Test 2: Ch 9
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The lateral ventricles are located within the:
The area of the cerebrum responsible for sensory and association is the:
The sense of smell is conveyed by the:
A glioma spreads by means of:
____________ brain tumors are known to spread via the CSF.
__________ brain tumors are seen more frequently in adults.
Single dose radiosurgery would be appropriate for a ____________ brain tumor.
Solitary 2 cm primary brain tumor
Headache, increased intra-cranial pressure (ICP) & Seizures are symptoms of:
The primary management modality for primary brain tumors is:
Uncontrolled diabetes, visual disturbances & sinus pressure are all symptoms of __________.
Incontinence/impotence and radiating pain down the legs may indicate a primary spinal cord tumor located in the __________ region.
Facial pain could be associated with a primanry CNS tumor near cranial nerve ______.
Cranial nerve VII (facial)
The TD 5/5 for the lense of the eye is:
The TD 5/5 for the optic nerve or optic chiasm is:
Involvement of cranial nerve ______ may manifest as dysphagia.
Cranial nerve IX (glossopharyngeal)
During primary brain tumor irradiation, normal brain tissue should be kept below:
The Clark method for classifying melanoma is based on:
Depth of invasion
Melanocytes are found in the ______ layer of the skin.
The cells most sensitive to radiation are located in the ________ layer of the epidermis.
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
Causing fetal damage:
Removal of WBC's for re-infusion:
Coal based chemical:
_____ rods are associated with leukemia
Alfred velpeau documented the first case of _________.
List the different white blood cells:
The most important diagnostic factor for detecting CML is:
Bone marrow depression nadir can occur within _____ days in patients that have received methotrexate .
A clinical spleen set-up requires a ____cm margin around the organ.
Patients with ____ leukemia always exhibit lymphocytosis.
______ leukemia has the worst prognosis.
_____ leukemia appears to have a hereditary component.
A _________ biopsy is needed for the diagnosis of ALL.
Bone marrow aspiration biopsy
The layers of the ________ include the dura mater, pia mater & the arachnoid mater.
The spleen is located in the ______ quadrant.
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
B cells mature in the _________.
Lymph nodes are usually ___ to ___ mm in length.
1 to 25 mm
Which type of lymphoma spreads randomly, originates in lymph nodes or extra nodal tissue and commonly arises in the GI tract?
The thoracic duct is the main collecting duct of the lymphatic system and begins in the _______.
75% of all Hodgkin disease will have
The most common presenting symptom for Hodgkin disease
Painless cervical node enlargement
A large binucleate or polynucleate cell present for a dx of Hodgkin is referred to as
Reed Sternberg Cell
Classification for staging of lymphoma is traditionally
Name the corresponding Organ for each letter when using the lymphoma staging system.
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?
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
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
In the tx of fields of Waldeyer ring for non Hodgkin lymphoma the fields delineation closely resembles that of carcinoma of the
Which lymphnode groups are treated in a mantle field
mediastinal and axillary
Which of the following are common side effects of RT of the abdomen?
T or F
Non Hodkin Lymphoma differs in a couple of ways from Hodgkins disease, one is that it occurs primarily in older persons
T or F
NHL is most likely to spread randomly, rather than orderly like HD does
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
The most favorable of the 4 subtypes of HD is
NHL may arise in
- Lymph nodes
- gastrointestinal tract
- Waldyer ring
In NHL, lymphocytes pathologically arrange themselves in patterns called
Follicular and nodular
The optimal dose to the mantle field is
which nodes are included in the inverted Y field
- common iliac
Radiation carditis is a chronic side effect after irradiation to the mantle field; this is inflammation of the
What is an acute side effect after radiation for Hodgkin's?
When txg the tumor bed for Wilm's tumor, care should be taken to include the entire width of the spine to prevent
Which of the following is not an assoc risk factor for pediatric solid tumors?
c. ionizing radiation
d. prenatal factors
The most common symptom of Wilm's tumor is
Nephroblastomas met most commonly to the
Neuroblastomas originate in the
neural crest tissue
What primary brain tumor typically spreads to the CSF
The most common symptom of Ewing sarcoma is
The most frequent orbital malignancy in children is
Wilm's tuor originate from what cell type?
(Wilm's tumor aka nephroblastoma)
Which type of childhood cancer is mostly assoc with prophylactic irradiation of the CNS
- Acute Lymphocytic Leukemia
- dose approx 18 Gy
Match these bone marrow transplants:
- Allogenic= compatible match
- autologous= self
- syngeneic= identical twin
The most important latent side effects from radiation therapy to the pediatric patient include
- impaired bone growth
- secondary cancers
An aggressive mgmt for retinoblastoma is an enucleation. An enucleation is
surgical removal of the orbit
Soft tissue sarcomas usually spread
locally, along the longitudinal muscle place
Sarcomas originate in the _____ tissue layer
Primary osseous tumors met to the lung via
___________ surgery would include intralesional incision, wide margin excision with bone grafting, and marginal margin excision with internal fixation.
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)
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
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
A natural barrier for regional spread of primary bone tumors is the
Compact bone is arranged in concentric circle patterns known as
The area of spongy bone is found in the
A solitary multiple myeloma tumor is known as a
Which bone cancer has an onion skin appearance on an xray
A common symptom for soft tissue tumors is
The most common childhood bone cancer is
The most common primary bone cancer overall is
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
Are soft tissue sarcomas common or rare
What is the most common primary orbital malignancy of childhood
Do regional lymph nodes have to be included in tx ports for primary bone tumors
What area of the brain would you expect to find involved if a patient had vision problems
What is the average survival for patients with brain mets
Distinguish between osteolytic and osteoblastic lesions as they may appear on a conventional xray
- Lytic-moth eaten
- Blastic- dense abnormal growth
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
What is superior vena cava syndrome
compression of the SVC by tumors in the apex of the lung or mediastinum
What is laminectomy
Removal of a portion of the lamina to decrease or prevent compression of spinal cord
Compression of the cauda equina will likely manifest as
Which radionuclide may be used in treating met bone disease
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
Is the humerus a likely site of bony mets?
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
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
A typical field size for the tx of thoracic vertebrae 5-10 would be
single posterior flds are not usually adequate for lower lumbar or sacral bone met because
This region of the spine has lordotic curvature
A T-shaped radiation tx field would likely be seen in the tx of
spinal cord compression in the lower lumbar or sacral region
A common symptom of liver mets is
Regional lymphatics are not usually included in rad flds for palliation because
disease spread is assumed to have already taken place
Daily tx charges for a single fld spine with no field shaping or beam modifiers would be
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