RTT exam 4

What is the laser tolerance for a linac that performs IMRT treatments? 0.5 mm 1.0 mm 1.5 mm 2 mm

1.5 mm

What is the typical gantry angle used for supraclavicular fields? 5-10 degrees 10-15 degrees 15-20 degrees 20-30 degrees

10-15 degrees

The occupational exposure limits are ______ than public exposure limits 20x more 20x less 10x more 10x less

10x more

What is the total workload of a machine that treats 25 patients with an average of 4 fields each and an average dose of 2 Gy. Each patient is treated 5 days per week.

2 x 25 x 4 x 5 = 1000 cGy/week.

What is the percent error if the patient was prescribed 300 cGy at 80 cm SSD if they were accidentally treated at 90 cm SSD? 21% overdose 21% underdose 27% overdose 27% underdose

21% underdose -Inverse square law factor to find overdose: (90/80)^2 x 100%=127% aka 27% over intended dose of 100%.

The patient is prescribed 180 cGy and is to be treated at 100 SSD. What does did the patient receive if they were accidentally treated at 90 SSD?

222 cGy

What is the standard fractionation scheme for whole brain radiation therapy? 10 Gy × 3 fractions 20 Gy x 5 fractions 30 Gy × 10 fractions 40 Gy × 20 fractions

30 Gy × 10 fractions

What type of radiation is being used in this treatment plan?

3D

A radiation department with two linacs treats 80 patients per day split evenly on each machine. What is the workload of one of the machines if the patients typically have 3 fields and 80 cGy/field. Assume a 5 day workweek.

40 x 3 x 80 x 5 = 48,000

What is the patient's PA SSD if the AP SSD reads 82 cm and the patient has a separation of 44 cm?

74 cm

The patient's separation for a treatment with two opposed laterals is 30 cm. If the right lateral SSD is 86, then what should the left lateral SSD read?

84 cm

What is an isodose line in radiation therapy? A line representing the boundary of the treatment field A line representing the location of the tumor A line representing the level of radiation dose in a patient A line representing the location of the radiation source

A line representing the level of radiation dose in a patient

Compared to machines that only treat complex treatments, machines that treat SBRT treatments have: A larger laser tolerance A smaller tolerance The same laser tolerance No laser tolerance

A smaller tolerance

All of the following are treatment field names for the following treatment EXCEPT: PA AP Right lateral Left lateral

AP

Which of the following couch adjustments can be made with a 6 DoF couch? Pitch Yaw Rotation All of the above

All of the above

Which of the following factors can affect the shape of the isodose distribution in radiation therapy? Patient anatomy Treatment machine parameters Treatment field size All of the above

All of the above

Which of the following particles has the highest ionizing power? Alpha particles Beta particles Gamma rays X-rays

Alpha particle (high LET)

The staging system associated with Hodgkin's lymphoma is? Ann Arbor Dukes FIGO Gleason

Ann Arbor

When viewing an axial image, which directions can the patient be moved in? Anterior and posterior Left and right Superior and inferior The patient can only be adjusted in 1 of the above

Anterior and posterior Left and right

When viewing sagittal images, which directions can the patient be moved in? Anterior and posterior Left and right Superior and inferior

Anterior and posterior Superior and inferior

Which of the following is NOT a common classification of chemotherapy drugs? Alkylating agents Antimetabolites Anticoagulants Topoisomerase inhibitors

Anticoagulants

Which part of the machine houses the Klystron?

B

Which part of the machine houses the electron gun?

C

Which acute radiation syndrome has the shortest latent stage? Bone marrow syndrome GI syndrome CNS syndrome

CNS syndrome

Which structure is located around the vertebral level of T4-T5? Hyoid bone Xiphoid GE junction Carina

Carina

What does CPT stand for in medical billing and coding? Clinical Payment Terminology Current Procedural Terminology Certified Professional Therapy Clinical Procedure Tracking

Current Procedural Terminology

Which of the following techniques could be used to reduce tumor motion? Gating Abdominal compression 4D CT DIBH

DIBH Gating Abdominal compression

Which of the following is a common side effect of radiation therapy for head and neck cancer? Weight gain Hair loss Nausea and vomiting Dry mouth

Dry mouth

What is a product of pair production? Electron Neutron Positron Isotope

Electron Positron

Which machine components are located within the gantry? Electron gun Klystron Accelerator structure Bending magnet

Electron gun Accelerator structure

What is the proper order of machine parts for a photon beam? Electron gun, accelerator structure, bending magnet, target Accelerator structure, electron gun, target, bending magnet Electron gun, accelerator structure, target, bending magnet Electron gun, target, accelerator structure, bending magnet

Electron gun, accelerator structure, bending magnet, target

Which of the following is an example of a late effect of radiation therapy? Nausea and vomiting Skin irritation Fibrosis All of the above

Fibrosis

Which of the following types of radiation can be detected using a Geiger-Muller counter? Alpha particles Beta particle's Gamma ravs Neutrons

Gamma ravs

What is the main difference between VMAT and IMRT? MLCs are stationary during VMAT and moving during IMRT MLCs are moving during VMST and stationary during IMRT Gantry & MLCs move during VMAT and only MLCs move during IMRT Gantry & MLCs move during IMRT and only MLCs move during VMAT

Gantry & MLCs move during VMAT and only MLCs move during IMRT -IMRT treatments have fixed gantry angles while MLCs move to create modulated beams. VMAT uses the MLC movement along with gantry motion during treatment (arc therapy).

What is the last step when donning PPE? Gloves Mask Goggles Gown

Gloves

Tumor differentiation also determines: Grade Staging Aggressiveness

Grade

What technique is being shown in this treatment?

Half-beam block

Which organ does NOT have a tolerance dose of 4500 cGy? Heart Kidney Eye retina Liver

Heart

This mechanical device uses a sling placed under the patient to assist in lifting the patient from a wheel chair to the treatment table and can move the patient in the vertical and lateral positions. Hoyer lift Sliding board Sling

Hoyer lift

Which of the following is a risk factor for developing head and neck cancer? Exercise Low alcohol consumption Human papilloma virus (HPV) infection High fiber diet

Human papilloma virus (HPV) infection

Vaginal cylinders are considered: Intraluminal Intracavitary HDR LDR

Intracavitary HDR

Atomic nuclei with differing Z numbers, but the same A number? Isotope Isomer Isobar Isotone

Isobar

Atomic nuclei with differing numbers of neutrons, but the same number of protons is? Isobar Isotope Isomer Isotope

Isotope

Which organ is most susceptible to damage from contrast media use? Esophagus Stomach Kidneys Bladder

Kidney

Which machine components are located within the drive stand? Klystron Circulator Power supply Accelerator structure

Klystron Circulator

The stage of acute radiation syndromes where the patient looks and feels healthy, although cells are rapidly dying is called Prodromal Manifest Latent Recovery

Latent

What is the most common type of brachytherapy used for prostate cancer? High-dose rate (HDR) brachytherapy Low-dose rate (LDR) brachytherapy Interoperative brachytherapy Intracavitary brachytherapy

Low-dose rate (LDR) brachytherapy

Which of the following cancers is associated with HPV? Oral cavity Salivary glands Astrocvtoma Papillary thyroid

Oral cavity

Which QA tests should be performed at least daily? Output Lasers Emergency off buttons Light field/Radiation field coincidence

Output Lasers

The patient is positioned head first prone for a PA treatment. The patient is accidentally treated with a posterior isoshift of 3 cm. How does this affect the dose to the planned isocenter? Planned iso is overdosed Planned iso is underdosed No effect

Planned iso is underdosed

The stage of acute radiation syndromes that is also called NVD due to nausea, vomiting and diarrhea is called: Prodromal Manifest Latent Recovery

Prodromal

Which type of breast surgery removes chest wall muscles? Radical mastectomy Total mastectomy Simple mastectomv Lumbectomy

Radical mastectomy

What is likely being treated in this treatment field?

Seminoma

Prophylactic cranial irradiation (PCI) is a common treatment option after which primary cancer? Small cell lung cancer Non-small cell lung cancer Esophageal adenocarcinoma Medulloblastoma

Small cell lung cancer

The most common pathology for tumors in the urethra are? Adenocarcinomas Transitional cell carcinomas Sarcomas Squamous cell carcinomas

Squamous cell carcinomas

Which of the following would be a reason why supraclavicular fields are included in breast treatments? Stage N2-N3 Tumor is located in superior aspect of breast Routine following whole breast 4+ positive axillary lymph nodes

Stage N2-N3 4+ positive axillary lymph nodes

Which of the following indicates that nodal spread has not been assessed? TXNIMO TINIMO T2NXMO T4N3MX

T2NXMO -The "N" in staging represents involvement in regional lymph nodes. N1-N3 refers to the number and location of lymph nodes involved. NX refers to instances when cancer involved in lymph cannot be measured or assessed.

List the order of machine parts in the linac head for a photon treatment: Target, flattening filter, ion chamber, primary collimators, secondary collimators, MLCs Target, ion chamber, primary collimators, flattening filter, secondary collimators, MLCs Target, flattening filter, primary collimators, ion chambers, secondary collimators, MLCs Target, primary collimators, flattening filter, ion chamber, secondary collimators, MLCs

Target, primary collimators, flattening filter, ion chamber, secondary collimators, MLCs

Which agency is responsible for regulating the manufacturing of linear accelerators? The U.S. Nuclear Regulatory Commission The Food and Drug Administration (FDA) The U.S. Environmental Protection Agency (EPA)

The Food and Drug Administration (FDA)

What is a sentinel lymph node? The largest lymph node in the body The first lymph node to receive drainage from a tumor A type of lymphocyte involved in the immune response The lymph node closest to the heart

The first lymph node to receive drainage from a tumor

What is the relationship between wavelength and frequency of electromagnetic radiation? The longer the wavelength, the higher the frequency The shorter the wavelength, the higher the frequency There is no relationship between wavelength and frequency The relationship is inverse: the shorter the wavelength, the lower the frequency

The shorter the wavelength, the higher the frequency

What is the purpose of the waveguide in a linear accelerator? To accelerate the electrons to high energies To focus the electron beam To generate high-energy photons To cool the electron beam

To accelerate the electrons to high energies

What is the purpose of imaging studies before brachytherapy? To identify the location and size of the tumor To ensure that the radioactive source is placed in the correct location To minimize the damage to healthy tissue To ensure the proper source is being used

To identify the location and size of the tumor To ensure that the radioactive source is placed in the correct location To minimize the damage to healthy tissue

The term "in situ" means. Tumor has not invaded basement membrane Tumor has spread to local organs Tumor has seeded throughout cavity Tumor cannot be assessed

Tumor has not invaded basement membrane

What is likely the treatment technique here:

VMAT