Palliative Care-Mosby Board Review Questions
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What area of the brain would you expect to find involved if patient has vision problems?
(occipital also, but is wasn't available as a choice)
What is the average survival time for pt with brain mets?
(6 wks to 6 months)
Distinguish between osteolytic and osteoblastic lesions as they may appear on x-ray:
- lytic=less dense(moth-eaten)
- blastic-more dense
Compare/contrast palliative doses of radiation for brain mets to curative doses for primary brain tumors:
- Palliative: 36 Gy (3 Gy/fx)
- Curative: 60 Gy (1.8-2 Gy/fx)
Superior Vena Cava Syndrome
Compression of the SVC by tumor (often pancoast tumor)
removal of a portion of the lamina
partial removal of the liver
Steriods are used to:
- decrease inflammation
- (often used with brain tumors)
A pt with brain mets may report(name 3 symptoms)
- 1)loss of memory
- 2)change in gait
Compression of the cauda equina will likely manifest as:
incontinence( both bowel and bladder)
Which of the following radionuclides may be used in treating metastatic bone disease:
In spinal cord compression and SVC syndrome, high doses of radiation are given in the first few treatments. The following doses are typical"
300-400 cGy per fraction
Which of the following oncological emergencies is NOT typically managed by RT?
(YES to radiation for:spinal cord compression, SVC syndrome, painfuo pathological fracture)
Which of following sites is least likely site of bony metastasis?
How do brain mets differ from primary brain malignancy?
- Mets are usually multi-focal
- Primary are usually solitary at diagnosis
When treating a pt who has spinal cord compression in the c-spine, the best position would be:
Prone with chin and forehead in horizontal plane and arms at side
A typical field size to treat thoracic vertebra 5-10 would be:
8 x 15
(always a width of 8 for spine, t-spine is 3 cm/vertebra for length)
A T-shaped radiation field would likely be seen in:
spinal cord compression in the lower lumbar or sacral region
Single posterior fields are not ususually adequete for lower lumbar or sacral mets because:
This region of the spin has a kyphotic curvature
Pt with brain mets begins to have a tonic-clonic seizure right before treatment. The therapist should:
Assist the pt to a safe position for the prevention of injury
A pt with SVC syndrome appears to have fainted during treatment. The therapist should:
Stop treatment, asses vital signs, and call Dr. or nurse
A common symptom of liver mets is:
Regional lymphatics are not usually included in radiation fields for palliation because:
disease has presumed to have already taken place
Single field spine, no field shaping:Charges are simple intermediate or complex?
Collimator rotation for the left lateral whole brain is 30 degrees, what is it for right lateral?
Separation for pts skull is 15 cm. What is treatment depth(midline)?
What would you like to do?
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