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Sample First FRCR (CR1) Practice Questions

Try these sample questions to review concepts for the First FRCR (CR1) exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1An X-ray tube operates at 100 kVp. What is the maximum energy of the photons in the resulting bremsstrahlung X-ray spectrum?
A.100 keV
B.50 keV
C.33 keV (one third of peak)
D.It depends on the tube current (mA)
Explanation: The maximum photon energy in keV equals the peak tube voltage in kVp (the Duane-Hunt limit), because the highest-energy photon is produced when a single electron loses all of its kinetic energy in one bremsstrahlung interaction. At 100 kVp the most energetic photon is 100 keV.
2Characteristic radiation from a tungsten X-ray tube target is produced when:
A.An incident electron is decelerated by the nucleus
B.An incident electron ejects an inner-shell electron and an outer-shell electron fills the vacancy
C.A photon undergoes Compton scattering in the target
D.An electron is annihilated by a positron
Explanation: Characteristic radiation arises when a bombarding electron ejects an inner-shell (e.g. K-shell) electron, and an electron from a higher shell drops down to fill the vacancy, emitting a photon whose energy equals the binding-energy difference between the shells. The energies are discrete and characteristic of the target element (tungsten K-edge ~69.5 keV).
3At the photon energies used in diagnostic radiography (around 20-120 keV), which interaction predominantly determines subject contrast in soft tissue and bone?
A.Compton scattering
B.Coherent (Rayleigh) scattering
C.Photoelectric absorption
D.Pair production
Explanation: The photoelectric effect is strongly dependent on atomic number (proportional to Z cubed) and falls off with energy (roughly inversely proportional to E cubed), so it amplifies differences between materials of different Z, such as bone (calcium) versus soft tissue. This Z dependence is the main source of diagnostic subject contrast at lower kVp.
4The half-value layer (HVL) of an X-ray beam is best described as:
A.The thickness of tissue that halves the patient dose
B.The kVp at which beam intensity is half maximal
C.The time taken for radioactivity to fall to half its value
D.The thickness of a specified absorber that reduces the beam air kerma rate to half its original value
Explanation: HVL is the thickness of a reference material (usually aluminium for diagnostic beams) that attenuates the beam to half its original intensity (air kerma rate). It is a practical measure of beam quality/penetration and increases with beam filtration and effective energy.
5Increasing the inherent and added filtration of an X-ray beam (e.g. adding aluminium) primarily has which effect?
A.It increases the number of low-energy photons reaching the patient
B.It removes low-energy photons, increasing mean beam energy and reducing patient skin dose
C.It reduces the maximum photon energy of the spectrum
D.It has no effect on patient dose
Explanation: Filtration preferentially absorbs low-energy ('soft') photons that would otherwise be absorbed in the patient's skin without contributing to the image. This 'beam hardening' raises the mean photon energy and lowers the entrance skin dose for a given image, which is why minimum filtration is mandated.
6Which statement about radiation quantities is correct?
A.Absorbed dose is measured in sieverts
B.Effective dose is measured in grays
C.Equivalent dose accounts for the relative biological effectiveness of different radiation types and is measured in sieverts
D.Air kerma and absorbed dose are always numerically identical in tissue
Explanation: Equivalent dose multiplies absorbed dose (in grays) by a radiation weighting factor reflecting the biological effectiveness of the radiation type, and is expressed in sieverts (Sv). For X-rays and gamma rays the weighting factor is 1, so the numerical equivalent dose equals the absorbed dose, but the unit differs.
7In radiation dosimetry, the effective dose (E) is used principally to:
A.Measure the deterministic skin reaction after a long fluoroscopic procedure
B.Quantify the radioactivity of an administered radiopharmaceutical
C.Express the absorbed dose to a single organ in grays
D.Estimate the overall stochastic risk from a non-uniform exposure by weighting organ doses by tissue radiosensitivity
Explanation: Effective dose sums equivalent doses to individual organs each multiplied by a tissue weighting factor that reflects that organ's contribution to total stochastic (cancer and heritable) risk. It allows comparison of risk between different non-uniform exposures and different procedures, and is expressed in sieverts.
8On a digital radiography system, doubling the tube current-time product (mAs) while keeping kVp constant will:
A.Approximately double the number of photons and the dose, improving signal-to-noise ratio
B.Double the maximum photon energy
C.Halve the patient dose
D.Have no effect because the detector applies automatic exposure correction
Explanation: mAs is directly proportional to the number of photons produced, so doubling mAs roughly doubles both the radiation dose and the signal, reducing quantum mottle (noise) and improving signal-to-noise ratio. kVp controls photon energy and penetration, not quantity.
9An anti-scatter grid is placed between the patient and the image receptor. Its main purpose is to:
A.Reduce the patient entrance dose
B.Increase spatial resolution of the focal spot
C.Absorb scattered photons and improve image contrast
D.Filter low-energy photons before they reach the patient
Explanation: A grid consists of thin lead strips that preferentially absorb obliquely travelling scattered radiation while transmitting primary photons, thereby improving image contrast. Because some primary photons are also absorbed, the technique factors (and hence patient dose) must be increased when a grid is used.
10Geometric unsharpness (penumbra) in a radiograph is reduced by:
A.Increasing the object-to-image receptor distance
B.Decreasing the focus-to-image receptor distance
C.Increasing the focal spot size
D.Using a smaller focal spot size
Explanation: Geometric unsharpness (the penumbra) is proportional to the focal spot size; a smaller focal spot produces a sharper edge. It is also reduced by increasing the focus-to-receptor distance and by minimising the object-to-receptor distance, all of which reduce magnification blur.

About the First FRCR (CR1) Exam

The First FRCR (CR1) is the first formal examination of the UK Fellowship of the Royal College of Radiologists in Clinical Radiology, comprising a Physics module and an Anatomy module. The Physics module uses 40 multiple-true/false stems (200 statements) over 2 hours, and the Anatomy module is a 90-minute image-viewing test of 100 annotated radiological images. It is normally sat three times a year (March, June and September).

Exam sponsor: Royal College of Radiologists (RCR). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Two modules over two days: a Physics module of 40 stems x 5 true/false statements (200 statements) and an Anatomy image-viewing module of 100 questions.

Time Limit

Physics 2 hours; Anatomy 90 minutes (held on separate days).

Passing Score

Standard-set per sitting; Physics typically around 70-75% and Anatomy typically around 75%.

Exam / Certification Fees

Around GBP 319 (members) / GBP 406 (non-members) per module in the UK; higher at some overseas centres. Confirm current fees with the RCR.

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

13%

Physics - Matter and Radiation

X-ray production, characteristic and bremsstrahlung radiation, photon interactions, attenuation, beam quality and dosimetry units.

12%

Physics - Radiography and Fluoroscopy

Exposure factors, digital detectors, image quality, scatter and grids, and fluoroscopy dose management.

8%

Physics - Computed Tomography

Hounsfield units, windowing, pitch, CT dosimetry, iterative reconstruction and artefacts.

7%

Physics - Magnetic Resonance Imaging

Larmor frequency, image weighting, sequences, gadolinium contrast, SNR and MRI safety.

6%

Physics - Ultrasound

Transducer frequency, resolution-penetration trade-off, acoustic impedance, Doppler, artefacts and safety.

5%

Physics - Radionuclide Imaging

Radionuclides, gamma camera and PET, activity units and half-life concepts.

9%

Physics - Radiation Safety and Legislation

IRR17, IR(ME)R 2017, justification and optimisation, dose limits, diagnostic reference levels and radiobiology.

12.5%

Anatomy - Head, Neck and Spine

Brain, skull base, sinuses, temporal bone, neck and spine anatomy on radiographs, CT and MRI.

12.5%

Anatomy - Chest and Cardiovascular

Cardiac chambers, mediastinal contours, airways, fissures and thoracic vessels.

12.5%

Anatomy - Abdomen and Pelvis

Solid organs, hepatobiliary and urinary structures, bowel, retroperitoneal vessels and pelvic anatomy.

12.5%

Anatomy - Musculoskeletal

Shoulder, wrist, pelvis, knee, ankle/foot, paediatric ossification and radiographic lines.

Preparing for the First FRCR (CR1) Exam

What You Need to Know

  • Passing score: Standard-set per sitting; Physics typically around 70-75% and Anatomy typically around 75%.
  • Assessment: Two modules over two days: a Physics module of 40 stems x 5 true/false statements (200 statements) and an Anatomy image-viewing module of 100 questions.
  • Time limit: Physics 2 hours; Anatomy 90 minutes (held on separate days).
  • Exam / certification fees: Around GBP 319 (members) / GBP 406 (non-members) per module in the UK; higher at some overseas centres. Confirm current fees with the RCR. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

First FRCR (CR1): Suggested Study Strategy

1For the Physics module, practise multiple true/false reasoning so that each of the five statements per stem is judged independently, and learn the UK regulations (IRR17 and IR(ME)R 2017) precisely.
2For the Anatomy module, drill named structures across all modalities and body regions, paying close attention to correct spelling and left/right labelling, since marks depend on exact answers.
3Work to time: aim for about 36 seconds per physics statement and about 54 seconds per anatomy image to build the recall speed the real exam demands.

Frequently Asked Questions

How is the First FRCR (CR1) structured?

It has two modules sat on separate days: a Physics module of 40 stems each with 5 true/false statements (200 statements, 2 hours) and an Anatomy image-viewing module of 100 questions (90 minutes).

What is the pass mark for the First FRCR?

The pass mark is standard-set for each sitting rather than fixed. In practice it is usually around 70-75% for Physics and around 75% for Anatomy.

How often is the First FRCR held?

Both modules are normally offered three times a year, typically in March, June and September, at RCR-approved test centres.

What does the Anatomy module test?

It is image-based, showing radiological images (radiographs, CT, MRI, ultrasound, fluoroscopy and angiography) with an arrow pointing to a structure; candidates type the name of the arrowed anatomical structure, with full marks for complete accuracy.