Radiation Therapy Mock Exam 2

A patient is treated with 2 adjacent 4 MV fields 8 cm and 12 cm in length respectively at 80 SSD. Calculate the gap on the skin necessary to give a uniform junction at a depth of 8 cm.

1.0 cm

If a given dose for a treatment is 200 cGy. What is the actual dose given if the tray is left in place. Tray factor = .91

182 cGy

In order to produce the least amount of electron contamination from a shadow tray, the material should have an atomic number of about ____.

50

What is the finishing angle for a clockwise rotational technique that has a starting angle of 28o degrees with an MU setting of 205 and MU/degree of 1.21?

89 degrees

Localization for the above tumor will require diligent computer planning. The optimal plan could be fairly conformed fields. What will be the radiation treatment field design and technique include? 1. Wedged pair, right and left laterals 2. Right lateral and vertex 3. While brain irradiation 4. Whole brain and C2 (helmet field) A. 1 & 2 B. 3 & 4 C. 1, 2, & 3 D. All of the above

A. 1 & 2

MSDS: 1. Contain information regarding the hazards associated with chemicals 2. Contains information for safe use 3. Need to be accessible only to administrators A. 1 & 2 B. 2 & 3 C. 1 & 3 D. 1, 2 & 3

A. 1 & 2

The common iliac node chain branches from the para-aortic chain at (the) : 1. L4 2. Iliac crest 3. ASIS A. 1 & 2 B. 1 & 3 C. 2 & 3 D. 1, 2, & 3

A. 1 & 2

Which of the following treatment techniques are most frequently used when irradiation the prostate? 1. Supine position 2. Prone position 3. Full bladder 4. Empty bladder A. 1 & 3 B. 1 & 4 C. 2 & 3 D. 2 & 4

A. 1 & 3

In treatment planning, the reduction of critical organ and unnecessary tissue irradiation can be accomplished by employing: 1. Shaped fields 2. Electron contamination 3. Overlapping A. 1 only B. 2 only C. 3 only D. 1, 2, & 3

A. 1 only

An entire spine is treated by matching two fields both treated at 100 cm SSD, field number one measures 8 x 20 and field number two measures 8 x 25. In order to match these fields at a depth of 5 cm, a ____ cm gap on the skin would be required. A. 1.1 cm B. 2.0 cm C. 5.0 cm D. 3.2 cm

A. 1.1 cm Skin Gap = (1/2 L1) (depth/SSD) + (1/2 L2) (depth/SSD) So for field #1: (1/2)(20) = 10 (5/100) = .05 (10)(.05) = .5 And for field #2: (1/2)(25) = 12.5 (5/100) = .05 (12.5)(.05) = .625 Therefore, . 5 + .625 = 1.125

A single fraction dose of ____ cGy to the lens of the eye can result in a cataract within a year. A. 1000 cGy B. 2000 cGy C. 2500 cGy D. 3000 cGy

A. 1000 cGy

If the intended dose for a treatment is 180 cGy, and a shadow tray with a favor of 0.97 is left in accidentally, what actual dose is received by the patient? A. 175 cGy B. 179 cGy C. 186 cGy D. 200 cGy

A. 175 cGy (180)(0.97) = 174.6 = 175 cGy

A left sided brain lesion is to receive 3000 cGy using parallel opposed fields with a 1.5:1 (left/right) weighting. The total dose delivered to the left lateral field will be: A. 1800 cGy B. 4500 cGy C. 1200 cGy D. 2000 cGy

A. 1800 cGy For unequally weighted fields, add the weights: 1.5 + 1 = 2.5 Then divide the total dose by the total weights: 3000/2.5 = 1200 The left lateral receives 1.5 portions, so: 1200 (1.5) = 1800

What is the maximum fractionated dose of radiation delivered to both kidneys in four weeks that will not induce high blood pressure and renal failure? A. 2000 cGy B. 3000 cGy C. 4000 cGy D. 5000 cGy

A. 2000 cGy

In treating tumors of the lung, the threshold dose for radiation pneumonitis is ____ cGy. A. 2000-2500 B. 3000-3500 C. 4000-4500 D. 5000-5500

A. 2000-2500

A 6 MV machine has an output of 1.1 cGy/MU to a small mass of tissue 100 cm from the source for a 10 cm x 10 cm field including the SAD factor. Calculate the number of MU necessary to deliver 160 cGy to a point 10 cm deep on the central axis through a single field.na compensating filter is used which absorbs 15% of the incident radiation and the TMR at 10 cm is 0.756. A. 226 MU B. 138 MU C. 263 MU D. 248 MU

A. 226 MU

The intensity of a radioactive beam is measured at a distance of 100 cm and found to be 250 mR/min. What will the intensity of this beam be at 105 cm? A. 226.8 mR/min B. 238.1 mR/min C. 262.5 mR/min D. 275.6 mR/min

A. 226.8 mR/min

A dose of 3000 cGy is to be delivered at a dose of 8 cm at a PDD of 76. What is the dose to an underlying organ at 14 cm at a PDD of 58? A. 2289 cGy B. 3947 cGy C. 4231 cGy D. 5172 cGy

A. 2289 cGy

The pelvic bones will normally contain about ____% of the adult bone marrow. A. 25% B. 50% C. 75% D. 90%

A. 25%

Point A is defined as: A. A point 2 cm cephalic and 2 cm lateral to the cervical os B. A point 2 cm cephalic and 5 cm lateral to the cervical os C. A point 3 cm cephalic and 3 cm lateral to the cervical os D. A point 3 cm cephalic and 5 cm lateral to the cervical os

A. A point 2 cm cephalic and 2 cm lateral to the cervical os

_____ is the absence of the iris, usually involving both eyes. It can be congenital or caused by a penetrant injury. A. Anirdia B. Beckwith-Weidemann syndrome C. Leukocoria 4. Retinopathy

A. Anirdia

What is the major toxic effect of most chemotherapeutic regimens? A. Bone marrow depression B. Nausea and vomiting C. Stomatitis D. Epilation

A. Bone marrow depression

The availability of these imaging modalities have proven to make diagnosis and treatment planning more effective: A. CT, MRI, PET B. CT, plain film, MRI C. CT, Ultrasound, PET D. MRI, Ultrasound, PET

A. CT, MRI, PET

Which of the following may be useful in prevention of skin reactions during treatment? A. Cornstarch applications B. Alcohol soaks C. Bromic acid soaks D. All of the above

A. Cornstarch applications

The external testicular shield used when treating Seminoma is intended to protect the remaining testicle from: A. Internal scatter B. Primary beam C. Radioactivity D. Contaminated hands

A. Internal scatter

The spinal cord in the adult extends to: A. L2 B. L4 C. S2 D. S4

A. L2

What best describes a 2D modality? A. Limited or no MLC's B. CT needed for planning C. Dynamic wedges D. All of the above

A. Limited or no MLC's

When treating the floor of the mouth, a bit block is used to: A. Move the palate away from the treatment fields B. Move the palate into the treatment fields C. Depress and move the tongue into the treatment fields D. To project and move the teeth away from the treatment fields

A. Move the palate away from the treatment fields

To reduce magnification during fluoroscopy, the image intensifier should be: A. Moved as close to the patient as possible B. Moved as far from the patient as possible C. Rotated in the direction of the central ray D. Centered

A. Moved as close to the patient as possible

Customized headrests are more likely comfortable than commercial headrests because they conform to the: A. Posterior neck and occiput B. Amterior neck and mandible C. Lateral neck and shoulders D. Posterior neck and tragus

A. Posterior neck and occiput

A total dose of 7200 cGy in fractions of 180 cGy is used to treat which male reproductive Cancer? A. Prostate B. Testicle C. Penis D. All of the above

A. Prostate

The extent of malignant cervical disease can be best outlined by a: A. Retrovaginal exam B. Hysterosalpingiography C. External Palpation D. Computed radiograph

A. Retrovaginal exam

What is the most common histologic form of cervical cancer? A. Squamous cell B. Adenocarcinoma C. Clear cell D. Germ cell

A. Squamous cell

Suitable material for skin sparing, customized compensators include all of the following EXCEPT: A. Superflab B. Lead C. Lucite D. Cerrobend

A. Superflab *Although Superflab can be customized tonuse as a tissue compensator, it would have to be placed on the skin. Compensators made of heavy metal or lucite can be placed at a distance from the patient's skin surface to maintain skin sparing benefits.

The usual position for the treatment of the intact Breast is: A. Supine with the ipsilateral arm up and chin turned away from the affected side B. Supine with the contrlateral arm up and chin turned away from the affected side C. Prone with both arms up and head turned to the right D. Prone with the ipsilateral arm up and chin turned to wards the affected side

A. Supine with the ipsilateral arm up and chin turned away from the affected side

To avoid beam divergence into the lung by the tangential fields: A. The central axis of the tangential fields can be separated by slightly more than 180 until the deep margins become parallel B. The central axis of the tangential fields can be separated by slightly less than 180 C. The couch can be turned 5 degrees toward the collimator when the medial field is treated and 5 away from the collimator when the lateral field is treated D. The collimator can be rotated to follow the slope of the chest wall

A. The central axis of the tangential fields can be separated by slightly more than 180 until the deep margins become parallel

The window width on a CT image is: A. The range of numbers displayed on a CT image B. The number of columns and rows of pixels demonstrated on an image C. An unwanted image characteristic D. The central Hounsfield unit of all the CT numbers displayed on the image

A. The range of numbers displayed on a CT image

Spatial resolution for a CT image is limited to: A. The size of the pixel B. mAs C. kVp D. Pitch

A. The size of the pixel

A complex cartilaginous structure that prevents regurgitation of stomach contents is the: A. Upper esophageal sphincter B. Oropharyngeal cavity C. Gastric junction D. Muscularis propria

A. Upper esophageal sphincter

The hierarchal arrangement of the stages of emotional development were 1st identified by:

Abraham Maslow

The practice that helps reduce the spread of microorganisms is called?

Asepsis

A diabetic patient who has taken his insulin and has been fasting for a small bowel series may begin to experience which of the following symptoms? 1. Shaking and nervousness 2. Cold, clammy skin 3. Warm, flushed, dry skin A. 1 only B. 1 & 2 C. 1 & 3 D. 2 & 3

B. 1 & 2

Of the four methods by which contrast media can be administered into the body, which are the most common in CT simulation? 1. Oral 2. Intrathecal 3. Intravascular 4. Intra-articular A. 1 & 2 B. 1 & 3 C. 2, 3, and 4 D. 1, 2, & 4

B. 1 & 3

Which of the following are recommended when discarding needles? 1. Never recap a needle before discarding 2. Break all needles to prevent reclamation from the trash 3. When unsure, consider all needles to be contaminated A. 1 & 2 B. 1 & 3 C. 2 & 3 D. All of the above

B. 1 & 3

The therapist may decrease CT image noise with: 1. Increased mAs 2. Increased kVp 3. Increased slice thickness A. 1 & 2 B. 1 & 3 C. 2 & 3 D. 1, 2, & 3

B. 1 & 3 *never change kVp

What is the approximate location of the external iliac lymph nodes? A. Adjacent to the Prostate gland B. 1 cm lateral to the pelvic rim C. At the bifurcation of the aorta D. Surrounding the bladder trigone

B. 1 cm lateral to the pelvic rim

Positioning lasers are located: 1. Side (lateral) 2. Overhead 3. Sagital 4. Coronal A. 1 & 2 B. 1, 2, & 3 C. 2 & 3 D. All of the above

B. 1, 2, & 3

Patient's rights include all of the following: 1. The right to treatment 2. The right to confidentiality 3. The right to possess/own his/her radiographs 4. Know the risks/benefits to procedure being performed on him/her A. 1, 3, & 4 B. 1, 2, & 4 C. 2 & 3 D. 1, 2, & 3

B. 1, 2, & 4

A spine is to be treated at 80 cm SSD with two adjacent field lengths. If the fields match at 5 cm depth, the skin gap would be: A. .625 cm B. 1.25 cm C. 2.0 cm D. 3.37 cm

B. 1.25 cm

The Dmax for a 6 MV photon is approximately: A. 1 cm B. 1.5 cm C. 2 cm D. 2.5 cm

B. 1.5 cm

A craniospinal field of 8 cm x 40 cm with an SSD of 100 is being treated. What is the collimator angle needed to eliminate divergence? A. 11 degrees on the spinal field B. 11 degrees on the brain field C. 6 degrees on the spinal field D. 6 degrees on the brain field

B. 11 degrees on the brain field

Calculate the equivalent square for a 10 x 15 cm rectangular field. A. 11.5 x 11.5 B. 12 x 12 C. 12.2 x 12.2 D. 13 x 13

B. 12 x 12

The fraction of dose due to scatter is greatest for which of the following 6 MV fields? A. 6 x 6 cm field at Dmax B. 12 x 12 cm field at 12 cm depth C. 6 x 6 cm field at 12 cm depth D. All of the above have an equal fraction of scatter

B. 12 x 12 cm field at 12 cm depth

The dose given to the whole brain for ALL patients is: A. 3000 cGy B. 1200 cGy C. 500 cGy D. 4500 cGy

B. 1200 cGy

Which of the following is an example of radiosurgery? A. 3000 cGy/5 fractions B. 1500 cGy/1 fraction C. 5000 cGy/10 fractions D. 4000 cGy/3 fractions

B. 1500 cGy/1 fraction

If a patient is to be treated at 140 cm SSD on a linear accelerator and the treatment field size is 22 cm x 40 cm at this extended distance, what would be the required collimator setting? A. 22 x 40 B. 16 x 29 C. 11 x 20 D. 8 x 16

B. 16 x 29 * use direct proportion: 22:140, x:100 So, 22/140 = .157 (.157)(100) = 15.7 = 16 Therefore, the new field size is 16 x 29

Which of the following types of treatments is normally accomplished using a source to skin distance of 50 cm or more? 1. Superficial 2. Supervoltage 3. Orthovoltage 4. Megavoltage A. 1 & 3 B. 2 & 4 C. 1, 2, & 3 D. All of the above

B. 2 & 4

If the output on a machine is 130 rad/min at 80 cm, what is the output at 60 cm? A. 65 rad/min B. 232 rad/min C. 110 rad/min D. 150 rad/min

B. 232 rad/min Use the inverse square law: SSD 1 = 80 ^ 2 = 6400 SSD 2 = 60 ^ 2 = 3600 I1/I2 = SSD2 ^ 2/SSD 1 ^ 2 130/x = 3600/6400 (6400)(130) = 832,000 832,000/3600(x) = 231.1 Therefore, the answer is 231 rad/min

The prescription reads 1.2 Gy t.i.d. For a total dose of 14.4 Gy for total body irradiation. How many days are required to fill this prescription? A. 2 B. 4 C. 6 D. 12

B. 4 t.i.d. = 3 x per day 1.2 x 3 = 3.6 14.4/3.6 = 4

Assuming ideal patient contour, a suitable wedge angle for two fields separated by 90 degrees would be: A. 30 degrees B. 45 degrees C. 60 degrees D. 90 degrees

B. 45 degrees Use the formula: WA = 90 - (HA/2) WA = 90 - (90/2) WA = 90 - (45) = 45

What is the standard dose delivered to the S/clav field? A. 4000-4600 cGy B. 4500-5000 cGy C. 5000-5600 cGy D. 6000-6600 cGy

B. 4500-5000 cGy

The chemotherapeutic agent most used with GI Cancer is: A. Nitrogen mustard B. 5 FU C. Vincristin D. Adriamycin

B. 5 FU

During 2 man CPR, the rate of cardiac compression to respirations should normally be about: A. 2:1 B. 5:1 C. 10:1 D. 15:1

B. 5:1

The lower border of the Breast extends to which rib? A. 5th B. 6th C. 7th D. 8th

B. 6th

What finishing angle results from an arc setup with a starting angle of 270 degrees in the clockwise rotation? MU/degree = 1.25 and MU setting = 208. A. 47 B. 76 C. 104 D. 123

B. 76

The staging system associated with Hodgkin's disease is: A. Dukes B. Ann Arbor C. French-American-British D. Clarks

B. Ann Arbor

Level II Breast cancer nodes are ones that are located: A. In the lowest most superficial part of the axilla B. Behind the pec minor muscle C. Behind the pec major muscle D. Superior to the pec major muscle

B. Behind the pec minor muscle

The target volume includes the regional nodes. The caudal margin nips in the inferior border of the obturator foramen. The cephalad margin is L5. The lateral margins are 1 cm beyond the true pelvis. The nodes included are the external and internal iliacs. The target volume just described is for the treatment of: A. Kidney B. Bladder C. Stomach D. Testis

B. Bladder

Electron contamination of high energy photon beams may result from photon interactions with the: A. Room air B. Collimators C. Bolus D. Lucite trays

B. Collimators

During radiation treatment to the thorax, the arm position should be: A. Wherever the patient is comfortable B. Consistent throughout the treatment course C. Consistent thought the treatment fraction D. Always above the head

B. Consistent throughout the treatment course *depending on the total dose, treatment to the thorax can be treated with Arms elevated or remain at the sides. Whichever position is determined at planning time should remain through the course of the treatment. Moving the arms will likely shift the target volume in the thorax.

As the field of view increases and the matrix size remains constant, the spatial resolution: A. Increases B. Decreases C. Remains the same

B. Decreases

What happens to TMR as depth increases? A. Increases B. Decreases C. Stays the same

B. Decreases

A therapist who has just completed a treatment leaves the area grumbling, "I hate to do AIDS patients because I am afraid of getting the disease." A member of the housekeeping staff hears the therapist and asks who has AIDS. The therapist responds by giving the patient's name and room number. After this incident, housekeeping personnel refuse to clean the room. One person from housekeeping tells the story to members of the housekeepers church, where the patient is also a member. After learning of the patient's condition, the church asks the patient not to return. What type of complaint might be brought against the technologist? A. Negligence B. Defamation C. Assault D. False imprisonment

B. Defamation

Your patient is receiving radiation to the pelvic region and has an onset of diarrhea 1-2 weeks after the start of treatment. The patient education information the therapist would review with this patient would be: A. Eat a high residue, low protein, high fiber diet, take Antidiarrheal medication such as miralax and flowease as directed B. Eat a low residue, high protein, low fiber diet, take Antidiarrheal medication such as Lomitil and Immodium as directed C. Limit your fluid intake to restore your electrolyte balance D. Spicy foods will be tolerated well

B. Eat a low residue, high protein, low fiber diet, take Antidiarrheal medication such as Lomitil and Immodium as directed

The purpose of an immobilization device is to: A. Make the patient's position comfortable B. Facilitate reproducing and maintaining the position C. Prevent the patient from falling off the couch D. Help the therapist set up the treatment faster

B. Facilitate reproducing and maintaining the position

All of the following are considered primary malignant bone neoplasms EXCEPT: A. Osteosarcoma B. Fibrosarcoma C. Chondrosarcoma D. Cystosarcoma

B. Fibrosarcoma

In general, the best method for a technologist to maintain medical asepsis and avoid the spread of infection is by frequent and proper: A. Mask usage B. Hand washing C. Isolation usage D. Personal hygiene

B. Hand washing

The disadvantage of electron beam scatters by a scattering foil, over a scanning electron beam is: A. Lower skin dose B. Higher bremsstrahlung C. Longer fall off between 90% and 20% depth dose D. All of the above E. B & C only

B. Higher bremsstrahlung

______ complex immobilization devices, such as thermoplastic molds and foaming agent devices, to the treatment couch will provide for " tighter" tolerance settings. A. Radiographing B. Indexing C. Taping D. Recycling

B. Indexing

A chemotherapeutic alkylating agent: A. Changes the body's hormonal status B. Inhibits substances which are necessary for the replication of DNA C. Interferes directly with the process of DNA synthesis D. Is used in cases of acute leukemia

B. Inhibits substances which are necessary for the replication of DNA

ICD-DM stands for: A. Internal Course of Diagnosis Clinical Modification B. International Classification of Diseases Clinical Modification C. International Classification of Diagnosis Clinical Modification D. Internal Course of Diseases Clinical Modification

B. International Classification of Diseases Clinical Modification

When the patient is positioned supine with feet in toward the gantry, and the digital readout is 340 degrees, the proper beam projection would be called: A. RAO B. LAO C. RPO D. LPO

B. LAO

Formation of intercellular edema is characteristic of ______. A. Dry desquamation B. Moist desquamation C. Erythema D. Fibrosis

B. Moist desquamation

When target margins are small, patient immobilization is: A. Not necessary because the patient's are told to hold still during the treatment B. More important than when margins are generous because small targets are more vulnerable to misalignments C. The same as when margins are generous because the patient's are told to hold still during the treatment D. Not important because it doesn't improve setup accuracy

B. More important than when margins are generous because small targets are more vulnerable to misalignments

The anterior margin is based on extension into the nasal cavity. The superior border is at the base of the skull. The posterior margin includes the posterior cervical nodes. The caudal margjn is at the inferior aspect of the clavicle. The target volume just described is for treatment of the: A. Paranasal sinuses B. Nasopharynx C. Salivary glands D. Tonsil

B. Nasopharynx

The superior extent of the nasopharynx may be located level with the: A. Supraorbital ridge B. Outer canthus of the eye C. Glabella D. EAM

B. Outer canthus of the eye

A patient to be treated with a 6 MV linac using an isocentric setup with blocks and a collimator setting of 10 cm x 10 cm, the irregular field program on the treatment planning computer utilizes a Clarkson calculation and yields an equivalent square field of 8 cm x 8 cm. The appropriate formula for computing the dose rate at isocenter is: A. Output in air (10x10) x TAR (10x10) B. Output in air (10x10) x TAR (8x8) C. Output in air (8x8) x TAR (10x10) D. Output in air (8x8) x TAR (8x8) E. Output in air (9x9) x TAR (9x9)

B. Output in air (10x10) x TAR (8x8)

Am inverted Y field is used for all of the following EXCEPT: A. Testes B. Ovaries C. Liver D. Spleen

B. Ovaries

The most potent radiosensitizer is: A. Nitrogen B. Oxygen C. Hydrogen D. Carbon

B. Oxygen

The most common field arrangement in radiation therapy is ____ where the dose is prescribed at the mid-depth on the central axis. A. Single field B. Parallel opposed fields C. 3D conformal D. Rapid Arc

B. Parallel opposed fields

The beam edge of a treatment field should form a straight line: A. Parallel to the spinal cord B. Perpendicular to the spinal cord C. Not near the spinal cord

B. Perpendicular to the spinal cord

Which structure is common to both the respiratory and digestive systems? A. Larynx B. Pharynx C. Esophagus D. Trachea

B. Pharynx

Where is the chest tube generally placed? A. Peritoneal cavity B. Pleural cavity C. Interstitial lung spaces D. Pericardial space

B. Pleural cavity

When irradiating extremities, a strip of soft tissue should be spared in order to: A. Prevent obstruction of blood flow from the distal portion of the limb B. Prevent obstruction of lymphatic flow from the distal portion of the limb C. Prevent destruction of bone at the distal portion of the limb D. Prevent radiation pneumonitis

B. Prevent obstruction of lymphatic flow from the distal portion of the limb

A patient is lying on the anterior portion of his body being treated to an AP/PA pelvis. The field size is 15 x 15 with an SSD of 90. What is the patient position? A. Supine B. Prone C. Lateral D. Decubitus

B. Prone

The cell that determines if the person has hodgkins is: A. Hurthle cell B. Reed-Sternberg cell C. Germ cell D. Squamous cell

B. Reed-Sternberg cell

Staging by means of this process offers the most accurate information about the tumor and the extent of disease spread: A. Urinalysis B. Surgical/pathologic staging C. Blood work D. CT imaging

B. Surgical/pathologic staging

Wedge angle refers to: A. The angle of the actual wedge filter B. The angle at which an isodose curve at a specific depth is tilted as a result of the wedge being inserted in the beam C. The angle at which an isodose curve at a specified depth is tilted with respect to the central axis of the beam

B. The angle at which an isodose curve at a specific depth is tilted as a result of the wedge being inserted in the beam

What is the goal of IGRT? A. To decrease treatment time B. To treat smaller volumes to higher doses C. To address positioning variation after treatment delivery D. To document electronic portal imaging accuracy

B. To treat smaller volumes to higher doses

All of the following are true regarding patient contouring EXCEPT? A. Patient must be in treatment position B. Tumor must be localized C. Horizontal line representing table top must be used D. Beam entry points should be indicated

B. Tumor must be localized

During the course of radiation therapy, patients should ideally be weighed; A. Daily B. Weekly C. Monthly D. As needed

B. Weekly

The principal advantage of a universal wedge is in its ability to function at ______.

Beam widths

The patient's daily treatment record should include: 1. Daily dose given 2. Cumulative dose 3. Monitor units 4. Machine warm up values 5. Elapsed days A. 1, 2, 3 B. 1, 2, 5 C. 1, 2, 3, 5 D. 3, 4, 5 E. All of the above

C. 1, 2, 3, 5

When comparing an isodose profile from a linear accelerator with one from an orthovoltage machine, the linear accelerator isodose will have the following characteristics: 1. Greater penetration 2. Greater side scatter 3. Higher % DD at depth 4. Flatter isodose lines A. 1, 2, 3 B. 2, 3, 4 C. 1, 3, 4 D. 1 & 2

C. 1, 3, 4

The closest equivalent Square for a 10 x 20 rectangular field with a 4 x 6 block in the field is: A. 8.6 B. 11.4 C. 13.3 D. 15.6

C. 13.3 Subtract the blocked field from the area of the open field. (10)(20) = 200 (4)(6) = 24 200-24 = 176 √¹⁷⁶ = 13.26 Therefore, square route of 176 = 13.3

If a field size of 35 cm x 35 cm is required and the maximum field size of a 20 cm x 20 cm field is obtained obtained at an SSD of 80, what distance is necessary to provide the desired field size? A. 100 cm B. 120 cm C. 140 cm D. 160 cm

C. 140 cm

For a for field treated with the isocenter at a depth of 12.5 cm on a 100 cm SAD linac, the collimator setting is 20 x 25 cm. The field would measure ____ on the patient's skin surface. A. 20 x 25 B. 7.5 x 12.5 C. 17.5 x 21.9 D. 22.9 x 28.6

C. 17.5 x 21.9 Use direct proportion: Figure the SSD: 100-12.5 = 87.5 The collimator setting is the measured field size at isocenter: 20:100 as x:87.5 20/100 = .2 (.2)(87.5) = 17.5 Do the same for the length: 25:100 as x:87.5 25/100 = .26 (.25)(87.5) = 21.87 = 21.9 Therefore, the field would measure 17.5 x 21.9 cm on the patient's skin.

Lip cancers are typically treated with: 1. Photons 2. Electrons 3. Surgery 4. Chemotherapy A. 3 only B. 1 & 3 C. 2 & 3 D. 2, 3, & 4

C. 2 & 3

The following is true of the ACR standard concerning a patient chart audit: 1. Chart audits should be performed by a member of the staff providing service 2. Charts should be audited by a reviewer monthly 3. Audits may be performed by a reviewer within or outside of the organization A. 1 & 2 B. 1 & 3 C. 2 & 3 D. All of the above

C. 2 & 3

The inferior extent of the hypo-pharynx is level with (the): 1. Thyroid cartilage 2. C6 3. Cricoid cartilage A. 1 & 2 B. 1 & 3 C. 2 & 3 D. 1, 2, & 3

C. 2 & 3

A right side brain lesion is to receive 300 cGy at midline by using parallel opposed fields with a 2:1 (right:left) weighting. The total dose delivered at the midline by the right side is: A. 100 cGy B. 150 cGy C. 200 cGy D. 300 cGy

C. 200 cGy

Total dose for prophylactic cranial irradiation for small cell lung carcinoma is typically: A. 2000 cGy B. 3000 cGy C. 3600 cGy D. 4500 cGy

C. 3600 cGy *prophylactic cranial irradiation for small cell lung carcinoma is typically 35-40 Gy

The TD 5/5 for 20 cm of spinal cord with and endpoint of myelopathy is: A. 4000 cGy B. 4500 cGy C. 4700 cGy D. 6000 cGy

C. 4700 cGy

The ratio of compression to ventilation for 2 person CPR is : A. 15:1 B. 15:2 C. 5:1 D. 5:2

C. 5:1

The principal serum enzyme in the demineralization of bone tissue is: A. Urea nitrogen B. Serum albumin C. Alkaline phosphatase D. Urine creatinine

C. Alkaline phosphatase

Foaming agents such as _____ have become widely used as an immobilization device. A. Vac-Lok B. Thermoplastic molds C. Alpha cradles D. Bite blocks

C. Alpha cradles ______ complex immobilization

Filtration of waste products carried by the blood occurs in the ____ of the nephron. A. Efferent anteriole B. Loop of Henle C. Bowman's capsule D. Collecting tubule

C. Bowman's capsule

Which of the following can be used to measure width of treatment field and the angle off of vertical when treating a chest wall? A. Backpointer B. Pin & Arc C. Breast bridge D. Front pointer

C. Breast Bridge

The larynx is coincident with what cerebral level? A. C3-C4 B. C3-C5 C. C4-C6 D. C5-C7

C. C4-C6

Which modalities are commonly used for IGRT? A. CT and MRI B. PET and MRI C. CT and Ultrasound D. Ultrasound and MRI

C. CT and Ultrasound

Fibrinogen and prothrombin are two blood proteins which are principally involved with: A. RBC production B. WBC production C. Coagulation of blood D. Production of platelets

C. Coagulation of blood

What communication standards are shaped by a joint committee of the National Electronic Manufacturers Association (NEMA) and the American College of Radiology (ACR)? A. Data entry B. HIPAA C. DICOM D. HL7

C. DICOM

What is the primary objective in radiation therapy? A. Treat the patient as fast as possible and stay on time B. Be a nice person to our patients and make sure all of their needs are met C. Deliver a high dose to a predefined volume while sparing normal tissue as much as possible D. Reporting any significant changes in patients status

C. Deliver a high dose to a predefined volume while sparing normal tissue as much as possible

Which of the following organs in the mediastinum is most radioresistant? A. Bone marrow B. Heart C. Esophagus D. Lung

C. Esophagus

The principal complication associated with irradiation of the extremities is: A. Hemopoietic suppression B. Osteonecrosis C. Fibrosis D. Muscular atrophy

C. Fibrosis

When operating the linear accelerator in the electron beam mode, comes are used primarily to: A. Scatter the raw electron beam across the treated area B. Flatten the isodose lines of the electron beam C. Focus the electrons so they are not easily scattered in the air D. Raise the point of electronic equilibrium in the patient's tissue

C. Focus the electrons so they are not easily scattered in the air

If a 30 degree wedge is left out of two to five treatments, the central axis dose is: A. Decreased and the distribution affected B. Decreased and dose distribution is not affected C. Increased and the distribution affected D. Increased and dose distribution is not affected

C. Increased and the distribution affected

Two concerns with MLC's are: A. Longer treatment times, not effective B. Longer treatment times, interleaf leakage C. Interleaf leakage, penumbra D. Penumbra, Longer treatment times

C. Interleaf leakage, penumbra

The staging of Cancer is dependent on the: A. Extent of its blood supply B. Type of neutral innervation C. Involvement of surrounding tissues D. All of the above

C. Involvement of surrounding tissues

A craniospinal field is being treated on the 6 MV machine with 100 SAD with the following field sizes: Lateral brain: X = 2 Y1 = 0 (inferior) Y2 = 17 (superior) The patient has a separation of 16 and is being treated mid-plane. What is the angle needed to eliminate divergence of thesis field? A. 10 degrees on the spinal field B. 10 degrees on the brain field C. No Collimation Needed D. 7 degrees on the brain field

C. No Collimation Needed

When a patient has a Foley catheter, it is important to do which of the following? A. Place the drainage bag above the level of the pelvis B. Place the drainage bag on the table or stretcher that the patient is lying on C. Place the drainage bag below the level of the pelvis D. Clamp of the Foley catheter

C. Place the drainage bag below the level of the pelvis

Bite blocks may be used in head and neck photon irradiation to: A. Open the patient's mouth for easier breathing B. Protect the oral cavity from secondary scatter C. Protect the oral cavity from the primary beam D. Include the submandibular and Submental lymph nodes

C. Protect the oral cavity from the primary beam

The blood-brain barrier: A. Protects the brain from radiation B. Prevents lipid soluble substances from passing into the brain C. Protects the brain from potentially toxic substances D. Nourishes the brain with oxygen

C. Protects the brain from potentially toxic substances * The blood-brain barrier inhabits the CSF fluid and Protects the brain from potentially toxic substances. It is restrictive and is permeable by lipid soluble substances unless manipulated or compromised.

The primary reason to use Bolus material is to: A. Compensate for surface irregularities when photon beams are used B. Compensate for surface irregularities when any beam energy is used C. Reduce the depth of maximum dose when photon beams are used D. Reduce the percent depth dose when photon beams are used

C. Reduce the depth of maximum dose when photon beams are used

Lung correction factors depend on all of the following EXCEPT: A. Beam energy B. Electron density of lung C. SSD D. Distance from the lung to point of calculation

C. SSD

The ultimate goal in Maslow's hierarchy scale of emotional development is called? A. Belonging B. Self-esteem C. Self-actualization D. Acceptance

C. Self-actualization

Respiration induced organ motion in the upper abdomen: A. Is nothing to worry about because the diaphragm separates the chest from the abdomen B. Should be considered when irradiating patients in the prone position only C. Should be considered when shielding the kidneys D. Does not exist

C. Should be considered when shielding the kidneys

Bone metastasis to the thoracic spine is often managed using ____ treatment fields (s): A. Parallel opposed B. 90 degree hinged C. Single posterior D. IMRT E. A & B F. C & D

C. Single posterior

The normal tissue tolerance doses (NTTD's) are affected by what two factors? A. Tissue type and surrounding structures B. Oxygen availability and tissue density C. The volume irradiated and fraction size D. Machine energy and tissue location

C. The volume irradiated and fraction size

Where would you find the beam energy, blocking, shifts, monitor units, field size, treatment field name, and SSD's? A. Prescription B. Set up notes C. Treatment plan D. Treatment record

C. Treatment plan

In the U.S., which organization works along with the individual states to establish regulations that are incorporated into federal and state laws? A. International Commission on Radiologic Protection (ICRP) B. National Council on Radiation Protection and Measurements (NCRP) C. United States Nuclear Regulatory Commission (USNRC) D. Committee on Biologic Effects of Ionizing Radiation (BEIR)

C. United States Nuclear Regulatory Commission (USNRC)

Patients treated while sitting upright are limited to treatment of the: A. Pelvis B. Whole abdomen C. Upper torso D. Extremities

C. Upper torso

The most frequent site of nosocomial infection is: A. Respiratory tract B. Wounds C. Urinary tract D. Digestive tract

C. Urinary tract

The ability to displace the bowel away from pelvic fields depends on: A. The volume of waste in the patient's bowel B. Whether the patient has had previous radiation C. Whether the patient has had previous pelvic surgery D. The patient's body habitus

C. Whether the patient has had previous pelvic surgery

Since the slope of the thorax will cause a higher dose to the superior mediastinum with parallel opposed AP/PA fields, this dose is often reduced by the use of _____.

Compensators

The CT number for dense bone is: A. -1000 B. -100 C. 0 D. +1000

D. +1000

Which of the following side effects can occur when radiation therapy is given to the Breast? 1. Erythema 2. Diarrhea 3. Nausea 4. Arm edema A. 1 & 2 B. 2 & 4 C. 1 & 3 D. 1 & 4

D. 1 & 4

Congenital anomalies associated with Wilm's tumors are: 1. Anirdia 2. Beckwith-Weidemann syndrome 3. Leukocoria 4. GU malformations A. 1 & 2 B. 1 & 3 C. 2 & 4 D. 1, 2, & 4

D. 1, 2, & 4

Which of the following communication sends messages to the patient? 1. Tone of voice 2. Eye contact 3. Appearance of the radiation therapist A. 1 only B. 1 & 2 only C. 3 only D. 1, 2, and 3

D. 1, 2, and 3

An entire spine field needs treatment with field dimensions of 9 x 45. The 100 cm SAD linac to be used has a collimator limit of 40 x 40. What treatment distance will be required? A. 89 cm SSD B. 140 cm SSD C. 105 cm SSD D. 112.5 cm SSD

D. 112.5 cm SSD Use direct proportion: Take the largest dimension needed: 40:x as 45:100 40(x) = 45(100) 4500/40(x) = 112.5

In the treatment of head and neck cancer, Dosimetry corrections for the presence of bone and sinuses are most important for: A. Co-60 gamma rays B. 4 MV X-rays C. 8 MV X-rays D. 12 MeV Electrons E. Equally important for all of these

D. 12 MeV Electrons

To avoid electron contamination, accessories should be kept at least ____ cm away from the patient. A. 5 cm B. 10 cm C. 12 cm D. 15 cm

D. 15 cm

A protective (reverse) isolation unit it most likely used for patients with: 1. Suspected hepatitis 2. Suppressed immune systems 3. Tuberculosis 4. Enteric disorders A. 1 & 2 B. 1 & 4 C. 2, 3, & 4 D. 2 only E. 4 only

D. 2 only

After what dose of radiation may xerostomia become permanent? A. 1000-2000 cGy B. 2000-3000 cGy C. 3000-4000 cGy D. 4000-5000 cGy

D. 4000-5000 cGy

Permanent alopecia will result when a patient is treated to a total dose of greater than: A. 1500 cGy B. 2275 cGy C. 3000 cGy D. 4500 cGy

D. 4500 cGy

The use of Radiographic film Dosimetry in the measurement of isodose curves may possess acceptable accuracy within (+\- 3%) at photon energies of: A. 150 KeV B. 250 KeV C. 500 KeV D. 6 MV

D. 6 MV

Necrosis of bone and soft tissue due to irradiation may result from a dose of: A. 3000 cGy B. 4000 cGy C. 5000 cGy D. 6000 cGy

D. 6000 cGy

A radiograph is taken using 75 kVp @ 20 mAs. Which change in technique would increase contrast but maintain the same density? A. 85 kVp @ 10 mAs B. 85 kVp @ 20 mAs C. 65 kVp @ 20 mAs D. 65 kVp @ 40 mAs

D. 65 kVp @ 40 mAs

A patient's separation is 25 cm. If the posterior SSD is 89 cm, what will the anterior SSD measurement be? A. 87.5 cm B. 89 cm C. 88.25 cm D. 86 cm

D. 86 cm

Assuming ideal patient contour, the optimal hinge angle for a 45 degree wedged pair is: A. 30 degrees B. 45 degrees C. 60 degrees D. 90 degrees

D. 90 degrees Use the formula: HA = 180 - 2(HA) HA = 180 - 2(45) HA = 180 - 90 = 90

Hyperalimentation can be considered: 1. When a patient's intestine cannot absorb food 2. When a patient is unable to consume adequate amounts of protein and calories 3. For periods of malnutrition during therapy 4. When upper GI tract is obstructed A. One of the above B. Two of the above C. Three of the above D. All of the above

D. All of the above

Which is true of cervical cancer T2 N1 M1? A. Vagina is involved B. Multiple nodes involved C. Metastasis is present D. All of the above

D. All of the above

Which of the following signs may indicate infiltration following venipuncture? A. Edema B. No backflow of blood C. Pain D. All of the above

D. All of the above

Which of the following parameters is required in construction of low melting alloy shielding blocks? A. Tattoo marks B. Treatment time C. Skin sloping D. Beam energy

D. Beam energy

______ is an overgrowth disorder usually present at birth, characterized by an increased risk of childhood cancer and certain congenital features. Common symptoms are macroglossia (large tongue) and macrosomia (above average birth weight and length). A. Acromegaly B. Gigantism C. Anirdia D. Beckwith-Weidemann syndrome E. None of the above

D. Beckwith-Weidemann syndrome

CPT codes are used for billing. CPT stands for: A. Clinical Procedure Text B. Clinical Planning Terminology C. Common Procedural Terminology D. Current Procedural Terminology

D. Current Procedural Terminology

Regional lymph nodes for carcinoma of the Prostate include all EXCEPT: A. Obturator B. External iliac C. Common iliac D. Epigastric

D. Epigastric

The EAM overlies the anterior border of the: A. Tentorium cerebelli B. Pituitary gland C. Nasopharynx D. Foramen magnum

D. Foramen magnum

The staging system for leukemia is: A. AJCC B. Duke's C. Ann Arbor D. French-American-British

D. French-American-British

Which of the following is the most serious side effect of a patient's platelet count dropping to 8,000? A. Anemia B. Infection C. Petechia D. Hemorrhage

D. Hemorrhage

A Breast bridge may be used to: A. Elevate the chest wall B. Immobilize the effected arm C. Separate the Breast tissue from the chest wall D. Immobilize the Breast tissue

D. Immobilize the Breast tissue

While treating early to midstaged vulvar Cancer, the patient may be positioned in the frog-legged position to avoid: A. A decreases dose to the labial fold B. Increased dose to the labial fold C. Decreased dose to the inguinal nodes D. Increased dose to the inguinal fold

D. Increased dose to the inguinal fold

What type of dose response model applies to MR to address biologic effects of the magnetic field used to image patients? A. Linear/threshold B. Nonlinear/nonthreshold C. Linear/nonthreshold D. Nonlinear/threshold

D. Nonlinear/threshold

Which treatment field arrangement is used to increase the mid-axillary dose to the prescribed level in some Breast cancer patients? A. Intact Breast tangents B. Chest wall tangents C. S/clav field D. PAB

D. PAB

All of the following are reasons for monitoring the patient EXCEPT: A. Patients safety B. Emotional support C. Treatment accuracy D. Record keeping

D. Record keeping

If the hand or forearm needs to be irradiated with anterior and posterior fields for soft tissue sarcoma, the patient could reasonably be: A. Sitting facing the PSA with the affected arm on the couch B. Supine on the PSA with the affected arm tucked close to the torso C. Standing facing the gantry with the affected arm on the couch D. Supine on the PSA with elbow bent, forearm and hand abducted

D. Supine on the PSA with elbow bent, forearm and hand abducted

What point does NOT define isocenter? A. The central point in space of gantry rotation B. The central point in space of collimator rotation C. The intersection of all the lasers on the treatment room D. The central point in the tumor mass

D. The central point in the tumor mass

The most important piece of identification for inpatients is? A. The patient's family member which is checked before moving the patient into the treatment room B. The patient's verbal authorizAtion which is checked before moving the patient into the treatment room C. The patients chart/record which is checked before moving the patient into the treatment room D. Their wrist bracelet which is checked before moving the patient into the treatment and/or ID card scanned

D. Their wrist bracelet which is checked before moving the patient into the treatment and/or ID card scanned

What is the purpose of the ASRT Code of Ethics? A. To dictate precisely how technologists should act B. To inform technologists of possible situations of malpractice C. To protect the patient D. To assist technologists in maintaining a high level of ethical conduct

D. To assist technologists in maintaining a high level of ethical conduct

Which of the following disorders is the likely cause of reported familial clusters of esophageal squamous cell cancers? A. Barret's esophagus B. GERD C. HIV/AIDS D. Tylosis

D. Tylosis * Tylosis is a rare genetic disorder that is associated with squamous cell esophagus cancers seen in familial clusters

Tumors of the head and neck may involve cranial nerves. The cranial nerve associated with facial paralysis would be cranial nerve: A. XII B. I C. VIII D. VII

D. VII

The hierarchal arrangement of the stages of grief were 1st identified by:

Elisabeth Kubler Ross

Which of the following are considered blood forming organs of a child? 1. Liver 2. Spleen 3. Bone marrow 4. Lymph nodes A. 1 only B. 1 & 2 C. 2 & 3 D. 1, 2, & 3 E. 2, 3, & 4 F. All of the above

F. All of the above

An increase in cori cycle activity is often associated with the development of _____.

Host energy deficit

The most common indicator of shock is ____.

Hypotension

The length of the uterine cavity can be obtained by the use of a _____.

Hysterometer

The most popular isotope used in the treatment of uterine cervix carcinoma is ____.

Iodine 125

The position most often employed for the insertion of a vaginal or uterine implant is the _____.

Lithotomy position

To determine if the ODI is accurate, the reading should be compare to a ______.

Mechanical distance indicator

The terminal position of the normal human stomach is the ___.

Pylorus

During a radiotherapy for Prostate cancer, Tenesmus and mucosis diarrhea are associated with _____.

Radiation proctitis

The answer for #64 is: A. I

The answer for #64 is: A. I

The answer to #100 is: D. Jugulodigastric node

The answer to #100 is: D. Jugulodigastric node

The answer to #23 is: D. 6

The answer to #23 is: D. 6

The answer to #25 is: A. 1

The answer to #25 is: A. 1

The answer to #96 is: D. Nasopharynx

The answer to #96 is: D. Nasopharynx

The answer to #98 is: C. Pulmonary trunk

The answer to #98 is: C. Pulmonary trunk

The sterile portion of an O.R. Gown is:

The front part above the waist