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rad pro final
flash cards for the final
| Question | Answer |
|---|---|
| 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
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