33 - Ionising Radiation Flashcards

1
Q

Radiation

A

Energy propagated in either electromagnetic or particulate form

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2
Q

Ionising radiation

A
  • Carries sufficient energy to produce ionisation in the tissues which absorb it (by displacing electrons from atoms)
  • Short wave length/high frequency waves
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3
Q

Electromagnetic energy

A
  • Bundles of energy propagated by wave motion
  • Continuous spectrum
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4
Q

Particulate radiation

A

Protons, neutrons, and high-speed electrons, capable of causing ionisation

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5
Q

Types of radiant energy from long wavelength, low frequency to short wavelength, high frequency

A
  • Radio waves
  • Microwaves
  • Infrared
  • Visible light
  • UV light
  • X, gamma rays
  • Cosmic rays
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6
Q

Alpha particles

A

2 protons, 2 neutrons

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7
Q

Beta particles

A

High speed positrons or electrons

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8
Q

High linear energy transfer

A

Particles which transmit large amounts of energy over short distances (eg alpha particles, high energy neutrons, beta
particles) produce severe but localised effects

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9
Q

Low linear energy transfer

A
  • Characteristic of gamma and x- rays
  • Penetrate deeply but interact with fewer molecules along the way.
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10
Q

Effects of ionising radiation on cells

A
  • Very high doses: cell death due to irreparable DNA damage
  • Lower doses: DNA synthesis interfered with
  • Altered gene expression: p53 activation may result in cell cycle arrest, often apoptosis
  • DNA synthesis without mitosis may produce cells with giant nuclei
  • DNA damage may produce chromosomal abnormalities
    -Reproductive death
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11
Q

Microscopic features of radiation injury

A
  • Nuclear changes
  • Cytoplasmic changes
  • Vascular changes
  • Fibrosis
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12
Q

Nuclear changes caused by radiation

A
  • Nucleus is more sensitive than cytoplasm
  • Swelling
  • Chromatin clumping
  • Micronuclei
  • Apoptosis
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13
Q

Cytoplasmic changes caused by radiation

A
  • Swelling
  • Vacuolation,
  • Membrane disruption
  • Organelle disintegration
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14
Q

Vascular changes caused by radiation

A
  • Early endothelial swelling
  • Necrosis of wall with haemorrhage
  • Later sclerosis → ischaemia
  • Atrophy
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15
Q

Fibrosis

A
  • Hallmark of radiation injury
  • Stromal cells more resistant
  • Often pleomorphic fibroblasts
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16
Q

Radiation injury

A

Acute vascular damage –> endothelial swelling, narrowing of lumen

17
Q

Radiation injury in the bladder

A
  • Chronic radiation cystitis
  • Dense fibrosis
  • Bizarre fibroblasts
18
Q

Genetic effects of radiation on germ cells

A
  • Chromosomal abnormalities (incompatible with life, may produce deformed babies)
  • Point mutations (affect future generations)
  • Sterility
19
Q

Somatic effects of radiation

A
  • May be acute or delayed
  • Localised or affecting total body
20
Q

Total body irradiation prodromal phase

A
  • Anorexia
  • Nausea and vomiting
  • Dose dependent
21
Q

Total body irradiation
asymptomatic latent phase

A
  • Surviving cells function as normal until mitosis
  • Dose dependent
22
Q

Total body irradiation principle phase

A
  • 1-3 successive syndromes
  • Dose dependent
23
Q

Syndromes of acute radiation sickness

A
  • Haemopoietic
  • Intestinal
  • CNS
24
Q

Haemopoietic syndrome

A
  • Loss of stem cells in marrow
  • No replacement of circulating cells.
  • Thrombocytopenia, neutropenia, anaemia.
  • Recovery by repair of non-lethal injury
25
Intestinal syndrome
- Damage to stem cells in crypts - Epithelium denuded - Loss of fluid, electrolytes - Haemorrhage, septicaemia - Regenerates within one week if possible
26
CNS syndrome
- Vascular effects: leakage and cerebral oedema - No neuronal injury unless massive dose
27
Delayed somatic effects
- Carcinogenesis - Abnormalities in growth and development (especially in foetus) - Diminished life span
28
Radiation induced cancers
- Thyroid - Leukemia - Lung - Breast - Skin - Angiosarcoma of liver - Oesteogenic sarcome
29
Thorotrast exposure
- Radiographic medium used 1930-1945 that emits alpha particles - Persists indefinitely in tissues - Associated with angiosarcoma of liver
30
Effects of radiation in skin
- Early changes: Blistering, necrosis, hyper/hypopigmentation - Chronic radiation damage: fibrosis, poor healing - Later: Malignant tumours (squamous cell carcinoma)
31
Acute effects of radiation on lung
- Radiation pneumonitis - DAD (diffuse alveolar damage)
32
Late effects of radiation on lung
- Impaired pulmonary function - Interstitial fibrosis - Carcinogenesis
33
Acute effects of radiation in bone marrow
Panhypoplasia
34
Chronic effects of radiation in bone marrow
Predisposition to acute and chronic myeloid leukaemia and acute lymphocytic leukaemia
35
Effects of radiation on kidney
Ischaemic vascular effects
36
Effects of radiation on gonads
Very susceptible, sterility common