MTMI Mammography Review questions with correct answers, Exams of Nursing

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MTMI Mammography Review questions with

correct answers

Informed Consent Answer✓✓ If below the age 50, pt should talk to MD to see if mammogram is appropriate. They should be asking if they should have the exam done. 1980s Answer✓✓ Screenings Started in what year? Female Disease Answer✓✓ Breast cancer is primarily a _________ disease. 40 Answer✓✓ Annual mammography should begin at what age? good health Answer✓✓ Annual mammography should continue as long as the patient is.......... 20s Answer✓✓ BSE should begin at what age? 20-39 (optional) Answer✓✓ CBE should occur for what ages? at least every 3 years Answer✓✓ CBE should occur how often? Asymptomatic Answer✓✓ Screening mammogram is for what type of women?

X-ray breast examination of asymptomatic women in an attempt to detect breast cancer when it is small, nonpalpable and confined to the breast. Answer✓✓ Define Screening Mammogram Mammography performed on patients who, by virtue of symptoms, physical findings, or screening mammograms, are considered to have a substantial likelihood of having breast disease. Answer✓✓ Define Diagnostic Mammography Compare current with priors; earlier detection of abnormalities. Answer✓✓ Why should we receive previous images?

1. Quadrants
2. Clock
3. Depth Answer✓✓ 3 ways to describe location of pt complain on breast 6th or 7th rib. (IMF) Answer✓✓ Describe anatomical location of Inferior breast 1st or 2nd rib (Clavicle) Answer✓✓ Describe anatomical location of Superior portion of breast Sternum Answer✓✓ Describe anatomical location of Medial portion of breast Midaxillary line Answer✓✓ Describe anatomical location of Lateral portion of breast Nipple Answer✓✓ Where is the Apex of the breast?

TDLU Answer✓✓ The lobule plus a small portion of the duct hold the milk producing elements (acinus) ELTD (Extralobular Terminal Duct) *where the stem enters Answer✓✓ The final branch of the terminal duct as it enters the lobule ILTD (Intralobular Terminal Duct) *Spine of the leaf Answer✓✓ The portion of the terminal duct within the lobule ELTD Answer✓✓ 85% Ductal ILTD Answer✓✓ 10% lobular Epithelial cell layer Answer✓✓ Where do most breast cancers arise? Myoepithelial Cell Answer✓✓ What type of cells tells you what it is cancer or not? Benign Answer✓✓ If a myoepithelial cell is present in hyperplastic tissue, is it benign or cancer? Cancer Answer✓✓ If a myoepithelial cell is absentin hyperplastic tissue, is it benign or cancer?

Modified Sweat gland. Answer✓✓ The mammary gland is a _________________.

1. Little fat
2. Prepubertal
3. Nulliparous
4. Pardiographically dense Answer✓✓ Characteristics of a fibroglandular breast. Annually (and at installation) Answer✓✓ Frequency of medical physicist tests 18 x 24 cm 24 x 30 cm Answer✓✓ Two sizes of IRSD ( Image receptor support devices) 5:1 Answer✓✓ Typically grid ratio Height to the width of interspaces (not the grid bars) in the grid Answer✓✓ Define grid ratio
5. Reduces Scatter
6. Increase contrast, short scale Answer✓✓ How does compression affect the image? 2-3x Answer✓✓ How much does a grid increase dose?
7. 2%

@ 4cm in front of chest wall edge IRSD Answer✓✓ Line Focus Principle. Where is the sweet spot? Chest wall Answer✓✓ Where is the cathode located in relation to patient anatomy? Better Answer✓✓ Is resolution better or worse towards the nipple edge of the IRSD? Worse Answer✓✓ Is resolution better or worse towards the chest wall of the IRSD? 24cm Answer✓✓ _____cm is the largest chestwall to nipple dimension FOV Cathode side is closest to the patient so that the anode-hell effect exposes the thickest part of the breast (chestwall) with the higher radiation output Answer✓✓ State the Anode Heel Effect Molybdenum Answer✓✓ Target material. What does "Mo" stand for?-Spell it correctly gets ride of soft photons (dose) *decrease in number of higher energy photons (which reduce contrast) Answer✓✓ Purpose of filtration AL

*only in 3D Answer✓✓ What type of filtration is used in DBT? (digital breast tomosynthesis) .5mm Al equivalent Answer✓✓ Tube filtration: total must exceed _________? 25-32 kVp Answer✓✓ X-RAY Spectra for "Mo" 28-35 kVp Answer✓✓ X-RAY Spectra for "Rh" 25-38 kVp Answer✓✓ X-RAY Spectra for "W" AL Answer✓✓ What type of filtration is not used in 2D digital mammography, but is usedin DBT (digital breast tomo_ penetrating Answer✓✓ HVL is a measure of the x-ray beam's _________ ability. Average glandular dose Answer✓✓ Considered to be the appropriate radiobiological dose in mammography Average glandular dose Answer✓✓ what is estimated from entrance skin exposure Linearly Answer✓✓ The risk of radiation induced carcinogenesis is considered to be __________ related to dose Glandular Answer✓✓ Most Breast cancer arises in what type of tissue?

great than or equal to Answer✓✓ SID for magnification 70cm Answer✓✓ SID for DBT Beryllium because it allows soft x-ray photons out of tube Answer✓✓ What is the x-ray tube window made of? and Why? Minimum Frequency ANNUALLY Answer✓✓ How often should the medical physicist tests be performed? To ensure all locks, dents, angulation indicators, and mechanical support devices for the xray tube and image receptor holder assembly are operating properly Answer✓✓ Purpose of the mammographic unit assembly evaluation To assure that the xray field aligns with the light field, that the collimator allows for full coverage of the image receptor by the xray field but does not allow significant radiation beyond its edgs, and that the chest-wall edge of the compression paddle aligns with the chest-wall edge of the film Answer✓✓ Purpose of collimation assessment to evaluate limiting resolution of the entire mammography system including effects from geometric (focal spot) blurring and screen-film combination. Answer✓✓ Purpose of system resolution To assess the performance of the mammography unit's AEC system, to maintain image optical density as breast thickness and imaging modes change, and to alter optical density using the density control selector function Answer✓✓ Purpose of AEC system performance assessment

To assess the uniformity of the radiographic speed of image receptors routinely used for mammographic imaging. Answer✓✓ Purpose of screen speed To assess the degree and source(s) of artifacts visualized in mammograms or phantoms. This procedure isolates the sources o the artifact so that appropriate measures to eliminate the artifact can be taken. Answer✓✓ Purpose of artifact evaluation To assess mammographic image quality and to detect temporal changes in image quality Answer✓✓ Purpose of image quality evaluation To assure that the actual kVp is accurate and the kVp is reproducible having a coefficient of variation to or less than 0. ***within +/- 5% of the indicated kVp Answer✓✓ Purpose of kVp accuracy and reproducability To assure that the half-value layer of the x-ray beam is adequate to minimize patient dose, while not so excessive that contrast is lost in the resultant image Answer✓✓ Purpose of beam quality assessment (Half Value Layer)

1. To measure the typical enterance exposure for an average patient to calculate the associated average glandular dose, to assess short-term AEC reproducibility, and to measure the air kerma rate. a. approx., 4.2 cm compressed breast thickness, 50% adipose, 50% glandular composition Answer✓✓ Purpose of Breast Entrance exposure, AEC, Reproducibility, average glandular dose, and radiation output rate To assure that the luminance of the viewboxes for interpretation or quality control of mammography images meet or exceed minimum levels, that the room

Separate overlapping anatomic structures ****Summation artifact ****Superimposed glandular tissue Answer✓✓ Benefit of compression ( separate terms that mean the same thing) Taut or slightly less than painful, whichever is first Answer✓✓ How do you know if you have optimal compression Upper outer quadrant Answer✓✓ Most common breast cancer location location of structure from Anterior to Posterior and Medial to Lateral Answer✓✓ What does the CC projection demonstrate in relation to breast anatomy? Posterior nipple line Answer✓✓ PNL stands for what? 1 Answer✓✓ For the Optimal CC projection, PNL measures within ____cm of the MLO Axilla to the IMF Answer✓✓ The MLO projection demonstrates most tissue from _______ to the ________. location of structures from anterior to posterior and from superior to inferior Answer✓✓ For the Optimal MLO projection, it demonstrates structures from ____________ to _____________ and from _________ t0 ______________ Medial to get the maximum amount of medial tissue Answer✓✓ The technologist stands on which side of the breast for the CC projection?

moving mobile tissue to the fixed Answer✓✓ When positioning for the CC, elevate the IMP by moving what type of breast tissue to the ________ tissue. Geometric unsharpness Answer✓✓ How would you describe a skin fold in relation to image critique? missing tissue Answer✓✓ For a suboptimal CC, the nipple usually point to the area of _____________ minimizing folds Answer✓✓ For the CC, what does externally rotating the humus do? 30-60 degree obliquity Answer✓✓ degree of angle for MLO convex Answer✓✓ Pectoral muscle shape for MLO Pec. Major Answer✓✓ when positioning for the MLO, position the IRSD angle parallel to _____________________? Pec. muscle fibers Answer✓✓ Match the Receptor Angle to

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1. Axillary
2. IMF Answer✓✓ Optimal receptor vertical position allow inclusion of what 2 areas

2. visual checklist
3. repeat analysis
4. viewboxes and viewing conditions
5. compression force Answer✓✓ Lists the 5 general tests done for Q.C.
6. purpose
7. frequency
8. equipment and procedure
9. performance criteria
10. corrective action Answer✓✓ List the 5 things to now about each QC test To assess the quality and consistency of the mammographic image Answer✓✓ Purpose of Phantom Imaging At least weekly Answer✓✓ Frequency of Phantom Imaging 4.2 cm Answer✓✓ Phantom imaging simulates a ___cm compressed breast with 50%/50% fat/glandular tissue 4 fibers 3 speck groups 3 masses Answer✓✓ Phantom imaging QC, you must see how many fibers, speck groups, and masses? 10 Answer✓✓ What is the minimum objects that must be seen in phantom imaging?

.5 Answer✓✓ When scoring the phantom, the number of test objects, of each test group type, should not decrease by more than _______ from phantom test to next phantom test. 0.5 or 0 Answer✓✓ When scoring fibers in QC, stop counting after fiber is scored ____ or ____ yes Answer✓✓ Are fibers out of position considered an artifact? 4 Answer✓✓ how many fibers are needed to be seen in QC in order to be considered passing? subtract from the last fiber scored. Answer✓✓ If any artifacts are found when looking at fibers in QC, what do you do with the total? look for fiber-like artifacts of equal or greater size and density to the last fiber scored at least 0.5 Answer✓✓ what makes a fiber "passing" in QC? 4-6 specks Answer✓✓ When scoring specs in QC, starting with largest specks, count each group as one if how many little specks are visible? 2-3. No. Answer✓✓ In QC scoring of specks, a count of how many specks is scored as 0.5? Is this considered group? NO Answer✓✓ Do "clear" specks count when looking for speck artifacts in QC?

18-24 months Answer✓✓ It is advisable to replace fluorescent tubes every

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type and color Answer✓✓ All replacement tubes should be of the same ________ and _________ Amount of light coming out of the viewboxes (3000 cd/m2) Answer✓✓ Define Luminance the amount of ambient room light shining down on the viewboxes (want to see this as close to zero as possible) Answer✓✓ Define Illluminance Semi-annually Answer✓✓ At what frequency should compression be tested as part of QC?

1. reduction in scattered radiation
2. increases contrast
3. reduces radiation to the breast
4. improves image sharpness
5. minimizes focal spot blurring
6. minimizes patient motion
7. results in more uniform image densities Answer✓✓ List results of adequate compression 25-45 pounds Answer✓✓ Performance criteria for compression: The compression force should range from ______ to ________ in the drive mode

additional views *triangulate lesion location *resolve superimposition of glandular structures *better demonstrates Lateral lesion (closest to IRSD) Answer✓✓ 90 degree lateral views (ML and LM) are most commonly used for ____________ Demonstrates gravity dependent calcifications ***Milk of calcium Answer✓✓ Why should an ML be used for calcifications? Lateral Answer✓✓ If the position of the lesion moves down relative to the nipple, or lower than the MLO, the lesion is in the _________ aspect of the breast Medial Answer✓✓ If the lesion moves up on the ML then the lesion is located on in the _______ portion of the CC Lateral Answer✓✓ If the lesion down on the ML then the lesion is located on in the _______ portion of the CC Medial Answer✓✓ If the position of the lesion moves up relative to the nipple, or higher than in the MLO, the lesion is in the _________ aspect of the breast 10% Answer✓✓ About how many screening exams need an XCCL for inclusion of posterolateral anatomy parallel to the axillary tail of the breast Answer✓✓ When imaging the axillary tail, angle the IRSD................