Mosby Questions - Clinical Concepts, Pt Care, Tx Delivery Flashcards
Acute effects following TBI include: (6)
nausea
vomiting
orthostatic hypotension
mucositis
diarrhea
parotiditis
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
D
Which type of chemotherapy is known to cause hearing loss?
A. vincristine
B. cisplatin
C. doxorubicin
D. ifosfamide
Cisplatin
Dose for permanent xerostomia:
40 Gy
Dose for permanent alopecia:
??
Surface landmark for true vocal cords:
thyroid cartilage
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?
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
How many cobalt sources are contained in the gamma knife unit?
201
Normal rectal temperature for the adult in Fahrenheit is:
99.6
In primary bone tumors, the primary mode of distant metastasis is through:
A. vasculature
B. lymphatic vessels
A. vasculature
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.
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
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
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
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
- low attenuation
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
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
The four cardinal signs of inflammation are:
pain, heat, swelling, and redness
Which histological type would a tumor of the larynx likely be?
SCC
Tumor markers helpful in diagnosis and management monitoring for testicular cancers: (3)
AFP (alpha fetoprotein)
HCG
alkaline phosphatase
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
The opening to the uterus is known as the:
A. cervical os
B. uterine fundus
C. cervical meatus
D. uterine meatus
A. cervical os
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)
The mediastinum contains which of the following lymph nodes (select two):
1. hilar
2. cervical
3. supraclavicular
4. subcarinal
- hilar
- 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
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
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
