Nicholes Board Exam Review - Mixed Bag 2 Flashcards
Which of the following has the greatest photoelectric effect?
- blood
- tissue
- bone
Bone
List the following 3 parts of the gantry head in order:
- flattening filter
- target
- primary collimator
- target
- primary collimator
- flattening filter
What is the most common primary bone tumor?
osteosarcoma
What produces microwaves?
magnetron
Where in the male body do we find the biggest incidence of seminomas?
undescended testicle
What is the most common type of skin cancer?
basal cell carcinoma
If you discover a therapist operating with a fake license, what organization should you report it to?
ARRT
What is the level of the kidneys?
T11 - L2
List a primary benefit of having a small focal spot?
small penumbra
Is TMR dependent on SAD?
No
If you have a patient with a compensating filter and the doctor moves the CAX 3cm, what would you need and why?
You would need a new compensating filter because each one is customized to the patient and the treatment.
When you’re using a superficial machine, why do you put a lead bolus in the patient’s nose?
to stop back scatter
If a patient refuses treatment, what do you do and why?
the pt has the right to refuse
Why is it important to keep the bladder bag low?
to prevent backflow, which can cause an infection
Why should you keep the IV bag high?
to maintain the IV flow and prevent infection
When using IV contrast, what do you need on hand in case the patient is allergic to the contrast?
Epinephrine which is a anti histamine
What is the most severe side effect of iodine contrast?
anaphylactic shock
What is the most common sign of urinary infection?
dysuria (trouble urinating)
What is the most common histology of testicular cancer?
seminoma
Ascites is a common sign of what type of cancer?
ascites - the accumulation of in the peritoneal cavity, causing abdominal swelling)
ovaries
Which of the following is most likely to cause SVC syndrome ( obstruction of blood flow through the SVC)?
A. HodgkinsDisease
B. LungCancer
C. Aneurysm
lung cancer
A 3-D treatment plan (conformal) would be billed as:
A. simple treatment (single field)
B. intermediate treatment
C. complex treatment (more than one field)
complex treatment
What is the primary purpose of divergent blocks?
decrease penumbra
Which of the following is more likely to seed to the cerebral spinal fluid?
- Ependymoma
- Medulloblastoma
- Astrocytoma
- Medulloblastoma
How many half-lives must a radioactive source go through before you can discard it?
10
If SSD increases, PDD ____
Increase
What is the most important thing to watch for during emesis?
aspiration of vomit
What is the most common leukemia in the western hemisphere?
CLL
_____ provides information about the extent and characteristic of a patient’s cancer
staging
_____ is based on degree of differentiation
grading
Medulloblastoma is most common in what patient population?
children
What is used to calculate changes in PDD?
Maynord Factor
The _____ lies behind the larynx and is divided into what 3 sub-sites?
hypopharynx
- pyriform sinus
- post hypopharyngeal wall
- postcricoid region
“To free from infection by physical or chemical means” is the definition of …
disinfect
How does basal cell carcinoma spread?
extensive local invasion and destruction
What is “Symptom A” of Hodgkins disease?
no symptoms
What are the “B Symptoms” of Hodgkins disease?
- unexplained fever of 38 C (100.4F) or higher
- drenching night sweats
- unexplained weight loss of 10% or more in 6 months
The measurement of dose in air, exposure in air (only), less than 3Mv all refer to …
roentgen
If you are treating a patient and notice half-way through the treatment that the wrong wedge is in, what do you do?
continue with the treatment and correct the dose for the next treatment
List 3 types of materials that a bite block can be made from
- Cork
- Aquaplast pellets
- Dental wax
Define myelogenous
Produced or originating in the bone marrow
Treating a bladder patient with an AP and 2 PA obliques allows us to avoid treating … (what?)
the rectum
What is the dose of cataract formation?
1000 cGy
Which is not a likely side effect from radiation for a primary brain lesion?
Epilation
Erythema
Memory loss
Headache
Headache
If a patient who has prostate cancer with mets to his hip complains of a tingling sensation in his arm, what is this caused by?
Mets to lung
Cranial involvement of a nerve
Spinal cord compression
Lhermitte’s sign
Lhermitte’s sign (mostly described as an electric shock-like condition that occurs when the neck is moved in a wrong way or flexed. It can also travel down to the spine, arms and legs, and sometimes the trunk)
What is the most histology of bladder cancer?
transitional cell
Which has the lowest melting temperature?
Aluminum
Bismuth
Lead
Tin
Tin 231.9 ( degrees celcius)
Aluminum 660.3
Bismuth 271.3
Lead 327.5
dose in tissue / dose in air
TAR
dose in Gy from 250 kev from another radiation source to produce the same biologic response
RBE
Rate at which energy is deposited as a charged particle travels through matter by a particular type of radiation
LET
Why is the most common 3-D treatment for esophageal cancer AP/PA + a boost with 2 posterior obliques?
spare the spinal cord
BSF is dependent on ____ and ____, but independent of ____
energy
field size
SSD
Define hypoxia and anoxia
hypoxia: Oxygen deficiency
anoxia: Total lack of oxygen
What are four limitations for visitors of brachytherapy patients?
No one under 18
No one who’s pregnant
Distance from bed must be 6ft
No visit longer than 20min per day per visitor
How do you talk to a ten year old about treatment procedures?
Give simple explanations, demonstrate how equipment works, allow him/her to manipulate equipment, be open & honest, and explain procedures in language they can understand.
List 2 types of XRT treatment that will affect the hemopoietic system the most. Explain why.
Mantle and inverted Y
Ovarian cancer XRT
The treatment fields include a large amount of red marrow
Tissue that encircles the nasopharynx and oropharynx, including the palatine, lingual and pharyngeal tonsils is referred to as …
Waldeyer’s ring
What is thrombocytopenia?
An abnormal decrease in the amount of platelets
List 5 places where adult red bone marrow is found
- ribs
- ends of long bones
- vertebrae
- sternum
- skull
The light and radiation field must be within ____ mm or ___%
+/- 2mm or 1% on a side
What is the largest lymphatic organ?
spleen
Where is the circumvallate papillae located?
base of the tongue
Who said that ionizing radiation is more effective against cells that are actively dividing, undifferentiated, and have a long dividing future?
Bergonie and Tribondeau
critical site is damaged by reaction produced via ionization elsewhere in the cell, which in turn damages the target
indirect action
What is a split level test and what does it check for?
A split level test is a multiple beam alignment test used to check for misalignment of parallel opposed beams.
List the 3 reasons why your split level test can show misalignment of parallel opposed beams
1) focal spot displacement
2) asymmetry of collimator jaws
3) displacement in the collimator rotation axis or the gantry rotation axis
A weekly calculated administered teletherapy dose that is more than the weekly prescribed dose by 15%, or a brachytherapy dose that is 10% different from the prescribed dose is referred to as …
a recordable event
Each of the following is referred to as … (what?)
a) Radiation to the wrong patient
b) Pharmaceutical dosage that is 20% different than the prescribed dose.
c) Delivered dose that differs by 10% when there is only a total of 3 or fewer fractions
d) Delivered teletherapy dose that is 30% higher than the prescribed dose
misadministration
What would you do following a misadministration?
Notify the NRC (nuclear regulatory commission), patient, & doctor by phone w/in 24 hrs & submit a written report w/in 15 days
List the 4 types of leukemia
a. ) AML - Acute myeloid leukemia
b. ) CML- Chronic myelogenous leukemia
c. ) ALL- Acute lymphoblastic (aka. lymphocytic) leukemia
d. ) CLL- Chronic lymphocytic leukemia
Weakness, fatigue, anemia, bruising, and neutropenia are symptoms of what type of leukemia?
AML
Fatigue, fever, night sweats, weight loss, and usually an enlarged spleen are symptoms of what type of leukemia?
CML
Non specific viral symptoms, low grade fever, malaise, anorexia, lethargy (a lack of energy and enthusiasm), and abdominal discomfort are symptoms of what type of leukemia?
ALL
Fatigue, malaise (a general feeling of discomfort), weight loss, excessive sweating, and enlarged lymph nodes are symptoms of what type of leukemia?
CLL
The Philadelphia chromosome is the hallmark (a mark indicating) of what type of leukemia?
CML
What are the A and B symptoms of Hodgkin’s disease?
A: “A” stands for asymptomatic
B:
- unexplained fever of 38C (100.4F), -
- drenching night sweats,
- unexplained weight loss of 10% or more in 6 months.
What is Mayneord’s factor used for?
To calculate changes in percent depth dose
Children with Von Recklinghausen’s disease, Von Hipple-Lindau disease, Cowden’s disease, or Turcot’s syndrome are at increased risk for ____ (what?)
medulloblastoma
Medulloblastoma is a malignancy found in children ages ____ to ____
0 to 4
Where are most breast cancers found?
upper outer quadrant
The most commonly treated nodes in prostate cancer are the periprostatic &
obturator nodes. However, what other nodes may be treated in prostate cancer? (list 5 nodal areas)
internal iliac, external iliac, common iliac, presciatic & presacral nodes
Which of the following reflects the proper disposal of radioactive sources? (more than 1 answer may be correct)
a. ) Return to manufacturer
b. ) Place in lead capsule in trash
c. ) Send to biohazard disposal service
d. ) Decay in storage, then place in trash
c.) Send to biohazard disposal service
Abdominal pain, anorexia, weight loss, and jaundice are symptoms of what kind of cancer?
pancreatic
define Lhermitte’s sign
A flexing of the neck producing electric shock-like sensations that extend down the spine and shoot into the limbs
In addition to bladder cancer, hematuria may be a sign of what type of cancer?
prostate cancer
Pain in the lower back, pelvis, or upper thighs may be a symptom of what type of cancer?
prostate cancer
The following fields describe what type of 3-D treatment?
- Lateral neck fields
- AP neck field for S/C & lower cervical nodes
nasopharynx
What is the nodal drainage for the nasopharynx?
(3 node groups)
- Retropharyngeal nodes (node of Rouviere is the uppermost node in this group),
- deep cervical nodes,
- jugulodigastric nodes
What 5 critical structures are in the treatment of maxillary sinus?
- Contralateral optic nerve
- Optic Chiasm
- Lacrimal apparatus
- Spinal cord
- Retina
What are the routes of spread for testicular cancer?
Para-aortic nodes & Pelvic (iliac) nodes
In later stages, testicular cancer can go from the para-aortic to the mediastinal and then left supraclavicular nodes by way of the thoracic duct.
In XRT, action is needed for platelet counts of ____ or less and WBC counts of ____ or less
platelet: 50,000 or less
WBC: 2000 or less
What does small cell lung cancer follow a different treatment regimen?
because of its rapid spread
As a source decays, how are energy and half-life related?
A source decays to ½ of its energy per half-life.
For instance, Cesium 137 has a half-life of 30 years and a photon energy of .66. This means that in 30 years, Cesium 137 will have an energy of .33
What medication is given to prevent edema in a patient having radiation to the brain?
Decadron (a steroid)
If the doctor adds 2 cms to the superior border, where would the CAX move to and why?
The CAX would stay the same because the doctor is opening the field, not ordering a shift.
What is the most sensitive stage to chemo in the cell cycle?
S phase
While the S phase of the cell cycle is the most sensitive stage to chemo, every phase is sensitive to chemo except the _____ stage.
G(0) resting stage
If you are treating a patient w/ glioblastoma multiform and the patient starts to experience nausea, vomiting, and blurred vision, what is the most likely cause?
edema (swelling)
You are at the console and the table is rising for no reason and will not stop. You hit the emergency stop button and the table still keeps moving. What do you do?
hit the circuit breaker
the complete removal of all microorganisms
sterile
If you are treating w/ arcs and the MU’s are being delivered but the gantry is not moving, what is the cause?
programmed incorrectly
What is the difference between invasive carcinoma and in situ carcinoma?
Invasive – invades normal surrounding tissues and structures or lymphatics
In situ – stays confined to the area and does not invade normal surrounding tissues and structures or lymphatics
What is the number of normal breaths per minute for an adult?
12 - 20 breaths
What is the normal oral temperature for an adult?
98.6 F or 37 C
What is the normal rectal temperature for an adult?
99.6 F or 37.6 C
What is the normal axillary temperature for an adult?
97.6 F or 36.4 C
What is the normal pulse rate for an adult?
60 - 90 beats per min
What is the normal pulse rate for a child?
70 - 110 beats per min
What is the normal pulse rate for an infant?
100 - 180 beats per min
