Test 2: Ch 9

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RadiationTherapy
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261231
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Test 2: Ch 9
Updated:
2014-02-24 20:29:13
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radiation therapy
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Mosbys
Description:
CNS, Lymphoma, Leukemia, Skin Ca, Peds, Soft Tissue Sarcoma, Palliative
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  1. The lateral ventricles are located within the:
    Cerebral hemispere
  2. The area of the cerebrum responsible for sensory and association is the:
    Parietal area
  3. The sense of smell is conveyed by the:
    Olfactory nerve
  4. A glioma spreads by means of:
    Local Invasion
  5. ____________ brain tumors are known to spread via the CSF.
    Medulloblastoma
  6. __________ brain tumors are seen more frequently in adults.
    Glioma
  7. Single dose radiosurgery would be appropriate for a ____________ brain tumor.
    Solitary 2 cm primary brain tumor
  8. Headache, increased intra-cranial pressure (ICP) & Seizures are symptoms of:
    Intracranial tumors
  9. The primary management modality for primary brain tumors is:
    Surgery
  10. Uncontrolled diabetes, visual disturbances & sinus pressure are all symptoms of __________.
    pitutary adenomas
  11. Incontinence/impotence and radiating pain down the legs may indicate a primary spinal cord tumor located in the __________ region.
    Lumbosacral
  12. Facial pain could be associated with a primanry CNS tumor near cranial nerve ______.
    Cranial nerve VII (facial)
  13. The TD 5/5 for the lense of the eye is:
    5-10 Gy
  14. The TD 5/5 for the optic nerve or optic chiasm is:
    50 Gy
  15. Involvement of cranial nerve ______ may manifest as dysphagia.
    Cranial nerve IX (glossopharyngeal)
  16. During primary brain tumor irradiation, normal brain tissue should be kept below:
    60 Gy
  17. The Clark method for classifying melanoma is based on:
    Depth of invasion
  18. Melanocytes are found in the ______ layer of the skin.
    Basal
  19. The cells most sensitive to radiation are located in the ________ layer of the epidermis.
    Stratum Basale
  20. Lentigo maligna is a histologic type of melanoma characterized by growth in a _______ pattern with ______ or black color.
    Radial pattern with tan or black color
  21. Causing fetal damage:
    Teratogenic
  22. Removal of WBC's for re-infusion:
    Leukopheresis
  23. Coal based chemical:
    Benzene
  24. _____ rods are associated with leukemia
    Auer rods
  25. Alfred velpeau documented the first case of _________.
    Leukemia
  26. List the different white blood cells:
    (6)
    • Basophils
    • Neutrophils
    • Eosinophils
    • Monocytes
    • Lymphocytes
    • Platelets
  27. The most important diagnostic factor for detecting CML is:
    Philadelphia chromosome
  28. Bone marrow depression nadir can occur within _____ days in patients that have received methotrexate .
    10-14 days
  29. A clinical spleen set-up requires a ____cm margin around the organ.
    1 cm
  30. Patients with ____ leukemia always exhibit lymphocytosis.
    CLL
  31. ______ leukemia has the worst prognosis.
    CML
  32. _____ leukemia appears to have a hereditary component.
    CLL
  33. A _________ biopsy is needed for the diagnosis of ALL.
    Bone marrow aspiration biopsy
  34. The layers of the ________ include the dura mater, pia mater & the arachnoid mater.
    Meninges
  35. The spleen is located in the ______ quadrant.
    LUQ
  36. In the _____ & _____ phases of the cell cycle the undifferentiated cells have a decreased proportion of blast cells compared to normal bone marrow blast cells in regards to the pathology of AML.
    S & M phases
  37. B cells mature in the _________.
    Bone Marrow
  38. Lymph nodes are usually ___ to ___ mm in length.
    1 to 25 mm
  39. Which type of lymphoma spreads randomly, originates in lymph nodes or extra nodal tissue and commonly arises in the GI tract?
    Non-Hodgkin's lymphoma
  40. The thoracic duct is the main collecting duct of the lymphatic system and begins in the _______.
    cisterna chyli
  41. 75% of all Hodgkin disease will have
    nodular sclerosis
  42. The most common presenting symptom for Hodgkin disease
    Painless cervical node enlargement
  43. A large binucleate or polynucleate cell present for a dx of Hodgkin is referred to as
    Reed Sternberg Cell
  44. Classification for staging of lymphoma is traditionally
    Ann Arbor
  45. Name the corresponding Organ for each letter when using the lymphoma staging system.
    SHLMPOD
  46. Marrow
    • Lung
    • Liver
    • Spleen
    • Osseous
    • Skin
    • Pluera
    • M-Marrow
    • L-Lung
    • H-Liver
    • S-Spleen
    • O-Osseous
    • D-Skin
    • P-Pleura
  47. A 21 yr old male pt has an enlarged cervical lymph node. Diagnostic work up reveals a mediastinal and axillary nodes as well. What stage is this pt?
    II
  48. Staging for Hodgkins also includes AB grouping. Which symptom is not one of the classical B symptoms?
    A. Profuse night sweats
    B. weight loss greater than 10% of body weight
    C. unexplained fever above 38 degrees 
    D unexplained pruritus
  49. Unexplained pruritus
  50. In Hodgkin disease, involvement of several nodal regions of both sides of the diaphragm accompanied by localized involvement of an extra lymphatic site is stage
    III E
  51. In the tx of fields of Waldeyer ring for non Hodgkin lymphoma the fields delineation closely resembles that of carcinoma of the
    nasopharynx
  52. Which lymphnode groups are treated in a mantle field
    mediastinal and axillary
  53. Which of the following are common side effects of RT of the abdomen?
    Nausea
    vomiting
    fatigue
  54. All of the above
  55. T or F
    Non Hodkin Lymphoma differs in a couple of ways from Hodgkins disease, one is that it occurs primarily in older persons
  56. True
  57. T or F
    NHL is most likely to spread randomly, rather than orderly like HD does
  58. True
  59. A young woman has swelling in her lower neck for suspected HD. A chest xray also revealed mediastinal adenopathy. She had not experienced any fever, night sweats, or weight loss. Staging would be
    IIA
  60. The most favorable of the 4 subtypes of HD is
    Nodular Sclerosis
  61. NHL may arise in
    (3)
    • Lymph nodes
    • gastrointestinal tract
    • Waldyer ring
  62. In NHL, lymphocytes pathologically arrange themselves in patterns called
    Follicular and nodular
  63. The optimal dose to the mantle field is
    35-44 Gy
  64. which nodes are included in the inverted Y field
    (3)
    • retroperitoneal
    • common iliac
    • inguinal
  65. Radiation carditis is a chronic side effect after irradiation to the mantle field; this is inflammation of the
    heart
  66. What is an acute side effect after radiation for Hodgkin's?
    dysphagia
  67. When txg the tumor bed for Wilm's tumor, care should be taken to include the entire width of the spine to prevent
    scoliosis
  68. Which of the following is not an assoc risk factor for pediatric solid tumors?
    a. parasites
    b. environment
    c. ionizing radiation
    d. prenatal factors
    parasites
  69. The most common symptom of Wilm's tumor is
    abdominal mass
  70. Nephroblastomas met most commonly to the
    lung
  71. Neuroblastomas originate in the
    neural crest tissue
  72. What primary brain tumor typically spreads to the CSF
    medulloblastoma
  73. The most common symptom of Ewing sarcoma is
    Pain
  74. The most frequent orbital malignancy in children is
    retinoblastoma
  75. Wilm's tuor originate from what cell type?
    nephroblasts

    (Wilm's tumor aka nephroblastoma)
  76. Which type of childhood cancer is mostly assoc with prophylactic irradiation of the CNS
    • Acute Lymphocytic Leukemia
    • dose approx 18 Gy
  77. Match these bone marrow transplants:
    Allogeneic donor 
    Autologous donor
    Syngeneic donor
    self
    compatible match
    identical twin
    • Allogenic= compatible match
    • autologous= self
    • syngeneic= identical twin
  78. The most important latent side effects from radiation therapy to the pediatric patient include
    • impaired bone growth
    • secondary cancers
  79. An aggressive mgmt for retinoblastoma is an enucleation. An enucleation is
    surgical removal of the orbit
  80. Soft tissue sarcomas usually spread
    locally, along the longitudinal muscle place
  81. Sarcomas originate in the _____ tissue layer
    mesoderm
  82. Primary osseous tumors met to the lung via
    blood
  83. ___________ surgery would include intralesional incision, wide margin excision with bone grafting, and marginal margin excision with internal fixation.
    Limb salvaging
  84. What feature would be present on an xray image of a lytic primary bone tumor
    decreased density in the region of the tumor

    (lytic = less dense)
  85. What is the likely explanation for weight loss and fever in the pt suspected to have primary bone cancer
    presence of the tumor causes hypercalcemia
  86. Rad to the abdomen for soft tissue sarcomas in the peritoneum is limited by low tolerance organs such as the kidneys. The TD 5/5 for the whole kidney is
    23GY
  87. A natural barrier for regional spread of primary bone tumors is the
    periosteum
  88. Compact bone is arranged in concentric circle patterns known as
    haversian systems
  89. The area of spongy bone is found in the
    epiphysis
  90. A solitary multiple myeloma tumor is known as a
    plasmacytoma
  91. Which bone cancer has an onion skin appearance on an xray
    Ewing sarcoma
  92. A common symptom for soft tissue tumors is
    painless mass
  93. The most common childhood bone cancer is
    Ewing Sarcoma
  94. The most common primary bone cancer overall is
    Osteosarcoma
  95. The variable that are used for staging soft tissue sarcomas are
    a. histologic grade
    b. tumor size
    c. regional lymph node involvement
    d. presence of distant mets
    Histologic grade & Presence of distant mets
  96. Are soft tissue sarcomas common or rare
    rare
  97. What is the most common primary orbital malignancy of childhood
    rhabdomyosarcoma
  98. Do regional lymph nodes have to be included in tx ports for primary bone tumors
    no
  99. What area of the brain would you expect to find involved if a patient had vision problems
    parietal
  100. What is the average survival for patients with brain mets
    3 mos
  101. Distinguish between osteolytic and osteoblastic lesions as they may appear on a conventional xray
    • Lytic-moth eaten
    • Blastic- dense abnormal growth
  102. Compare/contrast palliative doses of radiation for brain mets to curative doses for primary brain malignancy
    • palliative- 300 cGy per fraction total of 30-40GY
    • Primary- 180-200 cGy per fraction total of 60GY
  103. What is superior vena cava syndrome
    compression of the SVC by tumors in the apex of the lung or mediastinum
  104. What is laminectomy
    Removal of a portion of the lamina to decrease or prevent compression of spinal cord
  105. Compression of the cauda equina will likely manifest as
    incontinence
  106. Which radionuclide may be used in treating met bone disease
    strontium 89
  107. In spinal cord compression and SVC syndrome, high doses of radiation are given in the 1st few txs. What is a typical dose
    300-400 cGy per fraction
  108. Is the humerus a likely site of bony mets?
    No
  109. Met brain disease differs from primary brain malignancy in that
    met is usually multi focal and primaries are solitary at the time of dx and spread locally
  110. When txg a pt who has spinal cord compression in the cervical spine, the best position among the following would be
    prone with the chin and forehead in a horizontal plane and arms at the side
  111. A typical field size for the tx of thoracic vertebrae 5-10 would be
    8x15 cm
  112. single posterior flds are not usually adequate for lower lumbar or sacral bone met because
    This region of the spine has lordotic curvature
  113. A T-shaped radiation tx field would likely be seen in the tx of
    spinal cord compression in the lower lumbar or sacral region
  114. A common symptom of liver mets is
    jandice
  115. Regional lymphatics are not usually included in rad flds for palliation because
    disease spread is assumed to have already taken place
  116. Daily tx charges for a single fld spine with no field shaping or beam modifiers would be
    simple

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