Ouhsc Clinical Rad Therapy Exam 2

Front 1

Define pathology.

Back 1

-The branch of medicine devoted to the study of understanding disease

Front 2

Describe the difference between reversible and irreversible cellular changes

Back 2

-Irreversible cellular changes represent cellular death or changes that eventually prove lethal to the cell.
- changes representing reversible injury are consitant with cell survival if the precipitating cause is corrected. Cellular swelling is the hallmark of reversible damage.

Front 3

In discussing the characteristics of benign and malignant tumors, describe mitosis

Back 3

benign has little mitosis

malignant has a lot of mitosis

Front 4

In discussing the characteristics of benign and malignant tumors, describe differentiation

Back 4

benign is good

malignant is poor

Front 5

In discussing the characteristics of benign and malignant tumors, describe local growth

Back 5

bening is expansive

malignant is invasive

Front 6

In discussing the characteristics of benign and malignant tumors, describe nuclear chromatin

Back 6

benign is normal

malignant is increased

Front 7

In discussing the characteristics of benign and malignant tumors, describe encapsulation

Back 7

benign is encapsulated

maligngant is not encapsulated

Front 8

In discussing the characteristics of benign and malignant tumors, describe the destruction of tissue

Back 8

bening has little destruction

malignant has a lot of destruction

Front 9

In discussing the characteristics of benign and malignant tumors, describe vessel invasion

Back 9

bening has no vessel invasion

malignant there is usually vessel invasion

Front 10

These are tumors that arise from the epithelium. These include tissues that cover the surface or line a cavity.

Back 10

carcinomas

Front 11

Epithelial cells that are glandular are called _______(such as the lining of the stomach)

Back 11

adenocarcinoma

Front 12

These arise from the mesenchymal cells. This includes connective tissue such as cartilage and bone. (although blood and lymphatics are considered mesenchymal tissues, they are classified separately as leukemias and lymphomas)

Back 12

sarcomas

Front 13

This is a pathologic description of cells, describing a loss of differentiation and more primitive appearance (aka, no cellular differentiation)

Back 13

anaplastic

Front 14

This describes a great variability in size and shape of “undifferentiated” tumor cells

Back 14

pleomorphic

Front 15

Thsi is describes as programmed cell death

Back 15

apoptosis

Front 16

time between two events. During this time initiated cells may seem normal under a microscope.

Back 16

latent period

Front 17

What is the cell or tissue of origin of a Wilm’s tumor

Back 17

(malignant) renal anlage

Front 18

What is the cell or tissue of origin of a retinoblastoma

Back 18

(malignant) renal cells (cones)

Front 19

What is the cell or tissue of origin of Hodgkin disease

Back 19

(malignant) hematopoietic/ lymphoid tissues

Front 20

What is the cell or tissue of origin of a hemangioma

Back 20

(benign) blood vessel

Front 21

What is ASRT

Back 21

is the premier professional association for the medical imaging and radiation therapy community. It is an organization that advances the medical imaging and radiation therapy profession and enhances the quality of patient care.

Front 22

What is ARRT

Back 22

is the world’s largest credentialing organization that seeks to ensure high quality patient care in medical imaging, interventional procedures, and radiation therapy. It tests and certifies technologists and administers continuing education and ethics requirements for their annual registration.

Front 23

What is the Joint Commitee

Back 23

An independent, not-for-profit organization, The Joint Commission accredits and certifies more than 19,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.

Front 24

What is ASTRO

Back 24

mission is to advance the practice of radiation oncology by promoting excellence in patient care, providing opportunities for educational and professional development, promoting research and disseminating research results and representing radiation oncology in a rapidly evolving healthcare environment.

Front 25

List the four things the patient must be informed of before giving informed consent.

Back 25

-the nature of the procedure, treatment, or disease

- the expectations of the recommended treatment and the likelihood of success

-reasonable alternatives available and the probable outcome in the absence of treatment

-the particular known risks that are material to the informed decision about whether to accept or reject medical recommendations.

Front 26

What conditions are required before informed consent is valid?

Back 26

-to give consent a person must have the legally capacity to do so

-informed consent must be secured by a physician, unless otherwise specified by a facility policy and procedure or state law.

-informed consent must be secured in writing

Front 27

Recognize the 6 stages of the Grief cycle and their definitions

Back 27

shock
denial
anger
barganing
depression
testing
acceptance

Front 28

What stage of the Greif cycle does this describe:
pretending that what it isn’t

Back 28

denial

Front 29

What stage of the Greif cycle does this describe:
outward demonstration of pent up emotion and frustration

Back 29

anger

Front 30

What stage of the Greif cycle does this describe:
initial reaction to hearing the news of a bad event

Back 30

shock

Front 31

What stage of the Greif cycle does this describe:
trying to find a way out of the situation

Back 31

barganing

Front 32

What stage of the Greif cycle does this describe:
realization of the facts

Back 32

depression

Front 33

What stage of the Greif cycle does this describe:
searching for realistic resolutions to the problem

Back 33

testing

Front 34

What stage of the Greif cycle does this describe:
coping with the situation and finding a way forward

Back 34

acceptance

Front 35

This is neglect or omission of reasonable care or caution

Back 35

negligence

Front 36

This is any happening not consistent with the routine operation of the hospital or routine care of a particular patient

Back 36

incident

Front 37

This is written defamation of character

Back 37

libel

Front 38

This is a principle of law that holds a person liable for all consequences of negligent acts to another individual to whom a duty is owed and should have been reasonably foreseen under the circumstances.

Back 38

doctrine of foreseeability

Front 39

This is all the components used to document chronologically the care and treatment rendered to a patient

Back 39

medical record

Front 40

Both the living will and the durable power of attorney for health care are considered advance directives, because they clearly describe the wishes of the patient when he or she was competent. What does this describe?

Back 40

advance directives

Front 41

This is a legal document that allows an individual to designate anyone willing, 18 years old age or older, to be their surrogate and make decisions in matters of health care.

Back 41

durable power of attorney

Front 42

This is a program that provides care for patients who have limited life expectancy. Care is provided in the patient’s home or a hospital setting

Back 42

hospice care

Front 43

This is a principle that relates to the knowledge that information revealed by a patient to a health care provider, or information that is learned through the course of health care provider performing his/her duties is private and should be help in confidence

Back 43

confidentiality

Front 44

This is a legal doctrine that holds an employer liable for negligent acts of employees occurring while he or she is carrying out his or her orders or otherwise serving his or her interests.

Back 44

doctrine of respondent superior

Front 45

Explain why patient assessment is important

Back 45

Its important to assess the physiological, psychological, and spiritual
changes in the patient. Effective cancer care requires a thorough assessment of the patient and body systems. Assessment is an ongoing process and requires the entire radonc team

Front 46

List some ways of establishing a therapeutic relationship with a patient.

Back 46

Upon the initial encounter…
Be Genuine
Be accepting, interested, and patient
Speak slowly
Avoid using “big words” when explaining things to patients
-Be mindful of your verbal and nonverbal communication

Front 47

Discuss the importance of non-verbal communication to the patient relationship.

Back 47

-Verbal & Nonverbal communication between Patient & Therapist is the basis of an effective therapeutic relationship
-We must perceive non-verbal messages & respond both verbally & non-verbally
-Some believe 2/3 of communication is non-verbal

Front 48

Discuss helpful verbal and non verbal behavoirs

Back 48

-Verbal
Non-judgmental (Humor to reduce tension)
Gives info appropriately (Understandable words)
Summarizes the patient (Uses “I see” & “yes”)
Responds to real messages; (fear & doubt)

-Nonverbal
Good eye contact
Touches appropriately
Nods head occasionally Animated Facial express
Smiles occasionally Occasional hand gestures
Calm rate of speech Moderate tone of voice

Front 49

Discuss non helpful verbal and non verbal behavoirs

Back 49

-Verbal
Preaches
Placates
Blames
Directs & demand
Gives advice
Patronizing attitude
Strays from topic
Talks over pts head

-Nonverbal
Poor eye contact
Frowns
Expressionless face
Tight mouth
Yawns
Shakes finger
Unpleasant tone of voice

Front 50

Define reflective listening and list 5 of the 10 verbal response used to convey it.

Back 50

-healthcare workers can reflect the specific content or implied feelings of their non verbal observations or communication they feel has been omitted or emphasized

• Minimal verbal
• Reflecting
• Paraphrasing
• Probing
• Clarifying
• Interpreting
• Checking out
• Informing
• Confronting
• Summarizing

Front 51

Define the Karnofsky Performance Status

Back 51

scale that measures the neurologic function and status. KPS allows the measurement of quantity and quality of neurologic defects . scale ranges from 1 to 100

Front 52

This is a a reduction in bone marrow function

Back 52

myelosuppression

Front 53

This is a decrease in the peripheral red blood cell count

Back 53

anemia

Front 54

This is a decrease in the white blood cell count

Back 54

leukopenia

Front 55

This is a reduction in the number of the circulating platelets

Back 55

thrombocytopenia

Front 56

This summarize the broad based assessment of the combined effect of disease and treatment, and the tradeoff between the two.

Back 56

quality of life

Front 57

This is the second most common affective response in cancer patients. The perceived loss in self esteem resulting in a cluster of behavioral ( change in appetite, sleep disturbances, lack of energy, withdrawal and dependency) and cognitive (decreased ability to concentrate, indecisiveness, and suicidal ideas) responses

Back 57

Depression

Front 58

Identifying with the feelings, thoughts or experiences of another person describes

Back 58

empathy

Front 59

This is a state of general ill health and malnutrition with early satiety; electrolyte and water imbalances,; and progressive loss of body weight, fat, and muscle

Back 59

cachexia

Front 60

This is a calorie malnutrition that is observed in patients who are slender or slightly underweight and characterized by weight loss of 7% - 10% and fat and muscle depletion

Back 60

marasmus

Front 61

This is a protein malnutrition that includes an adequate intake of carbohydrates and fats but an inadequate intake of protein

Back 61

kwashiorkor

Front 62

List the following normal blood values for men and women:
Hematocrit (Hct)

Back 62

Men – 45% (38 – 54)

Women – 40% (36 – 47)

Front 63

List the following normal blood values for men and women:
Hemoglobin (Hcb)

Back 63

Men – 14 – 18 g/dL

Women – 12 – 16g/dL

Front 64

List the following normal blood values for men and women:
WBC’s (Platelets)

Back 64

5000 – 10,000 per cubic millimeter

100%

Front 65

Compare the assessment of children, adolescents and elderly patients.

Back 65

-Children
Help the Parents
Armstrong et al study
-Most children with cancer are normally adjusted.
-Due in part to Caregiver’s
concern and help with coping

-Older persons
Specific attention to sociologic issues
Sensory & cognitive impairment

Front 66

List the 8 major areas that are part of the multidisciplinary assessment approach.

Back 66

-General Health
-Physical
-Nutritional
-Pain Dimensions
-Blood
-Psychosocial
-Cultural
-Special Cases

Front 67

Define chemotherapy is and the goal of its usage

Back 67

-The use of cytotoxic drugs in the treatment of cancer
-Its goal is to provide cure, control or palliation to patient’s with cancer

Front 68

Discuss when chemotherapy is used for patient.

Back 68

-It is given to progressively lower the number of tumor cells to the point where the body’s own immune responses can control further tumor growth. Can provide cure, control or palliation. Can be used in conjunction with radiation therapy, surgery, and immunotherapy.

Front 69

List a major advantage of chemotherapy.

Back 69

-It involves the applicability to the treatment of widespread or metastatic disease because surgery and radiation therapy are limited to the treatment of localized disease.

Front 70

List what cells are most commonly affected by chemotherapy agents.

Back 70

-Bone marrow
-Hair follicles
-Mucosal lining of the gastrointestinal tract
-Skin
-Germinal cells (sperm and ova).

Front 71

the difference between cell cycle specific and non-specific drugs.

Back 71

-Cell Cycle Phase Specific (CCS)
These drugs are active on cells undergoing division in the cell cycle. Examples are: Antimetabolites and Vinca Alkaloids
-Cell Cycle Phase Non-Specific (CCNS)
These drugs are active on cells in either a dividing or resting state (all phases). Examples are: Alkylating Agents, Antibiotics, Hormones, Nitrosoureas

Front 72

These drugs are active on cells undergoing division in the cell cycle. Examples are: Antimetabolites and Vinca Alkaloids

Back 72

Cell Cycle Phase Specific (CCS)

Front 73

These drugs are active on cells in either a dividing or resting state (all phases). Examples are: Alkylating Agents, Antibiotics, Hormones, Nitrosoureas

Back 73

Cell Cycle Phase Non-Specific (CCNS)

Front 74

Explain factors considered in selecting a chemotherapy regime for a patient.

Back 74

-Diagnosis
-Expectation of longevity
-Bone marrow, nutritional, hepatic and renal status
-Previous treatment (chemotherapy or radiation therapy)
-Cancer cell type
-Rate of drug absorption
-Tumor location
-Tumor load
-Tumor resistance to chemotherapy

Front 75

List the major causes of chemotherapy failures

Back 75

-Inherent or acquired drug resistance, the body has always been or soon becomes somewhat used to the medication
-Response rate

Front 76

Define 8 ways chemotherapy drugs may be administered

Back 76

-Oral
-Sub-Q (subcutaneous, under the skin)
-Topical (on the skin)
-Intra-arterial (in the arteries, duh)
-Intracavitary (within a body cavity)
-Intraperitoneal (within the peritoneum??)
-Intrathecal (into the space that contains CSF)
-Intravenous (into a vein)

Front 77

Define synergistic in regarding combination chemotherapy regimes.

Back 77

combining two or more chemo agents allows each medication to enhance the action of the other

Front 78

Explain some possible causes of cancer.

Back 78

some cancers are associated with exposure to certain chemicals like tobacco. Other cancers are associated with exposure to radiation in small doses. Some cancers are associated with viral infections.

Front 79

Identify where the origin of most spontaneous cancers.

Back 79

environmental factors

Front 80

List the three procedures most commonly used to diagnose cancer.

Back 80

-recovery of exfoliating cells

-fine needle aspiration of malignant cells

-open biopsy of the tumor

Front 81

Define the six major causes of cell damage.

Back 81

Radiation – emission of energy of electromagnetic waves or as moving subatomic particles

Hypoxia – deficiency in the amount of oxygen reaching the tissues

Chemicals – a compound or substance

Microorganisms – type of bacteria or virus
Immunologic reactions – how the body responds to a foreign substance

Neoplasms – a new growth of tissue

Front 82

List the four major ways cancers are classified.

Back 82

Grade / differentiation

Stage

AJCC + IUCC

Front 83

This is the emission of energy of electromagnetic waves or as moving subatomic particles

Back 83

Radiation

Front 84

This is the deficiency in the amount of oxygen reaching ht e tissues

Back 84

Hypoxia

Front 85

This is a a compound or substance

Back 85

Chemicals (yeah, lame. I know)

Front 86

This is a type of bacteria or virus

Back 86

Microorganisms

Front 87

This is how the body responds to a foreign substance

Back 87

Immunologic reactions

Front 88

This is a new growth of tissue

Back 88

Neoplasms

Front 89

Explain the theory of cancer initiation.

Back 89

some mutations produce strategic damage sufficient to have potential neoplastic consequences chemical compound provoking such as a mutation called an initiator. Inititaon only conveys new potential to the cell, it does not produce an immediate cancer.