Ouhsc Rad Therapy Clinical Test 2

Front 1

This is the branch of medicine devoted to the study of understanding diseases

Back 1

pathology

Front 2

this is defined by cellular injury or malfunction

Back 2

disease

Front 3

what are the 2 main catagories of cell changes

Back 3

Reversible & Irreversible

Front 4

There are over ____ types of cancer

Back 4

100

Front 5

______ means new growth

Back 5

neoplasia

Front 6

Where does breast cancer usually met to

Back 6

bone

Front 7

Where does prostate cancer usually met to

Back 7

bone

Front 8

Where does lung cancer usually met to

Back 8

brain

Front 9

What are common ways cancer mets

Back 9

blood
lymph
seeding

Front 10

what are the 2 main catagories of radiation that people are exposed to

Back 10

natural background
man made

Front 11

what are the 3 types of natural background radiation

Back 11

cosmic rays
terrestrial radiation
internal exposure

Front 12

alpha particles have ___ protons and ____ neutrons

Back 12

2
2

Front 13

Alpha particles are emitted from what kind of nuclei

Back 13

unstable heavy nuclei

Front 14

Alpha particles have (high or low) linear energy transfere

Back 14

high

Front 15

With alpha particles, they are more hazardous if they are inhaled or come from an external beam source?

Back 15

more dangerous if they are inhaled. they have high linear energy transfere so they are extremely hazardous if ingested or inhaled, but when used in external beam, they can only travel a short distance and most can be stopped by a piece of paper

Front 16

these are electrons emmitted by the nucleus

Back 16

beta particles

Front 17

this is a positivly charged beta particle

Back 17

positron

Front 18

this is a negativly charged beta particle

Back 18

negatron

Front 19

When beta particles are emitted they are accompanied by a ______

Back 19

neutrino

Front 20

which is more penetrating, a beta particle or an alpha particle

Back 20

beta particle

Front 21

x-rays and gamma rays are both electromagnetic radiation, meaning they consist of _____

Back 21

photons

Front 22

x-rays and gamma rays have a mass of _____ and _____ charge

Back 22

0
no

Front 23

these are photons emitted from the nucleus of an atom

Back 23

gamma rays

Front 24

these are extranuclear and result from rearrangements within the electron shell or from bremsstrahlung radiaiton.

Back 24

x-rays

Front 25

what is the difference between x-rays and gamma rays

Back 25

their orgin
(x-rays come from electron shells and gamma rays come from the nucleus)

Front 26

x-rays and gamma rays are (high or low) linear energy transfere radiation

Back 26

low

Front 27

what are the most common types of ionizing radiation used in radiation therapy

Back 27

x-ray, gamma, and electron

Front 28

which is more penetrating, a beta particle or an alpha particle

Back 28

beta particle

Front 29

which is more penetrating, a beta particle or an alpha particle

Back 29

beta particle

Front 30

Natural background radiation accounts for____% of the exposure to U.S. population

Back 30

82

Front 31

x-rays and gamma rays are both electromagnetic radiation, meaning they consist of _____

Back 31

photons

Front 32

x-rays and gamma rays are both electromagnetic radiation, meaning they consist of _____

Back 32

photons

Front 33

x-rays and gamma rays have a mass of _____ and _____ charge

Back 33

0
no

Front 34

Cosmic rays account for what annual effective dose equivelant

Back 34

26 -50 mrem

Front 35

x-rays and gamma rays have a mass of _____ and _____ charge

Back 35

0
no

Front 36

these are photons emitted from the nucleus of an atom

Back 36

gamma rays

Front 37

these are photons emitted from the nucleus of an atom

Back 37

gamma rays

Front 38

these are extranuclear and result from rearrangements within the electron shell or from bremsstrahlung radiaiton.

Back 38

x-rays

Front 39

these are extranuclear and result from rearrangements within the electron shell or from bremsstrahlung radiaiton.

Back 39

x-rays

Front 40

what is the difference between x-rays and gamma rays

Back 40

their orgin
(x-rays come from electron shells and gamma rays come from the nucleus)

Front 41

what is the difference between x-rays and gamma rays

Back 41

their orgin
(x-rays come from electron shells and gamma rays come from the nucleus)

Front 42

x-rays and gamma rays are (high or low) linear energy transfere radiation

Back 42

low

Front 43

what are the most common types of ionizing radiation used in radiation therapy

Back 43

x-ray, gamma, and electron

Front 44

x-rays and gamma rays are (high or low) linear energy transfere radiation

Back 44

low

Front 45

Natural background radiation accounts for____% of the exposure to U.S. population

Back 45

82

Front 46

what are the most common types of ionizing radiation used in radiation therapy

Back 46

x-ray, gamma, and electron

Front 47

Cosmic rays account for what annual effective dose equivelant

Back 47

26 -50 mrem

Front 48

Natural background radiation accounts for____% of the exposure to U.S. population

Back 48

82

Front 49

Cosmic rays account for what annual effective dose equivelant

Back 49

26 -50 mrem

Front 50

Terrestrial radiaiton accounts for what annual effective dose equivelant

Back 50

16 - 63 mrem

Front 51

Internal exposure accounts for what annual effective dose equivelant

Back 51

20 mrem annually

Front 52

Manmade sources account for what annual effective dose equivelant

Back 52

60 mrem annually

Front 53

_____ mrem (of the 60 total from man-made) come from medical procedures alone

Back 53

50

Front 54

What 3 types of radiaiton are usually used in brachytherapy sources

Back 54

Gamma rays
X-rays
Alpha and Beta particles

Front 55

_______is defined as the amount of ionization produced by photons in air per unit mass of air.

Back 55

exposure

Front 56

Traditional unit for exposure is _____
The SI unit is _______

Back 56

Roentgen (R)
coulombs per kilogram (C/kg)

Front 57

1 Roentgen = how many coulombs/kg air

Back 57

2.58 x 10-4 C/kg air

Front 58

________ is the energy absorbed per unit mass of any material.

Back 58

absorbed dose

Front 59

Traditional unit for absorbed dose is _____
SI unit is _____

Back 59

rad
Gy (gray)

Front 60

With absorbed dose, how many joules of energy are absorbed per kilogram of absorbing material

Back 60

1 joule

Front 61

1 Gy = _____ cGy = _____ rad)

Back 61

100
100

Front 62

________takes into account the fact that different types of radiation produce different amounts of biologic damage

Back 62

dose equivalent

Front 63

rem stands for ______

Back 63

Roentgen Equivalent Man

Front 64

With _____ each type of radiation assigned a quality factor (QF)

Back 64

dose equiv

Front 65

how would you find the dose eqivalent

Back 65

rem = rad x QF

Front 66

Which unit takes into account high LET and low LET radiation

Back 66

dose equiv

Front 67

________ takes into account the effect of irradiation of only part of the body or the effect of non-uniform irradiation of the body.

Back 67

“Effective” Dose Equivalent

Front 68

With effective dose equivalent, to each significant organ is multiplied by a _________ for that organ and the sum is taken

Back 68

weighting factor (WF)

Front 69

________ is a rate at which a radioactive isotope undergoes nuclear decay.

Back 69

activity

Front 70

Traditional unit for activity is the _________
The SI Unit is the ______

Back 70

curie (Ci) = 3.7 x 10^10 dps

Becquerel (Bq) = 1 dps

Front 71

1 curie = how many disintigrations per second

1 becquerel = how many disintigrations per second

Back 71

(Ci) = 3.7 x 10^10 dps

(Bq) = 1 dps

Front 72

1 Ci = ____ Bq

Back 72

3.7 x 10 ^10

Front 73

What 2 radiation measurement devices in therapy use gas-filled chamber

Back 73

Ionization Chamber
Geiger-Muller (G-M) detector

Front 74

A properly calibrated ionization chamber is accurate within _____% so they are suitable for measurement of radiation output of therapy equipment

Back 74

2%

Front 75

Ring & wrist ‘badges’ are examples of what type of radiation monitoring device

Back 75

Thermoluminescent Dosimeters (TLD’s)

Front 76

__________ are used as TLD’s because of the intentional impurities in the material (“traps” some ionized electrons)

Back 76

Lithium fluoride crystals

Front 77

When the TLD's are heated up from ___ to ____ degrees, ____ are released from the impurities (traps) in the crystals, which results in _____ of visible light. Amount and intensity of light is proportional to the ________

Back 77

100 to 200
electrons
photons
radiation dose received.

Front 78

______are not only used for personnel monitoring but can be placed on the patient during treatment to measure the radiation dose

Back 78

TLD’s

Front 79

TLD's have a _____% accuracy

Back 79

5 %

Front 80

________are the most common personnel monitoring device utilized by radiation oncologist and therapist in radiation therapy departments

Back 80

Film badges

Front 81

With film badges, when irradiated the film turns ____
Optical density (proportional or inproportional) to amount of radiation received

Back 81

black
proportional

Front 82

Film badges have _____ that allow discrimination between different types and energies of radiation

Back 82

filters

Front 83

The overall accuracy of a film badge is

Back 83

+/- 20%

Front 84

Which type of radiation monitoring device uses laser light to stimulate
rearrangements of electrons
trapped in aluminum oxide Al2O3
when it is irradiated.

Back 84

Optically Stimulated Luminescent Dosimetry (OSL) Badges

Front 85

Amount of light given off after
laser stimulation is (directly
proportional or not directly proportional) to the radiation
exposure.

Back 85

directly proportional

Front 86

Which is more sensitive, OSL badge or a film badge

Back 86

OSL badge

Front 87

What does NCRPstand for

Back 87

National Council on Radiation Protection and Measurement

Front 88

What does ICRP stand for

Back 88

International commission on Radiation Protection

Front 89

What does UNSCEAR stand for

Back 89

United Nations Scientific Committee on the Effects of Atomic Radiation

Front 90

What does NAS-BEIR stand for

Back 90

National Academy of Sciences Advisory Committee on the Biological Effects of Ionizing Radiation

Front 91

Who oversees the use of isotopes for brachytherapy procedures and sources for external beam such as Cobalt

Back 91

Nuclear Regulatory Commission (NRC)

Front 92

If radioactive sources are transported who is involved

Back 92

Department of Transportation (DOT) and NRC

Front 93

The use of machines such as linear accelerators falls under the jurisdiction of the

Back 93

Food and Drug Administration (FDA) and state agencies

Front 94

We have more knowledge of high doses or low doses of radiaiton

Back 94

high doses

Front 95

LD 50/30 = 4.5 Gy
What does this mean?

Back 95

This means that a single whoel body exposure of approx 4.5 Gy (450 rads) is lethal to 50% of the exposed population within 30 days of the exposure.

Front 96

The NCRP states: A radiation worker should be at no higher risk of death from his or her employment than a worker in other “SAFE” industries.
-What does "safe” mean

Back 96

An annual accidental fatality rate of 1 / 10,000 per year

Front 97

This is the measure of the risk to a population as a whole form exposure to ionizing radiation of some of all of the members of that population

Back 97

Genetically significant dose

Front 98

Would a 70 year old woman have the same GSD as female teenager?

Back 98

no. the 65 year old woman would have a GSD of 0, the teenagers GSD would actually be weighed because she has a long reproductive life ahead of her

Front 99

The estimate for lifetime cancer risk for acute whole body exposure to low LET radiation is approx _______

Back 99

8 in 100 per Sv
(8 in 10,000 per rem)

Front 100

The overall risk of exposure to radiation is approx _______

Back 100

7 in 10,000 persons per rem

Front 101

This takes into account that a threshold exists for which the severity of the effect increases with dose

Back 101

Non-stochastic threshold

Front 102

This takes into account that there is no threshold, and that the probability of occurrence is a function of dose

Back 102

Stochastic threshold

Front 103

What is the dose limit for radiation workers

Back 103

50 mSv (5 rem) per year

Front 104

What is the dose limit for the general public
Frequently exposed and infrequently exposed

Back 104

Frequent 1 mSv (0.1 rem)
Infrequent 5 mSv (0.5 rem)

Front 105

What is the dose limit for an embryo/fetus

Back 105

5 mSv (0.5 rem) during gestation

Front 106

Radiation therapy uses higher _____ than conventional radiography, which translate to deeper penetration

Back 106

energies

Front 107

Limiting time of exposure is of consequence with the few cobalt 60 units still in use. Since they continuously emit small amounts of radiation it is important to limit time near the ____ of the cobalt unit

Back 107

head

Front 108

With ______ time is not a factor since no one but the patient is allowed in the treatment room during beam on

Back 108

linear accelerators

Front 109

Distance is not a factor with external beam because.......

Back 109

no personnel are in the treatment room

Front 110

________is the most important method for protection of personnel and family in a radiation therapy department

Back 110

Shielding

Front 111

________ for superficial x-ray units is similar to conventional x-ray units

Back 111

Shielding

Front 112

What kind of sheilding is preferred for superficial units

Back 112

Lead

Front 113

Linear accelerators and cobalt machine shielding is usually an economic or space factor because a given wall may be sheilded with different thicknesses of ____ , ______, or _______

Back 113

concrete, steel, or lead

Front 114

When shielding a therapy room, 1m of concrete = ___ m of iron which = ____m of lead

Back 114

1m of concrete = 0.30 m of iron, which = 0.21 m of lead

Front 115

When calculating the shielding requirements for linear accelerators what three main factors must be taken into consideration

Back 115

Workload (W)
Use factor
Occupancy factor

Front 116

Workload for linear accelerators and cobalt equipment is usually specified in .........

Back 116

cGy per week at the isocenter

Front 117

This is computed by taking the number of treatments per week and multiplying it by the isocenter dose.

Back 117

Workload

Front 118

If we had 200 patients per week with an isocenter dose of 300cGy, what would the workload be

Back 118

60,000 cGy per week

Front 119

The _________ in radiation oncology must be determined by how the equipment will be utilized

Back 119

use factor

Front 120

Unlike conventional x-ray rooms the radiation beam in therapy will be aimed at different positions; at the ceiling, both side walls and the floor
If the use factors can not be determined then the NCRP report No. 49 is used: ____% for floor,____for each wall & _____ for the ceiling

Back 120

100
¼
¼

Front 121

The ______ is the fraction of time an area adjacent to the therapy room is occupied

Back 121

occupancy time

Front 122

________ is why most vaults for linear accelerators are built having at least one wall to the outside of the building

Back 122

occupancy time

Front 123

How often are visual and audio componants checked

Back 123

daily

Front 124

Who must grant a license for departments to receive radioactive sources such a brachytherapy

Back 124

NRC

Front 125

Inventories of sources for brachytherapy are required how often, even when no implants are being performed

Back 125

weekly

Front 126

Brachytherapy sources must be tested for leaks at intervals not to exceed _____

Back 126

6 months

Front 127

The differentiation of a benign tumor is (good or poor)

Back 127

good

Front 128

The differentiation of a malignant tumor is (good or poor)

Back 128

poor

Front 129

is there encapsulation in a benign tumor

Back 129

yes

Front 130

is there encapsulation in a malignant tumor

Back 130

no

Front 131

this term refers to a malignant tumor taking its orgin from epithelial cells, which are wide spread and generally considered to be cells that line surfaces

Back 131

carcinomas

Front 132

this term refers to a neoplasm arising from cells other than those forming epithelial surface

Back 132

sarcoma

Front 133

This term refers to no cellular differentiation

Back 133

anaplastic

Front 134

This term referes to the great variability in size and shape of “undifferentiated” tumor cells

Back 134

Pleomorphic

Front 135

It is thought that maybe the etiology of bladder cancer comes from ________

Back 135

chemicals

Front 136

It is thought that maybe the etiology of esophagus cancer comes from ________

Back 136

viral infections

Front 137

This is the time between initiation & cancer

Back 137

latent period

Front 138

This is the sequence of events following the absorption of energy from ionizing radiations,
the efforts of the organism to compensate,
the damage to the organism that may be produced.

Back 138

radiobiology

Front 139

The 5 responses a cell has on radiaiton are that radiation may or may not interact with a cell.
If interaction occurs, damage may or may not be produced in the cell.
The initial energy deposition occurs rapidly & is ________
Visible tissue changes after irradiation are not usually distinguishable from those from other traumas.
Biologic changes that occur after irradiation do so after some time has elapsed.

Back 139

non-selective

Front 140

Radiosensitivity of a tissue or organ is a function of the ......

Back 140

most sensitive cell it contains.

Front 141

What is the time frame for a cellular reaction to radiation to be considered early or acute

Back 141

Within 6 months

Front 142

What is the time frame for a cellular reaction to radiation to be considered late or chronic

Back 142

6 months or later

Front 143

High Linear Energy Transfer radiaiton include what 3 types of radiaiton

Back 143

Alpha Particles, Protons, some neutrons

Front 144

Low Linear Energy Transfer radiaiton include what 3 types of radiaiton

Back 144

X-rays, Gamma rays, some neutrons

Front 145

This type of damage results from the interaction from ionizing radiation

Back 145

Direct damage

Front 146

This type of damage results from ionizing radiation through the radiolysis of water

Back 146

Indirect damage

Front 147

This is a highly reactive species with an unpaired valence outer-shell election

Back 147

free radical

Front 148

We want the cell to enter programmed cell death aka, _________

Back 148

apoptosis

Front 149

This is the ability of radiations with differing LETs delivered similar conditions to produce the same biologic effect

Back 149

Relative Biologic Effectiveness (RBE)

Front 150

This compares the response of cells with radiation in the presence or absence of oxygen

Back 150

Oxygen Enhancement Ratio (OER)

Front 151

Molecular oxygen O2 is a _________. It (increases or decreases) free radical formation

Back 151

radio-sensitizer
increases

Front 152

Ionizing Radiation is more effective against cells that
1) are actively mitotic
2) are undifferentiated (anaplastic)
3) have a long mitotic future
This is the law of

Back 152

Bergonie & Tribondeau

Front 153

What are the 4 R's of radiobiology

Back 153

Repopulation
Repair of sub-lethal damage
Redistribution
Re-oxygenation: applies to tumors only

Front 154

Proportion of _______cells re-oxygenate and become more sensitive for the next fraction of radiation.

Back 154

hypoxic

Front 155

Some believe _____ of communication is non-verbal

Back 155

2/3

Front 156

This type of verbal message consists of the actual facts & words of the message

Back 156

Cognitive

Front 157

This type of verbal message may be verbal or non-verbal & comprises feelings, emotions, attitudes & behaviors

Back 157

affective

Front 158

This is identifying with the feelings, thoughts or experiences of another person

Back 158

empathy

Front 159

Significant weight loss at 1 week is ___%, severe weight loss is _____%

Back 159

1-2%
>2%

Front 160

Significant weight loss at 1 month is ___%, severe weight loss is _____%

Back 160

5%
>5%

Front 161

Significant weight loss at 3 months is ___%, severe weight loss is _____%

Back 161

7.5%
>7.5%

Front 162

Significant weight loss at 6 months is ___%, severe weight loss is _____%

Back 162

10%
>10%

Front 163

What is the most feared consequence of cancer

Back 163

pain

Front 164

What are some examples (in the book) of viruses that cause disease

Back 164

Smallpox
Hepatitis B
HIV
Ebola

Front 165

What are some examples (in the book) of Bacteria that cause disease

Back 165

Vibrio Cholerae
Streptococci
Mycobacterium tuberculosis

Front 166

What is an examples (in the book) of protozoa that cause disease

Back 166

Plasmodium malaria

Front 167

This is the ability of an infectious agent to cause clinical disease

Back 167

Pathogenicity

Front 168

This describes the severity of a clinical disease and is typically expressed in terms of morbidity and mortality

Back 168

Virulent (virulence)

Front 169

This is the time interval between exposure and the appearance of the first sympoton

Back 169

Incubation

Front 170

This is the stage of recovery from an illness

Back 170

Convalescence

Front 171

Thsi is a contaminated inanimate vehicle that transmits an infectious disease

Back 171

Fomite

Front 172

This is an air born pathogen that is the remains of a droplet (5 micrometers or smaller) that has evaporated

Back 172

Droplet nuclei

Front 173

These are routinely shed superficial skin cells

Back 173

Skin squames

Front 174

This is something that transmits an infection to a host. Example is a fly, or a mosquito

Back 174

Vector

Front 175

A substance that when introduced into the body stimulates the production of an antibody.

Back 175

Antigen

Front 176

they are specific; they work only against a specific antigen

Back 176

Antibody

Front 177

This is a serum containing antibody. It is a sterile solution of globulins derived from pooled human blood that contains antibodies that are normally present in the blood of adults, used as a passive immunizing agent against rubella, measles, and hepatitis A and as treatment for hypogammaglobulinemia.

Back 177

Immune Serum Globulin (ISG)

Front 178

This is a genetically engineered DNA made by recombining fragments of DNA from different organisms

Back 178

Recominant deoxyribonucleic acid

Front 179

Beginning with transmissoin, what is the rest of the infection cycle

Back 179

Transmisson
Entrance portal
Susceptible host
Reservoir host
Exit portal

Front 180

What are the 5 transmission routes

Back 180

contact
droplet
common vehicle
airborne
vectorborne

Front 181

Define morbidity

Back 181

the proportion of sickness or of a specific disease in a geographical locality.

Front 182

Define mortality

Back 182

fatal outcome

Front 183

Common vehicle spread is the type of transmission that involves a contaminated inanimate vehicle known as a _______ for transmission of the infectous agent to multiple persons

Back 183

fomite

Front 184

This is where the microorganism lives and reproduces

Back 184

A reservoir

Front 185

Droplet contact and airborne transmissions are differentiated from one another by......

Back 185

particle size and distance

Front 186

skin, cilia in upper respiratory system, the acidity in the GI and urinary tract serve as a hostile environment, tears exhibit antibacterial activity, local inflammatory action, personal hygene, and age are examples of .........

Back 186

Nonspecific defense mechanisms

Front 187

Natural and artificial immunity are examples of

Back 187

Specific defense mechanisms

Front 188

This develops as a result of having acquired a specific disease

Back 188

Natural immunity

Front 189

Artificial immunity can be subdivided into

Back 189

active immunity and passive immunity

Front 190

vaccine serving as an antigen is an example of what type of immunity

Back 190

active immunity

Front 191

This is the transfer of protective antibodies from one host to a susceptible host. An example of this is immune serum globulin (ISG) and / or maternal antibodies

Back 191

passive immunity

Front 192

List a few enviromental factors that contribute to nosocomial disease

Back 192

airflow
temp
humidity
carpet and upholstered furniture in a hospital increases microbial level
flowers and fruit with immunosupressed patients
used linen
using sterile technique when tattooing patients
not using the same pen on different patients, etc

Front 193

When antibiotics are used to treat a bacterial infection, most bacteria will die. However, mutated bacteria may survive and go on to do what

Back 193

go on to produce more drug resistant clones.

Front 194

The transfer of a drug resistant gene from a harmless microbe to a harmful microbe occurs throught the ______ process

Back 194

conjugation process.

Front 195

What are the recommended vaccines for health care workers

Back 195

Hepatitis B (HB or HBV
Influenza
Measles, Mumps, Rubella (MMR)
Varicella
Tetanus, Diphtheria, Pertussis (pertussis is whooping cough)

Front 196

What is the effective vaccine for TB

Back 196

there is none

Front 197

What was one of the leading causes of death at the turn of the century

Back 197

TB

Front 198

is the disease that causes chickenpox and shingles.

Back 198

Varicella-Zoster Virus

Front 199

In cancer patients, chickenpox can be fatal. If exposed, a nonimmune cancer patient can be given a .........

Back 199

varicella-zoster immune globulin (VZIG).

Front 200

In 2007, the FDA approved , ________ a vaccine for the herpes-zoster virus

Back 200

Zostavax

Front 201

If not immune and exposed to varicella a health care worker should be excluded from work beginning on the _____ day after exposure and may not return until after the incubation period which is ______ days

Back 201

10th
21

Front 202

If an exposed health care worker receives the VZIG after exposure to lessen the severity, they may not return back to work for __ days after exposure

Back 202

28

Front 203

What was the disease that changed how health care workers applied blood and body fluid precautions

Back 203

HIV / AIDS

Front 204

review box 10-7

Back 204

review box 10-7 on pg 207

Front 205

Diseases requiring airborne precautions

Back 205

Measles
Varicella
TB

Front 206

Diseases requiring droplet precautions

Back 206

Diphtheria
Pertussis
Pneumonic plague
Mumps
Rubella
Influenze
Severe acute respiratory syndrome (SARS)
Avian flu

Front 207

Equipment used on patients who have been placed on one or more of the transmission based precautions should be cleaned in the same manner as patients on _______ precautions unless the pathogen or the amount of environmental contamination are such that special procedures are necessary.

Back 207

standard