [Lymph drainage from the medial half of the breast is generally directed to the] internal mammary lymph nodes external mammary lymph nodes axillary lymph nodes axilla None . [Increased kVp during mammography is sometimes necessary to penetrate dense fibroglandular tissue. Increased kVp, however,generally causes] increased subject contrast decreased subject contrast motion unsharpness less scatter None . [Densities on the sensitometric strip and phantom image were recorded as follows: density inside the disk = 1.23, the middensity = 1.25, the background density = 1.68, the density adjacent to the disk = 1.66, and the highest density = 1.69. What is the density difference (DD) on the phantom image?] 0.42 0.43 0.44 0.45 None . [The circular mixed-density lesions seen in Figure suggests a] calcified microhematomas galactocele, calcified malignant calcification epidermoid cyst None Comment . [If any breast tissue is poorly imaged or missed on the MLO projection it is likely to be] medial breast tissue lateral breast tissue inferior breast tissue superior breast tissue None . [A baseline mammogram shows that the patient’s breast consists primarily of adipose tissue. This patient is most likely to be] on hormone therapy above 60 below 20 above 35 None . [Identify the projection shown in Figure.] RM CV RL MLO None Comment . [In the LMO projection, the beam is directed from the] upper inner aspect to the lower outer aspect of the breast inner outer aspect to the upper outer None . [The CC shows a circumscribed oval radiolucent lesion. There was a definite halo surrounding the lesion. It is most likely to be a] fibroadenoma lymph nodes cyst hematoma None . [If the residual hypo in the mammography film exceeds 0.05 g/m2 or 5 g/cm2, this can indicate 1. improper washing of the film 2. improper fixer replenishment 3. the film will have poor archival quality] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Glandular tissue is usually found in the _______ of the breast] medial and lower inner quadrant central and upper outer quadrant medial and lower outer quadrant central and upper inner quadrant None . [Over age 40, it is recommended that women have a CBE every] year 2 years 3 years 4 years None . [An inverted nipple] always indicates breast cancer sometimes indicates breast cancer never indicates breast cancer usually indicates breast cancer None . [When is imaging of the irradiated breast recommended?] immediately after treatment 1–2 months after treatment 6–12 months after treatment 1–2 years after treatment None . [In addition to the routine CC and mediolateral oblique (MLO), a routine series for a postmastectomy patient could also include the] axillary tail (AT) mediolateral (ML) TAN lateromedial oblique (LMO) None . [A major cause of radiographic noise is] image graininess quantum mottle poor contrast resolution motion None . [Montgomery glands are specialized] sweat glands sebaceous gland Cooper ligaments hair follicles None . [Identify Cooper ligament in Figure.] site A site B site C site D None Comment . [Veins are normally located] in the periphery of the breast central areas of the breast in the axilla area of the breast in the medial areas of the breast None . [Figures A and B are mammograms of the same patient. Figure B was taken 6 months after Figure A. These mammograms demonstrate a] resolving oil cyst galactocele radial scar hematoma None Comment . [In the low kVp range using a molybdenum target tube, what type of photon interaction predominates?] photoelectric interaction Compton interactions Bremsstrahlung interaction Coherent interaction None . [Men with a family history of breast cancer will] have a greater risk for breast cancer have a minor risk for breast cancer have no significantly increased risk for breast cancer always get breast cancer None . [Contrast resolution in conventional imaging refers to the ability to] image high-contrast small objects such as microcalcifications distinguish anatomic structures with similar subject contrast visualize recorded detail when image contrast and optical density are optimized visualize recorded detail None . [What principle does compression use to visualize the borders of circumscribed lesions? 1. It brings the lesion closer to the image receptor. 2. It spreads apart overlapping tissue. 3. It separates superimposed areas of glandular tissue.] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [In establishing processor quality control (QC), the high average density is generally the density closest to] but not less than 2.20 but not less than 1.20 but not less than 0.45 2.20 None . [When cleaning the intensifying screens, the loaded cassette is unloaded under safelight conditions in the darkroom. The film in the cassette is] stored in the film bin during the cleaning process removed from the cassette and discarded returned to the cassette after cleaning returned to the film bin None . [Good compression results in 1. increased spatial resolution 2. decreased spatial resolution 3. improved subject contrast] 2 only 3 only 1 and 3 only 2 and 3 only None . [A “camel’s nose” breast contour can be prevented in the MLO projection by] including all of the breast under the compression paddle angling the image receptor parallel to the pectoralis muscle properly supporting the breast during compression ensuring that the nipple remains in profile during compression None . [The breast can be imaged in the FB projection 1. to improve visualization of lesions in uppermost aspect of breast by reducing object-to-image receptor distance (OID) 2. during needle localization to provide a shorter route to inferior lesions 3. to maximize the amount of tissue visualized in patients with kyphosis] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The phantom image background optical density should never be] more than 1.20 less than 1.20 more than 1.40 less than 1.40 None . [The nominal focal spot size of the mammography unit is 0.3. This means that the] actual focal spot size is 0.3 effective focal spot size is 0.3 both effective and actual focal spot size is 0.3 actual focal spot is smaller than 0.3 None . [In viewing phantom image, which of the following viewing conditions need not apply?] on the same view box using the same type magnifier at the same time of day using the same film emulsion batch None . [For the daily processor QC, the mid-density should remain within] ±0.15 of the established levels ±0.10 of the established levels +0.30 of the established levels +0.03 of the established levels None . [The absorbed dose in mammography is generally _______ the entrance skin exposure (ESE).] significantly higher than significantly lower than about the same as slighter higher than None . [Which projection is best used to visualize the tail of the breast?] LMO TAN LM AT None . [The specimen is radiographed to] confirm that the lesion was removed compare various needle localization techniques magnify the lesion to assess any possible microcalcifications check the position of the lesion None . [Factors that lower breast cancer risk include 1. having your first child after age 30 2. breast-feeding your child 3. late menarche] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Which is true for all tangential (TAN) projection positioning?] The patient is always in the CC position. The central ray is always directed vertically. The central ray is always parallel to the plane of the breast. The central ray is always perpendicular to the skin surface. None . [The basic premise of a medical audit is that 1. all positive mammograms should be followed 2. the pathology results of all biopsies performed should be collected 3. all pathology results should be correlated with the radiologist’s findings] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In positioning for the MLO, the tube is always angled] 90 degree 60 degree 50 degree none of the above None . [The mammography report has an assessment finding of Breast Imaging Reporting and Data System (BIRAD) 0. This means that] the mammogram is negative there is a high probability of a benign finding additional imaging is needed the findings are suspicious None . [The retromammary space is filled with] supportive and connecting tissue adipose tissue fibroglandular tissue blood vessels None . [Patients who are allowed to play an active role in applying the compression are usually 1. less likely to tolerate the compression 2. more likely to tolerate the compression 3. more relaxed during the compression] 1 only 2 only 1 and 3 only 2 and 3 only None . [Rhodium is not used as the primary anode material when imaging thinner breast because] rhodium has an emission spectrum similarto tungsten the higher energy of the rhodium beam is unsuitable for thinner breast the lower energy of the rhodium beam is unsuitable for thinner breast rhodium anodes are more expensive None . [AEC failure, resulting in an underexposed radiograph, can be caused by] processing deficiencies such as fluctuating developer temperature improper placement of the dense breast tissue/size over the detector decreased radiographic contrast inadequate breast compression None . [Which section of the breast is poorly visualized on the CC projection?] medial axial lateral superior None . [A woman should perform breast self examination (BSE) monthly to] become familiar with both of her breasts localize cancerous lumps recognize breast dimpling discover nipple discharge None . [The density difference, DD on the sensitometric strip is the difference between] the average density closest to 2.20 and the mid-density the mid-density and the base plus fog the average density closest to 0.45 and the mid-density the high and low average densities None . [Fatty tissue is generally radiolucent and will show on the mammogram as] glandular areas high-density areas low-density areas medium-density areas None . [One of the two reasons towels are used in the compression test is to] protect the cassette holder ensure that the compression is adequate force slower application of compression simulate 4 cm of compressed breast None . [The mammogram shows an oval-shaped lesion with mixed density. The lesion has a central radiolucent area and is freely movable. This lesion is most likely to be a] fibroadenoma hematoma lymph node galactocele None . [The circular pigmented area around the nipple is called the] skin areola Montgomery gland ampulla None . [Lack of breast compression is most likely to cause] geometric unsharpness screen unsharpness motion unsharpness parallax unsharpness None . [In the dedicated mammography unit, the single intensifying screen is positioned in contact with the film emulsion on] the side of the IR away from the x-ray source the side of the film facing the x-ray source the side of the IR facing the x-ray source either side—the placement does not matter None . [Which of the following techniques use a small-gauge needle to obtain cellular samples from a lesion?] core biopsy FNB ductography ductal lavage None . [Which of the following conditions must be met when imaging the breast in the MLO? 1. The pectoral muscle should extend to or below the PNL. 2. Visualized fat should be posterior to all the fibroglandular tissues. 3. The inframammary fold (IMF) should be open.] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In imaging the augmented breast in the CC position, using the modified implant displaced technique, the breast tissue is pulled/pushed] anteriorly posteriorly inferiorly superiorly None . [Anatomic parts with low subject contract will have] sharp difference in x-ray absorption very little difference in x-ray absorption the same x-ray absorption characteristics similar x-ray absorption characteristics None . [A routine series on patients with encapsulated implants could include an additional projection such as the] AT CC MLO ML None . [Chemotherapy] involves the use of drugs to treat cancer that may have spread is the destruction of cancer cells using high-energy radiation involves mapping the area around a tumor with the injection of a radioactive tracer involves the use of drugs to treat cancer that may have spread None . [Which of the following quality control tests does not require a densitometer?] darkroom fog screen-film contact screen cleanliness phantom images None . [Which procedure is performed to obtain cellular material from a suspicious area for cytological analysis?] Ductography Needle localization Pneumocystogram Fine needle aspiration (FNA) None . [In digital mammography, both the film and cassette can be replaced by] a detector and electronic system the CAD technology system a flexible storage phosphor photostimulable plates None . [Regardless of the reason, if the proper amount of compression cannot be applied which of the following must apply?] the patient must be told the patient’s doctor must be told the radiologist must be told it must be noted on the patient’s history form None . [In establishing processing quality control operating levels, the speed index is designated as the density] closest to but not less than 2.20 closest to but not less than 1.20 closest to but not less than 0.45 2.20 or higher None . [Although it often means losing some of the lateral breast tissue, in imaging for the craniocaudal (CC) projection, most experts advise a slight rotation of the patient’s body to maximize imaging of the medial breast tissue. Why?] Medial breast is imaged best on the CC. Medial breast is imaged only on the CC. Slight rotation avoids distorting the medial breast. The slight rotation enables ease in positioning. None . [The posterior nipple line (PNL), visualized on the ML, should be within how many centimeters of the PNL on the CC?] 0.25 0.50 1.00 1.50 None . [Montgomery glands are located on the breasts] skin nipple areola muscle None . [Which of the following patients has the greatest risk for breast cancer?] A nulliparous woman at age 40 A never married woman A woman, age 70 A woman, age 30 None . [Which alternative projection could be used, in addition to the CC, in imaging a patient with a prominent pacemaker?] ML lateromedial oblique (LMO) XCCL MLO None . [If the backup time stops a breast exposure, the mammographer can repeat the radiograph using a] higher kVp setting greater density compensation higher mAs setting different AEC setting None . [The superior inferior oblique (SIO) will best demonstrate the] OUQ and the LOQ of the breast LIQ and the UIQ of the breast UIQ and LOQ of the breast LIQ and the OUQ of the breast None . [In the CC position the pectoral muscle is seen] all the time rarely if ever about 30%–40% of the time about 50% of the time None . [A process of removing tissue, muscle, and fat from the belly and transferring that tissue to reconstruct the breast is called] TRAM flap latissimus dorsi flap implant placement silicone implant None . [A grid is not necessary during magnification because] grid use decreases spatial resolution the small focal spot used will compensate for the loss of image detail the large OID produces the same effect as a grid magnification will magnify the normally invisible grid line None . [The calcifications seen in Figure have the typical appearance of] mammographically malignant-type calcifications mammographically benign-type None Comment . [Sometimes described as an oil cyst, this lesion represents an encapsulated area on the mammogram and can be caused by surgery, biopsy, trauma, or radiation therapy.] stellate lesion galactocele fat necrosis lipoma None . [Extended processing increases the amount of time the film is immersed in the] developer solution fixer solution dryer both the developer and fixer solutions None . [The principle of mobile versus fixed tissue is used in mammography imaging to image the maximum] medial breast on the MLO projection inferior breast on the CC projection superior breast on the MLO projection medial tissue on the CC projection None . [Film fog is best demonstrated on the characteristic curve as] the straight-line portion of the graph the toe of the graph the shoulder of the graph the shift of the graph to the left None . [Postmenopausal obesity is associated with] a relatively high risk of developing breast cancer overall reduction in breast cancer risks circulating estrogen that is produced in fat tissue a lower overall estrogen level None . [In the optimum position of the patient for the CC projection, the patient’s head is turned] toward the side under examination away from the side under examination depending on the preference of the mammographer to the patient’s right None . [A patient had an ultrasound, which confirmed the presence of a cyst in the breast. The radiologist wished to rule out intracystic tumor. What additional study could be recommended?] ductography needle localization pneumocystogram FNA None . [Causes of radiographic noise include 1. quantum mottle on the image 2. scattered radiation 3. film graininess] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In magnification, what immediate role does the large object-to-image receptor distance (OID) play in reducing scattered radiation?] The compressed breast allows lower kVp values. Exposure is reduced because a grid is not needed. Most of the scattered radiation misses the image receptor. The larger source-to-image receptor distance (SID) utilizes the inverse square law. None . [The lesion seen in Figure is not palpable and is not associated with nipple or skin changes. It is likely to be] invasive ductal breast carcinoma a mammographically malignant tumor a mammographically benign tumor nonspecific; further testing is indicated None Comment . [Your patient has had recent chest surgery and has a scarred and painful area running along the sternum. With the medial aspect of the breast immobile, which of the following is an alternative to the RMLO?] RLMO LMLO LLM RML None . [The FB projection can be useful in imaging 1. nonconforming patients 2. abnormalities high on the chest wall or superior aspect of breast 3. inferior lesions or lesions near the IMF] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Which of the following could be used when imaging extremely small breasts in the craniocaudal (CC) position?] spatula ML cleavage (CV) exaggerated craniocaudal (XCCL) None . [In mammography, selecting extremely low kVp values] reduces contrast and lowers patient dose increases contrast but increases patient dose reduces contrast but increases patient dose increases contrast and reduces patient dose None . [Proving that a darkroom fog failure is a result of safelight problems involves] moving the safelight at least 6 ft from the work surface repeating the test with the safelights checking for light leaks around the doors and passbox changing the filter on the safelight None . [The most common cause of under compression is] a faulty compression paddle inadequate compression by the mammographer patient pain tolerance level broken automatic compression device None . [Using a cassette with poor film screen contact will result in] a noisy image localized unsharpness motion unsharpness a lower subject contrast None . [Contaminated developer will likely result in 1. decreased film speed 2. increased image receptor contrast 3. increased film base density] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [A thin supportive layer located between the basal surface of the epithelium and the connective tissue layer of the lobule is called] chief cells myoepithelial basement membrane superficial A cells None . [Today all mammographers (radiographer performing mammograms independently) must have 1. satisfied the interim requirements of the FDA 2. completed at least 40 contact hours of documented training in mammography 3. performed at least 25 examinations under direct supervision of a qualified mammographer] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [If the patient volume at a mammography site is 200 patients per week, the repeat/reject analysis should be done every] week 2 weeks 2 months 3 months None . [Identify the projection in Figure.] TAN from below (FB) XCCL ML None Comment . [For a menstruating woman, when is the best time of the month to perform a BSE?] 1 week before the start of menstruation on the first day of the month on the last day of the month when the breast is least tender None . [The darkroom fog test is performed] semiannually monthly weekly daily None . [Compression of the breast is most effective and most comfortable when applied against the] medial and lateral aspects inferior and superior aspects medial and superior aspects inferior and lateral aspects None . [A CBE can be performed by which of the following? 1. the radiologist 2. the patient 3. a health-care professional] 1 only 2 only 2 and 3 only 1 and 3 only None . [Fibrous and glandular tissues are more _______ than fatty tissue and result in areas of _______ optical density on the radiograph] radiolucent/lower radiolucent/higher radiopaque/higher radiopaque/lower None . [In the darkroom fog test, the optical density difference between fogged and unfogged areas of the film should not exceed] 1.20 0.15 0.05 0.02 None . [Skin thickening can be malignant but could also be caused by 1. a breast abscess 2. a calcified fibroadenoma 3. postradiation] 1 only 2 only 1 and 2 only 1 and 3 only None . [In which modified projection is the superior aspect of the breast rolled medially?] RM RL M LM None . [During pregnancy and lactation, the breast] shows increased density increases in fatty content atrophy of glandular structures shows decreased density None . [Identify the projection in Figure.] TAN FB XCCL ML None Comment . [Magnification in mammography can be useful in all of the following except] specimen radiographs to define borders of masses to assess calcification routine screening None . [The right craniocaudal (RCC) of the routine imaging series showed a small, irregular shaped lesion at the edge of the image plus scattered calcifications including calcification clusters (Figure). The next immediate step would be1. spot compression including magnification2. additional imaging to include the margins of the lesion3. ultrasound] 1 and 2 only 2 and 3 only 1 and 3 only None Comment . [Increased OID causes loss of image detail in magnification mammography. What factors help to compensate for this loss of image detail? 1. compression of the part 2. decreased focal spot size 3. increased OID] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Ideally, in an open surgical biopsy, when should a breast tissue specimen be imaged?] immediately after surgery within 24 hours of the surgery while the patient is still in the recovery room before the surgery is terminated None . [Two main disadvantages of extended processing are] decreased film speed and increased film fog increased film speed and decreased film fog increased processing artifact and increased film fog decreased processing artifact and increased film speed None . [The area of minus density in the upper part of Figure best represents] a pacemaker the patient’s chin a hematoma port-a-cath None Comment . [The greatest disadvantage of magnification is] increased OID increased patient dose decreased subject contrast increased risk of motion unsharpness None . [A woman with one first-degree relative with breast cancer has a higher risk for breast cancer than a woman with 1. early menarche, taking oral contraceptives 2. a personal history of breast cancer 3. late menopause] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Chemotherapy is a class of drugs that can be used to] stop the spread of cancer to other parts of the body block estrogen from cancer cells reduce estrogen levels in the body kill cancer cells by using high-energy radiation None . [On the American College of Radiology (ACR)-approved accreditation phantom, the total number of fibers, speck groups, and masses are] five fibers, five speck groups, and five masses five fibers, six speck groups, and five masses six fibers, five speck groups, and five masses five fibers, five speck groups, and six masses None . [In conventional imaging, the leading cause of false-negative mammograms in dense breast tissue is] motion overexposure underexposure grid lines None . [A BSE should be done regularly by 1. the radiologist 2. the patient 3. a health-care professional] 1 only 2 only 2 and 3 only 1 and 3 only None . [What is the major disadvantage of magnification?] reduced resolution of the image increased patient dose increased scattered radiation none of the above None . [Selection of rhodium anode/filter combination for a fatty breast 1. overpenetrates the fatty breast 2. alters the penetrating power of the beam 3. results in loss of subject contrast] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [The compression force should not exceed _______ on the initial power drive (automatic) mode.] 25 lb 35 lb 40 lb 45 lb None . [Daily processor control is used to 1. determine the film speed 2. check the film contrast 3. check the stability of the processor] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In conventional imaging, some causes of underexposure include 1. processing deficiencies 2. inadequate compression 3. improper AEC setting] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [In compression on the XCCL projection, the affected arm should] not be raised, but rest along the top of the image receptor be raised, with hand resting/holding bar of unit be place on the patient’s hips be placed according to the wishes and comfort of the patient None . [Magnification is beneficial in all of the following situations except] imaging the surgical site of a patient with a lumpectomy imaging a specimen radiograph evaluating microcalcifications in a lesion routine imaging None . [Gynecomastia defines] a localized abscess increased breast tissue in the male breast decreased breast tissue in the female breast None . [On a reject/repeat analysis, the rate was lower than 5% but one category of the reject/repeat analysis is significantly higher than others. What should be done?] Although the overall rate is less than 5%, that one area should be targeted for improvement. If the other categories are within normal limits, that area can be disregarded. Because the rate was more than 2%, the entire department needs to be reassessed. With an overall rate lower than 5%, one high rate is statistically meaningless. None . [The repeat rate should be analyzed if the rate changes from the previous measure rate by more than] ±2% ±3% ±4% ±5% None . [Compression reduces radiation to the breast by] providing a uniform breast thickness decreasing breast thickness decreasing motion unsharpness separating superimposed areas of glandular None . [When imaging a small breast, scattered radiation can be minimized by 1. increasing compression 2. reducing kVp 3. reducing field size] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The TDLU consists of the] mammary ducts and the extralobular terminal ducts (ETDs) intralobular terminal duct (ITD) and the segmental ducts the ETDs and the lactiferous ducts both the ETDs and the ITDs None . [The two-step method of BSE is to] look and feel for changes in the breast examine your breasts and have a regular mammogram check for lumps in the breast and keep a journal of changes in the breast examine your breasts and nipples None . [Hormone replacement therapy could be recommended to? 1. relieve insomnia symptoms 2. prevent osteoporosis 3. reduce weight gain] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [Who performs the compression device check for mammography QC?] physicist staff technologist radiologist mammographer None . [The large air gap used in magnification functions to 1. increase scatter 2. improve contrast 3. reduce scatter] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [Which age group is likely to get the most radiation dose from a mammogram?] between 20 and 35 between 40 and 50 between 55 and 60 above 70 None . [In imaging the breast in the MLO projection, compression to the lower portion of the breast is compromised if 1. the image receptor is too high 2. the patient has a protruding abdomen 3. too much axilla and shoulder are under compression] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [Magnification is contraindicated 1. when imaging the mastectomy site 2. in specimen radiography 3. as a normal/routine screening tool] 1 only 3 only 2 and 3 only 1 and 3 only None . [Since 1989, the death rate from breast cancer has declined because] more cancers are discovered at a later stage more cancers are discovered at an earlier stage the long-term survival rate for breast cancer patients is stable patients who survive 5 years will survive an additional 10 years None . [The characteristic curve, obtained by plotting density values from a sensitometer, can be used to assess all of the following except] to compare two different types of films to compare the same film under different processing conditions to compare the x-ray beam quality with different films to monitor the daily processing conditions None . [To reduce the possibility of imaging the abdomen in the MLO position, the mammographer could] have the patient stand just at the image receptor and bend back have the patient stand away from the image receptor and bend forward have the patient turn medially to image the lateral breast on the CC discard the MLO and image the breast in the lateral position instead None . [One major difference between collimation in mammography and collimation in general radiography is that] in mammography the entire image receptor area is exposed decreasing collimation increases exposure in mammography mammography uses a variety of beam limiting devices in radiography the entire image receptor area is always exposed None . [If the AEC cell is placed over an area of adipose tissue on a breast with a mixture of adipose and glandular tissue, the areas of glandular tissue will be] underexposed overexposed normally exposed the AEC cell position will not affect the exposure None . [The calcification seen in Figure have the typical appearance of] an oil cyst plasma cell mastitis calcification a small calcified hematoma a calcified sebaceous gland None Comment . [Most of the glandular tissue is arranged in the breast around the] medial and upper inner quadrants lateral and lower inner quadrants central and upper outer quadrants medial and upper outer quadrants None . [Which statement best describes a parallel or linear grid?] Lead strips are aligned adjacent to one another and placed lengthwise in the same direction within the structure of the grid. Lead strips are aligned at right angles to each other. Lead strips are designed to take advantage of the divergence of the x-ray beam as it leaves the x-ray tube. Lead strips are designed to move during the exposure. None . [What projection/position is shown in Figure?] CC MLO CV XCCL None Comment . [A lesion is present on the MLO but is not seen on the CC projection. What projection could best be used to determine whether the lesion is laterally or medially located?] XCCL CV ML AX None . [The best time for a woman to perform a BSE is] before the start of the monthly period just after the period starts within 5–10 days after the start of the period anytime None . [After parturition, contraction of which cells help to eject milk from the alveoli?] epithelial cells myoepithelial cells basement cells superficial cells None . [When imaging the breast using the MLO projection, drooping breast can be a result of which of the following? 1. too much compression of the anterior breast 2. too little compression of the anterior breast 3. too much axilla included in the compression field] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Some considerations that could be given to women with painful breasts include 1. having the patient take ibuprofen prior to the mammogram 2. scheduling the mammogram just after the menstrual cycle 3. explaining, before the examination, the importance of compression] 1 only 1 and 2 2 and 3 1, 2, and 3 None . [The tumor seen in Figure is characteristic of] invasive ductal breast carcinoma a mammographically malignant tumor a mammographically benign tumor a low-density tumor typical of benign None Comment . [X-ray photons leaving the breast enter the top of the cassette/image receptor 1. to go through the intensifying screen before reaching the film 2. then go through the film before reaching the intensifying screen 3. interact with the single intensifying screen of the cassette/image receptor] 1 and 2 2 and 3 1 and 3 1, 2, and 3 None .
