Board Prep 1

The deficiency in the number of circulating white blood cells in the body is called? Anemia Leukopenia Polycythemia Thrombcytopenia

Leukopenia

Written defamation of character is best know as: Slander Libel Cursing Literary fault

Libel

All chemicals used in a department require: Listing with the Human Resource Department Material Safety Data Sheets (MSDS) An (800) number for toxic information Labels containing information in case of exposure

Material Safety Data Sheets (MSDS)

Which of the following has the least radiosensitivity (most resistant)? Bone marrow Lymphoid tissue Muscle Mature cartilage

Mature cartilage

The most radiosensitive stage of the cell cycle is: DNA synthesis G1 G2 Mitosis

Mitosis

When treating the breast, if a slant board is used rather than the patient lying flat, which of the following is TRUE? The breast "falls" into the supraclavicular port More lung tissue is included in the supraclavicular port It is more difficult for the patient to raise her arm The chest wall cannot be treatedwhen the slant board is used

More lung tissue is included in the supraclavicular port

The most common presenting sign of Wilms tumor is: Fever and chills Non-tender mass Bone pain Nausea and vomiting

Non-tender mass

After what time period would fibrosis generally appear following standard external beam therapy? One month One year One week Two weeks

One year

What is the most potent chemical modifier of radiosensitivity to X and gamma rays? 5 FU Oxygen Misonidazole Adriamycin

Oxygen

The largest salivary gland in the head & neck is the: Submaxillary Sublinguinal Parotid Mastoid

Parotid

Bone marrow depression is most likely to occur when you are treating which part of the body? Skull Pelvic bones Femur Vertibrae

Pelvic bones

During a convulsive seizure, the most important action to be taken by a therapist is: Prevent patient injury Give the patient water Give the patient sugar Hold the patient's tongue

Prevent patient injury

When dealing with OER and anoxic tissue, which would be the most effective? 6 MV photons Protons Neutrons Electrons

Protons

For radiation workers, the occupational dose is usually reported in: RAD REM Roentgen Gray

REM

To verify that the radiation field and the light field are aligned on a 10 MV linear accelerator you could use the following: Tissue equivalent phantom and an ionization chamber Mechanical distance indicator and paper A shield block and a redi-pak x-ray film Redi-pak x-ray film, a pen and a ruler

Redi-pak x-ray film, a pen and a ruler

You have an extremely large patient and you must treat two lateral pelvic fields. What technique will give you the most even dose distribution throughout the treatment field? Isocentric technique treated to the patient's midline SSD technique moving the treatment table as far away from the source as possible Midline isocentric technique with blocks added Midline isocentric technique with wedges added

SSD technique moving the treatment table as far away from the source as possible

In the electron mode of linac operation, the beam, instead of striking the target, is made to strike this component first. Secondary collimators Flattening filters Ion chamber Scattering foil

Scattering foil

If 1.5 cm is added to the inferior border of a treatment port, what happens to the original isocenter if you are not using independent jaws? Shifts 0.75 cm superiorly Shifts 0.75 cm inferiorly Shifts 1.5 cm superiorly The isocenter remains the same

Shifts 0.75 cm inferiorly

The term that best describes the complete removal of all microorganisms is called? Medical asepsis Disinfection Antisepsis Sterilization

Sterilization

If you compare the penumbra of a 6 MV linear accelerator, operating in the photon mode, to the penumbra of a Co-60 teletherapy machine using the same SSD, which of the following is true? The 6 MV linear accelerator has a greater penumbra than the Co-60 source The 6 MV linear accelerator has less penumbra than the Co-60 source The 6 MV linear accelerator has the same amount of penumbra as the Co-60 source Neither machine would have measurable penumbra

The 6 MV linear accelerator has less penumbra than the Co-60 source

Portal verification is defined as the documentation of: Isodose curves through the use of film or electronic imaging devices The extent of disease using film or electronic imaging devices The actual treatment using film or electronic imaging devices The approval of the treatment port by a qualified physician

The actual treatment using film or electronic imaging devices

The rapid fall off of dose around a Cesium-137 source in a 5 cm radius of tissue is due primarily to: The inverse square law The low energy of the radiation Alpha and Beta emission Lack of gamma radiation

The inverse square law

Two wedges are used to treat a maxillary antrum through an anterior and lateral field. What part of the wedge should be adjacent? Thin side (toe) anterior and thick side (heel)laterally Thin side (toe)anterior and thin side (toe) laterally Thick side (heel) anterior and thick side (heel) laterally Thick side anterior (heel) and thin side (toe) laterally

Thick side (heel) anterior and thick side (heel) laterally

When treating a lesion on the outside of the nose with electrons, what is the major reason why you place wax-coated lead strips or fill the nose with a substance to fill the air cavity? To increase the dose to the outside of the nose To decrease the dose to the inside of the nose For patient comfort You never place anything in the patients nos

To decrease the dose to the inside of the nose

In the above question, why is it important to place isocenter where you placed it? To ensure total tumor coverage To eliminate hot spots To reduce the skin dose To clear the patients surface with the gantry

To ensure total tumor coverage

The purpose of Protective (Reverse) Isolation is: To prevent the transmission of pathogens in the feces To prevent the transmission of pathogens transmitted by direct contact with wounds To protect an uninfected patient with lowered resistance To prevent infection of personnel

To protect an uninfected patient with lowered resistance

When a patient has been treated with a cesium insertion for cervical cancer, why would she be treated with external beam radiation following the cesium? To decrease the size of the tumor To deliver a higher dose to the cervix To avoid infertility To treat the pelvic lymph nodes

To treat the pelvic lymph nodes

All of the following medications are anti-emetics EXCEPT: Norazine Compazine Tyenol Torecan

Tyenol

Which of the following is the best method to prevent the spread of infection? Wash hands Wear gowns Wear a mask Clean the table

Wash hands

The attenuation of Cerrobend (Lipowitz metal) is? about 15 - 17 percent more than lead about 15 - 17 percent less than lead the same as lead about 5 - 7 percent less than lead

about 15 - 17 percent less than lead

Bolus is often used in electron beam therapy to? flatten out an irregular surface reduce the penetration of the electrons in parts of the field increase the surface dose all of the above none of the above

all of the above

The laws of Bergonie and Tribondeau state that ionizing radiation is more effective against which of the following? cells that are actively mitotic cells that are differentiated both A & B neither A nor B

cells that are actively mitotic

An increase in the skin dose is associated with? increasing photon beam energy increasing beam shielding increasing angle of beam incidence increased SSD

increasing angle of beam incidence

The majority of damage to the body from exposure to x-rays or gamma rays results from the: direct effect indirect effect target effect threshold effect

indirect effect

As identified in a treatment plan, which volume is the largest? gross tumor volume (GTV) clinical target volume (CTV) irradiated volume treatment volume

irradiated volume

Insertion of aluminum, copper, and tin filters into the x-ray beam causes? low energy x-rays to be absorbed the kVp to increase an unnecessary dose on the skin surface the dose to increase

low energy x-rays to be absorbed

The simplest combination of two radiation fields is a pair of fields directed along the same axis from opposite sides of the treatment volume. These fields are called? wedged-pair orthogonals parallel-opposed weighted beams

parallel-opposed

Wharton's ducts receive saliva from the: sublingual gland submandibular gland parotid gland thyroid gland

parotid gland

The greatest proportion of salivary neoplasms occur in the? submandibular glands sublingual parotid glands all are equally affected

parotid glands

Regarding the TNM classification of head and neck cancers, the T classification is used to evaluate the: primary tumor lymph node involvement metastatic state tumor type

primary tumor

This is the time which the TOTAL dose is delivered. fractionation time delay latent period protraction

protraction

To "beam split" means to? weight portals evenly remove divergence employ mixed beam energies fractionated treatments

remove divergence

Which factor would most likely cause an increase in the required monitor units? an increase in beam energy a decrease in prescription depth use of a wedge an increase in field size

use of a wedge

Which tumor grade generally serves a better prognosis? well differentiated moderately differentiated poorly differentiated dedifferentiated

well differentiated

The two major energies associated with Co-60 beta decay are gamma energies of: 10.2 and 1.11 MeV 1.17 and 1.33 MeV 2.25 and 2.38 MeV 2.51 and 3.02 MeV

1.17 and 1.33 MeV

When treating with arc rotations, the isocenter of a 6 MV beam should be placed: 2.5 cm anterior to the tumor 1.5 cm posterior to the tumor At the tumor On the skin surface

1.5 cm posterior to the tumor

A patient's prescription requires a total of 180 cGy to be delivered per day to equally weighted fields. The treatment time to deliver 100 cGy is 2.15 minutes. What treatment time must be delivered to each field to follow the prescription? 0.87 min 1.94 min 2.15 min 3.88 min

1.94 min *2.15/100=.0215, .0215*90=1.94min

A patients thickness is measured to be 20 cm anterior to posterior. If the patient is brought to an SSD of 90 cm on a 100 cm SAD accelerator, what should a ruler read from the tabletop to isocenter. Assume the patient is flat on the table. 10 cm 15 cm 20 cm Connot be determined from the information provided.

10 cm

According to the definition of the ICRU, the wedge angle refers to: "the angle through which an isodose curve is tilted at the central ray of the beam at a specified depth." The recommended depth is: 5 cm 10 cm 15 cm 20 cm

10 cm

Find the equivalent square of the resultant field of an 12 x 12 field with a 4 x 6 cm block?In this question I want you to use the area of both fields to find the answer. 8 x 8 9 x 9 10 x 10 11 x 11

11 x 11 *Find area, subtract block area from field area, square root

A patient is treated on the 6 MV linear accelerator. The patient is set up to 94 cm SSD. The TAR at 6 cm depth is 0.87 and the output factor at isocenter in air is 1.02 cGy/MU for the required field size. How many monitor units will it take to deliver 100 cGy to a depth of 6 cm? 88 MU 113 Mu 102 MU 116 MU

113 Mu

A treatment designed to be given at 100 SSD is mistakenly given at 94 SSD. What is the error in dose delivered? 13% overdose 13% underdose 6% overdose 6% underdose

13% overdose

A treatment of 137 M.U. require that a blocking tray factor of 0.963 be included in the calculation. What are the correct M.U. if the tray is added? 132 M.U. 137 M.U. 142 M.U. 150 M.U.

142 M.U.

If a 200keV electron strikes an inner shell with a binding energy of 56keV, the resulting photoelectron will have an energy of? 56keV 3.5keV 256keV 144keV

144keV

To preserve the skin sparing properties of the megavoltage photon beams, the compensator is placed at least ___________ from the skin. 1 - 5 cm 5 - 10 cm 9 - 20 cm 15 - 20 cm

15 - 20 cm

What would be the TD 5/5 tolerance dose for both whole lungs in fractions of 180 cGy/day? 1500 - 2500 cGy 2500 - 3500 cGy 3500 - 4500 cGy 4500 - 5000 cGy

1500 - 2500 cGy

A patient is 20 cm thick. You are to give 3000 cGy midline weighted 2:1 right to left. The PDD for a depth of 10 cm is .641. What is the given dose to the left side? 1560 cGy 2340 cGy 3120 cGy 4680 cGy

1560 cGy

A patient was treated with a 20 cm long field and a 15 cm field is matched to it. Both fields are set at 80 cm SSD. What is the gap on the skin if the fields are to be matched at 10 cm depth? 0.9 cm 1.3 cm 1.8 cm 2.2 cm

2.2 cm *[(.5*L1/ssd1)+(.5*L2/ssd2)]*depth

A patient is treated with parallel-opposed mantle and para-aortic fields of lengths 30 and 15cm respectively. Calculate the gap required on the surface for the beams to intersect at a midline depth of 10cm. Assume 100 SSD for both fields. 1.1 cm 4.25 cm 2.25 cm none of the above

2.25 cm

The output of a Co-60 telethrapy iunt is 85 cGy/min in air at 80.5 cm for an 11 x 11 cm field size. The backscatter factor for this field is 1.10. Calculate the time necessary to deliver a dose of 170 cGy at a depth of 8 cm, 80 SSD. The PDD for an 11 x 11 field at a depth of 8 cm is 63%. 2.06 min 2.53 min 2.89 min 3.46 min

2.89 min

What is the TD 5/5 tolerance dose for the whole kidney given in fractions of 180 cGy/day? 1500 - 2000 cGy 2000 - 2500 cGy 2500 - 3000 cGy 3000 - 3500 cGy

2000 - 2500 cGy

A patient is accidentally treated at 78 cm SSD, instead of 80 cm SSD. The treatment depth is 3 cm. If the prescription dose is 200 cGy through a single field, what did the tumor actually receive? 190 cGy 195 cGy 205 cGy 210 cGy

210 cGy

A dose of 3000 cGy is delivered to a depth of 8 cm at a PDD of 76%. What is the dose to an underlying organ at 14 cm at a PDD of 58% 5172 cGy 2289 cGy 3947 cGy 4231 cGy

2289 cGy

When treating the parotid gland standard fractionation (180 - 200 cGy/day), what is the tolerance dose (TD 5/5) that patients will develop xerostomia? 500 - 1500 cGy 2500 - 3500 cGy 4500 - 5500 cGy 6500 - 7500 cGy

2500 - 3500 cGy

Calculate the dose at D-max if 200 cGy is delivered to 7 cm below the skin at the 72% depth dose. 144 cGy 197 cGy 206 cGy 278 cGy

278 cGy *Dose/.72

A lung lesion is being treated using POP isocentric ports with the patient in a supine position. The physician wants to place the isocenter at the patient's midline. The ruler placed on the table top reads 30 cm from the table top to the patient's anterior surface. There is a 1.5 cm immobilization device between the patient and the table. What is the patient's total thickness? 30 cm 28.5 cm 14.3 cm Unable to determine with the limited amount of information given.

28.5 cm

Calculate the M.U to deliver 200 cGy to the 90% isodose line using 12 MeV electrons at 100 cm SSD if measured output for the cone and cutout is 0.787 cGy/MU at 100 cm SSD 255 MU 229 MU 282 MU 301 MU

282 MU

300 rem is equivalent to? 30 Sv 30 mrem 300 Sv 3 Sv

3 Sv

When performing a CT on a patient for IMRT treatment of the prostate, what size slice should be used through the true pelvis? 5.0 mm 3.0 mm 1.0 mm 10 mm

3.0 mm

The 80% isodose curve line can be estimated for electrons by dividing the energy (E) by: 2.11 2.33 3.00 4.00

3.00

The 80% isodose line can be estimated for electrons by dividing the energy (E) by: 2.11 2.33 3.00 4.00

3.00

he normal platelet count is approximately: 60,000 cc 80,000 cc 120,000 cc 300,000 cc

300,000 cc

If a patient received a tumor dose of 250 cGy per day at the 79.2% depth dose, what is the daily maximum subcutaneous dose? 198 cGy 250 cGy 316 cGy 405 cGy

316 cGy

A patient is receiving 300 cGy per day to a spinal cord lesion at 89.5 percent depth dose. What is the daily given dose at D-max? 269 335 400 Not enogh information to calculate

335

The collimators on a linear accelerator are calibrated for a distance of 100 cm. To obtain a field size of 30 cm x 30 cm at 80 cm, what collimator setting is required? 26.7 x 26.7 cm 30 x 30 cm 37.5 x 37.5 cm 41 x 41 cm

37.5 x 37.5 cm

A treatment time of 2 min. requires that you add a wedge with a factor of 0.5, what will the new treatment time be? 1.0 min 2.0 min 2.5 min 4.0 min

4.0 min *Time/Factor

A normal red blood cell count is represented by which of the following? 150 - 200 Mil/mm3 2.0 - 11.0 K/mm3 4.20 - 6.20 MIL/mm3 none of the above

4.20 - 6.20 MIL/mm3

What is the dose at which you generally reduce the field "off cord" when treating a head and neck cancer? 3000 - 3500 cGy 4500 - 5000 cGy 5500 - 6000 cGy 6000 - 6500 cGy

4500 - 5000 cGy

What is the Tolerance Dose to the Spinal Cord? 2500 to 3000 cGy 3000 to 3500 cGy 4500 to 5000 cGy 6000 to 6500 cGy

4500 to 5000 cGy

In general, when treating with radiation, the proximal and distal margin around a soft tissue sarcoma should be a minimum of _____ cm. 2 5 10 12

5

The standard amount of time that should elapse between two radiation therapy treatments given in the same day to the same site is: 3 hours 6 hours 9 hours 12 hours

6 hours

The collimator setting is 8 x 10 cm on a 100 cm SAD machine, The SSD on the patient's skin reads 90 cm. What is the field size on the patient's skin? 7.2 x 9 cm 8 x 10 cm 8.9 x 11.1 cm Unable to determine

7.2 x 9 cm

The patient is positioned supine and is to be treated using an isocentric technique. The AP SSD reads 84 cm. If the patient's thickness is 36 cm, what is the PA SSD? 64 cm 80 cm 84 cm 88 cm

80 cm

A patient is treated with an 8 x 15 cm field, Co-60 unit, 80 cm SSD to a depth of 5 cm, 78.5% depth dose. What would the percent depth dose be if the SSD was changed to 100 cm? 76.9% 80.1% 90.2% 96.1%

80.1% Mayneord Factor Formula

A patient's separation is 30 cm. The posterior SSD reads 89 cm on a 100 cm isocentric machine, what should the anterior SSD read? 70 cm 81 cm 89 cm 96 cm

81 cm

The PDD for 12 x 12 cm field, 6 MV, 5 cm depth at 80 cm is 82.8%. Calculate the percent depth dose for the same field size and depth for a 100 cm SSD: 81.4% 82.1% 83.4% 84.1%

84.1%

The patient is positioned supine and is to be treated using an isocentric technique.The AP SSD reads 88 cm and you move the isocenter 2 cm posteriorly. What should the SSD read? 86 cm 88 cm 90 cm Unable to determine with the amount of information given

86 cm

A patient is to be treated isocentrically to his midline on the 6 MV linear accelerator at 100 cm SAD. Calipers have measured the patient thickness to be 21 cm. The patient is positioned flat on the table top. What SSD is required for the isocentric treatment to the patient's midline? 79 cm 89.5 cm 100 cm 110.5 cm

89.5 cm

The practical range for an 18 MeV electron is: 6 cm 8 cm 9 cm Unable to determine

9 cm

A localization film was taken at 109 cm FFD. A 3.5 cm magnification ring was placed on the patient's skin. It measures 4.2 cm on the film. What distance is the magnification ring from the focal spot? 83.2 cm 90.8 cm 138 cm 147 cm

90.8 cm

The normal oral temperature for an adult is? 99.6 to 101.6 degrees F 96.8 to 98.6 degrees F 39.6 to 42.6 degrees C 32.6 to 34.6 degrees C

96.8 to 98.6 degrees F

A split beam technique in which half of the filed is blocked: Prevents beam divergence Allows for fields to match at the central ray Overlays the penumbra of two fields A & B A & C B & C A, B & C

A & B

Restraining a patient in an aquaplast mask without consent can be considered: Battery Assault Humane A & B A & C C only A, B & C

A & B

When manipulating a CT image, increasing the width of the window: Decreases contrast Increases latitude Increases speed A & B B & C A & C A, B & C

A & B

Which of the following systems must be functioning in order to treat a patient safely on a high energy machine? A two-way audio system A visual system to monitor the patient and machine function An audible signal to inform the patient when the machine is on A & B A & C B & C A, B & C

A & B

Regarding electron beam which of the following is true: Directly ionizing due to their negative charge Less likely to interact with air that photons Have a higher LET than photons A & B A & C B & C A, B & C

A & C

A patient is set up on a wing board with both arms up. What areas are commonly treated using this position? Breast Lung Pancrease A & B B & C A & C A, B & C

A, B & C

Before activating the linear accelerator and delivering a treatment, the therapist should confirm that the following setting are correct: Monitor unit Wedge filter Beam energy A & B A & C B & C A, B & C

A, B & C

Percentage depth dose increases with: Field size SSD Energy A & B B & C A & C A, B & C

A, B & C

RBE is dependent on which of the following? Radiation quality Radiation dose per fraction Tissue irradiated A & B B & C A & C A, B & C

A, B & C

The practical range of an electron beam: Increases with increasing electron energy About 1 cm for every 2 MEV About one half the electron energy A & B A & C B & C A, B & C

A, B & C

What precaution should be taken when treating the chest of a patient with a pacemaker? Cover the region of the pacemaker with a lead block Keep the pacemaker out of the direct beam if possible Contact the manufacturer regarding radiation tolerance A & B A & C B & C A, B & C

A, B & C

When a patient is treated with more than one beam, misalignment between parallel opposed beams can occur due to displacement of the: Target Collimator axis of rotation Gantry axis of rotation A & B B & C A & C A, B & C

A, B & C

Which of the following is TRUE concerning a patient's medical record? It is a legal public document Patient's may review their records upon request It may be subpoenaed into a court of law A & B A & C B & C A, B & C

A, B & C

According to the AAPM TG-40, gantry / collimator angle indicators on the linear accelerator must agree within _____ degree(s): A. 1 B. 2 C. 3 D. 5

A. 1

The intensity of a radiation beam is measured at a distance of 100 cm and is found to be 150 cGy/min. What is the intensity of the beam at 105 cm? A. 136 cGy/min B. 143 cGy/min C. 157 cGy/min D. 165 cGy/min

A. 136 cGy/min (Inverse Square Formula)

The average photon beam energy produced by a 6 MV linear accelerator is approximately _____MV: A. 2 B. 4 C. 6 D. 9

A. 2

Which of the following is the most common primary brain tumor in adults? A. Glioma B. Meningioma C. Medulloblastoma D. Metastasis

A. Glioma

Regarding linear accelerators, which of the following is TRUE? A. Maximum photon energy is equal to the energy of the electron striking the target B.The bending magnet is rotated out of the beam in the electron mode C. The beam current is higher in the electron mode than in the photon mode D. The scattering foil is the primary component for photon production

A. Maximum photon energy is equal to the energy of the electron striking the target

Which is the allowable cumulative exposure for a radiation worker? A. One REM times the workers age in years B. Five REM times the worker's age in decades C.100 REM times the worker's age in years D. Five REM times the worker's age in years + 100

A. One REM times the workers age in years

Lead alone could be used in room shielding when the following interactions predominate: A. Photoelectric B. Bragg Peak C. Pair production D. Compton scattering

A. Photoelectric

The section of the bladder between the ureters and the urethra is known as the: A. Trigone B. Urogenital diaphragm C. Calyces D. Muscularis propria

A. Trigone

According to NRC regulations, what is the MPD for those who are NOT trained radiation workers? A.0.1 rem/yr B.1.0 rem/yr C.1.25 rem/year D.5.0 rem/year

A.0.1 rem/yr

A dose of 200 cGy is to be delivered at a depth of 10 cm at 100 cm SAD from a single 15 x 15 cm field with 6 MV photons. Given the information below, what would the treatment M.U. be?TMR (15 x 15 cm, depth 10 cm) = 0.806O.F in air, 100 cm SAD, 15 x 15 cm F.S. = 1.015 cGy/muBSF (15 x 15 cm) = 1.044PDD (100 SSD, 15 x 15 cm, depth = 10 cm) = 72.2% A.234 M.U. B.245 M.U C.251 M.U. D.273 M.U

A.234 M.U. *SAD TX no need for PDD

The most common histopathology of endometrial cancer is: A.Adenocarcinoma B.Squamous cell carcinoma C.Clear cell carcinoma D.Mixed cellularity

A.Adenocarcinoma

When treating the maxillary antrum, which neighboring structure is most sensitive to radiation? A.Eye B.Pituitary C.Spinal cord D.Brain

A.Eye

The patients chin is tilted down when treating a pituitary gland in order to avoid the: A.Eyes B.Surrounding brain tissue C.Spine D.Base of skull

A.Eyes

In the pancreas, where do most tumors originate? A.Head B.Tail C.Body D.Hilum

A.Head

Areas outside the target that receives a higher dose than the specified target dose is called: A.Hot spot B.Treated volume C.Maximum target dose D.Irradiated volume

A.Hot spot

The most common site for metastatic spread from cancer of the penis is the: A.Inguinal nodes B.Periaortic nodes C.Lungs D.Liver

A.Inguinal nodes

If you are using a gonad shield when treating a patient with seminoma on a 6 MV linear accelerator, why can't all of the scatter to the testicles be eliminated? A.Internal scatter from the patient cannot be eliminated B.The shield would have to be too thick C.Part of the testies must be exposed to properly treat the patient D.A 6 MV machine creates more scatter to the testicles when a testicular shield is used

A.Internal scatter from the patient cannot be eliminated

Where is the spleen located? A.LUQ B.LLQ C.RUQ D.RLQ

A.LUQ

Which of the following is the most radiosensitive structure? A.Liver B.Spine C.Brain stem D.Optic chiasm

A.Liver

Exposure is: A.Measure of ionization in air B.Known as a biological dose equivalent C.The absorbed dose multiplied by the quality factor D.The possibility of a radiation interaction

A.Measure of ionization in air

Nasopharyngeal tumors drain through what lymph node group first? A.Posterior cervical B.Submental C.Submaxillary D.Supraclavicular

A.Posterior cervica

What type of lung cancer has the highest incidence of metastasis at presentation? A.Small cell B.Large cell C.Squamous cell D.Adenocarcinoma

A.Small cell

Which type of lung cancer may need prophylactic brain irradiation? A.Small cell B.Large cell C.Squamous cell E.Adenocarcinoma

A.Small cell

What external landmark can be used to localize the top of the larynx? A.Thyroid prominence B.Hyoid bone C.Cervical vertebrae D.Waldyer's ring

A.Thyroid prominence

What is the primary reason to angle the gantry posteriorly when treating Grave's disease with two lateral fields? A.To avoid divergence into the lens B.To assure coverage of the posterior orbit C.To increase the dose to the orbital tissue D.To assure coverage of the protruding eye

A.To avoid divergence into the lens

When treating a patient with cancer of the tongue, what is the purpose of putting a bite block in the patient's mouth? A.To flatten the tongue B.To protect the teeth C.To localize the mandible D.To alter the dose distribution

A.To flatten the tongue

Hypofractionation is: A.Treatment given in fewer fractions than standard B.The use of very low dose rates C.Treatment given two or more times per day D.Treatments given not according to protocol

A.Treatment given in fewer fractions than standard

In the adult, the normal respiration rate (breaths/minute) is? A: 10 to 20 B: 60 to 90 C: 100 to 120 D: none of the above

A: 10 to 20

If treating a supine patient isocentrically and assuming there is no table sag, given a tabletop (Z) of 13.5cm, an anterior SSD of 84cm, and a 100cm SAD machine, the expected posterior SSD would be? A: 86.5cm B: 84cm C: 97.5cm D: 103.5cm

A: 86.5cm

A patient that is said to be experiencing dyspnea has: A: breathing difficulties B: high blood pressure C: a fever D: a urinary obstruction

A: breathing difficulties

Which of the following is not an item checked during daily warm-up of the linear accelerator? A: light/radiation field coincidence B: distance indicator C: localizing lasers D: audiovisual devices

A: light/radiation field coincidence

The photon beam created within the target of a linear accelerator is first intercepted by or incident upon the? A: primary collimators B: ion chambers C: scattering foil D: flattening filter

A: primary collimators

Variation of output of a linear accelerator by more that 3% from the baseline usually: A: requires notification of the physics staff B: requires a halt in all patient treatment C: requires calling vendor services D: requires no action from the therapist

A: requires notification of the physics staff

During radiation therapy to the pelvis if a patient is complaining of the following, which would most likely warrant interruption in the course of treatment: Dysuria Acute radiation enteritis Tenesmus Impotence

Acute radiation enteritis

Which of the following chemotherapeutic drugs sensitizes the human heart? Bleomycin Adriamycin Vincristine Cis-platinum

Adriamycin

Where are pancoast tumors located? Apex of lung Periphery of lung Mediastinum Hilum

Apex of lung

Which of the following is required for fabricating custom cut blocks? Source axis distance Source image distance Source to block tray distance A & B B & C A & C A, B & C

B & C

Which of the following statements concerning patient's rights are TRUE? A relative has the right to access a patient's record The patient has the right to refuse treatment The patient has the right to be informed of any alternative procedures prior to his treatment A & B A & C B & C A, B & C

B & C

When a field size is changed during the course of a patient's treatment, which of the following statements are true? Treatment depth must be changed The physician must include changes in the prescription The MU or time must be recalculated A & B only A & C only B & C only A, B & C

B & C only

Hot and cold spots are common problem associated with: isocentric fields abbutting fields four-field techniques A only B only C only A, B & C

B only

To prevent the spread of airborne droplet infection, which of the following must be employed? Gowns Masks Gloves A only B only C only A, B & C

B only

1 mSv is equal to ______ rem. A. 0.01 B. 0.1 C. 1.0 D. 10

B. 0.1

By what factor does the intensity decrease when something moves from 10 meters to 20 meters away from a radioactive source? A. 2 B. 4 C. 10 D. 20

B. 4

With breast cancer which of the following patterns of lymph node drainage occurs most often? A. Internal mammary B. Axillary C. Supraclavicular D. Mediastinal

B. Axillary

From what type of tissue do most sarcomas arise? A. Epithelial B. Connective C. Nerve D. Skin

B. Connective

What is the purpose of the scattering foil in the linear accelerator? A. Increase the intensity of the beam B. Provide uniform electron fluency C. Absorb radiation D. Flatten out photon beam

B. Provide uniform electron fluency

Direct exposure to lasers that are used for patient alignment purposes can be a hazard for the: A. Pituitary B. Retina C. Commisure D.Inner ear

B. Retina

In Bremsstrahlung radiation, the incoming electron: A. interacts with an orbiting electron B. is deflected by the nucleus of the atom C. creates a positive and negative ion D. cascades to a lower energy state

B. is deflected by the nucleus of the atom

What is the therapeutic ratio if the normal tissue tolerance is 5000 cGy and the tumor lethal dose is 4000 cGy? A.0.80 B.1.25 C.1.56 D.2.10

B.1.25

What is the TD 5/5 tolerance dose using standard fractionation, for the lens of the eye? A.450 cGy B.1000 cGy C.2000 cGy D.5000 cGy

B.1000 cGy

The pituitary is located: A.2 cm posterior and 2 cm inferior to the EAM B.2 cm anterior and 2 cm superior to the EAM C.1 cm posterior and 2 cm superior to the EAM D.2 cm anterior and 2 cm inferior to the EAM

B.2 cm anterior and 2 cm superior to the EAM

The tolerance dose (TD 5/5) for the whole liver using standard fractionation (180 - 200 cGy/day) is: A.1500 - 2000 cGy B.2500 - 3000 cGy C.3500 - 4000 cGy D.4500 - 5000 cGy

B.2500 - 3000 cGy

The tolerance dose (TD 5/5) for the whole brain using standard fractionation is approximately: A.3500 cGy B.4500 cGy C.5500 cGy D.6500 cGy

B.4500 cGy

What does ALARA stand for? A.Acting responsible as soon as required B.Advocating as little radiation as reasonably achievable C.Reporting all accidents as soon as discovered D.Always leaving an area right away

B.Advocating as little radiation as reasonably achievable

The collapse of part or all of the lung, which often results from bronchial obstruction is termed: A.Bronchiectasis B.Atelectasis C.Pneumonitis D.Pleurisy

B.Atelectasis

The angle of the mandible is generally located at which cervical vertebra level? A.C-1 B.C-3 C.C-5 D.C-7

B.C-3

The inferior border of a larynx port for a vocal cord tumor should anatomically correspond to: A.Bottom of the thyroid cartilage B.Cricoid cartilage C.Hyoid bone D.First tracheal ring

B.Cricoid cartilage

Effects for which the severity of the effect in the individual varies with the radiation dose, and a threshold usually exist is called: A.Stochastic B.Deterministic C. Acute D. Protracted

B.Deterministic

The degree of cellular differentiation and rate of tumor growth is the: A.Stage B.Grade C.Etiology D.Epidemiology

B.Grade

In the normal adult male the prostate is located ________ to the bladder: A.Superior B.Inferior C.Anterior D.Posterior

B.Inferior

Monitoring of dose rate and field symmetry is best accomplished by using a (an): A.Pocket dosimeter B.Ion chamber C.TLD D.GM counter

B.Ion chamber

The most common thermoluminescence material used in radiation dosimetry is: A.CaSO 4 B.LiF C.CaF2 D.Li2B

B.LiF

Where is a sarcoma most likely to metastasize? A.Bone B.Lung C.Blood D.Brain

B.Lung

Klystrons and magnetrons are: A.Radiation monitors B.Microwave sources C.Monitors used for mechanical motions D.Beam shaping devices

B.Microwave sources

Which of the following does not ionize directly? A.Proton B.Neutron C.Alpha particle D.Electron

B.Neutron

When treating a breast patient, the slope of the sternal notch to the xiphoid could be corrected by: A.Aquaplast B.Slant board C.Arm board D.Vaclok system

B.Slant board

The largest lymphoid tissue: A.Liver B.Spleen C.Thymus D.Jugulodiagastric node

B.Spleen

Which of the following is the most common site for a spinal cord compression? A.Cervical spine B.Thoracic spine C.Lumbar spine D.Sacrum

B.Thoracic spine

The inguinal lymph nodes are generally included in which of the following treatment sites? A.Cervix B.Vulva C.Prostate D.Rectum

B.Vulva

A high energy photon beam requires 2.13cm of cerrobend to reduce the original intensity by 50%. This beam has a half-value of? A: 1.06cm of cerrobend B: 2.13cm of cerrobend C: 10.65cm of cerrobend D: 4.26cm of cerrobend

B: 2.13cm of cerrobend

The approximate 5 year survival rate for Stage II (T4, N0, M0) colorectal cancer is? A: >95% B: 65-85% C: 35-45% D: 15-25%

B: 65-85%

If a portal was calculated to deliver 100cGy using 133 monitor units, what would the delivered dose be if the linear accelerator prematurely shut off after delivering only 98 monitor units? A: 130cGy B: 74cGy C: 87cGy D: none of the above.

B: 74cGy

The most frequently reported cancer treatment side effect is? A: mucositis B: fatigue C: epilation D: nausea and vomiting

B: fatigue

The most frequent site of soft tissue sarcoma metastasis is? A: brain B: lung C: bone D: liver

B: lung

If a LINAC is properly calibrated, the field size indicated at the control console will correspond to the size of the field at the? A: surface of the patient B: mechanical isocenter C: secondary collimators D: primary collimators

B: mechanical isocenter

When documenting and/or verifying off-axis SSD's, it is important to remember that the optical distance indicator is only accurate at? A: extended SSD's B: the central axis C: mechanical isocenter D: prescription depth

B: the central axis

The half-life of Co-60 is: A. 2.5 years B. 3.2 years C. 5.3 years D. 8.2 years

C. 5.3 years

The stomach is located in the: A. Right upper quadrant B. Right lower quadrant C. Left upper quadrant D. Left lower quadrant

C. Left upper quadrant

Which of the following structures are most radiosensitive (susceptible to long term damage at the lowest dose)? A. Spinal cord B. Heart C. Lung D. Liver

C. Lung

If a pathology report indicates a stage of T1-N0-M3, what can be said about the lymph node involvement of the nodes sampled? A.Positive nodes are found close to the primary tumor B.The nodes were unable to be sampled C.No positive nodes were present D.Positive nodes are found at distant sites

C. No positive nodes were present

Linear accelerators have which of the following type of target? A. Hooded anode B. Waveguide C. Transmission D. Rotating cathode

C. Transmission

A patient is to receive 300 cGy per day on a Co-60 unit through a single posterior field. The dose rate in air at 80 cm is 105.3 cGy/min and the backscatter factor is 1.029. The PPD is 87.5%. Find the treatment time to deliver the prescribed dose. A.4 min 22 sec B.3 min 12 sec C.3 min 10 sec D.2 min 34 sec

C.3 min 10 sec *Calculate MU then divide by dose rate. Values after decimal point are multiplied by 60 seconds

A patient was mistakenly treated at 90 cm SSD instead of 100 cm due to a misalignment of the ODI. The prescription dose was 2.5 Gy. What did the patient actually receive? A.2.03 Gy B.2.77 Gy C.3.09 Gy D.3.76 Gy.

C.3.09 Gy *Inverse Square

What external landmark can be used to localize the carina? A.Thyroid prominence B.Axilla C.Angle of Louis D.Clavicle

C.Angle of Louis

The depth of maximum dose is most dependent on: A.SSD B.Field size C.Beam energy D.Thickness of tissue

C.Beam energy

Which of the following is the most common metastatic site for prostate cancer? A.Lung B.Liver C.Bone D.Brain

C.Bone

What cancer is "peau de orange" associated with? A.Basal cell B.Melanoma C.Breast D.Prostate

C.Breast

If the total body is exposed to a dose of 4500 cGy in a single exposure, the most likely cause of death would be: A. Infection and low blood counts B. Severe damage to the intestines C.Cerebral edema D.Death would not be likely with this dose

C.Cerebral edema

The lower constricted portion of the uterus is called: A.Endometrium B.Myometrium C.Cervix D.Peritonial

C.Cervix

The vallecula is located at the level of which of the following anatomical structures? A.Pyriform sinus B.Thyroid cartilage C.Hyoid bone D.Cricoid cartilage

C.Hyoid bone

If a patient has reacted to contrast media, you would expect to see all of the following EXCEPT: A.Hypotension B.Choking C.Incontinence D.Prurtis

C.Incontinence

The most common type of breast cancer is? A.Tubular B.Lobular C.Infiltrating ductal D.Adenoidcysti

C.Infiltrating ductal

he vocal cords are found within a structure formed by cartilage called the: A.Pharynx B.Trachea C.Larynx D.Vallecula

C.Larynx

Which is the largest paranasal cavity? A.Nasopharynx B.Sphenoid C.Maxillary D.Frontal

C.Maxillary

What is the technique in which a skin cancer is removed and examined one layer at a time? A.Curettage B.Cryosurgery C.Moh's surgery D.Dermobrasion

C.Moh's surgery

When a patient presents with a bloody nasal discharge and a neck mass, the most likely diagnosis is: A.Larynx cancer B.Hypopharyngeal cancer C.Nasopharyngeal cancer D.Brain metastasis

C.Nasopharyngeal cancer

A Strontium-90 applicator may be useful in the treatment of which of the following diseases of the eye? A.Retionblastoma B.Malignant melanoma C.Pterygium D.Metastasis

C.Pterygium

Back-scatter factors are independent of: A.Field size B.Radiation quality C.SSD D.TAR at D-max

C.SSD

The false vocal cords are located __________ to the glottis: A.Anterior B.Posterior C.Superior D.Lateral

C.Superior

The trachea bifurcates at the level of: A.C-4 - C-5 B.T-12 - L-1 C.T-4 - T-5 D.L-4 - L-5

C.T-4 - T-5

The xiphoid is located at the level of: A.T-4 - T-5 B.T-7 - T-8 C.T-9 - T-10 D.T-11 - T-12

C.T-9 - T-10

A multiple field technique (3 or more fields) is generally utilized when treating pituitary cancers, opposed to 2 lateral fields, to avoid an excessive dose to which of the following structures? A.Eyes B.Optic chiasm C.Temporal lobes D.Sella turcica

C.Temporal lobes

7.5cm of Cerrobend is equivalent to about how many cm of pure lead? A: 2cm B: 4cm C: 6cm D: 8cm

C: 6cm *Lead attenuates approximately 20% more

At energies of 250kV, absorption in bone is due to? A: Compton effect B: Pair production C: Photoelectric effect D: Bremstrahhlung effect

C: Photoelectric effect

What part of the X,Y,Z set-up method is equivalent to the tabletop to isocenter? A: X B: Y C: Z D: none are equivalent

C: Z

Characteristic radiation occurs when: A: electrons move from inner to outer orbital rings B: photons interact with the nucleus C: electrons move from outer to inner orbital rings D: electrons are merely slowed down by an electric field

C: electrons move from outer to inner orbital rings

Dose rates: A: decrease with increased field size B: increase with decreased distance C: increase with increased field size D: none of the above

C: increase with increased field size

More than 80% of patients with pancreatic cancer present with? A: dyspepsia, dysphagia, or both B: dysphagia only C: pain, jaundice, or both D: a painless mass causing vague and nonspecific symptoms

C: pain, jaundice, or both

When treating a patient with glioblastoma, he begins to experience nausea, dizziness, and blurred vision. Which is the most likely reason? Tumor necrosis Cerebral edema CNS syndrome Reaction to medications

Cerebral edema

An iatrogenic infection is one caused by: Hospital employee Synergistic effect with radiation Blood borne pathogens Complications from treatment

Complications from treatment

For photon energies between 0.150 MeV and 10 MeV, the predominant type of interaction is: Photoelectric Compton Pair production Bremsstrahlung

Compton

MV portal films taken on a megavoltage machine has less contrast than kV films because the MV image results principally from: Pair production Photoelectric effect Compton interaction Photodisintegration

Compton interaction

When treating the whole brain, which drug is used to reduce radiation induced edema? Antibiotics Corticosteriods Diuretics Antihistamines

Corticosteriods

What is the approximate D-max of a 10 MV linear accelerator? A. 1.0 B. 1.5 C. 2.0 D. 2.5

D. 2.5 REMEMBER: 1.25MV = .5 4MV = 1.0 6MV = 1.5 10MV = 2.5 18MV = 3.5 24MV = 4.0

Photoelectric interactions of a 60 keV beam are greatest in: A. Water B. Fat C. Muscle D. Bone

D. Bone

Which of the following are interactions between an incident photon and an atomic nucleus? A. Photoelectric B. Compton C. Coherent D. Pair Production

D. Pair Production

The categories of visitors who are excluded from visiting a radiation iodine patient are: A. Families who have reproductive potential and children of any age B. Elderly females and children under 13 years of age C. No categories are excluded because radiation safety precautions are in effect D. Pregnant women and children under 18 years of age

D. Pregnant women and children under 18 years of age

A barrier that attenuates the useful portion of the beam to the required degree is called? A. the secondary barrier B. the incident shielding C. the tenth value layer D. the primary barrier

D. the primary barrier

What fraction would you multiply an electron energy by to estimate the 90% isodose range? A.2/3 B.1/2 C.3/8 D.1/4

D.1/4

A 3.5 cm block on a blocking tray 45 cm from the source will block what width at 100 cm? A.4.80 cm B.5.20 cm C.6.01 cm D.7.78 cm

D.7.78 cm

What symptoms are most often accociated with cancer of the cervix? A.Vaginal discharge B.Vaginal bleeding C.Bloating and weight gain D.A & B E.A & C F.B & C G.A, B & C

D.A & B

Bolus can be used to: A.Flatten out surface irregularities B.Reduce beam penetration C.Increase surface dose D.All of the above E.None of the above

D.All of the above

The trachea is a hollow tube about 10 cm in length that extends from the larynx to the bifurcation of the: A.Bronchus B.Saphanous C.Tributary D.Carina

D.Carina

The common iliac nodes are generally found around the level of: A.C-2 B.T-10 C.L-2 D.L-5

D.L-5

The epiglottis is a flap of cartilage that folds back to cover the entrance of the: A.Hypopharynx B.Esophagus C.Trachea D.Larynx

D.Larynx

A non-osseous tumor of the bone marrow is: A.Fibrosarcoma B.Chonrosarcoma C.Osteosarcoma D.Multiple Myeloma

D.Multiple Myeloma

When treating the entire CNS axis, the bottom of the spine port generally extends to the level of _____ when encompassing the cauda equina. A.L-3 B.L-4 C.L-5 D.S-1

D.S-1

The last part of the colon that leads into the rectum is known as the: A.Ascending colon B.Hepatic colon C.Descending colon D.Sigmoid colon

D.Sigmoid colon

Why is a tumor of the parotid gland frequently treated with a ipsilateral beam arrangement A.To avoid the eyes B.To avoid the spine C.For ease of set up D.To avoid the parotid gland

D.To avoid the parotid gland

Why do high energy photon accelerators require flattening filters? A.To increase the penetrating ability of the beam B.To reduce dose rates to a safe level C.To filter out low energy photons D.To decrease the intensity along the central axis

D.To decrease the intensity along the central axis

The TD5/5 for the larynx is? A: 1000cGy B: 3500cGy C: 5000cGy D: 7000cGy

D: 7000cGy

For x-ray beams in the megavoltage range, beam attenuation in any medium is primarily governed by the? A: average photon energy B: photoelectric effect C: mass number D: electron density

D: electron density

Doubling the distance from a radioactive source is equivalent to which of the following? A: doubling of the exposure rate B: decreasing the exposure rate by one half C: adding one half-value layer (HVL) of shielding D: none of the above

D: none of the above

In a 120 degree arc rotation technique, the center of the high dose zone would be: Deeper than the isocenter Displaced towards the surface Same shape as a 360 dehree rotation At the isocenter

Displaced towards the surface

Mayneord's factor is a correction for which of the following: Depth Field size Beam energy Distance

Distance

The most common presentation of SVC syndrome is: Distended veins in the head & neck Bloody nasal discharge Headaches Incontinence

Distended veins in the head & neck

Which of the following devices are used for an area surveys: A.Ionization chambers B.Parallel-plate chambers C.Geiger-Mueller detectors D.A & B only E.A & C only F.B & C only G.A, B & C

E.A & C only

If the daily treatment record is the document recording the actual treatment delivery, which of the following is included in the daily treatment record? A: Number of treatments delivered B: Cumulative dose C: Nursing notes D: patient positioning E: A & B F: A & C G: B & C H: B & D

E: A & B

Which patients with bladder cancer, the bladder should be ________ during treatment, when the entire bladder is the target volume. Empty Partially full Full Localized with contrast media

Empty

What normal organ would be at most risk when treating a maxillary sinus tumor? Oral cavity Pituitary gland Eye Ear

Eye

Lung cancer frequently spreads to: A.Brain B.Pancreas C.Bone D.A & B E.B & C F.A & C G.A, B & C

F.A & C

The most common long term effect of radiation therapy to the lung is: Pneumonitis Necrosis Fibrosis Esophagitis

Fibrosis

Where does the spinal cord start and stop in a normal adult? Foramen magnum to L-5 C-7 to L-5 Foramen magnum to L-2 Foramen magnum to t-12

Foramen magnum to L-2

A "star" shot on the linear accelerator is performed to test the rotational axis of the: A. Collimator B. Couch C. Gantry D. A and B only E. B and C only F. A and C only G. A, B & C

G. A, B & C

A patient is usually treated at 100 cm SSD. Today the patient must be treated on a stretcher at 135 cm SSD. For the tumor dose and size treatment area to remain the same as originally planned, which of the following statements is true? A.The collimator setting will decrease B.The monitor unit setting will increase C.The exit dose will slightly increase D.A & B E.B & C F.A & C G.A, B & C

G.A, B & C

Breast cancer metastasizes to: A.Bone B.Lung C.Brain D.A & B E.A & C F.B & C G.A, B & C

G.A, B & C

What doeS the oropharynx include: A.Base of tongue B.Tonsil C.Soft palate D.A & B E.A & C F.B & C G.A, B & C

G.A, B & C

Which of the following areas are generally encompassed in a " German helmet" radiationport when treating acute lymphocytic leukemia? A.Cribiform plate B.Meninges C.Posterior retina D.A & B E.B & C F.A & C G.A, B & C

G.A, B & C

Which of the following tissues arise form the mesenchymal stem cell (MSC)? A.Blood B.Cartilage C.Bone D.A & B only E.B & C only F.A & C only G.A, B & C

G.A, B & C

The Radiation Safety Officer must be notified if a personnel monitoring device is? A: Lost B: Damaged C: Left in the vault during treatment D: A & B E: A & C F: B & C G: A, B & C

G: A, B & C

On the linear accelerator, which of the following can be controlled via the hand pendent? A: Primary collimators B: Independent jaws C: Secondary collimators D: Couch vertical E: A, B & C F: A, B & D G: B, C & D H: B & D

G: B, C & D

According to the ICRU terminology, the area that is defined as the palpable or visible extent of the malignant tumor is called the: Treated volume Gross tumor volume Clinical target volume Planning target volume

Gross tumor volume

When treating with orthovoltage x-rays, the percentage depth dose will increase with all of the following EXCEPT: Increasing the field size Increasing the Kv Increasing the MA Increasing the distance

Increasing the MA

Patients who are neutropenic frequently present with ______ due to this condition: Headaches Shortness of breath Bleeding Infections

Infections

Which of the following types of medical apparatus should normally remain at a level above the patient at all times? Chest tubes Suction apparatus Intravenous infusion equipment Urinary drainage equipment

Intravenous infusion equipment

Which of the following methods is used to deliver hyperalimentation? Oral intake Intramuscular injection Intravenous injection Subcutaneous injections

Intravenous injection

Deodorants should not be used on the skin within the radiation treatment field because the deodorants will: Changes D-max Act as a bolus Enhance the radiation Irritate sensitive skin

Irritate sensitive skin

The point of intersection of the collimators and the gantry axis of rotation is the: Midline Isocenter Treatment volume Tumor volume

Isocenter

What is the main advantage of using Cerrobend over lead in custom blocking? It is softer than lead It cannot form air bubbles It requires thinner blocks to obtain the same effect It has a lower melting point

It has a lower melting point

Which of the following is not a principle of using proper body mechanics? Roll or slide objects when possible rather than lift Keep the feet close together to provide support Avoid twisting or bending at the waist Lift objects with knees flexed

Keep the feet close together to provide support

The amount of energy transferred to a material per unit length of travel is termed: RBE LET QF OER

LET