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