NAPPI PRACTICE EXAMS 1 & 2 - PROCEDURES RELATED Flashcards by Olivia Miller

Comparing CBCT images to CT simulation images and making adjustments is known as:

A. Registration
B. Representation
C. Rendering
D. Recording

A. Registration

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Which type of leukemia does NOT use bone marrow transplants as a form of treatment?

A. ALL
B. AML
C. CLL
D. CML

C. CLL

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which of the following is NOT assessed during a complete blood count study?

A. plasma
B. Hemoglobin
C. Hematocrit
D. Glucose

D. Glucose

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Brachytherapy is used for:

A. short distance radiation therapy
B. external beam radiation therapy
C. extended distance radiation therapy
D. stereotactic radiation therapy

A. short distance radiation therapy

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a patient is receiving arc therapy for 27 treatments. The total dose is 54 Gy, with a daily dose of 200 cGy. The arc will deliver 250 MU. The gantry is moving 360 degrees. Calculate the arc speed.

A..56 MU/degree
B. .69 MU/degree
C. 1.44 MU/degree
D. 1.80 MU/degree

B. .69 MU/degree

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If a lymphoma spreads in a random pattern, it is most likely -

A. Hodgkins
B. Non-Hodgkins
C. Chronic
D. Acute

B. Non-Hodgkins

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What is the tolerance dose to 1/3 the kidneys according to Emami et al.?

A. 2300 cGy
B. 3000 cGy
C. 4500 cGy
D. 5000 cGy

A. 2300 cGy

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What is the most common type of brain tumors?

A. astrocytoma
B. medulloblastoma
C. glioblastoma multiforme
D. metastatic tumors

D. metastatic tumors

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Parallel opposed fields have a hinge angle of:

A. 45 degrees
B. 90 degrees
C. 180 degrees
D. 360 degrees

C. 180 degrees

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the gantry, collimator, and treatment couch all rotate around the:

A. central axis
B. target
C. isocenter
D. past point

C. isocenter

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what is the most common type of skin cancer?

A. squamous cell carcinoma
B. melanoma
C. Basal cell carcinoma
D. Kaposi’s sarcoma

C. Basal cell carcinoma

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the part of the tumor that can be seen or palpated is?

A. GTV
B. PTV
C. ITV
D. CTV

A. GTV

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what is true about hand blocks and cast blocks?

A. cast blocks are cut to match the angle of the photon beam to reduce penumbra
B. hand blocks are custom for each patient
C. cast block can have 7.5% transmission
D. a positive block shields the periphery of the radiation field

A. cast blocks are cut to match the angle of the photon beam to reduce penumbra

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what is the dmax for a 6 MV beam?

A. 1.5 cm
B. 2.5 cm
C. 3.0 cm
D. 3.2 cm

A. 1.5 cm

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which lymph node is located below the mastoid tip and is involved in many HN cancers?

A. jugulodigastric
B. obturator
C. mesenteric
D. iliac

A. jugulodigastric

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what device is used to spread the beam of electrons when utilizing electron therapy?

A. bending magnet
B. electron gun
C. scattering foil
D. flattening filter

C. scattering foil

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the distance from the source to radiation to the isocenter is known as:

A. source-to-axis distance
B. source-to-surface distance
C. central axis
D. source to collimator distance

A. source-to-axis distance

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after what dose would permanent hair loss most likely occur?

A. 1500 cGy
B. 2500 cGy
C. 3500 cGy
D. 4500 cGy

D. 4500 cGy

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the radiation oncologist wants 100% of the dose to be delivered at the patient’s skin surface. The patient is going to be treated with an energy of 6 MV. What bolus thickness would be required?

A. .5 cm
B. 1.0 cm
C. 1.5 cm
D. 2.0 cm

C. 1.5 cm

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The most common pathology for cancers of the oral cavity are:

A. Adenocarcinoma
B. Squamous cell carcinoma
C. Transitional cell carcinoma
D. Clear cell carcinoma

B. Squamous cell carcinoma

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the standard format used to transfer images from diagnostic imaging computers to treatment planning computers is defined by:

A. DICOM
B. PACS
C. DRR
D. EMR

A. DICOM

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What is the wedge angle needed when there is a hinge angle of 90 degrees?

A. 15 degrees
B. 30 degrees
C. 45 degrees
D. 60 degrees

C. 45 degrees

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What can be used to treat anaphylactic shock?

A. Epinephrine
B. Methotrexate
C. Prednisone
D. Amifostine

A. Epinephrine

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Tumors that are slow growing and encapsulated are most likely:

A. superficial
B. deep
C. benign
D. malignant

C. benign

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the breast tissue that is located near the axilla is called:

A. Cooper’s ligaments
B. Tail of Spence
C. Latissimus dorsi
D. Pectoralis minor

B. Tail of Spence

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Which of the following would not be included on a radiation therapy treatment prescription?

A. beam energy
B. dose
C. bolus
D. monitor units

D. monitor units

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What is the correct order (listed in superior to inferior) of the three divisions of the pharynx:

A. oropharynx, nasopharynx, laryngopharynx
B. hypopharynx, oropharynx, nasopharynx
C. nasopharynx, oropharynx, hypopharynx
D. nasopharynx, hypopharynx, oropharynx

C. nasopharynx, oropharynx, hypopharynx

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If a brain tumor is classified as “well-differentiated”, it would be given a grade of:

A. G1
B. G2
C. G3
D. GX

A. G1

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At what age does the American Cancer Society suggest for men and women to have a screening colonoscopy?

A. 30
B. 40
C. 50
D. 60

C. 50

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what is the equivalent square for a rectangular field measuring 8 cm x 12 cm?

A. 4.8 cm x 4.8 cm
B. 9.6 cm x 9.6 cm
C. 10.5 cm x 10.5 cm
D. 11.2 cm x 11.2 cm

B. 9.6 cm x 9.6 cm

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How are tumors accurately diagnosed and staged?

A. CT simulation
B. MRI
C. Mammography
D. Biopsy

D. Biopsy

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All of the following types of treatment planning require a CT simulation, except:

A. 2D
B. 3D
C. 4D
D. IMRT

A. 2D

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What is the appropriate way to change an error made in the patient’s treatment chart?

A. Cover the error using white out and write the correct entry over it
B. Draw multiple lines through the error until it is not legible and sign your name
C. Draw a single line through the error and your initials
D. Do not make any changes to the error

C. Draw a single line through the error and your initials

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Which of the following are considered an early effect of radiation?

A. cataracts
B. alopecia
C. fibrosis
D. leukemia

B. alopecia

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What is the type of condition that is associated with cancers of the oral cavity?

A. Plummer Vinson Syndrome
B. Familial Adenomatous Polyposis
C. Ebstein-Barr Virus
D. Cryptorchidism

A. Plummer Vinson Syndrome

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the cause of a disease is defined by:

A. Epidemiology
B. Etiology
C. Screening
D. Incidence

B. Etiology

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A treatment plan for an AP/PA L spine requires field weighting. The fields will be weighted 3:1 respectively. If the total dose is 250 cGy, what dose will the AP field receive?

A. 62.5 cGy
B. 83.3 cGy
C. 187.5 cGy
D. 250.0 cGy

C. 187.5 cGy

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At least how much bone marrow needs to be in a treatment field for bone marrow depression to occur?

A. 10%
B. 15%
C. 20%
D. 25%

D. 25%

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What is the most common type of soft tissue sarcoma to occur in children?

A. Ewing sarcoma
B. Chondrosarcoma
C. Rhabdomyosarcoma
D. Malignant fibrous histiocytoma

C. Rhabdomyosarcoma

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IMRT is possible with the use of:

A. Cerrobend blocks
B. Compensators
C. Wedges
D. MLCs

D. MLCs

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What is the dmax for a 9 MeV beam?

A. 1.5 cm
B. 2.2 cm
C. 2.8 cm
D. 3.0 cm

B. 2.2 cm

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Regarding patient billing, “professional” charges are those that involve:

A. the radiation oncologist
B. the radiation therapist
C. the simulation
D. the treatment

A. the radiation oncologist

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a common chemotherapy treatment used to treat Hodgkin’s lymphoma is:

A. CHOP
B. CMF
C. MOPP
D. ABVD

D. ABVD

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All of the following planes that can be viewed on a CT scan EXCEPT:

A. Axial
B. Coronal
C. Sagittal
D. Lateral

D. Lateral

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What is the most common type of primary brain tumor in children?

A. Astrocytoma
B. Medulloblastoma
C. Glioblastoma multiforme
D. Ependymoma

A. Astrocytoma

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The radiation beam has an intensity of 50 mR/hr at a distance of 20 cm from the source. What is the intensity at 12 cm from the source?

A. 18 mR/hr
B. 30 mR/hr
C. 95 mR/hr
D. 139 mR/hr

D. 139 mR/hr

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What is the most sensitive part of the human cell?

A. RNA
B. DNA
C. Proteins
D. Mitochondria

B. DNA

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What does BID treatment mean?

A. Two treatments in one week
B. Two treatments in one day
C. Three treatments in one week
D. Three treatments in one day

B. Two treatments in one day

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An alpha cradle is what type of immobilization device?

A. positioning aid
B. simple immobilization device
C. complex immobilization device

C. complex immobilization device

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What radiation therapy technique would produce the most accurate positioning for patient treatment?

A. IGRT
B. IMRT
C. weekly port films
D. triangulation

A. IGRT

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What are the two most toxic materials in Cerrobend blocks?

A. Tin and Cadmium
B. Lead and Bismuth
C. Bismuth and Tin
D. Cadmium and Lead

D. Cadmium and Lead

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What staging system is used for gynecological cancers?

A. Dukes
B. Clarks
C. Ann Arbor
D. FIGO

D. FIGO

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check correctness - there is another question in practice test 1 about “contrast” and the answer is also Window Width… So is contrast = shades of gray
82. What is the term that describes the various shades of gray that is present on a CT image?

A. Window level
B. Window median
C. Window width
D. Window height

C. Window width

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Where is the most common location for pancreatic tumors to arise?

A. Body
B. Tail
C. Head
D. Fundus

C. Head

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Where is the field size defined?

A. on the patient’s skin surface
B. at the isocenter
C. in the collimator
D. at the source of radiation

B. at the isocenter

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What does the Pap smear screen for?

A. Prostate cancer
B. Cervical cancer
C. Breast cancer
D. Rectal cancer

B. Cervical cancer

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Which of the following is NOT a B symptom?

A. fever
B. night sweats
C. hives
D. weight loss

C. hives

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the orthogonal pair of images is considered images that are taken at angles of ______ degrees from each other

A. 10
B. 45
C. 90
D. 180

C. 90

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the CT number for water is?

A. -1000
B. 0
C. 1
D. 1000

B. 0

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When transferring a patient from a wheelchair to the treatment table, the patient to hold on to the lifter’s:

A. hands
B. arms
C. shoulders
D. neck

C. shoulders

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Arteriovenous Malformations are most likely treated with:

A. electron beam
B. brachytherapy
C. SBRT
D. SRS

D. SRS

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the main function of an immobilization device is to?

A. make the patient comfortable during treatment
B. create a reproducible setup that can be maintained throughout treatment
C. prevent the patient from falling
D. prevent the patient from talking throughout the treatment

B. create a reproducible setup that can be maintained throughout treatment

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Patients experiencing extreme difficulty swallowing from head and neck treatments may require a ________ to ensure they receive adequate nutrition

A. PEG tube
B. NG tube
C. PICC line
D. Catheter

A. PEG tube

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A liposarcoma tumor is what type of tissue?

A. fat
B. striated muscle
C. cartilage
D. smooth muscle

A. fat

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a brachytherapy applicator that is used to treat cervical cancer is:

A. intraluminal
B. Intracavitary
C. Interstitial
D. Intra-arterial

B. Intracavitary

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Which of the following bowel surgery preserves the anal sphincter?

A. anterior resection
B. abdominoperineal resection
C. pancreaticoduodenectomy
D. hysterectomy

A. anterior resection

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Why are diagnostic CTs not optimal for treatment planning?

A. flat couch top
B. small bore
C. slice thickness cannot be changed
D. spacing between slices cannot be changed

B. small bore

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Where is the most common location to measure a patient’s pulse?

A. apical artery
B. carotid artery
C. radial artery
D. femoral artery

C. radial artery

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The most common location for bone metastasis of prostate cancer is?

A. Ribs
B. Hip
C. Spine
D. Shoulder

C. Spine

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The cells ability to repair itself is represented in which region of the dose-response relationship graph?

A. D subscript o
B. D subscript q
C. n
D. TD 5/5

B. D subscript q

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ALARA stands for?

A. As Little As Reasonably Affordable
B. As Low As Reasonably Achievable
C. As Low As Realistically Attainable
D. As Little As Realistically Achievable

B. As Low As Reasonably Achievable

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A common chemotherapy combination used to treat breast cancer is

A. CHOP
B. CMF
C. MOPP
D. ABVD

B. CMF

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Which of the following is primarily used to treat small tumors within the cranium for one fraction using very high dose?

A. Intensity modulated radiation therapy
B. Total body irradiation
C. Stereotactic radiosurgery
D. Stereotactic body radiation therapy

C. Stereotactic radiosurgery

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If the dose given for a single treatment fraction is different than ________ of the prescription, it is considered a medical event

A. 20%
B. 30%
C. 40%
D. 50%

D. 50%

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CT simulation laser tolerance is?

A. +/- 1mm
B. +/- 2mm
C. +/- 1 cm
D. +/-2 cm

B. +/- 2mm

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The presence of Reed-Sternberg cell defines which type of cancer?

A. Hodgkin’s lymphoma
B. Non-Hodgkin’s lymphoma
C. Chronic Myelogenic Leukemia
D. Acute Myelogenic Leukemia

A. Hodgkin’s lymphoma

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Which of the following energies is the most penetrating?

A. Cobalt-60
B. 10 MeV
C. 6 MV
D. 10 MV

D. 10 MV

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The vagina is located _________ to the bladder and ___________ to the rectum

A. anterior, posterior
B. posterior, anterior
C. medial, lateral
D. superior, inferior

B. posterior, anterior

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What is the most common pathology for bladder cancer?

A. Squamous cell carcinoma
B. Transitional cell carcinoma
C. Adenocarcinoma
D. Clear cell carcinoma

B. Transitional cell carcinoma

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What part of the staging system describes the lymph node involvement?

A. T
B. N
C. M
D. G

B. N

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A microorganism that is the cause of an infectious disease is called:

A. pathogen
B. reservoir
C. droplet
D. antigen

A. pathogen

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All of the following are qualities of melanomas EXCEPT:

A. asymmetry
B. uneven borders
C. non-uniform coloring
D. diameters smaller than 6 mm

D. diameters smaller than 6 mm

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Cancer screening tests that can detect cancer in EARLY stages is:

A. sensitive
B. specific
C. detailed
D. precise

A. sensitive

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check correctness - check against Mosby too, you remember a similar question
123. To find the area of an irregularly shaped field use:

A. Clarkson Integration
B. Equivalent Square
C. Monte Carlo Computation
D. Mayneord “F” Factor

A. Clarkson Integration

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Immunosuppressed patients should follow what type of precaution?

A. reverse isolation precaution
B. contact precaution
C. droplet precaution
D. airborne precaution

A. reverse isolation precaution

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What would be used to decrease skin sparing?

A. wedges
B. compensators
C. bolus
D. IMRT

C. bolus

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Percocet is what type of medication?

A. antiemetic
B. analgesic
C. anti-inflammatory
D. antispasmodic

B. analgesic

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What is the most common pathology for esophageal tumors?

A. squamous cell carcinoma
B. adenocarcinoma
C. small cell carcinoma
D. clear cell carcinoma

B. adenocarcinoma

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The CT number for air is?

A. -1000
B. 0
C. 100
D. 1000

A. -1000

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Forward planning is when the:

A. planner chooses desired parameters and then the isodose curves are generated
B. planner chooses tolerance doses of all tissues in treatment area and then parameters are created
C. planner chooses isodose curves and parameters are created
D. planner choose parameters and isodose curves

A. planner chooses desired parameters and then the isodose curves are generated

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When a wedge is in the path of the radiation beam:

A. Beam hardening increases
B. Beam hardening decreases
C. PDD increases
D. PDD decreases

A. Beam hardening increases

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Which imaging study injects radioactive material into a patient before imaging?

A. Nuclear medicine
B. Radiography
C. Magnetic Resonance Imaging
D. Computed Tomography

A. Nuclear medicine

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When viewing a sagittal slice of the male pelvis, the prostate is located __________ to the rectum and ______________ to the bladder

A. anterior, posterior
B. posterior, anterior
C. superior, inferior
D. inferior, superior

A. anterior, posterior

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All of the following are localized treatments EXCEPT:

A. surgery
B. External beam radiation therapy
C. chemotherapy
D. brachytherapy

C. chemotherapy

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An example of a hormonal agent used to treat breast cancer is?

A. doxorubicin
B. methotrexate
C. cisplatin
D. tamoxifen

D. tamoxifen

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At least what dose is needed to the lens of the eyes to cause blindness?

A. 100 cGy
B. 500 cGy
C. 750 cGy
D. 1000 cGy

D. 1000 cGy

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At least what distance is needed between the compensator and patient’s skin surface to maintain skin sparing during photon therapy treatments?

A. 10 cm
B. 20 cm
C. 30 cm
D. 40 cm

B. 20 cm

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The small bowel can be moved out of the treatment field by using a special board and the patient is in which position?

A. supine
B. prone
C. right lateral decubitus
D. left lateral decubitus

B. prone

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A chemotherapy that can cause cardiac toxicity is?

A. Adriamycin
B. Bleomycin
C. Mitomycin
D. Actinomycin

A. Adriamycin

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The beam flattening filter is used for what type of treatments?

A. electron
B. proton
C. photon
D. orthovoltage

C. photon

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Cryptorchidism increases the risk for what type of cancer?

A. Testicular
B. Ovarian
C. Prostate
D. Penis

A. Testicular

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list the following in order from smallest volume to largest volume
PTV
GTV
CTV

A. GTV, PTV, CTV
B. CTV, GTV, PTV
C. GTV, CTV, PTV
D. PTV, GTV, CTV

C. GTV, CTV, PTV

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check correctness
151. All of the following are common locations for metastatic bone disease EXCEPT:

A. distal femur
B. vertebrae
C. pelvic bone
D. ribs

A. distal femur

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Chest tubes should be kept at what level

A. above the patient’s chest
B. same level as patient’s chest
C. below patient’s chest
D. 18-24” above chest

C. below patient’s chest

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The type of brachytherapy implant used for endometrial cancers is?

A. intracavitary implants
B. interstitial implants
C. intervascular implants
D. interluminal implants

A. intracavitary implants

on a dose-response graph, the portion of the curve that represents 37% of cell survival is:

A. D subscript o
B. D subscript q
C. n
D. TD 5/5

A. D subscript o

Which type of leukemia has stem cells that contain the Philadelphia chromosome?

A. ALL
B. AML
C. CLL
D. CML

D. CML

check correctness
158. Viewing images after the patient has been treated is considered?

A. Registration
B. Reconstruction
C. Online review
D. Offline review

D. Offline review

the most common pathology for tumors within the endometrium is?

A. squamous cell carcinoma
B. adenocarcinoma
C. clear cell carcinoma
D. sarcoma

B. adenocarcinoma

A patient who has mouth sores due to his/her treatment should eat foods that are all of the following EXCEPT:

A. soft
B. bland
C. spicy
D. room temperature

C. spicy

The DRR is created from?

A. CT
B. MRI
C. X-ray
D. Port film

A. CT

two posterior spine fields are required to treat a patient. They are treated with 6 MV and to get a depth of 5 cm - one field measures 6 cm x 15 cm at 110 SSD.
Another field measures 6 cm x 20 cm at 110 SSD.

What is the required gap needed for this treatment?

A. .1 cm
B. .3 cm
C. .8 cm
D. 1.2 cm

C. .8 cm

Which of the following is considered a minor reaction to contrast media?

A. hypertension
B. tachycardia
C. vascular shock
D. hives

D. hives

What is the method of MLC movement when the MLCs only move when the beam is turned off?

A. dynamic
B. step n shoot
C. sliding window
D. classic

B. step n shoot

Where does mesothelioma occur?

A. centrally located within the lungs
B. periphery of the lungs
C. lining of the lungs
D. in the mediastinum

C. lining of the lungs

When a brachytherapy source is placed directly into a tube within the body this is?

A. intracavitary implants
B. interstitial implants
C. intervascular implants
D. interluminal implants

D. interluminal implants

A patient receiving a dose of 3000 cGy to the upper-abdominal region would need which of the following medications to relieve a common side effect?

A. antiemetic
B. analgesic
C. anti-inflammatory
D. anti-diarrheal

A. antiemetic

an antiemetic prevents vomiting

an “analgesic” relieves what?

pain

A patient is to be treated with 6 MV and a depth of 6 cm. The linear accelerator is calibrated to 100 SAD. The patient has a separation of 26 cm. At midplane, the field is 12 x 12 cm. The field size on the patient’s skin is?

A. 9.1 x 9.1 cm
B. 10.4 x 10.4 cm
C. 11.3 x 11.3 cm
D. 13.8 x 13.8 cm

B. 10.4 x 10.4 cm

All of the following are true about non-small cell lung cancer EXCEPT?

A. connected to tobacco use
B. more common in women
C. tumors are not centrally located
D. better prognosis compared to small cell lung cancer

A. connected to tobacco use

a chemotherapy that can be used as a radiosensitizer is?

A. cisplatin
B. dexamethasone
C. doxorubicin
D. vincristine

C. doxorubicin

the depth where the total dose is delivered is known as?

A. PDD
B. TMR
C. Dmax
D. PSF

C. Dmax

What is the name of the largest salivary gland?

A. submandibular gland
B. sublingual gland
C. submantle gland
D. parotid gland

D. parotid gland

a patient’s prescribed total dose is 5400 cGy. The patient is prescribed to receive 180 cGy per fraction for 30 fractions at 100 SSD. What is the total dose the patient would receive if they were accidentally treated at 90 SSD?

A. 4374 cGy
B. 4860 cGy
C. 6000 cGy
D. 6666 cGy

D. 6666 cGy

a patient who is undergoing breast cancer treatments is complaining of a skin reaction after receiving 14 treatments at 180 cGy per fraction. Which option is most likely to be her reaction?

A. faint erythema
B. erythema
C. dry desquamation
D. Moist desquamation

B. erythema

What is the ratio of absorbed dose at a depth compared to the absorbed dose at dmax known as?

A. Percent Depth Dose
B. Dmax
C. Dose equilibrium
D. Tissue-air-ratio

A. Percent Depth Dose

What is the main location of lymphatic drainage for the right breast?

A. left axillary nodes
B. right axillary nodes
C. left supraclavicular nodes
D. right supraclavicular nodes

B. right axillary nodes

If you want to adjust the contrast of the CT image, you will be adjusting the:

A. window width
B. window level
C. field of view
D. scan field of view

A. window width

a patient is going to be treated on a linear accelerator using an energy of 6 MV to a depth of 5 cm. The SSD is 91 cm. The TAR is .875 and the output is 1.02 cGy/mu. The patient will receive 180 cGy per treatment. How many monitor units must be delivered?

A. 158. MU
B. 176 MU
C. 202 MU
D. 206 MU

C. 202 MU

chemotherapy administration into the spinal cord is known as:

A. intraperitoneal
B. intrathecal
C. intravenous
D. intraarterial

B. intrathecal

What is the most common type of breast cancer?

A. infiltrating lobular carcinoma
B. infiltrating ductal carcinoma
C. lobular carcinoma in situ
D. ductal carcinoma in situ

B. infiltrating ductal carcinoma

a thermoplastic mold that is flexible when in hot water and then can mold around the patient’s body is also called:

A. alpha cradle
B. vac-lok
C. aquaplast
D. cerrobend

C. aquaplast

what area of the head and neck region is typically treated with a field size of 6x6 cm due to the lack of nodal involvement?

A. Pharynx
B. Larynx
C. Oral cavity
D. Parotid glands

B. Larynx

practice exam 2:
1. the obturator node is most likely associated with a tumor in which organ?

A. breast
B. head and neck
C. prostate
D. pancreas

C. prostate

practice exam 2:
3. all of the following have a direct relationship with PDD, except?

A. energy
B. depth
C. field size
D. SSD

B. depth

practice exam 2:
4. a patient who has a skin reaction to radiation therapy should follow all of the following except:

A. use lotions only as prescribed
B. ventilate the area
C. wash the area with hot water and soap
D. avoid direct sunlight to the area

C. wash the area with hot water and soap

practice exam 2:
5. what is another name for small cell lung cancer?

A. oat cell
B. adenocarcinoma
C. transitional cell
D. mesothelioma

A. oat cell

practice exam 2:
7. what is the dmax for a 15 MV beam?

A. 1.5 cm
B. 2.5 cm
C. 3.0 cm
D. 3.2 cm

C. 3.0 cm

practice exam 2:
10. Gleason grading is used to grade tumors of which organ?

A. bladder
B. rectum
C. prostate
D. vagina

C. prostate

practice exam 2:
11. if a patient has two different types of treatments at the same time, this is termed?

A. adjuvant
B. sequential
C. substantial
D. concurrent

D. concurrent

practice exam 2:
13. the CT number for bone is?

A. -1000
B. 0
C. 100
D. 1000

D. 1000

practice exam 2:
14. which blood examination tests the kidney and liver function?

A. TBI
B. CBC
C. BUN
D. creatine

C. BUN

practice exam 2:
16. what part of the staging system describes metastatic disease

A. T
B. N
C. M
D. G

C. M

practice exam 2:
18. safety check tolerance limits are:

A. 1 degree
B. 2 mm
C. 2%
D. functional

D. functional

practice exam 2:
20. which gynecological cancer is the most deadly?

A. endometrial
B. ovarian
C. cervical
D. vaginal

B. ovarian

practice exam 2:
21. a chemotherapy that can cause pulmonary toxicity is?

A. adriamycin
B. bleomycin
C. mitomycin
D. actinomycin

B. bleomycin

practice exam 2:
23. if a patient has a superficial skin lesion on his/her forehead, the treatment technique most likely used is:

A. IMRT
B. conformal radiation therapy
C. SRS
D. electron therapy

D. electron therapy

practice exam 2:
24. the term used to describe how many people have a specific disease is:

A. epidemiology
B. etiology
C. specificity
D. sensitivity

A. epidemiology

practice exam 2:
25. the most common location for breast cancer to arise is the:

A. upper outer quadrant
B. upper inner quadrant
C. lower outer quadrant
D. lower inner quadrant

A. upper outer quadrant

practice exam 2:
29. at approximately what vertebral level is the pancreas located?

A. T10-T11
B. T11-T12
C. T12-L1
D. L1-L2

D. L1-L2

practice exam 2:
31. after aspiration, what percentage of bone marrow cells must be plasma cells to be diagnosed as multiple myeloma?

A. 5%
B. 10%
C. 15%
D. 20%

B. 10%

practice exam 2:
33. a common chemotherapy treatment used to treat non-Hodgkin’s lymphoma is:

A. CHOP
B. CMF
C. MOPP
D. ABVD

A. CHOP

practice exam 2:
34. which magnet arrangement would create a more confined radiation beam?

A. 0 degrees
B. 90 degrees
C. 180 degrees
D. 270 degrees

D. 270 degrees

practice exam 2:
35. a treatment plan for an AP/PA T-spine requires field weighting. The fields will be weighted 2:1 respectively. If the total dose is 300 cGy, what dose will the PA field receive?

A. 100 cGy
B. 150 cGy
C. 200 cGy
D. 300 cGy

A. 100 cGy

practice exam 2:
37. The part of the skin that produces pigment is:

A. melanocyte
B. dermis
C. epidermis
D. stratum basale

A. melanocyte

practice exam 2:
39. Where is “Point A” located?

A. 2 cm superior to the cervical os and 2 cm lateral to the endocervical canal
B. 2 cm superior to the cervical os and 5 cm lateral to the endocervical canal
C. 2 cm superior to the uterus and 2 cm lateral to the vaginal canal
D. 2 cm superior to the uterus and 5 cm lateral to the vaginal canal

A. 2 cm superior to the cervical os and 2 cm lateral to the endocervical canal

practice exam 2:
40. All of the following are types of biopsies EXCEPT:

A. fine needle
B. past point
C. core needle
D. incisional

B. past point

practice exam 2:
41. which imaging study uses high frequency sound waves and images soft tissue in the body?

A. nuclear medicine
B. ultrasound
C. magnetic resonance imaging
D. computed tomography

B. ultrasound

practice exam 2:
42. What is the most common type of primary brain tumor in adults?

A. astrocytoma
B. medulloblastoma
C. glioblastoma multiforme
D. ependymoma

C. glioblastoma multiforme

practice exam 2:
44. a patient is receiving arc therapy for 34 treatments. The total dose is 54 Gy, with a daily dose of 180 cGy. The arc will deliver 200 MU. The gantry is moving from 330 to 179 in a clockwise rotation. Calculate the arc speed -

A. .76 MU//degree
B. .96 MU/degree
C. 1.05 MU/degree
D. 1.32 MU/degree

B. .96 MU/degree

practice exam 2:
46. which of the following would be included on a radiation therapy treatment prescription?

A. bolus
B. monitor units
C. treatment position
D. immobilization device

A. bolus

practice exam 2:
47. how many lobes are within the right lung?

A. 1
B. 2
C. 3
D. 4

C. 3

practice exam 2:
48. the most common clinical presentation for endometrial cancer is?

A. palpable mass
B. pelvic pain
C. post-menopausal bleeding
D. abdominal pain

C. post-menopausal bleeding

practice exam 2:
50. the type of chemotherapy drug that has a chemical structure similar to that of mustard gas is?

A. antimetabolite
B. alkylating agent
C. antitumor antibiotic
D. nitrosoureas

B. alkylating agent

practice exam 2:
51. What is the wedge angle needed when there is a hinge angle of 150 degrees?

A. 15 degrees
B. 30 degrees
C. 45 degrees
D. 60 degrees

A. 15 degrees

practice exam 2:
53. which type of leukemia is most common in pediatrics?

A. ALL
B. AML
C. CLL
D. CML

A. ALL

practice exam 2:
55. Which of the following statements is true?

A. bigger field sizes cause more scatter
B. bigger field sizes cause less scatter
C. field sizes have no effect on scatter

A. bigger field sizes cause more scatter

practice exam 2:
56. If the total dose delivered for the patient’s entire treatment is different than ______ of the prescription, it is considered a medical event?

A. 20%
B. 30%
C. 40%
D. 50%

A. 20%

practice exam 2:
57. if the treatment planner chooses the tolerance doses for the organs at risk, as well as tumor volume and then that treatment computer creates a plan, this is most likely?

A. forward planning
B. inverse planning
C. 2D planning
D. 3D planning

B. inverse planning

practice exam 2:
59. a patient’s treatment plan consists of 4 fields. One field is going to receive 45 cGy. The wedge factor is .72, the output factor is .90 cGy/MU and the TMR is .765. How many monitor units will be needed for this field?

A. 50 MU
B. 65 MU
C. 91 MU
D. 363 MU

C. 91 MU

practice exam 2:
62. What is the dmax for a 10 MV beam?

A. 1.5 cm
B. 2.5 cm
C. 3.0 cm
D. 3.2 cm

B. 2.5 cm

practice exam 2:
63. Which of the following is not a daily check for the linear accelerator?

A. door interlock
B. beam on light
C. emergency switches
D. audio-visual monitor system

C. emergency switches

practice exam 2:
64. which lymph node of the head and neck region is difficult to reach during surgery?

A. delphian node
B. jugulodigastric node
C. node of rouviere
D. superior deep jugular node

C. node of rouviere

practice exam 2:
65. what is used during total body irradiation treatments to increase the skin dose without altering the beam’s penetration?

A. compensator
B. wedge
C. block
D. beam spoiler

D. beam spoiler

practice exam 2:
67. what staging system is used for lymphoma?

A. dukes
B. clarks
C. ann arbor
D. figo

C. ann arbor

practice exam 2:
68. which of the following would be prescribed if the patient needs an anti-inflammatory medication?

A. torecan
B. lomotil
C. hydrocortisone
D. compazine

C. hydrocortisone

practice exam 2:
69. lymph nodes located on either side of the sternum and could be included in a trt for breast cancer is?

A. supraclavicular nodes
B. internal mammary nodes
C. axillary nodes
D. mediastinal nodes

B. internal mammary nodes

practice exam 2:
71. what type of lung cancer is associated with the use of smoking tobacco and is located in the periphery of the lungs?

A. small cell lung cancer
B. non-small cell lung cancer
C. oat cell lung cancer
D. mesothelioma

B. non-small cell lung cancer

practice exam 2:
73. which imaging technique can visualize the MLCs and treatment field?

A. CBCT
B. MVCT
C. KV-pair
D. MV portal imaging

D. MV portal imaging

practice exam 2:
74. What test screens for breast cancer?

A. mammography
B. pap smear
C. colonoscopy
D. PSA

A. mammography

practice exam 2:
75. the treatment plan and the linear accelerator communicate through

A. R&V system
B. PACS
C. DICOM
D. HIPAA

A. R&V system

record and verify system

practice exam 2:
77. a total dose of 30 Gy is prescribed over 10 fractions. This treatment would most likely be:

A. curative
B. keloid
C. heterotrophic bone
D. palliative

D. palliative

practice exam 2:
79. In order to bring the beam’s dmax closer to the skin surface and reduce skin sparing, what must be added to the treatment plan for photon therapy?

A. wedge
B. compensator
C. bolus
D. blocks

C. bolus

practice exam 2:
81. when creating a treatment plan for IMRT, the type of planning used is most likely:

A. forward planning
B. inverse planning
C. 2D planning
D. 3D planning

B. inverse planning

practice exam 2:
83. the palatine tonsils are located in the:

A. nasopharynx
B. oropharynx
C. hypopharynx
D. larynx

B. oropharynx

practice exam 2:
85. what is the method of MLC movement when the MLCs move while the beam is being delivered?

A. dynamic
B. step and shoot
C. static
D. classic

A. dynamic

practice exam 2:
89. what is the tolerance dose to 3/3 of the brain according to Emami et al.?

A. 2300 cGy
B. 3000 cGy
C. 4500 cGy
D. 5000 cGy

C. 4500 cGy

practice exam 2:
90. The most common location for vaginal tumors to arise the?

A. anterior wall
B. posterior wall
C. inferior medial wall
D. superior lateral wall

B. posterior wall

practice exam 2:
91. a block that is used to shield the periphery of the treatment field and leave the central portion open is called:

A. hand block
B. cast block
C. negative block
D. positive block

C. negative block

practice exam 2:
92. when using unsealed ionization chambers to measure radiation, what correction factors are needed?

A. dose and depth
B. energy and size
C. temperature and energy
D. temperature and pressure

D. temperature and pressure

practice exam 2:
93. esophageal cancers in the upper portion are most likely:

A. squamous cell carcinoma
B. adenocarcinoma
C. small cell carcinoma
D. clear cell carcinoma

A. squamous cell carcinoma

practice exam 2:
95. where is the most common location for osteosarcoma?

A. proximal femur
B. distal femur
C. ribs
D. distal tibia

B. distal femur

practice exam 2:
97. the Gleason grading system takes scores from how many different locations of the organ?

A. 1
B. 2
C. 4
D. 6

B. 2

practice exam 2:
98. what is the equivalent square for rectangular field measuring 7.5 cm x 14 cm?

A. 4.8 cm x 4.8 cm
B. 6.2 cm x 6.2 cm
C. 9.8 cm x 9.8 cm
D. 10.4 cm x 10.4 cm

C. 9.8 cm x 9.8 cm

practice exam 2:
102. a patient has a tumor in the central nervous system. This patient experiences symptoms like pain, problems with bowel control and bladder control. In which area of the CNS would this tumor most likely be?

A. frontal lobe
B. parietal lobe
C. occipital lobe
D. spinal cord

D. spinal cord

practice exam 2:
104. when using an isocentric technique, as the gantry rotates to different angles around the patient’s body, what will change?

A. source to axis distance
B. source to surface distance
C. patient position
D. patient support assembly

B. source to surface distance

practice exam 2:
105. 1 Gray is equal to how many rad?

A. 1 rad
B. 10 rad
C. 100 rad
D. 1000 rad

C. 100 rad

practice exam 2:
106. All of the following are characteristics of collimating jaws in modern day linear accelerators EXCEPT:

A. moveable
B. asymmetric
C. tungsten
D. cerrobend

D. cerrobend

practice exam 2:
108. a spinal field at 110 SSD uses 320 MU for a treatment. What would the new MU be if the doctor changes the SSD to 100?

A. 264 MU
B. 290 MU
C. 352 MU
D. 387 MU

A. 264 MU

practice exam 2:
109. Which of the following is a radioprotector?

A. doxorubicin
B. amifostine
C. cyclophosamide
D. 5-FU

B. amifostine

practice exam 2:
112. what part of the body divides stages 1 and 2 from the stages 3 and 4 of Hodgkin’s lymphoma?

A. carina
B. umbilicus
C. diaphragm
D. aorta

C. diaphragm

practice exam 2:
113. the amount of time it takes a radioactive source to reach half of its original value is known as:

A. half-life
B. activity
C. intensity
D. average life

A. half-life

practice exam 2:
114. what part of the staging system describes the tumor size?

A. T
B. N
C. M
D. G

A. T

practice exam 2:
115. which of the following imaging studies does NOT use radiation?

A. nuclear medicine
B. radiography
C. magnetic resonance imaging
D. computed tomography

C. magnetic resonance imaging

practice exam 2:
116. in which plane are CT slices originally obtained?

A. axial
B. coronal
C. sagittal
D. lateral

A. axial

what is the most common pathology for tumors within the anus?

A. adenocarcinoma
B. transitional cell carcinoma
C. Squamous cell carcinoma
D. Merkel cell

C. Squamous cell carcinoma

practice exam 2:
119. a common combination of chemotherapy drugs used to treat breast cancer is:

A. CMF
B. ABVD
C. MOPP
D. PLV

A. CMF

practice exam 2:
121. when a brachytherapy source is placed directly into the tumor this is?

A. intracavitary implants
B. interstitial implants
C. intervascular implants
D. interluminal implants

B. interstitial implants

practice exam 2:
122. which of the following is a radiosensitzer?

A. doxorubicin
B. ethyol
C. sulfhydryls
D. amifostine

A. doxorubicin

practice exam 2:
123. 4D treatment planning incorporates _________ in addition to regular treatment planning.

A. involuntary motion
B. respiratory motion
C. multiple treatment sites
D. larger treatment margins

B. respiratory motion

practice exam 2:
124. which test screens for prostate cancer?

A. prostate specific antigen
B. prostate sensitive antigen
C. prostate significant an
D. prostate specific antitoxin

A. prostate specific antigen

practice exam 2:
125. which of the following will have the most skin sparing?

A. therapeutic electron beam
B. diagnostic xrays
C. orthovoltage
D. megavoltage xrays

D. megavoltage xrays

practice exam 2:
127. a leiomyosarcoma tumors is what type of tissue?

A. fat
B. striated muscle
C. cartilage
D. smooth muscle

D. smooth muscle

practice exam 2:
129. connective tissue in the breast that provides support is called:

A. cooper’s ligaments
B. tail of spence
C. latissimus dorsi
D. pectoralis minor

A. cooper’s ligaments

practice exam 2:
131. the maximum collimator setting on a linear accelerator is 40x40 cm at 100 SAD. What extended distance is needed for a TBI treatment in order to cover a field of 100x100 cm?

A. 200 cm
B. 250 cm
C. 300 cm
D. 350 cm

B. 250 cm

practice exam 2:
132. all of the following are contraindications for using contrast media EXCEPT:

A. patients under 50
B. patients over 50
C. patients with impaired kidney function
D. patients who have had reactions to contrast media in the past

A. patients under 50

practice exam 2:
133. what is the most effective radiosensitizer?

A. nitrogen
B. oxygen
C. hydrogen
D. helium

B. oxygen

practice exam 2:
134. what is the term that describes the AVERAGE level of shades of gray present on a CT image?

A. window level
B. window median
C. window width
D. window height

A. window level

practice exam 2:
135. if a wedge is added to a field, what needs to change about the MU?

A. the MU will decrease
B. the MU will increase
C. the MU will remain the same

B. the MU will increase

practice exam 2:
139. what is the dmax for a 12 MeV beam?

A. 1.5 cm
B. 2.2 cm
C. 2.8 cm
D. 3.0 cm

C. 2.8 cm

practice exam 2:
141. which type of leukemia has Auer Rods within the leukemic cells?

A. ALL
B. AML
C. CLL
D. CML

B. AML

practice exam 2:
142. a cyclotron is used for what type of treatment?

A. external beam radiation therapy
B. proton therapy
C. electron therapy
D. orthovoltage therapy

B. proton therapy

practice exam 2:
143. a name for a value that represents a specific shade of gray on the CT image is:

A. window width
B. window level
C. CT number
D. CT density

C. CT number

practice exam 2:
145. a chemotherapy that can be used as a radioprotector is?

A. amifostine
B. etoposide
C. tamoxifen
D. leuprolide

A. amifostine

practice exam 2:
146. when radioactive seeds are placed within a prostate, this is considered which type of brachytherapy?

A. intraluminal
B intracavitary
C. interstitial
D. intra-arterial

C. interstitial

practice exam 2:
147. DRRS can be created from the CT scans after a process called:

A. registration
B. reconstruction
C. transmission
D. transformation

B. reconstruction

practice exam 2:
149. where does most of the scatter that contributes to the “scatter factor” occur?

A. gantry head
B. patent
C. wedges
D. bolus

A. gantry head

practice exam 2:
150. what is the most common way to measure the radiation output in a linear accelerator?

A. Ion chambers
B. Gieger-muller detector
C. Thermoluminescent dosimeter
D. Diodes

A. Ion chambers

practice exam 2:
152. tumors that can grow and spread quickly ad are not encapsulated are most likely?

A. superficial
B. deep
C. benign
D. malignant

D. malignant

practice exam 2:
158. a benign condition of uncontrolled growth of connective tissue is:

A. heterotopic bone
B. keloid
C. arteriovenous malformation
D. sarcoma

B. keloid

practice exam 2:
159. which of the following combinations make up Lipowitz metal (cerrobend):

A. tin, lead, cadmium, bismuth
B. iron, bismuth, aluminum, lead
C. bismuth, aluminum, lead, cadmium
D. lead, iron, cadmium, tin

A. tin, lead, cadmium, bismuth

practice exam 2:
160. at what vertebral level does the spinal cord end?

A. T6-T7
B. T11-T12
C. L1-L2
D. L5-S1

C. L1-L2

practice exam 2:
161. the best scenario for a therapeutic ratio is:

A. the lethal tumor dose is higher than normal tissue tolerance
B. the lethal tumor dose is equal to normal tissue tolerance
C. the lethal tumor dose is less than normal tissue tolerance

C. the lethal tumor dose is less than normal tissue tolerance

practice exam 2:
162. if you want to adjust the brightness of your CT image, you will be adjusting the:

A. window width
B. window level
C. field of view
D. scan of view

B. window level

practice exam 2:
163. what is the minimum amount of hours that must pass between BID treatments?

A. 1
B. 2
C. 4
D. 6

D. 6

practice exam 2:
164. All of the following are located within the oral cavity except:

A. buccal mucosa
B. alveolar ridge
C. retromolar trigone
D. adenoids

D. adenoids

practice exam 2:
169. what is the type of condition that is associated with Hodgkin’s lymphoma?

A. Plummer-Vinson syndrome
B. Familial adenomatous polyposis
C. Ebstein Barr virus
D. Human papillomavirus

C. Ebstein Barr virus

practice exam 2:
170. the part of the body that has the most bone marrow is:

A. shoulder girdle
B. pelvis
C. femur
D. ribs

B. pelvis

practice exam 2:
171. images within the therapy department are shared and stored through:

A. DICOM
B. PACS
C. DRR
D. EMR

B. PACS

practice exam 2:
173. the wall that absorbs the useful beam is known as:

A. primary barrier
B. secondary barrier
C. useful barrier
D. scatter barrier

A. primary barrier

practice exam 2:
174. transmission through MLC leaves should be less than ___

A. .1%
B. .2%
C. 1%
D. 2%

D. 2%

***practice exam 2:
175. Cancer screening tests that can determine a certain type of cancer is:

A. sensitive
B. specific
C. detailed
D. precise

B. specific

practice exam 2:
176. what is the most common pathology for tumors within the anus?

A. adenocarcinoma
B. transitional cell carcinoma
C. squamous cell carcinoma
D. epidermoid carcinoma

C. squamous cell carcinoma

practice exam 2:
177. which of the following sets the standards for handling toxic materials such as Cerrobend?

A. HIPAA
B. OSHA
C. DICOM
D. HL7

B. OSHA

practice exam 2:
178. when treating a superficial lesion with electron therapy on the lip, what can be used to prevent dose to the gingiva?

A. block
B. transmission filter
C. internal shield
D. bolus

C. internal shield

practice exam 2:
180. what is the tolerance limit for the optical distance indicator?

A. +/- 1 mm
B. +/- 2 mm
C. +/- 1 cm
D. +/- 2 cm

B. +/- 2 mm

practice exam 2:
182. when comparing MV port films prior to the treatment, they are compared with?

A. CT slices
B. MRI slices
C. DRRs
D. Xrays

C. DRRs

practice exam 2:
183. what is the SI unit to describe the amount of radiation a person absorbs?

A. sievert
B. gray
C. rem
D. rad

A. sievert

practice exam 2:
184. when a brachytherapy source is placed directly into a vessel that is?

A. intracavitary implants
B. interstitial implants
C. intervascular implants
D. interluminal implants

C. intervascular implants

practice exam 2:
186. what is the largest gland in the body?

A. liver
B. stomach
C. adrenal
D. pancreas

A. liver

practice exam 2:
187. if the lower third of the esophagus receives a dose of 6500 cGy, what would most likely be the effect?

A. perforation
B. ulceration
C. obstruction
D. fistula

A. perforation

practice exam 2:
188. viewing images before the patient has been treated and making adjustments if necessary is considered:

A. CT simulation
B. Reconstruction
C. Online review
D. Offline review

C. Online review

practice exam 2:
190. all of the following are presentations of inflammatory breast cancer EXCEPT:

A. peau d’ orange
B. breast hardening
C. erythema
D. palpable mass

D. palpable mass

practice exam 2:
192. what type of device can help reduce hot spots in a treatment plan with multiple fields or compensate for irregular contours?

A. bolus
B. wedge
C. hand blocks
D. cast blocks

B. wedge

practice exam 2:
194. when determining the monitor units needed to treat fields at extended distances, what is needed for calculation?

A. Clarkson Integration
B. Equivalent Square
C. Monte Carlo Computation
D. Mayneord F Factor

D. Mayneord F Factor

practice exam 2:
195. after a dose of 300 cGy to the testes, sterility is most likely

A. permanent
B. temporary
C. no effect
D. acute

B. temporary

practice exam 2:
196. where is the most common location within the oropharynx for cancers to occur?

A. adenoids
B. tonsils
C. vocal chords
D. pyriform sinus

B. tonsils

***practice exam 2:
197. cancer screening tests that can determine a certain type of cancer is:

A. sensitive
B. specific
C. detailed
D. precise

B. specific

practice exam 2:
198. all of the following could be found on the treatment prescription except:

A. total dose
B. fractionated dose
C. monitor units
D. bolus

C. monitor units

practice exam 2:
199. during the CT simulation, the mA needs to be increased to create a change in the image quality, this will lead to:

A. an increased patient dose
B. a decreased patient dose
C. the same patient dose
D. no patient dose

A. an increased patient dose

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NAPPI PRACTICE EXAMS 1 & 2 - PROCEDURES RELATED Flashcards

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