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CTC GI and cancer staging > Cancer staging and every random thing i can think of > Flashcards

Cancer staging and every random thing i can think of Flashcards

1
Q

esophageal 1 - 4

A

critical = 3 vs 4

1 vs 2 endoscopic dx

T3 = adventitia

T 4 = invasion in to adjacent structures

T4a resectable (pleura, pericardium diphragm)

T4b NOT (trachea, aorta)

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2
Q

Rectal

A

Only really need T2

T3 into perirectal fat

T3 = pre-op chemo and RT

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3
Q

Renal

A

1 < 7cm

2 > 7cm

3 a Renal vein

3 b IVC below

3 c IVC above diaphragm

4 outside gerota or ipsi adrenal

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4
Q

Bladder

A

T2 muscularis propia

T3 perivesicular (outside bladder)

T4 a prostate uterus vagina

T4 b pelvic sidewall or abdominal wall

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5
Q

Endometrial

A

Stage 1 vs 2

cervical stroma invasion (don’t see normal cervical mucosal enhancement)

pre op RT and radiacal hyst

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6
Q

cervical cancer

A

IIa vs IIb

IIa beyond cervix, no parametrial

IIb = parametrial invasion (or lower 1/3 vagine) = chemo/RT

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7
Q

Prostate

A

2 vs 3

extracapsular extension

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8
Q

lung

unresectable =

A

unresesctable = Stage 3B (N3 or T4)

3B = supraclavicular, scalene, contra med/hilar (N3)

Same lung, diff lobe = T4

Malig pleural effusion = 3B

3B = unresectable

Diff lung = M1a

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9
Q

Skin doses

Early transient erythema

A

2Gy

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10
Q

Skin doses

Temporary epilation

A

3Gy

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11
Q

Skin doses

Main erythema (chronic)

A

6Gy

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12
Q

Skin doses

permanent hair loss

A

7Gy

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13
Q

Skin doses

Telangiectasia

A

10gy

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14
Q

Skin doses

Dry desquamation

A

13 Gy

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15
Q

Skin doses

Moist

A

18Gy

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16
Q

Skin doses

Secondary ulceration

A

24 Gy

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17
Q

Major spill

Tc99

A

100 mCi

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18
Q

Major spill

Tl 201

A

100

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19
Q

Major spill

In 111

A

10 mCi

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20
Q

Major spill

Ga 67

A

10 mCi

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21
Q

I 131

A

1 mCi

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22
Q

General public

annual limit

A

100 mrem

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23
Q

Unrestricted area

A

2mrem (.02mSv per hour) < 1mSv/7 days

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24
Q

Restricted area

A

anywhere receiving greater than 2 mrem per hour

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25
Q

Radiation area

A

> 5 mrem (.05 mSv) in one hour at 30cm

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26
Q

High radiation area

A

> 100 mrem (1mSv) in 1 hour at 30 cm

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27
Q

Very high radiation

A

500 rads (5 gray) in one hour at 1 meter

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28
Q

Occupational workers

Lens

A

150 mSv per year (0.15 Sv, 15 rem)

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29
Q

Occupational workers

Radiation worker

A

50 mSv/year (5 rem, .05 Sv)

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30
Q

Workers

extremity, individual organ or tissue

A

500 mSv/year (50 rem, 0.5 Sv)

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31
Q

Public exposure

Infrequent

Continuous

A

5 mSv/year

1 mSv/year

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32
Q

Embryo/fetus via mother

A

5 mSv for pregnancy (.005 Sv, .5 rem)

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33
Q

Public exposure

controlled areas

A

50 mSv/year

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34
Q

Public exposure

uncontrolled areas

A

5 mSv/year

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35
Q

Genetically significant dose

A

0.25 mSv

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36
Q

Background US per year

A

3 mSv

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37
Q

White 1

A

no special handling

surface <0.5 mrem/hr

1 meter 0

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38
Q

Yellow 2

A

surface 50 mrem/hr

1 meter <1 mrem/hr

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39
Q

Yellow 3

A

surface < 200mrem/hr

1 meter < 10 mrem/hr

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40
Q

I 123

A

Low

159

13 hours

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41
Q

Xe 133

A

Low

81

125 hours (30 seconds)

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42
Q

Thallium 201

A

Low

135

167

73 hours

use daughter Hg x rays

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43
Q

I 111

A

Medium

173

247

67 hours

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44
Q

Gallium

A

93

184

300

393

78 hours

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45
Q

I 131

A

365

8 days

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46
Q

F 18

A

511

110 minutes

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47
Q

Strontium 89

A

50 days

14 days in bone

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48
Q

Samarium 153

A

46 hours

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49
Q

Y 90

A

64 hours

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50
Q

Radium 223

A

11.4 days

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51
Q

Radionuclide purity

A

how much moly

Dose calibrator

.15 micro per 1 milli

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52
Q

Chemical purity

A

How much Al

pH paper

<10 micrograms per 1 ml

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53
Q

Radiochemical purity

A

Free Tc

Thin layer chrom

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54
Q

nodal SCC neck

A

N1 < 3 cm

N2 (abc) 3-6 cm

N3 > 6cm

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55
Q

DOSE CALIBRATOR QC

Constancy

A

Daily

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56
Q

DOSE CALIBRATOR QC

Linearity

A

Quarterly

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57
Q

DOSE CALIBRATOR QC

Accuracy

A

Annually

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58
Q

DOSE CALIBRATOR QC

Geometry

A

Install/repair

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59
Q

1 mCi = ? Bq

A

1 mCi = 37 MBq

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60
Q

Packages

attended to when?

A

within 3 hours or right away if they came overnight

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61
Q

/After making sure box not busted?

A

Survey and wipe

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62
Q

Wipe exceeds yellow 3?

A

notify carrier and NRC within 24 hours

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63
Q

Recordable vs Reportable

A

Report wrong patient, route, radiopharmaceutical, or >20% prescribed IF it exceeds occupational limit

5 rem whole body (0.05 Sv) 50 mSv

50 rem body part or skin (0.5 Sv) 500 mSv

Reportable = Call NRC or state within 24 hours, followed by written report

Call MD and patient

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64
Q

Major spill

I 123

65
Q

Record keeping

3 year records of

A

Each radionuclide admin

all receipt, storage and disposal

Record of all surveys and calibrations

66
Q

Record keeping

5 years

A

actions and management relative to radiation protection program

67
Q

Permanent record

A

Duties, authorities and responsibilities of RSO

68
Q

PPV 1 benchmark

A

4.4%

0,3,4,5

69
Q

PPV 2

A

biopsy recommended

4 or 5

25.4%

70
Q

PPV 3

71
Q

Target recall rate

72
Q

Cancers per 1000 screened

73
Q

Mammo

Processor QC

74
Q

Mammo

Darkroom cleanliness

75
Q

Mammo

viewbox conditions

76
Q

Mammo

Phantom eval

77
Q

Mammo

repeat analysis

78
Q

mammo

Compression test

A

SEMI annually

79
Q

Mammo

darkroom fog

A

semi - annually

80
Q

Mammo

screen film contrast

A

semi - annually

81
Q

How often certified for MQSA

by who

A

FDA

q 3 years

82
Q

To have honor of reading mamms?

A

3 months

240 during a 6 month period in last 2 years

83
Q

ir sentinel event

A

15 Gy to single field

84
Q

Male temporary

A

.15-2.5 Gy

85
Q

male permanent

86
Q

female 12 y

87
Q

Female 45y

88
Q

Female no age

A

ballpark 6 Gy

89
Q

ARS

BM

A

>2Gy

1-6 week latent

90
Q

ARS

GI

A

>8 Gy

5-7 day latent

dead in 2 weeks

91
Q

ARS

CNS

A

20Gy

4-6 hours latent

3 days dead

92
Q

Administered activities and critical organs

Gallium scan

A

6-10 mCi

Colon

93
Q

Administered activities and critical organs

Bone scan

A

25 mCi

bladder

94
Q

Administered activities and critical organs

cysto (sulfur colloid Tc99)

A

1 mCi

bladder

95
Q

Administered activities and critical organs

uptake and scan

A

5 MICRO I 131

10-20 MICRO I 123

96
Q

Thyroid cancer I 131 doses

A

100 thyroid

150 nodes

200 distal

97
Q

Critical organs

I 131 MIBG

98
Q

Critical organs

Renal cortex

A

thallium

DMSA

99
Q

Critical organs

PO sulfur colloid

A

Proximal colon

100
Q

Critical organs

sestamibi

A

proximal colon

101
Q

Critical organs

bladder

102
Q

Critical organs

Gallium

A

DISTAL colon

103
Q

Critical organs

spleen

A

Octreotide

Damaged RBC’s

In-WBC’s

104
Q

Critical organs

pertech

A

Colon

estomago

105
Q

I 123 administered activity

106
Q

1 mCi = ? Bq

107
Q

Administered activity

bleeding scan

Tc 99 RBC’s

108
Q

Administered activity

fdg

109
Q

Administered activity

I 131 MIBG

110
Q

Administered activity

I 123 MIBG

111
Q

Administered activity

Tl 201

112
Q

Administered activity

resting sestimibi cardiac

113
Q

Administered activity

Sestamibi cardiac total

114
Q

Premed protocols

Pred

A

50mg PO PRED

13, 7 and 1 hours before

50 Benadryl 1 hr before

115
Q

Premed protocols

methylpred

A

32 mg methylpred PO

12 and 2 hours before

50 benadryl

116
Q

Premed protocols

rapid

A

200 mg hydrocortisone IV q4 until exam

50 ben 1 hr prior

117
Q

Graves amount

118
Q

MNG amount

119
Q

Eovist

proper name

excretion

other biliary guy

A

Gadoxetate

ionic linear

50% bile, 20 mins

Gadobenate, multihance, 5% bile, 2-3 hours

120
Q

octreoscan administered activity

121
Q

I 111 administered activity

122
Q

Tl administered activity

(per oates)

123
Q

administered activity

I 123 Na iodide

124
Q

Gd

macro vs linear

ionic non ionic

A

macro more stable than linear

of the linear, ionic more stable than nonionic

125
Q

Gadavist

other macros

A

Macro, non-ionic

Gadobutrol

teriffic ‘ter’s

Gadoteridol - prohance

Gadoterate - Dotarem

126
Q

Linears a/w NSF

A

Gadodiamide - omniscan

Gadaversetamide - optimark

gadopentetate - magnevist

Die, adverse, petegram

the only O ones and Magnevist

127
Q

epi IM and IV doses

A

IM 1:1000 0.3 ml (0.3mg)

IV 1:10,000 1 ml (0.1 mg)

during a code, IV epi 1:10,000 10 ml, 1 mg

128
Q

Breast feeding and nuks

cessation

A

I 131

I 123 NaI

Gallium

129
Q

breast feeding

pertechnetate

130
Q

breast feeding

thallium

131
Q

stable isotope of iodine?

132
Q

administered activity

Thyroid uptake and scan

I 131

I 123

Pertech

A

I 131 10 MICRO

I 123 0.5 mCi

Pertech 2-10

133
Q

PE, comptom Z and E

A

PE Z cubed / E cubed

Compton 1/E (but does depend on electron density)

134
Q

Effective dose ballparks

PET

Cardiac CTA

chest CT

head CT

A

PET 10 + 15 mSv

Cardiac CTA 10 - 20 mSv

chest CT 5 - 7 mSv

head CT 1 - 2 mSv

135
Q

? radiosensitivity

A

?marrow

breast

gonads

thyroid

skin

136
Q

tube leakage should not exceed

A

1 mGy per hour at 1m from source

137
Q

minimum aluminum requirement

138
Q

10 mGy in first trimester increased Ca risk

139
Q

average US exposure background and medical

A

6 mSv

3mSv medical (mostly CT and nucs)

140
Q

retardation

organogen

A

retardation 9-15

organs 2-8

141
Q

BEIR VII risk of cancer mortality

A

5 % per Sv

142
Q

power for a CXR

mammo

A

100 kW

mammo 3 kW

143
Q

kub air kerma

144
Q

kub entrance skin dose

PA chest

lateral L spine

A

5 mGy (50% more than entrance air kerma)

chest PA 0.2 mGy

lat L spine 15 mGy

145
Q

good dose limiting strategy for

kids

fatties

A

kids = small focal spot

fatties = higher kVp

146
Q

MTF describes

A

spatial resolution in the frequency domain

product of component MTF’s

147
Q

Infection agent administered activities

148
Q

Geiger is a

A

gas chamber

149
Q

Well counter

A

na/I crystal with a PMT (small gamma camera)

150
Q

Thyroid probe

A

small gamma camera, modified naI well counter (PMT and a crystal)

151
Q

Geiger overwhelmed at

152
Q

Ion chamber

A

looks kinda like a Geiger, no dead time, up to 100 R/h

(most dose calibrators are ion chambers, gas)

153
Q

lp’s/mm

screen mammo

digi mammo

digi rad

CT

MRI

A

screen mammo 15

digi mammo 7

digi rad 3

CT 0.7

MRI 0.3

154
Q

entrance exposure rate for

Radiography

fluoro

Ir and cardiac cath

A

Radiography 3mGy/min

fluoro 30mGy/min

Ir and cardiac cath 300 mGy/min

155
Q

File size

CXR

single CT image

A

CXR = 10 mb

CT image = 0.5 mb

156
Q

AAST

Liver

A

grade I (tiny knick)

haematoma: subcapsular, <10% surface area
laceration: capsular tear, <1 cm parenchymal depth

grade II

subcapsular, 10-50% surface area laceration: capsular tear 1-3 cm parenchymal depth, <10 cm length

grade III

haematoma: subcapsular, >50% surface area of ruptured subcapsular or parenchymal haematoma
laceration: capsular tear >3 cm parenchymal depth

grade IV

laceration: parenchymal disruption involving 25-75% hepatic lobe or involves 1-3 Couinaud segments

Grade V = vascular hepatic avulsion

157
Q

AAST

Kidney

A

grade I: contusion or non-enlarging subcapsular perirenal haematoma, and no laceration

grade II: superficial laceration <1 cm depth and does not involve the collecting system

grade III: laceration >1 cm without extension into the renal pelvis or collecting system (no evidence of urine extravasation)

grade IV

laceration extends to renal pelvis or urinary extravasation

vascular: injury to main renal artery or vein with contained haemorrhage

V = shattered, devascularized

158
Q

AAST

spleen

A

grade I

subcapsular haematoma <10% of surface area

capsular laceration <1 cm depth

grade II

subcapsular haematoma 10-50% of surface area

intraparenchymal haematoma <5 cm in diameter

laceration 1-3 cm in depth not involving trabecular vessels

grade III

subcapsular haematoma >50% of surface area or expanding

intraparenchymal haematoma >5 cm or expanding

laceration >3 cm in depth or involving trabecular vessels

ruptured subcapsular or parenchymal haematoma

grade IV

laceration involving segmental or hilar vessels with major devascularisation (>25% of spleen)

grade V

shattered spleen

hilar vascular injury with splenic devascularisation

CTC GI and cancer staging (2 decks)

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