Nichole's Board Exam Review - Mixed Bag 1 Flashcards
(106 cards)
1
Q
The absorbed dose at a given depth expressed as a % of the absorbed dose at a reference depth (i.e. d-max) on the CAX of the field
A
PDD %DD
2
Q
PDD is dependent on these 5 variables
A
- Energy
- Field Size
- SSD
- Depth
- Composition of the irradiated medium
3
Q
Does PDD increase or decrease with …
- Increasing SSD?
- Increasing Field Size?
- Increasing Depth?
A
- Increasing SSD = Increasing PDD
- Increasing Field Size = Increasing PDD
- Increasing Depth = DECREASING PDD
4
Q
- Dose in tissue / dose at d-max in a phantom
A
TMR
5
Q
What is the most common type of thyroid cancer?
A
papillary
6
Q
What 3 factors is TMR dependent on?
A
- Depth
- Energy
- Field Size
7
Q
Talking about a patient’s treatment in an elevator that is filled with outside visitors is considered what kind of violation?
A
invasion of privacy
8
Q
Define hyperfractionation
A
Multiple fractions increasing the daily dose; increasing the total dose while keeping the treatment time the same
9
Q
Define accelerated fractionation
A
Multiple daily fractions that lead to a reduction in the overall treatment time (e.g. days).
10
Q
What is the most curable type of leukemia?
A
ALL (Acute lymphocytic leukemia) starts in the bone marrow (the soft inner part of certain bones, where new blood cells are made)
11
Q
List 5 signs & symptoms of AML (Acute myelogenous leukemia a cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.)
A
- weakness
- fatigue
- anemia
- bruising
- neutropenia (An abnormally low count of a type of white blood cell (neutrophils).
12
Q
List 5 signs & symptoms of CML (Chronic myelogenous leukemia)
A
- fatigue
- fever
- night sweats
- weight loss
- enlarged spleen
13
Q
List 6 signs & symptoms of ALL (Acute lymphocytic leukemia)
A
- non-specific viral symptoms
- low grade fever
- malaise (general feeling of discomfort, illness, or lack of well-being)
- anorexia
- lethargy (A condition marked by drowsiness and an unusual lack of energy and mental alertness
- abdominal discomfort
14
Q
List 5 signs & symptoms of CLL (Chronic Lymphocytic Leukemia)
A
- fatigue
- malaise
- weight loss
- excessive sweating
- enlarged lymph nodes
15
Q
List 2 reasons a bite block is used
A
- to help maintain the patient’s chin position
- moves the patient’s tongue out of the treatment area
(also to can be used when you want to displace the hard palate, mandible, or tongue away from the treatment volume)
16
Q
What is used to calculate changes in PDD?
A
Mayneord’s factor
17
Q
Where is the ampulla of vater?
A
where the common bile duct enters the duodenum
18
Q
The ampulla of vater drains the ____ and ____ via the ____.
A
The ampulla of vater drains the liver and pancreas via the common bile duct.
19
Q
medulloblastoma
A
- A childhood malignancy (ages 0-4
- 20-30% hereditary
- increased risk with Von Recklinghausen’s disease, Von Hipple-Lindau disease, Cowden’s disease, or Turcot’s syndrome.
- seeds to CSF
- craniospinal XRT
20
Q
List the following cell types by order of decreasing sensitivity:
- crypt cells
- endothelial cells
- erythroblasts
- fibrocytes
- lymphocytes
A
- lymphocytes
- erythroblasts
- crypt cells
- endothelial cells
- fibrocytes
21
Q
The stomach is located in which quadrant of the body?
A
upper left quadrant
22
Q
Sterile techniques must be applied to ALL of the following EXCEPT?
- lumbar puncture
- blood culture
- lesion biopsy
- thoracentesis
- sputum culture
- sigmoidoscopy
- urine culture
A
- sputum culture
23
Q
What are the 3 most radiosensitive organs in the body?
A
- gonads (testes & ovaries)
- bone marrow
- lens of the eye
24
Q
What are the 3 most radioresistant organs in the body?
A
- ureters (7,000 cGy)
- urethra (7,000 cGy)
- vagina (9,000 cGy)
25
What 2 sets of lymph nodes are involved in the lymphatic drainage of the vulva?
- inguinal
| - femoral
26
The parotid gland is located ____ and ____ to the EAM
- anterior
| - inferior
27
Which of the following does a pancoast tumor NOT present with?
a. rib destruction
b. arm or shoulder pain
c. pulmonary artery invasion
d. brachial plexus involvement
c. pulmonary artery invasion
28
What is NOT a late effect of Mantle treatment?
a. pneumonitis
b. hypothyroidism
c. radiation carditis
d. low sperm count
d. low sperm count
29
What are the 2 most commonly treated sets of nodes for prostate cancer XRT?
- periprostatic
| - obturator
30
What is the most common symList 3 primary risk factors for esophageal cancer?
hematuria
31
List 3 primary risk factors for esophageal cancer?
1. smoking
2. alcohol
3. Barrett's Esophagus
32
Dose in Tissue / Dose in Air
TAR
33
TAR depends on ____ and ____, but is independent of ____.
TAR depends on depth and field size, but is independent of SSD.
34
Define RBE
- Relative Biological Effect
| - Dose in Gy from 250 kev x-ray / Dose in Gy from another radiation source that produces the same biologic response
35
Define LET
- Linear Energy Transfer
| - Rate at which energy is deposited as a charged particle travels through matter by a particular type of radiation
36
List 5 symptoms associated with XRT of oral cavity
1. xerostomia (dry mouth)
2. loss of taste
3. weight loss
4. dental carries
5. osteoradionecrosis ((ORN) of the mandible is a severe iatrogenic disease of devitalized bone caused by radiation therapy of oral and oropharyngeal cancers.
37
What is a 3-D field arrangement for esophageal cancer XRT?
AP/PA, then boost with 2 posterior obliques to spare the spinal cord
38
BSF
- Ratio of dose on the CAX at d-max to dose at the same point in air
- dose at d-max / dose in air
39
BSF is dependent on ____ and ____, but independent of _____.
BSF is dependent on energy and field size, but independent of SSD.
40
BSF and ___ at Dmax are the same.
TAR
41
Encircles the nasopharynx and oropharynx
Waldeyer's ring
42
Put the following list in order according to which depletes first, second, etc.
Platelets 150 - 424 thousand/mm
Neutrophils 42% to 72%
Erythrocytes 3.9 - 5.90 million mm/3
Lymphocytes 17% to 45%
Lymphocytes
Neutrophils
Platelets (150 - 424 thousand/mm^3)
Erythrocytes (3.9 - 5.90 million/ mm^3
WBC ( 5, - 10.80 thousand/ mm^3)
43
Small, purplish hemorrhagic spots on the skin that appear in patient's with thrombocytopenia are referred to as ____.
petechiae
44
If you notice that a patient has petechiae, what would do you?
a. Send the patient for blood work
b. Tell the patient to take iron supplements
c. Advise the patient about skin care
d. Notify the oncologist
a. Send the patient for blood work
45
List 4 symptoms of pancreatic cancer
1. abdominal pain
2. anorexia
3. weight loss
4. jaundice
46
List 6 symptoms of prostate cancer
1. Weak or interrupted flow of urine
2. Difficulty starting or stopping the stream of urine
3. Increased frequency
4. Hematuria
5. Painful urination
6. Pain in the lower back, pelvis, or upper thighs
47
Describe a 3D treatment technique for nasopharynx
Lateral neck fields with an anterior neck field that includes the S/C and lower cervical nodes
48
Describe the nodal drainage for the nasopharynx
- Retropharyngeal nodes (Node of Rouviere)
- Deep cervical nodes
- Jugulodigastric node
49
List 5 critical structures in the treatment of maxillary sinus
1. Parotid
2. Temporomandibular joint
3. Lacrimal gland
4. Spinal cord
5. Lens
50
What are the routes of spread for testicular cancer?
- Para aortic nodes to pelvic nodes (iliac nodes)
| - In later stages, can go from para aortic to the mediastinal and then the left S/C nodes by way of the thoracic duct
51
True or false? Retinoblastoma is hereditary.
true
Retinoblastoma (an eye cancer that begins in the back of the eye (retina) most commonly in children, in 1 or both eyes
52
List a common example of hyperfractionation
BID
53
hyperplasia`
increase in the NUMBER of cells
54
List 5 histologies of thyroid cancer
1. medullary
2. papillary
3. squamous cell
4. follicular
5. anaplastic
55
Using an orthovoltage machine, what is the most common interaction with bone?
Compton scattering
56
inflammatory redness of the skin that resembles a sunburn; usually happens after about 2 weeks of XRT
erythema
57
shedding of the epidermis
dry desquamation
58
most of the cells of the basal layer are destroyed; the dermis then becomes exposed and begins producing a serous oozing from its surface
moist desquamation
59
Dry and moist desquamation may occur at around ____ to ____ cGy.
4500 - 6000 cGy
60
When would you use half beam blocking?
field abutment (match lines)
| common in left breast pt
61
If XRT is the only treatment being used for Hodgkin's disease, what is the normal dose prescribed for microscopic disease? Gross disease?
microscopic disease: 3000 - 3600 cGy
| gross disease: 3600 - 4400 cGy
62
In what age group do you find the peak incidence of larynx cancer?
50 - 60 year olds
63
How many division of the larynx are there? What are they?
3 ... supraglottic, glottic, & subglottic
64
Where do 65 - 75% of glottic lesions appear, in regards to the vocal cords?
on the anterior 2/3s of 1 vocal cord
65
single agent chemo used to treat breast cancer
tamoxifen
66
Which of the following is more radiosensitive?
a. esophagus
b. germinomas
c. teratomas
d. osteosarcomas
b. germinomas (relating to or having the nature of germ cells)
67
What is the vertebral level for the bifuration of the abdominal aorta?
L4
68
Why do you use a belly board when treating rectal cancer?
to allow the small bowel to fall anteriorly out of the treatment field
69
What is the dmax for 10MV?
2.5 cm
70
What is the dmax for 4MV?
1.0 cm
71
What is the dmax for 6MV?
1.5 cm
72
What is the dmax for 18MV?
3.5 cm
73
The practice that helps reduce the spread of microorganisms is referred to as ____.
asepsis
74
During treatment, the patient has complete cardiac failure. Their chart says DNR. What do you do?
call the doctor and wait with the pt
75
Why would Mantle & Inverted Y and ovarian cancer XRT impact the hemopoietic system the most?
These treatment fields include the largest amount of red bone marrow.
76
If your iso needs to move 0.5 cm anterior, how do you move the patient?
0.5 cm posterior
77
define thrombocytopenia
an abnormal decrease in the amount of platelets
| caused by autoimmune disease such as lupus and rheumatoid arthritis
78
define thrombocytosis
having too many platelets
| abnormal cells in the bone marrow can cause increase in platelets
79
hypertrophy
an increase in the size of cells
80
List 5 places where adult red bone marrow is found
1. ribs
2. ends of long bones
3. vertebrae
4. sternum
5. skull bones
81
Which type of lung cancer follows a different treatment regimen?
small cell carcinoma
82
What is the formula for HVL?
.693 / M
83
Why do we include the lung when treating breast cancer?
to treat the chest wall and avoid a recurrence of disease
84
Where does the trachea start & end?
starts at C6 & ends at the carina
85
If the patient is prone and the doctor orders a 1.5 cm anterior shift, what direction would you move the table? In what direction would this move the CAX?
move the table upward, which would then move the CAX anteriorly
86
If the focal spot is out of alignment, what is the most plausible reason?
The mirror in the gantry head was accidentally knocked out of place
87
Most larynx cancers occur in which region?
Glottic (65%)
| FYI: Supraglottic = 34% & Sublottic = 1%
88
Is cancer of the larynx more common in men or women?
men (5:1)
89
What is the most common malignant tumor encountered in the head & neck region?
larynx cancer
90
What is the most sensitive trimester in pregnancy with regard to radiation damage?
first trimester
91
What is the largest blood supply organ?
spleen
92
Name two organs that an urethrogram would be used for?
1. bladder
| 2. kidneys
93
In what organ is a pancoast tumor found?
lung (at the very top of either lung)
94
Where does the spinal cord begin and end?
foramen magnum to L2
95
Reverse isolation protects ____ (whom?).
the patient
96
Where is the circumvallate papillae located?
base of tongue
97
What kind of surface should you perform CPR on?
flat surface
98
If a breast patient has skin folds, what's something you can do (in treatment planning) to decrease their skin reaction?
add a wedge
99
What is the most sensitive part of the cell cycle?
M
100
What is the most resistant part of the cell cycle?
S
101
Describe the theory of Bergonie & Tribondeau
Ionizing radiation is more effective against cells that are actively dividing, are undifferentiated, and have a long dividing future
102
What is the most common neoplasm for children?
leukemia
103
What is the most common neoplasm for adults?
lung cancer
104
critical site is damaged by reactive species produced by ionization elsewhere in the cell, which in turn damages the target
indirect action
105
Put these parts of the machine in order: primary collimator, ion chamber, target, flattening filter
1. Target
2. Primary collimator
3. Flattening filter
4. Ion chamber
106
Put these structures in order from most radiosensitive to most radioresistant: brain, breast, lens, testes
1. lens
2. testes
3. brain
4. breast
