First Year Exam: Clinical Patient Monitoring and EMR Flashcards
Describe the TNM system
T: Tumor (0-4) (how big and what is the local extent of the tumor)?
N: Node (0-3) (extent to which lymph nodes are involved)
M: Metastatic (0-1) (either yes or no)
Describe the 5 staging scale (0-4)
Stage 0: Cancer is small and hasn’t spread at all
Stage 1: Cancer is small and spread regional area nearby
Stage 2: Cancer has spread into nearby tissue or lymph nodes
Stage 3: More advanced regional spread than stage 2
Stage 4: Cancer spread to distant parts of body. metastatic
What is the primary source for many of the guidelines that the rad oncs use?
NCCN Guidelines
How often do patients meet with the radonc?
Once at initial consult
Once a week during treatment
Once at the end of the treatment course
And then for follow ups
At what stage in the clinical workflow is the patient giving consent?
Right before simming. At this point they are consenting to radiation therapy, so you CANNOT sim without consent
Who usually decides on the immobilization devices, contrast, and type of imaging used in CT Sim?
Rad Onc
What is the ECOG score used to assess?
Assesses how the disease is impacting patient’s daily living abilities
How does the ECOG system work?
Grade from 0 - 5 with increasing severity
0: Fully active, able to carry on
1: restricted in strenous physical activitiy, but able to carry out work of a light or sedentary nature
2: Ambulatory and capable of self care, but unable to carry out any work
3: Capable of only limited self care, confined to bed or chair for more than 50% of working day
4: Completely disabled
5: Dead
What is the Karnofsky system?
Similar to the ECOG system
Scale: 100 - 0
100 is best performance (normal, no complaints, no evidence of disease), 0 is death.
What is the Shims system used for?
Specifically for prostate patients
Stands for “Sexual health inventory for men”
It’s a scale of the level of erectile dysfunction. Low SHIM score means severe ED, high SHIM score means no sign of ED
Scale: 1 - 25
The R&V system and EHR are combined into one system, essentially the treatment management system (TMS). What are some functions of the TMS?
Billing Scheduling Documentation Imaging Record and verification of correct delivery of treatment
What are the types of dicom that we concern ourselves with in RT?
RT Image (DRRs, portal imaging) CT Dicom RT Dose RT Structure Set RT Plan RT Treatment Record (session/summary recording information) RT Registration
What does DICOM stand for?
Digital Image and Communication in Medicine
What does PACS stand for?
Picture Archival and Communication System
What are the 6 functions of PACS?
Image reading station Archiving/storage Image transferring Image duplication Image processing Image editing
