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Radiation Protection > Week 8- Early Tissue Reactions > Flashcards

Week 8- Early Tissue Reactions Flashcards

1
Q

What are Early Effects of radiation?

A

Biological effects of radiation that occur relatively soon after receiving high doses of ionizing radiation

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2
Q

Where does evidence of early effects of radiation come from?

A

Studies on laboratory animal and data observed from irradiated human populations

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3
Q

What kind of imaging are early effects not common in?

A

Diagnostic imaging (except high dose fluoroscopic procedures)

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4
Q

What type of radiation produces early effects?

A

Substantial doses of ionizing radiation

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5
Q

What are somatic effects?

A

Biological damage sustained by living organism as a consequence of exposure to ionizing radiation

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6
Q

What are genetic effects?

A

Effects upon future generations because of irradiation of germ cells in previous generations

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7
Q

What are somatic effects dependent on?

A

Length of time from the moment of irradiation to the first appearance of symptoms

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8
Q

How are somatic effects demonstrated?

A

As early somatic effects or late somatic effects

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9
Q

What do early tissue reactions depend on?

A

The duration of time after exposure to ionizing radiation

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10
Q

As radiation dose increases what effect does it have on the severity of early tissue reactions?

A

The severity of these effects increase

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11
Q

What is a threshold as it pertains to early tissue reactions?

A

A point at which the reactions appear and below they are absent

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12
Q

What does the amount of biologic damage depend on?

A

The actual absorbed dose of ionizing radiation

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13
Q

When do early tissue reactions appear?

A

Within minutes, hours, days or weeks of the time of irradiation

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14
Q

What are some types of high-dose early tissue reactions?

A

Nausea, erythema, blood disorders, fever, fatigue, epilation, intestinal disorders, dry and moist desquamation, depressed sperm count in males, temporary or permanent sterility and injury to the CNS

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15
Q

What dose of radiation results in many of the high-dose effects?

A

6 Gyt

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16
Q

What is Acute Radiation Syndrome?

A

Radiation sickness that occurs in humans after whole-body receives large doses of ionizing radiation in a short period of time and is demonstrated by a collection of symptoms

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17
Q

Where is data obtained from to study the effects of ARS?

A
  • Atomic bomb survivors
  • Marshall islanders who were subjected to fallout
  • Nuclear radiation accident victims
  • Patients who have undergone radiation therapy
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18
Q

What are the three separate dose-related symptoms associated with ARS?

A
  • Hematopoietic syndrome
  • Gastrointestinal syndrome
  • Cerebrovascular syndrome
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19
Q

What radiation doses produce Hematopoietic syndrom?

A

From 1-10 Gyt

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20
Q

What radiation doses produce gastrointestinal syndrome?

A

Appear at a threshold dose of 6Gyt and peak at 10 Gyt

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21
Q

What radiation dose produces cerebrovascular syndrome?

A

Results from doses of 50 Gyt or more

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22
Q

What are the 4 stages of ARS?

A
  • Prodromal stage
  • Latent period
  • Manifest illness
  • Recovery or death
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23
Q

What is the prodromal stage of ARS?

A

Initial stage of symptoms appearing at 1 Gyt dose

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24
Q

What symptoms appear as part of the prodromal stage?

A

Nausea, vomiting, diarrhea, fatigue and leukopenia

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25
Q

When does the prodromal stage appear?

A

Within hours and may last up to 3 days after exposure

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26
Q

What is the latent period of ARS?

A

The second stage where the patient is apparently well and appear to be recovered

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27
Q

When does the latent stage appear in ARS?

A

Around a week after exposure

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28
Q

How long does the latent period last?

A

From a few hours (with highest doses) to weeks for the lowest doses

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29
Q

What is the manifest illness stage of ARS?

A

When the 3 manifest illness stages appear, each based on dose of radiation received (Hematologic, Gastrointestinal or Cerebrovascular)

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30
Q

What is the hematopoietic system?

A

Manufactures the corpuscular elements of the blood and is the most radiosensitive vital organ system in humans

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31
Q

In what dose range is Hematopoietic syndrome not lethal?

A

When doses of 1-2 Gyt are received

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32
Q

What is the main feature of hematopoietic syndrome?

A

Destruction of the bone marrow, which results in a depression of all blood cell counts

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33
Q

What are the symptoms of hematopoietic syndrome?

A

Nausea, vomiting, diarrhea, decrease in number of red blood cells, white blood cells and platelets, hemorrhage and infection

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34
Q

When may death occur in Hematopoietic syndrome?

A

6-8 weeks following exposure over 2 Gyt

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35
Q

When is hematopoietic syndrome considered to be more severe?

A

At the high end of dose ranges up to 10 Gyt

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36
Q

When can patients who survive hematopoietic syndrome expect to make a full recovery?

A

In around 6 months, but they will be at an increased risk of long term effects in life

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37
Q

What are the different measurement ranges Gastrointestinal Syndrome occurs in?

A

6-10 Gyt, or 1000-5000 rad

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38
Q

What is the survival rate of Gastrointestinal syndrome?

A

0% its always lethal

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39
Q

What is the lethal aspect of gastrointestinal syndrome?

A

Damage to the stem cells of the intestinal epithelium that result in severe vomiting and diarrhea, accompanied by intestinal bleeding

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40
Q

What is the impact of stem cell death in gastrointestinal syndrome?

A

When the stem cells die, the existing ones are no longer able to produce new cells and the lining wears away

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41
Q

What are the other symptoms of Gastrointestinal syndrome?

A

Severe nausea, vomiting, diarrhea, fever, fatigue, loss of appetite, lethargy, anemia, leukopenia, hemorrhage, infection, electrolyte imbalance and emaciation

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42
Q

When does death occur in gastrointestinal syndrome?

A

Within 3-10 days after the appearance of major symptoms

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43
Q

What is the most severe manifest illness of ARS?

A

Cerebrovascular syndrome

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44
Q

What are the different measurement ranges Cerebrovascular Syndrome occurs in?

A

Above 50 Gyt or 5000 rad

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45
Q

What is the main feature of cerebrovascular syndrome?

A

Destruction of cells in the brain and spinal cord

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46
Q

What are the main symptoms of Cerebrovascular syndrome?

A

All the same symptoms as hematopoietic and gastrointestinal plus excessive nervousness, confusion, lack of coordination, loss of vision, burning sensation of the skin, loss of consciousness, disorientation, shock, periods of agitation, alternating with stupor, loss of equilibrium, meningitis, prostration, respiratory distress, vasculitis and coma

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47
Q

When does death occur in cerebrovascular syndrome?

A

Within hours to 3 days after radiation exposure

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48
Q

How was ARS caused by the Chernobyl accident?

A

During the explosion at the side, contaminants were ejected upward into the atmosphere 3 miles high

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49
Q

Of the 444 people working at the plant what were the immediate impacts?

A

2 people died instantly and 29 died within 3 months of exposure

50
Q

What were used to identify the casualties of the Chernobyl exposure?

A

Biological symptoms that matched those of the 3 manifest illnesses

51
Q

What did survivors of the atomic bomb in Japan demonstrate in terms of radiation sickness?

A

Late tissue reactions and stochastic effects (leukemia)

52
Q

What did the atomic bomb and Chernobyl cause the medical community to recognize?

A

The need for a thorough understanding of ARS and subsequent support to persons affected

53
Q

What is Lethal Dose 50/30?

A

Signifies the whole body dose of radiation that can be lethal to 50% of the exposed population within 30 days

54
Q

What is the LD 50/30 dose for adult humans?

A

3-4 Gyt without medical support

55
Q

What threshold model does LD 50/30 follow?

A

A threshold non-linear model, where responses won’t show until over 1 Gyt and lethality begins between 3-4 Gyt for 50% and full lethality peaks at 6 Gyt

56
Q

What are the three other measures of lethality?

A

LD 10/30, LD 50/60 and LD 100/60

57
Q

Which of the three additional measures of lethality are more accurate for humans?

A

LD 50/60

58
Q

What part of cells enable them to possibly repair and recover when they’re exposed to sublethal doses of radiation?

A

Repair mechanisms

59
Q

What do the repair cells do to help recovery?

A

The surviving cells begin to repopulate, which permits the organ to regain some or most of its functional ability

60
Q

What determines the organs potential for recovery?

A

Overall health of the irradiated person and the amount of functional damage sustained

61
Q

Which cells have a better prospect of recovery when exposed to sublethal doses of radiation?

A

Oxygenated cells vs hypoxic cells

62
Q

Why do oxygenated cells have a higher prospect for recovery?

A

Because they are nutrient rich

63
Q

What effect does repeated radiation injuries produce?

A

A cumulative effect

64
Q

What percent of radiation-induced damage is irreparable?

A

10%

65
Q

What percent of radiation-induced damage is repairable?

A

90% over time

66
Q

What are the impacts to local tissue as a result of high radiation doses?

A

Significant cell death which leads to atrophy of organs and tissues

67
Q

What is the consequence of organs and tissues sustaining radiation damage?

A

They may lose their ability to function or recover

68
Q

What type of recovery can occur in organs and tissues?

A

Partial or complete, depending on type of cells and dose received

69
Q

If organs or tissues fail to recover what happens?

A

Necrosis or death of the biologic structure

70
Q

What do organ and tissue response to radiation exposure depend on?

A
  • Radiosensitivity
  • Reproductive characteristics
  • Growth rate
71
Q

What are the tissues that suffer immediate consequences of irradiation?

A
  • Skin
  • Reproductive organs
  • Bone marrow
72
Q

What are the 3 layers of the skin?

A
  • Epidermis (outer layer)
  • Dermis (middle layer)
  • Hypodermis (subcutaneous layer)
73
Q

What are the accessory structures of the skin?

A

Hair, sensory receptors, sebaceous glands and sweat glands

74
Q

What are the effects of ionizing radiation on the skin?

A
  • Radiodermatitis
  • Desquamation
  • Epilation
  • Erythema
75
Q

What is radiodermatitis?

A

Significant reddening of the skin

76
Q

Why is the skin relatively radiosensitive?

A

Because it is constantly regenerating

77
Q

What is Desquamation?

A

Shedding of the outer layer of skin (peeling then flaking)

78
Q

What is epilation?

A

Hair loss that can be temporary or permanent based on dose received

79
Q

What disease was treated by radiation that produced epilation?

A

Ringworm

80
Q

Which radiation procedures cause significant skin damage?

A

Orthovoltage radiation therapy and interventional procedures using high-level fluoroscopy

81
Q

What are the effects of radiation on male reproductive systems?

A

Gonadal doses can depress male sperm populations or cause genetic mutations in future generations

82
Q

What are the effects of radiation on female reproductive systems?

A

Gonadal dose may delay or suppress menstruation

83
Q

What dose level can depress male sperm populations and delay menstruation?

A

Doses as low as .1 Gyt

84
Q

Why do testes and ovaries respond differently to irradiation?

A

Because of the method in which the cells are produced and progress to maturity

85
Q

What are the stages of sperm development?

A

Spermatogonia > Spermatocyte > Spermatid > Sperm

86
Q

What are the stages of egg development?

A

Primordial follicle > Mature follicle > Corpus Luteum > Ovum

87
Q

What are the gonadal stem cells of females?

A

Oogonia

88
Q

What do Oogonia develop into?

A

Oocytes during late fetal life

89
Q

What stage of gonadal development are most susceptible to radiation in females?

A

Oocytes in the mature follicle

90
Q

What does irradiation of ovaries cause?

A
  • Atrophy
  • Delayed menstruation
  • Sterility
  • Genetic mutations
91
Q

What dose results in delayed or suppressed menstruation?

A

100 mGy (10 rad)

92
Q

What dose produces temporary sterility in females?

A

2 Gyt (200 rad)

93
Q

What dose produces permanent infertility in females?

A

5 Gyt (500 rad)

94
Q

What dose produces genetic mutations in females?

A

250-500 mGy (35-50 rad)

95
Q

What are the stem cells of the testes?

A

Spermatogonia

96
Q

What are the most sensitive stage of sperm development in males?

A

Spermatogonia

97
Q

What are the 4 possible effects of irradiation on testes?

A
  • Atrophy
  • Reduction in sperm count
  • Sterility
  • Genetic mutations
98
Q

What dose produces reduction in sperm count?

A

100 mGy (10 rad)

99
Q

What dose produces temporary sterility in males?

A

2 Gyt (200 rad)

100
Q

What dose produces permanent sterility in males

A

5 Gyt (500 rad)

101
Q

What dose produce genetic mutations in males?

A

100 mGy (10 rad)

102
Q

What was a former source of monitoring image personnel for radiation damage?

A

Hematologic depression

103
Q

What were the only means of monitoring radiation workers in the 1920/30s?

A

Periodic blood counts

104
Q

What dose of ionizing radiation produces a measurable amount of hematologic depression?

A

.25 Gyt whole body dose

105
Q

What does the hematopoietic system consist of?

A

Bone marrow, circulating blood and lymphoid organs

106
Q

What do cells of the hematopoietic system develop from?

A

A single precursor cell called the pluripotential stem cell

107
Q

Of the 3 parts of the hematopoietic system which one is the most susceptible to irradiation?

A

Bone marrow

108
Q

Why is the bone marrow the most susceptible?

A

Its the site of most blood cell manufacturing and damage to the marrow can cause a decrease in all types of these cells

109
Q

Which blood cell type is the most sensitive to radiation?

A

Lymphocytes

110
Q

Why are the lymphocytes the most sensitive?

A

They have a short life span (few hours) and are slow to recover

111
Q

How do granulocytes respond to radiation?

A

With an initial rise in numbers followed by a sharp decrease

112
Q

How do platelets respond to radiation?

A

They are relatively resistent

113
Q

Which blood cell type is the most resistent?

A

Red blood cells (erythrocytes) since the live about 120 days

114
Q

What is cytogenetics?

A

The study of cell genetics with emphasis on cell chromosomes

115
Q

How is a cytogenetic analysis of chromosomes conducted?

A

Through the use of a chromosome map called a karyotype

116
Q

What does a karyotype consist of?

A

A photograph or photomicrograph

117
Q

How is a karyotype contructed?

A

Individual chromosomes are cut out and paired with sister chromosomes

118
Q

How are chromosome pairs aligned in a karyotype?

A

By size from largest to smallest

119
Q

At what stage of cell division can chromosomal damage by radiation be evaluated?

A

Metaphase

120
Q

What two forms of chromosomal damage observed in metaphase?

A

Chromosomal aberrations and chromatid aberrations

121
Q
A

Radiation Protection (15 decks)

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