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Sim Lecture > Assignment 2 > Flashcards

Assignment 2 Flashcards

1
Q

List the four most common primary sites from which metastases can occur:

A

lung, prostate, breast, and kidney

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2
Q

TD 5/5: bladder

A

6500 cGy

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3
Q

TD 5/5: rectum

A

6000 cGy

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4
Q

TD 5/5: testes

A

100 cGy

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5
Q

TD 5/5: ovaries

A

200-300 cGy

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6
Q

TD 5/5: prostate

A

7000 cGy

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7
Q

TD 5/5: uterus

A

10000 cGy

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8
Q

TD 5/5: vagina

A

9000 cGy

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9
Q

TD 5/5: femoral head/neck

A

5200 cGy

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10
Q

TD 5/5: small bowel

A

4000 cGy

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11
Q

TD 5/5: colon

A

4500 cGy

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12
Q

How can the patient be positioned during CT Sim so that the small bowel is minimized in the treatment field?

A

the patient can be positioned prone on a bellyboard with a full bladder

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13
Q

when should the patient’s bladder be full or empty when treating the whole pelvis?

A

prostate: full
bladder: empty
ovarian: full

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14
Q

how can the bladder be localized on imaging?

A

Use Cystografin contrast via a Foley catheter

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15
Q

how can the rectum be localized on imaging?

A

Use a radiopaque rectal marker, or a rectal tube with barium

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16
Q

how can the vagina be localized on imaging?

A

Use a radiopaque vaginal marker, or a tampon dipped in barium

17
Q

how can the prostate be localized on imaging?

A

use fiducials

18
Q

What is the cisterna chyli and why is it important?

A

• It is a sac-like lymphatic organ anterior to L1/2 thought to be the origin of the thoracic duct, which is the main duct that collects lymph from the lower part of the body.

19
Q

what is the vertebral level for the bifurcation of the abdominal aorta

A

L4

20
Q

where does the spinal cord start?

A

foramen magnum

21
Q

List the type of brachytherapy procedure used in the treatment of uterine cervix.

A

LDR or HDR using Tandem & Ovoid (aka. Colpostat) applicators (e.g. Fletcher Suite)

22
Q

What are the most common applicators used?

A

Tandem & Ovoid (aka. Colpostat) applicators (e.g. Fletcher Suite)

23
Q

What 2 radioactive materials are used in the treatment of the uterine cervix? What is the half life for each?

A

Cesium 137: 30 years (used in LDR)

Iridium 192: 74 days (used in HDR)

24
Q

What type of brachytherapy procedure is used in the treatment of prostate cancer?

A
  • Interstitial – permanent seed implants

* Iridium 192 – temporary needles

25
Q

What 3 radioactive materials are used in prostate brachytherapy? List the half life of each.

A
  • Iodine 125 (permanent) – 59.4 days
  • Palladium 103 (permanent) – 17 days
  • Iridium 192 (temporary) – 74 days
  • Gold 198 (permanent) – 2.7 days
26
Q

What is a Fletcher Applicator? How are they used?

A

• Tandem & Ovoids (aka. Colpostats). A tandem is inserted through the cervix into the uterus, and two ovoids are inserted into the lateral vaginal fornices. Both are stabilized with sterile gauze packing, which also serves to displace the rectum and bladder from the sources.

27
Q

What is Point A and Point B?

A

• The anatomic points used historically for cervical and uterine treatment are points A and B. Point A, where the prescription dose is specified, is located 2 cm superior to the top of the ovoids along the tandem and 2 cm lateral to the tandem in the plane of the applicator. It is approximately where the uterine arteries and the ureters intersect, and is chosen to ensure that the part of the cervix located between point A and the applicator receives the prescription dose (at a minimum). Point B, located 2 cm superior to the top of the ovoids and 5 cm lateral to the patient midline, represents where the parametrial nodes are.

28
Q

list the accompanying disease with the following tumor marker: CEA

A

colon, breast, SCLC, and rectum

29
Q

list the accompanying disease with the following tumor marker: serum acid phosphatase

A

prostate

30
Q

list the accompanying disease with the following tumor marker: AFP

A

testes, ovaries, and liver

31
Q

the histological type of cervix cancer is

A

squamous cell carcinoma

32
Q

what lymph nodes are at risk in cancer of the cervix?

A

Obturator, internal iliac, and external iliac

33
Q

what is the most radiosensitive organ in the female reproductive system?

A

ovaries

34
Q

what is the dose prescription for cervical cancer?

A

180 cGy/ fraction x 25 fx = 4500 cGy

35
Q

in ovarian cancer, how does the disease spread?

A

seeding via cells suspended in abdominal fluid (ascites)

36
Q

when treating ovarian cancer AP/PA, what critical organ (s) must be blocked in the field?

A

the kidneys

37
Q

what is the histolgical type of endometrial cancer?

A

adenocarcinoma

Sim Lecture (19 decks)

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