CAMRT RTR Cheat Sheet

Professional, Communicator, Collaborator

5-10% of exam
Blueprint Question Counts Scope, Consent, Privacy Exam Day Logistics Observe vs Diagnose

Care Provider

10-20% of exam
Patient Identity + Transfer Infection Prevention (Canada) Emergency Code Colours Adult Vital Sign Ranges Precaution Picker

RTR.1 Safe Work Principles

9-14% of exam
Safety Code 35 Dose Limits Dose Quantities + Units Occupational Protection Radiation Safety Picker Cardinal Rules

RTR.2 Imaging Systems

5-10% of exam
X-ray Production + Interactions Beam Quality + QC Grids, Collimation, AEC Grid vs No Grid

RTR.3-5 Procedures + Substances

27-32% of exam
Chest + Thorax Routine Upper Extremity Keys Lower Limb + Pelvis Spine + Skull Angles Contrast Media Selection Projection Picker

RTR.6 Image + Data Quality

27-32% of exam
Exposure Factor Relationships Exposure Index + DI Resolution + Distortion Artifacts + Image Critique Exposure Correction Picker

Quick Facts

Exam CAMRT RTR certification
Body CAMRT, delivered by Yardstick
Questions 185 single-best-answer MCQ
Time 4 hours
Taxonomy Min 80% application
Pass Modified Angoff, Pass/Fail
Sittings 3 per year
Attempts 4 within 5 years
Fee $980 CAD + seat fee
Results 20 business days
Languages English and French
Blueprint May 2024 (2020 profile)

Observe vs Diagnose PR

MRT may

Note urgent findings
Alert the radiologist
Repeat for image quality

MRT may not

Give a diagnosis
Interpret for the patient
Change the order alone
Escalate, never interpret

Blueprint Question Counts PR

Professional, Communicator, Collaborator 5-10%, 9-19 questions
Care Provider 10-20%, 19-37 questions
RTR.1 Safe work 9-14%, 17-26 questions
RTR.2 Imaging systems 5-10%, 9-19 questions
RTR.3-5 Procedures 27-32%, 50-59 questions
RTR.6 Image quality 27-32%, 50-59 questions
Clinical Expert total 70-85%, 129-157 questions Biggest
Leader, Scholarly Practitioner 0%, not examined
Taxonomy split Min 80% application items
High secondary weight Respiratory and skeletal
Low secondary weight Mammography, BMD, interventional

Scope, Consent, Privacy PR

MRT scope No image interpretation
Urgent finding Alert radiologist immediately
Informed consent Ongoing, withdrawable anytime
Consent withdrawn Stop, make safe, notify
PACS lookup Only patients you serve
Registration body Provincial college, not CAMRT
Quebec candidates OTIMROEPMQ exam instead
Transfer of care Identity, contrast, lines, limits
Documentation Accurate, timely, complete

Exam Day Logistics PR

Delivery Yardstick centre or remote
ID required Name, DOB, photo, signature
Results Within 20 business days
Score released Pass/Fail only
Failed attempt Performance profile, 5 days
Cut score setters 8-10 member committee
Accommodations Before registration deadline
Official practice exam $75, about 100 questions
Certificate mailing Within 6 weeks

Fire Response CA

RACE the fire, then PASS the extinguisher
Rescue, Alarm, Confine, Extinguish Pull, Aim, Squeeze, Sweep Code Red means fire

Routine vs Additional Precautions CA

Routine practices

Every patient
Risk assessment first
Hand hygiene and PPE

Additional precautions

Specific suspected organism
Contact, droplet, airborne
Layered on top
Baseline vs layered

Precaution Picker CA

Any patient, any exam → Routine practices
Before every interaction → Point-of-care risk assessment
Draining wound, resistant organism → Contact precautions
Influenza or pertussis → Droplet precautions
Tuberculosis or measles → Airborne, fit-tested N95
Clostridioides difficile → Soap and water ( Not alcohol rub )
Used needle in hand → Sharps container, no recap
Severely immunocompromised patient → Protective measures, clean equipment

Patient Identity + Transfer CA

Identifiers Two person-specific, patient-stated
Not identifiers Room, bed, chart label
Pregnancy screen Ask, document, then justify
Requisition conflict Resolve before any exposure
Transfer prep Lock wheels, lower rails
Transfer aid Slider board, enough staff
Restless patient Immobilization devices first
Holder rules Apron, gloves, out of beam
Never routine Same person holding repeatedly

Infection Prevention (Canada) CA

Routine practices Every patient, every time
PCRA Point-of-care risk assessment
Additional precautions Contact, droplet, airborne
Hand hygiene Four Moments framework
Alcohol rub 60-90% alcohol content
C. difficile Soap and water only
Airborne Fit-tested N95 respirator
Sharps Never recap, dispose immediately
Cleaning order Clean before disinfecting

Emergency Code Colours CA

Code Red Fire OHA set
Code Blue Adult cardiac arrest
Code Pink Infant or child arrest
Code White Violent behaviour
Code Yellow Missing person
Code Amber Abducted child
Code Orange External disaster
Code Brown In-facility hazardous spill
Code Grey Infrastructure loss
Code Black Bomb threat
Code Green Evacuation
Code Silver Person with a weapon

Adult Vital Sign Ranges CA

Heart rate 60-100 beats per minute
Respiratory rate 12-20 per minute
Oxygen saturation 95-100% on air
Blood pressure About 120/80 mmHg
Temperature 36.5-37.5 degrees Celsius
Glasgow Coma Scale 3 lowest, 15 normal
Hypoglycemia Below 4.0 mmol/L
Stroke screen Face, arms, speech, time

Cardinal Rules SA

Time down, distance up, shielding on
Time: shortest exposure Distance: inverse square Shielding: apron, thyroid Distance wins in fluoroscopy

Deterministic vs Stochastic SA

Deterministic

Has a threshold
Severity rises with dose
Erythema, epilation, cataract
Long fluoroscopy risk

Stochastic

No threshold assumed
Probability rises with dose
Cancer, heritable effects
Reason for ALARA
Severity vs probability

Radiation Safety Picker SA

Cut your fluoroscopy dose → Step back from the patient ( Inverse square )
Must stay beside table → Apron and thyroid shield
Patient cannot hold still → Immobilization devices first
Someone must hold → Aproned escort, never staff
Wearing a single dosimeter → Trunk, under the apron
Adding a second badge → Collar, outside thyroid shield
Patient declares pregnancy → Justify, optimize, inform
Staff declares pregnancy → Notify employer, review duties
Apron may be damaged → Radiographic integrity check
Repeats keep rising → Reject analysis review

Safety Code 35 Dose Limits SA

Worker whole body 20 mSv/yr, 5-year average SC35 2024
Five-year total 100 mSv maximum
Single-year cap 50 mSv
Worker lens 20 mSv averaged, 50 cap
Worker skin 500 mSv equivalent dose
Worker hands, feet 500 mSv equivalent dose
Public whole body 1 mSv effective dose
Public lens 15 mSv
Public skin 50 mSv
Monitoring trigger 1/20th of worker limit
Pregnant worker Employer adjusts assigned duties

Dose Limit Numbers SA

20 average, 50 cap, 1 public
20 mSv/yr, 5-year average 100 mSv over 5 years 50 mSv single-year cap Public: 1 mSv yearly

Absorbed vs Effective Dose SA

Absorbed dose

Gray
Energy per mass
No weighting applied

Effective dose

Sievert
Tissue weighted
Compares exam risk
Physics vs risk

Dose Quantities + Units SA

Absorbed dose Gray, energy per mass
Equivalent dose Sievert, radiation weighted
Effective dose Sievert, tissue weighted
Weighting factor, x-rays Equals one
Air kerma Gray, beam output
KAP or DAP Gy-cm2, total beam energy
Peak skin dose Deterministic injury marker
ICRP principles Justify, optimize, limit

Occupational Protection SA

Cardinal rules Time, distance, shielding
Best fluoroscopy control Distance, by inverse square
Dosimeter placement Trunk, under the apron
Optional second badge Collar, outside thyroid shield
Apron storage Hang it, never fold
Apron testing Visual plus radiographic check
Scatter at one metre About 0.1% of primary
Lead curtains Not an apron substitute
Receptor holding Never hand-held during exposure
Energized tube Never left unattended
Deliberate training exposure Never permitted

Grid vs No Grid IM

Grid

Absorbs scatter
Higher contrast
More mAs needed
Cutoff risk

No grid

Parts under 10 cm
Lower patient dose
More scatter fog
Air gap alternative
Contrast costs dose

X-ray Production + Interactions IM

Bremsstrahlung Braking, most of beam
Characteristic K-shell, needs 69.5 kVp
Photoelectric Absorbed, creates subject contrast
Compton Scatter, fogs the image
Raising kVp More penetration, less dose
Cost of kVp Lower contrast, more scatter
Anode heel effect Cathode side more intense
Heel effect use Thick end under cathode
Line focus principle Steeper angle, smaller focus
Filtration Removes low-energy photons

Beam Quality + QC IM

HVL at 60 kV 1.9 mm aluminum minimum SC35 2024
HVL at 80 kV 2.4 mm aluminum minimum
HVL at 100 kV 3.0 mm aluminum minimum
HVL at 120 kV 3.8 mm aluminum minimum
Reject analysis Service quality, not discipline
Top reject cause Positioning errors
Automatic intensity control Double phantom, double output
PACS duty Verify data complete, accurate

Grids, Collimation, AEC IM

Grid ratio Strip height over spacing
Grid needed Part over 10 cm
Grid also above About 70 kVp
5:1 grid factor About 2x the mAs
8:1 grid factor About 4x the mAs
12:1 grid factor About 5x the mAs
Grid cutoff causes Off-level, off-centre, off-focus
Inverted focused grid Dense edges, clear centre
Air gap technique 10-15 cm OID alternative
Collimation Less scatter, less dose
AEC controls Exposure time only
AEC cannot fix Poor centring over chambers
Backup timer Caps a runaway exposure

Decubitus Side Rule PR

Fluid falls down, free air rises up
Effusion: affected side down Pneumothorax: affected side up Free air: left lateral decubitus Horizontal beam always

PA vs AP Chest PR

PA erect

Heart near receptor
180 cm SID
True heart size
Scapulae off lungs

AP supine

Heart magnified
Shorter SID
Mediastinum widened
Air-fluid levels lost
Erect PA preferred

Projection Picker PR

Suspected small pneumothorax → Erect PA, add expiration
Suspected small effusion → Decubitus, affected side down
Suspected free abdominal air → Erect chest or left decubitus
Suspected hip fracture → AP as-lies, cross-table lateral ( No rotation )
Snuffbox tenderness → PA with ulnar deviation ( Scaphoid )
Cervical spine trauma → Cross-table lateral first ( Show C7-T1 )
Shoulders hide C7-T1 → Swimmer's lateral
Glenohumeral joint space → Grashey AP oblique ( 35-45 degrees )
Intercondylar fossa → Camp Coventry or Holmblad
Suspected spondylolysis → 45-degree lumbar oblique ( Scottie dog )
Radial head, limited flexion → Coyle axiolateral method

Chest + Thorax Routine PR

Chest SID 180 cm (72 inches)
PA erect Heart nearest the receptor
Lateral side Left against the receptor
Breathing Second full inspiration
Adequate inspiration 10 posterior ribs visible
Rotation check SC joints equidistant
Arm position Shoulders rolled forward, down
Effusion decubitus Affected side down
Pneumothorax decubitus Affected side up
Free abdominal air Erect chest, five minutes

Chest Image Check PR

Ten ribs, no rotation, scapulae clear
10 posterior ribs visible SC joints equidistant 180 cm SID Second full inspiration

Barium vs Water-Soluble PR

Barium sulfate

Best mucosal coating
Routine GI studies
Never if perforated
Chemical peritonitis risk

Water-soluble

Suspected leak or surgery
Absorbed if it escapes
Poorer coating
Non-ionic if aspiration
Perforation means iodinated

Contrast Reaction Response PR

Warmth, flush, metallic taste → Reassure and continue ( Physiologic )
A few scattered hives → Observe, notify radiologist ( Mild )
Diffuse hives, mild wheeze → Stop, oxygen, call help ( Moderate )
Stridor or facial swelling → Epinephrine per protocol ( Airway )
Hypotension with tachycardia → Legs up, IV fluids ( Anaphylactoid )
Hypotension with bradycardia → Fluids, consider atropine ( Vasovagal )
Swelling at injection site → Stop, elevate, cold compress
Suspected bowel perforation → Water-soluble, never barium
eGFR 30 or under → Hold metformin, consult radiologist

Upper Extremity Keys PR

Scaphoid PA with ulnar deviation
Stecher method CR 20 degrees proximal
Carpal tunnel Gaynor-Hart tangential projection
True lateral elbow Epicondyles superimposed, three arcs
Medial (internal) oblique Coronoid process free
Lateral (external) oblique Radial head, capitulum free
Coyle radial head Elbow 90, CR 45 shoulder
Grashey method 35-45 degrees, glenoid open
AC joints Bilateral erect, weighted comparison
Rheumatoid survey Norgaard ball-catcher projection

Scottie Dog Parts PR

Eye pedicle, nose transverse, neck pars
Ear: superior articular process Front leg: inferior articular Collar on neck: spondylolysis 45-degree lumbar oblique

Lower Limb + Pelvis PR

Ankle mortise Rotate leg 15-20 degrees
AP foot CR 10 degrees toward heel
Calcaneus axial CR 40 degrees cephalad
AP pelvis Feet rotated 15-20 internally
Why rotate feet Overcome femoral neck anteversion
Suspected hip fracture No rotation, cross-table lateral
Danelius-Miller Axiolateral hip, horizontal beam
Intercondylar fossa Camp Coventry or Holmblad
Settegast patella Avoid until fracture excluded
Acetabulum Judet obliques, 45 degrees

Spine + Skull Angles PR

C-spine trauma first Cross-table lateral, unmoved patient
Lateral must show C7 and C7-T1 junction
Shoulders obscure junction Add swimmer's lateral
C1 and C2 AP open-mouth projection
Cervical obliques 45 degrees, intervertebral foramina
Posterior cervical oblique Foramina farthest, CR cephalad
Lumbar obliques 45 degrees, Scottie dog
Scottie dog neck Pars interarticularis
Towne (AP axial) 30 degrees caudad to OML
Caldwell 15 degrees caudad to OML
Waters OML 37 degrees to receptor

Contrast Media Selection PR

Barium sulfate Best coating, routine GI
Suspected perforation Water-soluble iodinated only
Aspiration risk Non-ionic low-osmolar agent
Ionic high-osmolar More reactions, older agent
Non-ionic low-osmolar Lower osmolality, safer
Negative contrast Air or carbon dioxide
Gadolinium MRI only, not radiography
Double contrast Barium plus gas, mucosa
Preparing agents Verify name, strength, expiry

Venipuncture + Reactions PR

Avoid that arm Fistula, mastectomy, cast, infection
Needle entry Bevel up, shallow angle
Tourniquet Release before withdrawing needle
Physiologic effects Warmth, flush, metallic taste
Mild reaction Limited hives, mild nausea
Anaphylactoid signs Stridor, wheeze, facial swelling
First action Stop injection, keep access
Adult epinephrine 0.3-0.5 mg IM, 1:1000
Vasovagal clue Hypotension with bradycardia
Extravasation Stop, elevate, cold compress

Contrast + Kidney Rules PR

Screening Questionnaire, never delay emergencies CAR
Prophylaxis threshold eGFR under 30
Metformin, eGFR over 30 Do not stop it
Metformin, eGFR 30 or under Hold at injection time
Metformin restart After 48 hours, stable
Stability threshold Under 25% creatinine rise
ACE inhibitors, diuretics Do not routinely stop
Post-contrast creatinine Not routinely required

Deviation Index Scale IM

3 half, 0 target, +3 double
DI 0: on target DI +1: 26% over DI -1: 20% under One unit: one mAs step

kVp vs mAs IM

kVp

Beam quality
Penetration
Subject contrast
15% rule

mAs

Beam quantity
Receptor exposure
Noise control
Direct proportion
Quality vs quantity

Exposure Correction Picker IM

DI strongly positive → Reduce mAs ( Dose creep )
DI strongly negative → Increase mAs ( Mottle risk )
Grainy, noisy image → Increase mAs ( Quantum mottle )
Thick part under-penetrated → Raise kVp 15% ( Halve mAs )
Low contrast, heavy fog → Collimate, add grid ( Scatter )
Motion blur present → Higher mA, shorter time ( Same mAs )
SID increased → Raise mAs by distance squared
Pleural effusion, ascites → Increase technique ( Additive )
Emphysema, osteoporosis → Decrease technique ( Destructive )
Anatomy collimated off → Repeat the image ( Not recoverable )

Exposure Factor Relationships IM

mAs controls Receptor exposure, directly proportional
kVp controls Penetration and subject contrast
15% rule +15% kVp, halve mAs
Reciprocity mA times time equals mAs
Inverse square law Intensity falls with distance squared
Double the distance Quarter the intensity
Direct square law mAs scales with distance squared
Standard SID Chest 180 cm, table 100
Motion control High mA, shortest time
Additive pathology Increase technique
Destructive pathology Decrease technique

Image Critique Order IM

Anatomy, alignment, exposure, markers, artifacts
Anatomy: all included Alignment: rotation, tilt Exposure: check the DI Markers: in beam Artifacts: removable

DI High vs DI Low IM

DI positive

Overexposed
Dose creep
Still looks fine
Lower the mAs

DI negative

Underexposed
Quantum mottle
Grainy image
Raise the mAs
Dose creep vs mottle

Exposure Index + DI IM

EI Detector exposure indicator IEC 62494
Target EI Exam-specific reference value
DI formula 10 log10 (EI/target EI)
DI zero Exposure on target
DI +1 About 26% overexposed
DI -1 About 20% underexposed
DI +3 About double the target
DI -3 About half the target
One DI unit About one mAs step
Action limits Site-derived, per AAPM TG-232
Dose creep Drifting positive DI values

Resolution + Distortion IM

Small focal spot Narrower penumbra, sharper edges
Reduce OID Less magnification and blur
Magnification factor SID divided by SOD
Detector element size Limits DR spatial resolution
Elongation Tube or receptor angled
Foreshortening Part angled to receptor
Shape distortion Alignment problem
Size distortion OID problem
Commonest unsharpness Patient motion

Artifacts + Image Critique IM

Quantum mottle Too few photons, low mAs
Moire artifact Grid lines alias with scan
Grid cutoff look Edge or overall density loss
Dead pixels Fixed detector defects
Ghosting or lag Previous image retained
Lead marker In beam at exposure
Annotation later Last resort, error prone
Post-processing limit Cannot restore lost data
Repeat criterion Cannot answer clinical question
Not a repeat Slight rotation, still diagnostic

High-Weight Pathology Signs IM

Pneumothorax, erect Fine apical pleural line
Pneumothorax, supine Deep sulcus sign
Pleural effusion Blunted costophrenic angle
Free intraperitoneal air Crescent under the hemidiaphragm
Pneumonia Consolidation, air bronchograms
Emphysema Hyperlucent, flattened diaphragms
Acute fracture line Sharp, lucent, no cortex
Accessory ossicle Smooth, corticated, often bilateral
Scaphoid fracture risk Avascular necrosis, non-union
Spondylolysis Collar across Scottie neck

Common Traps

Pass mark vs percentage

Modified Angoff sets it ≠ No fixed 70% pass

Results vs feedback

Pass or Fail only ≠ Profile only after failing

Dosimeter placement

Worn under the apron ≠ Not on top of it

Declared pregnancy limit

No separate fetal limit published ≠ Duties matched to Appendix I

Patient shielding updated

Gonadal weighting factor reduced ≠ Collimation is the control

Bright image vs correct dose

Digital rescales brightness ≠ Only DI reveals overexposure

Noise fix vs penetration fix

mAs fixes quantum mottle ≠ kVp cannot add signal

Metformin rule changed

No routine 48-hour hold ≠ Hold only eGFR 30 or under

Barium vs iodinated

Perforation means water-soluble ≠ Barium causes chemical peritonitis

Reject analysis purpose

Improves department quality ≠ Not technologist discipline

Repeat threshold

Repeat only if non-diagnostic ≠ Not for slight rotation

Scope of practice

Alert radiologist to findings ≠ Never give the diagnosis

Mortise rotation

Rotate the whole leg ≠ Not the foot alone

Code colours vary

This set is Ontario ≠ Confirm your provincial list

Post-processing limits

Windowing changes display only ≠ Cannot recover lost anatomy

Last Minute

1. 185 questions, 4 hours, Pass/Fail
2. Biggest bands: procedures, image quality
3. Leader and Scholarly Practitioner: 0%
4. Minimum 80% application questions
5. mAs = exposure; kVp = penetration
6. 15% more kVp = half mAs
7. DI 0 on target; +3 double
8. Grainy image means low mAs
9. Dosimeter goes under the apron
10. Worker 20 mSv; public 1 mSv
11. Distance beats shielding in fluoroscopy
12. Fluid down, air up on decubitus
13. Chest: 180 cm, left lateral
14. Perforation suspected: iodinated, never barium
15. eGFR over 30: keep metformin
16. Rotate the leg for ankle mortise
17. Hip trauma: no rotation, cross-table
18. Marker in beam, not annotated later
19. Escalate urgent findings; never diagnose
20. Routine practices for every patient

CAMRT National Certification Exam — Radiological Technology

Practice Questions 130 questions Study Guide 51 topics Cheat Sheet 247 facts Flashcards 50 cards Podcast

Same family resources

Explore More Canadian Medical Imaging Exams (CAMRT)
Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.

CAMRT National Certification Exam — Magnetic Resonance (MRI)

Practice Questions 100 questions

CAMRT Nuclear Medicine Certification

Practice Questions 100 questions Shorts 1 short

CAMRT Radiation Therapy Certification

Practice Questions 100 questions