Exam 2 Flashcards
1
Q
___ involves the reproduction of microorganisms in the human body
A
Infection
2
Q
___ is the collective term used to describe related clinical signs & symptoms associated with an infectious agent
A
Disease
3
Q
___ is a person with an infection but no observable symptoms
A
Subclinical infection
4
Q
___ is the reproduction of an infectious microorganism
A
Colonization
5
Q
___ is a person who has an infection that has colonized but not ill
A
Carrier
6
Q
___ is the presence of microorganisms on the body of an inanimate object
A
Contamination
7
Q
___ is an infection that is acquired in the hospital setting
A
Nosocomial infection
8
Q
Healthcare associated infections (HAI’s) include (9)
A
-pneumonia/surgical site infection
-gi infection
-UTI
-primary bloodstream infections
-eye, ear, nose, throat, mouth infection
-lower respiratory tract infection
-skin & soft tissue infection
-cardiovascular system infection
-bone & joint infection
9
Q
Major cause of mortality amongst cancer patients is ___
A
infections
-caused by immunosuppression caused by treatments & frequent contact with HCW’s & settings
10
Q
Disinfection examples include (4 items)
A
alcohol,
chlorine,
hp,
formaldehyde
11
Q
Disinfection facts (3)
A
-does NOT eliminate bacteria spores
-kills all microorganisms
-used for non-critical items
12
Q
Sterilization facts (4)
A
-destroys ALL organisms & spores
-ensures equipment & area are free of mo’s
-used for critical items (items inserted or contact w/ blood)
-used in surgery (sterile)
13
Q
Direct transmission route:
A
contact>person to person spread
14
Q
Indirect transmission route:
A
object that is contaminated is touched by an individual who becomes infected
15
Q
Droplet is tranfered by (3)
A
coughing, talking, sneezing (w/in 3 ft)
16
Q
Where do Droplets must be deposited for infection to spread (3)
A
nasal
Oral mucosa
eye
17
Q
Common vehicle utilizes ___ to transmit ___
A
Fomite
Infection
18
Q
Vector is a
A
live carrier of infection (ex: mosquito)
19
Q
Airborne infection characteristics (2)
A
Smaller than droplet particles
Can travel & stay in the air 6 ft or greater
20
Q
Non-specific defense mechanisms include (4)
A
-skin
-cilia
-secretions (like mucus)
-wbcs
21
Q
Natural immunity devolps in result of
A
Having the specific disease
22
Q
Artificial immunity is aquired by
A
vaccination triggering antibodies
23
Q
Passive immunity is the
A
transfer of protective antibodies from one host to possible secondary host
-ex: maternal immunity to fetus through the placenta
24
Q
Acme is the ___ of ___. Between ___ and ___ phases.
A
peak of disease
-between invasive & decline phases
25
Incubational period is the period of
no symptoms
26
Prodromal period def:
beginning feelings of feeling unwell
27
Invasive phase:
full blown symptoms
28
Decline phase:
symptoms brought under control
29
Convalescent period:
body is healing
30
Sequalae:
remaining symptoms the body cannot repair
31
Hepatitis B virus can live on surfaces for ___ days @ ___ temp
7
Room
32
Hepatitis B virus trasnmits through
Contact with infected blood and body fluids through skin breaks or mucous membrance contact
33
Hepatitis C virus transmits through (3)
- needle use (most common)
- infected blood
- skin breaks
34
Most common bloodborne infection in the U.S. is
Hepatitis C virus
35
Which virus has no vaccine
Hepatitis C virus
36
Influenza transmits through/by
Through large droplets (airborne)
37
Influenza self innoculation after
contact with contaminated material
38
Varicella-zoster virus:
- Cause
- Threatning to ___
- Transmission through
-caused by chickenpox & shingles
-life-threatening to immunocompromised pts
-transmission through droplets
39
Pertussis aka:
whooping cough
40
tetanus aka:
lockjaw
(caused by bacteria found in soil)
41
diptheria bacteria aka:
diptheria:
(spread through respiratory droplets)
42
Tuberculosis transmission:
airborne droplets from infected person sneezes, coughs, or talks
43
When in presence of a Tuberculosis patient (2)
-negative air flow room must be used
-must use n95 mask
44
HIV/AIDS started in (year)
1983
45
HIV/AIDS needlesticks account for ___% of job-related acquired HIV
84%
46
HIV/AIDS transmission between ___ & ___ is rare
Healthcare worker and patient
47
Universal precautions (3)
-apply to blood, body fluid, secretions, excretions, nonintact skin, mucus
-wear gloves if touching pts anywhere near an open wound or cleaning up body fluid
-never recap a needle
48
Healthcare workers should wash their hands when (4)
-before touching a pt
-after touching a pt or removing gloves
-when hands are moving from a contaminated site to a clean site
-after touching inanimate objects in the vicinity of a contaminated patient
49
Hand hygiene:
wash hands w soap __-__ seconds if hands are visibly soiled & after caring for someone w known or suspected ___
- 40-60 seconds
- diarrhea
50
Alcohol based hand rub should be rubbed in (time)
20-30 seconds
51
Alcohol based hand rub should be used unless hands are ___
Visible soiled
52
When to wash hands (5)
-visibly dirty or contaminated
-before eating
-after using restroom
-after caring for a pt known to have c diff or diarrhea
-after 10-15 alcohol rub applications
53
When to use alcohol rub: (6)
-hands not visibly soiled
-before & after touching a pt
-before inserting a catheter (or anything) into pt
-when moving from a contaminated body site to a clean one
-after touching an inanimate object within reach of a pt
-after removing gloves
54
Donning ppe: (4 in order)
-first gown
-mask
-goggles
-gloves
55
Removing ppe: (4 inorder)
-gloves
-goggles
-gown
-mask
56
PPE Precaution for contact transmission (2)
- Gown
- Glove
57
PPE Precaution for droplet transmission
Mask
58
PPE Precaution for airborne transmission:
n95 mask & respirator
59
PPE Reverse precautions: (3)
Used to protect immuinocompromised patients
- Mask
- Gown
- Gloves
60
Routine cleaning of a room: (4)
-equipment & room should be cleaned between each pt
-new pillowcases, sheets, table paper for each pt
-anything pt touches must be cleaned after each use
-blood or body fluids should be cleaned up immediately
61
Assessment is
a clinical plan that identifies the unique needs of the patient & how those needs will be addressed
62
Patient navigators provide assistance to pts as they move through: (3)
healthcare system
-medical
-social
-financial services
63
2 contents of verbal communication:
-cognitive: composed of the words & facts you say
-affective: feelings & emotions expressed
64
Protein-calorie malnutrition: often caused by change in _____. Patient has insufficient _______ intake, overall deficiency
- Taste
- Protein
65
2 types of malnutrition
-Marasmus (severe undernutrition)
-Kwashiorkor (lack of protein)
66
Marasmus develops from an extreme _______ deficiency
Calorie
67
Kwashiorkor consists of diet mainly of _____ & not enough _______
-carbs
-protein
68
Kwashiorkor leads to ____ loss, stunted ______, swollen _______, ______ wasting, behavioral & ______ changes
-Hair
-Growth
-Abdomen
-Muscle
-Mental
69
Oncology patients should have their weight checked _______
Weekly
70
2 types of pain:
-Acute (new/transient)
-Chronic (persistent > 3 months)
71
Examples of acute pain:
-back pain
-bowel obstruction
72
Examples of chronic pain:
-tumor invasion
-treatment side effects
73
T or F: Age, gender, race, & culture may affect a persons experience w/ pain
True
74
What causes erythema?
inflammation
75
Erythema radiation dosage
3000-4000 cGy
76
Dry desquamation radiation dosage
4000-6000 cGy
77
Alopecia radiation dosage
2000 cGy
78
Mouth changes (stomatitis, xerostomia, mucositis, taste changes, esophagitis) radiation dosage
2000-3000 cGy
79
Nausea/vomiting radiation dosage
1000-2000 cGy
80
Cancer patients are at an increased risk of ________________
myelosuppression
81
Myelosuppression is
Reduced bone marrow activity leading to less blood cells
82
Anemia
low rbc count
83
Leukopenia
low wbc count
84
Thrombocytopenia:
low platelet count
85
Air is a ________ contrast agent and appears _____
-Negative
-Black (radiolucent)
86
Barium & Iodine are ________ contrast agent and appears _____
-Positive
-White (radiopaque)
87
Osmolality: measure of how much one substance has _________ into another substance. The ________ the concentration, the higher the osmolality
-Dissolved
-Greater
88
T or F: If a patient experiences a reaction to contrast, check BUN & creatinine blood levels
True
89
BUN stands for ___ ___ ___ and evaluates ___ function
-Blood urea nitrogen
-Evaluates kidney function
90
Creatinine evaluates ___ function and ___ product levels
-Evaluates kidney function
-Evaluates waste product level (should be low)
91
Extravasation: ________ leaks out from IV & onto the skin
Contrast
92
Phlebitis:
inflammation of a vein
93
4 types of medications
-Antiemetic
-Analgesic
-Anti inflammatory
-Anti diarrheal
94
Antiemetic medications treat
-Treats nausea/vomiting
95
Which are antiemetic medications? (2)
-Compazine
-Norazine
has ZINE at end of name
96
Analgesia medications treat
pain
97
Which are analgesic medications? (2)
-Tylenol
-Percocet
98
Which are anti-inflammatory medications?
-Hydrocortisone
-Diprolene
Has "RO" in both names
99
Which are anti-diarrheal medications?
-Imodium
-Lomotil
Has "MO" is both names
100
Quality of life: A person's __________ sense of well being derived from ________ experience of life as a whole
-Subjective
-Personal
101
What is the 2nd most common affective response in cancer patients?
depression
102
Cathode: (2)
charge and function
-negative side of the tube
-primary role is to produce electrons and focus them in the direction of the metal anode
103
Filament: function
coiled wire (tungsten) that passes electrons through wire heating them as they pass
104
Focusing cup: (2)
Charge and function
-negatively charged
-directs beam in a straight path
105
Anode:
Charge and function
-positive side of the x-ray tube
-receives electrons from the cathode, reduces the heat, & serves as a path for high voltage flow
106
Glass envelope: function
keeps air from colliding with electrons by creating a vacuum
107
Protective housing: function
controls unwanted leakage radiation
108
Quantity (mAs): is the # of
Photons
109
mAs & density are (relationship)
Directly proportional
110
Quality (kVp):
What is it
voltage that determines the kinetic energy of the electrons
111
kvp causes ___ & ___ in film
density & contrast
112
Density is on a image
:
degree of darkening on an image
-high density image is dark=low density is light
113
Distance is the
gap between the target and the recording medium
-inverse square law
114
Bremsstrahlung is made from
sudden deceleration of high speed electrons as they are deflected around the nucleus of the tungsten atom (75%-80%)
115
Characteristic radiation is created when
there's a direct interaction of cathode electrons with the inner shell electrons of the target
116
Electrons that have sufficient energy to overcome the binding energy of the atom cause:
ionization
117
The line-focus principle: (3)
-allows a larger area of the target to be heated
-maintains a relatively smaller focal spot x-ray emission
-allows higher anode heating with small effective FS due to angling target
118
The heel effect: (2)
What is it
What causes it
-causes radiation intensity on the cathode side of x-ray tube to be higher than anode side
-caused by a differential in x-ray absorption by the target at different target thicknesses
119
The central ray/axis (2)
-imaginary line generated by the centermost x-ray in the useful beam
-intensity usually 100% at crosshai
120
To eliminate heel effect what is used (2)
Electrons
Photons
-scattering foil (electrons)
-flattening filter (photons)
121
2 types of units for superficial cancers and voltages:
-superficial (50-150 kV)
-orthovoltage (150-500kV)
122
Orthovoltage therapy unit: (4)
- Used with
- Depth limit
- Treatment locations (4)
- Cell types (2)
-used with cones or lead cutouts that lie directly on the patient
-depth limited to 2-3 cm
-treatment of skin, mouth, cervical lesions, keloids
-squamous cell & basal cell carcinomas
123
Cerrobend is made of: (4) ADD PERCENTAGE OF MATERIALS
Bismuth 50%
Lead 26.7%
Tin 13.3%
Cadmium 10%
(BLT with C)
124
Half value layer: (3)
- Def
- Dependant on what
- Why is it important
-thickness of any given material where 50% of the incident energy has been attenuated
-energy dependent
-important to determine how much shielding is needed
125
Linear accelerator:
charged particles travel in straight lines as they gain energy from an alternating electromagnetic field
126
Drive stand consists of: (4)
-klystron
-waveguide
-circulator
-cooling system
127
Kylstron: function
provides source of microwave power
128
Circulator:
- Function
- Prevents?
- directs radio-frequency energy into waveguide
- prevents backflow
129
Waveguide:
Function
channels microwaves into accelerator structure
130
Cooling system:
Function
controls temp of machine
131
Gantry consists of: (3)
-electron gun
-accelerator structure
-treatment head
132
Electron gun:
Function
produces & injects electrons into accelerator guide
133
Accelerator structure/guide:
synchronizes ___ with flow of ___
- microwaves
- electrons
134
Bending magnet:
bends the ___ through an ___ & onto the ___
- electrons
- angle
- x-ray target
135
Primary collimator:
shape the x-ray beam, set maximum field size
136
Beam-flattening filter:
distributes the x-ray beam across the field
137
Scattering foil:
distributes a pencil point beam of electrons evenly across the field
138
Ion chamber monitors: (3)
- symmetry across the field,
- dose rate,
- mu's
139
Secondary collimators:
- defines the
treatment field size, (and the jaws)
140
Field light:
outlines the treatment radiation field
141
Portfilms:
verification films taken regularly to assure accuracy in treatment field placement
142
Divergence:
- is when photons move
- Contributes to
-straight but in different directions from focal spot
-magnification & distortion
143
Focal spot selection:
-electrons are emitted from a measurable area on the anode
-square or rectangle instead of a "true" spot or point source
144
Penumbra: (2)
- What is it
- Results from
-the area of unsharpness (fuzziness) at the edge of the beam
-results from photons intersecting the object at different angles
145
Large FS:
Means ___ ___
greater penumbra
146
Small FS:
- Means ___ ___
- Better ___
- less penumbra,
- better detail
147
Digitally recontructed radiograph (DRR):
- Reffer to
- Produced by
-refers to the sim film
-produced by CT slices pieced together or a "data set" acquistion that is compliled
148
Electronic portal imaging device (EPID):
-creates a
-provides a means
-creates a real-time image of treatment volume
-provides a means to improve daily treatment accuracy
149
SAD is always:
100 (isocenter)
150
SSD depends on: (2)
-location of tumor
-thickness of tissue
151
Is the SAD for an AP field the same for a PA or lateral field?
yes
152
Bolus does what: (4)
-increases skin dose
-decreases dmax
-eliminates "skin sparing effect"
-tissue equivalent material
153
Compensators may be: (3 items)
-bolus material
-pb filter
-wedge
154
Compensating filters function:
adjust the beam to deliver an even distribution of radiation across an irregular surface
155
Plain films serve what 2 major functions
-localization
-verification
156
Beam film:
utilizes the treatment beam to acquire a 'time elapsed' image of the treatment field & related anatomy
157
Verification for brachytherapy used to
verify position of implants (sources)
158
brachytherapy orthogonal films are at ___ and ___ degrees
0 and 90
159
Ways to keep dose to pt alara: (2)
-collimation
-improving technique to reduces # of repeat x-rays
160
Types of diagnostic imaging: (5)
- Xray
- CT
- MRI
- Nuclear scintigraphy
- Ultrasound
161
Nuclear imaging uses ___to image ___ ___ & ___ structures
- radioisotopes
- physiologic processes
- anatomic
162
Common body parts nuclear medicne scans: (3)
-bone
-liver
-lung
*bc of metastases
163
PET scans show (4)
-analysis of function
-blood flow
-extent of disease
-infarct extent
164
MRI/CT/Ultrasound:
-localization of ___
-difficult to differentiate ___ ___ from recurrence
-difficult ___ ___ assessment
-slow to assess ___ to therapy
-requires ___of contrast agents
Anatomic
-localization of mass
-difficult to differentiate scar tissue from recurrence
-difficult whole body assessment
-slow to assess response to therapy
-requires concentrations of contrast agents
165
PET:
-identification of change in cell ___
-straight forward ___ of disease from scar
-___ min whole ___ study
-fast ___ of therapy effectiveness
-trace quantities of ___ don't change metabolism
Metabolic
-identification of change in cell biochem
-straight forward delineation of disease from scar
-30 min whole body study
-fast assessment of therapy effectiveness
-trace quantities of FDG don't change metabolism
166
Image fusion:
output that results from 2 or more original studies which are combined
167
Benefits of image fusion: (2)
-give more info than any single imaging modality alone
-enhances both the diagnosis & treatment of cancer pts
168
Why PET in oncology?
-unique contribution to TNM staging
-facilitates more accurate & effective delivery while minimizing dose effects
169
What is FDG?
- What is it
- cancer shows up as
Fluoro-deoxy-glucose
-radioactive sugar given intravenously
-cancer shows up as hot spots on PET scan
170
Organs that normally uptake FDG (4)
-brain
-heart
-kidneys & bladder
171
Ultrasound in rad onc used in which treatments
-external beam: NOMOS BAT system
-brachytherapy: transrectal probe in combo w treatment planning system
172
BAT system: (2)
-facilitates daily localization of the prostate, bladder, & rectal wall
-allows for more accurate positioning of treatment fields
173
Ultrasound for prostate patients uses (4)
-facilitates volumetric measurement of prostate
-images directly transferred to treatment planning system
-allows for pre-implant planning of seed placement & dosimetry
-post-implant analysis
174
Fluoroscopy: (3)
-facilitated off-line setup & real time imaging & planning
-accuracy
-efficiency
175
Fluoroscopy uses: (5)
-field delineation
-organ localization
-PTV definition
-contrast administration
-implant verification
176
Why is CT the method of choice for RT planning? (4)
- Better diagnosis
-tumor & normal tissue localization
-density data for dose calcs
-treatment monitoring
177
Diagnostic CT charcteristics: (6)
-curved table top
-no lasers
-pt positioning not needed
-no immobilization
-small FOV
-organ fill ignored
178
Therapy CT characteristics: (6)
-flat table top
-required lasers
-pt positioning same as treatment
-immobilization
-external contour needed
-gas & urine affects size & position of organs
179
What things are the same for diagnostic & therapy CT? (2)
-contrast
-slice thickness
180
Advantages of CT sim: (5)
- Better ___
-ability to achieve ___ beam arrangements
-ability to ___ with tx planning computer
-visualization of ___organs
-ability to create ___ that previously couldn't be produced
-accuracy
-ability to achieve various beam arrangements
-ability to interface with tx planning computer
-visualization of critical organs
-ability to create films that previously couldn't be produced
181
Disadvantages of virtual simulation: (6)
-size of ___
-use of beam ___ ___ is limited
-___ limitations
-simples sims take ___ as long
-___movement
-DRR quality ___ than optimal
-size of aperature
-use of beam shaping devices limited
-mechanical limitations
-simples sims take twice as long
-organ movement
-DRR quality less than optimal
182
CT vs MRI:
-CT provides ___ axial images
-MRI can scan ___, ___, ___, or ___ planes
-MRI doesn't use ___ radiation
-MRI has higher ___& better imaging of ___ ___
-CT provides transverse axial images
-MRI can scan axial, sagittal, coronal, or oblique planes
-MRI doesn't use ionizing radiation
-MRI has higher contrast & better imaging of soft tissue
183
MRI:
-images based on ___ properties of ___ nuclei
-images indicate ___ activity in area scanned
-useful in ___ studies in ___ planning
-images based on magnetic properties of hydrogen nuclei
-images indicate cellular activity in area scanned
-useful in fusion studies in intricate planning
184
Computed Radiography (CR):
-concept of ___ environment
-generation of ___ images
-___& storage
-reduced/eliminated of ___ film
-reduction of ___ associated w ___ copy images
-concept of filmless environment
-generation of digital images
-archiving & storage
-reduced/eliminated of lost film
-reduction of cost associated w hard copy images
185
Quantity mAs is the number of
photons
186
Quantity kVp
is the voltage that determins the kinetic energy of electrons
187
The intensity of a radiation beam is
measured at 10.0 mR/hr at a distance of
10cm. What will the intensity of the beam
be at 20 cm?
2.5. slide #12 on powerpoint
188
Bremsstrahlung or Characteristic makes ionizating raditaion
Characteristic
189
___% of x-rays are turned into heat
99
190
The thickness of any given material where 50% of the
incident energy has been attenuated is know as the
HVL
191
Dmax
depth of maximum build up, in which 100% of the dose is deposited
192
Parallel Opposed Fields
opposite fields, defined
as fields with hinge angle of 180 degrees
193
Radical resection may be required to obtain
clean margin
194
Failure to obtain clean margins indicates
adjuvant radiotherapy
195
Ionizing Radiation in the form of
X-ray
196
Goal of rad therapy
deliver a sufficient dose of radiation
to sterilize tumor cells with minimal damage to
surrounding normal tissue
197
Amount of radiation used to treat tumors is limited by
tolerance of the surrounding normal tissue
198
The Ideal Situation
the tumor lies in an area
of tissue that is more radioresistant.
199
Living will aka
Advanced directive
200
Principal interaction in x-ray production is
a result of output form
bremsstrahlung radiation
201
Electrons that have sufficient energy to
overcome the binding energy of the atom
causing
ionization
202
Credited for discovery of x-rays is ___ in ___
William Conrad Roentgen
1895
203
Rapidly dividing cells are ___ susceptible to radiation damage
More
204
Rapidly dividing cells require ___ dose than slow dividing cells
Less
205
Intensity equation
I1/I2 = D2^2/D12^2
206
Types of non-ionizing radiation (2)
- MRI
- Ultrasound
