Mosby's Flashcards
(494 cards)
1
Q
Define Oncology
A
the study of a large variety of diseases that behave in a similar way with lethal behavior; the study of neoplastic disease
2
Q
Define Tumor
A
Neoplasm composed of cells with abnormal proliferation capacity
3
Q
What are the two classifications of tumors?
A
Benign and Malignant
4
Q
Define Malignant Tumors
A
Referred to as cancer
5
Q
Where did the word cancer come from?
A
Greek physician Hippocrates. Found a group of diseases that resembled a crab and named the disease “karkinos” - greek word meaning crab. Crab is the symbol for the zodiac sign for cancer.
6
Q
Where did the word cancer come from?
A
Greek physician Hippocrates. Found a group of diseases that resembled a crab and named the disease “karkinos” - greek word meaning crab. Crab is the symbol for the zodiac sign for cancer.
7
Q
What are the thee main routes of spread for cancer?
A
Local extension, lymphatics, and blood
8
Q
Define Metastasis
A
when cancer has spread outside of the original locations in the body
9
Q
Define Epidemiology
A
The study of cancer as it is distributed in a given population
The study of the incidence f the disease
10
Q
Define Epidemiologic Studies
A
Help reveal patterns of incidence in a given population
11
Q
How are epidemiological studies of incidence divided in populations?
A
Race, gender, common social habits, occupation, geographical location, age, religion, marital status, among others
12
Q
Define Etiology
A
Study of cancer causes and risk factors study of the cause of the disease -identifying carcinogens -genetic factors - helps provide screening programs ad preventative cancer education
13
Q
What are some etiologic factors?
A
smoking, asbestos exposure, arsenic exposure, ultraviolet radiation, nickel compounds, among many others.
14
Q
What does the American Cancer Society recommend based on epidemiological and etiologic factors?
A
Cancer screenings
15
Q
Define Carcinogens
A
Cancer causing agents
16
Q
Define Carcinogenesis
A
The multistage process the occurs following exposure to a carcinogen leading to a malignancy
17
Q
How many mutations in the stem cells of the tissue of origin is likely required for a tumor to develop?
A
2
18
Q
How may carcinogens be categorized?
A
Chemical factors, physical factors, viral agents, or genetic factors
19
Q
What are some known chemicals that increase the likelihood of developing cancer?
A
soot, tar, nickel compounds, asbestos, arsenic, and benzene
20
Q
All mammalian cells contain genes known as:
A
protoncogenes, oncogenes, and antioncogenes (tumor suppressor genes)
21
Q
What are protoncogenes responsible for? How can they be transformed?
A
controlling cellular proliferation. Can be transformed into oncogenes when activated by the presence of certain viruses or chemical agents
22
Q
Cancers attributable to extrinsic (non-inherited) factors are classified as:
A
Sporadic
23
Q
Inherited cancers are classified as:
A
familial
24
Q
Sporadic cancers are typically caused by multiple:
A
outside factors
These cancers are likely due to a change in cell genes following multiple encounters with a carcinogenic agent
25
These show up in families who share a common environment and/or genetic abnormality that is passed down through generations:
Familial Cancers (the mothers side tends to be most influential)
26
Medical history should include these 7 things:
1. Chief complaint and main symptoms
2. Details of known or present illness
3. Review of all body systems
4. Past medical history
5. Social history
6. Family history
7. Work history
27
Upon physical examination, the examiner should check the status of :
the skin, lymph nodes, oral cavity, breast, testis, perineum, and central nervous system.
28
What is the perineum?
the area between the anus and the scrotum or vulva
29
Define dysphagia
Difficulty swallowing
30
Define cachexia
loss of weight, muscle atrophy, fatigue, weakness, and significant loss of appetite in someone who is not actively trying to lose weight
31
What is CAUTION?
7 warning signs of cancer by the American Cancer Society
32
Define CAUTION
```
C change in bowel habits
A a sore that will not heal
U unusual bleeding or discharge
T thickening or lump
I indigestion or difficulty swallowing
O obvious change in a wort or mole
N nagging, persistent cough
```
33
Define biopsy
the removal of tissue or cells for microscopic evaluation
34
Name the different types of biopsies:
1. Collection of body secretions: sputum or urine
2. Scraping or curettage
3. Aspiration of fluid as from the chest, fluid-filled mass, or other body cavity
4. Core needle sampling
5. Dermal punch
6. Scalpel incision or excision
7. Direct biopsy or endoscopy
8. Open surgery
35
Tumors are classified and sorted by:
- Biologic behavior
- Anatomic site - breast, prostate, pancreas
- Tissue origin - epithelial, connective, reticule-endothelial
- Differentiation aka tumor grade
- Stage
36
What is differentiation?
how well the cells can carry out the normal functions of cells of this origin; how well the cells exhibit normal physical characteristics; aka tumor grade
37
What is a well-differentiated tumor cell?
Well-differentiated cancer cells look more like normal cells and tend to grow and spread more slowly than poorly differentiated or undifferentiated cancer cells.
38
What is an undifferentiated tumor cell?
the cells are very immature and "primitive" and do not look like cells in the tissue from it arose. As a rule, an undifferentiated cancer is more malignant than a cancer of that type which is well differentiated. Undifferentiated cells are said to be anaplastic
39
What is anaplastic?
refers to a lack of differentiation in neoplastic cells
40
What are neoplastic cells?
abnormal growth of cells to form a tumor
41
What is the vena cava?
a large vein carrying deoxygenated blood into the heart
42
What is the superior vena cavas function?
carrying blood from the head, arms, and upper body
43
What is the inferior vena cavas function?
carrying blood from the lower body
44
Define aorta
the main artery of the body, supplying oxygenated blood to the circulatory system. In humans it passes over the heart from the left ventricle and runs down in front of the backbone
45
Left ventricle function:
the thickest of the heart's chambers and is responsible for pumping oxygenated blood to tissues all over the body
46
Right ventricle function:
solely pumps blood to the lungs
47
How does blood enter and exit the heart?
Blood enters the heart through the two atria and exits through the two ventricles
48
Right and left atria functions?
function as receiving chambers for blood entering the heart
49
Cancerous tissues originating in epithelial tissues are referred to as:
carcinomas
50
Cell types that form epithelial tissues include:
Basal cells, squamous cells, and transitional cells
51
Epithelial tissues:
line, cover, or are glandular
52
Define adenocarcinoma:
cancerous tumor of glandular epithelium
53
Cancerous tissues originating in connective tissues are referred to as:
sarcomas
54
If distance is doubled, the intensity of radiation will be? Why?
Reduced by a factor of four
-The inverse square law applies here. The change in distance will result in a change in intensity by a quart of the distance change.
55
How many Rem is 1 Sievert?
100
56
1 rem = ? mrem
1000
57
A stochastic effect is defined as one in which:
probability is dose dependent
58
Define electromagnetic radiation:
a kind of radiation including visible light, radio waves, gamma rays, and X-rays, in which electric and magnetic fields vary simultaneously
59
Define prodromal:
relating to or denoting the period between the appearance of initial symptoms and the full development of a rash or fever. nausea or vomiting
60
What is the SI (system international) unit for activity?
becquerel
61
photons produced during the orbital transitions of electrons from a higher to lower energy shell are called? Why?
Characteristic radiation
-when electrons from a higher shell drop down to a lower shell, characteristic radiation is emitted
62
two or more chemicals with the same chemical formula, but having different nuclear states are known as:
isomers
63
wavelengths of x-rays are measured in:
angstroms
64
What is hematopoietic syndrome caused by?
reduced blood cells
65
Two or more chemicals with the same chemical formula, but having different nuclear states are known as:
isomers
66
Which is not true of the electromagnetic spectrum? All photons in the spectrum have the same:
energy
67
What is the latent period?
The time between exposure and the manifestation of any late effects
68
The process of cellular growth and development is called:
proliferation
69
Which of the following cells has the highest radiosensitivity? Why?
- neurons
- chondrocytes
- osteoblasts
- lymphocytes
Osteoblasts
-They're the most sensitive because these bone cells are young and immature. Therefore they are still dividing, making them the most sensitive.
70
What is Bragg peak?
maximum ionization near the end of the range of a heavy, charged particle
71
A joule is a unit of:
energy
72
What is the half-life of iodine-125?
60.2 days
73
What is the half-life of radon?
4 days
74
How many joules are in one electron volt?
1.6 x 10 to 19 joules in 1 electron volt
75
what is adenocarcinoma?
cancerous tumor of glandular epithelium
76
what is an osteosarcoma?
cancerous tumor of the bone
77
cancerous tumors originating in connective tissues are referred to as:
sarcomas
78
The suffix -OMA means?
benign growths in various tissues
79
What are some exceptions to the root + suffix rule?
lymphoma, leukemia, glioma
80
What is a glioma?
malignancy originating in the central nervous system
81
What is leukemia?
malignancy originating in the blood
82
What is lymphoma?
malignancy originating in the lymphatic system
83
What is the lymphatic system?
the network of vessels through which lymph drains from the tissues into the blood
84
What is lymph?
a colorless fluid containing white blood cells, that bathes the tissues and drains through the lymphatic system into the bloodstream
85
What are the main functions of the lymphatic system?
- It is responsible for the removal of interstitial fluid from tissues.
- It absorbs and transports fatty acids and fats as chyle from the digestive system.
- It transports white blood cells to and from the lymph nodes into the bones
86
Pathologic staging requires the use of:
imaging and histologic study
-CT, MRI, PET, and tissue sampling
87
What is the most widely used and internationally accepted staging system?
TNM
88
What does the TNM system describe?
- The tumor's size, circumference, depth of invasion, or mobility status
- the involvement of lymph nods, their size, and mobility are also evaluated.
- the presence of distant metastasis
89
How many stages are there in the TNM staging system?
IV
90
What are the three main cancer management modalities?
surgery, chemotherapy, radiation therapy
91
What is an up and coming cancer management modality that is not yet widely used?
immunotherapy
-may become more prevalent as we continue studying the mechanisms for carcinogenesis, remission, and recurrent disease
92
What is a local approach used to diagnose or aid in disease staging, palliate symptoms, curatively manage, or as an adjunct to other cancer management modalities?
Surgery
93
Surgical lymph node dissections can be helpful in staging that kinds of cancers?
Breast and Head and Neck
94
What kind of cancers are easily cured with surgery?
small and localized with no evidence of distant metastasis
95
What is localized cancer?
usually found only in the tissue or organ where it began, and has not spread to nearby lymph nodes or to other parts of the body.
96
Define prophylactic:
intended to prevent disease.
-example: bilateral mastectomy for a patient with diagnosed breast cancer in one breast, who is at an increased risk of developing cancer in both breasts
97
The use of anticancer drugs (cytotoxic drugs) or hormonal agents to cure, palliate, maintain remission, or as a prophylactic measure is known as:
Chemotherapy
98
How is chemotherapy administered?
intravenously, orally, topically, or locally
99
What are the two categories of cytotoxic drugs?
Phase-specific and non-phase-specific
100
What are phase-specific drugs?
drugs that specifically work during the time in which the tumor cell is dividing
101
What are non-phase-specific drugs?
Drugs that can be given at any stage of cell division and may be effective on tumor cell populations that are no longer or sparsely dividing
102
What are the 5 classes of cytotoxic drugs?
- Alkylating agents
- Antitumor antibiotics
- Antimetabolites
- Plant alkaloids
- Nitrosoureas
103
Cytotoxics are intended to act as a _____ to malignant cells.
poison
104
Why are hormones administered?
to counteract the body's response to the presence of certain types of cancers.
105
What does BRM stand for?
Biologic Response Modifiers
106
What is a biologic response modifier?
Used in cancer management and are administered to induce or enhance the body's natural response to the presence of disease or physiologic imbalance
107
What can decrease swelling in central nervous system cancers?
an anti-inflammatory such as dexamethasone
108
chemotherapy agents that sensitize the cancerous tissues to other cancer therapy such as radiation are called:
radiosensitizers
109
Some chemical agents protect normal tissues from other therapy such as radiation, these are known as:
radioprotectors
110
What is the equivalent square for a field size?
2xlengthxwidth / length+width
Example:
15cm x 20 cm field size
Equivalent Square is 17.1 cm
111
During radiation treatment, the arm should be:
consistent throughout the treatment fraction
112
Your px being treated for bronchogenic adenocarcinoma complains of difficulty swallowing. His symptom is likely caused by:
esophagitis
113
Landmarks around the mouth are generally not very accurate due to:
extreme flexibility in the area
114
What does "renal" refer to?
The kidneys
115
What is the equivalent square for a field size ?
2xlengthxwidth / length+width
116
A joule is a unit of:
Energy
117
A T1 glottic larynx will likely be treated with parallel opposed laterals with field sizes of about:
6 x 6
118
Landmarks around the mouth are generally not very accurate due to:
Extreme flexibility in the area
119
What does "renal refer to?
The kidneys
120
Soft tissue sarcomas usually spread:
Along the muscle plane and compartment where it originated
-even neighboring compartments typically go unaffected by tumor growth
121
Which type of chemotherapy is known to cause hearing loss?
cisplatin
-as well as renal dysfunction
122
Your patient being treated for bronchogenic adenocarcinoma complains of difficulty swallowing. His symptom is likely caused by:
esophagitis
123
What is the density of water?
1
124
Deodorants should not be used in areas treated with radiation because:
The deodorant may cause a bolus effect
125
Soft tissue sarcomas usually spread:
Along the muscle plane and compartment where it originated
126
Which type of chemotherapy is known to cause hearing loss?
cisplatin
127
Placing marks on the central axis only is:
insufficient for daily realignment and targeting
128
What is the density of bone?
1.65 to 1.85
129
What are 4 methods of disposing of depleted radioactive materials?
- flushing into a holdup tank
- incineration
- transfer to an authorized recipient
- burial
130
What is the SI unit of exposure?
coulomb
131
What is the tradition unit of exposure?
roentgen
132
A surgical procedure in which an incision is made through the abdominal wall to examine lymph nodes and establish the extent of disease is called:
laparoscopy
133
The does at the point where the axis of the beam emerges from the patient is known as the:
Exit dose
134
The energy loss of mega voltage (MeV) electron beams in water is approximately ____ MeV/cm.
2
-Electrom beams lose about 2 MnV per centimeter of tissue
135
What is lidocaine?
Lidocaine is a local anesthetic that works by causing temporary numbness/loss of feeling in the skin and mucous membranes.
136
Lucite is often used as the material for positioning devices. One major concern when this material is in the path of the treatment beam is:
beam attenuation
137
What is the average diastolic pressure in an adult?
60-90 mm og Hg
138
The iliac breast is located at about the level of lumbar vertebrae number:
4
139
How many lumbar vertebrae are there?
5
140
How many cervical vertebrae are there?
7
141
What is C1 also referred to as?
Axis
142
What is C2 also referred to as?
Atlas
143
How many thoracic vertebrae are there?
12
144
How many ribs are there?
12
145
Which ribs are floating?
11 & 12
146
What is above the sternum?
manubrium
147
Partial breast irradiation may involve treatment techniques that employ all of the following except:
5-field breast technique
148
Which of the following would influence the onset or duration of action for a certain drug?
- purity
- kidney function
- nutrition
- liver function
nutrition (fluid and electrolyte balance)
-may be influenced by many things including the route of administration, dose, patient's age, health, ethnicity, state of mind, weight, and nutrition
149
The angle between two beams is known as the:
hinge angle
150
What is caudad?
toward the feet/ tail/posterior
151
When breathing in the diaphragm moves:
caudad
152
Which of the following reduces the skin sparing effect in photon beams?
bolus
153
The rate of kinetic energy lost per unit path length is referred to as:
stopping power
154
Varying the beam size and shape using multi-leaf collimators during treatment is known as:
intensity modulated radiation therapy
155
How do you figure this out and what is the answer:
The closest blocked equivalent for a 10 x 20 rectangular field with a 4 x 6 block in the field is:
Subtract the area of the block from the area of the open field, and them take the square root.
```
10x20 = 200
4x6 = 24
200-24 = 176
```
square root of
176 = 13.3
156
In radiation therapy, which of the following interactions with matter are least important?
photoelectric effect
157
What is the advantage of a rotating anode versus a stationary anode in an X-ray tube?
Larger exposures are possible without overheating the tube
158
The spinal cord proper extends in the adult from the:
foramen magnum to the second lumbar spine
159
How many sacral vertebra are there?
5 fused sacral vertebrae
160
How many coccygeal vertebrae are there?
4
coccyx
161
How far does the cauda equina extend?
2nd lumbar spine to the approximate level of the coccyx
162
What is the cauda equina?
a bundle of spinal nerves and spinal nerve rootlets, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enlargement and the conus medullaris of the spinal cord
163
What is the dural sac (aka thecal sac) and where does it terminate?
- membranous sheath or tube of dura mater that surrounds the spinal cord and the cauda equina
- at the approximate level of the second sacral body
164
When using rotational arc therapy, monitor units or treatment time should be calculated using which of the following methods?
TAR method- tissue air ratio
165
Every stage ovarian cancer can be successfully treated with:
surgery followed by chemotherapy
166
The following would be appropriate advice for a patient receiving radiation to the whole brain EXCEPT:
when dry desquamation occurs, use a dandruff shampoo
167
The dDmax dose for a 250 cGy tumor dose if the depth dose percentage is 96% would be:
What formula do you use?
-the applied dose formula
Applied dose = TD/%DD
So,
250/96% = 260
168
Which of the following examination instruments is necessary for examination of the pharynx?
laryngeal mirror
169
Anatomical data for CT imaging and reconstruction is acquired through the :
transverse plane
170
The equivalent square field size must be determined in order to calculate the:
dose to be delivered to the central axis of an irregular field
171
For patients with pancreatic cancer, extra care is taken to limit the dose to the radiosensitive:
liver, kidney and spinal cord
172
The method by which all healthcare workers can control the transmission of blood borne diseases is known as:
universal precautions
173
When clinically setting up an electron field, the electron cone should not be pointed obliquely to the patient surface because:
- The depth of Dmax in the patient can shift toward the surface
- beam penetration can be reduced
- side scatter to the patient increases
- all of the above
all of the above
174
What does the blood brain barrier do?
protects the brain from potentially toxic substances
175
What is dyspnea?
difficulty breathing
176
What is the semi Fowler's position?
Upright at 90 degrees is full or high Fowler's position. Semi-Fowler's would be tilted back to approximately 30 degrees.
177
```
A well healed skin graft would be treated:
With a decreased dose
With increased dose
Would not be treated
Same as normal tissue
```
Same as normal tissue
178
```
A tracheostomy is usually:
blocked
bolused
Treated, not bolused
boosted
```
bolus
179
```
If the chart states that the patient is ambulatory, this means that:
They can walk
They cannot walk
They need a wheelchair
They need a walker
```
They can walk
180
What is a normal platelet count range?
200,000-450,000
181
```
What is the shape of an isodose curve for tandem and ovoids?
Elliptical
Pear-shaped
Round
oval
```
pear-shaped
182
```
Which of the following implants are permanent?
Cesium
Radium
Gold
Iridium
```
gold
183
```
The iliac crest is at the level of:
T12
L1
L4
S1
```
L4
184
```
The tip of the xiphoid is at level:
T10
T12
L1
L4
```
T10
185
What is the xiphoid?
small cartilaginous process (extension) of the lower (inferior) part of the sternum
186
```
Which drug makes the heart more sensitive?
Bleomycin
Chlorambucil
Methotrexate
Adriamycin
```
adriamycin
187
What is adriamycin?
In some cases health care professionals may use the trade names Adriamycin® or Rubex® when referring to the generic drug name Doxorubicin. Drug Type: Doxorubicin is an anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drug
188
What is the target in a linear accelerator?
tungsten
189
```
Which drug is not used for diarrhea?
Lomotil
Imodium
Decadron
Kaopectate
```
decadron
190
```
Highest skin dose is with:
Grenz rays
Orthovoltage x-rays
9 MeV electrons
4 MV x-rays
```
Grenz Rays
191
What are grenz rays?
Grenz rays are a form of radiation, similar to ultraviolet radiation, x-rays and gamma rays. The difference is that Grenz rays are produced at low kilovoltages giving them a very low penetration power. They are absorbed within the first 2 mm of skin, which means they do not penetrate beneath the dermis of the skin.
192
What is decadron?
Decadron (dexamethasone) is a corticosteroid, similar to a natural hormone produced by the adrenal glands, used to treat arthritis, skin, blood, kidney, eye, thyroid, intestinal disorders, severe allergies, and asthm
193
```
Radiation myelopathy occurs:
During treatment
2-4 days after treatment
2-4 weeks after treatment
2-4 months after treatment
```
2-4 months after treatment
194
```
An adenoma is a tumor of:
Glandular tissue
Skin
Muscle
Mucous membrane
```
glandular tissue
195
```
Which of the following is most radioresponsive?
Seminoma
Dysgerminoma
Teratoma
Choriocarcinoma
```
seminoma
196
```
What is dyspnea?
Difficulty speaking
Difficulty swallowing
Difficulty chewing
Difficulty breathing
```
difficulty breathing
197
```
Where are the vallate papilla located?
In the epiglottis
In the intestines
At the back of the tongue
At the junction of the esophagus and stomach
```
At the back of the tongue
198
Where is the ramus?
jawbone
199
Where are the seminal vesicles?
superior to the prostate
200
```
Halfway through a treatment you notice that the wrong wedge was used. You should:
Continue treatment
Change the wedge and continue
Recalculate
Report to doctor
1 and 4
1 and 3
2 and 3
2, 3 and 4
```
2, 3, and 4
201
```
A patient suffering from emesis is at risk for:
Dyspnea
Aspiration
Anaphylaxis
Syncope
```
Aspiration
202
```
Whole brain x-ray therapy causes all but:
Skin irritation
Headaches
Memory loss
epilation
```
memory loss
203
```
Half beam blocks are used mainly for:
Skin sparing
Abutting fields
Reducing cord dose
Reducing hotspots
```
abutting fields
204
```
When moving a patient with a tumor in the midshaft of the bone, you need to support:
The proximal aspect
The distal aspect
The midshaft
1 only
2 only
1 and 2
2 and 3
```
1 and 2
205
```
When the patient is experiencing dyspnea, you want to position the patient in the _____ position.
Supine
Prone
Semi Fowler’s
Sims’
```
semi fowler's
206
```
How do you make a 10 year old feel comfortable with their treatment?
Tell the truth
Tell them it will not hurt
Let them watch someone else get treated
Let their mother explain the procedure
```
Tell the truth
207
```
When contrast is to be injected into a patient, ensure that _____ is available.
Prednisone
Atropine
Epinephrine
Albuterol
```
epinephrine
208
```
At what level does the abdominal aorta bifurcate?
T10
L1
L4
S2
```
L4
209
The principal advantage to using an electron beam is:
Skin sparing
High skin dose
Rapid fall off of dose with increasing depth
Rapid fall off of dose with decreasing depth
Rapid fall off of dose with increasing depth
210
```
If the patient’s platelet count is 225,000, you should:
Hold treatment and report to doctor
Treat, but report to doctor
Send patient home
Continue treatment as normal
```
continue treatment as normal
211
```
A brachytherapy source can be disposed of when it has gone through _____ half lives.
2
5
10
20
```
10
212
```
What diet should a patient being treated for cancer of the bladder be on?
Low residue
High residue
Low fat
High fat
```
low residue
213
```
A surgical opening in the small bowel.
Colostomy
Ileostomy
Laparotomy
gastrectomy
```
ileostomy
214
```
A mastectomy patient should:
Avoid blood pressure and needle sticks in affected arm
Keep arm immobile
Not lift heavy objects
a and c
```
a and c
215
```
What does the scattering foil do?
Shape the x-ray beam
Filter the x-ray beam
Spread the electron beam
Remove low energy electrons
```
spread the electron beam
216
```
Linear accelerators have what type of target?
Rotating anode
Reflexion
Thick transmission
Thin transmission
```
thick transmission
217
```
In an isocentric treatment, the machine field size is set:
At the isocenter
At the collimator
At the central axis
On the skin surface
```
at the isocenter
218
```
Highest skin dose is with:
Grenz rays
Orthovoltage x-rays
9 MeV electrons
4 MV x-rays
```
grenz rays
219
```
Surgical clips may be used to help define the treatment area for all but:
Breast
Prostate
Lung
Multiple myeloma
```
multiple myeloma
220
what is multiple myeloma?
Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs. Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells.
221
What is the myeloma prefix?
spinal cord or bone marrow
222
What is the prefix "dys"?
difficulty
223
what is the suffix "pnea" mean?
breathing
224
medical term: anemia
"without blood" - Low Red Blood Count
225
medical term: excise
to cut out
226
medical term: uria
presence of a substance in the urine
227
medical term: poly
many
228
medical term: ectomy
excision/ to cut out
229
medical term: incision
to cut into
230
medical term: excision
to remove or take out
231
medical term: cholecyst/o
gallbladder
232
medical term: chondr/o
cartilage
233
medical term: col/o
colon
234
medical term: colp/o
vagina
235
medical term: cost/o
rib
236
medical term: cyst/o
bladder
237
medical term: encephala/o
brain
238
medical term: hepa or hepat/o
liver
239
medical term: hyster/o
uterus
240
medical term: mast/o
breast
241
medical term: nephr/o
kidney
242
medical term: proct/o
rectum, anus
243
medical term: pyel/o
pelvis of kidney
244
medical term: spondyl/o
vertebrae
245
medical term: ostomy
new permanent opening
246
medical term: otomy
incision into
247
medical term: gyne
woman
248
medical term: ile/o
ilium (small intestine)
249
medical term: laryng/o
larynx (voice box)
250
medical term: metr/o
uterus
251
medical term: oophor/o
ovary
252
medical term: phleb/o
vein
253
medical term: -ectasis or ectasia
stretching/dilating
254
medical term: -osis, iasis
condition of
255
medical term: -algia or dynia
pain
256
medical term: -cele
hernia, swelling
257
medical term: -orrhagia
excessive bleeding
258
medical term: a-, an-, ar- (ie, anemic)
without or not
259
medical term: ad- (ie, adduction)
near, toward
260
medical term: ab- (ie, abnormal)
away from
261
medical term: dis- (i.e. disease)
from
262
medical term: hemi- (i.e. hemiplegia)
half
263
medical term: -plegia
paralysis
264
medical term: inter- (i.e. intercostal)
in between
265
What are the pelvis lymph nodes?
iliac, inguinal, femoral
266
What are the abdominal lymph nodes?
mesenteric, paraaortic, spleen
267
medical term: oma
tumor or growth
268
What is foramen?
holes in the bone for large vessels and nerves to pass through
269
Where are the mesenteric lymph nodes?
lower right abdomen
270
What is fossa?
depressions or hollows
271
What is fossa?
depressions or hollows
272
What is a film's tumor?
kidney
273
What are the thoracic lymph nodes?
mediastinal, hilar, axillary, pectoral, more?
274
```
If blocks for shielding the eyes during radiation treatment are incorrectly placed, what would be a serious complication?
Retinitis
Cataract
Erythema
Otitis
```
cataract
275
Why does a therapist wear gloves when tattooing a patient?
To prevent infecting the patient
Instead of washing hands
To protect self against body fluids
One should always wear gloves when touching a patient
To protect self against body fluids
276
```
What is an hypophysectomy?
Surgery of hypopharynx
Thyroid disease
Removal of ovaries
Removal of pituitary
```
removal of pituitary
277
```
The most radiosensitive part of a child’s bone is the:
Epiphysis
Diaphysis
Periosteum
Endosteum
```
epiphysis
278
```
TD5/5 for the liver is _____ cGY.
1500
2500
3500
4500
```
2500
279
```
Where is the corpus luteum located?
Uterus
Ovary
Heart
Testes
```
ovary
280
Are benign tumors cancerous or non-cancerous?
non-cancerous
281
Teo tumor classifications?
Malignant and benign
282
5 characteristics of benign tumors:
- normal to slightly increased growth
- encapsulated
- well differentiated
- not usually life threatening
- non-cancerous
283
5 characteristics of malignant tumors:
- cancerous
- normal to increased mitotic rate
- can metastasize
- well differentiated to anaplastic
- life threatening
284
What percent of tumors are carcinomas?
75-85%
285
What percent of tumors are sarcomas?
10-15%
286
5 characteristics of carcinomas:
- 75-85% of tumors
- originate from the epithelium
- squamous cell carcinomas
- glandular cells (adenocarcinomas)
- generally spread by lymphatics
287
4 characteristics of sarcomas:
- 10-15% of tumors
- originate from bone, connective tissue, or soft tissue
- generally spread through the blood
- most common metastatic site is the lungs
288
What is a screening test for the prostate?
blood PSA (prostate specific antigen)
289
Define neoplasm
a new and abnormal growth of tissue in some part of the body, especially as a characteristic of cancer
290
Measurements of absorbed dose:
Rad (Radiation absorbed dose)
291
1 Gy = ____ rads
100
292
1 cGy = ____ rad
1
293
What does KERMA stand for?
kinetic energy released in a medium
294
Measure of exposure:
roentgen
295
What does Rem stand for?
Roentgen equivalent man
296
1 sievert = ___ rem
100
297
0.1 rem = ___ mrem
100
298
1msv = ___rem
0.1
299
matter in its smallest form is composed of:
atoms
300
Define ionization:
any interaction that would cause an electron to be totally removed from the atom
301
once an atom is ionized, it is no longer _____
stable
302
what is the least number of electron volts needed for ionization? and wavelength?
124 eV and wavelength shorter than 10^-6 cm
303
What are the common energy ranges for radiation therapy?
200KeV - 50 MeV
304
What does KeV stand for?
kilo electron volt
1 KeV is 10^3 or 1000 electron volts
305
What does MeV stand for?
Mega electron volts
10^6 or 1,000,000 electron volts
306
all radiation in the electromagnetic spectrum are:
photons
307
Electromagnetic Spectrum Radiation includes:
- visible light
- heat
- radio
- microwaves
- ultraviolet rays
- gamma rays
- x-rays
308
What is frequency measured in?
cycles using hertz
309
What is wavelength measured in?
meters using angstrom
310
What is energy measured in?
joules/expressed in electron volts
311
What are some characteristics of x-rays and gamma rays?
found at the upper end of the spectrum, short wavelengths, high frequency and high energies
312
____ are a result of natural nuclear radiation
gamma rays
313
Name some heavy charged particles:
protons, neutrons, alpha particles, or deutrons
314
Energy deposit increases to a max and produces a more dense near the end of its path is:
Bragg Peak
315
What are the two types of electron interactions?
- collision - excitation and ionization
| - radiative
316
X-ray production requires:
high voltage source, cathode, anode, glass envelope, vacuum
317
What are the two main types of x-ray production?
characteristic and bremsstrahlung
318
5 major type of photon interactions:
- photodisintegration
- coherent scattering
- photoelectric effect
- compton effect
- pair production
319
Define beam intensity:
the amount of energy per unit of time per unit of area perpendicular to the beam direction
320
beam qulaity:
energy of the beam expressed in electron volts or the absorbing potential/ penetrating power of the beam expressed in half value layers (HVL) of material
321
What two things effect intensity of the beam?
attenuation and bam divergence
322
Define beam attenuation:
removal of energy from the beam
323
Define beam divergence:
expression of the scattering of photons away from the original point source
324
Define beam hardening:
when the effective energy of the beam increases as it passes through the filter
325
Isotopes:
same # of protons but diff # of neutrons
326
Isotones:
same # of neutrons, diff ## protons
327
Isobars:
same # nucleons, diff # protons and neutrons
328
isomers:
same # protons and neutrons but in a diff nuclear state
329
What is HVL?
half value layer
| the thickness of the material at which the intensity of radiation entering it is reduced by one half.
330
Define half-life:
the time taken for the radioactivity of a specified isotope to fall to half its original value.
the time required for any specified property (e.g., the concentration of a substance in the body) to decrease by half.
331
somatic cells
nonreproductive cells
332
cellular differentiation
occurs when a cell undergoes mitosis and divides into daughter cells. the cells continue to divide and differentiate until a mature cell with a specific function results
333
protooncogenes
normal genes that play a part in controlling normal growth and differentiation
334
oncogenes
gene that regulate and develope growth of cancerous tissues (cancer gene)
335
anti-oncogenes
tumor suppressor gene
336
mitosis
cellular division
337
cell cycle phases (in order)
G0, G1, S, G2, and M
338
G1
first growth phase, characterized by rapid growth and active metabolism
339
S
synthesis phase, period in which DNA is replicated to ensure that the resulting daughter cell will have identical genetic material
340
G2
second growth phase, the period where cells prepare for actual division
341
tumors are classified by what
anatomic site, cell of origin, biologic behavior
342
tumors that arise from the mesenchymal cells
sarcomas (include connective tissue and bone)
343
tumors that originate in the epithelium
carcinoma (include cancers that cover a surface or line a cavity)
344
epithelial cells that are glandular are called
adenocarcinoma
345
the american cancer society estimates that ____new cases of cancer will be diagnosed each year, with ______deaths.
665,000 new cases, 585,700 deaths
346
most common types of invasive cancer in the Unites States
prostate, lung, colorectal in men and breast lung and colorectal in women
347
etiology
study of the cause of the disease
348
epidemiology
study of the disease incidence
349
interferons
naturally occurring body proteins capable of killing or slowing down the growth of cancer cells
350
what type of tumors have a better prognosis
exophytic (grow outward)
351
what is tumor dissemination
spread (can be accomplished through blood, lymphatics, and seeding)
352
prostate cancer commonly metastasized to
bone
353
branch of medicine devoted to the study of disease
pathology
354
extravasation
accidental leakage of IV drugs into the tissue surrounding the venipuncture
355
six important causes of cell damage
radiation, hypoxia, chemicals, microorganisms, immunological reactions, neosplasms
356
cancer cells that exhibit no differentiation
anaplastic
357
great variability in size and shape of undifferentiated tumor cells
pleomorphic
358
Where is the perineal area?
The perineum is generally defined as the surface region in both males and females between the pubic symphysis and the coccyx. The perineum is below the pelvic diaphragm and between the legs. It is a diamond-shaped area that includes the anus and, in females, the vagina.
359
What are some side effects of city-toxic drugs?
nausea, myelosuppression, cardiac toxicity
360
Define parenteral:
Administered by some means other than oral or rectal intake, particularly intravenously or by injection.
361
Define lithotomy position:
a supine position of the body with the legs separated, flexed, and supported in raised stirrups, originally used for lithotomy and later also for childbirth.
362
Define trendelenberg position
In the Trendelenburg position, the body is laid supine, or flat on the back with the feet higher than the head by 15-30 degrees.
The reverse Trendelenburg position similarly has the body flat, but the head is 15-30 degrees higher than the feet.
363
define postural hypotension:
dizzy feeling associated with sitting or standing after a prolonged period of rest. caused by a drop in blood pressure and then a sudden increase
364
High blood pressure is also know as:
hypertension
365
What is a normal blood pressure range?
120/80 - 140/90
366
Normal heart rate:
60-100 beats per minute
367
normal respiration:
12-20 breaths per minute
368
normal platelet count:
150,000-450,000 platelets per microliter of blood
369
systolic pressure represents:
the highest point reached during contraction of the ventricles
370
What are the 6 tissue response factors?
1. total dose
2. radiation type
3. cellular sensitivity to radiation
4. volume of tissue irradiated
5. protraction (period of time over which total dose is absorbed)
6. fractionation (fraction of total dose given per unit of time)
371
Define acute response:
rad exposure response after short period of time
372
Define latent response:
rad exposure response after a long period of time
373
what's the most major molecule in body?
H2O
374
How are molecules formed?
Atoms in living tissue come together to form them
375
What percent of the body is water?
60-80%
it is believed that because of this encounters between water molecules and radiation are what lead to manifested responses in living tissue
376
What does irradiation of water do?
causes the breaking of the chemical bond between hydrogen and oxygen atoms - leading to production of free radicals
377
______ is an unchanged molecule that contains a single unpaired electron in its outer shell, making it unstable and carry excess energy.
Free Radical
378
What are the largest organic molecules?
Nuclic Acids: DNA and RNA
379
What are DNA and RNA responsible for?
- cellular structure and function
| - provide the map for developing cells
380
What are some other molecules (besides water) that are demonstrated in the effects of radiation exposure?
proteins, lipids, carbohydrates, nucleic acids
381
Where is DNA located in the cell?
Nucleus
382
______ is a direct encounter w/ DNA as the target and creates the greatest image in the cell.
Direct Effect
383
_____ is DNA damage that may be repaired leaving the cells to recover and resume normal function
Lethal Damage
384
What does the functional integrity of the cell depend on?
parenchymal and stroll cells within it
385
Do all cells differ in their sensitivity to radiation?
Yes
386
What does the law of Bergonie and Tribondeau state?
cells that are rapidly dividing have a long mitotic future and are undifferentiated - these are the most responsive to radiation
387
What is cell division in germ cells termed?
meiosis
388
What is cell division called? (other cells, not germ cells)
mitosis
389
What are the 4 phases of cell division in the correct order of sequence?
G1, S, G2, M
390
What phase of cell division is most sensitive to radiation?
M phase
391
Which cell division phase is most resistant to radiation?`
S phase
392
What is the average energy deposited per unit of path length to a medium by ionizing radiation as it passes through a medium called?
LET - Linear Energy Transfer
393
What is RBE? Describe. What is the formula?
Relative Biologic Effectiveness
provides a relative comparison of the effectiveness of a test radiation to the dose of 250 kv x-ray. Relates the ability of radiation with different LETs delivered under the same conditions to provide the same biologic effect.
250 kv dose for a given effect
RBE = -----------------------------------------------
Dose for test radiation for same effect
394
What are the main tissue types in the body?
Epithelial, connective, muscle, nerve, and membranes
395
What are the 4 cardinal signs for injury?
1. redness
2. swelling
3. heat
4. pain
396
Define non stochastic Effects:
Changes seen within days/weeks
397
Deine stochastic effects:
changes seen after months/ years
398
Are immediate (nonstochastic) effects more likely seen in radiation therapy or nuclear accidents?
Nuclear accidents
399
What are some tissue responses following significant doses?
vascular dilation, cellular inflammation, tissue necrosis (high doses)
400
Tissue response when absorbed dose exceeds 50 Gy:
1. Epilation
2. Erythema
3. Dry desquamation
4. Wet desquamation
401
What is the onset dose of erythema to the skin? (acute effects)
20 Gy
402
Onset dose of dry, then wet, desquamation to the skin? (acute effects)
dry - 30 Gy
| wet - 40 Gy
403
Onset dose of mild, patchy mucositis to the oral mucosa?
Confluent mucositis?
(acute effects)
30 Gy
| 40 Gy
404
Onset dose of esophagitis to the esophagus? (acute effects)
25 Gy
405
Onset dose of xerostomia to the salivary glands? (acute effects)
20 Gy
406
What is xerostomia?
also known as dry mouth and dry mouth syndrome, is dryness in the mouth
407
Onset dose proctitis after treatment to the rectum? (acute effects)
30 Gy
408
Onset dose decreased sperm from treatment of the testis? (acute effects)
0.25 Gy
409
Onset does leading to lowered blood count after treatment of the bone marrow?
Extensive hypoplasia?
(acute effects)
4 Gy
| 50 Gy
410
Onset dose of gastritis after treatment to the stomach? (acute effects)
20 Gy
411
TD 5/5 skin:
| Injury?
55 Gy
| ulceration/fibrosis
412
TD 5/5 intestine:
| Injury?
45 Gy
| stricture
413
TD 5/5 salivary glands:
| Injury?
40 Gy
| permanent xerostomia
414
TD 5/5 kidneys:
| Injury?
23 Gy
| kidney failure
415
TD 5/5 testis/ovary:
| Injury?
5-15
| sterility
416
TD 5/5 bone:
(child)
(adult)
Injury?
child - 20 Gy arrested growth
| adult - 60 Gy necrosis
417
TD 5/5 bone marrow:
| Injury?
20 Gy
reduced cellularity
418
TD 5/5 spinal cord:
| Injury?
45 Gy
| necrosis
419
Define necrosis:
the death of most or all of the cells in an organ or tissue due to disease, injury, or failure of the blood supply
420
TD 5/5 lens:
| Injury?
5 Gy
| cataract
421
TD 5/5 brain:
| Injury?
50 Gy
| necrosis
422
What is TD 5/5?
5% of n exposed population to realize an adverse latent (late) effect in 5 years following exposure
423
What is TD 50/5?
Dose that would likely cause 50% of n exposed population to realize an adverse late effect after 5 years following exposure
424
T/F: Any deviation from the standard fractionation scheme results in a different biologic response in both normal and cancerous tissue.
True
425
What is BED? Describe.
| What's the formula?
Biologic Effective Dose
Formula used when standard fractionation is interrupted or varied
BED = (nd) relative effectiveness
nd - total dose
relative effectiveness - lt d/d (????)
426
What are Isoeffect Lines?
they show the relationship between total dose and overall treatment time for a specific tissue response or late tissue responses
427
What are dose response curves?
Another visual representation of tissue response to radiation exposure. May be linear or nonlinear, have a threshold or not have a threshold.
428
What are the two types of dose response curves? What's the difference?
- Deterministic dose response curves - no threshold and linear
- Stochastic Dose Response curves - have a threshold and may be linear/nonlinear
429
What is the response progression to whole body radiation?
Prodromal, manifest syndromes, and latent
430
What is prodromal?
relating to or denoting the period between the appearance of initial symptoms and the full development of a rash or fever.
any symptom that signals the impending onset of a disease.
an early sign or symptom
431
T/F: A one time dose of 300-500 cGy could lead to death within 30-60 days w/out medical intervention
True
432
what is LD 50/30?
Lethal death of 50% of the population within 30 days
433
what is LD 50/60?
Lethal death of 50% of the population within 60 days
434
What is the whole body syndrome for doses between 300-800 cGy? time until death?
ARS - Acute Radiation Syndrome
```
Hematopoietic Syndrome (bone marrow syndrome)
10-15 days
```
435
What is the whole body syndrome for doses between 1000-5000 cGy? time until death?
ARS - Acute Radiation Syndrome
Gastrointestinal syndrome
| 3-10 days
436
What is the whole body syndrome for doses between > 5000 cGy? time until death?
ARS - Acute Radiation Syndrome
cerebrovascular syndrome
| hours - 3 days
437
What is Hematopoietic Syndrome?
aka bone marrow syndrome
Destruction of blood-forming tissue, especially bone marrow, due to radiation exposure, usually a dose from 10 to 1000 rads.
438
What is ARS?
Acute Radiation syndrome
Radiation sickness
a term used to describe a constellation of signs and symptoms that occurs after whole-body or significant partial-body irradiation of certain amount of radiation
439
What is. cerebrovascular syndrome?
is an extremely severe in-jury of Central Nervous System (CNS) and Peripheral Nervous System (PNS). CvARS can be induced by the high doses of neutron, heavy ions, or gamma radiation
440
What is gastrointestinal syndrome?
occurs at doses of between 6 and 15 Gy. Clinical signs and symptoms are due to the lack of replacement of cells in the surface of the villi because stem and proliferating cells located in the crypts are damaged by radiation and die in mitosis.
441
1 Gy = ___ rad
100
442
what does rad stand for?
radiation absorbed dose
443
What SI unit replaced the curie?
becquerel
444
What does the becquerel measure?
activity
445
What SI unit replaced the roentgen?
coulomb
446
What does the coulomb measure?
exposure
447
What SI unit replaced the rem? (roentgen equivalent man)
sievert - Sv
448
What does the sievert measure?
dose equivalent
449
What SI unit replaced the rad?
gray - Gy
450
What does gray measure?
dose
451
What are the four R's of radiobiology?
Repair, Reoxygenation, Repopulation, Redistribution (reassortment)
452
What are radioprotectors?
chemicals that may scavenge free radicals/facilitate direct chemical repair at sites of DNA damage in normal tissue. Founded on principles of repair and reoxygenation
453
What is protraction?
the period over which radiation is delivered
454
Define hematologic malignancy:
cancers that affect the blood and lymph system
455
Define genetic effects:
cell damages that pass on to succeeding cell generations.
456
Define Deterministic (Non-Stochastic) Effects
Deterministic effects have a threshold below which the effect does not occur. The threshold may be very low and may vary from person to person. However, once the threshold has been exceeded, the severity of an effect increases with dose
457
Define fistula
an abnormal or surgically made passage between a hollow or tubular organ and the body surface, or between two hollow or tubular organs.
458
define somatic effects:
effects limited to the exposed individual - not future generations
459
Radiation exposure to the fetus should not exceed what for the entire gestation period?
0.5 rem
460
The term Quality Factor (Q):
varies w Dif types of radiation
461
organization in the us responsible for recommending rad dose limits
NRC
462
Annual dose limit for the occupational workers lens:
150 mSv/15 rem
463
Annual dose limit for the occupational workers skin:
500 mSv
464
Define use factor:
fraction of time that a rad beam is directed at a specific area
465
annual radiation dose to the lung from radon gas is _____
200 mrem
466
Dose equivalent is measured in:
sievert
467
example of deterministic effect:
cataracts
468
What are the two groups of radiation sources?
- natural background radiation
| - man-made radiation
469
What are the 3 key terms for keeping radiation exposure low?
time, distance, shielding
470
What does ALARA stand for?
As Low As Reasonably Achievable
471
What does inverse square law directly relate to?
| What is the formula?
Distance from the source
I1(D1)^2 = I2(D2)^2
472
What are the different types of natural background radiation?
- Cosmic rays from nuclear reactions in space
- terrestrial from natural, radioactive earth elements
- Internal - from radiation always present in the human body: carbon-14, hydrogen-3, strontium-90, potassium-40
473
What are the different types of man-made radiation?
- x-ray equipment,
- radioactive sources produced for nuclear medicine and brachytherapy
- TV
- Nuclear reactors
474
What is the ICRP? What do they do?
International Commission on Radiologic protection
| develop standards of protection for users of x-rays and other ionizing radiation
475
What is the NCRP? What d they do?
National Council on Radiation Protection
| national group of experts who make recommendations for protection against exposure
476
What is the NRC? What do they do?
Nuclear Regulatory Commission
| national group that collaborates with states to establish regulations that are incorporated into federal and state law.
477
What is the ARRT?
The American Registry of Radiologic Technologists (ARRT) is the world’s largest organization offering credentials in medical imaging, interventional procedures, and radiation therapy. We certify and register technologists in a range of disciplines by overseeing and administering education, ethics, and examination requirements
478
What is the ASRT?
The American Society of Radiologic Technologists, located in Albuquerque, New Mexico, is a professional membership association for medical imaging technologists, radiation therapists and radiologic science students
479
What are some other agencies involved in radiation protection?
DOT- Department of Transportation
FDA - Federal Drug Administration
OSHA - Occupational Safety and Health Administration
EPA - Environmental Protection Agency
480
What was the original term for radiation dose limits?
Erythema Doses
481
Who was the roentgen named after?
Wilhelm Roentgen
482
What are the most common personnel exposure monitors?
1. film badge
2. thermoluminescent dosimeters TLD
3. OSL - optimal stimulated luminescence
4. pocket ionization chambers
483
at what point should personnel be monitored?
when they receive 1/10 the recommended dose
484
What are some characteristics of the film badge?
- measures kv, mv photons, electrons, gamma rays
- can detect approx. energy
- inexpensive
- can be damaged by: light, heat and humidity
- has to be sent out of facility for reading
- error margin+-20%
485
What are some characteristics of the TLD lithium fluoride?
- measures photons, electrons, and other particles
- very accurate
- small; can fit in a ring badge
- humidity won't damage
- can be processed and read on site
- cannot establish energy of radiation exposure
486
What are some characteristics of the pocket dosimeter?
- immediate reading
- high cost at first, but save in the end
- small
- very accurate, +- 2%
- humidity can damage it
487
What are some characteristics of the OSL aluminum oxide?
- can be reanalyzed
- wide range of accuracy, very sensitive
- more sensitive than TLD
- more expensive
- not well understood - new technology
488
What is the effective equivalent dose?
E = Wt(Wr) x absorbed dose
489
What kind of dose limits are students under 18 subject to?
Dose limits same as those recommended to the public
490
T/F: pregnant workers dose limits for the unborn take precedence
true
491
How much radiation can a restricted are receive per week?
less than 1 mSv/week
492
How much radiation can an unrestricted are receive per week?
less than 1 mSv/year
493
What are common barriers used for barriers? What is the most common and why?
concrete, lead, iron
concrete because it is the cheapest
494
What are some radiation detectors and applications?
ion chamber - cutie pie, Geiger counter
