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rad pro final

flash cards for the final

4 effects on testes local effect atrophy- high doses sterility - temp >200 perm >500 low sperm count >10 show up later genetic mutation- low doses but can be fixed
4 possible effects to oocyte or ovaries atrophy - high doses sterility - temp >200r perm >500r Suppression or delay of period >10r Genetic mutation - low doses sometimes repairable
rads where mental retardation can occur 10 rad .5 increase over norma 6%
Large whole body prodromal effects depends on dose ranges from minimal to severe
local effect depend on tissue type may not be seen immediately
symptoms of hematological syndrome malaise, lethargy, fever, easily caught infections, death may occur in weeks
hematological syn occurs when Manifest stage and i n lower dose range 200 - 1000 rad to whole body
latent period lasts few hours for high doses weeks for low doses
large whole body effects in prodromal stage appear within hours and can last up to 3 days
Hw many rad to increase 2nd trimester congenital damage 10 rad ups it to 1% of normal 5%
during pregnancy rad. concerns congenital malformation or long term stochastic
Absolute risk for malignancy due to radiation 10cases/million/rad/year
acute leukemia have the clearest proof fro rad exp (a-bomb, ankylosis spondylitis)
latent period def. average time btw. rad. and appearance of effect. 3-20 years
Doubling dose for human is 50 - 250 rad
Spontaneous abortion and rad. exp only known effect for 1st 2 weeks although low even 10 rad cause .1% increase
rad. damage to embryo and fetus cause different effects depending on stage or pregnancy
do low dose long term rad doses have any effect on fertilization no good proof it does
Pre-preg. concerns fertility effects
Risk period def. span of time where effect may appear 20+years
relative risk for A-bomb and Ankylosis spondylitis a-bomb 2.8 A.S. 10
acute types of leukemia acute lymphocytic- A.L.L or Acute Myelogenenes- AML
Benign life span shortening only evidence from early rad. workers, no evidence from modern image workers
benign late effects skin--- very high doses cataracts oogenesis -- threshold 200 rad non linear life span --- very high doses
absolute risk of late effect estimates occurrence of an effect by a certain dose
long term effect seen where and AKA appear years after exp. aka late effects
local hematological effects components Bone marrow, circulating blood, lymphatic tissue (spleen, lymph nodes)
skin damage threshold depends on the energy of rad. low energy hurts the most
local effects means partial body exp. local areas of the body require high doses
LD 50/30 for humans 300rad
Rads of rad. that cause death little over 100- few deaths >600- all deaths
Gastro death occurs 4-10 days after symptoms
4 categories of short term effects whole body local hematological chromosomal
>100 rad occur where nuclear catastrophe, poss. radiation therapy, NEVER IN DIAGNOSTICS
large whole body effects 3 stages prodromal, latent, manifestation
large whole body prodromal symptom. nausea, vomiting, diarrhea,reduction of wt. blood cells, poss. general illness
Whole body effect latent period Patient feels? well, even if they receive large doses and might even think they recovered
when does whole body manifest illness stage appear at the end of latent
3 syndromes of manifest illness stage (al depending on dose) Hematological syndrome Gastrointestinal syndrome Central nervous system syndrome
is hematological syndrome lethal not always most bone marrow destruction depression of blood count
death and hematological syndrome may come weeks later if not recovered in six months
gastrointestinal syndrome dose range 1000-5000rad always lethal
Gastrointestinal syndrome patient have these symptoms hematological sypm. but die cuz damage to stem cells in the intestinal epithelium severe vomit, diarrhea intestinal bleeding
Avoid administering radio-iodine when woman is in first 10 weeks of pregnancy during nuclear medicine for thyroid
during gestation what damage can occur leukemia childhood level relative risk 1.5 after 10 rad
benign skin effects thinning, discoloration,dryness, cracking
dose response model's 2 characteristics threshold/ non threshold & linear/non linear
dose response relationship says more dose- more effect
excess risk expressed like absolute cases/million/rad/year
symptoms of CNS syndrome convulsion,ataxia,lethargy, and coma
LD 50/30 quantifies lethality of radiation LD= lethal dose 50/30 50% in 30 days
Local skin effects basal cell damage(stem) erythema with one day then again in weeks moist desquamation or necrosis epilation
local gonadal effects ovaries oogonia(stem) makes oocytes most sensitive to radiation
local gonadal effects testes spermatogonia (stem) more sensitive than mature spermatozoa
men who receive >1r0 to testes are asked refrain from baby making for 2-4 months
local hematological biggest concerns and damage bone marrow stem cells which decrease all blood cells found in ends of long bones and in flat bones like sternum and ribs
local hematological effects on circulating blood lymphocytes- most sens. and take longest to repair granulocytes (scavenger) increase in #s then drops platelets- minimal hurt RBC- most resistant
high doses of rad. on chromosomes produce observable damage as well as invisible point mutation on molecular level
chromosomal effects can be seen where on Karyotype or after mitosis
3 ways or methods to express risk of radiation induced effects relative absolute excessive
relative risk outcomes if incidence of irradiated = unirradiated population then the radiation did not cause the effect (this relative risk is 1)
6cases/million radiated ------------------- 3 cases/million non-radiated whats the relative risk relative risk is 2 6/3 = 2
absolute risk is expressed in #cases/million individuals/rad/year
absolute risk equation cases * amount of radiation * year
excess risk of late effects are # of xtra cases caused by radiation past the expected number
why is long term so hard to study incidence of effect are low actual dose is unknown many effects occur naturally or by other things
acute exposure (>100) cause short term effects (early)
lower doses of radiation on chromosomes presumably cause hurt but less often
long term greatest concern possible radiation induced cancer and gene`tic effect rad pro guidelines are based on this
long term effects can be caused by low chronic doses or high acute doses
short term effects AKA and range Early effects range from hours - a few months
late effects for relative risk is usually between 1 & 2 but up to 10
what causes short term effect and how much energy acute exposure >100 rad
liver cancer data contrast (thorium) latent 15-20 years
lung cancer data uranium miners from radon relative risk 8 for smokers 20
breast cancer data A-bomb and TB fluro facing tube relative risk up to 10
osteosarcoma data radium dial painters relative risk 122 - highest ever
local chromosomal effects follows what kind of model non-threshold
stochastic stuff all or nothing probablistic severity not on dose linear non threshold cancer and genetic
what model do cancer on genetic mutation follow linear non threshold safest model
acute leukemia follows linear non threshold latent 4-7 years risk period of 20 years
thyroid cancer data Chernobyl - short latent shrinking thymus glands - large latent linear non threshold no good proof for <300 rad
fruit fly and mouse resulted dose response relationship for mutation in linear non threshold stochastic
solid tumor skin cancer data radiation therapy pat. large to skin latent 5-10 threshold relative risk 27
cataract induction follow threshold non linear
cataract oogenesis benign effects eveidence from a-bomb early cyclone physist latent 15 years non linear threshold 200r
acute radiation lethality follows threshold non-linear model
skin effects follow s-shaped threshold (sigmoid)
technologists must give what info in accidental pregnancy xray machine or room used, exams and # of exposures, techniques and field sizes, SID, Patient measurement for each x-ray, fluro: KV and # of minutes spot film and technique factors (snap Pics)
intermittent fluro lower dose compared to continuous last image hold- helps to reduce need to locate structures again once it stars back up
how do you get CT doses lower move thru gantry fast (high Pitch) your technique
when to get mammography exams 40-49 every other year >50- every year
Cumulative timer for fluro sounds a signal after 5 min. of on tube time
who calculates dose given by acc. to preg. person medical physicist
what to do if unsure if patient is pregnant pregnancy test
why less scatter in CT tightly collimated beam
when should uterus be shielded whenever possible close to the edge of a field (5cm)
Glandular dose AKA expressed as mammography dose
why SSD of 12 in bedside shorter distance gives large entrance dose than exit dose
this gives largest dose in diagnostic radiation fluro cus it extends over minutes
1st step in calculating dose in accidental exp to a pregnant patient calculate ESE for each projection then est. fetal dose from a table
fluro image intensifiers reduce__________ and ___________ patient does and provide a brighter image
beam HVL for 80kVp normal filtration_____mmal 2.5
cineradiology rarely used movie camera records image dose much higher than conventional`
CT low mA causes unacceptable noise
other ways to express patient dose skin dose mRad bone marrow dose mRad gonadal dose Mrad not in mR
increased doses in children are caused by repeats ( motion unsharpness) improper shielding or no shielding not enough collimation
x-rays procedure no longer considered necessary routine chest on hospital adm. pre-employ chest and spin routine physical xray on healthy patient mass tuberculous screening chest
portable fluro and fixed fluro requirements are the same except source ( focal spot) can be as close as 12" in portable (hardly happens)
what is the ncrp report 102 suggests elective abdomen exams for women of child bearing years be done only the first few days after period
CT produces how much of a dose about the same as a complete radiological exam of the same part
FDA limit for glandular dose no more than 300mR for each x-ray
govt. limit for fluro max ESE is 10r per minute for image intensifier (special purpose equip may go higher)
How to avoid repeats careful performance and good communication skills make sure pat. understands qhat you are saying
protection during HLC fluro continuous warning signal
responsible for patient dose during fluro radiologist and other physicians
if pregnant and an xray is needed careful collimation shield where possible low dose techniques
bedside portable radiography SSD at least 12"
portable (c-arm) fluro is done where O.R. bedside
normal # of exposures per breast 2
children x-rays details more vulnearble require less exposure than adults
2 viewing modes of intensifier normal magnification more dose here
fetal dose tables beam quality are arranged by what HVL HVL up Effective energy up
when does day 1 begin foe a 10 day rule 1st day of period
doses to pat. are usually expressed as ESE in mR because that can be measured directly
CT higher mA causes mA up dose up
digital fluro more common short pulses of rad. (pulsed progression system) last image hold
#of days considered reasonably safe for xray from beginning of menstruation within 10 days 1970 by ICRP
# of rads considered risky for fetus 15 rad few exams produce that fetal dose amount
how to lower patient dose during fluro image intensifier intermittent fluro limit field size higher kV 88-120 source to table >15" 38 cm filtration cumulative timer Gov't limits dead man switch
dead man switch stops when button is released
how do you calculate glandular dose ESE
modern day equipment uses___________ continuous image (spiral or helical)
ACR american college of radiography
HLC fluro high level control used to visualize smaller low contrast structures dose 2 times conventional fluro
SSD source to skin distance
equipment calibration ionizing chamber detectors
geiger mueller detector details highly sens. to small amts of rad detects rad from spills or lost radioactive source audible signal as well as a meter not very useful in diagnostic image
prportinal counter survey instr. is lab instr. measures alph and beta not used in diagnostic
ionization chamber survey meter details cutie pie measures rad rate (mR/min) or total exp over a time period delicate measures wide range of exposures usually a rate meter
survey inst are ___________ portable detect and measure rad. in the environment
3 types of survey instruments ionizing chamber survery meter proportional counter geiger mueller(gm) detector
personnel monitoring report are reported_____________ and include monthly/ quartely personnel id inception date type of dosimeter rad quality dose equiv. data for: current period and cumulatively they follow you for life as a rad worker
thermoluminescence dosimeter details ceramic block with lithium fluoride photon energy store until read by heating it changed quarterly more expensive usually ring badges
charging the pocket ionization chamber does what sets scale to zero
pocket ionizing chamber details very sensitive but short term only immediate response short use for high dose situation looks like a pen needs to be charged before each use
disadvantages to OSL's no know disadvantages
optically stimulated luminescence dosimeters aluminum oxide detectors (storage phosphurs) more sensitive 1mrem greater range of photon energy sensitiveness changed quarterly
disadvantages of film badges monthly replaced susceptibility to fog from heat
control badge (film badge) does not receive any radiation
film badge details like dental film in plastic holders aluminum and copper filters read by densitometer shows doses 10mrem - 300mrem inexpensive and a permanent record
4 types of personnel monitoring devices film badge Optically stimulated luminescence dosimeter pocket ionization chamber thermoluminescent dosimeter
ring badge for_________ rad workers who espose hands to radition
badge worn where_________ high doses area get how many badges collar level they get 2 one for under their lead apron
what do most institutions do about personnel dosimetry give to all workers who might receive 1% of the limit (50mrem) per month
when is personnel dosimetry required when likely to receive more that 10% of annual occup. effective dose limit
pregnant rad workers are excused form fluro assisting portable 2 badges must be worn one at waist for fetal dose
diisclosure of pregnancy for rad workers is voluntary and in writing employer must provide counseling about safety and such
classification of adjacent rooms in occupancy factors (t) controlled- occupied bu rad workers only uncontrolled- occupied by other workers and general public much lower limit permitted herre
Occupancy factors (T) how much the adjacent rooms are occupied more people more shielding needed
use factor (U) How many times primary beam is pointed at a wall or surface Floor's use factor 1 wall's use factor 1/2 or less
workload (W) amount of radiation in rad room measured in mAs per week (mA-min)
Factors in structural shielding 3 enter in to calculation Workload (W) Use factor (U) Occupancy factor (T)
personal shielding lead apron - most common, leaded rubber or plastic, .25 mm of pb most have .5 Leaded gloves 025 mmpb in fluro - thyroid shield and leaded glasses
Fluro shielding 3 extra features lead curtain between patinet and dr lead bucky slot cover fluro carriage and intensifier acts as primary barrier for eyes and face of dr
rules for barriers never point a primary beam at a secondary barrier
Structural shielding 2 types Primary- protects against primary beam -1/16 lead (1.6mm/pb) -7 ft high Secondary- protect against scatter and leakage -1/32 lead or leaded glass or plastic - extends to ceiling
lead tube housing details covers all surfaces except window overlapped seams
4 different shielding factors lead tubing housing structural shielding fluro shielding personal shielding
these protect you and the patient smaller field size higher kVp most scatter is straight through to image high speed image receptors
3 basic rules of personnel protection aka cardinal rules minimize time of exposure maintain max Distance from source patient and tube housing and tube shielding
leakage radiation from tube housing must be less than 100mR p/hr @ i meter from hosing when tube is on at maximum
Basic rule for scatter protection Photon must scatter twice before reaching personnel that reduced it to 1/1,000,000 (0.0001%) of Patient ESE
Know this about right angel scatter right a scatter form patient at 1 meter has intensity of 1/1000 of patient ESE (0.1%)
where is the major source of scatter coming from Patient
3 indirect sources of radiation we must protect ourselves from scatter leakage off focus
Created by: johnpolcari