Radiobiology Q

Chapter 1: The physics and chemistry of radiation absorption
1. What is the difference between X-rays and gamma rays?

a. X-rays are produced extranuclearly whereas gamma rays are produced in nuclear
decays.
b. X-rays have higher energies than gamma rays.
c. gamma rays are produced by bremsstrahlung.
d. X-rays and gamma rays interact with matter differently.
2. What is the main source of natural background radiation?
a. Electrons.
b. X-rays.
c. Neutrons.
d. Alpha-particles.
3. Which photon processes are dominant in the context of diagnostic radiology?
a. Compton scattering and photoelectric effect.
b. Photoelectric effect and pair production.
c. Compton scattering and pair production.
d. Compton and Rayleigh scattering.
4. The mass absorption coefficient for Compton scattering is independent of the

atomic number (Z) of the absorber whereas the mass absorption coefficient for
photoelectric effect depends strongly on Z.
a. True.
b. False.
5. Direct action of radiation is the dominant process for:
a. X-rays.
b. Neutrons and alpha particles.
c. Electrons.
d. Gamma rays.
6. Which of the following statements is true?
a. Indirect action can be modified by protectors or sensitizers.
b. Direct action can be modified by protectors or sensitizers.
7. A free radical is:
a. Any charged particle.
b. An atom or molecule with an unpaired electron in the outer shell.
c. An atom with an even number of electrons.
d. A chemically stable atom.
8. The main interaction process(es) of neutrons in biologic matter are:
a. Magnetic scattering.
b. Coulomb scattering by orbital electrons.
c. Fission.
d. Elastic and inelastic scattering by nuclei.
9. All types of radiation can induce biologic effects by direct or indirect action.
a. True.
b. False.
10. What is the main reason for the difference in biologic effects caused by
neutrons and photons?
a. The energy of the radiation.
b. The fact that the charged particles produced by neutrons are, for the most part,
positively charged.
c. The density of ionization.
d. The fact that neutrons can interact with nuclei.

Chapter 2
DNA strand breaks and chromosomal aberrations
1. What is the most important lesion produced in chromosomal DNA by exposure

to ionizing radiation?
a. A break on one DNA strand ('single-strand break').
b. Well-separated breaks on both DNA strands.
c. Breaks on both DNA strands which are opposite each other or separated by only a few
bases ('double-strand break').
d. Multiple breaks on the same DNA strand.
2. When cells are irradiated with x-rays, double-strand breaks occur at a rate of
about 5% in comparison to single-strand breaks.
a. True.
b. False.
3. Which of the following statements is correct?
a. Double-strand breaks can be repaired by homologeous recombination or

nonhomologous recombination.
b. Nonhomologous recombination is error-free.
c. Homologous recombination occurs often in mammalian cells.
d. Homologous recombination accounts for many of the premutagenic lesions induced in

the DNA of human cells by ionizing radiation.
4. Which of the following statements is false?
a. 95% of the energy deposition of x-rays and gamma rays occurs in spurs (which have a
diameter of about 4 nm and involve 3 ion pairs on average).
b. Spurs and blobs are equally frequent in the case of high energy gamma rays.
c. Blobs have a diameter of about 7 nm and contain 12 ion pairs on average.
d. As spurs and blobs have a diameter similar to the DNA diameter, complex lesions
occur when they overlap with the DNA helix ('locally multiply damaged site').
5. The D0 dose is the dose that:
a. induces an average of one lethal event per cell and leaves 37% still viable.
b. leaves 50% of all cells viable.
c. kills all cells.
d. kills 30% of all cells.
6. Chromosomal aberrations are caused by:
a. single-strands breaks.
b. double-strand breaks, i.e. breaks that cause the chromatin to snap into two pieces.
c. single-strand or double-strand breaks.
7. Following exposure to radiation, some of the chromatin strands are broken.

Broken ends are "sticky" and can join to other broken "sticky" ends. Which of the
following statements is false?
a. Broken ends of the same chromatin can recombine to restore the original structure of
the chromosome.
b. The broken end of one chromatin strand can join to the broken end of another
chromatin strand (which leads to a chromosomal aberration)
c. Broken ends fail to rejoin (which leads to a chromosomal aberration).
d. A broken end of a chromatin strand joins to an unbroken end of another chromatin

strand.
8. The chromosome material is duplicated at:
a. prophase.
b. metaphase.
c. interphase.
d. anaphase.
a. Chromosomal aberrations are divided into "chromosome aberrations" and "chromatid

aberrations".
b. Chromosome aberrations are caused by irradiation that takes place before the DNA is
duplicated.
c. Chromatid aberrations are caused by irradiation that takes place after the DNA is
duplicated.
d. Chromatid aberrations involve identical breaks in the two strands of chromatin of the
duplicated DNA structure.
a. Chromosomal aberrations can lead to cell killing, mutation or carcinogenesis.
b. The ring aberration and the dicentric aberration are chromatid aberrations that are
lethal to the cell.
c. The anaphase bridge is a chromosomal aberration that is lethal to the cell.
d. Symmetric translocations and small deletions are chromosomal aberrations that are
not lethal but they can cause malignancies.
a. The total-body dose in exposed persons can be evaluated by taking blood samples
and scoring the frequency of dicentrics and rings in the lymphocytes one year after
exposure.
b. The total-body dose in exposed persons can be evaluated by taking blood samples
and scoring the frequency of translocations in the lymphocytes up to several years after
exposure.
Chapter 3
Cell survival curves
a. For differentiated cells that do not proliferate, e.g. nerve and muscle cells, "cell death"
means the loss of a specific function.
b. A cell that has retained its reproductive integrity and can proliferate indefinitely to
produce a colony is said to be "clonogenic".
c. For proliferating cells, e.g. stem cells, "cell death" means that the cell ceases to be
clonogenic.
d. The purpose of radiotherapy is to cause the tumour cells to lose most of their functions,
while still being clonogenic.
2. What does a "cell survival curve" describe?
a. The relationship between the radiation dose and the number of cells that have gone
through one mitosis after irradiation.
b. The relationship between the radiation dose and the proportion of cells that remain
clonogenic.
c. The relationship between the radiation dose and the number of cells that have not
suffered the loss of a specific function.
d. The relationship between the radiation dose and the proportion of cells that can
produce DNA.
3. What is the dominant mechanism of reproductive death in irradiated cells?
a. Apoptosis, i.e. programmed cell death, which also occurs in normal tissues.
b. Mitotic death, when the cell dies while attempting to divide, the reason being
chromosomal aberrations.
4. One evidence that chromosomal aberrations in irradiated cells is the main

reason for cell death is that factors that modify cell lethality were found to affect in
a similar way the production of chromosome damage as well. Such factors are
variation in the type of radiation, oxygen concentration and dose rate.
a. True.
b. False.
a. A double-strand break in the DNA means that the chromatid breaks.
b. Two chromatid breaks are required to produce an asymmetric chromosomal

aberration, such as a dicentric or a ring.
c. Cells that have an asymmetric chromosomal aberration die.
d. At low doses, the two chromatid breaks are caused by the passage of one charged
particle, i.e. they have an occurence probability that is linearly proportional to the dose.
e. At high doses, the two chromatid breaks are caused by the passage of two charged
particles, i.e. they have an occurence probability that is proportional to the square of the
dose.
f. Points (d) and (e) above account for the linear-quadratic shape of the dose-effect curve
and of the cell survival curve.
g. As the dose increases, the probability that the two chromatid breaks above will be
caused by the same particle increases.
a. For sparsely ionizing radiations, the survival curve is initially linear (on a log-linear plot)
and subsequently bends at higher doses.
b. For densely ionizing radiations, the survival curve is linear (on a log-linear plot) at all
dose values which are relevant to radiotherapy.
c. The survival curves of various cell types have the same value of D0.
d. If many persons are studied, we see that the D0 values of various tumour cells vary
over a wider interval than in the case of normal tissues.
e. Certain tumour cells are more radiosensitive than normal tissue cells, whereas others
are more radioresistant.
a. Mitotic cells from various cell lines have different radiosensitivities.
b. The radiosensitivity of a cell line is proportional to the size of the shoulder of the its
survival curve.
c. The more radiosensitive the cell line, the more important the contribution of apoptosis
is.
8. It has been established that oncogene expression induces radioresistance in

human tumours.
a. True.
b. False.
9. There are certain inherited syndromes that are associated with an abnormally
severe reaction of normal tissue to radiation therapy with X-rays. Such patients
also exhibit an elevated incidence of spontaneous cancer.
a. True.
b. False.
a. "Multifraction regimen" means that the dose is delivered to the patient in a series of
equal fractions, which are separated by time intervals that allow the repair of sublethal
cell damage to take place.
b. Multifraction regimens in radiotherapy require the use of "effective dose survival

curves".
c. The effective dose survival curve is an exponential function of the dose.
d. The dose required to kill 10% of all cells is called D0.
Chapter 4
Radiosensitivity and cell age in the mitotic cycle
a. Autoradiography (a cell-labelling technique) can be used to determine the lengths of

the various phases of the cell cycle.
b. Autoradiography has been used to show that cells synthesize DNA only during the S
phase.
c. Autoradiography can be performed using tritiated thymidine or bromodeoxyuridine.
d. All proliferating mammalian cells have cell cycle phases of equal length irrespective of
their type.
a. By "synchronously dividing cell culture" is meant a population of cells in which all cells
are at the same phase of the cell cycle simultaneously.
b. Synchronously dividing cell curves are used to study how the radiosensitivity of the cell
varies with the age of the cell, i.e. with the position of the cell in the cell cycle.
c. The mitotic harvest technique consists in producing a synchronously dividing cell

culture by killing all the cells that are at mitosis.
d. The use of a drug such as hydroxyurea produces a synchronously dividing cell culture
by killing all cells that are in the S phase and by imposing a block at the end of the
G1 phase of the cell cycle.
3. Irradiation with x-rays of HeLa and Chinese hamster cells harvested at mitosis
has shown that the cells are most sensitive when they are:
a. in the M phase of the cell cycle.
b. in the G1 phase of the cell cycle.
c. in the G2 phase of the cell cycle.
d. in the S phase of the cell cycle.
a. Cells in the S phase are radioresistant.
b. When the G1 has an appreciable length, it has been shown to be resistant in its early
part and sensitive in its late part.
c. Cells in the G2 phase are resistant.
d. The G2 phase is almost as sensitive as the M phase.
5. Mitotic cells under conditions of hypoxia are as radiosensitive as:
a. mitotic cells that are aerated.
b. cells in the late S phase.
c. cells in the G1 phase.
d. cells in the early S phase.

a. "Molecular checkpoint genes" are genes that control the cell-cycle progression.
b. One particular molecular checkpoint gene is responsible for halting the cell at G2 when
a small dose has been delivered to the cell. The purpose of halting the cell cycle at G2 is
to check for chromosome damage and repair it before the cell attempts to divide. This
results in a pilling up of cells in G2.
c. Cells containing mutant G2-halting genes are more sensitive to ionizing radiation than
the wild type, as they proceed directly to mitosis without previously repairing chromosome
damage caused by the radiation.
d. The inverse dose-rate effect, according which cells become more sensitive to
radiation-induced cell killing as the dose rate is increased, is due to the G2 pilling up
mentioned in answer b.
7. The variation of radiosensitivity as a function of cell age has been found to be

qualitatively similar for x-rays and neutrons but the variation of sensitivity is
smaller in the case of neutrons.
a. True.
b. False.
8. The variation of cell radiosensitivity with cell age might be due to:
a. changes in the amount or form of the DNA and/or changes in the level of naturally
occuring sulfhydryl compounds in the cell.
b. changes in the oxygen enhancement ratio.
c. the activation of different members of the cyclin-dependent kinase family.
9. The variation of cell radiosensitivity with cell age is important to radiotherapy

because:
a. the first dose of radiation synchronizes the cell population.
b. sensitization does not occur in rapidly dividing cells.
c. sensitization does not differentiate between cancer cells and normal cells.
d. the first dose of radiation kills all cells which are at the S phase of the cell cycle.
10. The oxygen enhancement ratio shows a significant variation during the cell
cycle.
a. True.
b. False.
Chapter 5
Repair of radiation damage and the dose-rate effect
1. Radiation damage is divided into (a) lethal damage, (b) sublethal damage and (c)
potentially lethal damage (PLD). Which of the following statements is true?
a. PLD will cause cell death under ordinary circumstances.
b. PLD cannot be repaired under ordinary circumstances.
c. The variation of postirradiation conditions cannot enhance PLD repair.
d. Mitosis cannot be delayed by suboptimal growth conditions.
e. PLD repair is less likely to occur when mitosis is delayed.
2. By "sublethal damage" is meant:
a. an irreversible damage which leads to cell death.
b. an irreversible damage which does not always lead to cell death.
c. a damage that can be repaired unless it interacts with a subsequently induced

sublethal damage.
d. a damage that can be modified by postirradiation environmental conditions.
3. Sublethal damage repair is:
a. connected to PLD repair.
b. responsible for the radioresistance of certain types of tumours.
c. the reason for the increase in cell survival which is observed when a radiation dose is
split into two fractions separated by a time interval.
d. continuously enhanced as the time interval between the two dose fractions mentioned
in answer c is increased.
4. The increase of cell survival because of sublethal damage repair:
a. is not affected by the cell cycle.
b. is hindered by the increase in radiosensitivity as the cells progress around the cell
cycle ("reassortment").
c. has no connection to cell synchronization.

d. is not enhanced by cell division ("repopulation").
a. The strong variations in the cell survival curve which are due to reassortment and
repopulation are observed in the case of rapidly growing cells as well as in the case of
slowly growing cells.
b. Sublethal damage repair is a process which is not affected by the presence of oxygen
and nutrients.
c. In a fractionated dose regimen, increase in cell survival occurs because the shoulder of
the cell survival curve is repeated every time a dose is delivered.
d. Sublethal damage repair accounts for the increase in cell survival in a split-dose case
for all time intervals between dose fractions.
e. There is no correlation between the extent of sublethal damage repair and the size of
the shoulder of the acute survival curve.
f. Sublethal damage repair is completed within 1 to 2 hours both for cells in culture and
for tissues in vivo.
a. Sublethal damage repair consists in the repair of double-strand breaks.
b. Dose fractionation affects the cell killing component which is due to double-strand
breaks produced by single-track damage.
c. The amount of sublethal damage repair does not vary with the type of radiation.
d. Sublethal damage repair is not significant in the case of x-rays.
7. The dose-rate effect:
a. is not important in radiotherapy.
b. does not affect significantly the biologic effect of x-rays or gamma rays.
c. consists in the reduction of the biologic effect of a given dose when the exposure time
is increased.
d. is not due to sublethal damage repair.
e. has a magnitude that does not depend on cell type.
f. is not affected by cell proliferation.
a. Cells with a small shoulder in the cell survival curve exhibit a strong dose-rate effect.
b. The dose-rate effect is most important at low doses.
c. The dependence on cell type both of the size of the shoulder in the acute survival
curve and of the magnitude of the dose-rate effect are related to the significance of
apoptosis for the specific cell type.
d. When different cell types are compared, their inherent radiosensitivity is shown in the
survival curves obtained at low dose rates rather than high dose rates.
e. At high dose rates, the difference between survival curves of different cell types is
enhanced by the variation with cell type of the sublethal damage repair time.
9. The inverse dose-rate effect is evident in a given interval of dose rates and is
due to the fact that, within this given interval, cells are "frozen" in the phase of the
cell cycle they are in at the beginning of the irradiation in the case of high dose
rates; at low dose rates, cells continue to cycle during irradiation.
a. True.
b. False.
Chapter 6
The oxygen effect and reoxygenation
a. Cells are more sensitive to x-rays in the presence of oxygen than in its absence (i.e.
under hypoxia).
b. By "oxygen enhancement ratio" (OER) is meant the ratio of hypoxic to aerated doses
needed to achieve the same biological effect.
c. For sparsely ionizing radiation, the OER is about 3 at high doses and about 2 at low
doses (i.e. at doses of the order of the daily dose per fraction in radiotherapy).
d. The OER does not vary with the phase of the cell cycle.
This explains the different values of OER given in answer c: G1 cells are more
radiosensitive than S cells and thus dominate at low doses; they also have a lower OER
value, which gives a lower overall value for OER in the low-dose interval.
2. The OER for alpha particles is equal to:
a. 3.
b. 2.5.
c. 1.6.
d. 1.0.
3. Sensitization by oxygen takes place if oxygen is present:
a. during irradiation.
b. as late as 5 ms after irradiation.
c. as late as 1 h after irradiation.
4. The following sequence of statements explains the "oxygen fixation

hypothesis". One of the statements is false. Find which.
a. The absorption of radiation causes the production of fast charged particles.
b. The charged particles produce ion pairs.
c. The ion pairs produce free radicals (these molecules have an unpaired electron and
are thus highly reactive).
d. The free radicals break chemical bonds, thus initiating the chain of events that results
in biologic damage.
e. All biologic damage is caused by free radicals.
f. A part of the free radicals, produced as explained above, are located on the target
molecules (DNA).
g. When oxygen is present, it reacts with the free radicals in the target to produce organic
peroxides. These peroxides constitute a nonrestorable form of the target material (i.e. if
they were not formed, the damaged target molecules would still have the capability to
repair themselves).
a. The oxygen effect can be visualized as a change in the slope of the survival curve (on
a log-linear plot) as oxygen is gradually introduced into the biologic system (i.e. the
greater the concentration of oxygen, the greater the change in the slope).
b. The most sensitive cells are those which are fully aerated ("equilibrated with air"). The
most resistant cells are those that are under the lowest level of hypoxia (i.e. those that
have the smallest concentration of oxygen).
c. The slope of the survival curve increases significantly as the oxygen concentration is
increased between the value corresponding to air and 100%.
d. In the case of x-rays, very small amounts of oxygen are enough to induce dramatic
changes in the radiosensitivity of the irradiated cells.
6. The radiosensitivity of cells under various oxygen concentrations can be

expressed by a quantity proportional to the reciprocal of the D0 value of the curve
(i.e. by a quantity which is proportional to the final slope of the survival curve).
a. True.
b. False.
7. The radiosensitivity of cells under full oxygenation is a factor of 10 greater than
the radiosensitivity of cells under anoxia.
a. True.
b. False.
a. Rapid increase in radiosensitivity is observed when the partial pressure of oxygen is

increased from 0 to 30 mm Hg.
b. Further increase in oxygen tension from 30 mm Hg to 760 mm Hg (i.e. 100% oxygen)

has a significant effect in cell radiosensitivity.
c. An oxygen tension of 3 mm Hg results in a radiosensitivity halfway between anoxia and

full oxygenation.
d. Oxygen tension in different tissues varies between 1 mm Hg and 100 mm Hg.
a. Hypoxia in tumours can result from two different mechanisms: chronic hypoxia and
acute hypoxia.
b. Chronic hypoxia is caused by a temporary closing of a blood vessel in the tumour.
c. Acute hypoxia is caused by the limited diffusion distance of oxygen through tissue that
is respiring.
d. Oxygen does not affect the radiosensitivity of tumours.
10. Which of the following statements referring to chronic hypoxia is true?
a. The centers of large tumours are necrotic and surrounded by intact tumour cells.
b. As the tumour grows, the necrotic center remains unchanged.
c. Both large and small tumours have a necrotic center.
d. The necrosis observed in the center of large tumours is not caused by the absence of
oxygen.
11. The distance to which oxygen can diffuse in tumour cells:
a. is the same as in normal cells.
b. is limited in comparison to normal cells because oxygen is metabolized faster in

tumour cells.
c. is approximately 70 micrometers at the venous end of a capillary and less at the

arterial end.
12. Tumour cells at which the oxygen tension is high enough for them to be
clonogenic but low enough for them to be radioresistant are called:
a. Normoxic.
b. Anoxic (necrotic).
c. Hypoxic viable.
13. Which of the following statements referring to acute hypoxia in tumour cells is
false:
a. Tumour blood vessels open and close in a random fashion.
b. Acute hypoxia is due to blood-flow instability.
c. Most cells with acute hypoxia eventually die.
14. The difference between chronic hypoxia and acute hypoxia is that in the latter
case the cells return to the normoxic state.
a. True.
b. False.
15. The probability to kill tumour cells which are in an acute hypoxic state
increases when the dose is fractionated (in comparison to the single dose case).
a. True.
b. False.
This is because when the first fraction of dose is delivered, some of the tumour cells will
be in an acute hypoxic state (and thus be resistant) but when a later fraction is delivered,
they may be normoxic again and thus radiosensitive. If the dose was delivered only in
one fraction, these cells would not be killed.
16. The fraction of hypoxic cells in human tumours has been estimated to be:
a. 5%.
b. 10-15 %.
c. 20-25%.
d. 50%.
a. Oxygen probes are electrodes implanted directly into tumours to measure oxygen
concentration.
b. Oxygen probes can be used before treatment as a predictive assay.

c. Oxygen probe measurements have been shown to correlate with local control of
certain tumour types.
d. Hypoxia is not considered to be an indication of tumour aggression.
18. The fraction of hypoxic cells in a tumour is approximately the same before and
after a single dose has been delivered to the tumour if sufficient time is allowed to
elapse.
a. True.
b. False.
Immediately after irradiation, the fraction of hypoxic cells has increased (radiation kills
mainly the normoxic cells).
19. "Reoxygenation" is a phenomenon by which:
a. acute hypoxic cells become normoxic.
b. oxygen contained in a high pressure chamber is allowed to "explode" onto a layer of

irradiated tissue at given time intervals after irradiation.
c. oxygen diffuses to the necrotic center of the tumour.
d. hypoxic cells become oxygenated after a dose of radiation.
20. If reoxygenation did not take place, the fraction of hypoxic cells after a
fractionated radiotherapy regimen would:
a. increase.
b. decrease.
c. remain constant.
21. The extent and rapidity of reoxygenation in various types of tumours are:
a. quantitatively similar.
b. very variable and impossible to predict.
c. approximately the same.

Chapter 7
Linear energy transfer and relative biological effectiveness
1. For a given radiation type, the density of ionization:
a. increases with the velocity of the ionizing particle.
b. decreases with the velocity of the ionizing particle.
c. is independent of the velocity of the ionizing particle.
a. Linear energy transfer (LET) is the energy transferred to the biologic material per unit
mass of the material.
b. LET is the quotient dE/dl, where dE is the energy that a particle lost in causing an
ionization and dl is the distance that the ionizing particle travels between two ionizations.
c. LET is the quotient dE/dl, where dE is the average energy locally imparted to the
medium by a charged particle when the particle has traversed a distance dl.
3. The "track average" method and the "energy average" method for calculating
LET give different numerical values in the case of:
a. x-rays and gamma rays.
b. protons.
c. alpha particles.
d. neutrons.
a. LET is used to describe the quality of different types of radiation.
b. The higher the LET value, the lower the biologic effectiveness of the radiation.
c. The LET value of 60Co gamma rays is 5 keV/micrometer.
d. The LET value of 10 MeV protons is 0.2 keV/micrometer.
a. Equal doses of different types of radiation have the same biologic effect.
b. The "relative biologic effectiveness" (RBE) is used to compare different types of

radiation.
c. In the definition of RBE, the reference radiation is 1 MeV gamma rays.

d. The RBE of a radiation r is equal to Dr/D250, where Dr and D250 are the doses of the
radiation r and of 250 kV x-rays, respectively, that produce the same biologic effect.
6. If the LD50 for 250 kV x-rays is 6 Gy and the LD50 of a neutron beam is 4 Gy, the
RBE of the neutron beam is equal to 1.5.
a. True.
b. False.
7. As the dose decreases, the RBE of a given radiation type:
a. increases.
b. decreases.
c. remains constant.
This implies that the RBE of densely ionizing radiation is greater for a fractionated
regimen than for a single exposure (because a fractionated regimen schedule consists of
a number of small doses and RBE is large at small doses).
8. Fractionation introduces a "waste in dose", which is more pronounced for

beams with a wide shoulder than for beams with a narrow shoulder in the survival
curve.
a. True.
b. False.
9. The RBE of a given beam does not depend on:
a. the total dose delivered to the tissue.
b. the number of fractions in which the dose is delivered to the tissue (in the case of a
fractionated regimen).
c. the dose-rate (in the case of continuous irradiation).
d. the type of irradiated tissue.
e. the endpoint studied.
f. the phase of the cell cycle in which the irradiated cells are at the moment the irradiation
begins.
g. the radiation quality (LET).
10. The RBE varies with increasing LET as follows:
a. it increases slowly at low LET values and more rapidly at high LET values up to 500
keV/micrometer.
b. it increases with LET values up to 100 keV/micrometer and subsequently decreases
with increasing LET.
c. it is a constant function of LET.
11. There is an optimal LET value for the production of a biologic effect because:
a. lower LET values involve "wasting" of radiation energy.
b. this LET value corresponds to an average separation between ionizing events which is
approximately equal to the diameter of the DNA molecule.
c. radiations with higher LET values have a low probability of producing a double-strand
break by the passage of a single charged particle.
12. RBE values are low for tissues that accumulate and repair a substantial amount
of sublethal damage and high for tissues that do not.
a. True.
b. False.
13. The relation between OER and LET is as follows:
a. OER is a constant fuction of LET.
b. OER has a value of about 3 at high LET values and then decreases to zero at low LET
values.
c. OER has a value of about 3 at low LET values and then decreases to unity at high LET
values (approximately 200 keV/micrometer).
14. An absorbed dose of 0.1 Gy of radiation with a radiation weighting factor of 20

corresponds to an equivalent dose of:
a. 0.2 Sv.
b. 2 Sv.
c. 20 Sv.
Chapter 8
Acute effects of total-body irradiation
a. By "prodromal radiation syndrome" are denoted the symptoms that appear soon after a
high-intensity exposure to radiation. These symptoms last for a limited period of time.
b. By "early radiation lethality" is meant death occuring within, at most, a few weeks after
a high-intensity exposure to radiation.
c. Early radiation lethality is subdivided into three distinct modes of death: the
cerebrovascular syndrome, the gastrointestinal syndrome and the hematopoietic
syndrome.
d. The mode of early radiation lethality is not related to the dose.
2. Total-body doses in excess of 100 Gy (gamma rays), which cause death within
24 to 48 hours after exposure, are connected to:
a. the cerebrovascular syndrome.
b. the gastrointestinal syndrome.
c. the hematopoietic syndrome.
3. The gastrointestinal syndrome is induced by a total-body absorbed dose of:
a. more than 100 Gy of gamma rays.
b. more than 10 Gy of gamma rays.
c. 3-8 Gy of gamma rays.
4. Bone-marrow death occurs:
a. 24 hours after irradiation.
b. a few days after irradiation.
c. several weeks after irradiation.
5. Which of the following symptoms is characteristic of the cerebrovascular

syndrome?
a. Nausea.
b. Vomiting.
c. Disorientation.
d. Diarrhea.
6. By LD50/30 is denoted:
a. The dose required to induce death in 50% of a given population by 30 days after
irradiation.
b. The dose required to induce sublethal damage in 50% of a given population by

irradiation with a beam which has a LET value of 30.
c. The dose required to induce death of 30% - 50% of the population.
7. Which of the following statements regarding the prodromal syndrome is false?
a. The prodromal syndrome is caused by the LD50 dose.
b. The main symptoms of the syndrome are nausea and vomiting.
c. The syndrome is followed by a symptom-free period, known as the latent period.
d. No significant biological events take place during the latent period.
8. The LD50/60 dose for humans is approximately equal to:
a. 1 Gy.
b. 4 Gy.
c. 10 Gy.
d. 60 Gy.
9. Which of the following statements regarding the treatment of radiation accident

victims is false?
a. At doses less than 4 to 5 Gy, the patient is only treated in response to specific
symptoms.
b. At doses 5-8 Gy, infection, bleeding and physical trauma are to be avoided during the
period in which the circulating blood elements have a low concentration.
c. At doses 8-10 Gy, a bone-marrow transplant can be administrated.
d. At doses above 10 Gy, a bone-marrow transplant must always be administrated.
10. The LD50 dose (4 Gy) can be doubled by careful nursing and an antibiotic
screen.
a. True.
b. False.
Chapter 10
Radiation carcinogenesis
a. Radiation damage can cause a cell to either die or continue being viable but mutated.
b. The two events above are very different when it comes to the dose dependence of
their probability to occur and also when it comes to their impact on the organism to which
the cell belongs.
c. Cell killing by radiation is said to be a "deterministic effect".
d. Cell mutating by radiation is said to be a "nonstochastic effect".
2. A deterministic effect:
a. has a threshold in dose but the severity of the effect is otherwise dose-independent.
b. has a threshold in dose and the severity of the effect increases with dose.
c. has no threshold in dose and the severity of the effect is a constant function of dose.
d. has no threshold in dose and the severity of the effect increases with dose.
3. Carcinogenesis and hereditary effects are:
a. deterministc effects.
b. stochastic effects.
a. Stochastic effects have no threshold in dose.
b. The probability of induction of a stochastic effect increases with dose.
c. The severity of a stochastic effect increases with dose.
d. A cancer induced by 1 Gy is not worse than a cancer induced by 0.5 Gy.
5. Experiments with animals have shown that the cancer incidence probability
increases with dose, reaches a maximum value and then decreases with dose. The
decrease is due to the fact that:
a. higher doses than those corresponding to the incidence probability peak have no
further effect on the tissue.
b. sublethal damage at high doses is repaired faster than sublethal damage at low doses.
c. increasing the dose beyond the value corresponding to the incidence probability peak
results in increasingly larger amounts of cells that are killed by the radiation.
6. The latent period for leukemias is longer than for solid tumours.
a. True.
b. False.
7. Radiation-induced tumours appear:
a. at a fixed time interval following irradiation.
b. at random time intervals following irradiation.
c. late in life, i.e. at the same time as spontaneous tumours would.
8. The risk estimation model that calculates the excess incidence probability of
cancer induced by radiation as a function of dose, the square of the dose, age at
exposure, time since exposure and gender of the individual is called:
a. the absolute risk model.
b. the relative risk model.
c. the time-dependent relative risk model.
d. the time-independent relative risk model.
9. Quantitative risk estimates for radiation-induced cancer are mainly based on

data from:
a. victims of radiation accidents.
b. experiments with animals.
c. the survivors of Hiroshima and Nagasaki.
10. The ratio of radiation-induced solid cancers to leukemias is (by the end of the
lifespan of the irradiated population):
a. 2-4.
b. 4-6.
c. 6-8.
11. The number of radiation-induced malignancies:
a. is higher at low dose rates.
b. is lower at low dose rates.
c. is independent of the dose rate.

12. The lifetime risk of cancer lethality caused by radiation at high doses and high
dose rates is:
a. 10% per Sv.
b. 20% per Sv.
c. 30% per Sv.
13. The lifetime risk of cancer lethality caused by radiation at low doses and low
dose rates is:
a. 5% per Sv.
b. 10% per Sv.
c. 20% per Sv.
14. The enhancement in the risk of second malignancies associated to

radiotherapy is found to be:
a. statistically uncertain.
b. small.
c. significant.
Chapter 11
Hereditary effects of radiation
1. The thresholds for permanent sterility in men for an acute exposure and under
prolonged exposure conditions are:
a. 0.5 to 1 Gy and 0.2 Gy/y, respectively.
b. 2.5 to 3 Gy and 1.5 Gy/y, respectively.
c. 3.5 to 6 Gy and 2 Gy/y, respectively.
d. 7.5 to 10 Gy and 6 Gy/y, respectively.
2. The thresholds for permanent sterility in women for an acute exposure and
under prolonged exposure conditions are:
a. 0.5 to 1 Gy and 0.2 Gy/y, respectively.
b. 2.5 to 6 Gy and 0.2 Gy/y, respectively.
c. 3.5 to 6 Gy and 2 Gy/y, respectively.
d. 0.5 to 2 Gy and 2 Gy/y, respectively.

a. The genetic information is coded in terms of the order of the bases (A, C, G, T) in the
DNA molecule. The DNA is the essential ingredient of the chromosomes. The
chromosomes thus carry the information that specifies all the characteristics of a human.
b. A gene is a finite segment of DNA. The gene is defined by the sequence of the bases it
contains.
c. The position of a gene in the DNA molecule is called the "locus" of the gene.
d. Males have 22 pairs of autosomes plus a pair of X chromosomes. Females have 22

pairs of autosomes plus a Y and an X chromosome. One chromosome of each pair is
derived from each parent.
4. A segment of a gene that is transcribed and translated into protein is called:
a. an intron.
b. an exon.
5. By the term "genome" we denote:
a. the DNA of the chromosomes.
b. the translated parts of the genes.
c. the DNA of the mitochondria.
d. the DNA of the chromosomes and mitochondria.
6. Which of the following statements is false:
a. By "mutations of the genome" we mean changes in bases of the DNA of the

chromosomes.
b. Mutations can occur both in somatic cells and in germs cells.
c. Mutations in the germ cells are more apparent than mutations in the somatic cells,
unless the latter ones occur under conditions of clonal proliferation (cancer).
d. Mutations in the germ cells can cause death during embryonic development or adverse
effects in the progeny ("genetic diseases" or "hereditary diseases").
7. Which of the following statements is false:
a. If the two chromosomes in a chromosome pair have the genes for given characteristics
lined up in the same order, the two chromosomes are called "homologous".
b. If the two chromosomes in a chromosome pair have the genes for given characteristics
lined up in different orders, the two chromosomes are called "heterologous".
c. In a given chromosome pair, if the two genes controlling the same characteristic are
alike, the person is said to be homozygous for that pair of genes.
d. In a given chromosome pair, if the two genes controlling the same characteristic are
different, the person is said to be heterozygous for that pair of genes.
e. The chromosomes in the XY pair are homologous.
8. A recessive gene does not express itself if:
a. the person is homozygous for the recessive gene.
b. the person is heterozygous for the recessive gene.
c. the recessive gene is on a pair of heterologous chromosomes.
d. the corresponding gene on the other chromosome is not completely dominant.
9. Genetic diseases are divided into: mendelian, chromosomal and multifactorial.
a. True.
b. False.
10. Which of the following statements referring to mendelian diseases is false?
a. Mendelian diseases are caused by a mutation on a single gene either on the

autosomes or on the sex chromosomes.
b. Mendelian diseases are subdivided into: autosomal dominant, autosomal recessive

and X-linked.
c. Autosomal dominant diseases are caused by dominant mutant genes and autosomal
recessive diseases are caused by recessive mutant genes.
d. Autosomal recessive diseases are always expressed in the first generation of the
progeny.
11. X-linked recessive mendelian diseases are caused by recessive genes located
on:
a. an autosome.
b. the Y chromosome.
c. the X chromosome.
a. Chromosomal diseases are caused by gross abnormalities in the structure of the

chromosomes or in the total number of chromosomes.
b. Multifactorial diseases have a genetic component and an environmental component
and their expression varies among individuals, families and populations.
c. Most of the genetic diseases observed in a population are mendelian or chromosomal.
13. The effect of radiation on genetic diseases is:
a. to introduce new types of diseases.
b. to increase the occurence probability of naturally existing diseases.
c. both of the above.
14. The doubling dose is used to estimate the hereditary risks of radiation. It is the
dose required to produce as many mutations as those naturally occuring in a
generation. The doubling dose is used in the estimation of:
a. the absolute mutation risk.
b. the relative mutation risk.
15. The estimation of the hereditary risks of radiation is mainly based on:
a. studies of the children of the survivors at Hiroshima and Nagasaki.
b. animal data.
16. In the megamouse project, both male and female mice were irradiated with
different doses, dose-rates and fractionation patterns to estimate:
a. the relative mutation risk for seven specific-locus mutations.
b. the absolute mutation risk for seven specific-locus mutations.
17. Based on mice data, the doubling dose for humans (at low dose-rate
exposures) has been calculated to be:
a. 0.2 Gy.
b. 1 Gy.
c. 2.5 Gy.
d. 5 Gy.
Chapter 12
Effects of radiation on the embryo and fetus
a. Radiation can cause the following effects in the unborn child: cancer, lethality, organ
malformations or growth disturbances.
b. The effect of radiation on the unborn child is influenced by the total dose, the stage of
gestation and the dose rate.
c. The estimation of radiation-induced damage in utero has to be done against the

naturally occuring level of inborn defects.
d. The incidence of spontaneously malformed infants at birth is about 1%.
2. The most sensitive stage for the lethal effects of radiation is:
a. Preimplantation.
b. Early organogenesis.
c. Late organogenesis.
d. The fetal period.
a. During preimplantation, radiation damage can only result in death of the embryo. If the
embryo survives, it grows normally.
b. During organogenesis, the main effects of radiation is the production of anomalies in

the structure of the embryo and growth retardation.
c. The damage caused by radiation on the fetus include effects on the hematopoietic
system, liver and kidneys. Growth retardation and lethality have also been documented.
d. Higher doses of radiation are required in order to cause lethality in the early stages of
embryonic development than in the fetal period.
4. Which of the following statements is not part of the observations made about
children exposed in utero at Hiroshima and Nagasaki?
a. Increased fetal loss or infant mortality rate.
b. No birth defects for irradiation that took place in the first 15 days of gestation.
c. Growth retardation in irradiated embryos.
d. Catch-up growth in the cases mentioned in answer c.

5. The main effects on children irradiated in utero in Hiroshima and Nagasaki are:
a. fetal loss and mental retardation.
b. infant mortality and microcephaly.
c. microcephaly and mental retardation.
d. growth retardation and teratogenesis.
6. Find which of the following statements does not belong to the conclusions
drawn about mental retardation caused by irradiation in utero of children in
Hiroshima and Nagasaki.
a. Severe mental retardation was not observed if the irradiation took place before 8
weeks or after 25 weeks after conception.
b. The most sensitive period was between 8 to 15 weeks after conception.
c. The incidence of mental retardation in the sensitive period (mentioned in answer b) is a

linear function of the dose with a probability of 40% at a dose of 1 Gy.
d. There was no dose threshold observed in the dose-response curve for mental
retardation.
7. Which of the following statements regarding exposure in utero to medical

radiation is true?
a. Large doses (2.5 Gy) delivered to the embryo before 2 to 3 weeks of gestation are not
likely to cause lethality.
b. Irradiation between weeks 4 and 11 is not likely to cause organ abnormalities.
c. Irradiation between weeks 11 and 16 may produce eye, skeletal and genital organ
abnormalities as well as microcephaly and mental retardation.
d. Irradiation between weeks 16 and 20 has not been observed to lead to microcephaly,
mental retardation or stunting of growth.
e. Irradiation after week 30 is not expected to cause functional disabilities.
8. One difference between animal experiments and the observation of in utero

irradiation results in children in Hiroshima and Nagasaki was that the wide range of
congenital malformations found in animal data was not observed in the data of
human origin, which, on the other hand, reported several cases of mental
retardation and microcephaly. This is believed to be due to the fact that:
a. in the case of humans, the period of susceptibility to congenital malformations (10-32

days of gestation) is short in comparison to the 8 weeks (16 weeks) during which mental
retardation (microcephaly) can be induced.
b. the physiology of mice and humans is very different in that respect.

c. the doses delivered in animal experiments were not high enough to cause
microcephaly.
9. An obstetric x-ray examination increases the spontaneous risk of childhood

cancer by:
a. 10%.
b. 20%.
c. 30%.
d. 40%.
Chapter 13
Radiation cataractogenesis
a. By "cataract" is denoted any detectable change in the normally transparent lens of the
eye.
b. Cataracts can be caused by irradiation of the lens.
c. Cell division in the lens continues throughout life.
d. The lens has the same mechanisms for cell removal as other normal tissues.
a. Even low doses (2.5-6.5 Gy) induce, in most cases, severe opacity of the lens.
b. High doses to the lens (6.5-11.5 Gy) can result in lost of vision.
c. The probability of cataract induction by radiation is a function of the dose only and does
not depend on the exposure time.
d. Increasing the dose does not affect the probability for the occurence of a progressive
cataract.
3. In the case of radiotherapy patients, it has been shown that the lens can tolerate
a higher dose with increased fractionation and overall treatment time.
a. True.
b. False.
4. The average latent period for cataract in the lens for patients that have received
2.5 to 6.5 Gy is:
a. 1 year.
b. 5 years.
c. 8 years.
d. 20 years.
5. The average latent period for cataract in the lens for patients that have received
6.5 to 11.5 Gy is:
a. 1 year.
b. 4 years.
c. 10 years.
d. 17 years.
a. The dose-response relationship for radiation-induced cataract has been reconstructed

with high accuracy.
b. There seems to be a threshold for the induction of detectable lens opacification by

radiation.
c. Animal experiments indicate that high LET radiations have a high RBE for lens
opacification.
d. Radiation-induced cataracts are a deterministic late effect (there is a threshold below

which they do not occur and the severity of the biologic response is dose-related).
Chapter 14
Doses and risks in diagnostic radiology, interventional radiology and
cardiology and nuclear medicine
1. The dose rate from potassium-40 in the human body is:
a. 0.1 mSv/y.
b. 0.2 mSv/y.
c. 0.5 mSv/y.
d. 1 mSv/y.
2. The annual dose from radon gas is:
a. 2 mSv.
b. 10 mSv.
c. 15 mSv.
d. 20 mSv.
3. The average effective dose from medical radiation is about:
a. the same as the dose from natural background radiation.
b. the same as the dose from natural background radiation excluding radon.
c. half of the total effective dose.
d. one third of the total effective dose.
4. The annual effective dose from all sources (natural background and ordinary
medical examinations) is:
a. 1 mSv.
b. 1.5 mSv.
c. 3.5 mSv.
d. 6 mSv.
5. The doses relevant to diagnostic radiology cannot induce deterministic effects

(with the exception of the irradiation of the embryo or fetus) but they can induce
stochastic effects (carcinogenesis and hereditary effects).
a. True.
b. False.
6. Effective dose is the whole-body dose of x-rays that would have to be delivered
to produce the same stochastic risk as the partial-body dose that is actually
delivered.
a. True.
b. False.
7. The collective effective dose is:
a. the total dose a patient receives in a series of examinations.
b. the absorbed dose a patient receives in a single examination multiplied by the

appropriate tissue weighting factors.
c. the product of effective dose that an individual in a given population receives and the
numbers of exposed individuals.
8. The effective dose for a multiple-slice chest CT-scan is:
a. 1 mSv.
b. 2 mSv.
c. 4 mSv.
d. 8 mSv.
9. The effective dose for a single chest radiograph is:
a. 0.02 mSv.
b. 0.5 mSv.
c. 1 mSv.
d. 1.5 mSv.
10. In order to estimate the harm to an exposed population in terms of radiation

induced cancers and hereditary effects, we use:
a. the average absorbed dose per patient.
b. the average effective dose per patient.
c. the average equivalent dose per patient.
d. the collective effective dose to the patients and to the radiation workers.
11. The risks for cancer or hereditary diseases caused by ionizing radiation are:
a. 1% per Sv for fatal cancer induction and 0.2% per Sv for severe hereditary effects.
b. 1% per Sv for fatal cancer induction and 5% per Sv for severe hereditary effects.
c. 4% per Sv for fatal cancer induction and 0.6% per Sv for severe hereditary effects.
d. 0.1% per Sv for fatal cancer induction and 0.6% per Sv for severe hereditary effects.
12. In interventional radiology and cardiology, the doses are much higher than in
general diagnostic radiology, which:
a. increases the risk for stochastic effects, while there is still no risk for deterministic
effects.
b. increases the risk for stochastic effects and implies a risk for deterministic effects as
well.
13. Depending on the type of the examination, the effective dose in an

interventional procedure is in the interval:
a. 0.2-10 mSv.
b. 0.2-20 mSv.
c. 0.2-40 mSv.
d. 0.2-80 mSv.
14. The effective dose in a diagnostic nuclear medicine investigation is in the

interval:
a. 0.1-10 mSv.
b. 0.5-2 mSv.
c. 0.5-25 mSv.
d. 10-60 mSv.
15. The dose to the patient from a PET scan is relatively small because:
a. a small activity of radionuclide is used.
b. the radionuclide decays slowly.
c. the radionuclide decays quickly.
16. The use of iodine-131 for the treatment of hyperthyroidism has been
considered to induce:
a. thyroid cancer in adults.
b. thyroid cancer in children.
17. Children are most sensitive than adults to radiation induced cancer, especially:
a. lung cancer.
b. breast and thyroid cancer.
c. brain cancer.
d. ovarian cancer.
Chapter 15
Radiation protection
1. The radiation weighting factor depends :
a. only on the energy of the radiation.
b. only on the particle type of the radiation.
c. both on the energy and the particle type of the radiation.

2. The equivalent dose is:
a. the mean absorbed dose over all irradiated organs.
b. the product of absorbed dose and radiation weighting factor for a given tissue or organ,
where the absorbed dose is averaged over the tissue or organ.
c. the product of absorbed dose and tissue weighting factor.
3. In the case of non-uniform irradiation of the body, the risk for stochastic effects
is described by:
a. the equivalent dose.
b. the effective dose.
c. the total absorbed dose.
4. The susceptibility of a tissue or organ to radiation is accounted for in:
a. the equivalent dose.
b. the effective dose.
c. the absorbed dose.
5. In the case of internally deposited radionuclides, the dose rate:
a. increases with time.
b. decreases with time.
c. is a constant function of time.
6. The committed effective dose and committed equivalent dose are used in the
case of:
a. external irradiation.
b. internal irradiation.
7. The unit of the collective effective dose is:
a. person-Sv.
b. R.
c. Gy.
d. Sv.
8. The recommended monthly limit to the embryo or fetus is:
a. 0.05 mSv.
b. 0.1 mSv.
c. 0.5 mSv.
9. The recommended level for manmade sources other than medical in the case of
continuous exposure for the public is (annual effective dose):
a. 1 mSv.
b. 2 mSv.
c. 5 mSv.
d. 20 mSv.
10. The most important problem involving radiation exposure of the public is:
a. radon.
b. medical examinations.
c. accidents in nuclear power plants.
Chapter 18
Dose-response relationships for model normal tissues
a. Most cells in vitro die a mitotic death after irradiation.
b. Apoptosis (programmed death) occurs both in normal tissue cells and in neoplasm
cells.
c. Irradiated cells cannot die by apoptosis.
2.There is a number of techniques available to determine the dose-response

relationship of normal tissues. Amongst them, the clonogenic assays are
techniques in which:
a. the endpoint observed depends directly on the reproductive integrity of individual cells
(either in situ or in a different tissue where the cells are transplanted after irradiation.)
b. functional endpoints are studied (which tend to reflect the minimum number of
functional cells remaining in a tissue).
c. one infers the dose-response curve for a tissue in which it cannot be directly observed
by performing a number of multifraction experiments.
3. The intestinal epithelium cells are:
a. early-responding tissues.
b. late-responding tissues.
4. The kidney tissue is:
a. early-responding.
b. late-responding.
5. The radiation response of all tissues (early-responding and late-responding)

results from a depletion of the critical parenchymal cells.
a. True.
b. False.
6. Which of the following statements referring to clonogenic assays in situ is false?
a. The survival curves of mouse skin colonies were studied for single-dose and double-
dose exposures. The study resulted in a D0 value of 1.35 Gy and a Dq value of 3.5 Gy.
b. To obtain the survival curve for the jejunal crypt cells in mice, groups of animals were
exposed to graded total-body doses (at different fractionations) and the number of
regenerating (i.e. surviving) crypt cells were subsequently measured. The study resulted
in a D0 value of 1.3 Gy and a Dq value in the range 4 - 4.5 Gy.
c. In testes stem cells studies, it was found that D0 has the value of 1.7 Gy and Dq is
equal to 2.7 Gy.
d. The radiosensitivity of kidney tissue was found to be very different from the
radiosensitivities of skin, crypt cells and testes.
7. Which of the following statements about clonogen transplant assays is false?
a. In clonogen assays, the survival curve is extracted by measuring the ratio of irradiated
to unirradiated cells that are required to produce a colony (as a function of dose).
b. Bone-marrow stem cells in mice are the most sensitive mammalian cells to die a
mitotic death (D0=0.95 Gy) and they have a little shoulder in the survival curve.
c. The D0 for mammary cells has the value 1.27 Gy.
d. The D0 value for thyroid gland cells is a little higher than the D0 value for mammary
cells, which shows that the thyroid cells are more sensitive than the mammary cells.
8. The most radiosensitive cells are:
a. the bone-marrow cells.
b. the mammary cells.
c. the thyroid cells.
d. the ataxia telangiectasia cells.
9. Which of the following statements (regarding dose-response observations for

functional endpoints) is false?
a. Skin cells show both an early and a late reaction to radiation.
b. Experiments on skin reaction with pigs and mice have shown similar results.
c. The lung shows both early and late response to radiation.
d. Experiments on rats have shown that the spinal cord has a late response to radiation.
Chapter 21
Cell, tissue and tumour kinetics
a. The mitotic index (MI) gives the proportion of cells that are dividing, i.e. the duration of
mitosis as a fraction of the cell cycle.
b. The labeling index (LI) gives the proportion of cells that are synthesizing DNA, i.e. the
duration of the S phase as a fraction of the cell cycle.
c. Cells are distributed linearly in time around the cell cycle.
2. The "percent-labeled mitoses technique" entails:
a. the feeding of a population of cells in the S-phase and the subsequent observation of
the stained cells in the M phase.
b. the determination of the fraction of dividing cells at a given time after irradiation.
c. the determination of the relative duration of mitosis.
3. By the term "percentage of labeled mitoses" is meant:
a. the percentage of mitoses occuring at a given time as a fraction of the total number of
mitoses occuring in the cell cycle.
b. the percentage of cells at mitosis as a fraction of the total number of cells in the studied
population.
c. the percentage of mitotic cells that carry a radioactive label.

4. All cells in a population have indentical cell cycle times.
a. True.
b. False.
5. By using the percent-labeled mitoses technique, one determines the duration of

the various cell cycle phases.
a. True.
b. False.
6. In the percent-labeled mitoses technique, the time interval before any mitotic
cells appear gives the duration of:
a. the S phase.
b. the G1 phase.
c. the G2 phase.
d. the M phase.
7. In practice, the data obtained using the percent-labeled mitoses technique can
determine precisely:
a. the peaks and 50% levels of the curves.
b. the peaks of the curves.
c. the duration of the S period.
8. In the cases where at least two peaks are discernible in the data collected by
using the percent-labeled mitoses technique, the duration of all phases in the cell
cycle can be determined if one combines these data with:
a. the labeling index.
b. the mitotic index.
9. In the cases where only one peak is discernible in the data collected by using
the percent-labeled mitoses technique, the duration of all phases in the cell cycle
can be determined if one combines these data with:
a. the labeling index.
b. the mitotic index.

10. Cancer cells of a given tissue type have:
a. shorter cell cycles than the normal cells of this tissue type.
b. longer cell cycles than the normal cells of this tissue type.
c. about equal cell cycles than the normal cells of this tissue type.
By, Mohamed Kelany

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Chapter 1: The physics and chemistry of radiation absorption

1. What is the difference between X-rays and gamma rays?

b. X-rays have higher energies than gamma rays.

c. gamma rays are produced by bremsstrahlung.

d. X-rays and gamma rays interact with matter differently.

2. What is the main source of natural background radiation?

3. Which photon processes are dominant in the context of diagnostic radiology?

a. Compton scattering and photoelectric effect.

b. Photoelectric effect and pair production.

c. Compton scattering and pair production.

d. Compton and Rayleigh scattering.

4. The mass absorption coefficient for Compton scattering is independent of the

5. Direct action of radiation is the dominant process for:

b. Neutrons and alpha particles.

a. Indirect action can be modified by protectors or sensitizers.

b. Direct action can be modified by protectors or sensitizers.

7. A free radical is:

a. Any charged particle.

b. An atom or molecule with an unpaired electron in the outer shell.

c. An atom with an even number of electrons.

d. A chemically stable atom.

8. The main interaction process(es) of neutrons in biologic matter are:

b. Coulomb scattering by orbital electrons.

d. Elastic and inelastic scattering by nuclei.

a. The energy of the radiation.

c. The density of ionization.

d. The fact that neutrons can interact with nuclei.

1. What is the most important lesion produced in chromosomal DNA by exposure

a. A break on one DNA strand ('single-strand break').

b. Well-separated breaks on both DNA strands.

d. Multiple breaks on the same DNA strand.

3. Which of the following statements is correct?

a. Double-strand breaks can be repaired by homologeous recombination or

b. Nonhomologous recombination is error-free.

c. Homologous recombination occurs often in mammalian cells.

d. Homologous recombination accounts for many of the premutagenic lesions induced in

4. Which of the following statements is false?

c. Blobs have a diameter of about 7 nm and contain 12 ion pairs on average.

5. The D0 dose is the dose that:

c. kills all cells.

d. kills 30% of all cells.

6. Chromosomal aberrations are caused by:

c. single-strand or double-strand breaks.

7. Following exposure to radiation, some of the chromatin strands are broken.

c. Broken ends fail to rejoin (which leads to a chromosomal aberration).

d. A broken end of a chromatin strand joins to an unbroken end of another chromatin

8. The chromosome material is duplicated at:

9. Which of the following statements is false?

a. Chromosomal aberrations are divided into "chromosome aberrations" and "chromatid

a. Chromosomal aberrations can lead to cell killing, mutation or carcinogenesis.

c. The anaphase bridge is a chromosomal aberration that is lethal to the cell.

11. Which of the following statements is correct?

1. Which of the following statements is false?

2. What does a "cell survival curve" describe?

3. What is the dominant mechanism of reproductive death in irradiated cells?

4. One evidence that chromosomal aberrations in irradiated cells is the main

5. Which of the following statements is false?

a. A double-strand break in the DNA means that the chromatid breaks.

b. Two chromatid breaks are required to produce an asymmetric chromosomal

c. Cells that have an asymmetric chromosomal aberration die.