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Last Semester Board Prep > ASRT SEAL 5 > Flashcards

ASRT SEAL 5 Flashcards

1
Q

Tumor staging is used to describe which of the following? Please select all that apply.

The differentiation of the cells.
Where the tumor is located in the body.
The size of the tumor.
Whether the cancer has spread to a different part of the body.

A

Where the tumor is located in the body.
The size of the tumor.
Whether the cancer has spread to a different part of the body.

Hint: Tumor staging is used to describe the size or prevalence of the tumor, where the tumor is located in the body, and whether the cancer has spread to another part of the body or lymph nodes.

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2
Q

The total dose equivalent limit for an embryo/fetus is:

5 mSv
10 mSv
15 mSv
20 mSv

A

5 mSv

Hint: A developing embryo or fetus has lower dose limits than radiation workers because of the rapidly dividing cells. Babies and children are more sensitive to radiation effects than adults.

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3
Q

With the given information, using the table below, calculate the MU for the following isocentric AP/PA right femur treatment. Dr. Jones prescribes a 6 MV beam with 180 cGy to midline. The field size dialed is a 14 cm x 8 cm. The patient separation is 18 cm at the central axis.

90 MU per field
120 MU per field
123 MU per field
239 MU per field

A

123 MU per field

Hint: To find MU you need the following formula: TD/ TMR x CF x Sc x Sp (Sc x Sp= Scp if not block present) . First you need to find the equivalent square field size for 14cm x 8 cm. Use 2 (L x W/L + W)=10.2 cm; use 10 cm2. Then determine the Sc, Sp, CF and TMR.

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4
Q

Which of the following is a cancer of the plasma cells?

keloid
mycosis fungoides
multiple myeloma
non-hodgkin lymphoma

A

multiple myeloma

Hint: The American Cancer Society defines multiple myeloma as a cancer formed by malignant plasma cells. Healthy plasma cells are found in the bone marrow and are a type of white blood cell responsible for fighting infection by producing antibodies.

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5
Q

With 4D simulation, the 4th dimension refers to:

Breathing motion.
Internal organ motion.
Lateral table movement.
Superior to inferior table movement.

A

Breathing motion.

Hint: In 4D CT, the motion of the breathing cycle is acquired. Based on the breathing motion, the tumor may get 4D treatment, if reproducible breathing on the patient’s part can be replicated on a regular wave.

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6
Q

In the radiation treatment of a Wilms tumor, why would the field extend over to the other side of the spine opposite the kidney affected?

To prevent spread to the other kidney
Because most of Wilms tumors are bilateral
To treat contralateral lymph nodes
To allow for symmetrical growth in the spine

A

To allow for symmetrical growth in the spine

Hint: Wilms tumors most commonly occur in children. Therefore you do not want to cause scoliosis by treating only half of a vertebral body.

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7
Q

At the CT scanner, pitch can be defined as:

The median number of Hounsfield numbers displayed in the image.
The range of CT numbers displayed in the image.
The number of reconstructions completed.
Table travel per rotation / scan length.

A

Table travel per rotation / scan length.

Hint: CT window is the range of Hounsfield numbers displayed in an image, while CT level is the center HU displayed.

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8
Q

The surgical technique used in testicular cancer patients is termed a:

Lumpectomy.
Radical orchiectomy.
Radical prostatectomy.
Testicularectomy.

A

Radical orchiectomy.

Hint: With testicular cancer, the entire testicle must be removed through an inguinal incision. The procedure is called a radical orchiectomy.

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9
Q

The use of bolus materials:

Increases skin sparing.
Decreases skin sparing.
Provides immobilization .
Relieves effects of skin irritation

A

Decreases skin sparing.

Hint: Bolus is used in order to increase the dose at the surface of the patient, thus decreasing skin sparing.

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10
Q

Palpation of the cricoid cartilage indicates the inferior border of the:

Oral cavity.
Oropharynx.
Larynx.
Hypopharynx.

A

Larynx.

Hint: The field borders for a larynx treatment are superior: hyoid inferior: cricoid anterior: 2 cm of flash and posterior: anterior to the vertebral body.

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11
Q

A patient who has been on treatment for 2 weeks refuses to continue treatments due to the side effects. The radiation therapist should:

Tell the patient to go home.
Discontinue treatment for the day. Have the patient see the MD.
Cancel all remaining treaments for the patient.
Continue with set up and treat the patient.

A

Discontinue treatment for the day. Have the patient see the MD.

Hint: You can never treat a patient who is refusing treatment. However, the patient should consult with the doctor in order to fully understand the ramifications of discontinued treatment.

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12
Q

Universal Precautions requires:

Treatment of all patients as if they were contagious.
Wearing of gloves for all hospital procedures.
Notification of health care personnel of any possibly contagious patient conditions prior to patient contact.
Isolation precautions to be taken for all inpatient rooms.

A

Treatment of all patients as if they were contagious.

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13
Q

The ____________ dose is the total dose that will significantly increase the probability of severe normal tissue reactions.

time
survival
lethal
tolerance

A

tolerance

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14
Q

The typical radiation dose to the prostate post operatively is:

50 - 55 Gy to 200 cGy/fx
65 - 70 Gy to 200 cGy/fx
72 - 76 Gy to 200 Gy/fx
75 - 80 cGy to 200 cGy/fx

A

65 - 70 Gy to 200 cGy/fx

Hint: Usually a dose of 64.8 to 70.2 Gy at 180cGy to 200cGy per fx is given post op. If adjuvant treatment is given then the dose will typically be 60 - 66Gy at 180cGy/fx. If salvage treatment is used, patient will treat to 70 Gy at 200cGy/fx.

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15
Q

What is a normal systolic blood pressure reading?

below 120 mm Hg
120-130 mm Hg
130-140 mm Hg
140-150 mm Hg

A

below 120 mm Hg

Future Flash cards: A normal systolic blood pressure for an adult is below 120 mm Hg. A reading of 120-129 is elevated. 130-139 is stage 1 high blood pressure. 140 or higher is stage 2 hypertension. 180 or more is a hypertensive crisis and requires immediate emergency medical attention.

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16
Q

Which area of a treatment room is considered a secondary barrier?

Floor
Ceiling
Wall
Treatment couch

A

Treatment couch

More info: The couch is considered a secondary barrier because it only receives leakage radiation from the treatment head, or scattered radiation from the patient.

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17
Q

Single rescuer cardiopulmonary resuscitation (CPR) should be performed by giving ______?

15 chest compressions followed by 1 breath
15 chest compressions followed by 2 breaths
30 chest compressions followed by 1 breath
30 chest compressions followed by 2 breaths

A

30 chest compressions followed by 2 breaths

Need to know:
The compression-ventilation ratio without an advanced airway for both adults and pediatric victims is 30:2 with a single rescuer. For 2 or more rescuers in adult victims the ratio is still 30:2 but for children and infants the ratio is 15:2

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18
Q

Cerrobend is made up of what materials?

Bismuth, lead, tin, and aluminum
Bismuth, lead, tin, and cadmium
Lead, copper, aluminum, and tin
Lead, aluminum, bismuth, and copper

A

Bismuth, lead, tin, and cadmium

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19
Q

The chest compression to ventilation ratio for a single rescuer giving CPR to an adult patient is:

15: 1
15: 2
30: 1
30: 2

A

30:2

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20
Q

Which agency controls and limits the use of radioactive materials?

Department of Transportation (DOT)
Nuclear Regulatory Commission (NRC)
Food and Drug Administration (FDA)
Environmental Protection Agency (EPA)

A

The NRC was created by congress in 1974 to ensure the safe use of radioactive materials in all civilian areas, while protecting people and the environment.

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21
Q

A seizure can be described as:

Flailing of the limbs.
The flexing of muscles.
The uncontrolled movement of muscles.
Body spasms.

A

The uncontrolled movement of muscles.

A seizure is defined as a sudden episode of transient neurologic symptoms such as involuntary muscle movements, sensory disturbances and altered consciousness.

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22
Q

In digital imaging, the pixel number (2D) and the voxels (3D) are important in image quality. In which situation would you find the highest image resolution?

Having a low number of pixels and a high number of voxels
512 x 512 matrix
1024 x 1024 matrix
1920 x 1080 matrix

A

1920 x 1080 matrix

Reasoning: Having a greater number of pixels in the matrix will produce a higher quality/resolution of the image. Also needed is a more powerful computer to do the reconstruction of these high resolution quality images. In therapy, the higher resolution is needed to reconstruct CT data for DRR’s needed for treatments.

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23
Q

Upon completion of CT simulation, the data needs to be transferred to the dosimetry treatment planning system to enable a treatment plan and calculation to be completed. What vehicle would be used to send the data to the planning system?

DIBH
DICOM
HR-7
PACS

A

DICOM

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24
Q

An increase in the number of cells in an organ or tissue is defined as:

Metaplasia
Dysplasia
Hypertrophy
Hyperplasia

A

Hyperplasia

Hyperplasia, or hypergenesis, is defined as an increase in the amount of organic tissue that results from cell proliferation. It is often an initial stage in the development of cancer. Dysplasia denotes the presence of cells of an abnormal type within a tissue. It also may signify the development of cancer. Hypertrophy refers to the enlargement of an organ or tissue as a result of an increase in the size of its cells. Metaplasia is the abnormal change in the nature of a tissue.

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25
Q

Which vertebral body is adjacent to the base of the heart?

T1
T2
T3
T4

A

T4

More info: The base of the heart is located at the level of T4, which is also at the level of the superior vena cava.

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26
Q

The sum of all weighted equivalent doses for all irradiated tissues or organs is defined as ________ dose.

dose area
air kerma
equivalent
effective

A

effective

NCRP Report #116 defines effective dose and quantifies the overall potential harm for risk of radiation damage.

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27
Q

All of the following are considered cancers of the blood EXCEPT:

lymphoma.
leukemia.
multiple myeloma.
sarcoma.

A

sarcoma.

More info: Cancers of the blood are divided into three main types: leukemia, lyphoma, and myeloma. Leukemia is found in the blood and bone marrow and is caused by numerous abnormal white blood cells that are not able to fight infection. Lymphoma affects the lymph nodes and lymphatic system. Myeloma is a cancer of the plasma cells. Sarcomas are cancers of the connective tissue, not cancer of the blood.

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28
Q

If a prostate was being treated with an anterior arc, what would happen if the lasers were lined up 1 cm posterior to the central axis of the tumor?

There would be geometric target miss
There would be an overdose to the bladder and rectum
The prostate would be better covered by the isodose lines
The patient would experience greater acute side effects

A

There would be geometric target miss

Hint: If the lasers are not on the isocenter, the entire field would be off of target by 1 cm making the rectum have a higher dose and possibly missing the anterior portion of the prostate.

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29
Q

To perform an action that benefits others is:

veracity.
justice.
nonmaleficence.
beneficence.

A

beneficence.

Def: Beneficence is to perform an action that benefits others or to do good for the patient.

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30
Q

The duty to tell the truth and avoid deception is:

veracity.
justice.
nonmaleficence.
beneficence.

A

veracity.

By definition: veracity is the avoidance of lying, deception, and misrepresentation.

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31
Q

What does the inverse square factor correct for when performing a calculation?

Change in field size
Change in output
Change in treatment machine
Change in distance

A

Change in distance

When referring to the inverse square factor, as the distance from the source of the radiation increases, the intensity of the radiation decreases. By definition if you double your distance the intensity of your beam decreases by ¼ its original amount. This is a function of the change in distance. When this occurs you must add

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32
Q

Which condition would only require standard precautions?

Virus
Pertussis
Clostridium difficile
MRSA

A

Virus

A virus would only require standard precautions because it isn’t necessarily spread by only one method. The other options have more specific guidelines, such as contact precautions for MRSA.

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33
Q

Tissue maximum ratios (TMR) are determined by which of the following?

Blocking in field
Dose in air
Dose at a depth
Scatter from collimator

A

Dose at a depth

issue Phantom Ratio (TPR) is defined as the absorbed dose in tissue to the absorbed dose at the same point at a reference depth. The reference depth can be 5 cm, or 10 cm, determined by physics but if this reference dose is at Dmax, it is called TMR or Tissue Maximum Ratio.

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34
Q

In arc or rotational treatment fields, the gantry moves while delivering radiation. How do conformal arcs differ from standard arc treatments?

Jaws change while the gantry is moving
Lower dose is delivered at field edges
Localizing the target volume is localized between arcs
No image verification is needed

A

Jaws change while the gantry is moving

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35
Q

Which of the following are uses for a Geiger-Muller counter? Please select all that apply.

detect radioactivity
survey background radiation
measure radiation dose
estimate occupational dose limits

A

detect radioactivity
survey background radiation

Hint: Geiger-Muller counters are more sensitive than ionization chambers but are not used to measure radiation dose and can detect individual photons or particles. Used primarily to detect the presence of radiation.

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36
Q

Lymphatic drainage from the lateral side of the breast filters to the _________nodes.

Supraclavicular
Internal mammary
Axillary
Paratracheal

A

Axillary

Study: Drainage from the lateral breast goes to the axillary lymph nodes because of the close proximity. This is the reason for sentinal node biopsy, as the majority of breast tumors are located in the upper outer quadrant.

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37
Q

When treating a patient in partial arcs, the maximum amount of radiation is pulled away from the prescribed target volume. For this reason, the isocenter will NOT be getting the correct prescribed dose. How is this fixed in treatment planning?

Add an additional field to the plan
Place isocenter on the anterior skin surface
Speed up the dose rate of the arc
Use past pointing technique

A

Use past pointing technique

Hint: With this technique, the isocenter is placed past or beyond the tumor volume. This will allow for a more even dose distribution to the prescribed target. The isocenter is usually placed a few centimeters posterior to the target.

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38
Q

The tolerance for daily electron output on the linear accelerator is:

2%
2 mm
3%
3 mm

A

3%

Daily electron output should be within 3% of the standard reading. Electron output should be checked daily for all electron energies, typically with a 10 x 10 cm cone without any blocking. Typically, 100 MUs are delivered.

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39
Q

The primary element in Cerrobend is:

Cadmium
Tin
Lead
Bismuth

A

Bismuth

Cerrobend consists of 50.0% bismuth, 26.7% lead, 13.3% tin, and 10.0% cadmium.

40
Q

There are several methods in which an isocenter can be placed. Which of the following is NOT considered localization for isocenter placement method?

Computing isocenter based on field border placement
Placement of isocenter based on treatment volume
Placement based on linac type
Using external skin fiducials

A

Placement based on linac type

Choice A: This is when the MD defines the treatment borders that are defined by the field’s edge and the computer computes the isocenter. Choice B: This is when the MD is required to contour or delineate the target volume and then the computer will set the isocenter according to the structures identified. Choice D: This is when placement is done manually by placing the isocenter on the CT image at the correct location when doing the virtual simulation.

41
Q

Chromosome aberrations and chromatid aberrations are two types of anomalies that are observed at _________.

G1
G2
metaphase
anaphase

A

metaphase

Chromosome aberrations are caused when irradiation occurs early in interphase before DNA synthesis while chromatid aberrations occur after DNA synthesis. Both result in a break of one or both arms.

42
Q

Which type of nonverbal communication includes body movement and facial expressions?

kinesics
proxemics
touch
mimic

A

kinesics

Kinesics is a type of nonverbal communication that includes gestures, facial expressions, and gaze patterns.

43
Q

Which lab tests are performed to determine kidney function prior to administering iodine contrast in simulation?

Albumin, and electrolytes
Albumin and BUN
Creatinine and transferrin
BUN and creatinine

A

BUN and creatinine

BUN and creatinine are routinely checked to determine proper kidney function.

44
Q

Paraphrasing is important when communicating with a patient because it:

helps the patient practice their listening skills.
helps with problem-solving to determine the patient’s chief complaint.
verifies that the health care provider understands the patient.
is useful for charting purposes.

A

verifies that the health care provider understands the patient.

Paraphrasing helps the patient understand that the health care provider is listening and showing empathy toward the patient’s needs and requests.

45
Q

Which of the following is NOT part of the radiation therapy prescription?

Daily Dose
Energy of beam
Fractionation scheme
Position of patient

A

Position of patient

46
Q

The annual effective dose equivalent limit for the general population is:

1 mSv
5 mSv
15 mSv
50 mSv

A

1 mSv

47
Q

Using the equivalent square formula, what is the equivalent square for a 15 x 18 field?

  1. 4 cm2
  2. 4 x 14.4
  3. 4 cm2
  4. 8 cm2
A

16.4 cm2

You can use either formula: 4 (Area/Perimeter) or 2 (L x W/L + W). This factor is important as it is needed when doing treatment calculations. It is used when looking for output, percentage depth dose curve (PDD), tissue maximum ratio (TMR), and scatter factors.

48
Q

What is the given dose for the following treatment? Patient treated at 100 target to skin distance (TSD) with 6MV beam to a PA spine field. The patient’s separation is 15 cm. The tumor dose is 300 cGy prescribed at a depth of 5 cm from the posterior. The percentage depth dose curve (PDD) at 5 cm is 87% and PDD at 10 cm is 57.7%.

173 cGy
261 cGy
345 cGy
520 cGy

A

345 cGy

Given dose is solved by taking the tumor dose divided by PDD of point prescribed, therefore 300 cGy / .87 = 345 cGy.

49
Q

Kidney lymphatic drainage is filtered into the _________nodes.

Para-aortic
Common iliac
External iliac
Internal iliac

A

Para-aortic

More info: he para-aortic lymph nodes are adjacent to the abdominal aorta, from the level of T12 through L4.

50
Q

When treating the pancreas with radiation, which of the following organs in the field will be MOST sensitive to radiation?

Bowel
Kidney
Liver
Spinal cord

A

Kidney

Hint: The TD 5/5 of the kidney is 2,300 which is less than any of the others listed.

51
Q

Which of the following is the grading system commonly used to grade prostate cancer?

Elston-Ellis
Gleason
Nottingham
TNM

A

Gleason

Gleason score need to know: The Gleason grading system is often used in conjunction with prostate cancer staging. The grading system is based on a biopsy of the prostate and looks at cells under a microscope to determine the likely prognosis for a patient using a scale of 2 to 10. Cancers with a lower Gleason score tend to be less aggressive while a higher Gleason score tends to indicate a more aggressive cancer.

52
Q

An event that occurs and is found prior to treatment delivery is called a(n):

Radiation accident.
Near miss.
Close call.
Unforeseen circumstance.

A

Near miss.

A near miss is an event in which the patient is not affected. In other words, the incident is discovered before reaching the patient.

53
Q

If a patient experiences urticaria during administration of contrast, how should this acute reaction be managed?

Discontinue injection and give the patient a histamine
Ensure patients legs are elevated and monitor their blood pressure
Give O2 and epinephrine intramuscular
Monitor vitals and secure the airway

A

Discontinue injection and give the patient a histamine

Need to know:
Urticaria is defined as itching. This can occur at the site or disseminate through the body. Discontinue the injection, if not completed. In most cases treatment is not needed. If you do need to proceed with intervention, give the patient a histamine, like Benadryl or epinephrine.

54
Q

Which of the following methods of patient identification are inadequate?

Calling a patient’s name in the waiting room and treating the patient who responds
Asking a patient’s name and comparing with the name you called
Comparing a patient with his/her picture in the treatment chart
Checking a patient’s armband and asking his/her name

A

Calling a patient’s name in the waiting room and treating the patient who responds

55
Q

Which of the following is an example of an environmental risk factor?

Age
Family history
Tobacco smoke
Hormones

A

Tobacco smoke

56
Q

Myelosuppression is a problem encountered in a large field therapeutic irradiation. Which of the following blood studies are the MOST closely monitored as a result?

White blood cell count
Red blood cell count
Hematocrit
Platelet count

A

White blood cell count

Hint: White blood cell count is a good indicator of the patients level of immunosuppression.

57
Q

hemotherapy agents that increase radiation therapy effects are known as:

Interferons
Radiosensitizers
Radioprotectors
Immunotherapuetics

A

Radiosensitizers

Moere info: Radiosensitizers enhance the radiation effects when given simultaneously. For example, Doxorubicin is considered a radiosensitizing agent.

58
Q

Calculate the gap needed for the following treatment. Field 1 is 10 cm in length, and Field 2 is 20 cm in length. Both fields are treated at 100 cm at a depth of 6 cm with a 6 MV beam.

  1. 4 cm
  2. 9 cm
  3. 3 cm
  4. 6 cm
A

0.9 cm

59
Q

Which cancer staging system is the MOST widely used?

International Federation of Gynecology and Obstetrics (FIGO)
Okuda
TNM
Dukes system

A

TNM

60
Q

Respiratory gating is utilized when the tumor motion varies by __________ in any direction.

Less than 3 mm
Less than 5 mm
More than 3 mm
More than 5 mm

A

More than 5 mm

Significant normal tissue sparing occurs when respiratory management techniques are used for tumors with a range of motion greater than 5 mm in any direction.

61
Q

What is the average normal oral temperature for adults?

  1. 6
  2. 6
  3. 6
  4. 6
A

98.6

More info: A normal range for adult body temperature can be 1 degree more or less than the average, and individuals typically fall within the 97-99 degree range.

62
Q

The most radiosentive cell during female germ development is the ___________.

oogonia
ovum
oocyte
primordial follicle

A

oocyte

The oocyte in the mature follicle is the most radiosensitive cell during female germ cell development.

63
Q

Why might a belly board be used to treat a patient with rectal cancer?

To reduce the skin reaction
To allow for better isodose distribution
For better beam angulation
To move the small bowel out of the lateral treatment field

A

To move the small bowel out of the lateral treatment field

Reasoning: Laying prone on a belly board allows for the small bowel to be moved away from the rectum and reduces unnecessary dose to these organs.

64
Q

A normal blood urea nitrogen (BUN) level for an adult is:

7-20 mg/µl
20-33 mg/µl
33-46 mg/µl
46-59 mg/µl

A

7-20 mg/µl

BUN: Blood Urea Nitrogen

A BUN greater than 20 could indicate the kidneys would have difficulty excreting the contrast material. This would be a contraindication to contrast administration.

65
Q

What type of photon is emitted from a nucleus as it undergoes radioactive decay?

Gamma ray
Electron
Positron
Deuteron

A

Gamma ray

Electrons and positrons are examples of Beta particles.

66
Q

When performing a simulation on a patient in CT, contrast may be needed. Which of the following are methods that can be used to administer contrast media? Please select all that apply.

Intravascularlly
Intrathecally
Intraarteriorly
Orally

A

Intravascularlly

Intrathecally: occurring within or administered into the spinal theca.
“intrathecal injection”

Intraarteriorly: situated within, occurring within, or administered by entry into a joint intra-articular injection.

Orally

67
Q

Which of the following is true of a benign tumor? Please select all that apply.

It is not a malignant cancer.
It does not spread to other parts of the body.
It invades nearby tissue.
The prognosis, in most cases, is very good.

A

It is not a malignant cancer.
It does not spread to other parts of the body.
The prognosis, in most cases, is very good.

68
Q

A common sign of rectal cancer is:

Hematochezia
Abdomen tenderness
Achalasia
Jaundice

A

Hematochezia

Hematochezia, or rectal bleeding, is the most common presentation of rectal cancer. Other signs and symptoms may include change in bowel habits, dark colored stool or tenesmus (rectal spasms).

69
Q

When checking light field and radiation field agreement, which of the following tools are used? Please select all that apply.

Ready pack film
Bubble level
Solid water
Geiger Mueller counter

A

Ready pack film

Solid water

Reasoning: Light field and radiation field agreement should be checked monthly. To check, place a piece of ready pack film on the treatment table and mark the field edges with a ball point pen. Apply enough pressure so that the emulsion of the film is scratched. Next, place solid water over the top of the film (equal thickness to the Dmax of the beam you are testing). Expose and process the film in order to evaluate.

70
Q

How often must chart check be done by physicists?

Daily
Bi-weekly
Weekly
Monthly

A

Weekly

71
Q

Which lymph nodes in the head and neck are MOST likely to be affected by metastatic disease?

Submental
Cervical
Subparotid
Submandibular

A

Cervical

72
Q

According to NRC regulations, the standard radiation symbol background color must be:

Green.
Red.
Blue.
Yellow.

A

Yellow.

The yellow color is able to be seen from a further distance than the other colors.

73
Q

The instrument of choice, the _______ is used when determining exposure rates from patients with therapeutic doses of radioactive materials.

Geiger-Muller counter
cutie pie
pocket ionization
personnel digital ionization

A

cutie pie

More info: The cutie pie is an ionization chamber type survey meter and is both a rate meter used for area surveys and an accurate cumulative exposure instrument.

74
Q

For an unwitnessed child collapse which course of action shoud be first taken?

Begin cardiopulmonary resuscitation (CPR) and wait for another rescuer to arrive on the scene.
Give 1 minute of cardiopulmonary resuscitation (CPR) then leave the victim to activate the emergency response system.
Give 2 minutes of cardiopulmonary resuscitation (CPR) then leave victim to activate the emergency response system.
Leave the victim to activate the emergency response system.

A

Give 2 minutes of cardiopulmonary resuscitation (CPR) then leave victim to activate the emergency response system.

Reasoning: If cardiac arrest in a child or infant is unwitnessed, the rescuer should perform 2 minutes of CPR, activate the emergency response system, and obtain an automated external defibrillator (AED). Immediate CPR is recommended for unwitnessed cardiac arrest in this population because pediatric arrests are often due to asphyxia.

75
Q

The tolerance for monthly collimator angle accuracy is:

0.5 mm
1 degree
1 mm
2 degrees

A

1 degree

More info: The tolerance for monthly collimator and gantry angle accuracy is 1 degree. The digital and mechanical readout for both gantry and collimator readouts should be completed. A bubble level is used for these tests.

76
Q

A patient’s white blood cell count (WBC) is reported to be 800. The radiation therapist’s action could be to:

Continue treating since this is a normal lab value.
Report this value to a physician since the normal white blood cell count is 2,000 to 3,000.
Discontinue treatment and report this value to a physician since the normal white blood cell count is 5,000 to 10,000.
Continue to treat since the abnormal value does not pose any threat to the patient’s well being.

A

Discontinue treatment and report this value to a physician since the normal white blood cell count is 5,000 to 10,000.

A low white blood cell count could pose an increased risk of infection to the patient. A normal WBC count is 5,000 - 10,000.

77
Q

Patients receiving radiation to the whole brain may experience increased intracranial pressure. All of the following are signs of increased intracranial pressure, except?

Headache.
High blood pressure.
Nausea.
Seizure.
A

High blood pressure.

Hint: Whole brain irradiation can lead to increased intracranial pressure which may cause the patient to experience headache and nausea, and possibly a seizure.

78
Q

Airborne precautions would be used when treating a patient with:

Hepatitis C
Tuberculosis
Streptococcus
Pertussis

A

Tuberculosis

79
Q

Which of the following is NOT a risk factor for cancer?

Aging
Physical activity
Obesity
Tobacco use

A

Physical activity

Fun facts: Aging, obesity, and tobacco use are all risk factors for cancer. Increasing age increases an individuals risk of cancer, as 60% of those diagnosed with cancer are 65 years or older. A larger body mass index is linked to an overall risk of cancer. According to the American Cancer Society, excess body weight is considered to be responsible for about 8% of all cancers in the United States. Tobacco use accounts for about 30% of all cancer deaths in the United States and has long been known to be a risk factor for lung cancer as well as other cancers. Physical activity is the only example listed that lowers an individuals risk of developing cancer.

80
Q

Daily mechanical checks performed on the linear accelerator include:

X-ray output
A-V communication
Door interlocks
Localizing lasers

A

X-ray output
A-V communication
Door interlocks
Localizing lasers

All of the options in this question are tests that are performed daily. X-ray output, as well as electron output, are dosimetry checks. Door interlock and a check of the A/V equipment fall into the safety category.

81
Q

The __________ dosimeter is accurate to 10 µSv for x-ray and gamma photons and is not affected by heat, moisture or pressure.

optical stimulated luminescence (OSL)
thermoluminescent (TLD)
pocket ionization
personnel digital ionization

A

optical stimulated luminescence (OSL)

The OSL has increased sensitivity and gives accurate readings with energies from 5 keV to 40 MeV.

82
Q

Which lymph nodes drain the liver?
Show More

Celiac
Superior mesenteric
Inferior mesenteric
Common iliac

A

Celiac

The celiac lymph nodes are located superiorly to the others listed. They drain the liver, stomach, gallbladder and spleen.

83
Q

For which condition would droplet precautions be applied?

Chicken pox
Clostridium difficile
Shingles
Influenza

A

Influenza

Standard and contact precautions should be used when caring for a patient with influenza.

84
Q

What does “reasonable” refer to in terms of ALARA?

Not exceeding annual occupational dose
Not exceeding annual effective dose
There is a benefit to receiving the dose
Limits on genetically significant dose

A

There is a benefit to receiving the dose

While the ALARA concept is to limit radiation dose, there is medical benefit to having some procedures. In other words, the benefit outweighs the risk of radiation exposure.

85
Q

What dose will be given to dmax if a dose of 180 cGy is prescribed to the gross tumor volume (GTV) and the percentage depth dose curve (PDD) dose is 64.3%.

2.8 cGy
115.7 cGy
244 cGy
280 cGy

A

280 cGy

Given dose = tumor dose / PDD. Given dose is also known as the dmax dose or electron equilibrium dose. This is where you will see the maximum dose or 100% of the radiation delivered.

86
Q

Of these conditions, which is the most common nosocomial infection?

Pneumonia
Bone infection
Streptococcus
Cardiovascular infection

A

Pneumonia

Pneumonia and surgical site infections are the most common hospital-acquired infections. In fact, they both tie for the number 1 condition.

87
Q

Inguinal lymph nodes are responsible for draining the:

Prostate.
Bladder.
Cervix.
Vulva.

A

Vulva.

The inguinal nodes are more superficial than others, and drain the vulva, uterus, ovaries, and vagina

88
Q

Where are the adrenal glands located with respect to the kidneys?

Inferior and medial
Superior and medial
Inferior and lateral
Superior and lateral

A

Superior and medial

The adrenal glands are located superior and medial to each kidney. Like the kidneys, adrenal glands’ lymphatics drain to the para-aortic lymph nodes.

89
Q

Radioactive sources must be physically inspected every ___ months.

3
4
6
12

A

6

90
Q

Histologic grade refers to the:

Type of cell.
Differentiation of the cell.
Stages of the tumor.
TNM clinical classification.

A

Differentiation of the cell.

Histologic grade refers to the differentiation of the cell. Histologic type refers to the type of cell. Together, they can describe how similar the biopsied cell appears to a normal cell of the same type.

91
Q

A treatment schedule of 80.5 Gy (1.15 Gy BID) delivered in 70 treatments over 7 weeks is an example of a _________ treatment schedule.

conventional
hyperfractionated
accelerated
protracted

A

hyperfractionated

Accelerated treatment is the same total dose delivered in half the overall time of giving 2 or more fractions each day.

92
Q

The quantity of __________ dose adjusts the value of absorbed dose to reflect the harm from the types and energies of ionizing radiation.

dose area
air kerma
equivalent
effective

A

equivalent

The equivalent dose is the product of the absorbed dose and the radiation weighting factor for the type and energy of the radiation.

93
Q

Which of the following need not be printed to be included in the treatment chart record?

Elapsed days and treatment days
Monitor Units
Daily dose and total dose
Type of side effects noticed

A

Type of side effects noticed

Side effects do not need to be documented in the treatment chart. They should be reported to the physician or nurse if action is necessary and a note can be placed in the medical record. The others are mandatory and must be documented daily.

94
Q

A palliative patient’s plan is calcualted to deliver 8 Gy in 1 fx to the supine patient with 100 cm SSD spine PA only field. The patient is in severe pain at the time of treatment, and the physician orders a mattress be used. The distance to the spine is now 103 cm SSD. What is the dose to the target when the 103 cm SSD is used?

7 Gy
7.5 Gy
8 Gy
8.5 Gy

A

7.5 Gy

The inverse square correction factor is needed to calculate the new dose.

95
Q

If a patient experiences a mild reaction from contrast media, which of the following would be the MOST appropriate intervention?

Consider immediate treatment
Do nothing due to the mildness of the reaction
Hospitalization to prevent further reaction
Observation is required

A

Observation is required

96
Q

When positioning the patient in the CT scanner for a simulation, which is NOT an advantage for placing the scan field of view in the center of the bore?

Eliminates image artifacts
Ensures FOV is encompassed
Provides the best image quality
Yields a higher radiation dose to be delivered to the patient

A

Yields a higher radiation dose to be delivered to the patient

Last Semester Board Prep (21 decks)

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