RADIATION THERAPY MOCK REVIEW QUESTIONS
Figo staging is for
GYN tumore
Therapeutic ratio formulas
% Tumor Control/% normal tissue Damage or Normal tissue tolerance dose/Tumor lethal dose
Genetic Links for CNS cancer
(3) EGFR, P53 on Chromosome 17, Protein Kinase C
Von HIppel-Landau is characterized by lesions involving (3)
(3) Retina, Cerebellum, Spinal Cord
According to the AAPM TG-40, gantry / collimator angle indicators on the linear accelerator must agree within _____ degree(s): 1 2 3 5
1
Dmax for 6 MV Beam
1 1/2 cm
Dmax for 1.25 MV Beam
1/2 cm
Normal Adult Blood Pressure
120 / 80 mmHg
Lens of the Eye yearly dose:
150mSv/year (15rem/year)
What is the half life of Pd 103?
16.99 days
What is the half life of Ra-226?
1600 years
Gastrointestinal intubation can be used for: 1. visual inspection 2. aspiration of contents 3. direct feeding
2 & 3 only
Dmax for 10 MV Beam
2 1/2 cm
A radioactive source has an initial activity of 60 mCi. Its half is 8 days. what is the remaining activity after 10 days?
25mCi
The tolerance for the localizing laser and the ODI indicator is:
2mm
Survival for Persons With Hematopoietic Syndrome
3 weeks - 2 months
skin erythema begins at doses of
300-1000cGy
24MV dmax
4.0cm
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
Normal adult WBC range
4000-10,000 mm
Normal White Blood Count Values
4300 - 10800
Generally, a postoperative radiation shrinking-field technique plans the first field reduction at which dose?
4500-5000
Skin, hands, and feet dose
500mSv/year (50rem/year)
What percentage does metastatic disease account for?
60 to 65% of all malignant bone tumors
Regarding raditation, what is the dose if osteosarcoma has microscopically positive margins?
60 to 68 Gray
Average age of onset of ovarian cancer
60 years
Pulse range of normal adult
60-90 beats per min
The PDD for a 15 x 15 cm field size, 10 MV beam, @ 5 cm depth and 80 cm SSD is 88%. Calculate the PDD for the same field size and depth for 100 cm SSD.
89.0
Which of the following methods should be employed when it is desirable to increase the density in a given radiograph? I. Increase kVp II. Increase MAS III. Increase Distance A. I only B. II only C. III only D. All of the above
??? (NOT A...and you wouldn't change mAs for density, do that for contrast..)
Breast cancer is found more often in which quadrant of the breast? A. Upper outer B. Upper inner C. Lower outer D. Lower inner
A
Comfortable patients are more likely to be_____and better able to maintain the treatment position, both of which contribute to setup reproducibility and treatment accuracy. A. Cooperative B. Sleepy C. Drowsy D. Less irritated
A
The maximum permissible dose for a radiation therapist is: A. 50 mSv B. 500 mrem C. 500 mSv D. 5 mrem
A
Which carcinoma is most likely to be virally induced? A. Cervical B. Vaginal C. Endometrial D. Ovarian
A
Which critical structure is of least concern in the treatment of lung cancer? A. Small bowel B. Normal lung C. Heart D. Spinal cord
A
Time Patient is Most at Risk of Experiencing Radiation Nephropathy
A Few Weeks After Treatment Finishes
How long does the prodromal stage of acute radiation syndrome usually last? A few hours to several days Months Less than 1 hour Many years
A few hours to several days
A typical linear accelerator consist of: Drive stand Gantry Treatment couch Treatment console A only A & B B & C A, B, C, & D
A, B, C, & D
The SI unit for activity is the: A. Becquerel B. Curie C. Hertz D. Roentgen
A. Becquerel
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 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
More than 75% of patients with __________________ can be expected to experience complete remission
ALL
Fields Used For Esophagus Treatment
AP/PA and Oblique Opposed Fields
Hyperplastic
Abnormal Increase in Cells of a Tissue or Organ With Subsequent Enlargement or Increased Response to Stimulus
Energy At Which Pair Production Occurs
Above 1.022 MeV
The hierarchal arrangement of the stages of emotional development were 1st identified by:
Abraham Maslow
Cobalt transformation emits
Gamma Rays and Beta Negative Particles
Gap Calculation Formula
Gap = (1/2)(Length1)(Depth1)/(SSD1) + (1/2)(Length2)(Depth2)/(SSD2)
Symptoms of Radiation Induced Acute Hepatitis
Acites Hepatomegaly Portal Vein Hypertension
Type of Esophageal Cancer Associated with Barrett's Esophagus
Adenocarcinoma
The most common type of kidney tumor is:
Adenocarcinoma (not tranistional cell?)
Prognostic factors for patients with primary bone cancer include
Age Gender Location NOT weight
Most important prognostic factors for CNS cancers Age, Karnofsky, Tumor Type
Age, Karnofsky, Tumor Type
Lymph Node Regions Included in Mantle Fields
All Major Regions Above the Diaphragm Submandibular Occipital Cervical Supraclavicular Infraclavicular Axillary Hilar Mediastinal
A prodromal stage occurs with which of the following? Acute radiation syndrome Hematopoietic syndrome G.I. syndrome All of the above
All of the above
Mechanical or electrical interlocks shall be provided on therapy machines above 150 KeV to ensure: that opening the treatment door will terminate the exposure that the beam will terminate at the prescribed time or dose that the machine will not operate unless the proper accessory devices are noted and coded for the machine. All of the above None of the above
All of the above
All of the following are common causes which can lead to the misalignment of the photon beam of a linear accelerator EXCEPT: Failure of the ODI Asymmetry of the collimator jaws An increase in the source penumbra The misalignment of the gantry or collimator rotational axis
An increase in the source penumbra
Allergic reaction to iodine contrast is bronchial constriction. How would this be treated?
Anti-histamine
Pancoast tumors are found in the ____________________ of the lung
Apex
Target Volume
Area of Known and Presumed Tumor
45 cGY in a non-gravid female will result in
Genetic risk
An increased in object-film distance (OFD) produces: A. Increased detail B. Enlargement of image C. Greater contrast D. Decrease in image size
B
Anatomically, the hypopharynx includes which sites? 1. Pyriform sinus 2. Anterior 1/3 tongue 3. Post-cricoid region A. 1 and 2 B. 1 and 3 C. 2 and 3 D. all of the above
B
Cancers of the hypopharynx are usually of which histopathology? A. Transitional cell carcinoma, moderately to well-differentiated B. Squamous cell carcinoma, poorly to moderately differentiated C. Adenocarcinoma, moderately to well-differentiated D. Mucoepidermoid, poorly to moderately differentiated
B
The goal of radiation therapy planning is to deliver an evenly distributed radiation dose to the _____ while minimizing the dose to the normal surrounding tissue. A. Isodose lines B. Target volume C. Hinge angle D. Penumbra
B
The wedge angle is defined as the angle the central axis makes with the _______________ isodose line. A. 40% B. 50% C. 60% D. 70%
B
The chemotherapeutic agent most used with GI Cancer is: A. Nitrogen mustard B. 5 FU C. Vincristin D. Adriamycin
B. 5 FU
Which of the following describes the terminal slope portion of the cell survival curve? A. n B. Do C. Dq D. Surviving factors
B. D0
The staging system for cervical cancer is: A. Duke's B. FIGO C. TNM D. Ann Arbor
B. FIGO
Where is the chest tube generally placed? A. Peritoneal cavity B. Pleural cavity C. Interstitial lung spaces D. Pericardial space
B. Pleural cavity
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
Linear energy transfer is measured in units of: A. J/Kg B. keV/micrometer C. J/KeV D. J/C E. C/Kg
B. keV/micrometer
Factor With Greatest Influence of Delivery of Dose at Depth Treating Using MV
Beam Quality
Factors That Impact Backscatter Factor
Beam Quality Field Size and Volume Being Irradiated
Mechanism That Bends the Electron Stream Onto the Target
Beam Transport System
The force of attraction between the nucleus and an orbital electron is called the: Electron valence Transition number Binding energy Valence number
Binding energy
Organs at Risk During Intracavitary Cervical Brachytherapy
Bladder Rectum
The highest incidence of malignancy for females in the United States occurs in the
Breast
List Electron interactions
Bremsstrrahlung Characteristic
A field size of 42 cm length is required to treat an entire femur. The machine being used has a maximum field size of 35cm at 100 cm. What distance is required to treat the patient to the required field? A. 83 cm B. 110 cm C. 120 cm D. 135 cm
C
A therapist is accidentally punctured by a used syringe needle. This is classified as a/an _______ transmission. A. Endogenous B. Nosocomial C. Fomite D. Vector
C
All but which one of the following is associated with superior vena cava syndrome? A. visible vein on the upper chest and neck B. edema of the face and neck C. pain D. dyspnea
C
Epitaxis is another name for: A. seizure B. diabetic coma C. nosebleed D. syncope
C
Isocenter is defined as the point: I. at the center of the tumor II. that the gantry rotates around III. that the collimator rotates around IV. where the lasers all meet A. I only B. I and II only C. II, III and IV only D. I, II, III and IV
C
When using a thoraeus filter, the __________ layer must always be nearest the patient. A. tin B. copper C. aluminum D. lead
C
Which of the devices below may best be used to measure the dose at various points within a mantle field when treating a Hodgkin's patient? A. film dosimetry B. Geiger Mueller counter C. Thermoluminescent dosimeter D. Victoreen thimble chamber
C
X-ray diaphragms may also be referred to as all of the following except? A. X-ray shutters B. Blades C. Input Screens D. Collimators
C
If an individual receives 2 mRems a day from background radiation for 36 days, what will be the individual's cumulative dose be in mSv? A. 72 B. 7.2 C. 0.72 D. 0.018
C. 0.72
The purpose of CSF is: 1. Buoyancy 2. Protection 3. Chemical stability 4. Filtration A. 1, 2, & 4 B. 1, 3, & 4 C. 1, 2, & 3 D. 2, 3, & 4
C. 1, 2, & 3
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
All naturally occurring radioactive sources ultimately decay to a stable form of: A. Bismuth B. Carbon C. Lead D. Tungsten
C. Lead
Patients treated while sitting upright are limited to treatment of the: A. Pelvis B. Whole abdomen C. Upper torso D. Extremities
C. Upper torso
What is the state of general ill health and malnutrition, resulting in dehydration and progressive loss of body weight, fat, and muscle (½ to 2/3 of cancer patients suffer from it)?
Cachexia
Cellular Mechanism Involved In Mitotic Delay
Cells Attempts To Repair Injury Prior to Mitosis By Confirming DNA and Proteins Are Intact, To Avoid Disruptions in Cell Division or Cell Death
Mitotic Delay
Cells In Interphase When They Are Irradiated Which Are Delayed In the G2 Phase
An area inside of the treatment volume which has a dose lower than the specified dose is termed? Tolerance spot Hot spot Cold spot D-max
Cold spot
Monitor units of the linac is located within the _____.
Collimator
A protective device on a fluoro simulator to prevent tube and tabletop impact is called a ____.
Collision ring
The American Cancer society recommends__________ for men beginning at the age of 45
Colonoscopy
Cancer Screening recommendations from American Cancer Society for men and women
Colonoscopy at 50 Fecal Occult Blood Test at 50 Manual testicular exam adolescence DRE at 45 PSA at 50 Breast Pelvic (Pap Smear)
Device Used To Correct an Oblique or Curved Skin Surface Approximated With a Straight Line
Compensating Wedges
During brachytherapy, treatment planning involving three dimensional distribution of multiple sources is accomplished by
Computer generated isodose curves
The chemical bond formed when two or more atoms share electrons is termed: Ionic bond James Bond Polar bond Covalent bond
Covalent bond
One unique characteristic of substitute ureas is that they
Cross the BBB
Method Used to Treat Tumors On Large
Curved Surfaces, Such As Superficial Chest Wall Disease,Electron Arc
Factors Influencing Prescribed Dose
Cytogenetic Factors Diagnostic Stage Pathologic Grade
Which does not belong-Basal Cell, Squamous Cell, Adenocarcinoma, Glioma
Glioma does not belong because it does not originate in epithelial tissue
The single most important factor in the prognosis of STS is
Grade
Hysterometer
Graduated Sound for Measuring the Depth of the Uterine Cavity
Decay Constant Equation
- Decay Constant = Change in Number of Atoms / Change in Time
Methods for estimation of risk of low levels of radiation in humans include
-Epidemiology -Animal Studies -Extrapolation NOT Titration
compton scatter
-photons interact with an outer shell. -atom absorbs all the photon energy and electron is ejected from the outer shell -incoming photon must have an energy of 1.02 MeV
The half life of iridium 192 is 74 days. the decay constant is
.0094 days^-1 decay constant = ln2/ half life
On the linear accelerator, one monitor unit is equal to _____ for a 10 x 10 field size at 100 cm SSD? 1 gray .01 gray 10 cGy 100cGy
.01 gray
En utero exposure to radiation raisees spontaneous abortion probability by
.01%
If the decay constant is 45 sec^-1, the half life is
.0154 half life=.693/decay constant
general public dose dose
.1 rem/year
The Protective housing around the cobalt source in the cobalt machine should only allow transmission of ________ of the output.
.1%
Density of healthy lung
.3 g/cc
A Photon of 25 Angstroms has a kinetic energy of
.496 keV
Embryo fetus dose
.5 mSv/year (.05rem/year)
Increasing the distance from 100 to 110 cm causes the dose rate to change by ? 1.032 .826 .909 .504
.826
Superficial treatment machines are useful for treating tumors confined to: 0 - 5 mm 0 - 3 cm 10 - 20 mm 20 - 30 mm
0 - 5 mm
200KeV dmax
0.0
Annual Negligible Individual Risk Level Dose Equivalent
0.01 mSv (0.001 rem)
Dose Equivalent Limit for Entire Gestation of Health Care Worker
0.5 mSv
Dose Equivalent Limit for Exposure to an Embryo or Fetus
0.5 mSv (0.05 rem) / month 5 mSv (0.5 rem) Over Course of Gestation
Chest tube drainage systems are introduced to _________ to/in the pleural cavity. 1. create a negative pressure 2. remove air 3. create a positive pressure
1 & 2
The half life of iodine 125 is: A. 74.1 days B. 60.2 years C. 30 days D. 60.2 days
D. 60.2 days
A joule is a unit of: A. Absorbed dose B. Charge C. Mass D. Energy
D. Energy
Frequency of Testing X-Ray Output Consistency
Daily
The determination of the pulse can be made at various sites. Among these are: 1. radial arteries 2. carotid arteries 3. abdominal aorta
1 & 2
Which of the following are normally considered as part of the hemopoietic system? 1. Bone marrow 2. Spleen 3. Kidney
1 & 2 only
Which of the following pathologic conditions will most likely require an increase in technique in order to maintain the desired radiographic density? 1. Osteopetrosis 2. Pagets disease 3. Emphysema
1 & 2 only
Conversion Factor for Curies and Bq
1 Ci = 3.7 x 10E10
Conversion Factor for Gy and J/kg
1 Gy = 1 J/kg
Double Vision
Diploplia
Conversion Factor for Rad and Gy
1 Gy = 100 rad
Conversion Factor For Sv and Gy
1 Sv = 1 Gy
Conversion Factor for Rem and Sv
1 Sv = 100 rem
Dmax for 4 MV Beam
1 cm
the gantry or collimator angles should be accurate to within: 1 degree 2 degrees 3 degrees 45 degrees
1 degree
A general radiographic tube housing is designed to limit the amount of leakage radiation at a distance of one meter from the source to less than:
1 mGy per hour (100mR per hour)
Annual Dose Equivalent Limit for Continuous or Frequent Public Exposure
1 mSv (0.1 rem)
Exposure Limit for Controlled Areas
1 mSv / week
One Torr is equal to? 2 atmospheric pressures 1 mmHg 5 Kelvin the calculation required to convert Celsius to Fahrenheit
1 mmHg
Maximum leakage for walls, floors, etc. to reduce occupational exposure is
1 mrem/week
The amount of the divergence occurring in a radiation beam exiting from an x-ray tube is directly related to the: 1. Degree of magnification occurring in the objects being imaged 2. Amount of secondary radiation scattering occurring in the exposed tissues 3. Percentage of beam attenuation occurring in the exposed tissues
1 only
The reduction of radiographic noise and quantum mottle is most easily accomplished through the use of a: 1. Higher mAs value 2. Shorter exposure time value 3. Higher kilovoltage value
1 only
Which of the following equipment is considered a part of the high-flow oxygen system? 1. respirator 2. oxygen tent 3. O2 mask
1 only
Which of the following will be noted if an injury has affected an individual's motor control functions? 1. muscle coordination 2. pain sensitivity 3. visual reflex
1 only
What other imaging tools are used to diagnose bone cancer
1) CT, eshablishes extent of tumor and any soft tissue involvement 2) MRI, shows relationship between normal tissue, neurovascular structures and tumor tissue 3) Bone scan with technetium 99m 4) biopsy
Name 4 different Biopsy procedures
1) Fine needle aspiration biopsy 2) Core needle biopsy 3) Stereotactic core needle biopsy 4) Surgical (open) biopsy
Name 5 different treatment options
1) Radiation Therapy 2) Chemotherapy 3) Immunotherapy 4) Brachytherapy 5) Surgery
Physical assessment of the Radiation Therapist includes daily assessment of patients:
1) Skin - erythema, dry and moist desquamation 2) Fatigue/sleep patterns 3) NVD - nausea, vomiting, diarrhea 4) Mouth/throat changes 5) Pain 6) Alopecia 7) Weight loss 8) Refer to nurse or doctor if conditions worsen.
Pattern of Pain
1) brief, momentary or transient 2) rhythmic, periodic or intermittent 3) continuous, steady or constant
The atomic mass of an atom can be estimated by adding the atomic masses of the: Protons Neutrons Electrons 1 & 2 only 1 & 3 only 2 & 3 only 1, 2 & 3
1, 2 & 3
Ionization of an atom may occur from exposing the atom to: X-rays Ultraviolet rays Gamma rays 1 only 2 only 3 only 1, 2 and 3
1, 2 and 3
In order to obtain the appropriate vital signs for a patient will require the use of a: 1. watch 2. stethoscope 3. sphygmomanometer
1, 2, & 3
The pulse rate for individuals is dependent upon many factors. Among these is: 1. age of the patient 2. sex of the patient 3. patient's anxiety
1, 2, & 3
Which of the following is a common type of nasogastric or nasoenteric tube? 1. Miller-Abbott 2. Levin 3. Cantor
1, 2, & 3
electromagnetic energy equation
E=hv
Most radiotolerant gyn structure
Endocervix
Which of the following special precautions should be followed in a patient's room for a patient receiving oxygen therapy? 1. avoid open flames 2. keep doors closed 3. wear masks
1, only
Common screening exams - The ACS or American Cancer Society recommend screening for
1. Breast Cancer 2. Prostate Cancer 3. Colorectoral Cancer 4. Cervical Cancer
What are the 3 staging methods?
1. Clinical 2. Surgical 3. Pathological
Confidentiality, telling truth, & benevolence are which of the following? 1. Ethical principles 2. Legal rights 3. Ethical Characteristics 4. Legal Doctrines
1. Ethical principles
The overflow of tears when a nasolacrimal gland is obstructed is called ____.
Epiphera
Cultural differences involves in
1. Examining your own beliefs 2. Demonstrating respect for beliefs, even if you disagree 3. Be willing to make modifications to the treatment if possible 4. Do not stereotype
Which of the following is an ethical principle? 1. Justice 2. Individual freedom 3. Egoism 4. Confidentiality
1. Justice
Normal adult temperature
1. Oral temp is 96.8-96.6 2. Arm temp is 97.6 3. Rectal temp is 99.6
What are the factors in determining prognosis?
1. Patterns of spread (such as blood or lymphatics) 2. behavioral characteristics 3. tumor site 4. patient factors
Doctrines
1. Personal Liability 2. Respondeat Superior 3. Res Ipsa Loquitur 4. Foreseeability
Moral ethics are based on which of the following? 1. Right & wrong 2. Institutions 3. Codes 4. Legal rights
1. Right & wrong
What are 3 things tumors are classified by?
1. anatomic site 2. biological behavior 3. cell of origin
Ethical Models
1. engineering 2. priestly 3. collegial 4. contractual 5. covenant
Biopsy consists of:
1. fine needle aspiration 2. core needle 3. endoscopic 4. incisional 5. excisional
What are some characteristics of a benign tumor?
1. have suffix -oma 2. well differentiated 3. do not metastasize or invade surround tissue 3.encapsulated 4. slow growing
Inflammation is when there is:
1. redness 2. pain 3. swelling 4. warmth
What are the two disease theories of cancer?
1. systemic - no cure, surgery made it worse 2. localized - possibility of treatment and cure
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
Because of the decay of the Co-60 source, a patient calculation correction of what percent must be made monthly? 0.1% 1.0% 5.0% 10.0%
1.0%
4MV dmax
1.0cm
6MV dmax
1.5cm
Calculate the time necessary to deliver 180 cGy to the mid-plane of a patient 18 cm thick using an AP:PA isocentric Co-60 fields. The PDD at 9 cm is 62.5 and the backscatter factor is 1.034. The output factor in air at the distance of D-max is 84.3 cGy/min. 1.65 min .88 min 3.30 min 3.44 min
1.65 min
Proportion of the body's lymph nodes in the head and neck region
1/3
Tolerance Dose for Lung
1/3 - 4500 cGy 2/3 - 3000 cGy 3/3 - 1750 cGy
Tolerance Dose for Kidney
1/3 - 5000 cGy 2/3 - 3000 cGy 3/3 - 2300 cGy
Tolerance Dose for Liver
1/3 - 5000 cGy 2/3 - 3500 cGy 3/3 - 3000 cGy
Tolerance Dose for Heart
1/3 - 6000 cGy 2/3 - 4500 cGy 3/3 - 4000 cGy
Tolerance Dose for Brainstem
1/3 - 6000 cGy 2/3 - 5300 cGy 3/3 - 5000 cGy
Tolerance Dose for Esophagus
1/3 - 6000 cGy 2/3 - 5800 cGy 3/3 - 5500 cGy
Skin Exposure At Double the SSD
1/4 That Of the Original SSD
What is the time interval survival rate for breast cancer survivors
10 and 20 years because breast cancer is so successfully managed
alculate the closest equivalent square for an 8.5 cm X 12.5 cm rectangular field size: 10 cm X 10 cm 8.4 cm X 8.4 cm 12 cm X 12 cm 7.35 cm X 7.35 cm
10 cm X 10 cm
Dose Equivalent Limit for Cumulative Radiation Exposure
10 mSv (1 rem) x Age In Years
Maximum Dose For Hot Spots In Wedge Pair Treatments
10%
Percentage of Radiation Dose Absorbed in the First 2 cm of an Orthovoltage Beam
10%
When a wedge pair is used, the acceptable value for a high dose region (hot spot) for calculation purposes is: 2% 10% 20% 33.3%
10%
Orthovoltage unit operates at a tube current of:
10-2o Ma and 150-200 KVp
Dose Resulting in Hematopoietic Syndrome
100 - 1000 cGy
The majority of radiation therapy treatments involving linear accelerators are normally accomplished using a source-axis-distance of: 20 cm 50 cm 80 cm 100 cm
100 cm
Dose Resulting in Gastrointestinal Syndrome
1000 - 10000 cGy
Gastrointestinal syndrome dose
1000-5000cgy
Threshold for Cataracts
10000 rad/cgy 10 gy
Cumulative Effective Dose Limit dose
10mSv x age (1rem x age)
What is the normal adult Blood Pressure Range?
110-140 or 60-80 mm/hg
Depth of 50% Depth Dose at Central Axis for a 10 x 10 Field on a CO-60 Machine
12 cm
Normal adult Hemoglobin
12-16 g/dl
A treatment was prescribed at 80 cm SAD. If the field size indicator is set for 14 cm, what would the field size be at the surface of the patient if the SSD read 75 cm? 12 x 12 cm 13 x 13 cm 14 x 14 cm 15 x 15 cm
13 x 13 cm
What is the closest blocked equivalent square for a 20 cm X 10 cm rectangular field with a 4 cm X 6 cm block in the field? 8.6 cm x 8.6 cm 11.4 cm X 11.4 cm 13.3 cm X 13.3 cm 15.6 cm X 15.6 cm
13.3 cm X 13.3 cm
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? 136 cGy/min 143 cGy/min 157 cGy/min 165 cGy/min
136 cGy/min
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
Mrs. Jones has a nasty skin cancer on her right cheek which extends 3.25 cm in depth. What electron energy would be needed to effectively treat this tumor to the 95% isodose line? 6 MeV 10 MeV 15 MeV 20 MeV
15 MeV
Calculate the wedge angle for a 150 degree hinge angle: 15 degree 30 degree 45 degree 60 degree
15 degree
Hemoglobin levels
15.5 g/dl men 13.7 g/dl women 12-16 g/dl average
Orthovoltage therapy is delivered with X-rays produced by potentials ranging from: 50 - 100 KV 100 - 150 KV 150 - 500 KV 500 KV - 1 MV
150 - 500 KV
Annual Dose Equivalent Limit for Lens of the Eye
150 mSv (15 rem)
Equivalent Dose Limit for Occupational Exposure to the Lens of the Eye for Deterministic Effects
150 mSv (15 rem)
platelets normal range
150,000-400,000 dangerous below 50,000
Normal adult platelet count
150,000-450,000 mm
Tolerance of the kidney is about
1500 cgy (2300 cgy)
During a split field test for longitudinal displacement of the collimator for jaw symmetry, the collimator is rotated through an angle of:
180 degrees
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
Average age of clear cell vaginal cancer
19 years
Public dose limit dose
1mSv/year (.1rem/year)
The average photon beam energy produced by a 6 MV linear accelerator is approximately _____MV: 2 4 6 9
2
Best Way to Avoid Being Charged With Assault
Explanation of All Actions to the Patient
Possible Biologic Mechanisms for Cerebrovascular Syndrome
Extensive Blood Vessel Damage, Leading to Vasculitis, Meningitis, Edema, and Intracranial Pressure
Potential Complication of Apical Lung Treatments
Extremity Defects Secondary to Brachial Plexus Injuries
Clinical detection by cancer site: Maxillary Sinus
Eye displacement Involvement of the trigeminal cranial nerves (V)
Mayneord's Factor Equation
F Factor = [(SSD2 + Dmax)/(SSD2 + Depth)]^2 / [(SSD1 + Dmax)/(SSD1 + Depth)]^2 New PDD = Old PDD x Mayneord F Factor
T/F Surgery is never used prophylactically
F-Surgery is used prophylactically
Blood tumor markers are effective screening tools for early detection of cancer (true or false)
False
Most colorectal carcinomas arise from preexisting benign angiodysplasia (True or False)
False
The table function on the side of the treatment couch cannot be used independently from the hand control: True False
False
Effect of Protraction Rate On Relative Biologic Effectiveness
Faster Protraction Rate Results in Greater RBE
LD50 for adult is similar to
Fetal
Scintillation Counter
Field monitoring device that functions simiarly to auo exposure controls of x-ray units
Which of the following radiations depend on the least amount of oxygen in the cell? A. Neutrons B. X-rays C. Gamma Rays D. Alpha particles E. B & C F. B, C, D G. A & D
G. A & D
When calibrating ion chambers, which of the following correction favors are needed? A. Barometric pressure B. Volume of the chamber C. Temperature D. Beam energy E. A & B F. B & D G. A, B, and C D. A, B, C, and D
G. A, B, and C
Sievert
Gray x QF
Tolerance for Split Field Test for Parallel Opposed Fields
Greater Than 2.2 mm Gap
Exostotic
Growing Outward From Anatomical Structures
What do the different grades mean?
Gx- unknown differentiation G1- well differentiated G2- moderately differentiated G3- poorly differentiated G4- undifferentiated
Half Life Equation
Half Life = .693 / decay constant
Most Common Sites of Skin Cancers
Head Neck Face Arms Hands
When a wedged pair is used for treatment, how should the wedges be positioned? Heel to toe Heel to heel Toe to heel Does not matter
Heel to heel
Radiation Treatment techniques designed to treat cells that may be circulating in the CSF include (2)
Helmet (whole brain) Posterion Spine Field
Most Serious Consequence of Whole Body Irradiation
Hematopoietic Suppression
What syndrome most likely occurs when a person is exposed to 1 to 10 Gy of total body radiation. Cerebrovascular syndrome G.I syndrome Prodromal syndrome Hematopoietic syndrome
Hematopoietic syndrome
Coughing up blood
Hemoptysis
Atomic Number of Substances Involved In Photodisintegration
High Z Materials Generally Not Tissue, But Beam Production Devices Within High Energy Linear Accelerators, Responsible For Neutron Production In These Cases
Most of the information available to researchers of the dose response relationship comes from which of the following. Low dose radiation exposures Diagnostic testing research Therapeutic testing research High dose radiation exposures
High dose radiation exposures
The principal function of the high tension transformer is the production of a:
High potential difference
The greatest limitation of the orthovoltage beam for treating deeper tumors is: Low dose rate High skin dose Poor penumbra Unstable dose rate
High skin dose
Factor Which Increases the Likelihood of a Photoelectric Interaction Occuring
Higher Atomic Number
Effect Of Radiation Dose On Mitotic Delay
Higher Dose Results In Longer Mitotic Delay
Effects Of Increased Field Size
Higher Dose To the Buildup Region Less Skin Sparing
Relationship Between Therapeutic Ratio and Relative Biologic Effectiveness
Higher Values for Therapeutic Ratios Result In Greater Relative Biologic Effectiveness
A reduction in the size of the effective focal spot can be accomplished by employing all of the following EXCEPT: a. Smaller filament b. Smaller anode angle c. Higher anode rotational speed d. Higher focus cup voltage
Higher anode rotational speed
Waveguide
Hollow Tubelike Structure Directing the Microwave Power
The frequency (Hz) or the number of times the electronic beam is modulated in a television system is directly related to:
Horizontal resolution of the image
Anti-inflammatory drugs
Hydrocortisone, diprolene
The function of the _________ is to act as an attachment site for muscles associated with swallowing
Hyoid Bone
Condition Associated With Renal Insufficiency in Patients Who Undergo Pediatric Irradiation
Hypertension
The most common indicator of shock is ____.
Hypotension
The length of the uterine cavity can be obtained by the use of a _____.
Hysterometer
Components of Radiation Therapy chart
INCLUDES the "treatment record" - documentation & delivery of treatments, records fractional & cumulative doses, machine settings, verification imaging,ordering & implementing prescribed changes
Simulation to determing the actual size of kidney can be achieved with
IV iodinated solution
How can cytotoxic drugs be administered
IV, Topical, Enteral, Surface Applications
Indications For Completing Treatment If the Door Lock is Inoperable
If Patient Setup Has Been Completed
If someone is exposed to 1 Gy whole body dose of ionizing radiation, what will be the result? Certain death Death expected to 50% of those exposed No response at all Illness, but death will not normally occur
Illness, but death will not normally occur
Photoelectric Effect
Incident Photon Penetrates Deep Into the Atom and Ejects an Inner Shell Electron From Orbit
Oropharynx includes
Includes the uvula, tonsillar fossae and pillars, base of tongue, soft palate, and vallecula
Effect Of Increased Field Size On Exposure Rate
Increased Exposure Rate
Hormonal Conditions Associated With Increased Bone Turnover
Increased Parathyroid Hormone Increased Adrenal Cortical Hormone Decreased Calcitonin
The most likely reproductive side effect for a 6000 mrem dose equivalent to a non-gravid female patient is (an):
Increased genetic risk
When the digital image has been processed and the image appears on a monitor, the contrast can be modified electronically. Which statement below correctly describes the digital contrast control?
Increased window width decreases contrast
Depth dose increases when SSD ______.
Increases
Which of the following poisons the cell with H2O2?
Indirect effect
Three important states involved in the adminsitration of chemotherapy include all of the following
Induction Consolidation Maintenance NOT repair
Superior Border of Mantle Field
Inferior Border of Mandible Anteriorly To Include Occipital Nodes Posteriorly
What is typically the largest vascular structure in the neck
Internal Jugular Vein
Horny overgrowth
Keratosis
Pre-op radiation therapy for STS is done to (3)
Kill the reactive rim of tumor cells before they are cut out, Decrease the risk of implantation, attempt to preserve as much normal function as possible
The sources of accelerating power in the linear accelerator are: Thyratron and electron gun Klystron and Magnatron Magnatron and electron buncher Wavegiude and 220 v
Klystron and Magnatron
What is it when the intake on carbs and fats is adequate but PROTEIN INTAKE is Inadequate -& the conditions are: retarded growth and development, muscle wasting, depigmentation and depression of the immune system?
Kwashiorkor or "Protein Malnutrition"
landmark typically used to determine the lower border of the abdominal portion of the inverted Y-field
L4-L5
landmark typically used to determine the lower border of the abdominal portion of the inverted Y-field L4-L5
L4-L5
Inferior Border of Mantle Field
Level of the Insertion of the Diaphragm About T10
A short exposure is taken on a acrylic coated ready pack radiographic film aligned with metallic marks on the borders of the collimated light field. This arrangement best describes the test for: Light field coincidence Field flatness Collimator symmetry Field dosimtery
Light field coincidence
Type of Treatment Machine Requiring 2 Independent Dose Monitors
Linear Accelerator
The position most often employed for the insertion of a vaginal or uterine implant is the _____.
Lithotomy position
End Point for Tolerance of the Liver
Liver Failure
The majority of sof tissue sarcomas occur in the
Lower Extremities
Advantage of Cerrobend in Block Construction Versus Lead
Lower Temperature Required to Shape
Structures Shielded Treating Mantle Fields
Lungs Humeral Heads Larynx Spinal Cord Heart
Structures Destroyed As a Consequence of Large Lymphoid Irradiation
Lymphoblasts Lymphocytes Megakaryocytes
Most Commonly Diagnosed Malignancy in Pregnant Women
Lymphomas
In the linear accelerator, the flattening filter is used to: Flatten the front end of the accelerator head to accompany the bending magnets Make the beam intensity uniform Produce electron beams Filter the neutrons form the beam
Make the beam intensity uniform
What is the incidence of malignant giant cell tumors? Where do they primarily occur?
Make up 5% of primary bone cancer. Usually occur in the knee. Arise in the metaphysis or epiphysis of long bones in young adults
Carcinoma
Malignant Cancer Arising From Epithelial Cells
Clonal Expansion
Many Cells Produced From a Single Cell Mechanism That Transforms Cell Populations Into Neoplasms
Characteristics of Nodular Sclerosing Hodgkin's Disease
Many Reed Sternberg Cells Lacunar Spaces
What is characterized by weight loss of 7-10% and fat and muscle depletion - about 10 lbs of weight loss?
Marasmus or "Calorie Malnutrition"
Colpostat
Medical Instrument Designed to Facilitate Vaginal Treatment
Von Recklinghausen's Diease is associated with (3)
Meningiomas, Multiple Epedymomas, Optic Gliomas
The radiosensitivity of a living cell or tissue is related to its:
Metabolic rate
Type of Cancer Most Likely to Result in Superior Vena Cava Syndrome
Metastatic Disease to the Brain or Spinal Cord
Peak Age of Incidence for Chronic Myelogenous Leukemia
Mid 40s Rarely Diagnosed in Patients Under the Age of 20
Side Effect That Occurs As the Result of Intracellular Edema
Moist Desquammation
End Points for Tolerance of the Spinal Cord
Myelitis Necrosis
The most common side effect associated with cytotoxic drugs is
Myelosuppression
What is the reduction in bone marrow function commonly caused by radiation and chemotherapy?
Myelosupression
An electron with the lowest binding energy is most likely located in the: K shell L shell M shell N shell
N shell
The schematic display most often employed to represent the structure of the atom was developed by: Charles Dalton Niels Bohr Michael Crookes Charles Darwin
Niels Bohr
The histological type of lung ca that is assumed to indicate that there is already distant disease at the time of diagnosis is
Oat Cell Carcinoma
Painful Swallowing
Odynophagia
Best CNS imaging for telling the difference between malignancy and necrosis
PET
A course of radiation therapy which is intended to relieve the suffering of an individual with no intent to cure is called a: Superficial therapy Tolenanie Therapy Boost therapy Palliative therapy
Palliative therapy
Primary Lymphatic Drainage from the Testis
Para-Aortic Lymph Nodes
End Point for Tolerance of the Heart
Pericarditis
Large Cell ca is most often found in the _________ of the lung
Periphery
How does a very high dose of radiation effect stem cells? Temporary increase Permanent decrease Permanent increase Temporary decrease
Permanent decrease
The maximum amount of blurring during linear tomography occurs in the anatomical structures that are _______ to the direction of the tube movement.
Perpendicular
Compton or Incoherent Scatter
Photon Ejects Outer Shell Orbital Electron and Alters Its Own Path, Generally Resulting In the Freed Electron Attaching Itself To Another Atom Shortly Thereafter
Device Used to Measure Electron Beams for TG-21 Protocol
Plane Parallel Ionization Chamber
Mesothelioma is most often found in the _________ of the lung.
Pleura
Clinical detection by cancer site: Oral Cavity
Plummer Vinson Leukoplakia Ulcers that won't heal
End Point for Tolerance of the Lung
Pneumonitis
Virtual Source
Point From Which An Electron Beam Appears to Diverge
cutiepie detectors
Portable ion chamber for determining the exposure rate outside a radioactive room.
Types of Cervical Cancer Considered Stage I
Pre-invasive Carcinoma in Situ Intra-epithelium
Uremia
Presence of Poisonous Blood Products in the Patient's Blood As the Result Of Kidney Failure
The thin layer of lead foil that is placed on the back lid of most general purpose cassettes is included to:
Prevent backscatter radiation from reaching the image receptor
GTV encompasses
Primary Tumor Lynphadenopathy Other Mets
Stages of Radiation Syndromes
Prodromal Stage Latent Stage Manifest Illness Death
Duration of Stages of Hematopoietic Syndrome
Prodromal Stage - Hours After Exposure Latent Stage - Few Days to 3 Weeks Manifest Illness - 3 - 5 Weeks After Exposure Death - Within 2 - 6 Weeks, If Fatal, Dose Dependant
Duration of Stages for Cerebrovascular Syndrome
Prodromal Stage - Minutes - Several Hours Following Exposure Latent Stage - Several Hours or Less if Detectable Manifest Illness Stage - 5 - 6 Hours After Exposure Death - Less Than 3 Days
Duration of Stages of Gastrointestinal Syndrome
Prodromal Stage - Within Hours of Exposure Latent Stage - 2 - 5 Days After Exposure Manifest Illness - 5 - 10 Days After Exposure Death - During Second Week After Exposure
The rate of energy loss by a charged particle is:
Proportional to the square of the particle charge
The highest incidence of malignancy for males in the United States occurs in the
Prostate
Where is metastatic disease usually spread from?
Prostate, breast, lung, kidney, thyroid cancer
Condition Minimized Using the Application of Cornstarch
Radiation Induced Skin Reaction
Rales definition
Rattling, crackling sound in chest caused by lung congestion
The greatest potential hazard for a neonate during a radiologic examination is likely to be the risk of:
Reduced body temperature (hypothermia)
Endocrine Function of the Kidney
Release of Renin Involved With Blood Pressure Regulation
The _________ nodes area is a very high risk for dissemination of disease, inaccessible for surgery and therefore included in the treatment field for nasopharyngeal ca
Rouviere
Ideal Parameters for Phantoms
Same Electron Density Same Atomic Number Same Mass Density
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
The _________ is the device that provides a homogeneous beam of electrons at therapeutic depths: target Scattering foil Bending magnet Ion chamber
Scattering foil
When a patient is being treated with a linear accelerator in the x-ray mode, all of the following are normally placed in the path of the electron or photon beam EXCEPT: Tungston target Primary collimator Flattening filter Scattering foil
Scattering foil
Most Common Complication Associated with Eustachian Tube Inflammation Following Radiation Treatment
Serous Otitis Media
Symptom Treated Using Decongestants for Patients Undergoing Nasopharyngeal Treatment
Serous Otitis Media
Factor Dependant on Dose for Deterministic Effects
Severity of Reaction
Phases of Grieving
Shock Denial Bargaining Guilt Anger Depression Acceptance
Etiology of lung cancer
Smoking, pollution, COPD, Asbestos
Highest Dose to Which Structure Using High Energy Photons to Treat With a Bone Interface
Soft Tissue Surrounded By Bone
Interface Which Results In Most Echo Reflection During Ultrasound
Soft Tissue vs. Bone Interface
Clinical detection by cancer site: Hypopharynx
Sore throat Dysphagia Odynophagia Neck mass
Clinical detection by cancer site: Oropharynx
Sore throat Dysphagia Otalgia Upper spinal nodal swelling
Where do metastatic bone lesions occur most often
Spine
Organ for Which Radiation Treatment is Most Likely to Result in Immunosuppression and Decreased Blood Counts
Spleen
Most Common Histology Within the Aerodigestive Tract
Squamous Cell Carcinoma
Where does multiple myeloma start?
Starts in the plasma, therefore not primary bone
Complication That May Occur as the Result of Exposures of 1500 cGy or More to the Prepubescent Breast
Stunted Breast Development
The jugulodigastric nodes may also be referred to as the
Subdigastric Nodes
Wharton's Duct
Submandibular
Kidneys lie at the level of
T12-L3
A radionuclide decays at the rate of 20% per hour. Its half life is approximately:
T=.693/decay constant
hen treating an isocentric field, which of the following factor is used for dose calculations? PDD TAR STP All of the above can be used
TAR
Constancy checks may be accomplished in many ways using an ion chamber for air, water, phantom measurements and TLD's. Which method is not acceptable for machine calibration? Air measurements Phantom measurements TLD measurements Water measurements
TLD measurements
First Sign of Bacterial Infection
Temporary Increase in the Number of Leukocytes
Type of Cancer Examined Using Lymphangiogram
Testicular Cancers
ARRT
The American Registry of Radiologic Technologists is responsible for the credentialing examination that allows the radiation therapist to become nationally certified. The eligibility requirement for a student to take the registry exam is the satisfactory completion of a formal radiation therapy course in a JRCERT program. Candidates who successfully complete the ARRT exam are awarded certification, which is renewable every 2 years (based on the mandatory completion of 24 CE credits
The answer for #64 is: A. I
The answer for #64 is: A. I
The sterile portion of an O.R. Gown is:
The front part above the waist
Patient treated to intact breast using medial and lateral isocentric tangents. In order to eliminate divergence at the deep border of the tangets
The hinge angle should be greater tha 180 degrees
The frequency (number of cycles per seconds) of a diagnostic x-ray photon is directly proportional to all of the following EXCEPT: a. The quality of the beam b. The penetrability of the beam c. The ionization potential of the beam d. The intensity of the beam
The intensity of the beam
The orderly arrangement of the elements by their atomic number and chemical properties is found in: An emission spectrum The table of radionuclides A trilinear table The periodic table
The periodic table
The wave-particle duality of radiation is described by: Coulomb's law Einstein's law Ohm's law The quantum theory
The quantum theory
What happens to the recovery rate of bone marrow as the dose of radiation increases? There is no change The recovery time increases The recovery time decreases The recovery time increases until a dose of 100 cGy, where it levels off
The recovery time increases
The reduction in number of platelets is called
Thrombocytopenia
Application of Coefficient of Equivalent Tissue
To Correct For Tissue Inhomogeneities By Equating Them To Equivalent Thickness In Water
When to Use Inverse Square Law
To Determine Exposure When Treating Using Different Distances
When to Use Mayneord F Factor
To Determine PDD When Treating Using Different Distances
Lateral Borders of the Mantle Field
To Include the Axillary Lymph Nodes
Reason Compensators Should Remain 15 cm or Further From the Patient's Skin
To Preserve Skin Sparing
In radiation treatment of Wilm's tumor, why would the field extend over to the other side of the spine opposite the affected kidney
To allow symmetrical growth of the spine
Key Molecule Transfer
Transfer of a Free Radical to a Key Molecule That May Result in Bond Breakage or Inactivation of Key Functions
Dysplasia is reversible, true or false
True
Most meningiomas are very slow growing (true or false)
True
In order to visualize a single plane of tissue, an image technique called tomography is employed that requires the movement of the:
Tube and image receptor in opposite directions of each other.
Stage IVA Cervical Cancer
Tumors Tha tInvade the Mucosa of the Bladder or Rectum Tumors That Extend Beyond the True Pelvis
Stage III Cervical Cancer
Tumors That Extend To the Pelvic Sidewall or Lower 1/3 of the Vagina Tumors That Cause Hydronephrosis or a Nonfunctioning Kidney
Drugs Analgesic (pain killer)
Tylenol, percocet, MS Contin
Vaginal cancers most commonly occur in the ____.
Upper posterior wall
The likely result of the kidney's failure to remove excess levels of urea from the blood, is a condition called:
Uremia
Brachytherapy
Utilized to treat a small tissue volume to a high dose by placing a radioactive isotope in close proximity to the lesion -May be in the form of seeds, ribbons, needles or wires -Interstitial - placement is directly into the tissue -Intracavitary - placement in a natural body cavity
Magnetron
Vacuum Tube That Generates Microwaves
Structures With Radiation Tolerance Greater Than 7000 cGy
Vagina Articular Cartilage Aorta
The chemical properties of an atom are primarily controlled by the: Number of positrons in the nucleus Number of neutrons in the nucleus Atomic weight Valence number
Valence number
The number of electrons in the outer shell of an atom is know as the: Vector number Ground state number Valence number Quantum number
Valence number
Situation Requiring the Employment of TAR
Variable SSD
The ratio of x-ray to heat during x-ray production is
Variable depending on the maximum energ of electrons traversing the tube
The _________ is found at the base of the tongue
Vellacula
Treatment Options for Early Stage I Wilm's Tumors
Vincristine Postoperative Radiation Therapy Actinomycin
Cachexia
a state of general ill health and malnutrition with early satiety; electrolyte and water imbalances and progressive loss of body weight, fat, and muscle.
Wedge
a tapered block of attenuating material designed to produce wedge shaped isodose curves.
Paraphrasing
a verbal statement that is interchangeable with a patient's statement.
The lumen of a hypodermic needle is measured by the unit called a gauge. Which of the following possesses the largest diameter opening? a. 10 gauge b. 15 gauge c. 20 gauge d. 22 gauge
a. 10 gauge
Kaposi's sarcoma and pneumocystis carinii pneumonia are among the most common opportunistic infections associated with: a. AIDs b. nosocomial infections c. UTIs
a. AIDs
The five phases of the grieving process were identified by: a. Elizabeth Kubler Ross b. Sigmund Freud c. Abraham Maslow d. Miller Abbott
a. Elizabeth Kubler Ross
Histology of the parotid gland
adenocarcinoma
What factors affect each patient's perspective?
age, gender, culture, education, family background
Helium nucleus
alpha particle
Produced during natural radioactive decay:
alpha particle
What particle has the largest mass?
alpha particle
OER equation
anoxic radiation dose/dose in oxic conditions to produce the same effects.
Nonmaleficence
avoiding harmful acts to patients "do no harm"
Encapsulated
benign
Little destruction of tissue
benign
Resembles cell of origin
benign
Slow growth rate
benign
Suffix -oma
benign or malignant
The decay of cobalt 60 to stable lead is an example of:
beta negative and gamma rays
Can carry either a positive or negative charge:
beta particle
May be referred to as an electron or positron:
beta particle
CT & MRI Tests are
better due to CLEAR VISIBILITY
The term xray refers to a part of the electromagnetic spectrum having an energy of:
between 100 and 1
Astrocytomas originate in
brainstem cerebrum, white matter of the cerebrum, or spinal cord
Turcot's Syndrome definition cells
cells become abnormal and form masses called polyps. A polyp is benign, meaning noncancerous, but can eventually turn malignant.
penumbra trimmers
collimator that can be pulled close to patient to reduce penumbra.
Before a linear accelerator can be used to treat a patient, it must be commissioned for clinical use, this will normally involve all of the following EXCEPT: comparing that the treatment measurements are the same as the simulator measurements comparing that the generated dose distributions are checked against measured data checking the isodose curves for all modalities and energies checking dose per monitor unit calibration of all modalities and energies
comparing that the treatment measurements are the same as the simulator measurements
The machine that consists of a short metallic cylinder divided into two D shaped cavities is known as the
cyclotron
After a severe trauma, a patient has returned to the emergency room following a radiographic study of the ribs, a small pool of blood is found on the floor. The proper action of the radiographer includes all of the following EXCEPT: a. cleaning up the spill immediately b. washing the area with a disinfectant c. putting on protective gloves d. testing the blood for HIV
d. testing the blood for HIV
The radioactive decay is characterized by its:
decay constant
The probability of a photoelectric interaction ______ with increasing energy.
decreases
As source size decreases than the penumbra:
decreases. 1:1
Trismus
fibrosis around the masticatory muscles and temporomandibular joint
The term _______ means vomiting blood.
hematemesis
Von Hippel-Landau Disease definition
hereditary condition associated with hemangioblastomas, which are blood vessel tumors of the brain, spinal cord, and eye.
The _______ lymph nodes are typically treated in a mantle irradiation field.
hilar
Anti-Diarrheal drugs
imodium, Lomotil
Staging
is done when a person is first diagnosed, before any treatment is given.
MRI
is done within the soft tissue
CT Scan
is for the Bone
Auscultation
is listening to sounds within the body by using a stethoscope
Negligence
is neglect or omission of reasonable care
Tumor Suppressor Gene
is the absence or inactive gene that leads to uncontrolled growth or neoplasm
Confidentiality
may not discuss patient info with anyone not involved in their care or be discussed loudly where it's overheard. Charts need to be secure and locked up when not in use. Exceptions include presence of communicable disease, threats of suicide/ harm to self, or threats of harm to others
Brainstem glioma originates in
medulla, pons, midbrain
Heavy particles lose most of their energy:
near the end of their range
Calculations for new PDD
old ppd x may f
Anti-microbial
peridex
Anode assembly
positive, absorbs secondary electrons
Where is the nasopharynx located?
posterior to the soft palate
The probability that a photon interacts with a material is:
proportional to the total attenuation coefficient
PSA detects
prostate cancers. The test is highly specific.
Competency
refers to minimal mental, cognitive, or behavioral ability or trait required to assume responsibility
Interstitial implant for the vaginal wall, a vaginal cylinder can be used to
spare uninvolved tissue by increasing distance from active hsources and maintaining geometry of the implant
landmark typically used to determine the lower border of the mantle field
t10
False Imprisonment
the intentional confinement without authorization by a person who physically constricts another with force, threat of force or confining clothing or structures.
Most common site of FIBROSARCOMAS
tubular bones (femur and tibia)
The role of multi-leaf collimation is to produce a beam shape consistent with the 3D volume of the ___________, referred to as beam sculpting. normal tissue tumor and surrounding tissue tumor field
tumor
G4 means
undifferentiated
Clarifying
used to obtain more information about vague, ambiguous or conflicting statements... "I'm having trouble understanding
Electron Beam Therapy
utilizes electrons instead of photons to deliver relatively shallow treatments (near skin surface).
A long cylinder loaded with radioisotopes and placed in the vaginal space could be used to treat the:
vaginal vault
EBV is:
viral
Which of the following is not a B symptom Diarrhea (weight loss, night sweats, fever are)
weight loss, night sweats, fever
G1 means
well differentiated
Which tumor grade generally serves a better prognosis? well differentiated moderately differentiated poorly differentiated dedifferentiated
well differentiated
Informing
when the therapist shares objective and factual information
Tort Law
which is a "Civil Law": 2 Types-unintentional and intentional
Hematopoietic syndrome dose
whole body dose 200-1000cgy
Low LET energies
xray, gamma rays, secondary electrons
Topical or anesthetic drugs
xylocaine elixer
The localizing laser lights should be aligned to the isocenter and should be accurate to within: 5 cm 1 cm 7 mm 2 mm
2 mm
The optical distance indicator for the linear accelerator shall be accurate at all distances to at least: 10 mm 75 mm 100 cm 2 mm
2 mm
The verification of an isocenter for a linear accelerator requires that the final location of the images all lines shall pass through a diameter that does NOT exceed: 2 mm 6 mm 1.5 cm 5 cm
2 mm
Acceptance Criteria for Radiation / Light Field Coincidence
2 mm or 1% On Side
A patient involved in an industrial accident has extensive burns on his arms and chest. He should be placed in an area that can maintain: 1. Enteric precautions 2. Protective isolation 3. Strict precautions
2 only
During the evaluation of a patient's pulse rate it is important to: 1. determine the pulse using the thumb 2. record both strength and regularity 3. compare readings on opposite extremities
2 only
Which of the following devices could be used to reduce the amount of scattered radiation produced in a patient measuring 36 centimeters? 1. Stationary anode x-ray tube 2. Radiographic grid 3. Smaller focal spot
2 only
Acceptance Criteria for Field Flatness Over the Central 80% of the Field Using Photons
2%
The xray beam in the linac must exhibit flatness within about (tolerance)
2%
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
10MV dmax
2.5cm
During a 4 MV treatment, a sloping skin surface is corrected by a ___________ shift towards the skin surface of the isodose curve. 3/4 2/3 1/2 1/4
2/3
Most Common Region of Bulge Within the Electron Isodose Lines
20 - 40 %
Beam Energy Plane Parallel Ionization Chambers Are Calibrated To
20 MeV
Tolerance Dose of Ovary and Endpoint
200-300 cGy Sterility
Nephropathy occurs at a dose of ___.
2000 cGy
Normal Tolerance Dose Of Radiation Nephropathy
2000 cGy
Central Nervous system syndrome dose
2000-5000cgy
A dose of 3000 cGy is to be delivered at 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
A dose of 5000 cGy is prescribed to a axis in 20 fractions using a 4 MV unit at 80 cm SSD. If a readout error resulted in 83 cm SSD, the actual delivered dose would be:
232 cGy
If it is desired to demonstrate the vertebral arch of the cervical spine with the patient supine, the central ray should be directed:
25 degrees caudad
A therapist checks the temperature and pressure in the room during routine morning warm-ups and records a temperature of 78 degrees F. What is the temperature in Celsius? 32 78 25.6 33.3
25.6
The output of a Co-60 unit is 110.0 cGy/min at 100 cm. What will the output be at 200 cm? 440 cGy 27.5 cGy 110.0 cGy 50 cGy
27.5 cGy
Survival for Persons With Gastrointestinal Syndrome
3 - 10 days
Dmax for 18 MV Beam
3 1/2 cm
For electrons less than 10 MeV what is the thickness of lead required to obtain less than 5% transmission?
3 mm
Amount of Time to Recover From Hematopoietic Syndrome
3 weeks - 6 months, Dependant on Dose
Treatment Depth for 13 MeV Beam
3-4 cm
Which model presents a more cooperative method of pursuing healthcare for patients and providers than others? 1. Covenant 2. Analytical 3. Collegial 4. Engineering
3. Collegial
18MV dmax
3.5cm
1mCi is equivalent to
3.7x10^7dps dps from dpm means multiply by 60. mCi to Ci, multiply by 10^3.
Normal adult RBC range
3.90-5.4 million mm
Amount of Radiation a Patient Is Required to Have a Private Room and Bath If They Exceed
30 mCi Administered 5 mRem / hr 1 m From Their Skin Surface
Calculate the Dmax for a 300 cGy dose if the depth dose percent is 96%.
300/.96 = 312.5 cGy
THE FREQUENCY OF ELECTROMAGNETIC WAVES TYPICALLY USED IN A LINEAR ACCELERATOR TO ACCELERATE ELECTRONS IS: 3 kHz 30 MHz 300 MHz 3000 MHz
3000 MHz
Tolerance Dose for Parotid
3200 cGy to 2/3 of the Parotid
Dmax for 24 MV Beam
4 cm
The verification of an isocentric unit requires that the final location of the images of the cross wires shall pass through a sphere not exceeding ____ in diameter.
4 mm
The model of the caregiver with a paternalistic attitude who makes decisions for the patient and not with him or her is called the: 1. Analytical model 2. Covenant model 3. Contractual model 4. Priestly model
4. Priestly model
The maximum penetration (10% isodose line) for a 9 MeV electron beam will be at? 2 cm 4 cm 3 cm 4.5 cm
4.5 cm
A patient receives a dose of 90 rads (.9 Sv) of thermal neutrons with a radiation weighting factor (WR) of 5. The total dose equivalent of this patient would be approximately:
450 rem (4.5Sv)
Tolerance Dose of Pituitary
4500 - 5500 cGy
normal WBC range
4500-10,000
For bone cancer a post-operative radiation shrinking-field technique plans the first field reduction at which dose
4500-5000
Average age of onset of cervical cancer
48 years
Equivalent Depth of Calibration for MV Photons Up To 6 MV
5 cm Water
Limit for Radioactivity Surrounding a Patient Who Is Emitting Radiation's Room
5 mRem / hr
Dose Equivalent Limit for Infrequent Exposures to the Public
5 mSv
Annual Equivalent Dose for Occupational Exposure of Persons Under 18 years of Age
5 mSv (500 mRem)
Acceptable Amount of Beam Transmission Through a Block
5%
In general, when shielding blocks are employed, the acceptable primary beam transmission is approximately: 0.1% 1.0% 5% 15%
5%
Normal Red Blood Cell Values in Adult Males
5,000,000 / cc
Tolerance Dose for Spinal Cord
5-10 cm - 5000 cGy 20 cm - 4700 cGy
What is the half life of Co-60?
5.27 years
In order to produce the least amount of electron contamination from a shadow tray, the material should have an atomic number of about ____.
50
Superficial treatment machines operate at energies between: 10 - 50 KV 20 - 50 KV 50 - 150 KV 150 - 400 KV
50 - 150 KV
Dose Equivalent Limit for Annual Occupational Exposure
50 mSv (5 rem) for Stochastic Effects
The annual dose limit for occupational exposure to the hands is ____ annually.
50 rem or 500 mSv
Percentage of Patients Who Develop Liver Metastases
50%
The light field represents which isodose line? 10% 20% 90% 50%
50%
When is the peak incidence of multiple myeloma?
50-70
Bone marrow transplants can be used to help those exposed to which of the following doses of radiation. 10 cGy 100 cGy 500 cGy 5000 cGy
500 cGy
Tolerance Dose for Cataract Development
500 cGy
Dose Equivalent Limit for Annual Occupational Exposure for Deterministic Effects on Whole Body
500 mSv (50 rem)
Dose Resulting in Cerebrovascular Syndrome
5000 - 10000 cGy
The normal dosage of irradiation to the supraclav when treated with a H&N ca is:
5000 cGy
occupational dose- whole body
500mSv/year
Maximum Energy of a Scattering Object at a 180 degree Angle
511 KeV
Growth disorders would most likely occur from exposure following which gestational day
54
Regarding raditation, what is the dose if osteosarcoma has negative magins?
55 to 60 Gray
Tolerance Dose for Blindness as the Result of Irradiation of the Optic Nerve or Chiasm
5500 cGy
Tolerance Dose for the Brachial Plexus
5500 cGy
Average age of onset of uterine cancer
58 years
What is the half life of I-125?
59.43 days
Upper Limit for KeV to Result in Photoelectric Interactions
60 KeV
Necrosis of bone and soft tissue due to irradiation may result from a radiation dose of
6000
Tolerance Dose for Rectum
6000 cGy
Tolerance Dose of Whole Brain Treatment
6000 cGy
The TD 50/5 for whole brain irradiation is approximately ____.
6000 rads
A given atom has the following binding energies: K shell - 1000 eV, L shell - 70 eV, M shell - 10 eV. During a M-L transition, the photon energy emitted will be: 990eV 930eV 80eV 60eV
60eV
Average age of onset of vulvar cancer
65 years
Regarding radiation, what is the dose of osteosarcome if there is gross disease remaining after surgery?
68 Gray
Common Cerrobend Block Thickness Treating Using MV
7 1/2 cm
Peak Age of Incidence for Chronic Lymphocytic Leukemia
71 years Rarely Diagnosed in Patients Under the Age of 40
Beam Energy Above Which Backscatter at Depth Dose Becomes Negligible
8 MV
The PDD for a 12 x 12 cm field size, 4 MV beam, 5 cm depth, @ 80 SSSD is 82.8. Calculate the PDD for the same F.S. And depth at 100 cm SSD.
84.3%
What percentage of osteosarcoma occur in patients younger than 35?%
85%
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
# of Cartilages that make up the larynx
9
A light or plaster cast for immobilization should be constructed: A. Prior to simulation procedure B. Once simulation procedure is completed. C. After the first treatment once the port films are approved D. None of the above
A
A patient with a 4.5 cm tumor that does not invade the mediastinal structures and has no positive nodes is a: A. Stage 1 B. Stage 2 C. Stage 3 D. None of the above
A
A total dose of 45 Gy needs to be delivered at a rate of 1. 80 Gy per fraction. To accomplish this, how many fractions of treatment would be needed? A. 25 B. 5.55 C. 81 D. Not enough information provided
A
Back scatter factor is defined as: A. the ratio of the dose at dmax in phantom to the dose at dmax in air with all other factors the same B. the ratio of the dose at dmax in air to dose in phantom with all other factors the same C. the ratio of the dose at dmax in tissue to the dose in air at the same depth D. the difference in dose caused by the scattering of electrons by material of different atomic numbers
A
Charged particles such as protons and alpha are classified as having an LET that is: A. High B. Low C. Intermediate D. None of the above
A
Fatigue and pallor, presenting symptoms of leukemia, can be due to a decrease in the number of which circulation normal blood cells? A. Erythrocytes B. Leukocytes C. Platelets D. Pluripotent stem cells
A
For megavoltage treatment machines, what tissue inhomogeneity is most important to correct for? A. Lung B. Bone C. Muscle D. fat
A
If you wished to increase the penetration of the beam for a simulator film, how would the beam be changed? A. the wavelength used would be shorter (increase kVp) B. the wavelength used would be longer (decrease kVp) C. wavelength (kVp) would stay the same, amperage would be increased D. wavelength (kVp) would stay the same, only time would be changed
A
In order to ensure patient safety, the NCRP requires testing of the door interlocks system at least once a: A. Day B. Week C. Month D. Year
A
Methods of matching abutting fields include all of the following except: A. Penumbra method B. Gaps C. Feathering D. Use of non divergent beam edges
A
Normal range for a white blood cell count is: A. 4 to 11 thousand/mm B. 4 to 5 million/mm C. 37% to 47% D. 150 to 425 thousand/mm
A
One curie is equal to: A. 3. 7 x 1010 disintegrations/seconds B. 3. 7 x 107 disintegrations/second C. 2. 2 x 107 disintegrations/seconds D. 1 disintegration/seconds
A
Post-op radiation may be used for all but which one of the following situations? A. a well differentiated completely excised tumor B. a tumor with close surgical margins C. a concern to sterilize microscopic disease D. positive lymph nodes found at surgery
A
Primary lymphatic drainage of the lower lip would be to: A. submental nodes B. submaxillary nodes C. subdigastric node D. the posterior cervical chain
A
Sandbags and sponges are examples of: A. Patient positioning devices B. Simple immobilization devices C. Complex immobilization devices D. Individualized, beta-contoured immobilization devices
A
The PDD for a cobalt 60 beam at 80 cm SSD and a 10 x 10 field size at a depth of 5 cm is 74. 0%. What would the PDD be at 100 cm SSD? A. 75. 56% B. 57. 60% C. 74. 72% D. 70. 64%
A
The intercom system is not working. What should you do? A. Refuse to treat until it has been fixed B. Treat only if the physician approves C. Treat if the patient can still be monitored on camera D. Treat upon approval from the Radiation Safety Officer
A
The most common sign or symptom of oral cancer is: A. ulceration B. hoarseness C. odynophagia D. xerostomia
A
The most common type of breast carcinoma is: A. Infiltrating ductal carcinoma B. Medullary carcinoma C. Cystadenocarcinoma D. Infiltrating lobular carcinoma
A
The most common type of tumor that presents in the maxillary sinus is: A. Squamous cell carcinoma B. Adenocarcinoma C. Adenocystic carcinoma D. Lymphoepithelioma
A
The primary purpose of port filming is to verify: A. the treatment volume under actual conditions of treatment B. the gross tumor volume under actual conditions of treatment C. the planning volume under actual conditions of treatment D. the clinical target volume under actual conditions of treatment
A
The ratio of the absorbed dose at a give depth in a phantom to the absorbed dose at the same point in free space is the definition of: A. TAR B. TMR C. TPR D. PDD
A
The technique which would result in the lowest film density would be: A. 90 kVp, 300 mA, 3/10 Sec B. 85 kVp, 200 mA, 1 Sec C. 90 kVp, 100 mA, 3 Sec D. 80 kVp, 75 mA, 2 Sec
A
Using topographical anatomy, the pituitary fossa may be located by measuring: A. 2.5 cm anterior and 2.5 cm superior to the EAM B. 2.5 cm posterior and 2.5 inferior to the EAM C. 2.5 cm anterior and 2.5 inferior to the EAM D. 2.5 cm posterior and superior to the EAM
A
When treating with electrons you cannot beam on, all are possible causes EXCEPT: A. target will not go into place B. scattering foil is damaged C. wrong electron cone is engaged D. ionization chamber is damaged
A
Which cancer is the most common cause of morbidity from gynecological cancer in the United States? A. Ovarian B. Cervical C. Endometrial D. Vulvar
A
Which is a common method of the direct spread of infectious agents: 1. Sexual transmission 2. Fomite transmission 3. Vector transmission A. 1 only B. 2 only C. 3 only D. 1, 2 and 3
A
Which lymph node groups are treated in a mantle field? A. Mediastinal B. Paraaortic C. Inguinal D. pre auricular
A
Which of the following circulating blood cells is most resistant to radiation? A. Erythrocytes B. Lymphocytes C. Monocytes D. platelets
A
Which of the following compares the response of cells to radiation in the presence and absence of oxygen? A. OER B. RBE C. LET D. NST
A
Which of the following hormones increases heart rate and raises blood sugar levels? A. Epinephrine B. Oxytocin C. Aldosterone D. Prolactin
A
Which of the following is NOT a presenting symptom of vaginal cancer A. Bloating B. vaginal bleeding C. Foul-smelling discharge D. painful intercourse
A
Which of the following is NOT a use of medical records data? A. Employment screening B. Research C. Quality of Care Review D. Facility Planning
A
Which of the following is NOT true regarding patients right to privacy? A. The right to privacy is guaranteed by the US Constitution B. Case law and judicial review have inferred the right to privacy C. Invasion of privacy is any unwarranted disclosure of personal information D. Policies and Procedures to protect patient privacy is required by HIPPA
A
Which of the following occurs predominantly when x-rays or gamma rays compose the primary beam, thus producing fast electrons as the secondary particles that interact with the cellular medium, water? A. Indirect effect B. lytic effect C. blastic effect D. Compton effect
A
Which of the following tumors is most sensitive to radiation? A. Wilms' tumor B. breast cancer C. osteosarcoma D. larynx cancer
A
Which of the following variables are obtainable from the prescription? I. Daily dose II. Treatment technique III. Monitor units A. I and II only B. II and III only C. I and III only D. All of the above
A
Who is the owner of a physical medical record? A. The physician or Institution who creates it B. The Insurance company C. The patient D. The government
A
You treated the AP port. As you rotate to PA, you notice the table is off 5 degrees. You should: A. Notify physician; do not treat PA B. Notify physics; treat PA C. Correct table angle; treat the PA D. treat AP Treat PA; complete a misadministration form
A
The output for a 10 x 10 field at 80 SSD on a Cobalt-60 treatment unit is 110 cGy/min. The output factor is 1.023 and the percentage depth dose is 95.3%. In order to deliver 250 cGy through a single field, the correct timer setting should be: A. 2.33 min B. 2.15 min C. 2.62 min D. 1.02 min
A --
Depths Usually Treated Using Wedge Pair Fields
A Few cm Below Skin Surface
The dose response relationship used to approximate the biologic response to an ionizing radiation dose is which of the following. A linear-threshold dose-relationship A linear-non-threshold dose response relationship A non-linear non-threshold dose response relationship A non linear threshold dose response relationship
A linear-non-threshold dose response relationship
A wedge or filter indication system is used to: Indicate the presents or absence of the filter or wedge Help in the selection of a specific wedge number Indicate the relative transmission properties of the filter or wedge A only B only C only A, B & C
A only
Trace the path of the electron in the linear accelerator by selecting the best route from the following: Electron gun Collimator Accelerator guide Bending magnet A, B, C, & D A, C, D, & B B, A, D, & C C, A, B, & D
A, C, D, & B
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 are required on the personnel monitoring report: 1. Birth date 2. Cumulative lifetime exposure 3. Cumulative annual skin dose A. 1 & 2 B. 1 & 3 C. 2 & 3 D. All choices
A. 1 & 2
Which of the following are required on the personnel monitoring report? 1. DOB 2. Cumulative lifetime exposure 3. Cumulative annual skin exposure A. 1 & 2 B. 1 & 3 C. 2 & 3 D. All of the above
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
Possible sources of light field incongruence include: 1. Mirror misalignment 2. Gantry angulation 3. Collimator misalignment A. 1 only B. 2 only C. 3 only D. B & C E. A, B, and C
A. 1 only
Shielding in linear accelerator doors: 1. Is designed to specifically absorb neutrons 2. Is typically made of concrete 3. Intercepts the primary beam 4. Must account for scatter and leakage A. 1 only B. 2 only C 1 & 3 D. 2 & 4 E. All are correct
A. 1 only
The central panel for mega voltage therapy treatment must have a visual display of: 1. Operating voltage 2. Interlock status 3. Patient set up parameters A. 1 only B. 2 only C. 1 & 3 D. 2 & 3 E. All choices
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
The adrenal glands are located at the level of the thoracic vertebrae number: A. 12 B. 10 C. 8 D. 6
A. 12
A treatment designed to be given at 120 cm SSD mistakenly given at 112 cm SSD. What is the error in dose delivered? A. 15% overdose B. 15% underdose C. 7% overdose D. 7% underdose
A. 15% overdose
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
The pituitary gland is located: A. 2.5 cm superior and 2.5 cm anterior to the EAM B. 2.5 cm inferior and 2.5 cm anterior to the EAM D. 1.0 cm superior and 1.0 cm anterior to the EAM E. 1.0 cm inferior and 1.0 cm posterior to the EAM
A. 2.5 cm superior and 2.5 cm anterior to the EAM
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 depth of 8 cm with a PDD of 76%. What is the dose of an underlying organ at 14 cm with a PDD of 58%? A. 2289 cGy B. 3947 cGy C. 4231 cGy D. 5172 cGy
A. 2289 cGy
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%
The PDD for a 12 cm x 12 cm field, 4 MV beam, 5 cm Depth, and 80 cm SSD is 82.8%. Calculate the PDD For the same field size and depth for 100 cm SSD. A. 84.3% B. 87.6 % C. 89.6% D. 96.3%
A. 84.3%
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
All are true regarding the location of the spleen EXCEPT: A. Between T11-L3 B. Close to the 9th-11th ribs C. End 5 cm to the midline D. Lies posteriorly in the left hypochondrium
A. Between T11-L3
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
Which theory of radiation is illustrated by the operating principles of an ionization chamber? A. Bragg-Gray cavity theory B. Spencer-Attix theory C. Burlin cavity theory D. Compton theory
A. Bragg-Gray cavity theory
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 traditional unit of exposure is the roentgen, while the SI unit is the: A. Coulomb/kg or air B. Rad C. Rem D. Curie
A. Coulomb/kg or air
Landmarks around the mouth are generally not very accurate due to: A. Extreme flexibility in the area B. Daily variations in texture in the area C. Extreme Hyperpigmentation in the area D. Occasional occurrence of contagious mouth sores
A. Extreme flexibility in the area
This device is used for detection (rather than measurement) of radiation sources and low level radioactive contamination? A. GM counter B. Scintillation counter C. TLDd badge D. Pocket ionization chamber (PIC)
A. GM counter
______, also known as familial colorectal polyposis, is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with tumors outside the colon. A. Gardner's syndrome B. Barrets esophagus C. Achalsia disorder D. GERD
A. Gardner's syndrome
As the overall time of treatment is altered, with fraction size and total dose remaining the same, the biological effect: A. Increases as time is shortened B. Decreases as time is shortened C. Increases as time is prolonged D. Remains unchanged
A. Increases as time is shortened
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
The masses of lymphatic tissue located in the pharynx and intestinal mucosa are called: A. Lymph nodules B. Lymph capillaries C. Lymph nodes D. Lymph axillaries
A. Lymph nodules
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
The prodromal stage of acute radiation syndrome consists of: A. Nausea B. Fatigue C. Leukopenia D. Bleeding
A. Nausea
Etiologic factors for cervical cancer are: A. Obesity B. Multiple sex partners C. Infertility D. Oral contraceptives
A. Obesity
The chemotherapy related side effect characterized by a decrease in many cellular components of the blood is known as: A. Pancytopenia B. Neutrophilia C. Neutropenia D. Erythropenia
A. Pancytopenia Pancytopenia is a drop in several blood components. This is a common side effect of cytotoxic chemotherapy.
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
The _____ carries deoxygenated blood to the lungs. A. Pulmonary artery B. Pulmonary vein C. Cardiac artery D. Azygos vein
A. Pulmonary artery
An area where the radiation level could reach 60 mrem/hr would be classified as: A. Radiation area B. High radiation area C. Very high radiation area D. Dangerous radiation area
A. Radiation area Notice should be posted where radiation exposure has potential. An area above 100 mrem/hr must have a sign saying "Caution: High radiation area". Exposure below that can just read "radiation area."
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
The upper limit of the mediastinum occurs at: A. SSN B. Manubrium C. Sternal angle D. Xiphisternal angle
A. SSN *Suprasternal notch
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
The principal advantage of TAR is its ability to remove dependence upon: A. Target skin distance B. Field size C. PDD D. Backscatter radiation
A. Target skin distance
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
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
Functions of Lucite Shadow Trays
Absorption Of Electron Contamination Within the Beam Modification Of the Build Up Curve, Being Used As a Beam Spoiler
Which of the following sections of the linear accelerator must be gas-evacuated to ensure its proper operation? Electron gun Magnatron Accelerator tube Treatment head
Accelerator tube
The process for testing a new linear accelerator to ensure it meets advertised specifications and legal requirements of equipment safety is termed: insurance calibration testing Acceptance testing error correcting testing quality assurance testing
Acceptance testing
What is the incidence of Ewing's Sarcoma?
Accounts for 16% of bone tumors and affects a wide age group. 90% of patients are under 30. With peak incidence at 11 to 17 and as old as 60
SSD's of the patient's AP and Lateral measurements are needed to check:
Accuracy of contour taking
Radioactivity Equation
Activity = Initial Activity x e^(- decay constant)(time)
A radioactive source has an initital activity of 60mCi. Its half life is 8 days. What is the remaining activity after 10 days. Average life of this source is
Activity after time=Initial activity e ^-half life x time 25 mCi Average life is 1.44xhalf-life 11.5 days
Side Effect That Can Result in a Treatment Break For Patients Undergoing Pelvic Treatment
Acute Enteritis
Most Common Pediatric Malignancy
Acute Lymphocytic Leukemia
Form of Acute Leukemia Diagnosed Most Often in Adults
Acute Myelogenous Leukemia
Kidney Tumors are generally which histology
Adenocarcinoma
The histological type of lung ca not associated with smoking is
Adenocarcinoma
Safety considerations involved with linear accelerators may include: Electrical Mechanical Radiation All of the above Some of the above but I,m sure sure which ones
All of the above
The TAR (tissue-air ratio) at the depth of maximum electron equilibrium (D-max) is: Always less than or equal to 1 The backscatter factor Dependent on the field size All of the above None of the above
All of the above
What are the common symptoms of acute radiation syndrome? Depressed sperm count and temporary sterility Fatigue, nausea, and intestinal disorders Damage to the CNS and cardiovascular system All of the above None of the above
All of the above
Which of the following are stages of acute radiation syndrome? Prodromal stage Latent stage Manifest illness stage All of the above None of the above
All of the above
Which of the following cells are produced by pluripotential stem cells? Red blood cells White blood cells Platelet cells All of the above None of the above
All of the above
Which of the following statements is generally true of the time hospitals or physicians must retain radiographic images of a child?
All radiographic images are retained until the child reaches the age of 21
Smallpox, Diptheria, Staph
All require strict isolation
Clinical effects of excess secretion of prolactin may cause (2)
Amenorrhea, Galactorrhea
ASRT
American Society of Radiologic Technology is a national organization that encompasses radiographers, radiation therapists, nuclear medicine technologists, and sonographers.
Factors affecting surgical approach for CNS cancer (3)
Anatomic pathways, tuor size, tumor location
What is the term that describes the decrease in Red Blood Cells and Hemoglobin?
Anemia
_______ is a condition characterized by episodes of severe chest pain due to inadequate blood flow to the myocardium.
Angina (not myocardial infarction?)
Hinge Angle
Angle Separating the Two Central Axes
What is the term to describe the loss of appetite that results in weight loss?
Anorexia
Equivalent Square Formula
Area / Perimeter = Area / Perimeter Equivalent Square = 4 (A/P)
Target Volume
Area of known or presumed tumor
The practice that helps reduce the spread of microorganisms is called?
Asepsis
Primary Goal of Radiation Simulation
Assurance That Treatment Fields Enchompass the Target Value
Collapsed Lung
Atelectasis
n the symbol 27 Co, the number in the lower left hand corner on the periodic table is know as the: Mass number Atomic number Isotope number Ionization number
Atomic number
Linear Energy Transfer
Average Energy Deposited Per Unit Length To a Medium By Ionizing Radiation As It Passes Through the Medium
Clinical Management of Small Bowel Symptoms
Avoid Excessive Fiber Consumption Avoid Lactose Avoid a High Fat Diet
Purpose of Shielding
Avoid Unneccessary Exposure to Surrounding Tissues Not To Protect All Critical Organs
Lymphatics Usually Included In Breast Treatment
Axillary Internal Mammary Supraclavicular
A head and neck patient is treated to midline (separation 14 cm, and .688 FDD) with lateral fields to a total of 5750 cGy with a 2:1 RT to LT weighting. The left lateral field will contribute ________ cGy to the tumor. A. 1319 B. 1917 C. 2875 D. 3833
B
A malignant tumor of epithelial origin would be called an(a): A. Rhabdomyosarcoma B. Squamous cell carcinoma C. Osteoma D. Malignant angiosarcoma
B
A patient presenting with symptoms of increased ICP, weakness, and loss of memory would most likely have a brain tumor located in the ______lobe of the brain A. Frontal B. Parietal C. Temporal D. Occipital
B
All of the following are examples of primary bone tumors except: A. Malignant histiocytoma B. Squamous cell sarcoma C. Osteosarcoma D. Multiple myleoma
B
Chemicals that enhance the lethal effect of radiation are known as: A. Hyperthermia B. Radiosensitizers C. Concentration drugs D. None of the above
B
Clarkson's method: A. may be used to calculate the %DD of various distances B. determine the scatter component of dose of irregular fields C. can be used to determine wedge factors D. is a simple method to determine equivalent squares
B
Early skin changes after moderate doses (100 to 1000cGy) can include all of the following except: A. Temporary epilation B. Leukopenia C. Inflammation D. Erythema
B
Etiologic factor thought to be associated with cancer of the penis include: A. Smoking B. Smegma C. Elevated hormone levels D. Benzene byproducts
B
Every year a new decayed value must be determined for clinical use of the Cs 137 tubes. The decay is always calculated from the original assayed value obtained when the source was received. A particular source was received on September 3, 1989; the value was determined to be 69.5 mCi. What would the activity be, four years later? The half-life of Cs 137 is 30 years. A. 66. 4 mCi B. 63. 4 mCi C. 43. 6 mCi D. 46. 6 mCi
B
Filters are used in film badges to: A. Discriminate different directions of radiation B. Discriminate different radiation energies and types C. Correct for film fogging due to exposure D. Increase the sensitivity of the measuring device
B
Hospice is a service that provides all of the following options EXCEPT: A. Pain management B. Assisted suicide C. Palliative care D. Counseling
B
How frequently should the physics chart check be performed? A. Daily B. Weekly C. Monthly D. Yearly
B
Ideally, how soon after surgery should prophylaxis against heterotropic ossification of the bone be given? A. 1-2 days B. 2-3 Days C. 5-7 days D. Within 30 days post op
B
In general, the best method for a therapist 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
In taking a true patient diameter, the measurement is read: A. From the tabletop to the top of the air gap B. From the inside of the caliper surfaces C. From the outside of the caliper surfaces D. from flat surface to flat surface
B
In the middle of treatment, you notice that the wrong wedge was inserted into the head of the accelerator. What are the appropriate actions to take? A. Record MU's delivered with wrong wedge, insert correct wedge, and finish treatment B. Record MU's delivered with wrong wedge, page physics to advise C. Finish the port in question, insert correct wedge, and finish treatment D. Complete the treatment and notify a dosimetrist
B
In treating with an electron beam, the tumor dose will be calculated and carried according to which isodose line(s)? A. 100% B. 80-90% C. 60-70% D. 50%
B
It is important when treating an extremity for soft tissue sarcoma to have a strip of unirradiated tissue near the treatment volume to: 1. Maintain some lymphatic function 2. Avoid increase fracture possibilities 3. Avoid circumferential fibrosis A. 1 and 2 B. 1 and 3 C. 2 and 3 D. All of the above
B
Percent depth dose increases with an increase in distance because: A. backscatter factor increases B. there is a relatively smaller effect of inverse square law C. there is a relatively larger effect of inverse square law D. attenuation of the beam by tissue is decreased
B
Seminoma can spread to all of the following lymph nodes except: A. Paraaortic (retro peritoneum) B. Femoral C. Mediastinal D. Supraclavicular
B
The beam of a 6 MV linear accelerator consists of: A. photons of uniform energies of 6 MV B. a variety of photon energies up to 6 MV C. a variety of photon energies from 6 MV up D. photons having an average energy of 6 MV
B
The microwave power, generated by the klystron is directed into the circulator and out to the: A. Bending magnet B. Waveguide C. Cooling system D. Electron cone
B
The most common manifestation of an expanding pituitary adenoma is: A. Hypothyroidism B. Headache C. Spinal cord compression D. None of the above
B
The most common pathology associated with anal cancer is: A. Transitional cell B. Squamous cell C. Adenocarcinoma D. Large cell
B
The most common site of cancer in the breast is the: A. upper inner quadrant B. upper outer quadrant C. lower inner quadrant D. lower outer quadrant
B
The production of free radicals in a living tissue most often occurs from the irradiation of: A. RNA B. Water C. Protiens D. Lipids
B
The range of penetration of 12 MeV electrons is: A. 3 cm B. 6 cm C. 9 cm D. 12 cm
B
The scope of practice in radiation therapy: A. Sets forth a system of moral principles and standards governing the conduct of the therapist B. Defines the role and responsibilities of radiation therapists in the Contemporary practice of radiation therapy C. Grants an individual who has met predetermined qualifications the authority to use a specific title D. Is the process of external peer review
B
The threshold radiation dose to the whole liver for serious radiation-induced is: A. 1500 cGys B. 2500 cGys C. 3500 cGys D. 4500 cGys
B
Thick rubber bands and Velcro pull straps are examples of: A. Patient positioning devices B. Simple immobilization devices C. Complex immobilization devices D. Individualized, beta-contoured immobilization devices
B
What is the acceptable transmission of beam through a Cerrobend block? A. 2% B. 5% C. 10% D. 20%
B
What is the total skin gap needed between two fields to match at the specified depth? Field "A" is 40 cm long (total symmetric field length @ 100 cm) and Field "B" is 10 cm long (total symmetric field length @ 100 cm), 100 cm SSD for both, and match at 5 cm depth. A. .75 cm B. 1.3 cm C. 1.5 cm D. 2.2 cm
B
When should we use a slant board for breast cancer setup? A. For small size breasts B. large pendulous breasts C. Chest walls D. IMC node irradiation
B
When the urinary bladder is treated with full-dose external beam irradiation, the patient should be instructed to: A. Have a full bladder B. Have an empty bladder C. Eat plenty of fresh fruits and vegetables D. Have an enema at least once a week.
B
When treating a skin cancer of the nose, why would a lead piece be inserted into the nostril? A. to provide backscatter to the entrance site B. to block exit beam and protect the nasal septum C. to provide immobilization D. to shield and shape the primary beam
B
Where is the error in the chart above? A. Date B. Elapsed Days C. Fraction # D. Cumulative Dose
B
Which agency provides information and recommendations in the public interest concerning radiation measurements and protection? A. ACR B. NCRP C. ALARA D. AER
B
Which of the following situations is the most likely reason that the light field and the radiation field do not coincide? I. The jaws are misaligned II. The range finder light needs adjustment III. The mirror is out of alignment A. I only B. II only C. III only D. None of the above
B
Which of the following statements about percentage depth dose are correct? I. It increases with decrease in target to skin distance II. It decreases with decrease in treatment field size III. It increases with increase in beam energy A. I and II only B. II and III only C. I and III only D. all of the above
B
Which of the following would not be helpful in a personnel monitoring program? A. Film Badges B. Routine blood examinations C. Pocket Ion Chambers D. TLD'S
B
While treating a patient using a rotational technique, the gantry rotates past the end point. This is most likely a malfunction of the: A. Console B. Limit switch C. Collision ring D. Override switch
B
You have been asked to deliver 200 cGys to midplane depth using two- isocentric parallel-opposed portals on a Clinac 18. The field size is 16 x 24 and custom cut blocks will be used. The output factor is 1.025, the TMR is .803, the transmission factor for the block is .976 and the patient's separation is 24 cm. The number of monitor units per field is: A. 96 B. 125 C. 152 D. 248
B
Parameters that allow interpretation of cell survival curves include all of the following except: A. N B. RBE C. Dq D. Do
B *But make sure you know what each of these does, has turned up on other tests*
The most common presenting sign for nasopharyngeal tumors is: A. Hoarseness B. Cervical lymphadenopathy C. Nasal obstruction D. Facial nerve palsy
B *Naso often presents with affected nodes*
A patient is to receive 250 cGy at the isocenter by full rotational therapy, using 4 MV x-rays with a 6X10 field at isocenter and a SAD of 100 cm. The average TMR is calculated to be 0.756. Calculate the number of monitor units/degree to be set on the machine if the machine output is set at 200 MU/min and given the collimator and phantom scatter correction factors of 0.98 and 0.99 respectively. A. .901 B. .946 C. 1.24 D. 1.73
B 250/(.756*.98*.99) = 340.84 340.84/360 degrees = .946 (.96 is the keyed answer, but it's .946)
Determine the size or the penumbra at a depth of 10 cm in a patient treated at 80 cm SSD on a cobalt unit with a source of 2.5 cm diameter and 50 cm source to diaphragm distance. A. 1.5 cm B. 2.0 cm C. 2.5 cm D. 3.0 cm
B Don't worry about these, because they won't be on the test Formulas you can use: P=S(SSD-SDD)/SDD P=S(SSD + d - SDD)/SDD *use based on if it's SSD or SAD*
If two ends of a planar implant are crossed using Paterson-Parker rules, which of the following is true of the implanted area? A. Increased by 15% B. Increased by 20% C. Reduced by 10% D. None of the above
B Paterson-Parker: a radiotherapy system that uses sources of specific relative loadings arranged according to defined rules, which lead to a homogenous dose in the implanted region
Two Separate areas treated, 3 or more ports on a single area Multiple Devices (including wedges) Tangential Ports without devices best describes A. A Simple Treatment Delivery B. An Intermediate Treatment Delivery C. A Complex Treatment Delivery D. IMRT Treatment Delivery
B Simple: single tx area, 1-2 ports, 2 or less blocks Intermediate: two tx areas, 3 or more ports on single tx area, 3 or more blocks Complex: three or more tx areas, custom blocks, tangents, wedges, rotational beam, FIF, tissue compensation
Which of the following types of cancer would most likely present with ascites? A. rectal ca B. ovarian ca C. endometrial ca D. liver ca
B ascites: accumulation of fluid in the peritoneal cavity, causing abdominal swelling.
Radiation protection purposes, according to NCRP Report 116, what is the Quality or weighting factor a proton? A. 1 B. 2 C. 15 D. 20
B (but this is wrong according to black book-20)
Tuberculosis is transmitted by what two routes: A. direct contact or touching the patient B. airborne route C. droplet route D. contact with a fomite
B C
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
When a patient is treated with radioactive Iodine 131, the room should have a label that reads: A. "High Radiation-Grave Danger" B. "Caution: Radioactive Materials" C. "Caution: High Dose Radiation" D. "Do Not Enter: Radiation at Excessive Levels"
B. "Caution: Radioactive Materials" Where sources of radiation are stored and used, there should always be warning signs posted saying, "Caution: Radioactive Materials."
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
The treatment for salivary glands is: 1. Surgery 2. Radiation 3. Chemotherapy A. 1 only B. 1 & 2 C. 1 & 3 D. 2 & 3 E. All of the above
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
Screening for Breast cancer includes: 1. Monthly breast self exam after age 20 2. Mammogram yearly after age 25 3. Clinical Breast exam every 3 years after age 20 4. Needle biopsy annually after age 50 A. 1 & 2 B. 1 & 3 C. 1, 2, & 3 D. 2, 3, & 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
Risk factors for colorectal cancer include: 1. 1st degree relative 2. Achalsia disorder 3. Chronic ulcerative colitis 4. Gardner's syndrome A. 1, 2, & 3 B. 1, 2, & 4 C. 1, 3, & 4 D. All choices
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
How many joules are in 1 electron volt? A. 1.6 x 10 ^ -13 J B. 1.6 x 10 ^ -19 J C. 1.6 x 10 ^ 13 J D. 1.6 x 10 ^ 19 J
B. 1.6 x 10 ^ -19 J
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
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 0.888 and the output in air at the isocenter is 1.02 cGy/MU. How many monitor units will it take to deliver 100 cGy to a depth of 6 cm? A. 98 B. 110 C. 112 D. 116
B. 110
Calculate the equivalent square for a 10 cm x 15 cm rectangular field. A. 11.5 cm x 11.5 cm B. 12 cm x 12 cm C. 12.2 cm x 12.2 cm D. 13 cm x 13 cm
B. 12 cm x 12 cm
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
This is the most effective mean by which an occupational worker can minimize exposure to ionizing radiation? 1. Increase the time 2. Implement proper shielding 3. Increase distance from the source 4. Proper use of monitoring devices A. 1 & 2 B. 2 & 3 C. 1, 3, & 4 D. All choices
B. 2 & 3
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, and 3 D. All choices
B. 2 & 4
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
The alignment of the light field and therapy beam for a 10 cm x 10 cm field size may be ____ on any side. A. 2 inches B. 2 millimeters C. 3 centimeters D. 3 nanometers
B. 2 millimeters
Regarding primary barriers used for shielding linear accelerators: 1. The term primary means that they are the primary factor limiting dose to personnel 2. They intercept the primary beam 3. They are primarily made of steel A. 1 only B. 2 only C. 1 & 3 D. All are correct
B. 2 only
1 roentgen in air is equal to; A. 25.8 x 10 ^ 4 C/Kg B. 2.58 x 10 ^ -4 C/Kg C. 2.58 x 10 ^ -4 J/Kg D. None of the above
B. 2.58 x 10 ^ -4 C/Kg
The intensity of the radioactive beam is measured at a distance of 100 cm and found to be 250 mR/min. What will be up the intensity of this beam be at 105 cm? A. 238.1 mR/min B. 226.8 mR/min C. 262.5 mR/min D. 275.6 mR/min
B. 226.8 mR/min
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
Under the new standards (NCRP No. 91) a 25 year old radiation worker would be allowed body cumulative exposure of: A. 5 rem B. 25 rem C. 30 rem D. 35 rem
B. 25 rem
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
A 42 year old male who has been working in the field for 10 years would have a lifetime exposure of: A. 4.2 rem B. 42 rem C. .05 rem D. 5 rem
B. 42 rem * 1 rem per year in age is allowed
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 dosimetric physical field is the distance intercepted by a given _____ on a plane perpendicular to the beam axis at the stated source distance. A. 30% isodose curve B. 50% isodose curve C. 80% isodose curve D. 100% isodose curve
B. 50% isodose curve
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 set-up with a starting angle of 270 degrees clockwise rotation? MU/degree = 1.25 and MU setting = 208. A. 47 B. 76 C. 104 D. 123
B. 76
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 most common cancer in children is: A. Retinoblastoma B. ALL C. Ewings Sarcoma D. Medulloblastoma
B. ALL
The French-American-British (FAB) system is used to classify: A. Chronic leukemia B. Acute leukemia C. Non-Hodgkin's lymphoma D. Hodgkin's lymphoma
B. Acute leukemia
The staging system associated with Hodgkin's disease is: A. Dukes B. Ann Arbor C. French-American-British D. Clarks
B. Ann Arbor
In a SAD setup, the field size is defined: A. On the skin surface B. At the isocenter C. At the depth of Dmax D. None of the above
B. At the isocenter
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
The equation of depth dose assumes the variation of beam intensity along the: A. Isocenter B. Central axis of the beam C. Horizontal axis of the beam D. All axes of the beam
B. Central axis of the Beam
Which of the following tumors originates in osseous tissue? A. Ewing's sarcoma B. Chondrosarcoma C. Fibrosarcoma D. Chordoma
B. Chondrosarcoma Osseous tumors originate in hard bone, spongy bone and cartilage. Chondrosarcoma originates in cartilage tissue.
Which of the following is NOT part of the CT tube? A. Tungsten target B. Collimator C. Rotational anode D. Filament
B. Collimator
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
The common bile duct is formed by the: A. Left and right hepatic duct B. Common hepatic and cystic duct C. Pancreatic duct and hepatic duct D. Cystic duct and pancreatic duct
B. Common hepatic and cystic duct
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.
The tapered end of the spinal cord is called the: A. Cauda equine B. Conus medullaris C. Lumbar plexus D. Cisterna magna
B. Conus medullaris
The instrument used for recording higher energy gamma and x-radiation and beta particles specifically for contamination and measurement of radioactivity is the: A. Geiger-Mueller counter B. Cutie Pie C. Ionization chamber D. None of these
B. Cutie Pie
This instrument used for recording higher energy gamma and x-radiation and beta particles specifically for contamination and measurement for radioactivity is: A. Geiger-Mueller counter B. Cutie pie C. Ionization chamber D. None of these
B. Cutie pie
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
Advantages of film badges include all EXCEPT: A. Provide permanent record B. Exposure to interpretation delay C. Measure dose over large area D. Radiation type can be determined
B. Exposure to interpretation delay
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
Which of the following isotopes are most commonly used in Low Dose Rate (LDR) afterloading brachytherapy for the treatment of Prostate cancer? A. I-131 B. I-125 C. Cs-137 D. Ir-192
B. I-125
The tail of the pancreas is located: A. In the curve of the duodenum B. In the Hilum of the spleen C. At the level of L4 D. In the right Hypogastric region
B. In the Hilum of the spleen
______ 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
The radionuclide Tc-99m is an example of an: A. Isotope B. Isomer C. Isobar D. Isotone
B. Isomer Tc-99m has the same number of protons and neutrons as Tc-99 but it is in a metastable nuclear energy state.
Two or more chemicals with the same chemical formulas but having different nuclear states are known as: A. Isotopes B. Isomers C. Isobars D. Isotones
B. Isomers Two elements with the same formula in different nuclear states are called isomers.
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
The jugulodigastric node is a: A. Level 1 node B. Level 2 node C. Level 3 node D. Level 4 node
B. Level 2 node
Which of the following equipment produces extra nuclear indirectly ionizing radiation? A. A cobalt-60 unit B. Linear accelerator C. Ir-192 high-dose afterloader D. None of the above
B. Linear accelerator Photons are produced by a linear accelerator through the bremsstrahlung interaction that occurs when electrons impinge on the target. Bremsstrahlung occurs outside of the nucleus.
Germ cells proliferate during: A. Mitosis B. Meiosis C. Osmosis D. Organogenesis
B. Meiosis
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
"CAUTION RADIATION: This equipment produces radiation when energized" signs must be placed: A. In the treatment room B. On the control console C. A & B
B. On the control console
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
Which of the following isotopes has the shortest half life? A. Ra-226 B. Pd-103 C. Co-60 D. I-125
B. Pd-103 A. Ra-226 = 1600 years B. Pd-103 = 16.99 days C. Co-60 = 5.27 years D. I-125 = 59.43 days
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
Which of the following interactions occurs when the photon energy is totally given to the ionized electron? A. Classical scattering B. Photoelectric effect C. Compton scattering D. Pair production
B. Photoelectric effect
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
PSA stands for: A. Post-surgical anatomy B. Prostate specific antigen C. Prostate serum albumin D. Prostate superior antimetabolite
B. Prostate specific antigen
The basic types of interaction between X-radiation and matter include all of the following EXCEPT: A. Compton scattering B. Radiative bremsstrahlung production C. Photoelectric absorption D. Pair production
B. Radiative bremsstrahlung production Bremsstrahlung radiation is a product of electron interaction with matter.
The Loop of Henle: A. Filters fluids B. Reabsorbs water and ions C. Transfers the filtrate to the bladder D. Regulates the capillaries
B. Reabsorbs water and ions
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
The four R's of radiation therapy are: A. Reoxygenation, repopulation, replantantion, repair B. Reoxygenation, repopulation, redistribution, repair C. Reoxygenation, replantation, redistribution, repair D. Repair, Reoxygenation, redistribution, reorganization
B. Reoxygenation, repopulation, redistribution, repair
A common cause of longitudinal shift between radiation fields during a split field test is: A. Misaligned laser B. Sagging gantry arm C. Defective shadow tray D. Incorrect wedge placement
B. Sagging gantry arm
After a single injection of iodine 131, what is the proper procedure for disposing of the syringe? A. Place in biohazard container B. Send to manufactured for disposal C. Reuse for next patient D. None of the above
B. Send to manufactured for disposal
The most common histopathology for head neck cancers is: A. Adenocarcinoma B. Squamous cell carcinoma C. Transitional cell carcinoma D. Clear cell carcinoma
B. Squamous cell carcinoma
What is the most common pathology of anal tumors; A. Adenocarcinoma B. Squamous cell carcinoma C. Transitional cell D. Lymphoma
B. Squamous cell carcinoma
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 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 daily treatment record should be checked: A. Daily B. Weekly C. Monthly D. Annually
B. Weekly
Structure Which May or May Not Be Included in Nasopharynx Fields
Base of Skull
Factors Linear Attenuation Coefficient Is Dependant On
Beam Energy Physical Density of Attenuating Material Atomic Number of Attenuating Material
In a high energy linear accelerator, the electron stream is bent to direct it onto the target. This bending is accomplished by (a): Magnatron Wave guide system Beam transport system Flattening coils
Beam transport system
The _____ is responsible for bending the electron stream to direct it into the target.
Beam transport system
The principal advantage of a universal wedge is in its ability to function at ______.
Beam widths
Why is is so important to know the tumor stage & grade?
Because it allows a set of tumor classification to be identified using the TNM system to the specific area
Cold Spot Resulting From Treatments Using Proimos Head Treatment Device
Behind Acanthion
Energy At Which Coherent or Thomson Scatter Occurs
Below the Threshold For Ionization
Most Significant Component of Beam Transport System
Bending Magnet
A tumor marker for the detection of germ cell tumors is
Beta HCG
When an embryo fetus is exposed to high doses of ionizing radiation, mental retardation is most likely to occur at what point in development? After 30 weeks During the first 2 weeks During the last trimester Between 8 and 15 weeks
Between 8 and 15 weeks
Clinical detection by cancer site: Nasopharynx
Bloody discharge Auditory dysfunction Respiratory dysfunction Cranial nerve involvement (III, V, VI, IX, XII)
The mass attenuation coefficient for a 10 MV photon beam will be highest for: Water Blood Bone Soft tissue
Bone
Form of Neutron Shielding
Borated Plastic To Slow Down Neutrons and Allow For Their Capture
Functions of CSF (4)
Bouyancy, Control, Exchange, Transport
Site Most Likely to Metastasize To the Liver Overall
Breast
Staging for melonoma
Breslow and Clark level
A hazard associated with the radiation therapy room that could cause retinal eye damage is: A. X-ray radiation B. Electrical shock C. Laser beams D. None of the above
C
A patient being treated with an Aquaplast cast for a base of tongue lesion experiences a 10% weight loss. Which of the following steps should be considered? I. No longer use the cast and only tape patient in the correct position II. Add tissue compensators to the spaces where the mask no longer fits III. Make another cast before you treat the patient A. I only B. II only C. III only D. None of the above
C
A patient is treated with parallel-opposed mantle and paraaortic fields of lengths 30 and 15 cm, respectively. Calculate the gap required on the surface for the beams to intersect at a midline depth of 10 cm. A. .75 cm B. 1.5 cm C. 2.3 cm D. 3.2 cm
C
All of the following items should be worn as protective gear while cutting Cerrobend blocks EXCEPT: A. Apron B. Goggles C. Respirator D. Gloves
C
An aggressive breast cancer that presents with extensive lymphatic permeation, erythematous skin, and at times ridging best describes: A. Lymphoma B. Papillary carcinoma C. Inflammatory carcinoma D. Squamous cell carcinoma
C
Beam-shaping and modifying devices must be secured a minimum of _____from the patient in order to avoid electron contamination. A. 3 cm B. 5 cm C. 15 cm D. None of the above
C
Bragg peak is a dose-distribution term associated with the use of the: A. Orthovoltage B. Betatron C. Cyclotron D. Linear accelerator
C
Common immobilization devices include all of the following EXCEPT: A. Alpha cradles B. Bite blocks C. Safety belts D. Vac-Loc bags
C
Depth of maximum dose for a 10mvx beam is: A. 0. 1 cm B. 1. 5 cm C. 2. 5 cm D. 3.0 cm
C
Field sizes and arrangements for early glottic carcinomas are usually A. Parallel opposed fields, 10 cm x 11 cm B. Unilateral field, 5 cm x 5 cm C. Parallel opposed fields, 5 cm x 5 cm D. Unilateral field, 7 cm x 9 cm to include subdigastric nodes
C
Following local excision (lumpectomy), the usual radiation dose to the whole breast, exclusive of the dose to the boost volume, is: A. 2500 cGy to 3000 cGy B. 3500 cGy to 4000 cGy C. 4500 cGy to 5000 cGy D. 5500 cGy to 6000 cGy
C
Following repairs to the linear accelerator's field/distance light assembly, which of the following checks must be performed prior to resuming treatments? I. SSD/SAD readouts II. Dose rate III. Light field/radiation field coincidence A. I and II only B. II and III only C. I and III only D. All of the above
C
For patents with colorectal cancer, the main dose-limiting structure for acute and chronic side effects is the: A. Bladder B. Liver C. Small bowel D. Spinal cord
C
HDR uses_______to help deliver the radiation dose to the tumor volume A. Bolus B. Brass apertures C. Catheters D. Lead cutouts
C
In fields that abut on the skin surface, "feathering" (moving) the junction is done to: A. Spread out any hot or cold spot over a larger area B. Normalize the central axis dose distributions C. Both A and B D. Neither A nor B
C
In many emergency situations, a rapid systemic response to the medication is necessary. The route that will in most cases provide this is: A. Subcutaneous B. Intramuscular C. Intravenous D. Oral
C
Light cast and Aquaplast are examples of A. Patient positioning devices B. Simple immobilization devices C. Complex immobilization devices D. Individualized, beta-contoured immobilization devices.
C
Lomotil is an example of an: A. Anti-inflammatory B. Antiemetic C. Antidiarrheal D. Antiseptic
C
Microorganisms that live on or inside the body without causing disease are referred to as: A. pathogens B. endospores C. microbial flora D. parasites
C
Palliative doses of radiation to the whole brain for metastatic disease are generally about: A. 5000-6000 cGy B. 4500 cGy C. 3000 cGy D. 1500 cGy
C
Palpation of the cricoid cartilage indicates the inferior border of A. Oral cavity B. Oropharynx C. Larynx D. Hypopharynx
C
Primary treatment for osteogenic sarcoma involves: 1. Radiation therapy 2. Surgery 3. Chemotherapy A. 1 and 2 B. 1 and 3 C. 2 and 3 D. All of the above
C
Radiographs taken at right angles to each other that are used to determine three-dimensional source locations from two-dimensional films are called _______radiographs. A. Stereo shift B. Opposing C. Orthogonal D. Sievert
C
TD 5/5 is defined as: A. the dose that is necessary to control all but 5% of the tumors. B. the total dose absorbed by the tissue irradiated over the 5 week treatment period C. The dose which will cause 5% of the population to experience a defined side effect within 5 years D. the whole body dose which will kill 5% of the population within 5 years
C
The 'Split field" test is done to test for correct: A. gantry rotation B. collimator rotation C. field alignment D. focal spot alignment
C
The Gleason score used with prostate cancer indicates: A. The stage of the disease B. Number of positive lymph nodes C. The histologic grade of the tumor D. All of the above
C
The cause of colorectal cancer is largely attributed to all of the following EXCEPT: A. Diet high in animal fat B. Diet low in fiber C. Smoking D. Familial polyposis
C
The given dose rate for a 10 cm x 10 cm at 100 SSD electron beam of 15 MeV is 1.02 rad per monitor unit. The number of monitor units you must set in order to deliver 200 rad at the depth at which the depth dose is 80% is: A. 196 B. 204 C. 245 D. 250
C
The most common means by which infections are spread is by: A. airborne particulates B. Indirect (fomite) contact C. Direct (touching) contact D. Endogenous contact
C
The two types of microwave power sources used in linear accelerators today are: A. modulators and wave guides B. klystrons and injectors C. klystrons and magnetrons D. magnetrons and electron guns
C
The type of contour that runs across the patient from right to left and sections the body into upper and lower halves is the: A. Sagittal B. Coronal C. Transverse D. Medial
C
The umbilicus is at the level of the iliac crest and the vertebral body of: A. L2 B. L3 C. L4 D. L5
C
Treating patients with colorectal cancer with a full bladder reduces the dose to the: A. Kidney B. Liver C. Small bowel D. Spinal cord
C
Treatment unit outputs as measured at a reference point: A. Decrease with increased field size and increase with increased SSD B. Increase with increased field size and decrease with decreased SSD C. Increase with increased field size and decrease with increased SSD D. None of the above
C
Vacuum-formed plastic shells and Alpha Cradles are examples of: A. Patient positioning devices B. Simple immobilization devices C. Complex immobilization devices D. Individualized, beta-contoured immobilization devices
C
What factors affect the scatter air ratio (SAR)? I. SSD II. beam energy III. depth IV. field size A. I and II only B. I, III and IV only C. II, III and IV only D. I, II, III and IV
C
What is the TD5/5 for the heart? A. 20 Gy B. 30 Gy C. 40 Gy D. 55 Gy
C
What is the proper procedure to follow when a DNR patient goes into cardiac arrest? A. Begin CPR B. Stay with the patient and call for the doctor C. Call a code, but tell them the patient is DNR D. Resuscitate the patient
C
When a patient is connected to the chest tube drainage equipment, it is important to: A. Clamp off the chest tube B. Raise the bottle above the chest C. Avoid kinks in the drainage tube D. Flush the tube with saline
C
When checking the cross hairs of the accelerator, they must be within: A. +/-2% B. +/-10% C. 2 mm D. 4 mm
C
When referring to the anatomy of the large bowel, which of the following does not belong? A. Sigmoid B. Hepatic flexure C. Greater curvature D. Descending colon
C
When safely lifting heavy objects or assisting a patient from a wheel chair to the treatment couch you should remember all of the following principles EXCEPT: A. Obtain a base of support that provides stability B. Balance your body weight or center of gravity with the object or patient C. Always bend at the waist D. while lifting, hold heavy objects close to your body
C
Which of the following has the best overall five-year disease-free survival rate? A. Anaplstic thyroid carcinoma B. Adrenocortical carcinomas C. Pituitary adenomas D. Follicular thyroid carcinoma
C
Which of the following measurements are needed to aid you in checking the accuracy of the contour? I. Patient AP and lateral measurements II. Field size III. SAD IV. SSD A. I, II and III only B. I, II and IV only C. I, III and IV only D. II, III and IV only
C
Which of the radiation volumes below includes the largest amount of tissue? A. target volume B. tumor volume C. treatment volume D. planned volume
C
If a therapist stood 3 feet from the source and received 20 mR for 4 minutes of exposure, what would the therapists' exposure be if he/she stands two feet from the source for 1. 5 minutes? A. 3.33mR B. 6.33mR C. 16.9mR D. 23.6mR
C I=mR/time exposed x/1.5 = 20/4 * (9/4) = 16.9 mR
What is the anatomic location of Point B? A. A point 5 cm cephalic to the cervical os and 3 cm lateral B. A point 2 cm cephalic to the cervical os and 2 cm lateral C. A point 2 cm cephalic to the cervical os and 5 cm lateral D. A point 3 cm cephalic to the cervical os and 3 cm lateral
C Point A: 2cm superior to the cervical os and 2 cm lateral to the endocervical canal (2 and 2) Point B: 3cm lateral to point A (or 2cm superior to cervical os) and 5 cm lateral to endocervical canal (remember 5)
You have been asked to deliver 200 cGys to a midplane depth using two- isocentric parallel-opposed portal on a Clinac 18. The field size is 16 x 24 and custom cut blocks will be used. The output factor is 1.025, the TMR is .803, the transmission factor for the block is .976 and the patient's separation is 24 cm. Determine that the dose delivered from both fields for that one treatment was: A. 102 cGys B. 122 cGys C. 205 cGys D. 240 cGys
C just multiply dose by output factor to find the actual dose given
Which circumstances are related to higher incidence of lung cancer? 1. Increased duration of smoking 2. Increases use of unfiltered cigarettes 3. Increased number of cigarettes consumed 4. Decrease exposure to radon A. 1, 2, & 4 B. 2, 3, & 4 C. 1, 2, & 3 D. 1 & 3
C. 1, 2, & 3
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
After how many half lives can a radioactive source be tossed in the trash? A. 2 B. 4 C. 10 D. Never
C. 10
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.
As the energy of photons increases: 1. The number of photoelectric interactions in tissue increase 2. The number of photoelectric interactions in tissue decrease 3. The number of compton interactions in tissue increase 4. The number of compton interactions in tissue decrease A. 1 only B. 2 only C. 2 & 3 D. All of the above
C. 2 & 3
Laboratory studies used for the detection and evaluation of lung Cancer include: 1. CT scan 2. Sputum cytology 3. Pulmonary function tests A. 1 only B. 1 & 2 C. 2 & 3 D. All choices
C. 2 & 3
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
Dose equivalent (DE) is: 1. The unit of absorbed dose 2. Equal to the quality favor multiplied by the absorbed dose 3. Measured in rads (Gy) 4. Measured in rem (Sv) A. 1 only B. 2 only C. 2 & 4 D. 3 & 4
C. 2 & 4
During a 4 MV treatment, a sloping skin surface is corrected by a ______ shift toward the skin surface of the isodose curve. A. 1/4 B. 1/2 C. 2/3 D. 3/4
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
The following are a list of the respiratory conducting passageways. Select the letter that states the order in which air passes through the structures. 1. Secondary bronchus 2. Intralobular bronchiole 3. Trachea 4. Primary bronchus 5. Respiratory bronchioles 6. Alveoli 7. Carina A. 4, 7, 3, 1, 2, 5, 6 B. 3, 4, 7, 1, 2, 6, 5 C. 3, 7, 4, 1, 2, 5, 6 D. 3, 7, 4, 2, 1, 5, 6
C. 3, 7, 4, 1, 2, 5, 6
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
Radon is a natural reactive gas with a half life of: A. 4 minutes B. 4 hours C. 4 days D. 4 months
C. 4 days
Supraclavicular fields are typically treated to a dose of: A. 20-25 Gy B. 30-35 Gy C. 45-50 Gy D. 55-60 Gy
C. 45-50 Gy
The tolerance dose (TD 5/5) for the optic chiasm is: A. 10 Gy B. 45 Gy C. 50 Gy D. 60 Gy
C. 50 Gy
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
Beam symmetry and flatness are defined over what percentage of the field? A. 30% B. 50% C. 80% D. 100%
C. 80%
A "Grave Danger: Very high radiation area" sign must be posted if radiation levels are: A. > 1 Gy/hr B. < 1 Gy/hr C. > 5 Gy/hr D. < 5 Gy/hr
C. > 5 Gy/hr
Radiation high energy rooms should have "emergency off" buttons are installed: A. In the treatment room B. On the control console C. A & B
C. A & B
______ is a condition in which the muscles of the lower part of the esophagus fail to relax, preventing food from passing into the stomach. A. Gardner's syndrome B. Barrets esophagus C. Achalsia disorder D. GERD
C. Achalsia disorder
When the esophagus loses normal peristolic activity it is called: A. Plummer Vinson syndrome B. Barrets esophagus C. Ahalasia D. Colitis
C. Ahalasia
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
The three major lymphatic groups in order of incidence for Breast cancer are: A. S/clav, internal mammary, axillary B. Mediastinal, internal mammary, axillary C. Axillary, internal mammary, S/clav D. Axillary, internal mammary, mediastinal
C. Axillary, internal mammary, S/clav
When calibrating ionization chambers, which of the following correction factors is NOT needed? A. Barometric pressure B. Elevation C. Beam energy D. Temperature
C. Beam energy
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
The source of electrons in an electron accelerator is the: A. Klystron/magnetron B. Accelerating waveguide C. Electron gun D. None of the above
C. Electron gun
The thyroid gland is one of the: A. Digestive glands B. Exocrine glands C. Endocrine glands D. Lymph glands E. Ductless glands
C. Endocrine glands
Which of the following organs in the mediastinum is most radioresistant? A. Bone marrow B. Heart C. Esophagus D. Lung
C. Esophagus
The more common etiologic factor for esophageal cancer is: A. Ahalasia disorder B. Diet low in fiber C. Excessive alcohol and tobacco use D. Excessive coffee drinking
C. Excessive alcohol and tobacco use
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
Which radiation monitoring device is composed of ferrous sulfate, sodium chloride, and sulfuric acid? A. TLD B. OSL C. Fricke dosimeter D. Ionization chamber E. Cutie Pie
C. Fricke dosimeter
The proximal humerus articulates with the: A. Acromion process B. Acetabulum C. Glenoid fossa D. Sternum E. None of the above
C. Glenoid fossa
All of the following might account for beam flatness drifting outside of specifications except: A. Flattening filter shift B. Target position shift C. Incorrect mirror angulation D. Fluctuation of current to bending magnet
C. Incorrect mirror angulation
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
The most common metastatic site from head and neck cancer is: A. Brain B. Bone C. Lung D. Liver
C. Lung
The EAM overlies what part of the anatomy: A. Pituitary B. Thalamus C. Medulla oblongata D. Lateral ventricles
C. Medulla oblongata
The procedure to check alignment of the field light should be performed: A. Daily B. Weekly C. Monthly D. Annually
C. Monthly
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
Which of the following cells have the highest sensitivity: A. Neurons B. Chondrocytes C. Osteoblasts D. Lymphocytes
C. Osteoblasts Osteoblasts are the most sensitive because they are young and immature. They are still dividing making them the most sensitive.
The adenoids are also called the _____ tonsils. A. Palatine B. Lingual C. Pharyngeal D. None of the above E. All of the above
C. Pharyngeal
An incident x-ray interacts and ionizes inner shell electron and ejects an electron, is characteristic of which interaction? A. Compton scatter B. Classical scatter C. Photoelectric absorption D. Pair production
C. Photoelectric absorption
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
A stochastic effect is best defined as one in which: A. Severity is easily predicted B. Severity is dose dependent C. Probability is dose dependent D. Severity has a threshold
C. Probability is dose dependent For stochastic effects, the probability of a latent effect is dose dependent.
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 SI unit for absorbed dose is the Gray, while the traditional unit of exposure is the: A. Joule B. Calorie C. Rad D. Rem
C. Rad
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
If distance is doubled, the intensity of the radiation will be: A. Reduced by half B. Increased by a factor of 2 C. Reduced by a factor of 4 D. Increased by a factor of 4
C. Reduced by a factor of 4
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 coracoid process is a part of the: A. Ulna B. Tibia C. Scapula D. Radius E. None of the above
C. Scapula
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 Gleason Score used with Prostate cancer indicates: A. The stage of the disease B. The number of positive lymph nodes C. The histologic grade of the tumor D. All of the above
C. The histologic grade of the tumor
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)
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
Treatment for Splenomegaly in Leukemia patients occurs more commonly in (2)
CLL, CML
Type of Leukemia that essentially has no cure
CML
The basic method of determining the absorbed dose in a medium due to the production of heat is termed _____.
Calorimetry
Sarcoma
Cancer Arising From Mesenchymal Tissue, Including Connective, Supportive, or Soft Tissue
Protectant drugs
Carafate(inhibits pepsin)
Carcinoma vs Sarcoma
Carcinoma arises from the epithelial "skin" tissue, & Sarcomas arise in connective tissue or "cartilages"
If a patient is thought to have had a heart attack, the pulse should be taken at
Carotid Artery
Examples of Deterministic Effects of Radiation
Cataract, Infertility, Erythema
Structures That Are Most Likely to Experience Chemical Changes Resulting in Radiation Induced Cell Death
Cell Membranes Lysosomes
The average time from one mitosis event to another is known as the:
Cell-cycle time
Most Common Side Effects From Palliative Radiation Therapy to the Brain
Cerebral Edema May Lead to Memory Impairment
Hemorrage of small blood vessels is associated with which of the following. Cerebrovascular syndrome Genetic cell destruction G.I syndrome Hematopoietic syndrome
Cerebrovascular syndrome
Location of most brain tumors
Cerebrum
ulti-leaf collimators are designed to reduce the use of: The klystron Patient support assembly Cerrobend custom made blocks All of the above None of the above
Cerrobend custom made blocks
Stage I Cervical Cancer
Cervical Cancer Confined to the Uterus
Stage II Cervical Cancer
Cervical Cancer Invading Beyond the Wall of the Uterus But Not To The Pelvic Sidewalls or Lower 1/3 of the Vagina
The photons produced during orbital transition of electrons from higher to lower energy are termed: Characteristic radiation Corpuscular radiation Vacancy radiation Field radiation
Characteristic radiation
What is the youngest treatment modality
Chemotherapy
Functions of a Hickman Catheter
Chemotherapy Administration Dialysis Blood Draws Apheresis Parenteral Nutrition
Cause of Petechiae
Chemotherapy Leading to Blood Clotting Disorders
According to the Guidelines for Environmental Infection Control in Health Care Facilities, the EPA (Environmental Protection Agency) recommends that soiled areas of blood should be cleaned with which proportion of solution?
Chlorine bleach and water at a ratio of 1:10
this piece of equipment is the link between the clystron and the accelerating structure. It conveys microwave power to the accelerator structure and deflects reflected microwave power that could damage the klystron: Accelerating structure Velocity modulator Circulator Hand control
Circulator
End Point for Tolerance of the Kidney
Clinical Nephritis
End Points for Tolerance of the Esophagus
Clinical Stricture Perforation
Staging has 2 types
Clinical or pathologic
Oxygen Enhancement Ratio
Comparison of Response of Cells to Radiation in the Presence and Absence of Oxygen
Method of Maintaining Skin Sparing On a Sloped Skin Surface
Compensating Wedges
For a sloping skin surface, isodose curves are not perpendicular to the direction of the beam. The skin sparing effect can be maintained and the situation corrected by using a(n): Bolus Multi-field technique Shielding block Compensating wedge filter
Compensating wedge filter
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
Substances That Synthesize Antimicrobial Proteins Which Attach to the Bacterial Surface
Complement Interferon
Electron output depends on
Cone/Applicator Size SSD Size of Custom Insert NOT dose rate at Dmax
Damage to the G-M counter will result in operation in the ______ region: Threshold Starting potential Plateau Continuous discharge
Continuous discharge
Klystron
Converts Kinetic Energy to Microwave Energy in Linear Accelerators Using Microwave Cavities Tuned Near Operating Frequency of the X-ray Tube
A risk of serious infection may result from a: A. WBC in excess of 100,000/cc3 B. RBC of less than 2 million/ cc3 C. Platelet count of less than 200,000/ cc3 D. WBC less than 1000/ mm3
D
A single direct field is setup at 100 cm SSD. The prescription is 300 cGy in 10 Fractions at 5 cm depth. The output factor is 1cGY/MU and the PDD at 5cm depth is 78%. What is the correct monitor units to deliver this treatment? A. 272 MU B. 300 MU C. 349 MU D. 385 MU
D
All of the following are acceptable forms of bolus EXCEPT A. Superflab B. Water soaked gauze C. Rice bags D. Aluminum filters
D
All of the following influence the patient's pain experience EXCEPT: A. Culture B. Psychological status C. Previous painful experiences D. Nationality
D
An early lesion (T1) of the true vocal cords: A. Commonly metastasizes to the subdigastric nodes B. Midjugular metastasizes to the nodes C. Retropharyngeal metastasizes to the nodes D. Rarely metastasizes to any lymph nodes
D
Arrange the following tasks involved in delivering a dose of radiation therapy in the proper order: 1. Complete a daily treatment record 2. Initiate the beam-on setting and monitor the patient and equipment 3. Align the field light to surface landmarks 4. Prepare the room A. 1, 2, 3, 4 B. 2, 1, 3, 4 C. 4, 2, 1, 3 D. 4, 3, 2, 1
D
Common sources of error in contour production include: 1. Air gaps between contour material and skin surface 2. Inaccurate reproduction of patient positioning 3. Inaccurate documentation of measurements A. 1 and 2 B. 1 and 3 C. 2 and 3 D. All of the above
D
During the treatment of total body irradiation for bone marrow transplants, dose may be verified by all of the following EXCEPT: A. TLD's B. Ionization chambers C. Diodes D. Gieger Muller
D
If a patient is to be treated on a linear accelerator that uses a 100-cm SAD, and the isocenter has been placed at a point in the patient that provides a right lateral SSD reading of 87 cm, what is the patient's depth to isocenter on the right lateral side? A. 187 cm B. 100 cm C. 87 cm D. 13 cm
D
In the treatment fields of Waldeyer's ring for non Hodgkin's lymphoma, the fields, delineation closely resembles that of carcinoma of the: A. Supraclavicular fossa nodes B. Orbit C. Pelvis D. Nasopharynx
D
Late somatic effects of radiation include all of the following EXCEPT: A. Leukemia B. Osteosarcoma C. Skin cancer D. Nausea and vomiting
D
Most institutions classify or stage pancreatic cancer: A. Using the modified Aster-Coller staging system B. Using Dukes staging system C. Using the Ann Arbor staging system D. resectable/non-resectable
D
Palliative radiation for lung cancer is extremely effective and most commonly used for: A. Brain metastases B. Bone metastases C. Hemoptysis D. Both A and B
D
Patient education is necessary information provided to the patient for: A. Effective management of a health condition B. Legal purposes C. Informed consent D. All of the above
D
Reactions to water soluble iodinated contrast media include: I. urticaria II. bronchospasm III. nausea and vomiting A. I only B. I and II C. II and III D. All of the above
D
Retinoblastoma is associated with: A. The ventricular linings of the brain B. The posterior fossa of the brain C. A small, round, blue cell tumor derived from glandular origin D. A primitive neuroectodermal tumor of the retina
D
Staging for Hodgkin's disease also includes an A-B grouping. Which symptom is NOT one of the classical B symptoms? A. Profuse night sweats B. Weight loss greater than 10% of body weight C. Unexplained fever above 38øC D. Unexplained pruritus
D
The area at the edge of the radiation beam at which the dose rate changes rapidly as a function of distance from the beam is the: A. Dmax B. Half-life C. Gamma gradient D. Penumbra
D
The auditory (Eustachian) tubes are situated to exchange air between the: A. larynogopharynx and middle ear B. oropharynx and middle ear C. nasopharynx and inner ear D. nasopharynx and middle ear
D
The cornea of the eye is a continuation of the: A. Retina B. Choroids C. Iris D. Sclera
D
The loss of hair after exposure to large amounts of radiation is termed: A. Epistaxis B. Bromidrosis C. Erythema D. Epilation
D
The most primitive level of a blood cell is termed: A. Erythrocyte B. Basophil C. Platelet D. Pluripotent stem cell
D
The principal site of ATP production in the cell is the: A. golgi complex B. endoplasmic reticulum C. lysosome D. mitochondrion
D
The radiation therapist's duties include: 1. Administration of the radiation treatment 2. Care and emotional support during treatment 3. Observation of the patient's clinical progress 4. Education of the patient regarding treatment A. 1 and 2 B. 1 and 3 C. 1, 3, and 4 D. All of the above
D
The single most important factor in the prognosis of soft tissue sarcoma is? A. Size B. Nodal involvement C. Stage D. Grade
D
Treatment for malignant fibrous histiocytoma involves: 1. Radiation therapy 2. Surgery 3. Chemotherapy A. 1 and 2 B. 1 and 3 C. 2 and 3 D. All of the above
D
What are the proper body mechanics require to lift, push, pull or carry something? A. Provide a broad base of support Work at a comfortable height B. Bend your knees and keep back straight while lifting C. Keep load close to your body D. All the above
D
What fraction of the maximum permissible dose of occupational workers is the general public allowed to receive? A. 1/2 B. 1/4 C. 1/3 D. 1/10
D
When determining shielding for a treatment room, which type of radiation need not be accounted for? A. Neutrons B. Primary C. Secondary D. background
D
When the colon is viewed in cross-section, the main layers of the colon include: 1. Mucosa 2. Submucosa 3. Muscularis 4. Serosa A. 1 and 2 B. 1, 2 and 3 C. 3 and 4 D. all of the above
D
When transferring a patient over to the treatment couch you should? 1. Check patient identification 2. Move the patient without notifying them 3. Plan what you are going to do 4. Move the patient by yourself while your partner is at the control console A. 1 and 2 B. 2 and 3 C. 2 and 4 D. 1 and 3
D
Which of the following are common side effects of radiation therapy to the abdomen? 1. Nausea 2. Vomiting 3. Fatigue A. 1 and 2 B. 1 and 3 C. 2 and 3 D. All of the above
D
Which of the following are possible sources of light fielding incongruence? 1. Mirror misalignment 2. Gantry angulation 3. Collimation misalignment A. 1 only B. 2 only C. 1 and 2 only D. 1 and 3 only
D
Which of the following are signs of infiltration? 1. Pale skin 2. Localized pain 3. Evidence of microorganism invasion A. 1 and 2 B. 1 and 3 C. 2 and 3 D. All of the above
D
Which of the following brain tumors most commonly seeds through the CNS? A. astrocytoma B. pituitary C. oligodendroglioma D. medulloblastoma
D
Which of the following clinical situations do not lend themselves to the reproducible placement of localization marks? 1. Mobile skin surfaces 2. Obese patients 3. Irregular or sloping surfaces 4. Areas covered by dressings A. 1 and 2 B. 1 and 3 C. 2, 3, and 4 D. All of the above
D
Which of the following normal tissues is most sensitive to radiation? A. Brain B. Skin C. Small bowel D. Bone marrow
D
Why is indexing of positioning and immobilization devices done? A. Patient comfort B. Prolong the life of the materials C. Contain costs D. Provide additional accuracy in set up
D
In the middle of the treatment, the patient begins to cough. What is NOT an appropriate step to take? A. hit the emergency off button B. beam off and verify alignment C. turn the key off D. tell the patient to hold still and continue the treatment
D *Although why would you hit the emergency off for a cough????*
What is the best resource for directions for cleaning up chemical spills, such as radiographic film processor chemicals? A. RDMS B. AGFA C. NCRP D. MSDS
D Material Safety Data Sheet: a detailed information bulletin prepared by the manufacturer or importer of a chemical that describes the physical and chemical properties, physical and health hazards, routes of exposure, precautions for safe handling and use, emergency and first-aid procedures
The CT number for dense bone is: A. -1000 B. -100 C. 0 D. +1000
D. +1000
The most common Lymphatics involved in the oropharyx is (are): 1. Subdigastric 2. Deep cervical 3. Midjugular 4. Submandibular A. 1 & 2 B. 2 & 3 C. 2 & 4 D. 1 & 3
D. 1 & 3
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
Common diagnostic imaging procedures for a suspicious lesion in women with fibrous breasts include: 1. Mammograms 2. FNA 3. MRI 4. Mastectomy 5. Ultrasound A. 1, 2, & 5 B. 1, 2, & 3 C. 1, 3, & 4 D. 1, 3, & 5
D. 1, 3, & 5
Malfunction of radiation monitoring devices may occur due to: 1. Power failure 2. Humidity 3. Damage to probe 4. Meter failure A. 1 only B. 2 only C. 1 & 3 D. 1, 3, and 4 only
D. 1, 3, and 4 only
For a controlled area, the shielding must be sufficient to reduce exposure to no more than: A. 1 mrem/hr B. 10 mrem/hr C. 1 mrem/week D. 100 mrem/week
D. 100 mrem/week For sufficient shielding, exposure has to be be reduced to 100 mrem/week (.1 rem/week) for a controlled area.
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
Regarding non-stochastic effects: 1. The effects are never on the individual exposed 2. The effects are never on the progeny of the person exposed 3. The probability of occurring is related to the dose 4. The severity of the effect is related to the dose A. 1 only B. 2 only C. 3 only D. 2 & 4 E. All are correct
D. 2 & 4
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
What types of cancers have a high risk of lymph node involvement even with small Tumors? 1. Oral cavity 2. Base of tongue 3. Tonsil 4. Hypopharynx 5. Nasopharynx A. 1, 2, & 4 B. 2, 3, & 4 C. 1, 3, & 5 D. 2, 4, & 5
D. 2, 4, & 5
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 physical field size is defined at the: A. 90% isodose line B. 100% isodose line C. 80% isodose line D. 50% isodose line
D. 50% isodose line
Which of the following is the energy of a photon detected by a Postitron Emission Tomography (PET)? A. 5.11 MV B. 1.022 MV C. 0.511 kV D. 511 kV
D. 511 kV A positron will combine with an at rest electron resulting in annihilation reaction that emits two 511 kV photons.
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
The mathematical correction for the effect of temperature and pressure on ionization is based on a standardized barometric pressure of: A. 273.2 mmHg B. 295.2 mmHg C. 727 mmHg D. 760 mmHg
D. 760 mmHg
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
Which of the following techniques is used to treat early-precancers of the cervix? A. Hysterectomy B. Brachytherapy C. External beam radiation D. A loop electrosurgical excision
D. A loop electrosurgical excision LEEP, A loop electrosurgical excision, is a suitable technique to remove precancerous tissues of the cervix.
A radiotherapy simulator is used to: A. Prepare isodose curves B. Calculate beam divergence C. Calculate block thickness D. Aid in block placement
D. Aid in block placement
Exposure (X) is: 1. Ionization in air 2. Is the amount of charge per unit mass 3. Measured using an ionization chamber A. 1 only B. 1 & 2 C. 2 only D. All choices
D. All choices
The following equipment should be included in the QA program: 1. Simulators 2. Physics instrumentation 3. Treatment planning computers 4. Calibration A. 1, 2, & 3 B. 1 & 2 C. 2 & 4 D. All choices
D. All choices
The slip ring on continuous rotation CT scanners: 1. Prevent the high voltage cable from winding up 2. Allows the exam to commence more rapidly 3. Eliminates the need for reversal of gantry frame rotation A. 1 only B. 2 only C. 3 only D. All choices
D. All choices
The spleen is: A. Close to the 9-11th ribs B. Ends 5 cm from the midline C. Lies in the left hypochondrium posteriorly D. All choices
D. All choices
Which of the following can be used for calibration? A. Ionization B. Photographic C. TLD D. All choices
D. All choices
Which of the following methods can be used for calibration? A. Ionization B. Photographic C. Thermoluminescent dosimetry D. All choices
D. All choices
Alpha particles are; A. Composed of 2 protons and 2 neutrons B. Are equivalent to a helium nuclei C. Have a high linear energy transfer D. All of the above
D. All of the above
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
NCRP recommends the following dose limits; 1. 50 mSv total body annually 2. 150 mSv annually to the lens of the eye 3. 500 mSv annually to the skin 4. 5 rem total body annually A. 1 only B. 2 only C. 2 & 4 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
The wavelengths of X-rays are measured in: A. Millimeters B. Centimeters C. Roentgens D. Angstroms
D. Angstroms
Full recalibration of gamma beam therapy should be done: A. Daily B. Weekly C. Monthly D. Annually
D. Annually
When calibrating ionization chambers, which of the following correction factors is NOT needed? A. Barometric pressure B. Elevation C. Temperature D. Beam energy
D. Beam energy
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
Ionizing radiation can disrupt chemical ____ in biological materials. A. Balance B. Distribution C. Energy D. Bonds
D. Bonds
The total body syndrome seen at doses of 1-10 Gy is known as the: A. Mean lethal dose B. CNS syndrome C. GI syndrome D. Bone marrow syndrome
D. Bone marrow syndrome
Clubbing of the distal phalanges may be a clinical sign of: A. Basal cell carcinoma B. Metastatic melanoma C. Upper extremity lymphedema D. Chronic obstructive pulmonary disease
D. Chronic obstructive pulmonary disease
Which of the following symptoms are NOT indicative of SVC syndrome? A. Thoracic vein distention B. Orthopnea C. Cyanosis D. Clubbing
D. Clubbing
Which of the following radiation interactions with matter occur independently of atomic number? A. Pair production B. Photoelectric effect C. Coherent scattering D. Compton effect
D. Compton effect The incident photon has a higher energy compared to the binding energy of an orbital electron. Thus the photons interact with essentially free electrons.
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
The primary function of area control activities, personnel monitoring, and proper radioactive material disposal is for the: A. Prevention of unnecessary exposure from background radiation B. A determination of the degree of penetration of x-Rays C. A determination of the variation of traditional units used to measure radiation D. Determination of appropriate ALARA procedures and process
D. Determination of appropriate ALARA procedures and process
Regional lymph nodes for carcinoma of the Prostate include all EXCEPT: A. Obturator B. External iliac C. Common iliac D. Epigastric
D. Epigastric
An example of a non stochastic effect from radiation exposure is: A. Cancer B. Genetic abnormalities C. Shortened life span D. Erythema
D. Erythema A non stochastic effect is an early effect. Erythema or skins reddening is an example of early response to radiation exposure.
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
Primary CNS Tumors use the following staging system: A. Ann Arbor Staging B. FIGO C. French American British staging D. Grade staging
D. Grade staging
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
Which isotope is most commonly used in High Dose Rate (HDR) afterloading brachytherapy? A. I-131 B. I-125 C. Cs-137 D. Ir-192
D. Ir-192
The vallecula: A. Is part of the sphenoid sinus B. Is a process of the hyoid bone C. Is part of the vulva D. Is a fossa at the base of the tongue E. None of the above
D. Is a fossa at the base of the tongue
Virchow's node lies in the: A. Ilium B. Mediastinum C. Right S/clav D. Left S/clav
D. Left S/clav
The most common solid tumor in children is: A. Retinoblastoma B. ALL C. Ewings Sarcoma D. Medulloblastoma
D. Medulloblastoma
Which of the following is an example of indirectly ionizing radiation? A. Electrons B. Protons C. Alpha particles D. Neutrons
D. Neutrons Neutrons interact by recoil nuclei and are indirectly ionizing.
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
The interaction in which a positron and negation with an energy of .511 MeV each are formed is called: A. Compton scatter B. Classical scatter C. Photoelectric absorption D. Pair production
D. Pair production
The process of cellular growth and development is called: A. Mitosis B. Meiosis C. Differentiation D. Proliferation
D. Proliferation
The rectum is located in which of the following regions? A. Epigastric B. Inguinal C. Lumbar D. Pubic
D. Pubic
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
Which structures are located in the left upper quadrant? A. Duodenum, splenic flexure, left kidney B. Hepatic flexure, left adrenal, liver, gallbladder C. Spleen, cecum, sigmoid colon, fundus of stomach D. Spleen, left adrenal, fundus, splenic flexure
D. Spleen, left adrenal, fundus, splenic flexure
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
Which of the following is considered an "annual check" by the AAPM? A. Lasers B. Gantry collimator angle indicators C. Light/Radiation coincidence D. Table top sag
D. Table top sag
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
Dose received from terrestrial radiation varies according to: A. Thickness of the atmosphere B. The magnetic distribution of the earth C. The number of diagnostic x-rays received D. The composition of soil or rock in nearby areas
D. The composition of soil or rock in nearby areas Dose received from terrestrial radiation comes from radioactive elements in the soil or rock of the earth. Some geographic regions have higher concentrations of radioactive elements in the earth.
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
The lymphatic vessel that returns lymph to the left subclavian vein is the: A. Right lymphatic duct B. Cisterna chyli C. Left cistern D. Thoracic duct
D. Thoracic duct
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
A triangular shaped surface landmark often used in radiation therapy that partially covers the External Auditory Meatus (EAM) is known as the: A. Helix B. Glabella C. Canthus D. Tragus
D. Tragus
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 energy of an electromagnetic radiation is inversely proportional to its: A. Frequency B. Mass C. Speed D. Wavelength
D. Wavelength
Half life of iridium 192 is 74 days. The decay constant is
Decay constant is ln2/half life
Reproductive Failure
Decrease in Reproductive Integrity or Limits To Number of Potential Divisions Following Irradiation
Anemia
Decrease in the Number of Circulating Red Blood Cells
Mechanism of Flattening Filter for Treatment Using a 4 MV Beam
Decreased Dose Away From the Central Axis
Rationale for Treating Obese Female Patients Undergoing Pelvic Irradiation in the Prone Position
Decreased Dose to the Patient's Bladder
Impact of Treating Less Cross-Sectional Area
Decreased Exposure Rate On the Patient's Skin Surface
Consequence of Mitotic Delay
Decreased M1 Phase Population, Resulting in Fewer Daughter Cells Produced
Consequence of Diminished Pituitary Function
Decreased Sex Hormone Production Decreased Cortisone Production Decreased Thyroxin Production
An embryo-fetus's sensitivity to radiation does which of the following? Does not change over time Increases over time Decreases over time
Decreases over time
A satisfactory lumbar spine radiograph is performed using 20 mAs at 83 kVp. If a cone down view of L3 is done using the same technique, the image density _______ and contrast will _______.
Decreases/increase
The highly evacuated section of a cyclotron in which the particles are accelerated is called the: Dee Stripper Waveguide Injection chamber
Dee
Biologic Mechanism Responsible for Gastrointestinal Syndrome
Depopulation of Crypt Cells, and Subsequent Denudation of the Villi Decreased Absorption Leakage of Fluid Into the Lumen Dehydration Bacteria Can Access Circulating Blood, Leading to Overwhelming Infection Bone Marrow Demonstrates Severely Decreased Amount of Circulating Leukocytes Electrolyte Imbalance
Factors Influencing TAR at Depth of Dmax
Depth Size Of Field Less Significant
The principle difference between a free air ionization chamber and a thimble chamber is: Design of the chamber Range of energies detected Number of channels for analysis Number of pentrometer steps
Design of the chamber
Use of Scatter - Air Ratio
Determination of Amount of Scatter Produced by Irregular Fields
Cancer care allows healthcare workers to
Determine the nature of the problem, Select an intervention for the problem, & Evaluate the effectiveness of the intervention
Effects for which the severity of the effect in the individual varies with the radiation dose, and a threshold usually exist is called: Stochastic Deterministic Acute Protracted
Deterministic
Type of Effect for Which There Is a Threshold Dose
Deterministic Effects
Stage IV Hodgkin's Disease
Diffuse Involvement of 1 or More Extralymphatic Organs or Extralymphatic Disease and Distant Metastatic Spread
Most Common Mechanism of Spreading Infection Within the Hospital
Direct Contact
Relationship Between Isodose Depth and Beam Quality
Directly Proportional
Relationship Between LET and RBE
Directly Proportional
Stage III Hodgkin's Disease
Disease Exists On Both Sides of the Diaphragm May Include Extralymphatic Extension or Involvement of the Spleen
Stage II Hodgkin's Disease
Disease Within More Than 1 Lymph Node Region on the Same Side of the Diaphragm or Disease Within an Extralymphatic Site With Lymphatic Involvement, With Entire Scope of Disease Limited to One Side of the Diaphragm
Stage I Hodgkin's Disease
Disease Within a Single Lymph Node Region or a Single Extralymphatic Site without Lymph Node Involvement
Consequences of Misaligned Photon Beam
Displaced Focal Spot Asymmetric Collimator Jaws Improper Rotational Axis of Collimator
Autonomy
Disregard for Normal Limitations of Growth Exhibited By Cancer Cells
Medium Used to Calibrate Electron Beams
Distilled Water
Dmax Equation
Dmax = (DD / PDD)(100)
Shoulder Of Survival Curve
Dose Below Which Cells Generally Are Not Accumulating Enough Damage To Be Killed
Relative Biologic Effectiveness Equation
Dose From 250 keV x-ray / Dose From Test Radiation Needed to Produce the Same Biologic Effect
The Seivert (Sv) is the standard international (SI) unit used for the determination of: Radiation intensity Radiation activity Radiation Dose equivalent
Dose equivalent
An increase in the field size will increase the: Electron emission from the collimator Electron emission from the air Dose in the build up region Skin sparing effect
Dose in the build up region
The most desirable feature of a wedge pair technique is ___________ beyond the ovelap region. Rapid dose build up Rapid dose fall off Dose uniformity Unequal dose distribution
Dose uniformity
Organ's response to radiation is a function of:
Dose(rate and number of fractions) volume irradiated Time of observation after irradiation The most sensitive cell in the organ
Factors Most Likely to Interfere With Accuracy of Pap Tests
Douches Vaginal Infections
What chemo agents are used for osteosarcoma? Doxrubicin or Adriamycin, methotrexate, leucovorin and cisplatin
Doxrubicin Adriamycin, methotrexate, leucovorin cisplatin
The cooling system that uses city water or a chiller to cool secondary components of the linear accelerator is located in the: Drive stand Gantry Modulator cabinet Control console
Drive stand
Characteristics of pain
Duration: 1) Acute: pain generally is a sudden onset with an identifiable cause lasting 3 to 6 months and responds to treatment. 2) Chronic: the persistence of pain for more than 3 months with a less well defined onset
Difficulty Swallowing
Dysphagia
Abnormal Cell growth
Dysplasia
The hard palate is formed by which bones? A. Maxilla B. Malor C. Palatine D. Sphenoid E. A & C F. A, B, & C G. A, C, & D
E. A & C
Daily or weekly safety checks should be performed for: A. Door interlocks B. Monitor system C. Protective barrier D. Laser lights E. A only F. A & B G. A, B, and D H. B, C, and D
E. A only
The construction of the respiratory system structure functions to include all of the following EXCEPT: A. Protects respiratory surfaces from environmental debris and temperature changes by filtering inhaled air B. Defends the respiratory system and other tissues from pathogenic invasion by trapping and or engulfing debris C. Provides an extensive area for gas exchange D. Helps to adjust blood pH and blood volume E. Always prevents choking from accidental aspiration of chewed food
E. Always prevents choking from accidental aspiration of chewed food
Jaundice is caused by: A. A decrease in bile formation B. Biliary tree obstruction C. Excessive production of bile D. A & B E. B & C
E. B & C
Initial AP/PA fields for lung ca may require an anterior wedge to facilitate:
Easier alignment of off-cord obliques
A pt with a middle lobe posterior lung tumor may be positioned prone to facilitate:
Easier alignment of off-cord obliques & boost fields directed posteriorly
The octet rule states that the most chemically stable atoms have an outer shell configuration with: Two electrons Four electrons Seven electrons Eight electrons
Eight electrons
The structure that provides the source of electrons injected into the accelerator tube in a linear accelerator is called the: Circulator Electron gun Bending magnet Beam transport system
Electron gun
he linear accelerator produces ___________ for treatment purposes: Neutrons and protons Neutrons and electrons Electrons and photons X-rays and neutrons
Electrons and photons
Characteristic radiation emission occurs when: Electrons move from lower to higher orbital shells within the atom Electrons move from higher to lower orbital shells within the atom The atom has an unstable nucleus The atom has undergone nuclear fission
Electrons move from higher to lower orbital shells within the atom
The hierarchal arrangement of the stages of grief were 1st identified by:
Elisabeth Kubler Ross
Perameters needed in block construction
Energy Source to Tray Source to Film NOT SSD
Most Common Cause of Mechanical Bladder Obstruction
Enlarged Prostate Gland
Patient being treated POP (AP/PA). The dose at the maximum point on the Anterior field is defined by
Entrance Dose at dmax for ap field and Exit dose at dmax for PA field.
During an acute reaction to iodinated contrast media, the medication that is most commonly given to treat hypotension, laryngeal edema or bronchus spasm is:
Epinephrine (Adrenaline)
When using shielding blocks for a particular treatment, which of the following is affected: Equivalent square SSD STD SAD
Equivalent square
Red velvet patches in the mouth
Erythroplasia
Least Radiosensitive Structure In the Gastrointestinal System
Esophagus
Critical Organ Dose
Estimated dose delivered to principal organ of interest
Etiology example:
Etiology is the REASON of a disease & pathogenesis of how signs or symptoms DEVELOPS
The purpose of a flattening filter in the linac is to:
Evenly distribute the energy of the photon beam across a specified area.
Cutterage
Exfoliation
Which of the following are used to measure isodose charts: A. Radiographic films B. Ion chambers C. Solid state detectors D. A only E. B & C F. All choices
F. All choices
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
The principal difference from modified radical and radical mastectomy is the extent of the ____ removal. A. Breast B. Tumor C. Lymph node D. Muscle E. A & B F. C & D G. All choices
F. C & D
Factors Geometric Divergence is Dependant Upon
Field Diameter Treatment Angle
The maximum difference from the dose on the central axis over 80% of the field dimension best defines: Isocenter axis Field size limits Penumbra Field flatness
Field flatness
Even when proper warm-up procedures are followed, the life of an x-ray tube is limited. A possible cause for this is:
Filament Burnout
Which personnel monitoring device is most sensitive to heat
Film Badge
Mechanism of Liver Metastases
Filtration of Hematogenous Tumor Cells
The highest electron binding energy of an atom is found in the: First energy orbital shell Second energy orbital shell Third energy orbital shell Outer orbital shell
First energy orbital shell
The process by which electrons build up on objects which are rubbed together is termed:
Friction
Diagnostic Test Used for Bladder Carcinomas
Fulguration
In setting up patients for treatment, the correct collimator angle should line up with: A. Portal markings on patients skin B. Anatomical landmarks C. Tattoo marks D. A only E. B only F. C only G. All choices
G. All choices
The death of immature cells in the epithelial lining will result in death from which of the following. CNS syndrome Cerebrovascular syndrome Bone marrow syndrome G.I syndrome
G.I syndrome
Site Most Likely to Metastasize To the Liver vs. Other Sites
Gastrointestinal
Systems That Originate As the Endoderm
Gastrointestinal System Genitourinary System Respiratory System
Tuberous Sclerosis definition
Genetic disorder that causes non-malignant tumors to form in many different organs, primarily in the brain in the form of hard tube shaped
What is immunotherapy?
Goal is to amplify the body's own disease fighting system to destroy the cancer
Effect Of Beam Energy On Penumbra
Higher Energy Results in Wider Penumbra
Effect of Quality Factor On Relative Biologic Effectiveness
Higher Quality Factor Results in Greater RBE
An increase in cori cycle activity is often associated with the development of _____.
Host energy deficit
An area outside of the target area which receives a higher dose than the specified target dose is termed a: Thermal spot Threshold spot Cold spot Hot spot
Hot spot
Comparisons of humans and animals have shown which of the following? Humans are most resistant to high doses of radiation Humans are more radiosensitive than many animals There is no difference between humans and animals when it comes to radiation exposure
Humans are more radiosensitive than many animals
Cancer of the _________ has the highest rate of nodal metastasis of all H&N cancers
Hypopharynx
The postcricoid and pyriform sinus are located in the
Hypopharynx
During a radiation therapy treatment whenever possible, the patient should be placed: In a supine position In a prone position In the left posterior oblique position In the semi-fowler position
In a supine position
Location of the Pancreatic Head
In the C Loop of the Duodenum
The penetrating power of an x-ray can be increased
Increasing the tube filtration
The majority of radiation damage occurring in a patient during a radiographic imaging procedure is most closely related to exposures resulting from a/an:
Indirect Effect
The principal lymph node group involved in patients with rectal cancer is the
Internal Iliac
Primary Lymphatic Drainage of the Colon
Internal and Presacral Mesenteric Lymph Nodes
Complication That May Occur at Doses of 2000 cGy or More to the Stomach or Small Intestine
Intestinal Hemorrhage
Which of the following parenteral administrations will most likely require the use of an 18 gauge needle?
Intravenous
Legal Violation for Intentionally Failing to Cover a Patient
Invasion of Privacy
he Mayneord F-factor that compensates for changes in central axis depth dose includes corrections for: Penumbra Field size Tissue absorption Inverse square law
Inverse square law
The intensity of a high energy photon beam at any given distance from the source is: Directly proportional to the distance Inversely proportional to the square of the distance Directly proportional to the square of the distance Inversely proportional to the distance
Inversely proportional to the square of the distance
Bone Remodeling Cycle
Involves Resorption and Formation of Bone Mass
The most popular isotope used in the treatment of uterine cervix carcinoma is ____.
Iodine 125
Device Used to Measure Dose Rate Consistency
Ion Chamber
Machine dose rate constancy is most commonly checked using (a)n ____.
Ion chamber
An atom that loses an orbital electron from the electrical influence of the nucleus has undergone: Radioactive decay Subjugation Ionization Covalent bonding
Ionization
The radiation detection device that is most commonly employed to determine the amount of scatter produced in a room or area during the irradiation of a patient is a/an: Ionization type survey meter Pocket dosimeter TLD Scintillation counter
Ionization type survey meter
The radiation detection device that is most commonly employed to determine the amount of scatter produced in a room or area during the irradiation of a patient is:
Ionization-type survey equipment
Interphase Death
Irradiation of the inCell During the G1, S, or G2 Phase That Results In Cell Death, Prior to Their Undergoing Mitosis
Scatter air ratio is most often used for the scatter dose produced in _____ fields.
Irregular
Appearance of Mucosa Immediately Following the Completion of Treatment for Laryngeal Cancer
Irregular Mucosal Slough
The representation or volumetric or planar variations in absorbed dose at different levels are depicted by means of: Depth dose maximums Mayneord F-factor Off axis points Isodose curves
Isodose curves
Two or more chemicals with the same chemical formula, but having different chemical properties, are termed: Isomers Isotopes Isobars Isotones
Isomers
Which of the following concerning CLL is NOT true?
It is a disease of children -It resembles CML, but with a malignant lymphoid cell line -It can be confused with lymphoma -Therapy is usually reserved until the patient is symptomatic
In a linear or non-linear threshold dose response relationship, which of the following is true of the biologic response to radiation. It will occur at all doses It may not occur at low doses It will never occur It is estimated to be proportional to the dose
It may not occur at low doses
attenuation equation
Ix=Ioe^-(ux) x=absorber thickness u=linear attenuation coefficient
Symptoms of pancreatic cancer
Jaundice Anorexia Weight Loss
JRCERT
Joint Review Committee on Education in Radiologic Technology is responsible for the development and review of educational standards in radiologic sciences.
This nodal group recieves nearly all the lymph from the head and neck
Jugulodigastric
Organ at Greatest Risk for Complication Using 4500 cGy to Treat the Whole Abdomen
Kidney
Effect of Field Size On Penumbra
Larger Field Size Results in Wider Penumbra
Region of Internal Mammary Lymph Nodes
Lateral Border of the Sternum
Acceptance Criteria For Amount Of the Beam Transmitted Through the Beam Interceptor
Less Than 0.5% 1 m From The Housing
Survival for Persons With Cerebrovascular Syndrome
Less Than 3 days
Complication Most Likely to Result From Exposure to 1.4 Sv (140 rem) Over a Year
Leukemia
Malignancy with shortest latent period is
Leukemia
Prolonged exposure to low levels of radiation to normal adults have been implicated in the delayed development of:
Leukemia
As a group, white blood cells are known as which of the following. Erythrocytes Hematopoitics Platelets Leukocytes
Leukocytes
First noticeable reaction to sublethal dose of TBI
Leukopenia
What is the reduction in White blood cells called?
Leukopenia
White patches in the mouth
Leukoplakia
Neoplasms, including those in connective tissues, seen in adult tissues are affected by metabolic stimulation from which of the following?
Long standing Paget's disease
Region Esophageal Adenocarcinomas Are Most Likely to Develop
Lower Thoracic Esophagus
Greatest incidence of CNS mets originates from
Lung
Most common site of mets from bone cancer
Lung
The most common site for STS
Lung
The most common site of distant mets from H&N cancer is the
Lungs
Equation for Determining Dose for High Energy Electron Beams
MU = Prescribed Dose / (cGy / MU)(Area Factor)(% Depth Dose)
Type of Treatment For Which Dose Must Be Verified By an Ion Chamber
MV
Tool Used to Measure Jaw Symmetry
Machinist's Dial Indicator
What types of tumors effects both bone and connective tissue?
Malignant fibrous histiosarcoma Ewing's sarcoma
Ionization chambers if not sealed require their readings to be corrected for the temperature and pressure because: Walls of the chamber expand and shrink with temperature The collecting electrodes electrical conductivity changes The volume of the air changes Mass of the air in the chamber changes
Mass of the air in the chamber changes
The most commonly involved site for malignancy of the sinuses would be:
Maxillary
Mean Life Equation
Mean Life = Half Life x 1.44
Exposure is: Measure of ionization in air Known as a biological dose equivalent The absorbed dose multiplied by the quality factor The possibility of a radiation interaction
Measure of ionization in air
Purpose of Cerebral Spinal Fluid in Ventricles of the Brain
Mechanical and Immunological Protection of the Brain
To determine if the ODI is accurate, the reading should be compare to a ______.
Mechanical distance indicator
Which of the following equipment is considered a part of the high-flow oxygen system?
Mechanical ventilator
Location Of the Ovaries
Medial To the Ureter
When a pin hole or resolution phantom test is performed for focal spot size measurements, the hole of the phantom should be located:
Midway between the source and image receptor
Most Common Cause of Light Field Incongruence In a High Energy Linear Accelerator
Misaligned Collimator Mirror
Substances Used to Deliver Immunotherapy
Monoclonal Antibodies
Types of White Blood Cells
Monocytes, Neutrophils, Eosinophils
The evaluation for light radiation field congruence, accuracy of field size indicators and cross hair centering for a linear accelerator needs to be performed at least once per: Week Month Year Decade
Month
Purpose of Scattering Foil
More Homogeneous Dose Distribution When Treating Curved Surfaces Being Treated Using Electrons
Energy At Which Incoherent or Compton Scatter Occurs
Most Radiation Treatment Energies
True statements involving Hodgkins disease (2)
Most commonly starts in the lymph nodes, Mesenterin nodal involvement is common in Stage III
Is the soft palate part of the oral cavity?
NO
Therapeutic Ratio Equation
NTTD / TLD
The therapeutic ratio equation:
NTTD/TLD
Epsteinn-Barr virus is linked to what kind of cancer
Nasopharynx
Tumors of the _____________ may involve major cranial nerves
Nasopharynx
Procedure Most Likely to Employ Negative Shielding
Nasopharynx Treatment
Symptoms of Prodromal Stage of Hematopoietic Syndrome
Nausea Vomiting
Symptoms of Prodromal Stage of Gastrointestinal Syndrome
Nausea Vomiting Diarrhea Cramping
Symptoms of Manifest Illness for Gastrointestinal Syndrome
Nausea Vomiting Diarrhea Fever
Side effects of cytotoxic drugs
Nausea, Cardiac Toxicity, Myelosuppression, Alopecia
End Points for Tolerance of the Brainstem
Necrosis Infarction
Abdominal Disease Not Treated Using Whole Abdomen Fields
Nephroblastomas
Symptoms of Prodromal Stage of Cerebrovascular Syndrome
Nervousness Confusion Nausea Vomiting Loss of Consciousness Burning Sensation of the Skin
Chemo for brain tumors
Nitrosoureas (Carmustine, Procarbazine, Nincrisine, Lomostine, Temodar) and Alkylating Agents
The linear accelerators that are in use today are know as the: First generation Second generation Third generation None of the above
None of the above
Relationship Between Oxygen Enhancement Ratio and Relative Biologic Effectiveness
Not As Straightforward, But Directly Proportional Under Ideally Oxygenated Conditions
Lymph Nodes Included in Treament Fields for Prostate Cancer Treatment
Obturator Lymph Nodes Common Iliac Lymph Nodes
An important advantage of image intensified fluoroscopy, as compared to conventional fluoroscopy, is a substantial reduction in exposure to the:
Operator of the equipment, and patient undergoing the procedure
Most Commonly Diagnosed Head and Neck Cancer
Oral Cavity
Plummer-Vinson syndrome (iron deficiency anemia), often seen in females, is considered an important etiological factor in _________ cancer.
Oral Cavity
The tonsils are the most common site of disease for the
Oropharynx
What types of bone cancer is radiation linked to?
Osteosarcoma, chondrosarcoma fibrosarcoma
Ear Pain
Otalgia
Diseases Treated With Whole Abdomen Fields
Ovarian Cancer Bulky Seminomas Wilm's Tumors
The tolerance of normal tissues is related to the:
Overall volume irradiated Radiosensitivity of the organ under treatment Stage of the cancer treated
A lateral pelvis is to be treated with a wedged pair using 30 degree wedges. The therapist realized after one treatment that a 15 degree wedge was used instead of the 30 degree. The tumor for that treatment was: Overdosed Underdosed Remained the same Not enough information in the question to give an accurate answer Cannot be corrected
Overdosed
Percent Depth Dose Equation
PDD = Absorbed Dose at Depth / Absorbed Dose at Dmax x 100%
Which of the following are interactions between an incident photon and an atomic nucleus? Photoelectric Compton Coherent Pair Production
Pair Production
Symptoms of Manifest Illness of Hematopoietic Syndrome
Pancytopenia Anemia Hemorrhage Serious Infection
The following can be presenting factors for STS when the tumor impinges on nerve and vasculature supply (3) Paralysis, Neuralgia ,Ischemia
Paralysis ,Neuralgia ,Ischemia
Sigmoid Threshold
Partial recovery from lower doses, decreased response at lower doses, certainty effect
Effect of Shock on Blood Pressure
Patient is Hypotensive
Where do you typically see fibrosarcoma?
Pelvis and Jaw are most common, also seen in the distal femur, proximal tibia, proximal humerus
Which of the following does not relate to beam QUALITY? Penumbra kVp Central axis depth dose energy of the machine
Penumbra
Difference Between Tissue Air Ratio and Percent Depth Dose
Percent Depth Dose is Dependant on the SSD and Tissue Air Ratio Is Not
Adenocarcinoma is most often found in the ____________ of the lung
Periphery
List photon interactions
Photodiintegration Coherent Scattering Photoelectric Effect (Rayliegh) Compton Pair Production
Pair Production
Photon Approaches Nucleus, Is Absorbed and Then Emitted As An Electron-Positron Pair Which Is Ejected By the Atom
Energy At Which Photoelectric Effect Occurs
Photon Energies At Or Below 1 MeV
Photodisintegration
Photon Is Absorbed After Striking the Nucleus Directly, Which Then Emits Neutrons and Gamma Rays to Maintain Stability
Thomson or Coherent Scatter
Photon Is Absorbed and Photon of Same Energy Is Emitted In a Different Direction
Energy At Which Photodisintegration Occurs
Photon or Electron Beam Energies At or Greater Than 10 MeV
Factor Dmax is Most Dependant On
Physical Tissue Density
Tumors of which of the following endocrine glands are treated using arc radiation therapy
Pituitary
Gland with greatest single affect on bone development and growth is
Pituitary Gland
A contrast media that absorbs more radiation than thee organ in which it is placed, is termed a:
Positive Agent
A neutral atom that loses an electron by ionization is termed a: Negative atom Positive atom Negative ion Positive ion
Positive ion
Structures That Are Always Included in Nasopharynx Fields
Posterior 1/3 of the Orbits Retropharyngeal Lymph Nodes
Most Common Location For Vaginal Cancers
Posterior Upper 1/3 of the Vagina
The categories of visitors who are excluded from visiting a radiation iodine patient are: Families who have reproductive potential and children of any age Elderly females and children under 13 years of age No categories are excluded because radiation safety precautions are in effect Pregnant women and children under 18 years of age
Pregnant women and children under 18 years of age
During the calibration of a high energy photon beam, an increase in the field size will increase the exposure rate. The principle reason for this is an increased amount of scatter radiation that occurs from the: Flattening filter Primary collimator Scattering foil Shadow tray
Primary collimator
Factor Dependant on Dose for Stochastic Effects
Probability of Reaction Occuring
Malignant Transformation
Process By Which Normal Cells Acquire the Properties of Cancer
End Points for Tolerance of the Rectum
Proctitis Necrosis Fistula Stenosis
Daily safety checks should be performed on a linear accelerator for all of the following EXCEPT: Protective barriers Audiovisual monitoring systems Door interlocks Laser locations
Protective barriers
Condition Which Occurs as the Result of Renal Disease
Proteinuria
Liver Secretions Active in Blood Coagulation
Prothrombin Fibrinogen
High LET energies
Protons, alpha particles
Squamous cell ca is most often found in the _________ of the lung.
Proximal (involves the hilum)
More Radiosensitive Muscle
Pterygoid Muscle
The terminal position of the normal human stomach is the ___.
Pylorus
The radiation unit derived when a RAD is multiplied by the quality factor results in the unit of dose equivalency termed the: Roentgen RAD (Gray) REM (Sievert) REP (Calorie)
REM (Sievert)
Direct Hit Effect
Radiation Damage to the DNA of the Irradiated Cells
Oxygen Enhancement Ratio Equation
Radiation Dose Under Hypoxic or Anoxic Conditions / Radiation Dose Under Oxic Conditions to Produce the Same Effect
Complication Suggested By Dry Cough and Shortness of Breath When Treating Thymomas
Radiation Pneumonitis
Early Response to Irradiation of the Lung
Radiation Pneumonitis
Therapies Associated With the Complication of Pneumonitis
Radiation Therapy Cyclophosphamide Doxorubicin
Treatment for malignant fibrous histocytoma involves (3)
Radiation Therapy, Surgery, Chemotherapy
During a radiotherapy for Prostate cancer, Tenesmus and mucosis diarrhea are associated with _____.
Radiation proctitis
Treatment for MFH
Radiation, Surgery, Chemo
What is currently not a standard procedure to treat breast cancer
Radical Mastectomy (Tylectomy, Modified Radical, Lumpectomy all are)
Indirect Hit Effect
Radiolysis of Water Ultimately Responsible for Transferring Energy from Ionizing Radiation From Irradiated Molecules to Non-Irradiated Molecules
Whole abdominal radiation is effective for ____.
Radiosensitive tumors
Five Rs of Radiobiology
Radiosensitivity Repair Reoxygenation Redistribution Repopulation
One of the more common characteristics associated with radiation-induced malignancy resulting from damage to a DNA molecule is a(an):
Rapid proliferation of the effected cells
What are some facts about Ewing's Sarcoma?
Rarely seen in African Americans and Chinese. Second most common childhood bone tumor. Makes up 3% of all cancer in children. More predominant in males and taller individuals
Dose
Represented By Do or D37 Reduces Surviving Fraction Of Cells to 37% Reciprocal Of the Slope of the Linear Part of the Curve Measure Of Cell's Radiosensitivity Proportional to Radioresistance Usually Between 100 - 220 cGy For Mammal Cells
Quasithreshold Dose
Represented By Dq Dose At Which Survival Becomes Exponential Width Of the Shoulder On the Survival Curve Dose At Surviving Fraction of 1 Measure Of a Cell's Ability to Accumulate and Repair Sublethal Damage
Extrapolation Number
Represented By n Intersection Of Linear Part of Curve Extrapolated to the Y-Axis Suggests Number Of Targets That Must Be Hit To Kill Cell Range From 2 - 10 For Mammal Cells
Primary Lymphatic Drainage of the Paranasal Sinuses and Nasal Pharynx
Retropharyngeal Lymph Nodes
Oblique Field Used to Treat Patients Who Have Had a Right Pneumonectomy
Right
The radiation unit best suited for measuring the output of an X-ray tube below 3 MeV is the Roentgen RAD REM Gray
Roentgen
The amount of radiation exposure or intensity of x-rays or gamma rays is usually measured by a radiation unit called the:
Roentgen or Coulomb per kilogram
The concept known as air kerma is employed to equate the quantity of radiation traditionally measured by the: REM, and expressed in the units of the Roentgen Becquerel, and expressed in the units of a Curie Roentgen, and expressed in the units of the Gray Rad, and expressed in the units of the Coulomb
Roentgen, and expressed in the units of the Gray
Factors Which Influence the Shape of Isodose Curves
SAD SSD Wedge Angle
Bodily Fluids Composed Predominantly Of Water and Methylcellulose
Saliva Tears Aqueous Humor
Bloodstream is the most likely route for which cancer type
Sarcomas
Put the following in order from how it exits the linac from 1st to last: A. Xray collimator B. Scattering foil C. Ion chamber
Scattering foil, ion chamber, x-ray collimator
Examples of Stochastic Effects of Radiation
Secondary Malignancy, Genetic Aberrations
Where are secondary bone tumors typically located vs primary bone tumors?
Secondary typically diaphyseal vs primary which are typically metaphyseal
Common Characteristics of Neoplastic Processes
Self-propagation Autonomy Anaplasia
Linear Part of Survival Curve
Semilogarithmic Representation Indicating Equal Increases in Dose Result in Equal Decreases in Surviving Fraction Of Cells, With Actual Number Of Cells Varying
Parameters for Imaging Port Films
Single Emulsion Film Lead Cassettes
Factors Which Impact the Effect of Homogeneities
Size of Inhomogeneity Type of Radiation Delivered Energy of Radiation Delivered
Treatment Most Likely to Result in Decreased Number of White Blood Cells
Skeletal Disease
Potential Complications Of Irradiation During Adolescence
Slipped Femoral Capital Epiphysis Maturation Abnormalities of the Bone and Soft Tissue
Phenomenon Associated With Positron Created During Pair Production
Slows Down and Creates Annihilation Reaction, Destroying Both Positron and Electron and Leaving Two Photons Emitted Opposite Each Other Out of Their Energy
The two most common etiological factors contributing to head and neck
Smoking and alcohol
Clinical detection by cancer site: Larynx
Sore throat Hoarseness Stridor
Rationale for Chin Extension Treating Mantle Fields
Spares Oral Mucosa, Particularly Posterior Field Exit Dose
What is the most sensitive organ to whole organ irradiation?
Spinal cord
Type of Cancer Diagnosed Most Often in the Vagina
Squamous Cell Carcinoma
Most Common Form of Esophageal Cancer and Percentage of Diagnoses This Accounts For
Squamous Cell Carcinoma 90%
This muscle divides the neck into anterior and posterior portions
Sternoclomastoid
Type of Effect for Which There Is No Safe Threshold Dose
Stochastic Effects
Inflammation of the mouth is called
Stomatitis
A high capacity magnetic or optical disk is becoming an essential component of the _______ for digital radiographic or digital fluoroscopic imaging systems.
Storage System
Block Used for the Longest Source to Surface Distance
Straight Block
Wheezing, raspy cough or breath
Stridor
The fundamental force responsible for holding the nucleus together is called the: Strong force Electromagnetic force Weak force Gravitational force
Strong force
The usual wedge pair technique often used in treatment of the parotid gland is:
Superior/Inferior oblique combo
Patient Position for Treating Mantle Fields
Supine Arms Akimbo Chin Fully Extended
Treatment for Multiple Myeloma
Surgery and Chemo
How is osteosarcoma treated?
Surgery and chemotherapy have the greatest role. Radio-resistant, so radiation is only used for palliative
Means of Localizing Pancreatic Cancers
Surgical Clips
After a massive exposure to over 5000 rad (50 gray), death to the exposed individual will normally occur in a few hours due to:
Swelling of the brain and spinal cord
The normal location of the kidneys is the posterior abdominal wall between:
T12-L2
Which one does not belong-Methotrexate, 5-Flouracil, Purinethol, Tamoxifen
Tamoxifen-hormonal agent. All others are cytotoxic
The total amount of backscatter that occurs in a treatment field is dependent on
Target Depth Size of field Quality of Beam NOT Block Orientation
Treatment Volume
Target Volume and Margin for Limitations of Setup Technique
The answer to #100 is: D. Jugulodigastric node
The answer to #100 is: D. Jugulodigastric node
The answer to #162 is: B. External iliac
The answer to #162 is: B. External iliac
The answer to #164 is: A. Internal iliac
The answer to #164 is: A. Internal iliac
The answer to #166 is: D. Para aortic nodes
The answer to #166 is: D. Para aortic nodes
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 field light on a linac is intended to represent:
The area of radiation exposure.
Where are the 2 most common locations for bone cancers? T
The distal femur proximal tibia because of growth plates and rapidly proliferating cells in those areas
What can happen to individuals who survive acute radiation syndrome? The effects of radiation exposure can result in cancer The effects of radiation exposure can result in genetic damage The effects of radiation exposure can result in both cancers and genetic damage None of the above will occur
The effects of radiation exposure can result in both cancers and genetic damage
The organ most at risk when treating the maxillary antrum is the:
The eye
Epidemiology
The study of disease incidence (defining the distribution and determinants causing disease and injury in human populations). Patterns of cancer occurrence and death rates, factors: age, race, gender, location
Which of the following detection devices can be used to determine the exposure received during a particular radiation treatment? Film badge monitor Pulse and blood oximeter Thermoluminesent dosimeter Pocket dosimeter
Thermoluminesent dosimeter
A radiation oncologist wants to decrease the dose that a patient receives per fraction but does not want to change the total number of fractions. The physician wants to change from 200 cGy per fraction of 25 fractions to 180 cGy per fraction from the same number of fractions. After the change in administered dose is found, what type of proportionality is evident in relating dose per fraction and total dose? A. Direct B. Indirect C. Both A and B D. Neither A nor B
This should be Direct, it's a bad question If you have 200 cGy in 2 fractions (TD: 400 cGy) and decrease to 100 cGy in 2 fractions your total dose changes to 200 instead of 400...so are they not directly related? (answer isn't A)
A monitoring device that is worn on the outside of the lead apron at the level of the collar is primarily intended to measure the dose to the: Auditory ossicles Pituitary gland Thyroid gland Eyes
Thyroid gland
The primary reason patients are tatood
To indicate the location of previous treatment fields
Continuing education
To stay current with constantly changing technology and to broaden the perspective of the radiation therapist. Can be obtained by attending conferences offered by ASRT, MSRT, and TCRT; in services and directed readings
Presence of Disease Within the Patient's Cervical Lymph Nodes Demands Inclusion of Which Structure Within the Treatment Volume
Tonsils
When treating the oropharynx with IMRT, most structures can be avoided except for the
Tonsils
Cancers of the head and neck linked to HPV
Tonsils ,Floor of Mouth, Tongue
Drugs for antiemetics(nausea)
Torecan, norazine, compazine
Protraction Rate
Total Extent of Time Over Which The Dose Is To Be Delivered
Integral dose (volume dose)
Total energy imparted to an irradiated area by ionizing radiation (ergs/gram).
Which of the following is not an accelerator component? Waveguide Transducer Circulator Thyratron
Transducer
After the electrons leave the accelerator guide (structure), they are directed towards the target or scattering foil located in the: Drive stand Waveguide Cooling system Treatment head
Treatment head
The tumor, presumed tumor volume and a margin of normal tisuue that is enclosed by the minimum target dose (50% isodose line) is called the: Maximum target volume Mean target volume Treatment volume Error in the treatment volume
Treatment volume
Bladder/Rectal doses are more important to gyn planning than kidney or ovary doses (true or false)
True
Skin Care Recommendations
Use Mild Soap Only Continue Using Appropriate Topical Steroid Creams
Autoradiography
Used to Evaluate the Distribution, Uniformity, and Symmetry of Brachytherapy Sources
Rationale for Using Wedges to Treat Laryngeal Cancers
Used to Modify Isodose Distribution, and Not to Decrease the Number of Hot Spots
Conformal Radiation Treatment
Using 3D Planning to Deliver Radiation to the Exact Target Volume In Any Plane
The electronic signal that carries the information generated in the television camera to the TV monitor is termed a/an:
Video Signal
Clarkson is a method of dose calculation using which of the following. Volume Isocenter Horizontal axis Electron density
Volume
Symptoms of Manifest Illness for Cerebrovascular Syndome
Watery Diarrhea Convulsions Coma
During a course of radiation therapy for basal cell carcinoma of the medial canthus, an obstructed nasolacrimal duct may result in _____.
Watery eyes
All of the following are located in the treatment head of the linear accelerator EXCEPT: Beam flattening filter Bending magnets Secondary collimators Waveguide
Waveguide
The microwave power generated by the klystron is directed into the circulator and out to the: Bending magnet Waveguide Cooling system Electron cone
Waveguide
Limitations of Ultrasound
Waves Reflected By Air, Limiting Use With Structures That Contain or Are Surrounded By Air
Factors That Must Be Included When Labeling Wedges
Wedge Angle Name of Treatment Unit Maximum Field Size
Hinge Angle Equation
Wedge Angle = (180 - Hinge Angle) / 2
Which of the following are used to change the shape of the dose distribution (isodose lines) within the treatment volume. Shielding blocks Sandbags Headrest Wedges
Wedges
The RT chart Component consists of
Weekly assessment checks, side effects, vitals, and weight
Which of the following is not a B symptom
Weight Loss Night Sweats Fever NOT Diarrhea
Main symptoms of partial respiratory obstruction are
Wheezing Rales NOT Tachypnea
Contraindication for Continuing Hodgkin's Disease Treatment
White Blood Cell Count Under 2000
Treatment Used for Generalized Abdominal Disease
Whole Abdomen Irradiation with Boost
Exposure Accuracy for the Dose Delivery System
Within 5% of the Delivered Dose
TLD measures dose
Within the body On the external surfaces Within a phantom
Most Common Sites of Melanomas
Women's Legs Men's Trunks and Faces
Type of Radiation Most Often Measured With Free-Air Ionization Chambers
X-Rays and Gamma Rays Up To 3 MeV
Dryness of mouth is called
Xerostomia
Xanthosis
Yellowing of the Skin Without Yellowing of the Eyes
Can fibrosarcomas occur in soft tissue?
Yes
What is Chemotherapy?
a drug administered orally through injection, perfusion, and topically. Classified by action on the cell and source
Which of the following devices is incorporated into the design of the linear acclerator to amplify the microwaves used to accelerate the electron beam? a betatron a klystron a microtron a cyclotron
a klystron
Describe multiple myeloma.
a nonosseous malignant tumor that originates in the bone marrow. Malignant disease of plasma cells that arise from the B-lymphocytes of the bone marrow
When a patient is connected to the chest tube drainage equipment, it is important to _____________ when moving the patient. a. avoid kinks in the drainage tube b. clamp off the chest tube c. raise the bottle above the chest
a. avoid kinks in the drainage tube
The escape of fluids into the surrounding tissues, often seen when intravenous needles infiltrate, is termed: a. extravasation b. emasculation c. embolization d. exacerbation
a. extravasation
A medication which is given to an in-patient by the physician during a radiographic procedure must be recorded: a. on the patient's chart b. on the physician's report c. on the patient prescription
a. on the patient's chart
In general, oral temperature readings possess a high degree of accuracy. A common factor that may cause erroneous readings is: a. oxygen therapy b. tachycardia c. dyspnea d. chest pain
a. oxygen therapy
The loss of muscle coordination which may be seen with a cerebral vascular accident or other neurologic pathologies is termed: a. paralysis b. anemia c. ataxia d. dysphasia
a. paralysis
To enlarge the vein to make penetration easier, a tourniquet is often placed on the patient's arm: a. proximal to the injection site b. distal to the injection site c. over the injection site
a. proximal to the injection site
Cardiac and respiratory sounds and apical pulse determinations are made using a device called a: a. stethoscope b. spriometer c. cardiac monitor
a. stethoscope
Blood or other secretions, which may be accidentally aspirated, are often removed by using: a. suction equipment b. respirator c. t-tube drainage
a. suction equipment
A patient shows signs of respiratory distress. This can often be helped by placing the patient in a semi-fowler's position in which: a. the head is elevated about 30 degrees b. the head is placed level with the body c. the patient is placed in their stomach d. the head is lowered below the level of the heart
a. the head is elevated about 30 degrees
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
REM =
absorbed dose x quality factor x N
The linac generates a high energy photon or electron beam by:
accelerating charged particles in a linear path.
A mechanical distance indicator is used to verify:
accuracy of optical distance indicator
What particle has the highest LET:
alpha particle 166 KeV/Micrometer
Actinomyocin D is a
anti-tumor antibiotic
Importance of position & immobilization
any artificial devices must be removed such as dentures, temporary prostheses, & the treatment description in the chart is used to reproduce a consistent position with the prescribed simulation, while immobilization devices reproduce treatment position while restricting movement
Thimble chamber walls: are made of high "Z" material need to be very thick are air equivalent are made of ferromagnetic material
are air equivalent
Oncogene
are genes that accelerates the normal development & growth of cancerous tissues
Rules of Ethics
are not aspirational because they are enforceable
Cellular differentiation
are the daughter cells
Systemic treatment
are those that destroy the cancer cells throughout the body. Chemotherapy and hormonal therapy are both systemic treatments
Local treatment
are those that destroy, remove, or control the breast cancer cells in a particular area. Surgery and radiation are both local treatments
Parallel opposed field (POP)
are treatment beams that is 180 degrees apart from one another
You need to use a 10 cm x 38 cm field size in order to treat metastatic cancer in your patient's vertebral column. The maximum field length one can set on the clinac 4 is 30 cm at 80 cm. The SSD that must be used in order to obtain a 38 cm long field is: A. 81 cm B. 101 cm C. 110 cm D. 120 cm
b 30/80 = 38/X
Res Ipsa Loquitur means... a. "Things speak for themselves" b. "The thing speaks for itself" c. "Do no harm" d. "No negligence was involved"
b. "The thing speaks for itself"
When IV administration is taking place, the solution should always remain ______ above the level of the vein. a. 36"-40" b. 18"-20" c. 8"-12"
b. 18"-20"
A step-wedge (penetrometer) film showing a small number of widely varying density steps (High Contrast) is desired. Which set of factors below will most likely demonstrate this appearance? a. 600 mA, 75 ms, 82 kVp, 2.5 mm Al c. 300 mA, 8 ms, 94 kVp, 3.5 mm Al d. 400 mA, 3 ms, 76 kVp, 3.5 mmAl
b. 200 mA, 15 ms, 68 kVp, 2.5 mm Al
The normal range for diastolic blood pressure is about: a. 30-50 mmHg b. 60-90 mmHg c. 90-110 mmHg d. 110-114 mmHg
b. 60-90 mmHg
A document which enables a trusted person to act on behalf of an incapacitated individual is called a: a. Good Samaritan document b. advance directives (healthcare power-of-attorney) c. self-care release
b. advance directives (healthcare power-of-attorney)
The common sites for the injection of subcutaneous medications are the: a. elbow and wrist b. arm and thigh c. 3rd and 4th fingers d. webs of fingers and toes
b. arm and thigh
The unlawful touching of a person without their consent is called: a. assault b. battery c. invasion of privacy d. negligence
b. battery
The failure to keep an IV bottle above the level of the patient during an IV infusion is most likely to result in: a. bacterial contamination of the IV fluids b. blood clot formation in the needle or line c. an increase in the infusion rate of the contrast agent
b. blood clot formation in the needle or line
The use of inappropriate arm or leg restraints on a patient is considered a form of: a. nonverbal assault b. false imprisonment c. unintentional malpractice d. malicious prosecution
b. false imprisonment
In order to reduce the need for oxygen during surgery and to reduce high fever, a technique called ___________ is sometimes employed. a. hypoalimentation b. hypothermia c. hyperpnea d. hypochondria
b. hypothermia
In many emergency situations, a rapid systemic response to the medication is necessary. The route that will in most cases provide this is: a. subcutaneous b. intravenous c. oral d. intramuscular
b. intravenous
The flow rate of an oxygen delivery system is normally measured in units of: a. cubic feet per hour b. liters per minute c. cubic centimeter per hour d. respirations per minute
b. liters per minute
Cancer treatment is not only based on survival expectations
but how it affects the patient's quality of life
5 transmission routes identified are
by contact, droplet, common vehicle, airborne, and vector borne
The normal adult resting respiration is about: a. 3-5 times/min b. 7-10 times/min c. 16-20 times/min
c. 16-20 times/min
A tort falls under which of the following? a. Criminal law b. Statutory law c. Civil law d. Common law
c. Civil law
The core beliefs concerning what is desirable and helps assess worth of intangibles are called: a. Theories b. Prospects c. Values d. Principles
c. Values
Chest drainage apparatus should always be placed: a. 12-20" above the level of the chest b. at the level of the chest c. below the level of the chest
c. below the level of the chest
A tube and optical system for observing the inside of a hollow organ or capacity is called a/an: a. organometer b. microscope c. endoscope d. cytometer
c. endoscope
If pressure is not maintained on a vein immediately after the removal of the needle, a collection of blood may result called a: a. hemolysis b. hemorrhage c. hematoma d. diaphoresis
c. hematoma
During oxygen therapy, the passage of the oxygen through distilled water serves to: a. increase the concentration of the oxygen in the blood to improve uptake b. improve purity of the oxygen to prevent infections c. increase the humidity to prevent drying of the mucous membranes d. decrease the possibility of combustion in oxygen therapies
c. increase the humidity to prevent drying of the mucous membranes
A form which must be signed by the patient indicating their understanding of the potential risks of a particular treatment or diagnostic procedure is called a: a. living will b. POA c. informed consent d. prior detectives
c. informed consent
A normal body temperature reading of 38 degrees C (99.6 degrees F) can be expected for: a. oral temperatures b. axillary temperatures c. rectal temperatures
c. rectal temperatures
Which of the following technical factors will produce a radiograph with the GREATEST definition? a.50 mA, 80 kVp, FSS 1 mm, SID 100 cm, OID 8 cm b.75 mA, 90 kVp, FSS 2 mm, SID 150 cm, OID 4 cm c.25 mA, 80 kVp, FSS 1 mm, SID 150 cm, OID 4 cm d.300 mA, 90 kVp, FSS 2 mm, SID 100 cm, OID 10 cm
c.25 mA, 80 kVp, FSS 1 mm, SID 150 cm, OID 4 cm
Toxicities of Doxorubicin(adriamycin)
cardiac toxicities
Alcohol is:
chemical
Hydrocarbons are:
chemical
Tobacco is:
chemical
Callibration of an ion chamber means that it has been: exposed to radiation and then stabilized compared against a national standard to establish a correction factor tested against leakage and electrical shorts made to be waterproof
compared against a national standard to establish a correction factor
most dominant interaction in soft tissue
compton scatter
The source of electrons in a linac:
cyclotron
What legal document allows the competent adult to provide direction to the health care providers regarding their choices under certain circumstances, should the individual no longer be able to make those decisions? a) Scope of practice b) Informed consent c) Durable power of attorney d) Living will
d) Living will
The normal retention period for which radiographs must legally be kept in file for an adult patient is: a. 6 months b. 1-2 years c. 3-4 years d. 5-7 years
d. 5-7 years
The normal resting pulse rate for a child up to age 10 years old is about: a. 40 B/min b. 55 B/min c. 75 B/min d. 95 B/min
d. 95 B/min
A company being punished for the actions of one of its employees is an example of which doctrine? a. Doctrine of foreseeability b. Doctrine of personal liability c. Doctrine of res ipsa loquitur d. Doctrine of respondent superior
d. Doctrine of respondent superior
Which ethical model identifies the caregiver as a scientist dealing only with the facts & doesn't consider the human aspect of the patient? a. Collegial b. Covenant c. Priestly d. Engineering
d. Engineering
All are intentional torts except for: a. Breach of confidentiality b. False imprisonment c. Defamation of character d. Negligence
d. Negligence
The most common type of catheter placed in the pulmonary artery to monitor pulmonary disorders and heart function is a: a. Miller-Abbott tube b. Greenfield tube c. Fowler's catheter d. Swan-Ganz catheter
d. Swan-Ganz catheter
A sphygmomanometer is a device that is employed in the evaluation of: a. respiration b. cardiac sounds c. pulse rate d. blood pressure
d. blood pressure
The abnormal fear of death or of dying is termed: a. narcolepsy b. noctosis c. narcophobia d. necrophobia
d. necrophobia
Living will
directs the course of future medical conditions if patient is no longer competent to make decisions. Must be: 1. Competent, States what measures may/ may not be taken 2. Relieves hospital & doctors from liability for following living will, 3. Witnessed by two non-interested parties.
When calibrations are attempted for electron beams, the preferred phantom material is: distilled water aluminum paraffin cerrobend
distilled water
The drug currently most useful in the treatment of cardiogenic shock due to its cardiac stimulating properties and vasodilatory properties is:
dobutamine
Ptosis
drooping eyelids
Chemotherapy for breast cancer may consist of:
drug therapy endocrine therapy
Heyman capsules may be used to treat the:
endometrium
Ionizing radiation is:
environmental
Ultraviolet is:
environmental
Ependymoma originates in
ependymal cells which line the ventricles. May block exit of cerebrospinal fluid causing the ventricles to enlarge (hydrocephalus).
Adolescents with cancer
experiences a disruption of self-esteem, body-image, autonomy, and social function
In step-and-shoot IMRT delivery systems are of higher complexity than dynamic systems requiring complicated leaf speed and dose rate modulation. true false
false
4-field box
fields are arranged 90 degrees from one another and generally require no more than blocks for optimal dose distribution in the target volume
An increase in the uniformity of the X-ray beam intensity, in a linear accelerator can be accomplished by the use of a: bending magnet angled target flattening filter scattering foil
flattening filter
The calibration of survey meters used by a licensed facility is required: daily to insure proper accuracy You Answered under standard conditions of temperature, pressure and humidity after the unit has been exposed to high energy radiation following any repairs which are made on the unit
following any repairs which are made on the unit
Energy of electromagnetic radiation is directly proportional to its:
frequency
Von Recklinghausen's Disease definition
genetic disorder characterized by the growth of tumors on the nerves. The disease can also affect the skin and cause bone deformities
Most common brain tumor for adults
glioblastoma multiforme
PET is an effective modality of biologic imaging, useful for tumor delineation because: the magnetic frequency highlights the tumor photon emission has been shown to define active cell proliferation protons are attached to the tumor glucose metabolism of cancer cells take up the F-flurodeoxyglucose
glucose metabolism of cancer cells take up the F
If the half life of Cobalt-60 is 5.26 years, the average life is
half life x 1.44
subcutaneous fibrosis
hardening of the skin
The acceleration of a charged particle in a linear accelerator primarily results from their exposure to: high frequency electromagnetic waves high energy ultrasonic waves super thermal pulse activators high electrical potentials
high frequency electromagnetic waves
The purpose of the blood-brain barrier is to:
hinder the penetration of some substances into the brain and CSF protect the brain from potentially toxic substances
Ann Arbor staging is for
hodgkins and non hodgkins
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
Toxicities of bleomycin
interstitial lung disease
Total body irradiation "TBI"
involves irradiation of the entire body, though in modern practice the lungs are often partially shielded to lower the risk of radiation-induced lung injury
Confronting
involves therapists making the client aware that their observations are not consistent with the patient's words
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
The normal adult Respiration
is 10-20 breaths per min
Anemia
is a decrease in red blood cell count. Without sufficient RBC, the circulatory systems oxygen is impaired due to a "decrease in the hemoglobin level" of RBC, which serves as the carrier of oxygen from the lungs to tissues. Symptoms are pallor, fatigue, and muscle weakness.
Compensator
is a device used to correct irregularities in body surfaces. The result is a more uniform distribution of radiation dose in the tumor. Compensators are generally mounted on the collimator system of a teletherapy unit.
Intensity Modulated Radiotherapy (IMRT)
is a high-precision RT that improves the ability to conform the treatment volume to concave tumor shapes
Prophylaxis
is a measure taken to maintain health and prevent the spread of disease
Workup
is a series of tests done to determine the general health status of the patient, whether the patient has cancer and if so how far along is it and collect of as much information about the tumor as possible
MLC or Multi Leaf Collimator
is a set of metal blocks, fixed and movable, in the treatment head that limit the treatment field to a desired size. It is used in a linear accelerator to provide conformal shaping of radiation beams
Quality of life
is a subjective sense of well-being, summarize the broad-based assessment of the combined effect of disease and treatment and the trade off between the two.
Bolus
is a type of beam modification device used to even out irregular surfaces and to increase skin dose
Reflective listening
is a way for a person to listen and communicate effectively
Fractionation
is an Individual treatment dose
Prognosis
is an estimation of the life expectancy of cancer patient base on all info obtained from clinical trials
Probing
is an open-ended statement used to obtain more information and facilitate much more open conversation.
Marasmus
is calorie malnutrition, fat and muscle depletion
Stage 0
is carcinoma in situ for most cancers
Empathy
is defined as identifying with the feelings, thoughts or experiences of another person.
In Bremsstrahlung radiation, the incoming electron: interacts with an orbiting electron is deflected by the nucleus of the atom creates a positive and negative ion cascades to a lower energy state
is deflected by the nucleus of the atom
Percussion
is the act of striking or tapping gently to determine pain
Etiology
is the study of cause of disease
Inspection
is the use of sight to observe with a distinction between seeing & observing. Example is when there is a group of 10 people, however the distinction is that there were women and children
Palpation
is the use of touch to acquire information of patient whether pain is present
Palliation
is to alleviate pain, bleeding, obstruction, paralysis
Intra Operative radiation therapy (IORT)
is used to treat cancers that are difficult to remove during surgery and there is a concern that microscopic amounts of cancer may remain.
Benign
is well differentiated
Autonomy
is when patients are free to make life directing decisions, and are protected by informed consent
Components of prescription treatment
is when the radiation oncologist prescribe treatment it must be SIGNED like a medication prescription with the use of beam modifiers & prescription treatment must ALWAYS BE REVIEWED right before treatment.
While treating a patient using a rotational arc technique, the gantry rotates beyond the endpoint. This is likely a malfunction of the:
limit switch
Survival Curve Equation
log(e) n = Dq / Do
Anorexia
loss of appetite resulting in weight loss
Any HGB "Hemoglobin" under 7.5 is considered severely
low and transfusion may be necessary
The Fletcher suite application is for:
low dose rate brachytherapy
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
What is the #1 death causing cancer in men? women?
lung and bronchus
The term __________ describes the condition commonly known as swollen glands.
lymphadenitis
Justice
maintains fairness and equality among individuals
Invades vessels
malignant
Many mitosis
malignant
Often metastasize
malignant
Sarcoma
malignant
Unencapsulated
malignant
G2 means
moderately differentiated
Cobalt beam output must be checked:
monthly
Informed consent
must contain nature of the disease, procedures, treatments and expectations of recommended treatments and likelihood of success, reasonable alternatives discussed, probably outcome if no treatment is sought, and all known possible risks to procedure/treatment.
Cathode
negative, tungsten filament, focusing cup
Cannot ionize directly: interacts only with the nucleus
neutrons
Does the cyclotron accelerate electrons?
no
Anhydrosis
no sweat on affected side
When a radionuclide decays, radiation is emitted from the:
nucleus`
endocrine dysfunction
occurs when 75% of endocrines are irradiated at high doses
Interpreting
occurs when the therapist adds something to the patient's statement or tries to help the patient understand underlying feelings.
Checking out
occurs when therapists are genuinely confused about patients perceptions of "verbal or nonverbal behavior" or have a hunch that should be examined... "Does it seem as if...?"
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
Trimmer bars are attached to the collimator of the cobalt machine to reduce the effect of:
penumbra
If a radiation detector receives more radiation than it is capable of recording or processing in a given amount of time, it has exceeded its: point of rotation point of resolution point of efficiency point of saturation
point of saturation
G3 means
poorly differentiated
Kwashiorkor
protein malnutrition seen in patients with an adequate intake of carbohydrates and fats but an inadequate intake of protein, characterized by retarded growth and development, muscle wasting, depigmentation of the hair and skin, edema and depression of the cellular immune response
hydrogen nucleus
proton
This is the time which the TOTAL dose is delivered. fractionation time delay latent period protraction
protraction
Verify & record system
provides validated parameters from the treatment plan for treatment machine setup & delivery
Hypopharynx includes
pyriform sinus and pharyngeal wall
Radiation Team consists of
radiation oncologist, physicist, dosimitrist, nurse, therapist, reception, staff
Reflecting
refers to health care providers communicating their understanding of the patients concerns and perspectives... "You're feeling uncomfortable about finishing your treatments."
To "beam split" means to? weight portals evenly remove divergence employ mixed beam energies fractionated treatments
remove divergence
Stereotactic radio surgery
reproduce the placement of the isocenter in the cranium with an accuracy of less than 1mm; the area of high relative dose is increasingly focused on the target volume
Invasion of privacy
revealing confidential information or improperly and unnecessarily exposing a patients' body.
Penumbra formula
s(SDD + d - SDD)/SDD or s(SAD - SCD)/SCD
In the electron mode of the linear accelerator, spreading of the electron beam to produce a uniform electron fluence is accomplished by a thin layer of lead called the: scattering foil flattening foil dispersion modulator target
scattering foil
schwannoma originates in
schwann cells which surround the cranial nerves and other nerves responsible for hearing.
Toxicities of MOPP
secondary neoplasms
Superficial therapy machines used short treatment distances because:
secondary radiation augments the skin dose.
When a very long lived radionuclide decays to a short lived daughter, it is known as
secular equilibrium
In the production of bremsstrahlung, the electron:
slows down and loses some of its energy as an xray photon.
Bragg peak is not observed in electrons because of their:
small mass
The amount of vertical movement of the table top of a linear accelerator to a distributed weight of 180 pounds is useful for the determination of the: gantry lag gantry rigidity tabletop flatness tabletop sag
tabletop sag
Grading
the TNM system is used & assigned a letter or number to describe the tumor, node, and metastases.
Which of the following is a likely cause for the light outside of the treatment room failing to be on when the unit is activated? the machine in improperly calibrated the shadow tray is too close to the patient the light bulb has burned out the beam is improperly centered
the light bulb has burned out
The energy of the linac is said to be 10 MV, this most closely relates to: the average energy of the photons produced the speed of the electrons in the target material the minimal energy of the electrons produced the maximum energy of the photons produced
the maximum energy of the photons produced
A barrier that attenuates the useful portion of the beam to the required degree is called? the secondary barrier the incident shielding the tenth value layer the primary barrier
the primary barrier
Ionization implies
the removal of an electron from the atom
Homeostasis
the state of controlling or regulating the internal body normally according to its genetics or DNA
Minimal verbal response is
the verbal counterpart to the occasional head nodding, a simple indication that you are listening to and understanding the patient... "Yes"
The following radiographic studies are commonly used in the diagnosis workup of lymphoma:
thoracic CT scan PET scan MRI
The large, shield-shaped cartilage that forms the anterior portion of the larynx is called the:
thyroid cartilage
What are some burdens the patient will go through?
time, emotional, social, psychological, physical, and financial burdens.
The role of IMRT is to produce a beam that varies the radiation intensity delivered to the tumor volume producing changes in dose delivered as a function of _____________ within the field and tumor status. This forms the basis for the DVH. tissue volume monitor units critical structures total dose
tissue volume
Beneficence
to act in the best interest of patients, even at some inconvenience and sacrifice to themselves
Purpose of ion chamber in a linac?
to monitor doserate and beam symmetry
What type of target is in a linac:
transmission
In a linear accelerator the thick-shelled lead lined covering that prevents the leakage of high energy radiation is called the: treatment head primary collimator beam interceptor beam limiter
treatment head
Kaposi Sarcoma
tumors below the skin surface that appear as raised, red, purple or brown blotches. common in HIV patients.
Mycosis Fungoides
type of non hodgkin's lymphoma and is the most common form of cutaneous.
The BAT system uses ________ energy to localize the treatment target.
ultrasound
Severely low platelet count is
under 20,000 - considered severely low
A normal body temperature reading of 37 degrees C (98.6 degrees F) can be expected from the mercury thermometer inserted_____.
under the tongue
GX means
unknown differentiation
To check the accuracy of the gantry digital readouts of a linear accelerator, the radiation therapist should: close the collimator shutters use a spirit level at 90 degree angles use a breast bridge at 45 degree angles use a split field test at 180 degree angles
use a spirit level at 90 degree angles
HPV is:
viral
HTV-1 is:
viral
The pericardial space is found between the:
visceral and partietal pericardium