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LG 2024 > mosbys > Flashcards

mosbys Flashcards

1
Q

Which element of the hematopoietic system shows the earliest response to
radiation?

A

lymphocytes

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2
Q

What is the energy of a photon detected by PET?

A

511 kV

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3
Q

What does an image intensifier convert?

A

xray image into a light

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4
Q

What is afebrile?

A

without fever

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5
Q

What radiation interaction with matter occurs independently of atomic number?

A

compton

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6
Q

In what region of the pharynx is the pyriform sinus located?

A

hypopharynx

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7
Q

Patients that receive TBI at an early age may develop what secondary cancer?

A

osteochondroma

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8
Q

In order to reduce potential electron contamination, what is the preferred material
for custom blocks and compensator holders?

A

lucite

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9
Q

The adrenal glands are located at what thoracic level?

A

T12

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10
Q

Which photon interaction with matter involves direct photon interaction with the
nucleus?

A

pair production

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11
Q

The energy loss of MeV electron beams in water is approximately ___ MeV/cm

A

2

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12
Q

What does the back pointer determine?

A

beam exit point

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13
Q

In what age group in Hodgkin’s disease most common?

A

males and
females younger than 35/ over 60 (2 peaks)

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14
Q

A patient with a systemic infection risks ____ shock

A

septic

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15
Q

What kind of shock is associated with bacterial infections and its toxic byproducts?

A

septic

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16
Q

For which organ would the hypogastric lymph nodes be included in the treatment
field?

A

rectum

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17
Q

According to the law of Bergonnie and Tribondeau, ___ increases cell
radiosensitivity

A

high division rate

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18
Q

What is the process of cellular growth and development called?

A

proliferation

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19
Q

What is the threshold dose for radiation pneumonitis?

A

20-25 Gy

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20
Q

In RBE, the biologic effect of a particular type of radiation for a given dose is
compared to the biologic effects of ___ x-rays for the same dose.

A

250 kV

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21
Q

linear attenuation coefficient is expressed as

A

1/cm

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22
Q

what has a lower PDD, superficial or ortho

A

superficial

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23
Q

to prevent distant mets of prostate spread you need to include what in the tx field

A

common iliac

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24
Q

what would be an advantage of using the
wedged pair technique?

A

rapid dose fall off

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25
Q

Chondrosarcoma originates in what type of tissue?

A

osseous tissue

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26
Q

When treating the whole brain with opposing laterals, what is one way to minimize
beam divergence into the eye opposite the entrance port?

A

center the axis near the lateral canthus

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27
Q

What is the approx location of the external iliac lymph nodes?

A

1 cm lateral of the pelvic brim

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28
Q

What is the most cephalic portion of the normal stomach?

A

fundus

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29
Q

What is the last portion of the small intestine?

A

ileum

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30
Q

The field size is determined by which isodose line?

A

50%

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31
Q

Where is the head of the pancreas normally located?

A

sweep of the duodenum

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32
Q

where is the tail of the pancreas located

A

hilum of the spleen

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33
Q

What is the dose for prophylactic cranial irradiation for SCLC?

A

35-40 Gy

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34
Q

What imaging is not an example of functional imaging?

A

CT

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35
Q

Positron Emission Tomography (PET) is based on imaging with photons produced
by what?

A

annihilation of positrons by electrons

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36
Q

What is the actual physical dimensions of the tumor including regions of presumed
occult spread called?

A

tumor volume

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37
Q

Which has the highest frequency: 1) x-rays, 2) visible light, 3) microwaves, 4)
radiowaves

A

xrays

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38
Q

Dose is normalized to what in an SSD treatment technique?

A

Dmax

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39
Q

Dose is normalized to what in an SAD technique?

A

treatment depth

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40
Q

What does BSF depend on?

A

field size and beam energy

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41
Q

Which of the following effects describes the following: Increased dose equals
increased probability of effects?

A

stochastic

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42
Q

The blood count is depressed following a whole-body dose equivalent of at least
how many sievert?

A

0.25 Sv

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43
Q

How is damage to the cell being irradiated described?

A

somatic

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44
Q

What is used to modify the absorbed dose amount to account for the greater
damage inflicted by some forms of ionizing radiation?

A

weighting factor

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45
Q

Differential absorption is a result of which photon-tissue interaction?

A

photoelectric

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46
Q

Res ipsa loquitur

A

A case involving obvious negligence would be defined by the doctrine of

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47
Q

standard precautions

A

A system that emphasizes the placement of barriers between the health care worker
and the patient

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48
Q

medical asepsis

A

The process of eliminating as many organisms as possible by the use of water and
chemical disinfectants

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49
Q

Which of the following is used if there is any chance of coming in contact
primarily with products of the GI system of an infected person

A

enteric isolation

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50
Q

What causes blood to pool in peripheral vessels

A

neurogenic shock

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51
Q

What condition is caused by loss of a large amount of blood or plasma

A

hypovolemic shock

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52
Q

What is caused by infection that results in extremely low blood pressure

A

septic shock

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53
Q

butterfly injection

A

A smaller, easier-to-handle injection set that includes plastic projections on both
sides of the needle and may be used for venipuncture

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54
Q

venous catheter

A

is more flexible and easier to use than a needle or butterfly

is a combination unit with a needle inside a flexible plastic catheter; both the
needle and the catheter are inserted into the vein, after which the needle is
withdrawn

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55
Q

Which of the following contains points that are enforceable

A

ARRT Rules of Ethics

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56
Q

Which of the following serves as a guide to professional conduct

A

ARRT Code of Ethics

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57
Q

According to NCRP Report #160, what is the annual effective dose
equivalent per person from natural background radiation?

A

3.11 mSv

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58
Q

The x-ray machine
receives what type of current from the incoming line?

A

120 Hz AC

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59
Q

What is the limit on leakage radiation from a diagnostic x-ray tube?

A

1 mGya per hour at a distance of 1 m from the housing

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60
Q

The purpose of beam limitation devices is to:

A

control scatter radiation

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61
Q

The photon-tissue interaction that does not occur in diagnostic imaging is

A

pair production

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62
Q

Visible light is converted into an electronic image in what part of the imageintensifier tube?

A

photocathode

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63
Q

mAs controls the number of electrons passing from:

A

cathode to anode

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64
Q

The WR used to calculate sievert is a measure of what aspect of the radiation being measured?

A

RBE

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65
Q

Increased dose equals increased
probability of effects?

A

stochastic

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66
Q

As kVp is increased, the
wavelength of the x-ray photons:

A

decreases

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67
Q

If ionizing radiation
interacts with a human cell, causing it to die after one or more divisions, it is
classified as:

A

mitotic death

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68
Q

The blood count is depressed following a whole-body
dose equivalent of at least how many sievert?

A

0.25

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69
Q

Free
radicals may recombine to form:

A

hydrogen peroxide

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70
Q

Barium sulfate is a(n):

A

inert salt

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71
Q

From what anatomic structure does the zygomatic
process arise?

A

temporal bone

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72
Q

The cardiac portion is where the:

A

esophagus enters the stomach

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73
Q

Which machine components are located within the gantry?

A

electron gun
accelerator structure

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74
Q

Which agency is responsible for regulating the manufacturing of linear accelerators?

A

FDA

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75
Q

Which machine components are located within the drive stand?

A

klystron
circulator

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76
Q

Which type of breast surgery removes chest wall muscles?

A

radical mastectomy

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77
Q

What is the typical gantry angle used for supraclavicular fields?

A

10-15 degrees

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78
Q

Which machine components are located within the treatment head?

A

target
ion chambers

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79
Q

Which of the following does NOT need to be on a consent form?

A

treatment dose

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80
Q

Which acute radiation syndrome has the shortest latent stage?

A

CNS

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81
Q

If MLCs move only when the beam turns off, this is known as:

A

step and shoot

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82
Q

What is the main difference between VMAT and IMRT?

A

Gantry & MLCs move during VMAT and only MLCs move during IMRT

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83
Q

What is the last step when donning PPE?

A

gloves

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84
Q

What is the purpose of the waveguide in a linear accelerator?

A

accelerate electrons to high energies

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85
Q

Atomic nuclei with differing Z numbers, but the same A number?

A

isobar

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86
Q

Vaginal cylinders are considered:

A

HDR
intracavitary

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87
Q

Which type of imaging will cause the MOST compton scatter?

A

ports

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88
Q

The scattering foil is used to:

A

spread out electron beam

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89
Q

Which of the following types of radiation can be detected using a Geiger-Muller counter?

A

gamma

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90
Q

What is the standard fractionation scheme for whole brain radiation therapy?

A

30 Gy x 10 Fx

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91
Q

Which process helps to generate machine-produced radiation?

A

electron acceleration

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92
Q

What happens to the energy of a photon as its wavelength decreases?

A

energy increases

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93
Q

Which of the following radiation units takes into account the biological effects of different types of radiation?

A

Sv

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94
Q

Which type of radiation is most affected by oxygen enhancement?

A

xrays

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95
Q

Which of the following is a deterministic effect of radiation exposure?

A

skin erythema

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96
Q

Which of the following organs is not part of the digestive system?

A

spleen

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97
Q

Which agency regulates the disposal of radioactive materials in the United States?

A

NRC

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98
Q

Which of the following parameters in CT simulation is responsible for determining image brightness?

A

level

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99
Q

Which of the following might be a main risk of using iodinated contrast?

A

allergic reaction
kidney damage

100
Q

what does BSF depend on

A

field size
energy

101
Q

what is not a symptom of SVC

A

pain

102
Q

artery most often used for pulse

A

radial

103
Q

artery most accurate for pulse

A

apical artery

104
Q

what is used for light field and radiation field checks

A

monthly

ready pack film and solid water

105
Q

daily mechanical check

A

localizing lasers

106
Q

daily dosimetry check

A

photon and electron output

107
Q

1 cm off the CA is a

A

geometric target miss

108
Q

is OSL or TLD not affect by heat, moisture or pressure

A

OSL

109
Q

use gating when you have more than __ of movement

A

5 mm

110
Q

what precaution is used for a virus

A

standard

111
Q

cricoid is inf border of

A

larynx

112
Q

vertebral body at base of heart

A

T4

113
Q

flatness and symmetry check

A

2%
monthly

114
Q

ODI check

A

daily
2 mm

115
Q

MLC leaf position

A

1 mm

116
Q

gantry and coll angle indicators check

A

monthly
1 degree

117
Q

asymmetric light field check

A

1 mm or 1% on a side
monthly
mechanical

118
Q

symmetric light field

A

2 mm or 1% on a side
monthly
mechanical

119
Q

where do celiac and mesenteric lymph nodes meet

A

cisterna chyli

120
Q

leak testing for brachy can detect

A

0.005 micro Ci

121
Q

is lung adenocarcinoma in periphery or central

A

periphery

122
Q

SI unit and original unit for absorbed dose

A

Gy
rad

123
Q

SI unit and original unit for dose equivalent

A

SV
rem

124
Q

absorbed dose is energy absorbed_____.

A

in matter

125
Q

dose equivalent is radiation absorbed______.

A

by a persone

126
Q

equation of SV

A

Gy x QF

127
Q

what section are personal dosimeters in

A

dose equivalent

128
Q

1 R = ________

A

2.58 x 10^-4 C

129
Q

energies that are exposure

A

below 3 MeV

130
Q

effective dose shows____-

A

difference of response for organs and tissues

131
Q

yttrium HL and use

A

64 hours
liver and lymphoma

132
Q

gold HL and use

A

2.7 days
prostate seeds

133
Q

radon HL

A

3.8 days

134
Q

I131 HL and use

A

8 days
thyroid

135
Q

phosphorus HL

A

14 days

136
Q

palladium HL and use

A

17 days
prostate implants
low emission

137
Q

Sr89 HL and use

A

50 days
bone mets pain

138
Q

I125 HL and use

A

59 days
prostate implants
low emission

139
Q

Ir192 HL and use

A

74 days
cervix implants in fletcher
nylon ribbon
LDR & HDR

140
Q

Co60 HL and use

A

5.27 years
brachy and teletherapy

141
Q

Sr90 HL and use

A

29 years
eye (pterygium)

141
Q

Cs137 HL and use

A

30 years
brachy for cervix or uterus
cervix implants in fletcher

141
Q

Ra226 HL and use

A

1600 years
original radioactive isotope
decays into radon gas

141
Q

ionic contrast

A

high osmo
adverse reactions

142
Q

non ionic contrast

A

low osmo
fewer adverse reactions
less discomfort
more common

142
Q

diff between mild and moderate contrast reactions

A

mild: monitor vitals
moderate: medical intervention

142
Q

antisdasmodic

A

GI and IBS symptoms

142
Q

tumor marker for ovarian cancer

A

Ca125

143
Q

analgesic

A

pain killer

144
Q

MOPP chemo causes

A

myelosuppression –> decreased WBC, RBC, platelets

145
Q

where is the most bone marrow

A

pelvis

146
Q

when do you report weight loss to nurse

A

5% loss in a month
10% loss in 6 months
3 pounds a week

147
Q

diagnostic radioactive source

A

technetium - 99 m

148
Q

1 dps = _____ Ci

A

2.7 x 10^-11

149
Q

most common radioisotopes are sealed except for

A

I131

150
Q

LDR brachy

A

40-200 cGy/HR

151
Q

HDR brachy

A

0.2 Gy/min - 12 GY/hr

152
Q

% efficiency for diagnostic xray tubes

A

1% and 99% converted to heat

153
Q

energy for coherent

A

less than 10 KeV

154
Q

is photoelectric diagnostic or thereapeutic

A

diagnostic

155
Q

energy for compton

A

25 KeV - 10 MeV

156
Q

energy for photodisintegration

A

7-15 MeV

157
Q

difference between elastic and inelastic

A

elastic: no energy lost
inelastic: some energy lost and reappears (excitation, ionization, brem)

158
Q

unit that a person absorbs

A

SV

159
Q

when do you use lead aprons

A

fluoroscopic exams

160
Q

apron shield

A

0.5 mm lead
2 HVL in diagnostic
reduces exposure to 10%

161
Q

after how many HLs can radioactive materials be disposed

A

10

162
Q

what regulates removal, storage, and usage of nuclear waste

A

EPA

163
Q

what regulates safe use of radioactive materials and protects public

A

NRC

164
Q

2 examples of ionization chamber

A

pocket dosimeter
cutie pie

165
Q

what are correction factors for

A

if not sealed, for temp, pressure, volume

166
Q

pocket dosimeter

A

personal
detect low energy

167
Q

cutie pie

A

portable survey meter

168
Q

what type of radiation dose is monitored using personal dosimeters

A

equivalent dose

169
Q

thimble chamber

A

calibrates ion chambers in LINAC
1) farmer
2) condensor

170
Q

Geiger Muller

A

not for personal monitoring
portable
survey rooms
not a dose measuring device
contamination (alpha, beta, gamma)
very sensitive
100 mR and less

171
Q

TLD

A

LiF (similar to human)
+/- 5%
excited by heat
solid state detector

172
Q

OSL

A

excited by light
AlO
occupational exposure
unique ID

173
Q

stochastic vs deterministic effects

A

stochastic: no threshold
- probability and by chance
- ex: carcinogenesis, leukemia, genetic effects
deterministic: threshold
- depends on severity of dose
- ex: cataracts and erythema

173
Q

chemical used for neutron dosimeter

A

BF3

173
Q

machine numbers

A

40 +/- degrees C
45-50 PSI
SF6 –> 25-32 PSI

173
Q

diodes

A

small solid state detectors
real time reading
daily QA for output
not used for calibration

173
Q

correction factors for CT warmup

A

760 mmHg
22 degrees C

174
Q

FOA hazards

A

class 1: death/serious
class 2: small risk

175
Q

direct relationship for CT correction factors

A

pressure and exposure

176
Q

indirect relationship for CT correction factors

A

temp and exposure

177
Q

is OER higher or lower for low LET

A

higher

178
Q

higher LET = ____ RBE

A

higher

179
Q

what are the most radiosensitive stages of human life

A

embryo and fetus

180
Q

stage with prenatal death the most common effect

A

preimplantation

181
Q

do early effects have a threshold

A

yes

182
Q

acute changes

A

reduction in parenchymal cells
ex: inflammation, edema, hemorrhage

183
Q

chronic changes

A

reduction in stomal and vascular cells
ex: fibrosis, atrophy, ulceration
permanent

184
Q

GSD for the year

A

20 mrad/year

185
Q

radioprotectors

A

search for free radicals
ex: sulfhydryls and amifostine and ethyol

186
Q

what does the dose effect factor say

A

the ratio of radiation dose needed to cause damage without chemo compared to radiation dose needed with chemo

187
Q

at what point do chemo drugs have a sensitizing effect

A

DEF is greater than 1

188
Q

what amplifies microwaves

A

klystron (above 12 MV)

189
Q

what generates microwaves

A

magnetron (low energies)

190
Q

what stops microwaves from being reflected and going backwards

A

circulator
between klystron and waveguide

191
Q

what generates electrons and sends them to the accelerator (waveguide0

A

electron gun

192
Q

what is the electron gun made of

A

tungston

193
Q

what is the tube that electrons flow to the gantry under a vacuum

A

accelerator structure

194
Q

what contains SF6 to prevent arcing

A

accelerator structure

195
Q

hyperalimentation

A

nutrients given via IV for weak and malnourished patients

196
Q

MUs should be _____ and should not be_____.

A

should be on the treatment plan
should no be on the prescription

197
Q

medical event TD

A

20% difference

198
Q

medical event one Fx

A

50% difference

199
Q

after a medical event, how soon should a written report be submitted

A

15 days

200
Q

how soon after a medical event should the patient and physician be informed

A

within 24 hours

201
Q

billing charge for patient comfort

A

no charge

202
Q

when are devices billed

A

only once

203
Q

wh at is a simple tx billed as for sim verification or dry run

A

simple sim

204
Q

diff between simple sim, intermediate sim, and complex sim

A

simple: 1 field and no custom blocking
intermediate: 2 or more tx sites
complex: arc therapy, complex/custom blocking, 3+ tx sites

205
Q

diff between simple tx, intermediate tx, and complex tx

A

simple: 1-2 field, 2 simple blocks
intermediate: 2 separate tx areas, 3 fields and 3 simple blocks
complex: 3 tx areas and custom blocks, tangent fiels, wedges, arcs, FIF, electron

206
Q

weekly port films vs IGRT billing vs IMRT

A

ports: separate charge
IGRT: billed daily
IMRT: own charge
- simple: breast and prostate
- complex: everything else

207
Q

main source in our body of internal radioactive elements

A

potassium 40

208
Q

picket fence test

A

radiograph leaves 8 times
each image of MLCs open 5 cm and abut previous field
optical density changes of +/-20% signifies misaligned leaves

209
Q

IMRT vs non IMRT MLC QA

A

IMRT: monthly, 1 mm tolerance, speed 0.5 cm/s
non IMRT: monthly, 2 mm tolerance

210
Q

how often is MLC transmission checked and what is the tolerance

A

annually
less than 2%

211
Q

what is the winston lutz test

A

laser accuracy verification
SRS

212
Q

islets of langerhans

A

secrete hormones like insulin and glucagon in pancreas

213
Q

what organ has local spread in radial style

A

large bowel

214
Q

4 lymphatic organs

A

spleen, thymus, tonsils, thoracic duct

215
Q

what is reed sternberg cells

A

giant connective tissue cell that is binucleate

216
Q

pathology for hodgkins

A

nodular
classic: lymphocyte rich, nodular sclerosing, mixed cellularity, lymphocyte depleted

217
Q

most common subcategory for hodgkins

A

nodular sclerosing

218
Q

cause of hodgkins vs non hodgkins

A

hodgkins: EBV
non hodgkins: ionizing radiation

219
Q

ages of hodgkins vs non hodgkins

A

hodgkins: 25-30 and 75-80
non hodgkins: older people

220
Q

signs of hodgkins vs non hodgkins

A

hodgkins: painless mass
non hodgkins: B symptoms

221
Q

radiation technique used for hodgkins

A

mantle

222
Q

chemo of hodgkins vs non hodgkins

A

hodgkins: MOPP o/g, ABVD best
non hodkins: CHOP

223
Q

more common pathology of non hodgkins

A

diffuse lymphomas

224
Q

what is the updated version of ann arbor

A

lugano

225
Q

oncologic emergencies

A

SVC
skeletal mets
brain mets w/ increased cranial pressure
vaginal bleeding

226
Q

how is grade determined

A

biopsy

227
Q

nottingham grading system

A

breast: G1-G3

228
Q

clinical vs pathological stage

A

clinical: estimate of extent of tumro
pathological: extent of tumor determined after surgery

229
Q

ann arbor states

A

A: no symptoms
B: B symptoms
E: extranodal
S: splenic involvement

230
Q

breslows vs clark

A

breslow: tumor invasion of skin layers
clark: microscopic

231
Q

common tx for 3 field technique

A

in abdomen

232
Q

common tx for 4 field technique

A

deep tumors in pelvis or abdomen

233
Q

cancers for MRI fused with CT vs PET fused with CT

A

MRI: prostate
PET: lung, H/N

234
Q

BSF vs PSF

A

BSF: low energy
PSF: high energy (+4 MV)

235
Q

when is DCA used

A

when 3D without IMRT do not adequately deliver dose to the tumor and spare OAR

236
Q

what has replaced DCA

A

VMAT

LG 2024 (4 decks)

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