-
The lateral ventricles are located within the:
Cerebral hemispere
-
The area of the cerebrum responsible for sensory and association is the:
Parietal area
-
The sense of smell is conveyed by the:
Olfactory nerve
-
A glioma spreads by means of:
Local Invasion
-
____________ brain tumors are known to spread via the CSF.
Medulloblastoma
-
__________ brain tumors are seen more frequently in adults.
Glioma
-
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:
Intracranial tumors
-
The primary management modality for primary brain tumors is:
Surgery
-
Uncontrolled diabetes, visual disturbances & sinus pressure are all symptoms of __________.
pitutary adenomas
-
Incontinence/impotence and radiating pain down the legs may indicate a primary spinal cord tumor located in the __________ region.
Lumbosacral
-
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:
5-10 Gy
-
The TD 5/5 for the optic nerve or optic chiasm is:
50 Gy
-
Involvement of cranial nerve ______ may manifest as dysphagia.
Cranial nerve IX (glossopharyngeal)
-
During primary brain tumor irradiation, normal brain tissue should be kept below:
60 Gy
-
The Clark method for classifying melanoma is based on:
Depth of invasion
-
Melanocytes are found in the ______ layer of the skin.
Basal
-
The cells most sensitive to radiation are located in the ________ layer of the epidermis.
Stratum Basale
-
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:
Teratogenic
-
Removal of WBC's for re-infusion:
Leukopheresis
-
Coal based chemical:
Benzene
-
_____ rods are associated with leukemia
Auer rods
-
Alfred velpeau documented the first case of _________.
Leukemia
-
List the different white blood cells:
(6)
- Basophils
- Neutrophils
- Eosinophils
- Monocytes
- Lymphocytes
- Platelets
-
The most important diagnostic factor for detecting CML is:
Philadelphia chromosome
-
Bone marrow depression nadir can occur within _____ days in patients that have received methotrexate .
10-14 days
-
A clinical spleen set-up requires a ____cm margin around the organ.
1 cm
-
Patients with ____ leukemia always exhibit lymphocytosis.
CLL
-
______ leukemia has the worst prognosis.
CML
-
_____ leukemia appears to have a hereditary component.
CLL
-
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.
Meninges
-
The spleen is located in the ______ quadrant.
LUQ
-
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 _________.
Bone Marrow
-
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?
Non-Hodgkin's lymphoma
-
The thoracic duct is the main collecting duct of the lymphatic system and begins in the _______.
cisterna chyli
-
75% of all Hodgkin disease will have
nodular sclerosis
-
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
Ann Arbor
-
Name the corresponding Organ for each letter when using the lymphoma staging system.
SHLMPOD
-
Marrow
- Lung
- Liver
- Spleen
- Osseous
- Skin
- Pluera
- M-Marrow
- L-Lung
- H-Liver
- S-Spleen
- O-Osseous
- D-Skin
- P-Pleura
-
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
-
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
III E
-
In the tx of fields of Waldeyer ring for non Hodgkin lymphoma the fields delineation closely resembles that of carcinoma of the
nasopharynx
-
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?
Nausea
vomiting
fatigue
-
-
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
IIA
-
The most favorable of the 4 subtypes of HD is
Nodular Sclerosis
-
NHL may arise in
(3)
- 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
35-44 Gy
-
which nodes are included in the inverted Y field
(3)
- retroperitoneal
- common iliac
- inguinal
-
Radiation carditis is a chronic side effect after irradiation to the mantle field; this is inflammation of the
heart
-
What is an acute side effect after radiation for Hodgkin's?
dysphagia
-
When txg the tumor bed for Wilm's tumor, care should be taken to include the entire width of the spine to prevent
scoliosis
-
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
-
The most common symptom of Wilm's tumor is
abdominal mass
-
Nephroblastomas met most commonly to the
lung
-
Neuroblastomas originate in the
neural crest tissue
-
What primary brain tumor typically spreads to the CSF
medulloblastoma
-
The most common symptom of Ewing sarcoma is
Pain
-
The most frequent orbital malignancy in children is
retinoblastoma
-
Wilm's tuor originate from what cell type?
nephroblasts
(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:
Allogeneic donor
Autologous donor
Syngeneic donor
self
compatible match
identical twin
- 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
mesoderm
-
Primary osseous tumors met to the lung via
blood
-
___________ surgery would include intralesional incision, wide margin excision with bone grafting, and marginal margin excision with internal fixation.
Limb salvaging
-
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
23GY
-
A natural barrier for regional spread of primary bone tumors is the
periosteum
-
Compact bone is arranged in concentric circle patterns known as
haversian systems
-
The area of spongy bone is found in the
epiphysis
-
A solitary multiple myeloma tumor is known as a
plasmacytoma
-
Which bone cancer has an onion skin appearance on an xray
Ewing sarcoma
-
A common symptom for soft tissue tumors is
painless mass
-
The most common childhood bone cancer is
Ewing Sarcoma
-
The most common primary bone cancer overall is
Osteosarcoma
-
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
rare
-
What is the most common primary orbital malignancy of childhood
rhabdomyosarcoma
-
Do regional lymph nodes have to be included in tx ports for primary bone tumors
no
-
What area of the brain would you expect to find involved if a patient had vision problems
parietal
-
What is the average survival for patients with brain mets
3 mos
-
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
incontinence
-
Which radionuclide may be used in treating met bone disease
strontium 89
-
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?
No
-
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
8x15 cm
-
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
jandice
-
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
simple
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