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RAD 360 - Fundamentals of Radiation Therapy > Final > Flashcards

Final Flashcards

1
Q

Helps determine structure’s radiation tolerance

A

Alpha beta ratio (a/B)

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2
Q

Radiosensitivity of cells/nonrepairable

A

Alpha (a)

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3
Q

Repairable portion of radiation damage

A

Beta (B)

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4
Q

Larger B = _______ ratio = _______ repair and _______ shoulder

A

Small
Increase
Broad

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5
Q

Law stating that ionizing radiation is more effective against cells that are actively mitotic, undifferentiated, and have a long mitotic future

A

Law of Bergonie and Tribondeau (B&T)

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6
Q

Mature/well differentiated cells with less division/mitotic activity (A) = _______ radioresistant

A

More

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7
Q

Sensitivity of cells is ______ proportional to mitotic A and _______ proportional to differentiation

A

Directly, inversely

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8
Q

Environmental conditions can affect radiosensitivity, especially if stressed

A

Law of Ancel and Vitemberger

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9
Q

2 parts that affect the Law of Ancel and Vitemberger

A

Biological stressor on cells
Environment: in poor environment (less oxygen) cells have more time to repair because they’re less likely to move into mitosis (M)

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10
Q

What is the biologic stressor on cells?

A

Mitotic A/division

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11
Q

Cells that divide _______ damage earlier

A

Quickly

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12
Q

3 cell populations

A

Stem cell
Transit
Static cell

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13
Q

Cells that provide/divide for its and other populations, undifferentiated

A

Stem cell

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14
Q

2 examples of stem cells

A

Basal cells

Bone marrow

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15
Q

Cells that go from one place to another, may or may not divide; red blood cells (RBCs)

A

Transit cell

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16
Q

Fully differentiated and mature cells, no or limited mitotic A

A

Static cell

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17
Q

2 examples of mitotic cells

A

Adult nervous tissue

Muscle

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18
Q

5 cell population categories

A 
Vegetative intermitotic cells (VIM)
Differentiating intermitotic cells (DIM)
Multipotential connective tissue cells
Reverting postmitotic cells (RPM)
Fixed postmitotic cells (FPM)
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19
Q

Most radiosensitive cell population, rapidly dividing undifferentiated with short life spans

A

Vegetative intermitotic cells (VIM)

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20
Q

___% of VIM undifferentiated, ___% mature leukocytes

A

95%, 5%

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21
Q

3 examples of VIM

A

Basal cells
Crypt cells of intestines
Erythroblasts

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22
Q

Immature RBCs

A

Erythroblasts

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23
Q

Second most radiosensitive cell population, actively mitotic but more differentiated; more specialized

A

Differentiating intermitotic cells (DIM)

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24
Q

4 examples of DIM

A

Type B spermatogonia
Urinary bladder
Lens of eye
Mucous membranes of of lung

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25
Q

Intermediate/moderate radiosensitivity cell population

Divide irregularly and are more differentiated than VIM and DIM cells

A

Multipotential connective tissue cells

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26
Q

2 examples of multipotential connective tissue cells

A

Endothelial cells

Fibroblasts

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27
Q

Cells of the cavity of the heart and vessels

A

Endothelial cells

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28
Q

Cell in connective tissue that produces collagen and other fiberes

A

Fibroblasts

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29
Q

Cell population doesn’t divide normally unless stimulated, live longer and are more differentiated than other groups
Radioresistant

A

Reverting postmitotic cells (RPM)

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30
Q

3 examples of RPM

A

Liver cells
Mononuclear cells in blood and lymph
Mature lymphocytes

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31
Q

Most radioresistant cell population, don’t divide and highly differentiated; may or may not be replaced when they die
Long living mature cells

A

Fixed postmitotic cells (FPM)

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32
Q

2 tissue organizations

A

Parenchyma

Stroma

33
Q

Contains characteristics of cells of that organ, functional unit of cell; VIM, DIM, RPM, and FDM

A

Parenchyma

34
Q

Connective tissue and vasculature intermediate radiosensitivity
Supporting structures; blood vessel, nerves, etc.

A

Stroma

35
Q

Function of tissues’ most sensitive cell it contains

A

Radiosensitivity

36
Q

Lethal dose that kills 50% of population in 60 days

A

LD50/60

37
Q

3 modifying tissue responses

A

Physical factors
Chemical factors
Biological factors

38
Q

High LET curves _______, no _______; cells show quick response, linear

A

Steeper, shoulder

39
Q

HDR produce more damage, _______ shoulder on LDR graph

A

Broad

40
Q

Rate at which radiation is delivered

A

Dose rate

41
Q

_______ LET and LDR allow cells to repair

A

Low

42
Q

2 chemical factors

A

Sensitizers

Protectors

43
Q

Enhance killing effect of radiation, used to make tumor cells more sensitive
Best known ex: molecular oxygen
Must be in cell environment at time of exposure
Oxygen must be 0-20 mm of mercury, over 20 has no effect

A

Sensitizers

44
Q

Decreases cellular response

A

Protectors

45
Q

Dose _______ with oxygen

A

Decreases

46
Q

Low LET oxygen = _______ radiosensitivity 2-3 times = shoulder gets _______/_____ broad = _______ Do

A

Increases
Smaller
Less
Decrease

47
Q

Magnitude of oxygen effect, compares response with radiation without the presence of oxygen
More pronounced with low LET because whether or not oxygen is present with high LET (average = 1.2-1.7) there’s no healing

A

Oxygen enhancement ratio (OER)

48
Q

OER for mammalian cells

A

2-3

49
Q

OER formula

A

OER = dose without oxygen/dose with oxygen > 1 gives same biologic effect

50
Q

Chemicals that protect normal cells from effects of radiation
Act as free radicals that compete with oxygen in body
Ex: sulfhydryls (1.5-2) contain free sulfur atom in their structure
Present during exposure
Used to protect esophagus, parotids and military; give 15-20 mL before radiation

A 
Dose reduction factor (DRF)
Protection factor (PF)
51
Q

DRF/PF formula

A

DRF/PRF = dose with protector/dose without protector

52
Q

2 problems with DRF/PFs

A

Amount needed to protect from whole body exposure usually lethal
Decreases blood pressure (BP)

53
Q

4 biologic factors

A

Position in cell cycle to phase in cell cycle
Intracellular repair
Age: very young and old more sensitive
Sex

54
Q

Synthesis (S) phase more _______, G2-M most _______, and G1 ______

A

Resistant
Sensitive
Moderate

55
Q

Cells can repair _______ damage, _______ don’t repair as well

A

Sublethal

Hypoxic

56
Q

2 factors intracellular repair takes in

A

LET

Extrapolation/n number

57
Q

3 reasons females are 5-10% more resistant to radiation than males

A

Nutrition
Lipid/fat count greater
Work environment

58
Q

Dose of permanent sterility

A

15-20 Gy

59
Q

Most sensitive trimester

A

First, 1-3 months

60
Q

Why are younger patients more sensitive to radiation?

A

Less differentiated cells

61
Q

4 stages to radiation syndromes

A

Prodromal
Latent
Manifest
Recovery or death depending on dose and radiation type

62
Q

Symptoms correlate to dose and can be gastrointestinal, neurologic, or both

A

Prodromal

63
Q

Period in which victim appears to have no symptoms

A

Latent

64
Q

Effects of exposure return typically worse than before correlated with dose

A

Manifest

65
Q

3 radiation syndromes

A

Hematopoietic syndrome/bone marrow syndrome
GI
CNS

66
Q

Syndrome at 1-10 Gy that affects blood, females more resistant
4-6 weeks 3-5 Gy = death

A

Hematopoietic syndrome/bone marrow syndrome

67
Q

Survival and death dose for hematopoietic syndrome

A 
Survival = under 2 Gy
Death = over 10 Gy
68
Q

At 100-1000 Gy; nausea and vomiting within hours lasts two days

A

Hematopoietic prodromal stage

69
Q

Bone marrow and stem cells dying, blood counts decrease in a few days to 3 weeks

A

Hematopoietic latent stage

70
Q

Anemia and serious infection 3-5 weeks after exposure

A

Hematopoietic manifest stage

71
Q

2 causes of death from hematopoietic syndrome

A

Hemorrhage

Infection

72
Q

Loss of crypt cells in small intestine at 1,000-10,000 cGy
Death by bone marrow loss leads to infection, dehydration, and electrolyte imbalance
100% mortality rate without medical support; average survival = 3-10 days, 2 weeks with medical support
Latent period 2-10 days after prodromal or absent

A

GI syndrome

73
Q

GI syndrome threshold

A

10-50 Gy

74
Q

Nausea, vomiting, cramps and diarrhea within hours

A

GI prodromal stage

75
Q

Symptoms reappear after 5-10 days
Severe diarrhea by 6th day leads to dehydration; bacteria enters blood stream and leads to sepsis
Blood forming organs show severe radiation damage

A

GI manifest stage

76
Q

Caused by gamma or neutrons, external whole body exposure at 20-50 Gy
Death in several days
Final stage
Latent period several hours long
Cause of death: intracranial pressure before other two syndromes
Over 10,000 cGy

A

CNS syndrome

77
Q

Rapid dehydration, lethargy, nervousness, confusion, severe nausea, vomiting, and burning sensation within minutes to hours

A

CNS prodromal stage

78
Q

Coma and death in 5-6 hours, death 2-3 days past 50 Gy

A

CNS manifest stage

79
Q

3 criteria for occurrence of total body radiation syndromes

A

Whole body exposure
Exposure to gamma rays, neutrons, or x-ray externally; not isotopes
Exposure must have occurred acutely, within minutes

RAD 360 - Fundamentals of Radiation Therapy (5 decks)

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