Practice Exam 3 Flashcards
The radiation therapist should wear an N95 mask when treating patients with which type of precaution?
A
Airborne
B
Droplet
C
Contact
D
Reverse
A
Airborne
Healthcare workers should wear the proper size of N95 mask or higher-level respirator for patients with airborne precautions (ex: measles, varicella, tuberculosis).
The main purpose of a beam spoiler in a photon beam is to:
A
Increase the build-up region
B
Reduce the PDD at 5 cm depth
C
Filter out low energy photons
D
Increase TMR past dmax
A
Increase the build-up region
A beam spoiler is used in larger fields like Total Body Irradiation (TBI) and eliminates skin sparing.
A photon strikes an object and scattered radiation occurs. This is due to:
A
Compton effects
B
Photoelectric effects
C
Characteristic effects
D
Bremsstrahlung effects
A
Compton effects
Compton effects, also known as Compton scattering is a photon interaction that causes scatter. The photon interacts with an outer shell atomic electron and gives up partial energy before it changes direction.
After drawing blood from a patient with a disease, the nurse accidentally sticks herself with the needle when trying to recap it. Later she finds she has contracted the patient’s disease. This transmission is called:
A
Airborne
B
Vector-borne
C
Vehicle-borne
D
Droplet
C
Vehicle-borne
Vehicles include fomites, which are inanimate objects such as medical equipment which can allow for indirect transmission of infectious agents.
Palladium 103 seeds are most commonly used for:
A
Intrauterine HDR
B
Intrauterine LDR
C
Prostate HDR
D
Prostate LDR
Palladium (Pd-103) is commonly used for permanent implants for prostate cancer treatments and has a half-life of 17 days.
Cancer cachexia is:
A
Receiving fluids through an IV
B
Loss of appetite
C
Dilated blood vessels
D
Malnutrition and physical waist
D
Malnutrition and physical waist
- Cachexia = malnutrition and wasting due to an illness. Symptoms include early satiety, electrolyte imbalance and water imbalance disease as well as loss of fat and muscle.
The radioactive source has an activity of 800 mCi and a half life of 6 hours. What will the new activity be in 12 hours.
A
1600 mCi
B
800 mCi
C
400 mCi
D
200 mCi
D
200 mCi
A =A_o 〖(0.5)〗^(t⁄t_(1/2) )=800〖(0.5)〗^(12⁄6)=200 mCi
Frequency is defined as:
A
The wave height
B
The distance the wave travels
C
The number of wave cycles per second
D
The speed of the photon
C
The number of wave cycles per second
Frequency = the number of waves that pass through a point in a certain amount of time. Measured in Hertz (Hz) = 1 cycle per second.
Which diagnostic imaging procedures do NOT utilize radiation?
1. Ultrasound
2. Nuclear medicine
3. Radiography
4. Computed Tomography
5. Magnetic Resonance Imaging
A
1 only
B
2 only
C
5 only
D
1 & 2
E
1 & 4
F
1 & 5
F
1 & 5
Ultrasound and MRI do not use radiation to create images, but nuclear medicine, radiography and computed tomography do. Ultrasound uses high-frequency sound waves and MRI use radiofrequency waves and a magnetic field.
What is the equivalent square of an 8 x 18 cm field?
A
10.20 cm
B
10.93 cm
C
11.07 cm
D
11.68 cm
C
11.07 cm
Equivalent square can be found by the equation 2ab/(a+b)= 2x8x18/(8+18) = 11.07 x 11.07 cm
A patient cannot breathe and becomes unconscious. After he was brought to the ER and tests were run, it was determined he had a tumor blocking his airway and radiation would be the best treatment. Which type of consent would be adequate for this situation?
A
Written consent
B
Verbal consent
C
Simple consent
D
Implied consent
D
Implied consent
Implied consent = it is implied the patient would give consent if they were able to because there is no obvious reason for the patient to refuse treatment.
The akimbo position means:
A
The patient’s arms are placed by their sides
B
The patient’s arms are crossed and lie above their chest
C
The patient’s arms are raised above their head
D
The patient’s arms are bowed outwards with their hands on their hips
D
The patient’s arms are bowed outwards with their hands on their hips
“Used for TBI”
Shoulder straps may be used for position a patient being treated for head and neck cancer to:
A
Provide patient comfort
B
To pull the shoulders caudal to the treatment field
C
To push the shoulders cranial into the treatment volume
D
Allow the patient to hold arms akimbo
B
To pull the shoulders caudal to the treatment field
Shoulder straps and arm pulls assist in lower the patient’s shoulder in the caudal direction (toward feet) to move further away from the treatment
When the treatment plan for disease or disorder that has been chosen as the best one for a patient after all other choices have been considered
A
Curative therapy
B
Palliative therapy
C
Definitive therapy
D
Preventative therapy
C
Definitive therapy
Stochastic effects are also called:
A
Probabilistic effect
B
Persistent effect
C
Deterministic effect
D
Latent effect
A
Probabilistic effect
Stochastic radiation responses are also known as probabilistic effect. They are common for low-dose exposure and late responses. Effects have a probability of occurring depending on the radiation dose.
The prescription for a patient’s radiation therapy treatment includes all of the following EXCEPT:
A
Treatment site
B
Dose
C
Monitor units
D
Fractionation schedule
C
Monitor units
Monitor units are not found in the treatment prescription, but are found on the treatment plan.
If the planned SSD is 100 cm, but the patient was accidentally treated at 99 cm, this would be an example of underdose.
A
True
B
False
B
False
If the patient was treated at 99 cm instead of 100 cm, they were treated closer to the source which would be an overdose.
An example of a tissue compensator is:
A
Bolus
B
Wedge
C
Cerrobend
D
Dynamic MLCs
E
All of the above
E
All of the above
Compensators are meant to create a homogeneous isodose distribution within the patient. Dynamic MLCs (IMRT), wedges, bolus, and cerrobend compensators can provide homogenous dose distributions.
The fecal occult blood test screens for which type of cancer?
A
Cervical
B
Breast
C
Prostate
D
Colorectal
D
Colorectal
Colorectal cancer has multiple screening tests: colonoscopy, sigmoidoscopy, and stool tests (fecal occult blood tests and stool DNA tests).
Which type of test is a Pap smear considered?
A
Blood
B
Cytology
C
Genetic
D
Excisional biopsy
B
Cytology
Cervical cancer screening is the Pap test (Papanicolaou smear). This is a cytology test that looks for cell changes.
The pancreas is located at the level of:
A
T4
B
T8
C
L1
D
L5
C
L1
Which of the following provides information on doses received by organs within the irradiated area?
A
DVH
B
EKG
C
OAR
D
MSDS
A
DVH
Dose-volume histograms (DVH) show the doses that normal tissue and tumor will receive during the treatment.
A medical event is when the total dose delivered to a patient is at least _____ different from prescribed dose.
A
10%
B
20%
C
40%
D
50%
B
20%
The staging system used for cancers in the bowel:
A
Dukes
B
Ann Arbor
C
FIGO
D
FAB
A
Dukes
Dukes staging is used for colorectal tumors.
The ________ is responsible for creating reports for medical events.
A
Radiationt Therapist
B
Chief Radiation Therapist
C
Radiation Oncologist
D
Radiation Safety Officer
D
Radiation Safety Officer
The radiation safety officer (RSO) creates and sends reports during medical events.
A treatment with POP fields that does NOT use MLCs or blocks should be charged as:
A
Simple Simulation
B
Simple Treatment
C
Intermediate Treatment
D
Complex Treatment
E
Complex simulation
B
Simple Treatment
Simple treatments are a single treatment area with only one or two treatment fields and fewer than two simple blocks.
Which of the following beam energies would give the highest skin dose?
A
250 KV
B
1.25 MV
C
511 KV
D
6 MV
A
250 KV
Lower beam energies have shallower dmax and more skin dose. 250 kV is the lowest beam energy listed
The upper part of the stomach is called:
A
Lesser curvature
B
Greater curvature
C
Pyloric
D
Fundus
D
Fundus The fundus is a dome-shaped section at the top of the stomach.
Pyloric: relating to or affecting the region where the stomach opens into the duodenum (small intestine)
Lesser curvature (curvatura ventriculi minor), extending between the cardiac and pyloric orifices, forms the right or posterior border of the stomach.
Greater curvature – forms the long, convex, lateral border of the stomach. Arising at the cardiac notch, it arches backwards and passes inferiorly to the left. It curves to the right as it continues medially to reach the pyloric antrum.
Cancers in which of the following organs can spread through skip metastasis
A
Nasopharynx
B
Esophagus
C
Larynx
D
Lung
B
Esophagus
Esophageal tumors can have skip lesions. There can be up to 8 cm of healthy tissue between the tumor and a metastasis
Which photon beam energy provides the LEAST skin sparing effect?
A
4 MV
B
6 MV
C
25 MV
D
150 KV
D
150 KV
As energy is increased, skin sparing is also increased for photon beams. The lowest beam energy listed is 150 kV, which would provide the least skin sparing
Which of the following is NOT a B symptom?
A
Fever
B
Night sweats
C
Weight loss
D
Leukopenia
D
Leukopenia
B symptoms include fever, night sweats, and 10 percent weight loss within six months.
What should be included when obtaining informed consent?
A
Treatment site
B
Treatment side effects
C
Treatment intent
D
Consequences of not having treatment
E
All of the above
E
All of the above
The consent form includes the patient’s name, date of birth, person or organization performing procedure, statements about side effects, statements about tattoos, statements about photographs for documentation purposes and information about risks of pregnancy if applicable. Consent explains the procedure, the risks and benefits of the procedure, as well as risks to not having the procedure, and it provides alternatives to this procedure. Treatment site and intent should also be clearly stated.
Which of the following effects describes cancer?
1. Stohastic
2. Non-stochastic
3. Deterministic
4. Threshold
5. Non-Threshold
A
3 & 4
B
3 & 5
C
2 & 4
D
2 & 5
E
1 & 4
F
1 & 5
1 & 5
Cancer is an example of a stochastic effect. There is no threshold and any dose can cause cancer.
Cervical cancers are most commonly detected by:
A
Pap smear
B
PSA
C
Fecal Occult Blood Test
D
Mammogram
A
Pap smear
Which of the following is chosen by the planner during inverse planning:
1. Beam energy
2. Field size
3. Beam direction
4. Tissue tolerance
5. Total dose
A
1 & 2
B
1, 2, 3
C
1, 2, 5
D
2 & 5
E
4 & 5
- For inverse planning, the planner chooses the energy, appropriate dose to the tumor, and the tolerances of the normal healthy tissues. The computer then creates a plan with beam MLC patterns, shapes, directions, etc.
BMT is an optimal treatment choice for all of the following EXCEPT:
A
ALL
B
AML
C
CLL
D
CML
C
CLL
Bone marrow transplant (BMT) is the main treatment for ALL, AML, and CML.
What is the Monitor Unit setting for a wedged field with the following parameters:
The prescription is 90 cGy at isocenter
TMR is 0.76
Output is 1.02 cGy/MU
Wedge Transmission factor is 0.82
A
115 MU
B
129 MU
C
137 MU
D
140 MU
E
142 MU
E
142 MU
MU = 90/(0.76 x 1.02 x 0.82)=141.6=142 MU
When are cells most radioresistant?
A
G2 phase
B
S phase
C
M phase
D
Anaphase
B
S phase
A patient’s skin dose will increase for a MV photon beam by all of the following EXCEPT:
A
Increasing field size
B
Adding a lucite blocking tray
C
Using bolus
D
Increasing beam energy
Increasing beam energy will increase skin sparing. Increasing field size, increases scatter and skin dose. Bolus & lucite trays add to skin dose as well.
Which of the following radiation measurements takes into account the quality factor?
A
Rad
B
Sievert
C
Exposure
D
Gray
B
Sievert
Sievert and rem factor in different types of radiation (quality factors). Sievert (Sv) = absorbed dose x quality factor (QF)
Which diagnostic scan shows the tumor’s activity?
A
X-ray
B
Ultrasound
C
MRI
D
PET
D
PET
PET scans show tumor activity because they have a higher metabolic rate that normal cells. These scans can detect cancer and reveal if cancer has spread.
Convert 100 rads into Gy
A
1
B
10
C
100
D
1000
A
1
100 rad = 1 Gray
A patient with MRSA should be on which precaution?
A
Standard
B
Contact
C
Droplet
D
Airborne
B
Contact
MRSA uses contact precautions &. healthcare workers should wear gloves and a gown over clothing and clean hands when leaving rooms of patients with MRSA
Tumors within the vagina are MOST likely to spread to which lymph nodes?
A
Paraaortic
B
Inguinal
C
Porta hepatic
D
Delphian
B
Inguinal
The gap needed to match two adjacent spinal fields, both measuring 26cm in length, at a depth of 5.5cm using 6MV photons, and an SSD of 100cm is:
A
1.4
B
2.1
C
2.8
D
3.5
A
1.4
Gap calculations: Gap= (L_1/2 x d/〖SSD〗_1 ) + (L_2/2 x d/〖SSD〗_2 )= (26/2 x 5.5/100) + (26/2 x 5.5/100)=1.4 cm
The most common bone tumor that often occurs in extremities is:
A
Rhabdomyosarcoma
B
Chondrosarcoma
C
Osteosarcoma
D
Ewing’s sarcoma
C
Osteosarcoma
Tumors in the epithelium are classified as:
A
Sarcoma
B
Carcinoma
C
Lymphoma
D
Blastoma
B
Carcinomas are malignant tumors that occur in epithelial tissues
A common treatment of thyroid cancer:
A
I-131
B
Ir-192
C
Co-60
D
C-137
A
I-131
???
Peau d’orange, skin thickening and warmth are all clinical presentations of:
A
Inlammatory breast cancer
B
Non-Hodgkin’s Lymphoma
C
AML
D
Merkel Cell
A
Inlammatory breast cancer
Inflammatory breast cancer has a clinical presentation is peau d’orange, erythema, thickening, warmth, and hardening of the breast
Which of the following is considered an early effect of radiation?
A
Scarring
B
Cataracts
C
Telangiectasis
D
Erythema
D
Erythema
Erythema is an early effect of radiation that can occur as low as 1600 cGy (faint erythema).
A patient’s plan has a field size of 15 x 15 cm at 100 SAD and 11 cm depth. What will the field size be on the patient’s skin surface?
A
12 x 12 cm
B
13.4 x 13.4 cm
C
15 x 15 cm
D
16.5 x 16.5 cm
B
13.4 x 13.4 cm
Direct proportion. 15/100= x/((100-11)) =13.4 x 13.4 cm
Which of the following will decrease the response to radiation?
A
Oxygen
B
Doxorubicin
C
Amifostine
D
Adriamycin
C
Amifostine
Doxorubicin is considered a radiosensitizer
Distant spread from tumors in the small bowel is commonly to:
A
Lung
B
Liver
C
Brain
D
Bone
B
Liver
The liver is a common site of distance spread for tumors within the abdomen, including the small bowel.
In TNM staging, stage IV indicates:
A
Large tumor size
B
Nodal involvement
C
Distant metastasis
D
Unable to determine
C
Distant metastasis
The energy range of a superficial therapy unit is:
A
50-150 kV
B
150-500 kV
C
500 kV - 1 MV
D
Greater than 1 MV
A
50-150 kV
The main site of lymphatic drainage from the breast is
A
Axillary
B
Mastoid
C
Internal mammary
D
Supraclavicular
A
Axillary
The chemotherapy combination used for Non-Hodgkin’s lymphoma is
A
CHOP
B
MOPP
C
ABVD
D
CMF
A
CHOP
The chemotherapy combination used for non-Hodgkin’s lymphoma is CHOP (cyclophosphamide, vincristine, doxorubicin, and prednisone).
What organ is used as a landmark to divide stages for Hodgkin’s lymphoma
A
Lungs
B
Liver
C
Diaphragm
D
Carina
C
Diaphragm
The diaphragm divides stages in Hodgkin’s lymphoma. Stages I & II include lymph nodes above the diaphragm and stages III & IV include lymph nodes on both sides of the diaphragm
All of the following are daily checks on the linac EXCEPT:
A
ODI accuracy
B
Laser alignment
C
Photon output
D
Door interlock
E
Photon flatness
E
Photon flatness is annually
______ is how long the machine will run per week.
A
Workload
B
Occupancy factor
C
Use factor
D
Barrier factor
A
Workload
Workload indicates how long the machine will run in a week. Expressed as rad/week at 1 m.
The use factor (U) requires that one know the fraction the time beam ontoward the area to be shielded. Use factors only apply to the primary beam
The occupancy factor (T) refers to the fraction of time that the space that is shielded is occupied
The relationship between distance and dose is:
A
Direct
B
Direct square
C
Inverse
D
Inverse square
D
Inverse square
_____ is used to prevent arcing within the waveguide.
A
Sulfur hexafluoride
B
Aluminum oxide
C
Lithium fluoride
D
Tungsten
A
Sulfur hexafluoride
Sulfur hexafluoride (SF6) prevents arcing within the waveguide.
Which of the following sources has the longest half-life?
A
I-131
B
Ir-192
C
Sr-89
D
Pd-103
B
Ir-192
Ir-192 has the longest half-life listed for 73.8 days.
What provides power to the electron gun?
A
Modulator
B
Magnetron
C
Circulator
D
Drive stand
A
Modulator
The modulator powers the electron gun and klystron.
The staging system used for GYN cancers is:
A
Dukes
B
Ann Arbor
C
FIGO
D
TNM
FIGO
The daily check for CT number of water is 0 +/- __
A
1 HU
B
2 HU
C
3 HU
D
5 HU
D
0 +/- 5 HU
Research shows that the Epstein Barr virus is linked to ________ cancer.
A
Nasopharynx
B
Prostate
C
Breast
D
Cervical
A
Nasopharynx
The degree the tumor cells resemble the cell origin and function is:
A
Differentiation
B
Specificity
C
Gleason
D
Sensitivity
A
Differentiation
Differentiation refers to the similarity between tumor cell and original cell. This helps to determine tumor grade
Left breast tangents should be billed as:
A
Simple treatment
B
Intermediate treatment
C
Complex treatment
D
IMRT
C
Complex treatment
Complex treatments can be three or more treatment areas and use custom blocks, tangential fields, wedges, arcs, field-in-field, or electron beams
Tumors in which part of the head and neck are LEAST likely to have nodal involvement?
A
Glottis
B
Nasopharynx
C
Hypopharynx
D
Oral cavity
A
Glottis
Tumors of the glottis/larynx do not typically involve ly
Injection of drugs into CSF:
A
Intravenous
B
Intramuscular
C
Intrathecal
D
Subcutaneous
C
Intrathecal
Intrathecal drug administration = injected into the cerebrospinal fluid (CSF).
An example of a fomite is:
A
Person
B
Furniture
C
Mosquito
D
Droplet
B
Furniture
- Fomites = inanimate objects like tables, linen, or medical equipment.
The most common pathology of tumors in the parotid are
A
Mucoepidermoid carcinoma
B
Squamous
C
Tansitional
D
Sarcoma
A
Mucoepidermoid carcinoma
Temporary epilation occurs at a dose of at least
A
1000 cGy
B
2000 cGy
C
3000 cGy
D
4000 cGy
B
2000 cGy
eutron contamination can occur in the linac head at energies of ____ and above.
A
4 MeV
B
6MV
C
9 MeV
D
10 MV
D
10 MV
Which of the four R’s is least desirable for tumor cells?
A
Reoxygenation
B
Repopulation
C
Repair
D
Redistribution
B
Repopulation
Repopulation = remaining cells undergo mitosis and repopulate tissues and is unfavorable for malignant tumor cells.
Reoxygenation: is the process by which hypoxic cells gain access to oxygen and become radiosensitive between radiation fractions.
Redistribution: Irradiation of a asynchronous cell population (cells are distributed in all the phases of the cell cycle) typically results in cell death in the most sensitive phase G2 and M
Repair: repair of sublethal damage has occurred within hours of radiation in normal and tumor cells in vitro. Fractionated rx tx takes advantage of repair
The trigone is located on which organ?
A
Brain
B
Oropharynx
C
Bladder
D
Rectum
C
Bladder
The trigone is on the posterior wall of the bladder and formed from three openings from the two ureters and the urethra.
