Mosby Questions - Clinical Concepts, Pt Care, Tx Delivery Flashcards by Brianne Bradford

Acute effects following TBI include: (6)

nausea
vomiting
orthostatic hypotension
mucositis
diarrhea
parotiditis

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A nonpharmacological management for mild to moderate xerostomia would be:
A. drinking caffeinated beverages
B. eating more fibrous foods
C. drinking thickened shakes
D. eating applesauce and sorbets

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Which type of chemotherapy is known to cause hearing loss?
A. vincristine
B. cisplatin
C. doxorubicin
D. ifosfamide

Cisplatin

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Dose for permanent xerostomia:

40 Gy

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Dose for permanent alopecia:

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Surface landmark for true vocal cords:

thyroid cartilage

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When is a sentinel lymph node biopsy most appropriate?
A. Primary tumor is larger than 5 cm.
B. Patient has had previous treatments with chemotherapy.
C. Primary tumor is small, and lymph nodes need assessment.
D. Superficial axillary lymph nodes are positive.

D. Superficial axillary lymph nodes are positive.?? or is it C?

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Luteinizing hormone (LH) stimulates sexuality and some reproductive function. LH is secreted by the_______gland.
A. pineal
B. adrenal
C. pituitary
D. prostate

C. pituitary

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How many cobalt sources are contained in the gamma knife unit?

201

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Normal rectal temperature for the adult in Fahrenheit is:

99.6

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In primary bone tumors, the primary mode of distant metastasis is through:
A. vasculature
B. lymphatic vessels

A. vasculature

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If the electron energy selected is 12 MeV, this energy selected indicates the:
A. energy at the patient’s skin surface
B. energy of the bremstraahlung radiation
C. maximum energy of electrons in the beam
D. energy of the secondary radiation

C. maximum energy of electrons in the beam

Explanation: The electron and photon beams coming from the linac have a spectrum of energies. The energy selected indicates the maximum energy at Dmax.

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The target volume includes the regional nodes. The caudal margin is the inferior border of the obturator foramen. The cephalad margin is L5. The lateral margins are 1 cm beyond the true pelvis. The nodes included are the external and internal iliacs. The target volume just described is for the treatment of:
A. kidney
B. bladder
C. stomach
D. testis

Bladder

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The tunica albuginea is a part of the ovary and describes a/an:
A. capsule of collagenous connective tissue
B. single layer of cuboidal epithelial tissue
C. gland that secretes estrogen
D. source of ovarian follicles

A. capsule of collagenous connective tissue

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Which modalities are commonly used for IGRT?
A. CT and MRI
B. PET and MRI
C. CT and ultrasound
D. ultrasound and MRI

C. CT and ultrasound

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The preferred material for the patient couch as part of the CT simulator or linear accelerator is carbon fiber. This material is preferred due to its (select two):
1. transparency
2. radiolucency
3. radio-opacity
4. low attenuation

radiolucency
1. low attenuation

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The clinical whole brain inferior border should coincide with: (3) mastoid process, external auditory meatus and supra-orbital ridge.

mastoid process
external auditory meatus
supra-orbital ridge

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The type of resection in which the tumor is scraped away is known as:
A. curettage
B. en bloc resection
C. excisional resection
D. wide margin resection

A. curettage

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The four cardinal signs of inflammation are:

pain, heat, swelling, and redness

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Which histological type would a tumor of the larynx likely be?

SCC

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Tumor markers helpful in diagnosis and management monitoring for testicular cancers: (3)

AFP (alpha fetoprotein)
HCG
alkaline phosphatase

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When extremities are irradiated for the management of primary bone malignancy, it is important to spare a portion of:
A. tissue along the entire extremity to prevent obstruction of blood flow
B. bone to prevent obstruction of lymphatic flow
C. tissue along the extremity to prevent obstruction of lymphatic flow
D. muscle on each side to prevent obstruction of blood flow

C. tissue along the extremity to prevent obstruction of lymphatic flow

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The opening to the uterus is known as the:
A. cervical os
B. uterine fundus
C. cervical meatus
D. uterine meatus

A. cervical os

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The head of the pancreas will normally be located in the:
A. hilum of the spleen
B. sweep of the duodenum
C. porta of the liver
D. lesser curvature of the stomach

B. sweep of the duodenum (cradles the head of the pancreas)

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The mediastinum contains which of the following lymph nodes (select two): 1. hilar 2. cervical 3. supraclavicular 4. subcarinal

1. hilar 4. subcarinal

A. nasopharynx B. base of tongue C. oropharynx D. hypopharynx

Hypopharynx

What type of dose response model applies to MR to address biologic effects of the magnetic fields used to image patients? A. linear, threshold B. nonlinear, nonthreshold C. linear, nonthreshold D. nonlinear, threshold

D. nonlinear, threshold

Hair loss is usually permanent when the scalp is exposed to radiation doses exceeding:

60 Gy

You are called in to treat a spinal cord compression. The physician asks you to set a preliminary field to cover thoracic vertebrae 3, 4, and 5 on the treatment table. The approximate field size will be: A. 6 x 6 B. 8 x 8 C. 10 x 10 D. 8 x 12

B. 8 x 8 Explanation: The thoracic vertebrae are about 2.5 cm in length. 3(2.5) = 7.5. To include the transverse processes, the width of the field will be about 8 cm.

Metastatic disease may lead to an abnormal accumulation of fluid in the pericardial sac. This may lead to: A. mitral stenosis B. tachycardia C. pericarditis D. pericardial tamponade

D. pericardial tamponade

Which of the following techniques is used to treat early pre-cancers of the cervix? A. loop electrosurgical excision B. hysterectomy C. brachytherapy D. external beam radiation

A. loop electrosurgical excision

A procedure used in which an implant is made using a trocar, with radioactive sources introduced into the trocar and then trocar is removed is called: A. self-attenuation B. interstitial preloading C. intracavitary microloading D. interstitial afterloading

D. interstitial afterloading

Ovarian

The tail of the pancreas is located: A. in the curve of the duodenum B. in the hilum of the spleen C. at the level of L4 D. in the right hypogastric region

B. in the hilum of the spleen

The parathyroids are located on the: A. posterior surface of the left thyroid lobe B. anterior surface of the left thyroid lobe C. posterior surface of both thyroid lobes D. anterior surface of both thyroid lobes

C. posterior surface of both thyroid lobes

The distance between the entrance and exit points for parallel opposed ports is called the: A. source to skin distance B. source to axis distance C. interfield distance D. source-to tray-distance

C. interfield distance

The pituitary gland secretes which reproductive hormones? A. TSH, ACTH, LTH B. LH, estrogen, progesterone C. FSH, LH, LTH D. progesterone and estrogen

C. FSH, LH, LTH

The image intensifier converts: A. an X-ray image into a light image at the input screen B. a light image into an electronic image at the input screen C. an electronic image into a light image at the output screen D. an amplified image to an electronic image at the output screen

A. an X-ray image into a light image at the input screen

During treatment requiring the use of whole abdomen fields, the structure at the greatest risk for latent effects after 44 Gy is the: A. liver B. kidney C. pancreas D. gallbladder

kidney

The __ position has the patient's feet slightly elevated to promote blood flow to the heart. The position would be beneficial for a patient in __ or ___.

Trendelenberg, shock, syncope

Adults undergoing total body irradiation may be treated at an extended distance while assuming the position of: A. supine with arms folded on the PSA B. semirecumbent, with the knees bent on a gurney C. Trendelenberg position on the gurney D. Sim's position on a gurney

B. semirecumbent, with the knees bent on a gurney

If a 1.0 cm bolus is applied to an area being treated with a 6 MV beam, the maximum dose point will be located at: A. the skin surface B. 0.5 cm below the skin surface C. 1.0 cm below the skin surface D. 1.5 cm below the skin surface

B. 0.5 cm below the skin surface

Which of the following foods should be avoided by patients receiving radiation therapy to the pelvis? 1. corn 2. oatmeal 3. raw vegetables

All

The pathogen among the following that commonly causes infection in cancer patients is: A. pseudomonas B. streptococci C. staphylococci D. hepatitis B

A. pseudomonas

__ thyroid cancer is the most aggressive type, showing rapid growth and local invasion of structures.

Anaplastic

If the lower mantle is treated in a female patient with Hodgkin's disease, gonadal protection may consist of: A. delivering all treatments using posterior ports B. positioning the patient in prone position for all treatments C. placing a lead apron over the ovaries during treatment D. moving the ovaries away from the treatment field

D. moving the ovaries away from the treatment field (surgically)

During gamma knife radiosurgery, gamma radiation is focused toward the target by: A. Lucite cones attached to the gamma helmet B. intraoperative circular cones attached to the gamma helmet C. several sources with energy directed through collimated spaces in the gamma helmet D. Lucite cones attached to the head frame

C. several sources with energy directed through collimated spaces in the gamma helmet

Between the thyroid notch and cricoid cartilage lies the: A. epiglottis B. larynx C. base of tongue D. carina

B. larynx

The approximate location of the external iliac pelvic lymph nodes is: A. 1 cm lateral of the pelvic rim B. 2 cm medial of the pelvic rim C. surrounding the bladder D. at the aorta bifurcation

A. 1 cm lateral of the pelvic rim

The clavicle and 1st rib articulate with the: A. manubrium B. body of the sternum C. xiphoid process D. 1st thoracic spine

A. manubrium

nasopharyngeal cancer

When treating a patient with prostate cancer, which of the following factors would not cause prostate movement? A. respiration B. rectal volume C. patient position variation D. cecum volume

D. cecum volume

In which region of the pharynx is the pyriform sinus located? A. oropharynx B. hypopharynx C. nasopharynx D. larynx

C. nasopharynx

Patients who receive total body irradiation at an early age may develop a second cancer such as: A. osteochondroma B. hepatocellular carcinoma C. meningeoma D. small cell lung carcinoma

A. osteochondroma

What is the most cephalic portion of the normal stomach termed? A. greater curvature B. pylorus C. fundus D. body

fundus

___ (chemo drug) may cause hearing loss and renal dysfunction.

Cisplatin

The most common nosocomial infections occur as:

urinary tract infections

Which of the following does not improve the therapeutic ratio? A. single field B. multiple fields C. fractionation D. combined modalities

A. single field

In which region of the pharynx are the pharyngeal tonsils located?

naso

A. hypopharynx B. base of tongue C. nasopharynx D. supraglottic larynx

C. nasopharynx

The anterior margin is based on extension into the nasal cavity. The superior border is at the base of the skull. The posterior margin includes the posterior cervical nodes. The caudal margin is at the inferior aspect of the clavicle. The target volume just described is for treatment of: A. paranasal sinuses B. nasopharynx C. salivary glands D. tonsil

B. nasopharynx

In which region of the pharynx are the palatine tonsils located?

oro

Most thyroid cancers develop from cells of which histological origin? A. papillary B. follicular C. anaplastic D. serous

A. papillary

The transient sensation of electrical shock traveling down the neck and extremities following radiation to the spine is called: A. Lhermitte's sign B. Babinski's sign C. Turner's syndrome D. Gardner's syndrome

A. Lhermitte's sign

During radiation treatment to the thorax, the arm position should be: A. wherever the patient is comfortable B. consistent throughout the treatment course C. consistent throughout the treatment fraction D. above the head

B. consistent throughout the treatment course

During total central nervous system irradiation, the patient is typically: A. supine with an extended chin B. supine with the chin flexed C. prone with the chin slightly extended D. prone with the chin flexed

C. prone with the chin slightly extended

If custom blocks need to be used, the shadow tray will_________the output. A. increase B. decrease C. not effect D. slow

B. decrease

All of the following are signs of ovarian cancer except: A. vaginal bleeding B. abdominal bloating C. constipation D. nausea

A. vaginal bleeding

D. nonlinear, threshold

You may acquire an external contour by using: A. plaster of paris B. solder wire C. CT D. any of the above

Any

You have an emergency spinal cord compression at the level of lumbar spine 2. The physician orders a preliminary field to cover L1 to L3. The approximate field size will be: A. 6 x 6 B. 8 x 10 C. 12 x 15 D. 11 x 14

B. 8 x 10 Explanation: The lumbar spine is about 3-3.5 cm in length 3(3.5) = 10.5. To cover the transverse processes, the width of the field will be about 8 cm.

Soft tissue sarcomas usually spread: A. through several neighboring muscle compartments B. along the muscle plane and compartment where it originated C. across muscle planes and compartments D. toward the nearest joint

B. along the muscle plane and compartment where it originated

Your patient being treated for bronchogenic adenocarcinoma complains of difficulty swallowing. His symptom is likely caused by: A. mucositis B. poor oxygen exchange C. perforation of the trachea D. esophagitis

D. esophagitis

The ability to displace the small bowel away from pelvic fields depends on: (2 , which is best answer?) A. the volume of waste in the patient's bowel B. whether the patient has had previous radiation C. whether the patient has had previous pelvic surgery D. the patient's body habitus

C. whether the patient has had previous pelvic surgery - best answer D. the patient's body habitus

For treatment of a soft tissue sarcoma on the calf of the leg, it would be reasonable to position the patient: A. prone with both legs together and immobilized with a foot band B. lateral decubitus with the affected leg elevated as high as possible C. supine with both legs together and immobilized with a foot band D. lateral decubitus with the affected leg moved away from the opposite leg and parallel to the couch

D. lateral decubitus with the affected leg moved away from the opposite leg and parallel to the couch

A complex cartilaginous structure that prevents regurgitation of stomach contents is the: A. upper esophageal sphincter B. oropharyngeal cavity C. gastric junction D. muscularis propria

A. upper esophageal sphincter

Hodgkin's disease is most common in: A. females over 50 years old B. males over 50 years old C. females younger than 10 years old D. males and females younger than 35 years ol

D. males and females younger than 35 years ol

When more than one cancer modality is used simultaneously, it is known as:

concurrent therapy

A type of isolation used for highly communicable diseases and requiring personnel to wear gown, gloves. and mask would be called___________isolation: A. respiratory B. strict C. enteric D. aseptic

B. strict

Epistaxis is another name for:

nosebleed

The breast bridge may be used to __ and reposition a large breast. It may also be used to assist in the determination of tangential angles of the gantry.

immobilize

The volume percentage of red blood cells in whole blood per 100 ml is the: C. hematocrit D. hemaglobin

C. hematocrit

Exchange of oxygen and carbon dioxide to tissues occurs across the walls of: A. capillaries B. mucosa C. areoles D. chambers

A. capillaries

All of the following are methods of delivering oxygen to patients except: A. nasal cannula B. face mask C. IV catheter D. oxygen tent

C. IV catheter

What percentage of adenomatous polyps of the colon contains invasive cancer cells? A. 3% to 5% B. -6% to 8% C. 10% to 20% D. 40% to 50%

A. 3% to 5%

The __ is the most common location for Ewing's sarcoma.

pelvis

To prevent the distant spread of prostatic tumors, the ___________should be included in the treatment fields A. seminal vesicles B. bladder C. common iliac nodes D. inguinal nodes

C. common iliac nodes

Another term for the pituitary gland is the __. A. hypothalamus B. hypophysis C. pineal gland D. neurotic fascia

hypophysis

Early stage ovarian cancer can be successfully treated with: A. external beam radiation to a dose of 65 Gy B. surgery followed by external beam radiation to 50 Gy C. surgery followed by chemotherapy D. surgery, chemotherapy and hormone therapy

C. surgery followed by chemotherapy

Which of the following disorders is the likely cause of reported familial clusters of esophageal squamous cell cancers? A. Barrett's esophagus B. GERD C. HIV/AIDS D. tylosis

D. tylosis

When actual dose delivered needs to be verified, in vivo dosimetry can be accomplished by using: A. radiographic film B. TLDs C. Geiger Muller counters D. Fricke dosimeters

B. TLDs

Which of the following factors influence brightness of an image displayed on a viewing monitor? A. signal intensity B. density intensity C. window level D. window width

C. window level

Metastasis from primary bone cancer often shows up in the: A. breast B. diaphragm C. liver D. kidney

C. liver

Custom shielding blocks that are divergent reduce: A. beam shadowing B. side scatter C. transmission D. beam edge cutoff

D. beam edge cutoff

Why is a stereotactic frame used in linear accelerator based stereotactic radiosurgery? A. to track patient motion B. to provide reference for identifying the target C. to improve patient comfort D. to adjust the treatment beam

B. to provide reference for identifying the target

Fine needle aspiration can be used for bone biopsy. What is the main disadvantage of this procedure? A. Results are often false-negative. B. It is very expensive. C. It is dangerous and too invasive. D. The histological architecture of the bone might not be preserved.

D. The histological architecture of the bone might not be preserved.

Tamoxifen therapy may increase the risk of __ cancer.

endometrial

Which of the following most accurately describes when chest compressions should be started? A. as soon as you find no signs of circulation B. after reassessing the victim's breathing C. after giving 2 initial ventilations and no circulation is confirmed D. whenever you find an unresponsive person

C. after giving 2 initial ventilations and no circulation is confirmed

Which of the following factors influence contrast of an image displayed on a viewing monitor? A. signal intensity B. window level C. proton density D. window width

D. window width

If the hand or forearm needs to be irradiated with anterior and posterior fields for soft tissue sarcoma, the patient could reasonably be: A. sitting, facing the PSA with the affected arm on the couch B. supine on the PSA with the affected arm tucked close to the torso C. standing facing the gantry with the affected arm on the couch D. supine on the PSA with elbow bent, forearm and hand abducted

D. supine on the PSA with elbow bent, forearm and hand abducted

Bite block systems may be used in head and neck irradiation for the purpose of : A. keeping the patient's mouth open B. protecting the teeth from secondary radiation C. facilitating easier breathing during treatment D. reducing the volume of oral mucosa in treatment fields

D. reducing the volume of oral mucosa in treatment fields

The anterior margin flashes over the anterior surface of the neck. The posterior margin includes the arytenoids. The superior margin includes the infra-hyoid epiglottis and the inferior margin includes the cricoid cartilage. This describes the target volume for the treatment of the: A. salivary gland B. tonsil C. true vocal cord D. oral cavity

C. true vocal cord