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FINALS > P&P > Flashcards

P&P Flashcards

1
Q

TRUE OR FALSE

1 Gy=100J/kg

A

FALSE–1 Gy=1J/kg

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2
Q

describe scatter and talk about how it effects dose

A

scatter ends up being a majority of dose a patient receives. it occurs when the primary beam is interfered with and causes secondary beams/scatter. it is caused by blocks/wedges/electrons already in patient’s body.

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3
Q

________ occurs at the point at which the energy of the electrons coming to rest equals the energy of electrons set into motion by new photon interactions.

A

Dmax

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4
Q

the ratio of the absorbed dose at a given depth in phantom to the absorbed dose at the same point in free space

A

TAR (tissue air ratio)

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5
Q

the ratio of absorbed dose at a given depth to the absorbed dose at a fixed reference depth

A

backscatter factor

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6
Q

the ratio of absorbed dose at any given depth in a phantom to the dose at the same point at a reference depth in phantom

A

TPR (tissue phantom ratio)

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7
Q

TAR at the level of Dmax

A

PDD (% depth dose)

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8
Q

the ratio of scattered dose at a given point in a medium to the dose in air at the same point

A

SAR (scatter air ratio)

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9
Q

describe what it means if you have a wedge transmission factor of 94%

A

94% of the beam is transmitted & 6% of the beam is attenuated

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10
Q

TRUE OR FALSE
having a tray in the path of the radiation beam means that you will have to increase the number of MUs in your calculation

A

TRUE

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11
Q

what does it mean when you have a wedge angle of 30 degrees

A

the angle between the isodose line and a line perpendicular to it is 30 degrees

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12
Q

calculate the equivalent square of 12.7 x 8.3 field size

A

4A/P = 4 (105.41) / 42 = 421.64 / 42 = 10.04 x 10.04 field size

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13
Q

what four factors are PDD dependent upon? describe how each of them effect PDD

A

energy ^ PDD ^
field size ^ PDD ^
SSD ^ PDD ^
depth ^ PDD v

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14
Q

beam energy=200kV

Dmax=?

A

0.0

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15
Q

beam energy=1.25MV

Dmax=?

A

0.5

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16
Q

beam energy=4MV

Dmax=?

A

1.0

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17
Q

beam energy=6MV

Dmax=?

A

1.5

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18
Q

beam energy=10MV

Dmax=?

A

2.5

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19
Q

beam energy=18MV

Dmax=?

A

3.5

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20
Q

beam energy=20MV

Dmax=?

A

4.0

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21
Q

what field arrangements is PARALLEL OPPOSED FIELDS used to treat? angles?

A

whole abdomen

AP/PA, LAO/RPO, left lat/right lat

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22
Q

what field arrangements is FOUR FIELD BOX used to treat? angles?

A

pelvis

AP/PA, left lat/right lat, RAO/LPO/LAO/RPO

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23
Q

what field arrangements is THREE FIELD used to treat? angles?

A

colon, rectum, pancreas

RPO/LPO/AP

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24
Q

what two things must occur for clinically useful electrons to be produced in the head of the linear accelerator?

A

the target and flattening filter must be removed from the path of the beam AND the electron gun current must be lowered

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25
Q

describe the characteristic shape of electron isodose lines

A

balloon out laterally

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26
Q

TRUE OR FALSE
placing a high Z number material between the tissue and the shield helps to minimize the backscatter dose when treating with electrons

A

FALSE–a low Z number material minimizes back scatter

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27
Q

when might it be important to gap an electron field

A

when you have abutting fields. to avoid an over/underdose/hot spots

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28
Q

what is the significance of the build-up region

A

this area is at risk for being underdosed

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29
Q

calculate the following for a 12 MeV electron beam:

80% isodose line

A

12 / 3 = 4 cm

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30
Q

calculate the following for a 12 MeV electron beam:

90% isodose line

A

12 / 4 = 3 cm

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31
Q

calculate the following for a 12 MeV electron beam:

range

A

12 / 2 = 6 cm range

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32
Q

the rate at which an electron beam loses energy is approximately

A

2 MeV/cm

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33
Q

in what part of the lung are primary squamous cell carcinomas usually found?

A

centrally

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34
Q

identify the number one cause of lung cancer

A

tobacco

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35
Q

which of the following mediastinal lymph nodes are classified as superior mediastinal nodes?

A

upper paratracheal and pretracheal

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36
Q

symptoms associated with regional disease include

A

dysphagia and cyanosis/dyspnea and superior vena cava syndrome

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37
Q

this form of lung cancer occurs most often in women

A

adenocarcinoma

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38
Q

the most significant variables that affect lung cancer prognosis are:

A

stage of the disease, clinical performance status, and weight loss

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39
Q

which form of lung cancer is staged as limited or extensive?

A

small cell lung cancer

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40
Q

in order for a true pancoast tumor to be diagnosed as person must be clinically present with certain symptoms, identify 2 of these symptoms

A

pain around the shoulder and down the arm, atrophy in hand muscles, horner’s syndrome, bone erosion in the ribs and sometimes the vertebral column

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41
Q

list 5 common sites for lung cancer to metastasize to

A

liver, brain, bone, other lung, spleen

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42
Q

TRUE OR FALSE

only 35% of lung cancer patients are surgical candidates.

A

FALSE–20% of lung cancer patients are surgical candidates

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43
Q

the primary lymph nodes that drain the lungs are:

A

mediastinal nodes, superior mediastinal nodes, inferior mediastinal nodes

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44
Q

name the disorder associated with lung cancer characterized by a clubbing of the distal phalanges of the fingers

A

Hypertrophic pulmonary osteoarthropathy

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45
Q

what is the standard of care for patients with local disease or those who are not surgical candidates?

A

radiation therapy and chemo

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46
Q

doses of ______ can provide symptomatic relief for brain mets from lung cancer

A

3000 to 4000 cGy in 10 to 15 fractions

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47
Q

if the tumor is located in the upper lobe, what lymph nodes need to be included in the treatment field?

A

superclav lymph nodes

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48
Q

TRUE OR FALSE

boost fields are usually delivered to the GTV and involved lymph nodes

A

FALSE–boost delivered to GTV excludes involved lymph nodes

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49
Q

what are the three most important organs to consider when treating the lung?

A

spinal cord, heart, other lung

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50
Q

an acute side effect of lung irradiation is

A

esophagitis

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51
Q

what is the most effective single agent chemotherapeutic drug used to treat lung cancer

A

cisplatin

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52
Q

identify 5 epidemiological factors of lung cancer

A

2nd most common cancer in men & women
occurs in older people
black men 40% more likely than white men
risk of development for men is 1:13, women is 1:16
accounts for 14% of all new cancer diagnosis

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53
Q

identify 5 etiological factors of lung cancer

A

significant tobacco exposure
occupational exposure
fumes from coal, tar, nickel, chromium, and arsenic
radioactive materials that give off alpha emissions
radon exposure
uranium exposure

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54
Q

what is a typical total dose when treating superior vena cava syndrome?

A

4500 to 5000 cGy

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55
Q

TRUE OR FALSE

the bifurcation of the trachea is located at the level of T4-T5

A

TRUE

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56
Q

which of the following symptoms appear in 2/3 of ALL patients

A

anemia and thrombocytopenia

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57
Q

80% to 85% if ALL is characterized by

A

B cell markers

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58
Q

identify the two sanctuary sites for ALL

A

CNS and testes

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59
Q

name the two staging systems used to stage CLL

A

Rai & Binet

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60
Q

briefly describe the cells that leukemia develops from

A

begins with pluripotent stem cells (myeloid & lymphoid). during differentiation and maturation, hematopoietic or lymphopoietic progenitors is uncontrolled and greatly accelerated, resulting in incomplete or defective cellular maturation.

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61
Q

TRUE OR FALSE

10% to 20% of people diagnosed with AML exhibit some form of chromosomal abnormalities

A

FALSE–30 to 50% diagnosed with AML have chromosomal abnormalities

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62
Q

what genetic disorder increases a persons chance of developing ALL to 10 to 30 fold?

A

down syndrome

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63
Q

what are we trying to achieve when performing a total body irradiation

A

preparation for bone marrow transplant. kills overproductive cells

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64
Q

what procedure must be performed in order to give a definitive diagnosis of leukemia

A

bone marrow biopsy

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65
Q

AML/ALL/CML/CLL:
a person with a 1st degree relative with this type of leukemia has a 2 to 7 fold increased chance of developing the same leukemia

A

CLL

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66
Q

AML/ALL/CML/CLL:

95% of cases of this leukemia express the philadelphia chromosome

A

CML

67
Q

AML/ALL/CML/CLL:

approximately 80% of adults with acute leukemia have this subtype

A

AML

68
Q

AML/ALL/CML/CLL:

TBI is not used as a treatment for this type of leukemia

A

CLL

69
Q

AML/ALL/CML/CLL:

an allogenic bone marrow transplant is the only cure for this form of leukemia

A

CML

70
Q

AML/ALL/CML/CLL:

this form of leukemia impairs erythropoiesis

A

CML

71
Q

AML/ALL/CML/CLL:

this form of leukemia is the most common pediatric malignancy

A

ALL

72
Q

AML/ALL/CML/CLL:

symptoms of this form of leukemia include: night sweats, weight loss, enlarged spleen, and lymphadenopathy

A

CLL

73
Q

AML/ALL/CML/CLL:

this form of leukemia can be treated with chemotherapeutic agents such as gleevec, interferon and hydroxyurea

A

CML

74
Q

AML/ALL/CML/CLL:

this type of leukemia is identified by the circulation of auer rods in the cytoplasm of the leukocyte

A

AML

75
Q

AML/ALL/CML/CLL:

this leukemia is a disease of the older population with the average age of 70 at the time of diagnosis

A

CLL

76
Q

AML/ALL/CML/CLL:
if more than 30% blast cells are present in a bone marrow biopsy sample, a positive diagnosis of this form of leukemia is made.

A

AML

77
Q

AML/ALL/CML/CLL:

the t cell variety of this leukemia tends to be more aggressive

A

CLL

78
Q

the most common testicular tumor pathology is

A

seminoma

79
Q

70% of prostate carcinomas develop in which zone

A

peripheral

80
Q

TRUE OR FALSE

95% of prostate tumors are squamous cell in origin

A

FALSE–95% of prostate tumors are adenocarcinomas

81
Q

an elevation of what protein would signal a diagnosis of nonseminoma

A

alpha-fetoprotein (AFP)

82
Q

what isotopes are commonly used for prostate seed implants

A

palladium 103 and iodine 126

83
Q

where is the most common site of metastatic spread from renal cell carcinoma?

A

lung

84
Q

TRUE OR FALSE
patients who suffer from long term catheterization and renal calculi are at greater risk for developing adenocarcinoma of the bladder

A

FALSE–patients who suffer from long term catheterization and renal calculi are at greater risk for developing squamous cell carcinoma of the bladder

85
Q

what is considered a normal PSA level

A

< 4 ng/mL

86
Q

what two organs does nonseminoma tend to metastasize to?

A

lung, liver

87
Q

a man with a PSA > 20 is a predictor that would indicate the patient should undergo what form of treatment

A

hormonal therapy

88
Q

what is the most significant cause of bladder cancer

A

cigarette smoking

89
Q

which lymph nodes are the most common site of spread for penile cancer

A

inguinal lymph nodes

90
Q

what genetic disease has renal cell carcinoma been linked to

A

von hippel lindau

91
Q

TRUE OR FALSE

prognosis for carcinoma of the urethra varies depending based on the location of the primary lesion

A

TRUE

92
Q

TRUE OR FALSE

cisplatin based chemotherapy is the mainstay of treatment for nonseminoma

A

TRUE

93
Q

identify two important prognostic factors of renal pelvic and urethral cancer

A

stage and grade

94
Q

what are the three subtypes of seminoma

A

classic, anaplastic, spermatocytic

95
Q

list three ways a person with penile cancer might present clinically

A

presence of phimosis may obscure the primary lesion, secondary infection and foul smell, inguinal lymph nodes are palpable in 30 to 45% of patients.

96
Q

bladder cancer primarily spreads via _______

A

direct extention

97
Q

why would including or excluding the seminal vesicles in a treatment field need to be taken into account when planning a prostate treatment?

A

increases dose to rectum

98
Q

how might a person with T1 or T2 renal cell carcinoma be treated

A

radical nephrectomy

99
Q

identify 4 epidemiologic factors of renal cell carcinoma

A

represents 2% of all new cancers and cancer deaths annually
average age at time of diagnosis is 55 to 60 years
men are more likely to develop the disease than women at a rate 2:1
environmental, occupational, hormonal and genetic factors have been linked

100
Q

how are gleason scores determined

A

2 most prominent types of cells in sample are rated and added together. lower scores have better prognosis.

101
Q

which form of GYN malignancy is the most common

A

endometrial

102
Q

which form of GYN malignancy has the highest rates of death due to the disease

A

ovarian

103
Q

what staging system is used for all GYN malignancies

A

FIGO (international federacy of gynocology and obstetrics)

104
Q

where is the most common location for vulvar carcinoma to develop

A

labia majora

105
Q

TRUE OR FALSE

adenocarcinoma accounts for 80% to 90% of all vaginal carcinomas

A

FALSE–squamous cell carcinoma accounts for 80% to 90% of all vaginal carcinomas

106
Q

identify three presenting signs and symptoms of cervical cancer

A

abnormal bleeding, discomfort during intercourse, nonspecific GI symptoms

107
Q

which of the following are risk factors for endometrial carcinoma

A

late menopause and obesity

108
Q

average age of OVARIAN

A

between 50 and 70

109
Q

average age of ENDOMETRIAL

A

median age is 61

110
Q

average age of CERVICAL

A

younger than 50

111
Q

average age of CLEAR CELL VAGINAL

A

19

112
Q

average age of VULVAR

A

7th and 8th decade

113
Q

75% of women with endometrial carcinoma clinically present with which of the following symptoms?

A

post-menopausal bleeding

114
Q

80% of women with this form of carcinoma will have abdominal cavity involvement at the time of diagnosis

A

ovarian

115
Q

where does vaginal carcinoma most commonly arise

A

posterior upper third

116
Q

lymphatic spread from cervical carcinoma is known to be orderly. place lymph node involvement in the correct order.

A

parametrial, pelvic, common iliac, periaortic.

117
Q

serum CA125 levels may be elevated in what form of carcinoma

A

ovarian

118
Q

TRUE OR FALSE

90% of ovarian carcinomas are clear cell

A

FALSE–90% of ovarian carcinomas are epithelial cell

119
Q

when treating vaginal cancer with a vaginal cylinder, what isotope is typically used

A

cesium 137

120
Q

the most common site for a woman to develop skin cancer is

A

legs

121
Q

afterloading techniques were developed primarily to reduce the

A

exposure to personnel

122
Q

this form of treatment has been the mainstay in the treatment of cervical brachytherapy: cancer for over 50 years

A

intracavitary

123
Q

brachytherapy: places radioactive material within blood vessels

A

intravascular

124
Q

brachytherapy: rigid needles or flexible tubes are placed directly into the tumor

A

interstitial

125
Q

brachytherapy: can be used to treat the esophagus, trachea, rectum, bronchi

A

intraluminal

126
Q

TRUE OR FALSE

activity is directly proportional to the decay constant, as decay increases, activity increases

A

FALSE–decay increases, activity decreases

127
Q

describe the differences between LDR and HDR. identify 2 advantages of one over the other

A

LDR has a long history of use and success. HDR can be as effective, higher dose in shorter amount of time, less expensive.

128
Q

average energy for RADIUM 226

A

.830 MeV

129
Q

average energy for CESIUM 137

A

.662 MeV

130
Q

average energy for COBALT 60

A

1.253 MeV

131
Q

average energy for IODINE 125

A

.028 MeV

132
Q

average energy for GOLD 198

A

.412 MeV

133
Q

average energy for IRIDIUM 192

A

.380 MeV

134
Q

point B, an anatomical point used for cervical and uterine treatment, is located

A

1 cm lateral to the medial aspect of the pelvic side wall

135
Q

define brachytherapy

A

radiation therapy that involves placing a radioactive material directly into or immediately adjacent to the tumor

136
Q

identify 3 significant factors to the prognosis of skin cancer

A

thickness, ulceration, age, location, depth, gender

137
Q

identify 5 characteristics of basal cell carcinoma

A

slow growing, arise as smooth red or milky lumps and have pearly border and multiple telangiectases, can be shiny or pale, arise from stem cells of stratum basale, most prevalent form of skin cancer, 80% on head and neck.

138
Q

TRUE OR FALSE

50% of malignant melanoma develops from a preexisiting nevus

A

FALSE–70% malignant melanoma develops from a preexisting nevus

139
Q

identify 5 characteristics of squamous cell carcinoma

A

faster frowing than basal cell type, scaly crusty slightly elevated lesion, 80% of UV induced SCC occur on head neck and arms, higher rate of mets, arise from mature keratinocytes of upper layers of epidermis, most common on sun exposed areas such as face head neck arms and hands.

140
Q

this isotope is monoenergetic and can be used to treat the prostate

A

gold 198

141
Q

the technique in which the tumor is removed and analyzed one layer at a time is

A

moh’s surgery

142
Q

when using a tandem and ovoid in a gyn implant, the typical resultant dose distribution shape is

A

pear

143
Q

SCC has been associated with

A

prolonged arsenic exposure, HPV infection, sun exposure

144
Q

isotope’s half life: RADIUM 226

A

1622 years

145
Q

isotope’s half life: RADON 222

A

3.82 years

146
Q

isotope’s half life: CESIUM 137

A

30 years

147
Q

isotope’s half life: COBOLT 60

A

5.27 years

148
Q

isotope’s half life: IODINE 125

A

59.4 days

149
Q

isotope’s half life: GOLD 198

A

2.7 days

150
Q

isotope’s half life: IRIDIUM 192

A

73.83 days

151
Q

the physical length of a radioactive source is 3 cm. if you were to open the source, you would see that there is .21 cm of space at each end between where the actual source lies and the end of the casing. what is the active length of the source

A

2.58 cm

152
Q

describe the four main categories of people who are more prone to developing skin cancer

A

geographic location-closer to equator at greater risk
skin type-fair skin more likely
prior skin cancer-increases odds
gender-men more likely for melanoma. women 3x more likely for nonmelanoma.

153
Q

a typical border for a radiation therapy field when treating skin lesions is

A

1 to 2 cm

154
Q

the average lifetime for the decay of radioactive atoms is the definition of

A

mean life

155
Q

the disease that is most commonly treated by total skin irradiation is

A

mycosis fungoides

156
Q

point A, an anatomical point used for cervical and uterine treatment is located

A

2 cm superior and 2 cm lateral to the center of the cervical canal

157
Q

TRUE OR FALSE

a person that lives farther from the equator has an increased risk of developing skin cancer

A

FALSE–closer to the equator, increased risk

158
Q

the most common subtype of malignant melanoma is known as

A

superficial spreading melanoma

159
Q

identify 5 characteristics of malignant melanoma

A

most lethal form of skin cancer.
originates in melanocytes of stratum basale.
most common sites for men are trunk and the face, for women its legs.
can also arise in places such as the choroid or ciliary body of the eye, eyelids, mucosa of oral cavity, genitalia, and anus.

160
Q

what is the role of radiation therapy in SCC, BCC, and malignant melanoma?

A

Nonmelanoma: treats lesions on lips ears scalp nose eyelids and face because good cosmetic results.
malignant melanoma: treats metastases and large facial lentigo maligna melanomas.

161
Q

clark method for classifying melanoma is based on

A

level of invasion from the epidermis into the dermis

162
Q

TRUE OR FALSE

squamous cell carcinoma accounts for more than half of all radiation induced skin cancers

A

TRUE

163
Q

calculate the mean life of cesium 137

A

30.0 years

164
Q

list two advantages of brachytherapy over external beam

A

allows a very high dose or radiation to be delivered locally to the tumor in a relatively short time while very low doses are administered to surrounding tissues.

FINALS (4 decks)

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