A1 Registry Review_ Golden Sheets.txt

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A1 Registry Review_ Golden Sheets.txt
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  1. Which way is the table kicked in breast tangents?
    Away from the gantry
  2. The relationship between activity and half-life is _________ proportional.
    Inversely
  3. Temperature is controlled by the __________
    Hypothalmus
  4. What is the life span of red blood cells?
    120 days
  5. What is the life span of a white blood cell?
    • 10 days 
    • (except for lymphocytes which is 100 days)
  6. Skin reactions from xrt may persist ____ to ____ after treatment.
    6 months - 5 years
  7. Name the interaction:
    Pair Production
  8. Name the interaction:
    Coherent (Thompson/Raleigh) Scattering
  9. Name the interaction:
    Compton Scattering

    (200 keV - 10 mev)
  10. Name the interaction:
    Pair Production
  11. Name the interaction:
    Photoelectric scattering

    (10 - 50 keV)
  12. Bremsstrahlung (braking) radiation
  13. During which phase of cellular mitosis are cells most and least radiosensitive?
    MOST: Mitosis

    LEAST: S
  14. 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)
  15. The adrenal glands are located at about the level of thoracic vertebrae number _______.
    T-12
  16. The French-American-British (FAB) staging system is used to classify ________.
    Acute Leukemia

    • FAB system:
    • 3 levels for cell size in ALL
    • 7 levels for maturation of cells in AML
  17. Moh's surgery may be used to establish diagnosis and staging of ________ cancer.
    Nonmelanoma Skin cancer
  18. The lymph nodes immediately inferior to the chin are called:
    the Submental Nodes
  19. The Dukes staging system uses letters A-D to classify tumors of the ________.
    Colon
  20. The true vocal cords are located in the ________.
    the Glottis
  21. What are the components of cerrobend blocks, aka Lipowitz metal, and what is the melting point?
    • BLT with Cheese
    • Bismuth
    • Lead
    • Tin
    • Cadmium
    • melts @ 70° C
  22. Name the plane:
    Axial  (transverse)
  23. Name the plane:
    Coronal
  24. Name the plane:
    Sagittal
  25. Name the plane:
    Axial  (transverse)
  26. Name the plane:
    Coronal
  27. Name the plane:
    Sagittal
  28. What is found in the mediastinum?
    (6)
    • Heart
    • Greater Vessels
    • Trachea
    • Esophagus
    • Thymus
    • Pericardium
  29. For healed scar tissue do you treat more or less?
    • More
    • (there is a possibility that as the knife was coming out it seeded cancer cells, plus Scars are always included in the treatment field and the boost field)
  30. The supratentorial region of the brain contains the _________, while the infratentorial region contains the __________.
    Cerebrum (supratentorial)

    Cerebellum (infratentorial)
  31. What are some side effects associated with supratentorial (cerebrum) treatment?
    • Mood changes
    • Dizziness/balance issues
    • Vision changes
  32. What is the main advantage of a small focal spot?
    Less penumbra
  33. Sudden numbness or weakness in the arm face or leg; confusion, trouble speaking, trouble seeing, trouble walking, dizziness and severe headache are all symptoms of _________.
    Stroke
  34. What device will attenuate the beam the least?
    A. tray
    B. compensating filter
    C. wedge
    D. bolus
    A. Tray
    (this multiple choice question has been scrambled)
  35. Is a 3D conformal treatment considered simple or complex in regards to billing?
    Complex
  36. If the whole abdomen receives 3000 cGy, which organ would be damaged?
    A. liver
    B. stomach
    C. kidney
    D. bladder
    C. Kidney
    (this multiple choice question has been scrambled)
  37. What is L'hermitte's sign (aka L'hermitte's syndrome) syndrome and what cancer is it associated with?
    • 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.
  38. What is the most common histology of breast cancer?
    Infiltrating ductal carcinoma
  39. Which type of lung cancer is not likely to receive radiation?
    Small cell lung cancer
  40. What type of treatment should a patient receive with glioblastoma multiform?
    • Gross total resection followed by
    • Radiation (60-70Gy) & Chemotherapy
  41. Which bones would prostate cancer metastasize to first?
    A. lumbar spine
    B. ribs
    C. sternum
    A. Lumbar spine
    (this multiple choice question has been scrambled)
  42. What are the two main lymph systems of the lower body?
    Inguinal nodes & Iliac nodes
  43. Which of the following does not control hormones?
    a. ovaries
    b. pituitary
    c. adrenals
    d. prostate
    Prostate
  44. What part of the body is emesis associated with?
    Abdomen
  45. When treating a soft tissue sarcoma, the treatment field should include _____ cm of normal tissue, partial extremity and _______, but always spare a strip for lymph flow!
    • 1 to 2 cm of normal tissue
    • tumor bed


    (some sources say up to a 5cm margin)
  46. Neutron Detector
  47. What type of cancer has the longest latency?
    Mesothelioma
  48. What is the order of flow of electrons through the machine?
    Accessory mount, Scattering foil, Patient, Primary collimator, Ion chamber, Electron applicator, Secondary collimator
    Primary collimator⇒ Scattering foil⇒ Ion chamber⇒ Secondary collimator⇒ Accessory mount⇒ Electron applicator⇒ Patient

    (collimator, foil, chamber, collimator, mount, applicator, patient)
  49. Which lymph node does the anterior 2/3 of the tongue drain to?
    A. submental
    B. submandibular
    C. submaxillary
    D. upper jugular
    B. Submandibular
    (this multiple choice question has been scrambled)
  50. What is most damaged by exposure to radiation?
    DNA
  51. Mitochondria is an organelle found in cells that aids in __________.
    Energy production on a cellular level
  52. Numbness in the left arm, chest pains, shortness of breath, nausea, sweating, tachycardia, weakness and dizziness are all indicators of a patient experiencing ________.
    Heart Attack
  53. Ascites is common in what type of cancer?
    Ovarian cancer
  54. What would be the rationale for giving a patient with cervical ca external beam therapy after she has already undergone an interstitial implant?
    To treat the lymph nodes
  55. What is the most common cancer in children?
    Acute Lymphocytic Leukemia (ALL)
  56. Compression of the svc that causes edema in the face, neck & arms and cyanosis is known as __________.
    Superior Vena Cava syndrome
  57. What type of tumor causes SVC syndrome?
    lung cancer- Pancoast tumor
  58. What side effect is the latest side effect after radiation?
    Fibrosis

    occurs approx a year after completion
  59. What is the most common brain tumor in children?
    • Astrocytoma
    •  

    (Medulloblastoma #2)
  60. What are some examples of MCT cells?
    • Endothelial cells
    • Fibroblasts
  61. What are some examples of RPM cells?
    Parenchymal cells
  62. What are some examples of FPM cells?
    • Nerve cells
    • Muscle cells
    • Erythrocytes
    • Spermatozoa
  63. What are some examples of DIM cells?
    • Intermediate spermatogonia
    • Myelocytes
  64. What are some examples of VIM cells?
    • Type A spermatogonia
    • Crypt cells
    • Basal cells
    • Erythroblasts
  65. What are the major components found in the gantry?
    • Accelerating waveguide
    • Electron gun
    • Treatment head bending magnet,target, collimators, scattering foil/flattening filter
  66. What are the four major components found in the stand?
    • Magnetron or Klystron 
    • Waveguide
    • Circulator
    • Cooling System
  67. What is the order of parts inside the treatment machine?
    Jaws, Collimator, Bending Magnet, Target, Waveguide, Electron gun
    • Electron gun 
    • Waveguide
    • Bending magnet
    • Target (photons only)
    • Collimator
    • Jaws
  68. Where do the lymphatics of the nasopharynx drain to?
    • Retropharyngeal nodes
    • Superior jugular 
    • Posterior cervical nodes
  69. What is considered a low-residue diet?
    • Soft foods, low fat, low fiber
    • High-fiber foods include whole-grain breads and cereals, nuts, seeds, and raw or dried fruits.
    • (easier to digest and slows digestion/bowel production)
  70. What are Workload and Use Factor used to calculate?
    Shielding requirements
  71. What are the units of measure for exposure?
    Roentgen and Coloumb of charge per kilogram of air

    1R = 2.58 x 10-4 C/kg
  72. What are the units of measure for absorbed dose?
    • Rad and Gray
    • 1 Gy = 100 rad
    • 1 rad = .01 Gy
  73. What takes in to account the fact that different types of radiation produce different amounts of biologic damage?
    What are the units of measure?
    • Dose Equivalent
    • rem & Sieverts

    • 100 rem = 1 Sv
    • 1 rem = 10 mSv
  74. What are the units of measure for activity?
    • Curie (Ci) and Becquerel (Bq)
    • 1 Ci = 3.7 x 1010 Bq
  75. Human LD50/30
    4.5 Gy (450 rads)

    Lethal Dose 50% of population/30 days of the event
  76. What should a warning sign read if the exposure rate is: 
    1 mSv in 1 hour  (100 mrem 1 hour)
    Caution: High Radiation Area
  77. 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
  78. 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

    • 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)
  79. Which type of brain tumor can metastasize out of the head to the bone?
    Medulloblastoma
  80. Where is a Wilm's tumor found?
    Kidney

    (wilm's tumor = kiddie kidneys)
  81. What is the most common primary bone lesion?
    Most common: Multiple Myeloma

    Second choice: osteosarcoma
  82. What is the most common bone cancer?
    Metastatic bone lesions
  83. What is the most common brain cancer?
    Metastatic brain lesions
  84. What is the most common primary brain cancer in adults?
    Glioma or astrocytoma  DOUBLE CHECK!!!!!
  85. Where do Sarcomas typically metastasize to?
    the Lungs
  86. List the ABCD's of melanoma
    • Asymmetry
    • Border
    • Color
    • Diameter
  87. Where do head and neck cancers typically metastasize to?
    the Lungs
  88. What are the most common types of head & neck cancer to metastasize?
    Nasopharynx & hypopharynx
  89. What is the most common cancer of the head & neck?
    Larynx
  90. 80% of head & neck cancers are ________ cell. (histology)
    Squamous
  91. What are the two most common solid tumors that metastasize to the CNS?
    Lung and Breast cancers
  92. What type of cancer is associated with fetal adrenal tumors?
    Neuroblastoma
  93. What histology is cancer of the lower esophagus?
    Adenocarcinoma
  94. What histology is cancer of the upper 2/3 of the esophagus?
    Squamous cell
  95. What are the most hazardous materials in cerrobend blocks?
    Cadmium & Lead
  96. Is catheterization considered a sterile procedure?
    Yes
  97. What is agenesis?
    Absence or incomplete development of an organ or body part
  98. What is the most common site of occurrence for an astrocytoma?
    Cerebral hemispere
  99. Why is shielding used for nasal carcinoma?
    To protect the lens of the eyes and inside the nostrils
  100. Which portion of the colon is near the fundus of the uterus?
    The sigmoid colon
  101. An electron block should be kept _____ away from the patient's skin surface.
    5 cm
  102. Where is the pyriform sinus located?
    In the hypopharynx between the throat and the esophagus
  103. Syndrome of progressive weight loss, fatigue, muscle atrophy and weakness is known as _______.
    Cachexia
  104. An exogenous infection is generally spread by direct contact with a ________ or a _______ in a hospital setting.
    Host or Fomite
  105. What is a common site of lymphatic metastasis for a seminoma?
    Para-aortic nodes
  106. Which two of the following have uniform lymphatic spread?
    a. seminoma
    b. nonseminoma
    c. hodgkins lymphoma
    d. non-hodgkinslymphoma
    • a. seminoma
    • c. hodgkins lymphoma
  107. What type of cancer is Plummer Vinson syndrome associated with?
    Esophageal cancer
  108. Which organ drains to the para-aortic nodes?
    the Kidneys

    (the upper GI tract & abdominal organs)
  109. What is leukocytosis?
    Raised white blood cell count
  110. What is the most common type of lung cancer?
    Non small cell lung cancer (NSCLC)

    {adenocarcinoma most common NSCLC}
  111. What type of cancer is not caused by occupational exposure to carcinogens?
    Leukemias & Lymphomas
  112. What is common treatment for esophageal cancer?
    Surgery
  113. What type of cancer involves one true vocal cord?
    Laryngeal cancer of the glottis
  114. Who regulate radioactive materials?
    the NRC
  115. What systems are used for intraoperative XRT?
    • a Mobetron or an Intrabeam system
    • (which produce electrons for IORT)
  116. The lower lobe of the left lung can drain back into the _______ or back to the _________.
    • Hilum  
    • Celiac axis
  117. Which of the following types of cancer are known to respond to hormone therapy:
    a. prostate
    b. ovarian
    c. testicular
    d. breast
    • a. prostate
    • d. breast
  118. ___________ almost never metastasizes but it can spread via direct extension to skin & bone.
    Basal cell carcinoma
  119. Arrange the following in order from most radiosensitive to least radiosensitive:
    ureters
    gonads
    bladder
    uterus
    • 1. gonads
    • 2. bladder
    • 3. ureters
    • 4. uterus
  120. What is the Karnofsky scale used to measure?
    A standard way of measuring the ability of cancer patients to perform ordinary tasks, ranges from 0 to 100
  121. What kind of tumor can cause shoulder pain that radiates down the arm and causes atrophy of the hand muscles?
    Pancoast tumor
  122. What cancer has the shortest latency period?
    Leukemia
  123. What organ does blood travel through before arriving at the inferior vena cava?
    the Liver
  124. How does barometric pressure & temperature affect output?
    Barometric pressure & temperature can affect the dose reading of the ion chamber
  125. What are the homogeneity factors for different tissue types?
    • Air is negative
    • Structures are dense
    • Lung 0.25-0.3
    • Bone 1.65
  126. If you are using the hand pendant but the table keeps moving, what is a likely problem?
    Short circuit
  127. Otitis media is a presenting symptom of what type of cancer?
    Nasopharyngeal

    (bloody nose also a symptom)
  128. Which field will have more divergence; a larger field or an irregular field?
    the Irregular field
  129. What would be the typical XRT dose for a unresectable non small cell lung tumor?
    50-60 Gy
  130. What is the recommended thickness of an electron block?
    1-2 cm
  131. To properly dispose of a radioactive source it should be stored at a designated location until it decays _______ half lives.
    10 half lives
  132. Scenario: You are treating a patient & notice the wedge is backwards. What do you do?
    Stop the treatment, fix the wedge for the remaining beams, document everything and notify physics/dosimetry to recalculate.
  133. When a photon beam encounters a surface obliquely, Dmax moves _________ to the surface.
    Closer
  134. 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
  135. 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
  136. 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
  137. 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
  138. What would block neutrons?
    Concrete, waxy substance
  139. 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: systemic treatment for widespread bone metastasis
  140. What do lasers cause the most damage to?
    the Retina
  141. What is the most common site of spread for laryngeal cancer?
    Subdigastric nodes
  142. What is the most common condition associated with adenocarcinoma of the esophagus?
    Barrett's esophagus
  143. Is bone marrow radiosensitive or radioresistant?
    Radiosensitive
  144. What are the most sensitive blood cells in the body?
    Lymphocytes
  145. What type of wedge produces a straighter isodose curve?
    Sigmoid shape
  146. The compensating filter is made for the patient but the Dr decides to move the iso 3 cm, what do you do?
    Move the patient and make a new compensator filter
  147. What is the most common histology for prostate cancer?
    Adenocarcinoma
  148. What is the most common histology for brain cancer?
    Astrocytoma
  149. What is the most common histology of bladder cancer?
    Transitional cell
  150. What is the largest adult lymph tissue?
    the Spleen
  151. In relation to the patella, the Popliteal lymph nodes are ________ the knee and _______ to the patella.
    • BEHIND the knee
    • POSTERIOR to the patella
  152. What is the most common interaction in CT scans?
    Photoelectric
  153. A rapid heartbeat is known as _______.
    Tachycardia
  154. Between bone and muscle, which is more radiosensitive?
    Muscle
  155. Is using contrast for an imaging procedure assigned a simple or complex billing code?
    Complex
  156. Most blood born metastasis travels through the _______ system.
    Venous
  157. Arrange the blood cells from most sensitive to least sensitive:
    a. parenchymal cells
    b. endothelial cells
    c. crypt cells
    d. erythrocytes
    • c. Crypt cells
    • b. Endothelial cells
    • c. Parenchymal cells
    • d. Erythrocytes
  158. Arrange the cell types according to radiosensitivity from most to least:
    a. red blood cells
    b. neutrophils
    c. platelets
    d. white blood cells
    • d. White blood cells
    • b. Neutrophils
    • a. Red blood cells
    • c. Platelets
  159. What other organs could be effected when the fundus of the uterus is treated?
    Bladder, Colon & Ovaries
  160. What type of cancer would represent a dot on a CT above the femoral heads?
    • rectum or bladder?
    • weird question, needs re-wording
  161. What is the range of a CT scanner?
    100 to 150 keV
  162. What is methotrexate most often used for?
    Lymphomas & Breast ca
  163. When the temperature in the treatment vault is too high, the _______ and the ________ can be effected.
    Dose & Dose Rate
  164. What is the most common type of lung cancer?
    • Non Small Cell Lung Cancer
    • (NSCLC)
  165. Which chem drug is cardiotoxic?
    Adriamycin (generic: doxorubicin)
  166. Which cancers are most likely to metastasize to both sides of the neck?
    Base of tongue & Nasopharynx
  167. When treating 5,000 cGy to the parotid, what side effect could occur?
    Xerostomia
  168. What artery directly arises from the aorta?
    Pulmonary arteries
  169. Which quadrant is the spleen located in?
    Left upper quadrant
  170. The drug ________ is used for early stage and metastatic breast cancer by working against estrogen.
    Tamoxifen
  171. Why is bladder cancer treated with an empty bladder?
    To shrink the field size and encompass the entire bladder
  172. What is the occupational limb dose in mSv?
    • 500 mSv
    • (50 rem)
  173. A common side effect of a patient being treated over most of his skeleton is _________.
    Leukopenia
  174. If you want more detail on a CT scan, you should ________ the density, make _______ slices, and ________ the contrast.
    • RAISE the density
    • make THINNER slices
    • RAISE the contrast
  175. An AP film is not appropriate for ______ /_______ shifts.
    • anterior / posterior
    • an AP film is used for superior/inferior (in/out), and right/left shifts
  176. Wilm's tumors present with what symptom?
    Painless abdominal mass
  177. Tumors that arise from mesenchymal tissue are called _________.
    Sarcomas
  178. Where do leiomyosarcomas arise from?
    Smooth muscle & vascular systems
  179. Lymphatic drainage of the breast is primarily to the:
    Axillary, supraclavicular & internal mammary nodes
  180. What structures are of concern when treating the pancreas?
    • Kidney
    • Spinal Cord
    • Liver
    • Small Bowel
  181. Where do the lymphatics of the prostate drain to?
    Internal iliacs
  182. What is the best way to diagnose pancreatic cancer?
    Spiral CT of the abdomen
  183. During a radiation treatment, direct patient assistance may be provided if the beam energy is below ______.
    50 keV
  184. Which structure drains into the internal iliacs?
    A. Stomach  
    B. Colon    
    C. Uterus    
    D. Bladder
    • D. Bladder
    • (also vagina, cervix, prostate)
  185. Put the layers of the rectum in order from innermost to outermost:
    muscularis
    submucosa
    mucosa
    serosa
    • Mucosa
    • Submucosa
    • Muscularis
    • Serosa

    (MSMS)
  186. How much more radiation can a workers extremity get vs. their whole body?
    Whole body: 50 mSv/yr      

    Extremity: 500 mSv/yr
  187. HVL 3mm how many mm to get to less than 5%?
    15 mm

    (5 HVL's)
  188. What kind of treatment do you give for a low grade glioma?
    Gross tumor resection (GTR) followed by observation; if tumor progresses XRT 50-55Gy
  189. What factors should be considered when making immobilization devices?
    (3)
    Beam orientation, reproducibility, gantry/CT clearance
  190. If your field size gets smaller, what would happen to your dose?

    If you wanted to keep the same dose but the field size has been reduced, how would you adjust the MU's ?
    Decrease   (due to less scatter)

    Increase the MU's
  191. List the following in order of greatest to least in terms of radiosensitivity:
    1. kidney
    2. brain
    3. lens
    4. vagina
    • 1. Lens
    • 2. Kidney
    • 3. Brain
    • 4. Vagina
  192. The pituitary gland is located inside the _________ at the base of the brain.
    Sella turcica
  193. Waldeyer's ring located in the _________ at the back of the _________ cavity.
    in the PHARYNX at the back of the ORAL cavity
  194. The _________ are located on the sides of the cervix.
    Fornices
  195. The __________ sinuses are located below the orbits.
    Maxillary
  196. What are 2 common factors of nasopharyngeal cancer?
    Epstein Barr virus & Alcohol
  197. ________ are a know precursor to colon cancer.
    Polyps
  198. Increased frequency, dysuria, & urgency to urinate are signs of _________ cancer.
    Bladder ca
  199. The patient is supine, head towards the gantry. The gantry is at 90° and the patient support assembly/couch is also at 90°. What projection has been described?
    Vertex
  200. After the bending magnet, what order does the photon beam exit the gantry?
    • 1. Bending magnet
    • 2. Target
    • 3. Primary collimator
    • 4. Flattening filter
    • 5. Ion chamber
    • 6. Secondary collimator
    • 7. Patient
  201. Name that field: Patient is lying on their right side (head towards the gantry) and the gantry is at 0°.
    Left lateral
  202. ___________ cells arise from bone and cartilage.
    Mesenchymal
  203. What are the 3 most common sites of metastasis for breast cancer?
    Lung, Bone, Brain

    (breast mets=LBB)
  204. What is the most common site of metastasis for stomach cancer?
    Liver

    (stomach mets⇒ liver)
  205. What are the 2 most common sites of metastasis for anal cancer?
    Liver & Lungs

    (Anal mets= Liver, Lungs)
  206. What are the 3 most common sites for metastasis of lung cancer?
    Liver, Bone & Brain

    (lung mets=LBB)
  207. What are the three most common site of metastasis for bladder cancer?
    Liver, Bone & Brain

    (bladder mets=LBB)
  208. What are the three most common sites of metastasis for lung and bladder cancer?
    Liver, Bone & Brain

    (Lung, Bladder = Liver, Bone, Brain)
  209. What is the best treatment field for a kidney?
    AP/PA or 3 field
  210. What is the most common histology of cancer of the oral cavity?
    Squamous cell carcinoma
  211. The most common site of metastasis from primary bone cancer is: 
    A. Brain 
    B. Bowel 
    C. Distal extremities
    D. Lung 
    D. Lung
    (this multiple choice question has been scrambled)
  212. What is the most common histology of cancer of the pharynx?
    Squamous cell carcinoma
  213. What is the most common histology of colon and rectal cancer?
    Adenocarcinoma
  214. What is the most common histology of anal cancer?
    Squamous cell carcinoma
  215. What is the most common histology of cervical cancer?
    Squamous cell carcinoma
  216. What is the most common histology of endometrial cancer?
    Adenocarcinoma
  217. If a breast cancer lesion is located in the upper inner quadrant, what nodes would it drain to?
    Internal mammary nodes
  218. Which acute whole body exposure response syndrome(s) will result in death from infection?
    Hematopoietic syndrome & Gastrointestinal Syndrome
  219. The _________ trimester is the most sensitive time of the pregnancy for the fetus.
    First trimester

    (organogenesis takes place between week 2-8)
  220. The __________ is located behind the root of the tongue between the folds in the throat.
    Epiglottic vallecula
  221. Lymphatics from the vagina, cervix, prostate, and bladder drain into the _________ nodes.
    Internal iliac nodes
  222. The PAB (posterior axillary boost) field is intended to treat the level _____ axillary nodes.
    Level 3 axillary nodes
  223. When using a breast board for positioning, the optimal angle is influenced by the:
    Slope of the patient's chest
  224. Leakage tests must be performed every ______ months.
    6 months
  225. What is the order of the cell cycle of mitosis?
    • Prophase
    • Metaphase
    • Anaphase
    • Telophase
    •  
    • (PMAT)
  226. Mitosis occurs during the ____ phase of the cell cycle.
    M phase
  227. The ribs and the diaphragm make the ________ angle.
    Costophrenic angle
  228. Angina can be caused by:
    (6)
    Blood clots, heart attacks, pulmonary embolism, pericarditis, a panic attack or a lung infection
  229. The angle of louis is a helpful landmark for the treatment of _______ cancer and is at approx the same level of the ________.
    Breast cancer

    Carina
  230. What is the half life of Iridium 192?
    73.8 days
  231. Cesium 137 is most commonly used in the treatment of __________ cancer.
    Cervical cancer
  232. Iridium 192 is commonly used in the treatment of:
    (3)
    • Soft tissue sarcomas
    • Lung
    • Head & Neck
  233. What is the half life of Cesium 137?
    30 years
  234. What type of chemotherapeutic drugs are often used to treat patients with brain tumors?
    Corticosteroids
  235. The adrenal glands are located at the ____________ of the kidneys at the vertebral level of T-12
    The superior pole of the kidneys at the vertebral level of T-12
  236. The most common symptom for pituitary tumors is a __________.
    Headache
  237. TAR & TMR are affected by:
    (3)
    Energy & Field Size (directly proportional)

    Depth (inversely proportional)
  238. PDD is affected by:
    (4)
    • Field size, Energy & Distance (SSD)
    • (directly proportional)

    Depth (inversely proportional) 
  239. Pruritis is also known as:
    Itchy skin
  240. What is the most common thickness of cerrobend blocks for mV treatments?
    7.5 cm
  241. The most threatening form of malnutrition is:
    A. marasmus
    B. kwashiorkor
    C. cachexia
    A. marasmus
    (this multiple choice question has been scrambled)
  242. Where does cerebrospinal fluid drain through?
    The venous system
  243. Where are the lateral ventricles located?
    the Cerebral Hemisphere
  244. Cisplatin is a chemotherapy drug that is a ___________ agent and has been linked to hearing loss.
    Cytotoxic Alkylating Agent
  245. What is the commonly accepted density for the Lungs?
    Air?
    Water?
    Bone?
    • Lungs: -200
    • Air: -1000
    • Water: 0
    • Bone: 1000
  246. The primary advantage of afterloading brachytherapy is the reduction of exposure to __________.
    Personnel
  247. What would be the result of patient motion during a CT?
    (3)
    Blurriness, Artifacts & Missed Registration
  248. Which of the following is NOT a form of IMRT:
    A. 3D conformal
    B. step & shoot
    C. cone-beam 
    C. cone-beam
    (this multiple choice question has been scrambled)
  249. Malaria, lyme disease and west nile are all spread by a ________ and not via a fomite.
    Vector
  250. Grading is used to show the degree of cellular __________.
    Differentiation
  251. What quadrant is the liver in?
    Right upper quadrant
  252. What are 2 presenting symptoms of uterine cancer?
    Unexpected vaginal bleeding & discharge
  253. The increased proliferation of cells is known as _____________.
    Hyperplasia
  254. The loss of differentiation of cells is known as ___________.
    Anaplasia
  255. Using contrast that is not diluted will cause:
    Patient side effects & Artifacts
  256. The artificial supply of nutrients is known as:
    Hyperalimentation
  257. The treatment of choice for cancer of the small intestine is:
    Surgery
  258. A radiation therapy prescription must include the following 7 items:
    • 1. Tumor dose
    • 2. Number of fractions
    • 3. Dose per fraction
    • 4. Frequency of fractions
    • 5. Type & Energy of radiation
    • 6. Beam shaping devices
    • 7. Treatment volume
  259. A ______ test measures the nitrogen level of blood.
    BUN
  260. A surgical procedure that involves resecting from the head of the pancreas, entire duodenum, distal stomach, gallbladder & common bile duct is known as a ___________.
    Whipple procedure
  261. What is a presenting symptom of cholesteatoma?
    Otitis media

    (cyst of the middle ear)
  262. What converts kinetic energy to microwave energy in the linac?
    the Klystron
  263. The 2 most common signs of nasopharyngeal cancer are:
    Nose bleeds & Difficulty hearing
  264. What is a state of being self governing?
    Autonomy
  265. When a photon deposits its mass it is known as:
    Linear attenuation
  266. Bronchogenic carcinoma can cause __________ syndrome.
    Superior vena cava syndrome
  267. A rare condition that is characterized by ipsilateral miosis (contracted pupil), ptosis (drooping eyelid), enophthalmos (recession of the eyeball into the orbit) and bone erosion of ribs & vertebrae is known as ___________.
    Horner's syndrome
  268. What is the TD 5/5 of the small intestine?
    40-45 Gy
  269. What is the most common chemo drug for pancreatic ca?
    Gemcitabine
  270. The ___________ are considered the endocrine portion of the pancreas.
    Islets of Langerhans
  271. The most common fungal infection seen in patients is:
    Candida albican
  272. What are the most common signs of oral cavity cancer?
    Swelling or an ulcer that fails to heal
  273. What are the most common symptoms of oropharynx cancer?
    Painful swallowing & Otalgia
  274. What are the most common symptoms of larynx cancer?
    Hoarseness & Stridor
  275. What are the most common symptoms of hypopharynx cancer?
    Dysphagia & painful neck nodes
  276. What are the commonly used chemo drugs for Hodgkin's disease?
    • Adriamycin
    • Bleomycin
    • Vinblastine
    • Dacarbazine
  277. What lymph nodes are covered by a mantle field?
    (8)
    Submandibular, Occipital, Cervical, Supraclavicular, Infraclavicular, Axillary, Hilar & Mediastinal
  278. What is the most potent radiosensitizer?
    Oxygen

  279. An immunosuppressed patient will require __________ isolation.
    Reverse isolation
  280. The cells at the center of a large tumor tend to be:
    A. anoxic
    B. hypoxic
    C. aerobic
    D. oxic
    A. anoxic

    (from the center out: anoxic, hypoxic, oxic)
    (this multiple choice question has been scrambled)
  281. True or False: An immunosuppressed patient should sterilize eating utensils.
    False
  282. The main reason an IV bag is placed above the injection site is to prevent:
    Back flow of fluids
  283. When treating the parotid gland with 3000 cGy with standard fractionation, what is most likely to occur?
    Xerostomia
  284. Placing an immobilization device on a patient without their consent can be considered:
    Battery
  285. Hyperfractionation refers to a schedule of:
    Two or more treatments a day, usually separated by 6 hours
  286. Why is the gantry angled 10-15° on a supraclav field?
    To protect the cord & esophagus and avoid a hot spot at the tangent border
  287. A urinalysis specimen should be collected " _______ & _________."
    Clean & mid-stream
  288. What are the two most important structures when making a face mask?
    Nose & Chin
  289. A constant error in treatment would be called a __________ error.
    Systematic
  290. If the table continues to move after you have released the pendant safety switch (dead-man), what is probably wrong?
    Short circuit, hit the emergency off button
  291. Is high LET or low LET radiation more damaging?
    High LET
  292. The suprasternal notch corresponds with the vertebral level of ______.
    T2 -T3
  293. Why is a bite block used when treating the base of the tongue?
    To push the hard palate up & out of the field
  294. As the source decays, the half life:
    A. increases
    B. remains constant
    C. decreases
    B. remains constant
    (this multiple choice question has been scrambled)
  295. If a patient has loose skin, what is the best way to verify iso is in the correct place?
    Port film before treating
  296. If the light field doesn't coincide with the treatment field, what is a likely cause?
    The mirror may be off
  297. Z refers to the ________, or number of _______ in an atom

    A refers to the _________ of an atom
    Z = atomic number (protons)

    A = atomic mass number (protons + neutrons)
  298. Isotopes have the same number of ________ but a different number of ________.
    • Isotopes
    • same protons
    • different neutrons
  299. The carina bifurcate at the level of approximately ________ of the spine.
    T4 - T5
  300. The hockey stick or dog leg field is most commonly used to treat:
    Seminoma (testicular cancer)
  301. A beam that enters a patient at the left scapula and exits the anterior chest is known as a ________ beam.
    Left Posterior Oblique
  302. Iso is set 2cm anterior & 2 cm superior of the EAM, what are you most likely treating?
    Pituitary tumor
  303. List in the order of radiosensitivity most to least:
    RPM
    DIM
    MCT
    FPM
    VIM
    • 1. VIM
    • 2. DIM
    • 3. MCT
    • 4. RPM
    • 5. FPM
  304. The ________ is formed by the union of the pancreatic duct & common bile duct, and is located at the major duodenal papilla.
    Ampulla of Vater
  305. The Dr wants you to extend the superior border by 2 cm while keeping the inferior border where it is. Assuming you do not have asymmetrical jaws, how will you accomplish this?
    Open the jaws 1 cm and shift the patient 1cm in (towards the gantry)
  306. What type of breast cancer has the worst prognosis?
    Inflammatory
  307. Which plane is perpendicular to the long axis of the body?
    Axial (transverse)
  308. Radiation therapy and chemotherapy can lead to _________ (more/less) severe side effects.
    More severe side effects
  309. If 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
  310. What is a beam spoiler used for?
    Reduce beam energy

    (make a 6x machine a 4x)
  311. What allows an x-ray tube to be able to rotate around a patient without the cables getting tangled?
    Slip Ring

    (eliminated the need for cables and allowed a full 360° rotation)
  312. What histology is commonly found in the lower third of the esophagus?
    Adenocarcinoma
  313. What is the equation to find the wedge factor?
  314. What is Meniere's syndrome?
    An inner ear disorder that affects balance and hearing
  315. What is a yellow progesterone secreting mass of cells that form an ovarian follicle after the release of a mature egg known as?
    Corpus luteum
  316. What does CPT mean?
    Current Procedural Terminology
  317. What is the most common histology of bladder cancer?
    Transitional cell (urothelial)
  318. List no less than 3 cardio toxic chemo drugs besides Adriamycin (doxorubicin):
    • Daunomycin
    • Idarubicin (Idamycin)
    • Mitoxantrone
    • 5 FU
    • Cyclophosphamide
    • Vinca Alkaloids
    • (Anthracycline family will end with "cin")
  319. Where does lymphatics of the larynx drain to?
    (3)
    • Deep cervical nodes
    • Subdigastric
    • Submaxillary


    (lymph involvement RARE w/ glottic ca)
  320. At what energy does neutron blocking have to be taken into account to shielding requirements?
    • 10-12 mV and greater 
    • &
    • Any type of heavy particle acceleration (ie. proton therapy)
  321. The administration of nutrients by intravenous feeding, especially to individuals unable to take in food through the alimentary tract, is known as:
    • Hyperalimentation
    • or
    • Total Parenteral Nutrition (TPN)
  322. Label the diagram:
    • 1. Articular process (upper)
    • 2. Articular process (lower)
    • 3. Spinous Process
    • 4. Transverse process
    • 5. Pedicle
    • 6. Faucet
    • 7. Spinous process
  323. What is the arrow pointing to?
    Coronoid process
  324. What is the most sensitive kidney tumor?
    Wilm's tumor
  325. During arc therapy, if the gantry doesn't move what is a likely issue?
    Wrong mode
  326. Which sinus is most likely to get cancer?
    Maxillary sinus
  327. The annual maximum permissible dose (MPD) for the general public is:
    1 mSv

    (0.1 rem)
  328. The annual effective dose equivalent limit for the general public with continuous or frequent exposure:
    1 mSv

    (0.1 rem)
  329. The annual occupational whole body exposure effective dose equivalent limit (stochastic effects):
    50 mSv

    (5 rem)
  330. The annual effective dose equivalent limit for the general public with infrequent exposure:
    • INFREQUENT
    • 5 mSv

    (0.5 rem)
  331. The dose equivalent limit for the skin and extremities:
    (nonstochastic/deterministic)
    500 mSv

    (50 rem)
  332. What is this field used to treat?
    Nasopharynx

    • BORDERS 
    • Ant: posterior 1/3 of the maxillary sinus & nasal cavity
    • Post: 2cm margin beyond mastoid process
    • Sup: 2cm beyond tumor to include base of skull & sphenoid sinus
    • Inf: thyroid notch (to allow sparing of the larynx)
  333. Name that fractionation: Delivering the same dose over a shorter period of time.
    Accelerated fractionation
  334. Dose rates in air express:
    Dose without a phantom & with a build-up cap at a given distance
  335. If the whole abdomen received 30 Gy, what organ would be damaged?
    Kidneys

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