P&P final - nhti
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show | diagnosis, therapeutic decisions (method of treatment), target volume localization Locate), fabrication of treatment aids, treatment planning, treatment, patient evaluation during treatment, patient follow up
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show | radiation therapist, oncology nurse, dosimetrist, physician
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show | conventional SIM - DRR (digitally reconstructed radiograph), 2-D, fluoroscopy, locate fields, locate target, shape the field
CT - work station, spiral scan, 3-D, locate target, shape field and beams
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define simulation | show 🗑
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state the key of successful simulation | show 🗑
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define CAX | show 🗑
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show | intrafield distance
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show | patient support assembly
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show | parallel opposed ports, 2 fields 180 degrees apart
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define what a radiopaque marker is and describe its use | show 🗑
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describe the patient separation measurements | show 🗑
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show | GTV - gross tumor volume, tumor only
CTV - clinical tumor volume, tumor plus subclinical disease
PTV - planning tumor volume, CTV & GTV, accounts for patient movement
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show | left posterior oblique - gantry angle on left side of patient's back
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show | left anterior oblique - gantry angle on left side of patient's front
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define and describe RPO | show 🗑
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define and describe RAO | show 🗑
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define and describe the difference between SAD and SSD | show 🗑
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define ODI | show 🗑
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define SDD | show 🗑
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define SFD | show 🗑
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show | source to target/tray distance
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define TT | show 🗑
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show | anatomic body planes, CT imaging, conventional simulation and CT simulation
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state the 3 major anatomic body planes | show 🗑
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summarize the difference between CT simulation and diagnostic CT | show 🗑
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show | where tumor is, densities, BEV, tells what organs laser will travel through
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show | image technique used in planning of radiation treatment, view of exactly where te laser will encounter the body
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define orthogonal fields | show 🗑
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show | - a drug to make internal organs visible on CT
- barium (GI, colon, rectum), iodinated contrast (vascular system, bladder) (postive shows up white)
- positive agents - radiopaque, show up white
- negative agents - radiolucent, shows up black (air)
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show | positive pathology
consent
prepare immobilization devices
prepare room
explanation
make sure flat table
simulate patient through apperature
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summarize the conventional simulation procedure | show 🗑
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show |
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state the 3 categories of immobilization and summarize each | show 🗑
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immobilization cont. | show 🗑
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describe the simulator controls | show 🗑
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define photo timing | show 🗑
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list several tips for producing high quality radiographic portals | show 🗑
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show | film processor
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show | where radiograph is taken anatomically (area of interest), preliminaryfied size, fluoroscopy to fine tune field
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list the patient setup information that is always in the chart | show 🗑
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state the 2 ways that patient positioning can be performed | show 🗑
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show | the outline of a patient's body
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list the 3 types of patient contour | show 🗑
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show | solder wire - plyable, cheap, stay away from open wounds, need pressure to mold
plaster strip - cheap, molds, could get into wounds, warm, sticks to hair
aquaplast - accurate, reusable, sticks to hair, takes a while to dry
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list the 3 types of mechanical contours | show 🗑
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show | vrify that you are treating the right patient, right dose, right field - make sure everythign is right
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state the benefits and limitations of CT simulation | show 🗑
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describe room preparation, explanation of procedure to patient and patient positioning for a CT simulation | show 🗑
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show | treatment chart - remains in oncology dept., legal document, primary element of QA progra
medical records chart - patient's history
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show | chart
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show | throughout and following completion of treatment
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show | 2 forms of ID - picture recognition, patient bracelet, DOB, area of treatment, license
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describe a record and verify system and explain its use | show 🗑
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show | dose prescription, setup parameters, daily dose record
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list all of the components of a prescription | show 🗑
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explain the process should a correction need to be made in a chart | show 🗑
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show | treat every patient as if they are carriers of bloodborne pathogens
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show | get as close as possible, lock the wheels, get help, let patient do as much as possible, be parallel with treatment couch, use movin board, use your knees, 2 people lift, universal precautions (glove up)
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list the different areas that serve as landmarks for localization | show 🗑
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define verification image and explain its use | show 🗑
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state the alternate term for a "field" | show 🗑
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define orthogonal fields | show 🗑
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show | systemic error - if not fixed, it would stay that way (clearlyff, setup incorrectly)
radom setup error - if not changed, chances are they would go back and be ok
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show | must take a good image, time factors, poor image quality
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show | semipermanent - markers, paint, bleeds on skin, may be toxic, need to be re-touched
permanent - tattoos, stay, can always tell where patient has been treated
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show | MLC, cerrobend blocks
square and rectangle
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compare the treatment prescription with the treatment plan | show 🗑
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describe the role of the radiation therapist in treatment deliveryq | show 🗑
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define a gap and the terms hot spots and cold spots | show 🗑
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show | beam modifiers - device that changes the shape of the treatment field or distribution of the radiation at depth
bolus - tissue equivalent material that brings beam anterior, evens outskin, increase skin dose
wedges - beam modifier, lessens beam dose
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discuss the purpose and application of compensators | show 🗑
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show | unexpected complication, unexpected condition, life threatening
superior vena cava syndrome
pericarditis
pericardial effusion
malignant pleural effusions
spinal cord compression
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SVC | show 🗑
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pericarditis | show 🗑
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pericardial effusion | show 🗑
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show | fluid accumulation in the pleura (between outsie of lung lining and chest cavity), dyspnea, surgery
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show | bone tumor pressing on spine, metastasis to spine, RT, chemo, or surgery
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describe electron contamination | show 🗑
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discuss the different field arrangements that can be constructed with discussion of new treatment modalities | show 🗑
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discuss the different field arrangements that can be constructed with discussion of new treatment modalities - cont. | show 🗑
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show | cervical, vaginal, endometrial, breast, prostate, some head and neck
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define the term brachytherapy | show 🗑
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show | cosmetic and functional results, don't have as many side effects, large dose to tumorwith sharp dose fall off to surrounding structures
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show | repair and repopulation of healthy cells - not affected with brachytherapy
redistribution - can still treat cells
reoxygenation - shrink tumor, center becomes more oxygenated
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show | brachytherapy can shrink tumor before another form of treatment or give a boost of radiation to the tumor while not giving dose to surrounding tissue
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show | keloid
pterygium
hyperthyroidism
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3 commonly used brachytherapy materials | show 🗑
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show | fibrosis
stenosis
atrophy
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most common prostate seeds used | show 🗑
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define interstitial | show 🗑
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show | within a cavity - cervix
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show | within a tube - esophagus, uterus
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show | within a vessel - coronary vessels, stenosis
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show | placing source on the area to be treated - eye, keloids
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summarize the reasons that source strength is useful in the field of brachytherapy | show 🗑
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show | curie, Becqueral
1 curie = 3.7x10^10 dps (disintegrations per second)
1Bq = 1dps
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oldest radioactive source | show 🗑
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define radioactive decay | show 🗑
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define decay constant | show 🗑
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decay constant formula | show 🗑
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show | A = Ao e- (.693/t(1/2)*(T)
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mean life formula | show 🗑
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inverse square law formula | show 🗑
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show | 1622 years (alpha)
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show | 5.26 years (gamma)
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show | 30 years (beta)
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half life of iridium-192 | show 🗑
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show | 59 days (beta)
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show | gold-198 - 2.8 days (beta)
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show | 3.8 days (beta)
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half life of copper-64 | show 🗑
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half life of phosphorus-32 | show 🗑
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half life of iodine-131 | show 🗑
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show | 28 years (beta)
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average energy of 60Co | show 🗑
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average energy of 226Ra | show 🗑
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show | cesium137 - 662KeV (.662MeV)
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average energy of 192Ra | show 🗑
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define mean life | show 🗑
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show | radium substitute
high dose rate afterloader
uterine and cervix
30 year half life - long half life
662 KeV energy
temporary implant
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describe 192Ir | show 🗑
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show | 5.26 year half life
energy 1.25MeV
external treatment
ocular melanoma - plaque on eye
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describe 198Au | show 🗑
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describe 125I | show 🗑
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show | 1622 year half life
830KeV energy
decays to radon gas then to lead (becomes more stable)
pellets
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show | low dose rate - up to 12Gy/hr dose rate, in patient, in hospital for a few days
high dose rate - any dose rate above 12 Gy/hr, preferable, after loader(cesium), out patient, can go home, (high dose, short time), less expoure to staff
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show | out patient, can go home
high dose short time
less exposure to staff
patient gets a specific dose
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describe an interstitial applicator and list its use | show 🗑
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describe an external applicator and list its use | show 🗑
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show | insertion of radiioactive source into body cavity
sparing dose to adjacent sensitive structures
rectum, bladder
tandems and ovoids
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describe an intraluminal applicator and list its use | show 🗑
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show | 192Ir high dose rate afterloader
radioactive source placed in bronchus
catheters placed n bronchus
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show | Patterson-Parker system - Manchester system *most common*
the Quimby/memorial system
the Paris system
computer calculations
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summarize radiation therapy and nursing procedures for brachytherapy | show 🗑
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show | process of introducing oxygen to the body to help repair tissues damaged by radiation therapy
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list the cases in which hyperbaric therapy has been used | show 🗑
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describe how the patient is treated using a hyperbaric machine | show 🗑
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show | DNA or RNA
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show | replace missinf/altered genes
radiosensitizers - weaken cell, more susceptible
radioprotection - make body stronger
improve immune response - able to fight
suicide genes - genes that self destruct
prevent development of new blood vessels
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show | low level virus
mutate healthy cells into becoming cancerous
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describe how a gene is introduced into a cell | show 🗑
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compare and contrast photons and protons | show 🗑
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show | positive charge
Bragg peak - travel to certain depth, give off all energy, exit dose
pediatric, head and neck, ocular melanoma
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describe how a proton is made | show 🗑
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show | dynamic adaptive radiation therapy
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show | respiratory gating
IGRT
IGBT
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describe respiratory gating | show 🗑
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describe IGRT | show 🗑
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show | image guided brachytherapy
using image guiding while brachytherapy in patient via ultrasound
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Created by:
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