Total Board Review(Candice's and Meghan's w/Katy's edits).txt

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jaxkaty5437
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269668
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Total Board Review(Candice's and Meghan's w/Katy's edits).txt
Updated:
2014-05-03 11:02:54
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Radiation Therapy
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RTT review
Description:
Candice's Board review-with Katy's changes(up to 96)
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  1. Why give radiation to a metastatic lesion on a femur?
    to prevent fractures and relieve pain
  2. What factors should be considered when making an immobilization device?
    • Aperture/bore size
    • table type/flat
    • Type of immobilization device or boards
    • Patient positioning?
  3. Calculate the 80% isodose line for 12MeV
    • 4
    • Divide by 3
  4. What is a fomite and what can you get from one?
    • A fomite is an inanimate object like a urinary catheter, xray table, positioning sponges, contaminated gloves, stethoscope, etc. See page 155 of patient care book
    • You could get bacteria or viruses
    • This is one of the #1 ways for hospital infections
  5. What is a vehicle for disease?
    any medium that transports microorganims like contaminated food, water, drugs, or blood
  6. What is direct contact for diseases?
    • Contact Diseases are transmitted when an infected person has direct bodily contact
    • with an uninfected person and the microbe is passed from one to the other. Contact diseases can also be spread by indirect  contact with an infected person’s environment or personal items. The presence of wound drainage or other discharges from the body suggest an increased potential for risk of transmission
    • and environmental contamination.  Precautions that create a barrier and procedures that decrease
    • or eliminate the microbe in the environment or on personal belongings, form the basis of interrupting transmission of direct contact diseases.
    • http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/
  7. What is a vector?
    An anthropod in whose body an infectious organism develops or multiplies before becoming infective to a new host. The bite of an insect that transmits diseases like a skeeter(i.e. malaria, West Nile) or a tick(Lyme disease).
  8. What is droplet contamination
    • occurs when an infectious individual coughs, sneezes, speaks, or sings. It involves contact of the mucus membranes of the eyes, nose, or mouth. they travel in air and only short distances. Flu, meningitis, pertussis, and strep pneumonia, mumps are examples of respiratory illnesses that spread by means of droplet contamination. The difference
    • between airborne and droplet transmission is in the size of the particles expelled.
    • Droplet transmission occurs by droplets greater than five microns in diameter. The
    • droplets are sprayed into the air, but usually fall short of three feet. Exposure does
    • not generally occur beyond this range.
  9. What is airborne transmission?
    • Airborne transmission occurs when bacteria or viruses travel on dust particles or on small respiratory droplets(smaller than 5 microns) that may become aerosolized when people sneeze, cough, laugh, or exhale. They
    • hang in the air much like invisible smoke. They can travel on air currents over considerable distances. Special air handling and ventilation is needed to prevent airborne transmissions. TB, rubeola(measles), and the varicella viruses are examples.

    Airborne precautions are designed to prevent transmission of extremely small particles of evaporated droplets that can stay suspended in the air for long periods of time.  Particles smaller than 5 microns require airborne precautions, while particles larger than 5 microns call for droplet precautions.
  10. What is acquired immunity versus passive immunity
    • Active immunity=body MAKES it OWN antibodies(from exposure to disease or vaccine)
    • Passive Immunity: body receives pre-made antibodies  (from placenta or through direct introduction)

    • Active immunity results when exposure to a disease organism triggers the immune system to produce antibodies to that disease. Exposure to the disease organism can occur through infection with the actual disease (resulting in natural immunity), or introduction of a killed or weakened form of the disease organism through vaccination (vaccine-induced immunity).Either way, if an immune person comes into contact with that disease in the future, their immune system will recognize it and immediately produce the antibodies needed to fight it. Active immunity is long-lasting, and sometimes life-long.
    • Passive immunity is provided when a person is given antibodies to a disease rather than producing them through his or her own immune system. A newborn baby acquires passive immunity from its mother through the placenta. A person can also get passive immunity through
    • antibody-containing blood products such as immune globulin,which may be given when immediate protection from a specific disease isneeded. This is the major advantage to passive immunity; protection is
    • immediate, whereas active immunity takes time (usually several weeks) to
    • develop. However, passive immunity lasts only for a few weeks or months. Only active immunity is long-lasting.

  11. Give example of a secondary barrier
    Whichever walls receive scatter but not a direct hit of the beam.
  12. What happens to your MU when the field gets smaller?
    Question is worded badly...Either it should ask what happens to DOSE when field size gets smaller, what do you need to do with MU's to compensate for smaller field size?

    Dose will be decreased with smaller field size because of less scatter. If you need the dose to remain the same, then you need to increase MU's as compared to larger field.
  13. What is an expected side effect of treating supratentorial (rare brain tumor in kids, also called medulloblastoma) treatment?
    • Short term effects
    • fatigue
    • mild skin reactions
    • upset stomach
    • loose stool
    • Long term effects
    • growth
    • hormone deficiencies
    • problems with learning(neurocognitive dysfunctions)
  14. What is an expected signs and symptoms of a supratentorial brain tumor(rare brain tumor in kids, also called medulloblastoma)?
    • Loss of balance, trouble walking, worsening handwriting, or slow speech.
    • 1)Morning headache or headache that goes away after vomiting.
    • 2)Nausea and vomiting.
    • 3)Unusual sleepiness or change in energy level.
    • 4)Change in personality or behavior.
    • 5)Unexplained weight loss or weight gain.
  15. What is the main advantage of a small focal spot
    less penumbra
  16. Out of tray, bolus, compensating filter, and a wedge, what would attenuate the beam the least?
    Tray
  17. What is a stroke and what are the signs of one
    • A stroke happens when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack." If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage.
    • Numbness or weakness in your face, arm, or leg, especially on one side
    • Confusion or trouble understanding other people
    • Trouble speaking
    • Trouble seeing with one or both eyes
    • Trouble walking or staying balanced or coordinated
    • Dizziness
    • Severe headache that comes on for no known reason
  18. What billing type is 3D conformal?
    complex
  19. If the whole abdomen receives 30GY what organ would be damaged
    kidney
  20. What is Lhermitte's syndrome?
    • a sudden sensation resembling an electric shock that passes down the back of the neck and into the spinal column and can radiate out to the fingers and toes.
    • This is a symptom of helmet or CNS radiation
  21. What is the most common histology for breast cancer
    invasive/infiltrating ductal carcinoma
  22. Which lung cancer is not likely to receive radiation?
    • small cell/oat cell
    • surgery is the #1 choice
  23. Which way is the table kicked for breast tangents?
    Away from the gantry
  24. What type of tx should a pt receive with glioblastoma multiforme?
    Gross total resection followed by radiation 60-70 Gy and chemo
  25. What histology are glandular tumors
    Adenocarcinoma
  26. Which bones would prostate cancer met to first
    lumbar (pelvis)
  27. What are the 2 main lymph systems of the lower body?
    • Inguinal
    • Iliacs
    • **research**
  28. Which of the following does not control hormones
    ovaries
    pituitary
    adrenals
    prostate
    prostate
  29. If you are treating this area, emesis will result
    abdomen
  30. What do you include in the tx field for a soft tissue sarcoma?
    • 1-2 cm some say 1-3cm of normal tissue is spared to avoid fibrosis and edema
    • You can use generous tumor margins but always spare a small strip of tissue along the extremity.
  31. What cancer has one of the longest latencies?
    mesothelioma 20-50 years
  32. Order of flow for electrons through the machine
    • (NO TARGET FOR ELECTRONS)
    • primary collimator
    • scattering foil
    • ion chamber
    • secondary collimator
    • accessory mount
    • electron applicator
    • patient
    • Page 144 in purple book
  33. Order of flow of photons thru the machine
    • target
    • primary collimator
    • flattening filter
    • ion chamber
    • secondary collimator
    • slot for wedges
    • flattened beam
    • patient
    • Page 144 in purple book
  34. Order of parts within the machine
    • Gantry
    • electron gun
    • energy switch
    • waveguide
    • focal spot
    • steering system
    • bending magnet
    • target(used for photons only)
    • primary collimator
    • flattening filter(for photons)
    • or scattering foil(for electrons)
    • ion chamber
    • secondary collimator(jaws)
    • page 141 in purple book
  35. **What are the 4 major components that are housed in the stand
    • *magnetron( or klystron is it is present to amplify the microwaves produced by the magnetron)
    • *Waveguide
    • *Circulator
    • *Cooling System
  36. what are the major components in the gantry
    • accelerating waveguide
    • electron gun
    • treatment head(bending magnet,target, collimators, scattering foil/flattening filter)
  37. Where does posterior 2/3 of the tongue drain to?
    submandibular nodes

    (tip of tongue drains to submental nodes)
  38. What is the best way to tell if someone is having a heart attack?
    • Uncomfortable pressure, fullness or squeezing pain in the center of the chest
    • Prolonged pain in the upper abdomen
    • Discomfort or pain spreading beyond the chest to the shoulders, neck, jaw, teeth, or one or both arms
    • Shortness of breath
    • Lightheadedness, dizziness, fainting
    • Sweating
    • Nausea
  39. What gets the most damage from radiation exposure
    DNA
  40. What is mitochondria and what is it used for?
    An organelle found in cells that aids in energy (ATP) production in cells
  41. What does a beta particle consist of?
    • Can be
    • positrons (beta+)
    • electrons (beta-)
  42. What does an alpha particle consist of
    2 protons and 2 neutrons bound together(identical to helium nucleus)
  43. What is ascites and what cancer is it commonly found in?
    • fluid build up in the space between the lining of the abdomen and the abdominal organs
    • common in ovarian cancer
    • (also found w/ breast, colon, stomach and pancreas)
  44. Why give external beam radiation with internal brachytherapy for txg the cervix
    The usual tx is TAH for cervical cancer but for pts who are medically inoperaple, we would use both, the brachy for the cervix using tandem and ovoids to pt A, and external to capture the nodes
  45. What is SVC syndrome
    superior vena cava syndrome is compression of the superior vena cava that causes edema in the face, neck and arms. usually from lung cancer like Pancoast tumor
  46. What is the most common cancer in children?
    • ALL
    • acute lymphocytic leukemia
    • or
    • acute lymphoblastic leukemia
  47. What is the most common brain tumor in children
    medulloblastoma
  48. What blood cells are most sensitive to the least sensitive
    • VIM-vegetative intermitotic cells which include basal cells, crypt cells, eythroblasts, and type A spermatogonia
    • DIM-differentiating intermitotic cells which include type B spermatogonia
    • RPM-reverting postmitotic cells which include liver cells and mature lymphocyte
    • FPM-fixed postmitotic cells which include nerve cells, muscle cells, eythrocytes, and spematozoa.
    • Know page 68 chart in the purple book

    "Valentine's Day Rips Farts"
  49. What side effect is the latest side effect after radiation?
    fibrosis(usually one year)
  50. What cancer is the hockey stick field used for?
    seminoma
  51. Where does the nasopharynx drain to
    • retropharyngeal nodes into the superior jugular and
    • posterior cervical nodes and the
    • lateral retropharyngeal nodes (Nodes of Rouviere)
  52. What is considered a low residue diet
    A low residue diet is a diet designed to reduce the frequency and volume of stools while prolonging intestinal transit time. It is similar to a low-fiber diet, but typically includes restrictions on foods that increase bowel activity, such as milk, milk products, and prune juice.

    • Foods to avoid:
    • Whole grain breads and pastas
    • corn bread or muffins
    • products made with whole grain products, or bran
    • Strong cheeses
    • yogurt containing fruit skins or seeds
    • Raw vegetables except lettuce and other leaves
    • Tough meat, meat with gristle
    • Peanut butter
    • Millet, buckwheat, flax, oatmeal
    • Dried beans, peas, and legumes
    • Dried fruits, berries, other fruits with skin or seeds
    • Food containing whole coconut
    • Juices with pulp
    • Highly spiced food and dressings, pepper, hot saucesCoffee and other foods with caffeine[medical citation needed]PopcornNuts and Seeds[2]
  53. What is workload and use factor used for?
    • workload is the amt of time the beam is on
    • use factor is the amt of time the beam is directed toward a wall.
  54. what type of cancer is in the lower esophagus
    adenocarcinoma
  55. What is considered a sterile procedure
    • critical sterile pg 217 purple book
    • needles/injections
    • surgical instruments
    • urinary catheters
    • implants
    • IV
    • anything entering the body or blood stream
    • Semi critical
    • endoscopes
    • thermometers
    • anethesia equipment
  56. What is it called when a dr surgically opens and inserts something into the patient?
    • brachytherapy
    • IORT
  57. What kind of test is used to test how many WBCs there are?
    • A WBC(white blood cell count) or a CBC(complete blood count:which measures RBC, WBC, platelets, etc) A  CBC with differential can measure the amounts of different types of white blood cells in your blood.
  58. What are the most hazardous materials in blocks?
    cadmium and lead
  59. How far does an electron cone have to be from the skin surface
    5cm
  60. How far do tx machine accessories composed of dense metal need to be kept away from the pt?
    at least 15cm away
  61. What is the TD 5/5 of the heart that causes pericarditis?
    40 GY (whole)
  62. What is agenesis?
    absence of incomplete development of an organ.
  63. What is ionization
    the removal of an electron from an atom
  64. What is bremsstrahlung
    The most important method in producing xray beams. "braking radiation" or "deceleration radiation") is electromagnetic radiation produced by the deceleration of a charged particle when deflected by another charged particle, typically an electron by an atomic nucleus. The moving particle loses kinetic energy, which is converted into a photon because energy is conserved. The term is also used to refer to the process of producing the radiation. Bremsstrahlung has a continuous spectrum, which becomes more intense and whose peak intensity shifts toward higher frequencies as the change of the energy of the accelerated particles increase.
  65. what is the most imp method in producing xray beams?
    bremsstrahlung
  66. What is characteristic radiation?
    When an electron drops down to fill a vacant hold in the electron shell, it loses some of its energy in the process. The lost energy usually appears as characteristic radiation. We usually see this in photoelectric scattering.
  67. What is pair production?
    This occurs at high energies 1.022 Mev and higher. the incident photon passes close to the nucleus of the atom. When the photon interacts with the EM field of the nucleus, it is absorbed and instantly the energy is re emitted as an electron positron pair which is then ejected from the atom, each has an energy of .511 MeV
  68. What 2 cancers have uniform lymphnode spread?
    Seminoma and Hodgkins

    **research**

  69. What is leukocytosis?
    Raised WBC count
  70. Which organ(s) drains to the para aortic nodes?
    • testis, ovaries,cervix(very common), uterus(common), fallopian tubes, rectum(very rare)
    • *The para-aortic nodes help drain the organs in the pelvis and the lower part of the digestive system. The preaortic group(a sub section of para-aortic nodes) is located in front of the aorta, where each node drains sections of the gastrointestinal tract found in the abdomen until the mid-rectum.The set of lymph nodes located near the third and fourth lumbar vertebral bodies, just behind the aorta, is called the retroaortic or
    • postaortic group(collectively termed the lateral group). They drain in males to
    • the testis: and in females to the ovaries,cervix, uterus, fallopian tubes.

  71. Does ½ life increase, decrease, or stay the same as the source decays?
    stays the same

  72. What is the most common lung cancer?
    Non small cell(squamous cell type)


    *Adenocarcinoma and large cell carcinoma are also types of NSCLC, but squamous cell is the most common type of lung cancer
  73. *What type of cancer is not caused by occupation exposure to carcinogens?
    leukemias, lymphomas


    • *Check this
    • Radiation exposure can cause leukemia...so maybe not leukemia but lymphoma(unknown cause-thought to be possibly triggered by and infection or compromised immune system) would make more sense????

  74. What is the most common site of occurrence for an astrocytoma?
    Cerebral Hemisphere (cerebrum)

  75. Where is the pyriform sinus located?
    Hypopharynx between the throat and the esophagus

  76. Why is shielding used for nasal carcinoma?
    To protect the lens of the eye and the inside of the nostrils
  77. Which portion of the colon is near the fundus of the uterus
    sigmoid colon
  78. What syndrome is associated with esophageal cancer?
    Plummer Vinson Syndrome (triad of dysphagia, iron deficiency anemia, and esophageal webs)
  79. What is Barrett's Esophagus
    A disorder that is most common with adenocarcinoma of the esophagus, in which the lining of the esophagus is damaged by stomach acid and changes the lining similar to what the stomach has.
  80. What is a common tx for esophageal cancer
    • radiation for the upper portion and
    • surgery for the lower portion
  81. What type of cancer involves one true vocal cord
    laryngeal cancer of the glottis
  82. Who regulates the radioactive materials
    NRC
  83. What do you use when doing IORT
    Mobetron or an intrabeam system
  84. Where would the lower lobe of the lung drain to
    drain back to the hilum but can drain back to the celiac axis

    **research**
  85. Where does lung cancer met to?
    #1 brain
  86. What is the pancoast tumor
    tumors that present in the apex of the lung and is characterized by pain in the shoulder which radiates down the arm, atrophy of the hand muscles, Horner's syndrome (droopy eyelids (miosis), teary eyes, (ptosis), etc
  87. Which of these would do well with hormone tx?
    prostate
    breast
    testis or
    ovaries
    • prostate and breast(most common)
    • **research**

    **ALSO Possibly: Ovarian(currently being researched in clinical trials),Kidney, Endometrial
  88. How does basal cell cancer spread
    Almost never does but can to the skin and bone
  89. Label in order most sensitive to least
    gonads
    ureters
    bladder
    uterus
    • gonads 100-200 cgy
    • bladder 6000
    • ureters 7500
    • uterus 7500-10000
  90. What is the karnofsky's scale used for?
    used to rate a pts performance status and can be used to evaluate their status after a procedure. 0=dead and 100= alive
  91. What tumor causes shoulder pain that radiates down the arm and causes atrophy of the hand muscles?
    Pancoast tumor of the lung
  92. What cancer has the shortest latency period?
    Leukemia
  93. How does barometric pressure and temperature affect output?
    It can affect the dose reading of the ion chamber
  94. What organ does blood go through before getting to the IVC?
    • Liver
    • After passing through the portal circulation and the liver, blood drains into either the left or right hepatic vein. The hepatic veins leave the liver, emptying into a vein called the inferior vena cava, which is part of the systemic blood circulation that carries blood back to the heart. From the inferior vena cava, blood is delivered to the right upper chamber of the heart, or right atrium, before being ejected from the right lower chamber, or ventricle, into the pulmonary circulation of the lungs, where oxygen is added.
  95. What are the homogeneity factors?
    • soft tissue 1.0
    • bone  1.3
    • air/lung  .3
  96. If you are using the hand pendant and the table keeps moving, what may be wrong?
    short circuit
  97. Otitis media is a presenting symptom in
    nasopharyngeal cancers
  98. Will you have more divergence on a larger field or an irregular field?
    irregular field



    check
  99. If you have an unresectable non small cell tumor, what would be the dose?
    • 55-60 GY
    • **Research**
  100. What is the thickness of an electron block?
    1-2cm



    (Varian standard is 1.5 cm)
  101. If you are treating a pt and you notice that the wedge is put in wrong what do you do?
    • Stop the beam. physics will have to recalculate
    • **research**
  102. What would block neutrons?
    • Because of their exceptional ability to penetrate other materials, neutrons can travel great distances in air and require very thick hydrogen-containing materials (such as concrete or water) to block them. Fortunately, however, neutron radiation primarily occurs inside a nuclear reactor, where many feet of water provide effective shielding.
    • My sheet also says waxy substance but I cannot find anything to prove that theory?
  103. What is Strontium 90?
    beta emitter and used in eye txs. usually 3-5 txs
  104. What is Strontium 89?
    A systemic tx given for bone mets. It is intravenously or intracavitary administered into pts who have wide spread bone mets. 1/2 life of 50 days
  105. What do lasers cause the most damage to?
    Retina
  106. What is the most common site of spread for laryngeal cancer?
    • supraglottis-jugulodigastric and midjugular nodes
    • glottic-rare to have ln spread due to lack of ln in the region
    • subglottic- peritracheal and cervical nodes
  107. What is the most common condition assoc with adenocarcinoma of the esophagus
    Barrett's Esophagus
  108. What is the most radiosensitive tissue?
    bone marrow
  109. What are the most sensitive cells in the body?
    lymphocytes
  110. What type of wedge produces a straighter isodose curve?
    sigmoid shape
  111. The compensating filter is made for the pt but the doc decides to move iso 3cm, what do you do?
    You move the pt and make a new compensator filter.
  112. What is the most common primary histology for brain cancer?
    Astrocytoma-glioma
  113. What is the most common bladder cancer
    transitional cell
  114. What is the largest adult lymph tissue
    spleen
  115. Popliteal lymphs are where in relation to the patella?
    behind the knee, posterior to the patella
  116. What is the most hazardous material in cerrobend blocks?
    cadmium then lead
  117. What is the most common interaction in CT scans
    Photoelectric
  118. What is tachycardia
    fast heart beat
  119. What is the worst type of seizure
    Grand mal
  120. Which is more radiosensitive, bone or muscle?
    Bone
  121. What type of billing would you do for contrast?
    complex
  122. What system does metastasis generally travel through for blood?
    Most blood born mets go thru the venous system
  123. List from most radiosensitive to least
    wbc, neutrophils, rbc, platelets
    • WBC-neutrophils-platelets -RBC
    • **Still not sure on this one...know WBC's are most sensitive, and RBC are more radioresistant, not sure otherwise**
  124. What could be affected if you treat the fundus of the uterus?
    • ovaries
    • colon
    • bladder
  125. If you are a retired therapist, can you work as a sonographer?
    no, you have to be active before you can treat

    Need to check to see if you would also have to go to sonography school as well
  126. What type of cancer would represent a dot on a CT above the femoral heads?
    rectum or bladder?
  127. what is the range for a CT scanner?
    100-150 KeV
  128. What is methotrexate most often used for?
    Need to double check...doesn't sound right..

    (Answer on Candice's cards-Lymphomas of the breast)
  129. If the temperature is high, what can it affect?
    dose and dose rate
  130. What is the most common histology of lung cancer
    • NSCL-subtype:???
    • Tracey's PP say SCC, but some sources say Adenocarcinoma, so only sure thing is Non Small Cell Lung
  131. Which drug is cardiotoxic
    adriamycin
  132. What cancer most likely mets to both sides of the neck?
    nasopharynx, I believe that is due to the fact that 80-90% of nasopharynx tumors have cervical ln involvement
  133. When treating 50 GY to the parotid, what side effect can occur?
    Xerostomia can occur at 20 GY and permanently at 40 GY
  134. What artery directly arises from the aorta?
    • left subclavian artery,  brachiocephalic artery,
    • left common carotid artery
  135. Which quadrant is the spleen located in?
    Left upper quadrant
  136. What is tamoxifen used for
    breast cancer. it works against estrogen
  137. Why is bladder cancer treated with an empty bladder?
    to shrink the field size and encompass the entire bladder but less surrounding tissue
  138. What is the occupational limb dose?
    500 msv and 50 rem
  139. A patient is irradiated over most of his skeleton, what is likely to happen?
    leukopenia
  140. If you want more detail on a CT scan, what should you do?
    raise the density, make the slices thinner, and raise the contrast

    **research**
  141. An AP film of the pelvis is good for interpretation of all of the following except? right/left
    superior/inferior
    anterior/posterior
    anterior/posterior
  142. If a pt is immunosuppressed, what type of isolation must be used?
    reverse isolation
  143. Wilms tumor presents with what symptom?
    painless abdominal mass
  144. Why do you angle for a SCV field?
    • **Check Bentel
    • Thought was to avoid cord and esophagus...

    so there is no hot spot on the tangent
  145. What are tumors that arise from mesenchymal tissue?
    sarcomas
  146. Where do leiomyosarcomas arise from?
    smooth muscles and vascular systems
  147. Lymphatic drainage of the breast is primarily to the
    axillary nodes, scv nodes, and IMC nodes
  148. What are the structures of concern when treating the pancreas?
    • liver
    • cord
    • kidneys
    • small bowel
    • stomach
  149. what should you consider when making immobilization devices for ct
    • make sure if fits in the bore
    • make sure you can reproduce the set up
    • consider beam angles
  150. Which lymph nodes do the prostate drain to?
    The prostate drains principally into the internal iliac nodes
  151. What is the best way to diagnose pancreatic cancer?
    spiral ct of the abdomen
  152. List in order from greatest to lease radiosensitive organs
    kidney
    brain
    lens
    vagina
    • lens
    • kidney
    • brain
    • vagina
  153. Where is the pituitary gland situated
    inside the sella turcica of the sphenoid bone
  154. Where is the Waldeyer's ring located
    in the pharynx at the back of the oral cavity
  155. Where are the fornices located
    on the sides of the cervix
  156. What are the sinuses below the orbits?
    Maxillary sinus
  157. What are common factors for nasopharyngeal cancer?
    • EBV(Epstein Barr Virus)
    • alcohol
  158. What is a precursor for colon cancer
    polyps
  159. What are the signs of bladder cancer
    • frequency
    • dysuria
    • urgency to urinate
    • hematuria
  160. If the gantry is at 90 and the patient is at 90, and the patient is supine head first, what projection is this?
    vertex
  161. After the bending magnet, what order the beam exit the gantry?
    • target
    • primary collimator
    • flattening filter
    • ion chamber
    • secondary collimator
    • patient
  162. If a patient is lying on their right side, but the gantry is at zero, what is the angle
    left lateral
  163. Where do mesenchymal cells arise from?
    bone marrow
  164. What is the most common site of metastasis for stomach cancer?
    liver
  165. What are the most common sites of mets for anal cancer?
    liver and lungs

    ( ALL:Anal Liver Lungs)
  166. What are the most common sites of mets for lung cancer
    • brain
    • liver
    • bone
  167. What are the most common sites of mets for bladder cancer?
    • lungs
    • bone
    • liver
  168. What is the best treatment field for a kidney
    AP/PA
  169. What is the most common histology for oral cavity
    squamous cell
  170. what is the most common histology for colorectal cancer
    adenocarcinoma
  171. What is the most common histology for anal cancer
    squamous cell
  172. What is the most common histology for cervical cancer
    squamous cell
  173. What is the most common histology for endometrial cancer
    adenocarcinoma
  174. If a breast cancer lesion is located in the upper inner quadrant, which nodes would it drain to
    IMC
  175. Which syndrome and at what dose could a patient die form infection?
    • Hematopoietic TBI-100-1000GY
    • Gastrointestinal TBI 1000-5000GY
  176. What is the most sensitive period of time for a fetus?
    1st trimester
  177. Where is the epiglottic vallecula
    behind the root of the tongue between the folds in the throat
  178. What organs drain to the internal iliac nodes?
    • vagina
    • cervix
    • prostate
    • bladder
    • ureter, urethra
    • rectum
    • anus
  179. The PAB field is intended to iradiate the
    level 3 axillary nodes
  180. When using a breast board for positioning, the optimal incline angle is influenced by
    the slope of the pts chest
  181. How often must a leakage test be preformed
    every 6 months
  182. What is the order of the cell cycle
    G1, S, G2, M

    DO NOT CONFUSE CELL CYCLE WITH PHASES OF MITOSIS
  183. What phase of the cell cycle is when mitosis occurs?
    • During the M phase 
  184. What could cause angina
    blood clots, heart attacks, pulmonary embolism, pericarditis, panic attack, lung infection
  185. What angle dose the diaphragm and ribs make
    Costophrenic
  186. The angle of Luis is helpful in the tx of
    breast
  187. What is the 1/2 life of IR192
    74 days
  188. Cesium 137 is most commonly used in which tx
    cervical cancer

    **research**
  189. Iridium 192 is most common in txg
    • soft tissue sarcoma
    • lung
    • h&N

    • **research**
    • ??????
  190. What is the 1/2 life of cesium 137
    30 years
  191. What type of chemo drug is used to tx patients with brain tumors
    corticosteroids
  192. Where are the adrenal glands located
    top of kidneys about T12
  193. What is the most common symptom of pituitary tumors
    headache
  194. What effect TAR
    • Energy
    • depth
    • field size
  195. What effects PDD
    • Energy
    • field size
    • ssd
  196. What is pruritis
    itchy skin
  197. What is the most common thickness of cerrobend for MV txs
    7.5 cm
  198. What is the most life threatening form of malnutrition
    Marasmus
  199. Where does cerebrospinal fluid drain to
    venous system
  200. Where are the lateral ventricles located
    the cerebral hemisphere
  201. What is Moh's surgery used for
    skin cancer(TYPICALLY NON MELANOMA)
  202. What is cisplatin
    a chemo drug that is cytotoxic alkylating agent
  203. What is the density for lungs(I'm assuming we are asking for Hounsfield Units)
    Lung−500

    HU


    • Air:−1000
    • Lung: -500
    • Fat:−100 to −50
    • Water:0
    • CSF:15
    • Kidney:30
    • Blood:+30 to +45
    • Muscle+10 to +40
    • Grey matter:+37 to +45
    • White matter:+20 to +30
    • Liver:+40 to +60
    • Soft Tissue, Contrast:+100 to +300
    • Bone:+700 (cancellous bone) to +3000 (dense bone)
  204. What is the density for air
    -1000
  205. What is the density for bone
    1000
  206. What is the density for water
    0
  207. What are the advantages of afterloading
    to reduce exposure to medical personnel
  208. When a pt moves during a ct, what does it cause
    • Artifacts
    • blurring
    • missed registration
  209. **What is not a method of IMRT delivery out of conebeam, 3D conformal, and step and shoot
    • *weird question..
    • 3D is not IMRT either....

    conebeam
  210. What disease cannot be spread from a fomite?
    • Malaria
    • Lyme
    • West nile
    • etc
  211. What is grading used for
    cell differntiation
  212. What is the most common reason to use bolus for photon txs
    fill air gaps is what my sheet says but I would think it would be to bring dose to the surface
  213. How do you get dose from TLD
    The dosimeter will have to be heated and then give off a light reading.
  214. What quadrant is the liver in
    upper right quadrant
  215. What is the presenting symptom of uterine cancer
    Vaginal bleeding and discharge
  216. What is hyperplasia
    increased proliferation (growth and multiply) of cells
  217. What is anaplasia
    lack of cell differntiation
  218. If you use contrast that is not diluted, what can it cause
    • patient side effects
    • artifacts
    • **research**
  219. What is hyper alimentation
    • artificial supply of nutrients.
    • giving food via IV
  220. What is the treatment of choice for small intestine
    surgery
  221. What is included on a radiation therapy prescription
    • name of patient
    • date
    • Site
    • tx volume
    • total dose
    • dose per fx
    • freq of fx
    • type of energy
    • beam shaping devices
    • diagnosis and staging
    • treatment modality(IMRT, 3D etc)??
    • More?
  222. What is a BUN test
    A common blood test, the blood urea nitrogen (BUN) test reveals important information about how well your kidneys and liver are working. A BUN test measures the amount of urea nitrogen that's in your blood.

    10-20
  223. What is the whipple procedure
    It is used for pancreatic cancer. Resecting of the head of the pancreas, entire duodenum, distal stomach, gall bladder, and common bile duct.
  224. What is cholesteatoma and what is the presenting symptom of it
    • abnormal growth in the ear drum
    • otitis media
  225. What converts kinetic energy to microwave energy in the linac
    klystron
  226. Most common sign of nasopharyngeal cancer
    • nose bleeds
    • and according to Tracy's power points..respiratory and auditory dysfunction
  227. What is a state of being self governing
    autonomy
  228. What is is called when the probability that each photon in the beam will interact with the medium and lost its energy per cm of material that the photons pass thru and has units of cm. it is not a constant but instead depends greatly on the energy of the photon beam and the medium in which the interaction is taking place
    linear attenuation coefficient
  229. What can bronchiogenic carcinoma cause
    SVC syndrome
  230. What is Horner's syndrome
    • ipsilateral miosis(contracted pupil), ptosis(dropping eyelid), enophthalmos(recession of eyeball into orbit), bone erosion of ribs and vertebrae caused by damage to the sympathetic nerves at the neck.
    • Horner syndrome isn't a disease itself. Rather, it's a sign of another medical problem — such as a stroke, tumor or spinal cord injury. In some cases, however, no underlying cause can be found. Per Tracey's power point, if you hear Horner's syndrome, think apical tumor of the lung or Pancoast tumor
  231. What is the TD 5/5 for the bowel
    4500
  232. Most common chemo drug for the pancreas is
    Gemcitabine
  233. What are considered the endocrine portion of the pancreas
    Islets of Langerhans (hormone producing)
  234. What is the most common fungal infection seen in pts
    Candid albican (yeast infection)
  235. Most common sign of oral cancer
    swelling of an ulcer that fails to heal
  236. Most common sign of oropharynx cancer
    • painful swallowing
    • sore throat
    • referred otalgia
  237. Most common symptom of Larynx cancer
    Hoarseness or stridor
  238. Most common symptom of hypopharynx cancer
    dysphagia and painful neck node
  239. What are the most common chemo drugs used in Hodgkin's disease
    • Adriamycin/Doxorubicin
    • Belomycin
    • Vinblastine
    • Dacarbazine
    • Typically just called ABVD
  240. What lymph nodes are covered in the mantle field
    • Submandibular
    • occipital
    • cervical
    • scv
    • infraclavicular
    • axillary
    • hilar
    • mediastinal

    (SOCS In A Hot Mess)
  241. What happens if you are treating a prostate and the machine's isocenter is 1cm below the laser?
    complete miss of the prostate
  242. PDD increases with what factors
    • Energy
    • field size
    • SSD
  243. What is it called when a person undergoes chemo and radiation therapy at the same time
    concurrent therapy
  244. How many msv are allowed for a non occupational worker with frequent exposure
    1msv or .1 rem
  245. What is the Law of Bergonie and Tribondeau
    Radiation is more effective against cells that are actively mitotic, undifferentiated, and have a long mitotic future
  246. What is the OER ratio
    It compares the response of cells with radiation in the presence and absence of O2
  247. What is the most potent radiosensitizer
    O2
  248. Cells at the center of a tumor tend to be
    necrotic

    **research**
  249. When do you use interstitial brachytherapy
    • The two main types of brachytherapy treatment in terms of the placement of the radioactive source are interstitial and contact.
    • In the case of interstitial brachytherapy, the sources are placed directly in the target tissue of the affected site, such as the prostate or breast.
    • Contact brachytherapy involves placement of the radiation source in a space next to the target tissue. This space may be a body cavity (intracavitary brachytherapy) such as the cervix, uterus or vagina; a body lumen (intraluminal brachytherapy) such as the trachea or oesophagus; or externally (surface brachytherapy) such as the skin. The radiation source can also be placed in blood vessels (intravascular brachytherapy) for the treatment of coronary in-stent restenosis
  250. What do you use intracavitary brachytherapy
    cervical cancer on into an actual cavity
  251. What do you use intraluminal brachytherapy
    esophagus, uterus, trachea, bronchus, or rectum
  252. Which of the 4 can cause secondary cancer
    chemo
    surgery
    radiation
    hormone therapy
    radiation and chemo
  253. What is the SI unit and the traditional unit that represents absorbed dose?
    • SI Gray
    • Trad is Rad
  254. Where are pancoast tumors located
    apex of the lung
  255. What is the brain tumor that seeds down into the spinal cord
    medulloblastoma
  256. What is the most common brain tumor in children?
    medulloblastoma, occurs in the cerbellum of kids
  257. What is the main reason an IV bag must remain above the injection site
    to prevent the back flow of fluids
  258. Which of the chemo drugs is cardiotoxic
    adriamycin aka doxorubicin
  259. When treating the parotid gland with std fx of 50 GY, what is most likely to occur
    • permanent xerostomia which occurs after 40
    • temporary is at 20GY
  260. What is the Td 5/5 for the Parotid
    30GY
  261. Placing an immobilization device on a pt without consent can be considered
    battery
  262. What is an example of hyperfractionated radiation schedule
    Twice a day but at least 6 hours apart
  263. If you need to look up what chemicals are in a product in your dept, it would be best to check
    the MSDS sheet material safety data sheet
  264. Dose rates increase with increased field size because of
    scatter within the irradiated volume from the collimator and other beam shaping devices
  265. The monitor unit is independent of
    field size
  266. As the field size increases, the absorbed dose in a medium is _____ due to the increased scatter
    greater
  267. Back scatter is independent  or dependent on SSD
    independent BUT depends on the energy and field size
  268. Assume the HVL of material is 3mm, how much material is needed to reduce the beam intensity to 12.5% of its original value?
    9mm
  269. when a field size changes during the course of a pts tx, what will happen
    MU's will change
  270. Why is the gantry angled 10-15 degrees on a SCV field
    • to protect the cord and the esophagus
    • page 151 radiation essentials book
  271. What two structures are important when making a mask
    nose and chin
  272. What kind of tx do you give for a low grade glioma
    gross total resection and observation /partial brains

    **research**
  273. What is a constant error in tx called
    systemic
  274. What is wrong if the table is still moving after you let go of the pendent
    short circuit
  275. Is high Let or low Let more damaging
    High
  276. The suprsternal notch is at what level
    T2-T3
  277. Which direction can you not tell from an AP film
    Anterior-posterior
  278. As the source decays, the 1/2 life
    stays the same
  279. How often do you check the patient's prescription
    daily before tx
  280. If a pt has loose skin, what is the best way to ensure that you are still txg at iso
    pre treat port film
  281. what is a voxel
    3D equivalent of a pixel and the tiniest distinguishable element of a 3D object. It is a volume element that represents a specific grid value in 3D space
  282. Which energies are represented in the EM spectrum
    xrays
    alpha particles
    neutrons
    gamma rays
    visible light
    • xrays
    • gamma rays
    • visible light
  283. If the light field doesn't coincide with the tx field, what could be the problem
    the angle of the mirror could be off.

    **research**
  284. What does an isotope have the same # of
    protons
  285. What do Z, A, and N stand for
    • Z=atomic #(number of protons)
    • A= atomic mass (protons +neutrons)
    • N= neutrons
  286. What level does the carina bifurcate
    T5
  287. What kind of diet should a person be on when receiving tx to the mediastinum
    soft bland foods
  288. What kind of diet should a person be on when recv'd tx to the abdomen and pelvis
    low fat, low residue
  289. A beam enters thru the pt's left scapula and exits thru the anterior chest. What projection is this
    LPO
  290. If you go 2cm anterior and 2cm superior from the EAM, what are you treating?
    Pituitary
  291. If you see a pt slumped over in a chair, what do you do first
    shake and shout, check for alertness
  292. PDD is dependent on what 4 factors
    • energy
    • depth
    • field size and
    • SSD
    • PDD increases as energy, field size, and SSD increase.
    • Page 499 in purple book
  293. TAR is dependent on what 3 factors
    • energy
    • depth
    • field size
    • TAR increases or decreases as the any of the above do the same
  294. PDD is dependent on SSD, what about TMR, TAR, and TPR
    no they are not. They are dependent everything that PDD is like energy, depth, and field size, but NOT SSD
  295. What is the Ampulla of Vater
    It is formed by the union of the pancreatic duct and the bile duct and enters the duodenum. It regulates the flow of bile and pancreatic juices.
  296. What does agenesis mean
    failure of an organ to devlop
  297. What is anaplastic
    Loss of differentiation same as anaplasia
  298. Put the cell types VIM-FPMin order from most to least sensitive and briefly describe
    • VIM-divides regularly and rapidly, undifferentiated and does not differentiate between divisions.
    • DIM-actively divides, a little more differentiated than VIM and differentiates between divisions
    • RPM-Does not normally divide but has the capability to differentiate
    • FPM- Does not divide, highly and well differentiated
  299. What are the 3 total body radiation syndromes and their doses
    • Hematopoietic Syndrome 100-1000 cGy. Depression of blood cell counts termed pancytopenia. can die from serious infection
    • Gastrointestinal Syndrome-1000-10,000 cGy, but can happen as low as 600. The mean survival time is 3-10 days but up to 2 weeks with medical support. Die of serious infections
    • Cerebrovascular Syndrome-5000-over 10,000 cGy. usually dies within hours
  300. What is the most radiosensitive portion of the digestive system
    small intestine
  301. What is the difference between aerobic and anaerobic
    Aerobic is presence of O2 and anaerobic is no presence of O2
  302. Td 5/5 of the heart
    4000 cGy
  303. Td 5/5 of the esophagus
    5500-6000
  304. Td 5/5 of the bladder
    6000-6500
  305. Td 5/5 of the rectum
    6000
  306. Td 5/5 of the testis
    100
  307. Td 5/5 of the uterus
    7500
  308. Td 5/5 of the whole brain
    4500
  309. Td 5/5 of the lens of the eye
    500-1000
  310. Td 5/5 of the fetus
    200
  311. Td 5/5 of the kidney
    2300
  312. Td 5/5 of the intestines
    4500
  313. Td 5/5 of the Parotid
    3200
  314. Td 5/5 of the liver
    3000
  315. Td 5/5 of the lung
    • 1/3= 4500
    • 2/3=3000
    • 3/3=1750
  316. Td 5/5 of the vagina
    9000
  317. Td 5/5 of the stomach
    4500
  318. What does the epiglottis do
    Prevents food from entering the trachea
  319. Label this diagram
  320. Label this diagram
  321. What is the annual exposure limit on a hand
    50 rem or 500 msv
  322. What is the annual exposure limit for the public fo frequent exposure and infrequent
    • frequent =.1 rem or 1 msv
    • Infrequent= .5 rem or 5 msv
  323. What is the annual exposure limit for the fetus
    .5 rem or 5 msv
  324. What is the exposure limit monthly for the fetus
    .05 rem or .5 msv
  325. What is most sensitive cell cycle phase
    M(mitosis)

    M is for MITOSIS  NOT METAPHASE-which is one part of mitosis(consisting of prophase, metaphase, anaphase, telophase)
  326. Where is the sanctuary site for leukemia
    CNS
  327. What is grading of a tumor mean
    Provides info about its biological aggressiveness and is based on the degree of cell differentiation
  328. List orders the plans for tx PTV, CTV, GTV
    • GTV
    • CTV
    • PTV
  329. How does the barometric pressure/humidity and temperature affect the ion chamber
    The safe and accurate delivery of the prescribed absorbed dose is the central function of the dose monitoring and beam stabilization system in a medical linear accelerator. The absorbed dose delivered to the patient during radiotherapy is often monitored by a transmission ionization chamber. Therefore it is of utmost importance that the chamber behaves correctly. We have noticed that the sensitivity of an unsealed chamber in a Philips SL linear accelerator changes significantly, especially during and after the summer season. The reason for this is probably a corrosion effect of the conductive plates in the chamber due to the increased relative humidity during hot periods. We have found that the responses of the different ion chamber plates change with variations in air humidity and that they do not return to their original values when the air humidity is returned to ambient conditions.
  330. What is the treatment for the small intestine
    typically surgery but can treat with chemo and/or XRT to a dose of 40-45
  331. What is multiple myeloma
    A cancer that starts in the plasma cells in the bone marrow. This is generally treated with a combo of chemo and XRT. XRT is usually to treat the pain and chemo is typically curative. A typical dose of 30 GY is usually given to help alleviate pain. TBI has also been used in instances when pts have failed to respond to all chem agents. This is a last resort
  332. What type of radiation do you use in IORT
    electrons. A typical dose is 1000-2000 cGy to the tumor bed in a single fraction. It is 2-3 times the dose if delivered via XRT. Sometimes they will even give XRT after IORT.
  333. which breast cancer has the worst prognosis
    inflammatory breast cancer
  334. Why are brain mets treated with a whole brain field
    Because they tend to be multicentric
  335. What is the plane that is perpendicular to the long axis of the body
    Transverse
  336. If you have a breast tx with a 45 degree wedge and a portion is not getting enough dose, what do you do
    • Change the wedge to a 30
    • **research**
  337. What does beneficence mean
    Charitable, kind, or beneficial
  338. What is the exposure for total body for a radiation worker
    50 msv or 5 rem per year
  339. What is the exposure limit for the total body of the general public
    1 mSv or .1 rem
  340. You are treating a person's right foot and the pt is supine, feet first. The gantry is at 225, what angle are you treating
    LPO
  341. What does a beam spoiler do
    reduces the beam energy
  342. What is the best way to dx a brain tumor
    MRI
  343. Does an immunosuppressed pt have to sterilize their utensils
    no
  344. What allows an xray tube to be able to rotate around a pt without cables getting tangled
    slip ring
  345. What is Meniere's syndrome
    An inner ear disorder that affects balance and hearing
  346. Put the layers of rectum in order from innermost to outermost
    • mucosa
    • submucosa
    • muscularis
    • serosa
  347. What is corpus luteum
    Yellow progesterone secreting mass of cells that form an ovarian follicle after the release of a mature egg
  348. What is CPT used for
    medical code set called current procedural terminology
  349. Where do leiomyosarcomas arise from
    soft tissue
  350. What does the mitochondria do
    breaks down sugars for energy/ATP
  351. In TNM, what does the accronyms stand for
    • T=size and extent of tumor
    • N= nodes
    • M=metastais
  352. What is the normal platelet count
    150,000-500,000
  353. What is the normal RBC count
    4-6 million
  354. What is the normal WBC
    4500-10,000
  355. How do you check the door interlocks
    open door during treatment
  356. What is the most radiosensitive kidney tumor
    Wilms
  357. Basal cell carcinoma is most common in women or men?
    men
  358. What is the best way to treat a patient with very loos skin
    daily port films
  359. Where do you do CPR compressions
    lower 1/3 of the sternum
  360. What histology is the prostate
    adenocarcinoma
  361. Ascites in most common in which cancer
    ovarian or liver
  362. When do you have the most beam divergence
    irregular field
  363. anterior 2/3 of the tongue drain to the
    submandibular nodes
  364. What is the most common sinus cancer
    maxillary
  365. How many sources are used at a time in HDR
    1
  366. What organ drains to the para aortic lymph nodes?
    • testes
    • ovaries
    • cervix
    • uterus


    (keep researching)
  367. Ionization chambers measure radiation output of therapy equipment and their accuracy is
    2%
  368. isodose distribution are a ____ of spatial distribution
    2D
  369. As depth in tissue increases, what does PDD do
    decreases
  370. If the field size decreases, what happens to TAR
    it decreases
  371. During a radiation treatment, direct patient assistance may be provided if the beam energy is below ______.
    50 keV
  372. What is the life span of red blood cells?
    120 days
  373. What is the life span of a white blood cell?
    • 10 days
    • (except for lymphocytes which is 100 days)
  374. Skin reactions from xrt may persist ____ to ____ after treatment.
    6 months - 5 years
  375. Name the interaction:
    Pair Production
  376. Name the interaction:
    Coherent (Thompson/Raleigh) Scattering
  377. Name the interaction:
    Compton Scattering
  378. Name the interaction:
    Pair Production
  379. Name the interaction:
    Photoelectric scattering
  380. Bremsstrahlung (braking) radiation
  381. The spinal cord, about 45 cm in length, extends from the _____________ to the level of ______________.
    Foramen Magnum

    • approx L-2
    • (the range is T12 to L3)
  382. The adrenal glands are located at about the level of thoracic vertebrae number _______.
    • T-12
    • The adrenal glands are located at about the level of thoracic vertebrae number 12.
  383. The French-American-British (FAB) staging system is used to classify ________.
    • Acute Leukemia
    • the FAB system is used to classify acute leukemia using three levels for cell size in ALL or seven levels for maturation of cells in AML
  384. What are the components of cerrobend blocks, aka Lipowitz metal, and what is the melting point?
  385. BLT with Cheese
    • Bismuth
    • Lead
    • Tin
    • Cadmium
    • melts @ 70° C
  386. What is found in the mediastinum?
    (6)
  387. Heart
    • Greater Vessels
    • Trachea
    • Esophagus
    • Thymus
    • Pericardium
  388. The supratentorial region of the brain contains the _________, while the infratentorial region contains the __________.
    Cerebrum (supratentorial)
  389. Cerebellum (infratentorial)
    What are some side effects associated with supratentorial (cerebrum) treatment?
  390. Mood changes
    • Dizziness/balance issues
    • Vision changes
  391. What is L'hermitte's sign (aka L'hermitte's syndrome) syndrome and what cancer is it associated with?
  392. Electric-like shocks, tingling and numbness in the arms, legs or neck when the patient flexes their neck.
    It can be associated with laryngeal cancer as well as a side effect of H&N xrt.
  393. What is the most common histology of breast cancer?
    • Infiltrating ductal carcinoma
    • Which type of lung cancer is not likely to receive radiation?
    • Small cell lung cancer
    • What type of treatment should a patient receive with glioblastoma multiform?
  394. Gross total resection followed by
    Radiation (60-70Gy) & Chemotherapy
  395. Which bones would prostate cancer metastasize to first?
    • A. lumbar spine
    • B. sternum
    • C. ribs
    • A. Lumbar spine
  396. Where do the lymphatics of the nasopharynx drain to?
    • Retropharyngeal nodes
    • Superior jugular
    • Posterior cervical nodes
  397. What is the range of a CT scanner?
    100 to 150 keV
  398. Human LD50/30
    • Lethal Dose 50% of population/30 days of the event
    • 4.5 Gy (450 rads)
  399. What should a warning sign read if the exposure rate is: 1 mSv in 1 hour (100 mrem 1 hour)
    Caution: High Radiation Area
  400. Point B: 1 cm lateral to the medial aspect of the pelvic side wall
    (point B receives 1/3 of the dose received at point A)
  401. Which type of brain tumor can metastasize out of the head to the bone?
    Medulloblastoma
  402. Where do Sarcomas typically metastasize to?
    the Lungs
  403. List the ABCD's of melanoma
    • Asymmetry
    • Border
    • Color
    • Diameter
  404. Where do head and neck cancers typically metastasize to?
    • the Lungs
    • What are the most common types of head & neck cancer to metastasize?
    • Nasopharynx & hypopharynx
    • What is the most common cancer of the head & neck?
    • Larynx
  405. What are the two most common solid tumors that metastasize to the CNS?
    Lung and Breast cancers
  406. What type of cancer is associated with fetal adrenal tumors?
    Neuroblastoma
  407. What histology is cancer of the lower esophagus?
    Adenocarcinoma
  408. What histology is cancer of the upper esophagus?
    Squamous cell
  409. What are the most hazardous materials in cerrobend blocks?
    Cadmium & Lead
  410. Is catheterization considered a sterile procedure?
    Yes
  411. What is a common site of lymphatic metastasis for a seminoma?
    Para-aortic nodes
  412. Arrange the following in order from most radiosensitive to least radiosensitive:
    • ureters
    • gonads
    • bladder
    • uterus
  413. 1. gonads
    • 2. bladder
    • 3. ureters
    • 4. uterus
  414. Based on the symptoms listed below where is the most probable location of the brain tumor?
    • increased cranial pressure, personality changes, seizures, motor dysfunction, speech impairment, urinary incontinence, CN VI palsy
    • Frontal lobe
    • Based on the symptoms listed below where is the most probable location of the brain tumor?
    • Increased cranial pressure, vision loss, seizures, weakness, memory loss, loss of touch
    • Parietal lobe
    • Based on the symptoms listed below where is the most probable location of the brain tumor?
    • Speech disorders, seizures, loss of smell, weakness of CN VI, defective hearing and memory
    • Temporal lobe
  415. Based on the symptoms listed below where is the most probable location of the brain tumor?
    • Seizures, loss of vision, tingling, weakness, hallucinations
    • Occipital lobes
  416. Strontium 90 is a ______ emitter and often used to treat the _____ in 3 to 5 treatments.
    • Strontium 89 is a _________ treatment given for wide-spread ________.
    • Strontium 90: beta emitter, treats the eye
    • Strontium 89: system treatment for widespread bone metastasis
  417. What is the most common site of spread for laryngeal cancer?
    Subdigastric nodes
  418. What should a warning sign read if the exposure rate is:5 Gy in 1 hour (500 cGy in 1 hour)
    Grave Danger: Very High Radiation Area
  419. When using tandem and ovoid brachytherapy; where is Point A? Point B?
    Point A: 2 cm superior & 2 cm lateral to the center of the cervical canal in the plane of the uterus

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