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RTT Lecture > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

___ involves the reproduction of microorganisms in the human body

A

Infection

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2
Q

___ is the collective term used to describe related clinical signs & symptoms associated with an infectious agent

A

Disease

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3
Q

___ is a person with an infection but no observable symptoms

A

Subclinical infection

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4
Q

___ is the reproduction of an infectious microorganism

A

Colonization

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5
Q

___ is a person who has an infection that has colonized but not ill

A

Carrier

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6
Q

___ is the presence of microorganisms on the body of an inanimate object

A

Contamination

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7
Q

___ is an infection that is acquired in the hospital setting

A

Nosocomial infection

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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

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9
Q

Major cause of mortality amongst cancer patients is ___

A

infections
-caused by immunosuppression caused by treatments & frequent contact with HCW’s & settings

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10
Q

Disinfection examples include (4 items)

A

alcohol,
chlorine,
hp,
formaldehyde

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11
Q

Disinfection facts (3)

A

-does NOT eliminate bacteria spores
-kills all microorganisms
-used for non-critical items

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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)

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13
Q

Direct transmission route:

A

contact>person to person spread

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14
Q

Indirect transmission route:

A

object that is contaminated is touched by an individual who becomes infected

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15
Q

Droplet is tranfered by (3)

A

coughing, talking, sneezing (w/in 3 ft)

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16
Q

Where do Droplets must be deposited for infection to spread (3)

A

nasal
Oral mucosa
eye

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17
Q

Common vehicle utilizes ___ to transmit ___

A

Fomite
Infection

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18
Q

Vector is a

A

live carrier of infection (ex: mosquito)

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19
Q

Airborne infection characteristics (2)

A

Smaller than droplet particles

Can travel & stay in the air 6 ft or greater

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20
Q

Non-specific defense mechanisms include (4)

A

-skin
-cilia
-secretions (like mucus)
-wbcs

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21
Q

Natural immunity devolps in result of

A

Having the specific disease

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22
Q

Artificial immunity is aquired by

A

vaccination triggering antibodies

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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

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24
Q

Acme is the ___ of ___. Between ___ and ___ phases.

A

peak of disease
-between invasive & decline phases

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25
Q

Incubational period is the period of

A

no symptoms

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26
Q

Prodromal period def:

A

beginning feelings of feeling unwell

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27
Q

Invasive phase:

A

full blown symptoms

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28
Q

Decline phase:

A

symptoms brought under control

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29
Q

Convalescent period:

A

body is healing

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30
Q

Sequalae:

A

remaining symptoms the body cannot repair

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31
Q

Hepatitis B virus can live on surfaces for ___ days @ ___ temp

A

7
Room

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32
Q

Hepatitis B virus trasnmits through

A

Contact with infected blood and body fluids through skin breaks or mucous membrance contact

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33
Q

Hepatitis C virus transmits through (3)

A
  • needle use (most common)
  • infected blood
  • skin breaks
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34
Q

Most common bloodborne infection in the U.S. is

A

Hepatitis C virus

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35
Q

Which virus has no vaccine

A

Hepatitis C virus

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36
Q

Influenza transmits through/by

A

Through large droplets (airborne)

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37
Q

Influenza self innoculation after

A

contact with contaminated material

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38
Q

Varicella-zoster virus:
- Cause
- Threatning to ___
- Transmission through

A

-caused by chickenpox & shingles
-life-threatening to immunocompromised pts
-transmission through droplets

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39
Q

Pertussis aka:

A

whooping cough

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40
Q

tetanus aka:

A

lockjaw
(caused by bacteria found in soil)

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41
Q

diptheria bacteria aka:

A

diptheria:
(spread through respiratory droplets)

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42
Q

Tuberculosis transmission:

A

airborne droplets from infected person sneezes, coughs, or talks

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43
Q

When in presence of a Tuberculosis patient (2)

A

-negative air flow room must be used
-must use n95 mask

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44
Q

HIV/AIDS started in (year)

A

1983

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45
Q

HIV/AIDS needlesticks account for ___% of job-related acquired HIV

A

84%

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46
Q

HIV/AIDS transmission between ___ & ___ is rare

A

Healthcare worker and patient

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47
Q

Universal precautions (3)

A

-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

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48
Q

Healthcare workers should wash their hands when (4)

A

-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

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49
Q

Hand hygiene:
wash hands w soap __-__ seconds if hands are visibly soiled & after caring for someone w known or suspected ___

A
  • 40-60 seconds
  • diarrhea
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50
Q

Alcohol based hand rub should be rubbed in (time)

A

20-30 seconds

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51
Q

Alcohol based hand rub should be used unless hands are ___

A

Visible soiled

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52
Q

When to wash hands (5)

A

-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

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53
Q

When to use alcohol rub: (6)

A

-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

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54
Q

Donning ppe: (4 in order)

A

-first gown
-mask
-goggles
-gloves

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55
Q

Removing ppe: (4 inorder)

A

-gloves
-goggles
-gown
-mask

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56
Q

PPE Precaution for contact transmission (2)

A
  • Gown
  • Glove
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57
Q

PPE Precaution for droplet transmission

A

Mask

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58
Q

PPE Precaution for airborne transmission:

A

n95 mask & respirator

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59
Q

PPE Reverse precautions: (3)
Used to protect immuinocompromised patients

A
  • Mask
  • Gown
  • Gloves
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60
Q

Routine cleaning of a room: (4)

A

-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

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61
Q

Assessment is

A

a clinical plan that identifies the unique needs of the patient & how those needs will be addressed

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62
Q

Patient navigators:

A

provide assistance to pts as they move through healthcare system
-medical
-social
-financial services

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63
Q

2 contents of verbal communication:

A

-cognitive: composed of the words & facts you say
-affective: feelings & emotions expressed

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64
Q

Protein-calorie malnutrition: often caused by change in _____. Patient has insufficient _______ intake, overall deficiency

A
  • Taste
  • Protein
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65
Q

2 types of malnutrition

A

-Marasmus (severe undernutrition)
-Kwashiorkor (lack of protein)

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66
Q

Marasmus develops from an extreme _______ deficiency

A

Calorie

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67
Q

Kwashiorkor consists of diet mainly of _____ & not enough _______

A

-carbs
-protein

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68
Q

Kwashiorkor leads to ____ loss, stunted ______, swollen _______, ______ wasting, behavioral & ______ changes

A

-Hair
-Growth
-Abdomen
-Muscle
-Mental

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69
Q

Oncology patients should have their weight checked _______

A

Weekly

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70
Q

2 types of pain:

A

-Acute (new/transient)
-Chronic (persistent > 3 months)

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71
Q

Examples of acute pain:

A

-back pain
-bowel obstruction

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72
Q

Examples of chronic pain:

A

-tumor invasion
-treatment side effects

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73
Q

T or F: Age, gender, race, & culture may affect a persons experience w/ pain

A

True

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74
Q

What causes erythema?

A

inflammation

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75
Q

Erythema radiation dosage

A

3000-4000 cGy

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76
Q

Dry desquamation radiation dosage

A

4000-6000 cGy

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77
Q

Alopecia radiation dosage

A

2000 cGy

78
Q

Mouth changes (stomatitis, xerostomia, mucositis, taste changes, esophagitis) radiation dosage

A

2000-3000 cGy

79
Q

Nausea/vomiting radiation dosage

A

1000-2000 cGy

80
Q

Cancer patients are at an increased risk of ________________

A

myelosuppression

81
Q

Myelosuppression is

A

Reduced bone marrow activity leading to less blood cells

82
Q

Anemia

A

low rbc count

83
Q

Leukopenia

A

low wbc count

84
Q

Thrombocytopenia:

A

low platelet count

85
Q

Air is a ________ contrast agent and appears _____

A

-Negative
-Black (radiolucent)

86
Q

Barium & Iodine are ________ contrast agent and appears _____

A

-Positive
-White (radiopaque)

87
Q

Osmolality: measure of how much one substance has _________ into another substance. The ________ the concentration, the higher the osmolality

A

-Dissolved
-Greater

88
Q

T or F: If a patient experiences a reaction to contrast, check BUN & creatinine blood levels

A

True

89
Q

BUN stands for ___ ___ ___ and evaluates ___ function

A

-Blood urea nitrogen
-Evaluates kidney function

90
Q

Creatinine evaluates ___ function and ___ product levels

A

-Evaluates kidney function
-Evaluates waste product level (should be low)

91
Q

Extravasation: ________ leaks out from IV & onto the skin

A

Contrast

92
Q

Phlebitis:

A

inflammation of a vein

93
Q

4 types of medications

A

-Antiemetic
-Analgesic
-Anti inflammatory
-Anti diarrheal

94
Q

Antiemetic medications treat

A

-Treats nausea/vomiting

95
Q

Which are antiemetic medications? (2)

A

-Compazine
-Norazine
has ZINE at end of name

96
Q

Analgesia medications treat

A

pain

97
Q

Which are analgesic medications? (2)

A

-Tylenol
-Percocet

98
Q

Which are anti-inflammatory medications?

A

-Hydrocortisone
-Diprolene
Has “RO” in both names

99
Q

Which are anti-diarrheal medications?

A

-Imodium
-Lomotil
Has “MO” is both names

100
Q

Quality of life: A person’s __________ sense of well being derived from ________ experience of life as a whole

A

-Subjective
-Personal

101
Q

What is the 2nd most common affective response in cancer patients?

A

depression

102
Q

Cathode: (2)
charge and function

A

-negative side of the tube
-primary role is to produce electrons and focus them in the direction of the metal anode

103
Q

Filament: function

A

coiled wire (tungsten) that passes electrons through wire heating them as they pass

104
Q

Focusing cup: (2)
Charge and function

A

-negatively charged
-directs beam in a straight path

105
Q

Anode:
Charge and function

A

-positive side of the x-ray tube
-receives electrons from the cathode, reduces the heat, & serves as a path for high voltage flow

106
Q

Glass envelope: function

A

keeps air from colliding with electrons by creating a vacuum

107
Q

Protective housing: function

A

controls unwanted leakage radiation

108
Q

Quantity (mAs): is the # of

A

Photons

109
Q

mAs & density are (relationship)

A

Directly proportional

110
Q

Quality (kVp):
What is it

A

voltage that determines the kinetic energy of the electrons

111
Q

kvp causes ___ & ___ in film

A

density & contrast

112
Q

Density is on a image
:

A

degree of darkening on an image
-high density image is dark=low density is light

113
Q

Distance is the

A

gap between the target and the recording medium
-inverse square law

114
Q

Bremsstrahlung is made from

A

sudden deceleration of high speed electrons as they are deflected around the nucleus of the tungsten atom (75%-80%)

115
Q

Characteristic radiation is created when

A

there’s a direct interaction of cathode electrons with the inner shell electrons of the target

116
Q

Electrons that have sufficient energy to overcome the binding energy of the atom cause:

A

ionization

117
Q

The line-focus principle: (3)

A

-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
Q

The heel effect: (2)
What is it
What causes it

A

-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
Q

The central ray/axis (2)

A

-imaginary line generated by the centermost x-ray in the useful beam
-intensity usually 100% at crosshai

120
Q

To eliminate heel effect what is used (2)
Electrons
Photons

A

-scattering foil (electrons)
-flattening filter (photons)

121
Q

2 types of units for superficial cancers and voltages:

A

-superficial (50-150 kV)
-orthovoltage (150-500kV)

122
Q

Orthovoltage therapy unit: (4)
- Used with
- Depth limit
- Treatment locations (4)
- Cell types (2)

A

-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
Q

Cerrobend is made of: (4) ADD PERCENTAGE OF MATERIALS

A

Bismuth
Lead
Tin
Cadmium
(BLT with C)

124
Q

Half value layer: (3)
- Def
- Dependant on what
- Why is it important

A

-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
Q

Linear accelerator:

A

charged particles travel in straight lines as they gain energy from an alternating electromagnetic field

126
Q

Drive stand consists of: (4)

A

-klystron
-waveguide
-circulator
-cooling system

127
Q

Kylstron: function

A

provides source of microwave power

128
Q

Circulator:
- Function
- Prevents?

A
  • directs radio-frequency energy into waveguide
  • prevents backflow
129
Q

Waveguide:
Function

A

channels microwaves into accelerator structure

130
Q

Cooling system:
Function

A

controls temp of machine

131
Q

Gantry consists of: (3)

A

-electron gun
-accelerator structure
-treatment head

132
Q

Electron gun:
Function

A

produces & injects electrons into accelerator guide

133
Q

Accelerator structure/guide:
synchronizes ___ with flow of ___

A
  • microwaves
  • electrons
134
Q

Bending magnet:
bends the ___ through an ___ & onto the ___

A
  • electrons
  • angle
  • x-ray target
135
Q

Primary collimator:

A

shape the x-ray beam, set maximum field size

136
Q

Beam-flattening filter:

A

distributes the x-ray beam across the field

137
Q

Scattering foil:

A

distributes a pencil point beam of electrons evenly across the field

138
Q

Ion chamber monitors: (3)

A
  • symmetry across the field,
  • dose rate,
  • mu’s
139
Q

Secondary collimators:
- defines the

A

treatment field size, (and the jaws)

140
Q

Field light:

A

outlines the treatment radiation field

141
Q

Portfilms:

A

verification films taken regularly to assure accuracy in treatment field placement

142
Q

Divergence:
- is when photons move
- Contributes to

A

-straight but in different directions from focal spot
-magnification & distortion

143
Q

Focal spot selection:

A

-electrons are emitted from a measurable area on the anode
-square or rectangle instead of a “true” spot or point source

144
Q

Penumbra: (2)
- What is it
- Results from

A

-the area of unsharpness (fuzziness) at the edge of the beam
-results from photons intersecting the object at different angles

145
Q

Large FS:
Means ___ ___

A

greater penumbra

146
Q

Small FS:
- Means ___ ___
- Better ___

A
  • less penumbra,
  • better detail
147
Q

Digitally recontructed radiograph (DRR):
- Reffer to
- Produced by

A

-refers to the sim film
-produced by CT slices pieced together or a “data set” acquistion that is compliled

148
Q

Electronic portal imaging device (EPID):
-creates a
-provides a means

A

-creates a real-time image of treatment volume
-provides a means to improve daily treatment accuracy

149
Q

SAD is always:

A

100 (isocenter)

150
Q

SSD depends on: (2)

A

-location of tumor
-thickness of tissue

151
Q

Is the SAD for an AP field the same for a PA or lateral field?

A

yes

152
Q

Bolus does what: (4)

A

-increases skin dose
-decreases dmax
-eliminates “skin sparing effect”
-tissue equivalent material

153
Q

Compensators may be: (3 items)

A

-bolus material
-pb filter
-wedge

154
Q

Compensating filters function:

A

adjust the beam to deliver an even distribution of radiation across an irregular surface

155
Q

Plain films serve what 2 major functions

A

-localization
-verification

156
Q

Beam film:

A

utilizes the treatment beam to acquire a ‘time elapsed’ image of the treatment field & related anatomy

157
Q

Verification for brachytherapy used to

A

verify position of implants (sources)

158
Q

brachytherapy orthogonal films are at ___ and ___ degrees

A

0 and 90

159
Q

Ways to keep dose to pt alara: (2)

A

-collimation
-improving technique to reduces # of repeat x-rays

160
Q

Types of diagnostic imaging: (5)

A
  • Xray
  • CT
  • MRI
  • Nuclear scintigraphy
  • Ultrasound
161
Q

Nuclear imaging uses ___to image ___ ___ & ___ structures

A
  • radioisotopes
  • physiologic processes
  • anatomic
162
Q

Common body parts nuclear medicne scans: (3)

A

-bone
-liver
-lung
*bc of metastases

163
Q

PET scans show (4)

A

-analysis of function
-blood flow
-extent of disease
-infarct extent

164
Q

MRI/CT/Ultrasound:
-localization of ___
-difficult to differentiate ___ ___ from recurrence
-difficult ___ ___ assessment
-slow to assess ___ to therapy
-requires ___of contrast agents

A

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
Q

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

A

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
Q

Image fusion:

A

output that results from 2 or more original studies which are combined

167
Q

Benefits of image fusion: (2)

A

-give more info than any single imaging modality alone
-enhances both the diagnosis & treatment of cancer pts

168
Q

Why PET in oncology?

A

-unique contribution to TNM staging
-facilitates more accurate & effective delivery while minimizing dose effects

169
Q

What is FDG?
- What is it
- cancer shows up as

A

Fluoro-deoxy-glucose
-radioactive sugar given intravenously
-cancer shows up as hot spots on PET scan

170
Q

Organs that normally uptake FDG (4)

A

-brain
-heart
-kidneys & bladder

171
Q

Ultrasound in rad onc used in which treatments

A

-external beam: NOMOS BAT system
-brachytherapy: transrectal probe in combo w treatment planning system

172
Q

BAT system: (2)

A

-facilitates daily localization of the prostate, bladder, & rectal wall
-allows for more accurate positioning of treatment fields

173
Q

Ultrasound for prostate patients uses (4)

A

-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
Q

Fluoroscopy: (3)

A

-facilitated off-line setup & real time imaging & planning
-accuracy
-efficiency

175
Q

Fluoroscopy uses: (5)

A

-field delineation
-organ localization
-PTV definition
-contrast administration
-implant verification

176
Q

Why is CT the method of choice for RT planning? (4)

A
  • Better diagnosis
    -tumor & normal tissue localization
    -density data for dose calcs
    -treatment monitoring
177
Q

Diagnostic CT charcteristics: (6)

A

-curved table top
-no lasers
-pt positioning not needed
-no immobilization
-small FOV
-organ fill ignored

178
Q

Therapy CT characteristics: (6)

A

-flat table top
-required lasers
-pt positioning same as treatment
-immobilization
-external contour needed
-gas & urine affects size & position of organs

179
Q

What things are the same for diagnostic & therapy CT? (2)

A

-contrast
-slice thickness

180
Q

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

A

-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
Q

Disadvantages of virtual simulation: (6)
-size of ___
-use of beam ___ ___ is limited
-___ limitations
-simples sims take ___ as long
-___movement
-DRR quality ___ than optimal

A

-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
Q

CT vs MRI:
-CT provides ___ axial images
-MRI can scan ___, ___, ___, or ___ planes
-MRI doesn’t use ___ radiation
-MRI has higher ___& better imaging of ___ ___

A

-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
Q

MRI:
-images based on ___ properties of ___ nuclei
-images indicate ___ activity in area scanned
-useful in ___ studies in ___ planning

A

-images based on magnetic properties of hydrogen nuclei
-images indicate cellular activity in area scanned
-useful in fusion studies in intricate planning

184
Q

Computed Radiography (CR):
-concept of ___ environment
-generation of ___ images
-___& storage
-reduced/eliminated of ___ film
-reduction of ___ associated w ___ copy images

A

-concept of filmless environment
-generation of digital images
-archiving & storage
-reduced/eliminated of lost film
-reduction of cost associated w hard copy images

185
Q

Quantity mAs is the number of

A

photons

186
Q

Quantity kVp

A

is the voltage that determins the kinetic energy of electrons

187
Q

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?

A

2.5. slide #12 on powerpoint

188
Q

Bremsstrahlung or Characteristic makes ionizating raditaion

A

Characteristic

189
Q

___% of x-rays are turned into heat

A

99

190
Q

The thickness of any given material where 50% of the
incident energy has been attenuated is know as the

A

HVL

191
Q
A

RTT Lecture (3 decks)

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