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Test Outline

1. Radiation Physics and Instrumentation





1. Radiation Physics and Instrumentation


A. Matter and Atomic Structure

1. Know the structure of an atom

2. Know the definition of atomic mass, atomic number, isotope and isobar

B. Alpha, Beta, Gamma Emissions, Internal Conversion

1. Understand when different types of decay are probable

2. Know the atomic number and mass of the daughter product of each decay

3. Understand internal conversion and gamma emission

C. Decay Schemes

1. Recognize the decay characteristics of iodine isotopes

D. Unit of dose

1. Understand the Photoelectric effect

2. Understand the Compton effect

3. Understand the Pair Production effect

E. Counting statistics

1. Know the Poisson distribution

2. Know the Gaussian distribution

3. Understand how statistics influence dose

4. Understand how statistics influence counting rate

F. Sealed Radioactive Sources, Standards

1. Know what standards are and how they are used

2. Understand the difference between primary and secondary standards

3. Know which procedures require the use of standards

G. Counting efficiency, minimum detectable activity and background

1. Know what counting efficiency is and how to calculate

2. Know when to use minimum detectable activity

3. Know what background is and how it varies

H. Radiation Detectors

1. Know which detectors use ionization chambers

2. Understand how gas filled detectors detect radiation and the characteristics of each type of detector

3. Understand how dose calibrators measure radioactivity

4. Know the quality control tests that must be performed on dose calibrators

I. Radiation detectors

1. Know related NRC Regulatory guidelines

2. Know how to measure different forms of radiation

3. Know proper use of a check source

4. Know proper use of battery checks

5. Know different types of survey meters

6. Know which survey meter to use in differing situations

7. Know how to use each type of survey meter

J. Survey Techniques

1. Know how to use of area surveys to check ambient radiation levels

2. Know proper use of survey for surface contamination and to avoid contamination

K. Instruments using scintillation detectors

1. Understand how a thyroid probe and well counter work

L. Dose Calibration (might go under survey meters section)

1. Understand the purpose of, and need for, calibration

M. Thyroid Uptakes

1. Know the procedures for a thyroid uptake

2. Know the methods of calculation for a thyroid update

3. Know the calculation with standard capsule vs. patient capsule for its own standard

N. Common pitfalls of thyroid uptakes

1. Understand the importance of distance in obtaining good uptake results

2. Know how patient positioning can affect uptake results

3. Know how a large goiter affects uptake results

2. Radiation Protection





2. Radiation Protection


A. Radiation Safety: Environmental Services

1. Know the definition of radiation

2. Recognize hazards from ionizing radiation

3. Know who is affected by ionizing radiation

B. Unit of dose

1. Understand the CGS and SI units and the relationship between them

2. Know the definition and nature of Rad - absorbed dose of 100 ergs/gram

3. Know the definition and nature of Rem - dose equivalent

4. Know the definition and nature of Quality factor

5. Know the definition and nature of Roentgen - unit of exposure

6. Know the definition and nature of Gray - SI unit of absorbed dose, 1 Joule/kg.

7. Know the definition and nature of Sievert- SI unit for dose equivalent

8. Know the definition and nature of Exposure - 1 coulomb of charge produced in 1 kg of air by ionizing photons

9. Know the definition and nature of committed dose equivalent to an organ

10. Know the definition and nature of committed effective dose equivalent

11. Know the definition and nature of annual limits imposed by federal regulation on total

12. Know the definition and nature of effective dose equivalent

13. Know the definition and nature of eye dose equivalent

14. Know the definition and nature of shallow dose equivalent

15. Know regulatory limits for exposure to the public

C. Radiation Safety: Security

1. Know how to detect ionizing radiation

D. Survey Techniques

1. Know how to prepare an I-131 patient's hospital room

2. Know how to establish a visitor safe line

3. Know how to prepare room to maintain ALARA in radioactive patient's room

4. Understand how patients excrete I-131

5. Know proper procedures to reduce exposure to others

6. Understand when it is permissible to release a patient treated with I-131

7. Know  the NRC rules governing patient release

8. Know the methods acceptable for compliance with NRC patient release rules

9. Know under what circumstances patients treated with I-13 cannot be released

10. Understand, and be familiar with, the patient release form

E. Basic Radiation Safety

1. Understand personnel dosimetry

2. Understand dosimetry badge records

3. Understand how time is used in radiation protection

4. Understand how distance is used in radiation protection

5. Know the inverse square law

6. Know the principles of radiation shielding

7. Understand how to use TDS for protection from ionizing radiation

8. Understand shielding I-13

9. Understand the protective devices used for protection from external sources and the photon energies for which they are effective

F. Area Surveys, Wipe Tests, Spill procedures

1. Know procedures for conducting area surveys

2. Know procedures for collecting and counting wipe tests

3. Understand how to contain a radioactive spill to prevent further contamination

4. Know whom to call if a radioactive spill occurs

G. Proper administration of dose

1. Understand safe handling techniques for administering radioactive material to patients

2. Know how to avoid contamination of personnel and equipment when giving a radioactive material

H. Radioactive package receipt and return

1. Understand the difference between Class 1, Class II, and Class III labels

2. Know the steps involved in opening a radioactive package

3. Know how to prepare, and practice preparing, a box before returning to radiopharmacy

I. Personnel Monitoring Requirements

1. Know to whom you must provide radiation dosimeters

2. Recognize when you must provide a finger ring badge

3. Know which records must be provided to monitored individuals

4. Know how long you must keep your records

J. Advanced Radiation Safety

1. Know how to keep track of radiation levels in and around the work area

2. Understand how to measure ambient radiation levels in the work area

3. Understand how to treat a radioactive patient in a medical emergency

4. Know who to contact should a radioactive patient die

5. Know principles of designing a good work area for handling radioactive materials

K. ALARA Program

1. Know the ALARA I Limits

2. Know the ALARA II limits

3. Know what must be done if limits are exceeded

4. Know what management's responsibility is to the ALARA program

L. Spill Procedures

1. Know how to monitor personnel involved in a radioactive spill

2. Understand the proper method for cleaning up radioactive spills

3. Know the reporting requirements and who to contact regarding radioactive spills

4. Understand what is involved in assembling a radioactive spill kit

3. Mathematics Pertaining to the Use and Measurement of Radioactivity





3. Mathematics Pertaining to the Use and Measurement of Radioactivity


A. Logarithms

1. Know calculations using exponential functions

B. Radioactivity and Decay

1. Know how to apply the decay equation to I-131 dosage

C. Units of measurement

1. Convert Curies to Becquerels

4. Chemistry of Byproduct Material for Medical Use





4. Chemistry of Byproduct Material for Medical Use


A. Production of Radioisotopes

1. Know how I-131 is produced

B. Review of Iodine chemistry

1. Understand direct methods used in the preparation of iodine radiopharmaceuticals

2. Understand indirect methods used in the preparation of iodine radiopharmaceuticals

3. Know the number of moles of iodine given in a standard dose of iodine

4. Recognize iodine allergies and the affect diagnostic doses may have

5. Know at least 10 foods or drugs that are known to interfere with thyroid uptake of radioiodine

C. Iodinated Radiopharmaceuticals

1. Know the specific characteristics of iodinated radiopharmaceuticals

2. Know the ideal characteristics of radiopharmaceuticals

3. Know the different methods used in the production of radiopharmaceuticals

5. Radiation Biology





5. Radiation Biology


A. Unit of dose

1. Understand interactions of particles and photons with matter

2. Understand how each particle causes ionization and excitation in the material which they travel

3. Understand all mechanisms of interaction of ionizing particles

4. Understand how emissions of I-131 interact with tissue

B. Thyroid physiology

1. Understand the historical basis of nuclear endocrinology

2. Know ALARA concepts specifically with the thyroid cancer patient in mind

C. Radiation Biology I

1. Know the pathways by which ionizing radiation affects cells and cell function

2. Understand conditions affecting cell survival after irradiation

3. Know which point in the Mitotic cycle cells are most radiation sensitive

4. Understand single cell survival curves

5. Understand the importance of risk models and dose response models in estimating the effect of radiation exposures on irradiated populations

6. Know the difference between the absolute risk model and the relative risk model

D. Iodine 131 in the treatment of graves and thyroid cancer

1. Know the regulatory limitation in your area for treatment of hyperthyroidism and thyroid cancer with Iodine 131

2. Understand the importance of assessing the radiation fears ofpatient and their family

3. Recognize the radiation health issues in the use of iodine 131 for treatment of hyperthyroidism

E. Radiation Biology II

1. Understand the difference between stochastic effects and non-stochastic effects

2. Know the characteristics of radiation induced carcinogenesis

3. Understand the mutant clone theory of carcinogenesis

F. Radiation  Biology III

1. Know the estimates for risk of cancer production from uptake of radioactive iodine

2. Understand the megamouse experiment and its general results

3. Understand the hereditary effects in humans of exposure to ionizing radiation

4. Understand the concept of a genetically significant dose

5. Understand the effects of radiation on the cataract of the eye

G. Tracer Kinetics

1. Understand why a thyroid uptake is a meaningful reflection of thyroid activity

2. Understand the basis of tracer kinetics

3. Understand the mass of a radioactive isotope allows competition with the stable form of the same element

H. Thyroid treatment and calculation of dose

1. Know how to calculate a therapy dose from results of an uptake

2. Know the various philosophies used to determine treatment dose

3. Understand why the dose of Iodine 131 must be greater for cancer than for hyperthyroidism

I. Pregnancy and the radiation worker

1. Know how the radiation effects the fetus throughout the different stages of gestation

2. Know the radiation dose necessary to cause harm to the fetus in different stages of gestation

3. Know how radioactive materials can internally contaminate the fetus

4. Know the two sources of fetal radiation exposure

5. Understand basic safety techniques to protect the fetus from exposure to ionizing radiation

6. Regulatory





6. Regulatory


A. Production of Radioisotopes

1. Know definition of "by-product material"

2. Understand scope of the NARM regulations

3. Know which isotopes are considered to be by-product

B. Measurement of dose and proper records

1. Know how to measure the dose administered to the patient

2. Know the required records

3. Know the allowable error between a prescribed dose and the administered dose

4. Know what a prescribed dose is (Written Directives)

C. State and NRC Regulations

1. Know the regulations that will apply to the use of radioactivity for the treatment of thyroid disorders

2. Know how these regulations can be met in the normal functioning of a laboratory

3. Know the compliance records that must be maintained for review by your regulatory agency

4. Know the requirements for reporting incidents to your regulatory agency

5. Know how to identify an agreement state and the address needed for submission of license materials

D. QMP Program

1. Know the proper records required to maintain a QMP program

2. Know which procedures fall under a QMP program

3. Know how often you must review your QMP program

E. Essential records for license compliance

1. Know what records the NRC require a facility to keep

2. Know how long each type of record must be kept to comply with the NRC regulations

3. Understand the frequency which surveys, audits, and reviews must be performed

4. Know the records required to maintain an ALARA program

5. Know how to conduct a facility review of the ALARA program

F. Regulations, Variation from state to state

1. Understand the legal distinction between an agreement state and the NRC

2. Know when an agreement state must comply with the NRC

G. ALARA and the Administrator

1. Know the responsibilities of the facility administrator with respect to radiation safety

2. Know what a radiation safety committee is and which facilities must have one

3. Know what an exit summary is

4. Know the type of action regulatory bodies may take if deficiencies occur

5. Know what a 'management commitment to an ALARA Program' is