-
an increase of exposure results in __________ chance of interaction.
an increase
-
an increase of exposure __________ severity.
does not increase
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our radiation protection guides are based on the late effects of radiation and on:
linear, nonthreshold dose-response relationship
-
in late effects, diagnostic exposure is:
low LET and chronic
-
late effects are the result of:
while the early effects result from:
- late: low doses delivered over long periods of time
- early: high doses of radiation
-
Personnel in diagnostic imaging experience _________________________ over a long time span.
low doses and low LET periodically
-
two primary long term effects resulting from low dose radiation over long periods of time:
- malignancy
- genetic effects
-
there is not a specific dose to relate to various late effects such as:
- malignancy
- genetic effects
- life-span shortening
- local tissue effects
-
what is the method of choice when studying late effects?
epidemiological method
-
when a large number of people exposed to toxic substance requiring considerable statistical analyses:
epidemiological method
-
name some problems that arise with the epidemiological method:
- the dose is usually not known but presumed to be low
- the frequency of response is very low
- **this results in less statistical accuracy than early effects**
-
inflammation of the skin caused by exposure to x-rays or emissions from radioactive particles:
radiodermatitis
-
give examples of radiodermatitis:
- callused, discolored and weathered appearance
- skin very tight and brittle
- late-developing carcinoma
- (erythema early effect takes 200 rads)
-
in chromosomal effects of radiation to local tissue, _______________ is the early effect while _____________ is the late effect.
- hematologic depression (25 rads)
- leukemia
-
chromosomal damage in the _________________ can take place in both early and late effects
- circulating lymphocytes
- (early: 5 rads chromosomal aberration)
-
may not become apparent until many years after the radiation exposure:
low dose aberration
-
radiation exposure can remain in the peripheral lymphocytes for as long as:
- 20 years
- (if lymphocyte stem cells are irradiated, they may not undergo replication and maturation for many years - this explains the possible delay)
-
who developed the first cyclotron, when, and what was its principle use?
- E. O. Lawrence
- 1932
- to produce radionuclides for use in nuclear medicine, and fluorine-18 in PET
-
where are the largest cyclotrons in the world located?
Argonne National Laboratory in the U.S. and CERN in Switzerland
-
describe how the cyclotron contributed to cataracts:
- physicists used a fluorescent screen to locate the high energy beam which resulted in very high doses to the lens of the eye
- by 1960, several hundred cases of cataracts were reported in the high-energy physics
-
where do high energy cataracts form?
in the posterior pole of the lens
-
concerning cataracts, radiosensitivity of the lens is ____________, the latent period varies from ___________ years, and the average latent period is _____ years.
- age dependent
- 5-30 years
- 15 years.
-
High LET such as ______________ radiation have a ______ RBE for the production of cataracts.
-
dose-response relationship for cataracts is:
nonlinear, threshold
-
concerning cataracts, acute threshold is _________; chronic threshold is approximately _________.
- 200 rads (acute)
- 1000 rads (chronic)
-
in CT, a patient can receive up to _______ per slice intersecting the lens of the eye. On average, the lens may be intersected ______ resulting in _______ to the lens of the eye.
-
concerning the late effects of radiation in life-span shortening, dose response is:
linear, nonthreshold
-
concerning the late effects of radiation in life-span shortening - at worst, humans can expect a reduced life span of:
approximately 10 days per rad
-
give some examples of life-span shortening:
- radiation worker: 12 days
- being male rather than female: 2800 days
- heart disease: 2100 days
- being married: 2000 days
- one pack of cigarettes a day: 1600 days
- working as a coal miner: 1100 days
- cancer: 980 days
- 30 pounds overweight: 900 days
- airplane crashes: 1 days
- motor vehicle accident: 200 days
-
the period after the prodromal stage of the acute radiation syndrome during which there is no visible sign of radiation sickness:
latent period
-
time period a person could actually die from a disease brought on by radiation:
risk period
-
what are the three types of risk estimates in late effects of radiation?
- relative risk
- excess risk
- absolute risk
-
when one observes a large population for late radiation effects without having any precise knowledge of the radiation dose to which they were exposed:
relative risk
-
determined by the number of observed cases in the irradiated population and comparing
them with the number that would have been expected on the basis of known population levels:
excess risk
-
when one must assume a linear dose-response relationship and if the dose-response relationship is assumed to be nonthreshold, then only one dose level is required:
absolute risk
-
which type of risk estimate deals with observed or expected cases?
relative risk
-
name some human population groups affected by leukemia as a radiation-induced malignancy:
- atomic bomb survivors
- american radiologist
- radiation therapy patients
- children irradiated in utero
-
radiation-induced leukemia follows what type of dose-response relationship?
linear, nonthreshold
-
describe leukemia cases in atomic bomb survivors:
from 100,000 atomic bomb survivors, cases hit a plateau at 5 years and declined slowly for approximately 20 years
-
describe the latent and at-risk periods for leukemia as a radiation-induced malignancy:
- latent period of 4 to 7 years
- at-risk period of approximately 20 years
-
give some causes of leukemia occurring as a radiation-induced malignancy:
- radiologist receiving over 100rads/yr
- ankylosing spondylitis patients receiving radiation for relief
- radiation therapy patients relapsing with leukemia
-
when studying the effects of cancer as a radiation malignancy, ______ of all deaths are due to cancer which can obscure the data.
20%
-
list three examples of thyroid cancer occurring as a radiation-induced malignancy:
- 500 rads for thymic enlargement in newborns resulted in thyroid nodules and cancer 20 years later
- native children of rongelap atoll in 1954 were exposed to an excess of 1200 rads from the fallout of a hydrogen bomb test
- chernobyl 1986, recent studies have shown no excess leukemia or cancer, but there was an increase in thyroid nodularity
-
give an example of bone cancer occurring as a radiation-induced malignancy:
- 1920-1930 watch dial painters exposure to high amounts of radium (half-life 1620 years); ingested radium metabolizes like calcium which resulted in as much as 50,000 rads to the bone
- today tritium and promethium is used for the glow purpose without the excessive exposure
-
concerning skin cancer as a radiation-induced malignancy, give the following:
how it begins
induced by
latent period
risk factors
- how it begins: radiodermatitis
- induced by: radiation therapy orthovoltage (200-300kVp) or superficial xray (50-150kVp)
- latent period: approximately 5-10 years
- risk: 500-2000 rads relative risk of 4:1, 4000-6000 rads risk of 14:1, 6000-10000 rads risk of 27:1
-
describe aspects of breast cancer occurring as a radiation-induced malignancy:
- patients were treated for TB with fluoroscopy of the chest to induce a pneumothorax in affected lung
- patients would receive as much as several hundred rads per treatment
- the relative risk of radiation induced breast cancer due to this procedure was found to be 10:1
- patients also treated with 75 to 1,000 rads for postpartum mastitis resulting in a relative risk factor of 3:1
- atomic bomb survivors of 10 rad or more showed a relative risk of 4:1
-
describe some aspects/locations of lung cancer occurring as a radiation-induced malignancy:
- 50% of bohemian mines of germany died of lung cancer
- today it is known that radon found in the mines contributed to the lung cancer of these miners
- radiation exposure in colorado mines are contributed to high levels of uranium (half-life 10,000,000,000 years)
- a decay product of uranium is radon, a radionuclide capable of emanating through rock to produce a high level in the air to be breathed
-
describe some aspects of liver cancer occurring as a radiation-induced malignancy:
- thorium dioxide made up 25% of thorotrast media used during 1925-1945 for angiography
- latent period of 15 to 20 years
- thorium dioxide deposited in phagocytic cells of the reticuloendothelial system and concentrated in the liver and spleen
-
concerning late effects, give the risk period for:
bone cancer
leukemia
and the latent period for:
skin cancer
leukemia
liver
thyroid
cataracts
- bone cancer: 50 yrs
- leukemia: 20 yrs
- skin cancer: 5-10 yrs
- leukemia: 4-7 yrs
- liver: 15-20 yrs
- thyroid: 5-10 yrs
- cataracts: 5-30 yrs
-
give information concerning total risk of malignancy when it comes to three mile island:
- 2,000,000 people residing in 80 km radius near the susquehanna river in pennsylvania
- ave. doses were 160 km-1.5 rad, 80km-8mrad
- 20% of population will have cancer considering statistics not taking into account the additional exposure from three mile island
- prediction is 1.2 deaths due to exposure
-
be familiar with this chart:
BEIRS: Biologic Effects of Ionizing Radiation
-
a relationship in which the increased incidence of cancer is a constant number of cases after a minimal latent period:
absolute age-response relationship
-
a relationship where the increased incidence of cancer is proportional to the natural incidence:
relative age-response relationship
-
what are the three main concerns dealing with radiation and pregnancy (before, during, after)?
- before: concern with interrupted fertility
- during: possible congenital effects in newborns
- after: related to genetic effects
-
____________ irradiation does NOT impair fertility.
low-chronic
-
describe what we know about the risks of radiation during pregnancy (in utero):
- all observations point to first trimester during pregnancy as the most radiosensitive period
- the first 2 weeks of pregnancy may be of least concern because the response is all-or-nothing
- relative risks: 1st trimester-8.3, 2nd trimester-1.5, 3rd trimester-1.4, total-1.5
- relative risk of childhood leukemia after irradiation in utero is 1.5
-
radiation effects occurring to offspring as a result of radiation exposure in-utero:
teratogenicity effects
-
name some examples of teratogenicity:
- death-embryonic, fetal, neo-natal
- microcephaly
- hydrocephaly
- spina bifida
- club feet
- mental retardation
- skeletal abnormalities
- abnormalities of internal organs
- diminished growth and development
- childhood malignancy
-
that dose of radiation that produces twice the frequency of genetic mutations as would have been observed without the radiation:
doubling dose
-
radiation induced mutations are usually:
harmful
-
genetic effects of radiation during pregnancy depend on:
protraction and fractionation
-
are most genetic mutations dominant or recessive?
recessive
-
radiation-induced genetic mutations is extremely low, at:
.000001 mutation/rad/gene
-
name some genetic effects that can occur from radiation during pregnancy:
- increased risks of malignancy
- increased spontaneous abortions and stillbirths
- increased infant mortality
- increased congenital effects
-
name two general facts about genetic effects:
- there is no data suggesting radiation induced genetic effects in humans
- follow a single-hit model(more damage being done to an immature/undifferentiated type cell)
-
a theory that states small amounts of radiation can be good for humans:
radiation hormesis
-
according to the theory of radiation hormesis, __________________ can possibly stimulate molecular repair and immunologic response mechanisms.
approximately 10 rads
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