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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show | procedure of locating the tumor, documenting it with CT or radiograph, creating any immobilization aids you need, constructing any blocks/positioning aids, and taking measurements.
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show | reproducability and accuracy
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show | central axis
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define IFD | show 🗑
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define PSA | show 🗑
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define POP | show 🗑
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define what a radiopaque marker is and describe its use | show 🗑
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show | how thick the patient is, use IFD or calipers
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list and describe the 3 specific target volumes | show 🗑
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show | left posterior oblique - gantry angle on left side of patient's back
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define and describe LAO | show 🗑
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show | right posterior oblique - ganty angle on right side of patient's back
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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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define STD | show 🗑
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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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define contrast media and give examples | show 🗑
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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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show | positioning aids - provides reproducability, simple aids to assist patient with potion but not hold (head rest, knee sponge)
simple immobilization - restricts some movement but not all (velcro, tape)
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immobilization cont. | show 🗑
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show | radiographic components - fluoro & image intensifier (proof and setup)
mechanical components - table, gantry, collimator
optical components - lasers, ODI, field light
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define photo timing | show 🗑
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show | exposure techniques, phototiming cells, film processor,
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state the most sensitive variable factor in the production of radiographs | show 🗑
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show | where radiograph is taken anatomically (area of interest), preliminaryfied size, fluoroscopy to fine tune field
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show | all setup information, picture, SSD, isocenter, couch/gantry/collimator angle, immobilization devices, diagram, patient information, where tattoos are
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show | visual positioning - positioning the patient by sight
radiographic positioning - using untrasound or xray to confirm patient position
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explain a patent contour | show 🗑
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show | transverse
coronal
sagittal
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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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show | aluminum
pantograph
CT (most accurate)
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summarize treatment verification | show 🗑
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show | benefits - beam orientation, outline of critical structures, delineate target volume and lymph nodes, boost fields, BEV
limitations - aperture size, flat couch, block verification cannot be performed, lateral cutoff
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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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most important equipment | show 🗑
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list the time periods in which the patient response to treatment is monitored and recorded | show 🗑
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show | 2 forms of ID - picture recognition, patient bracelet, DOB, area of treatment, license
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show | verifies patient information and treatment area/dose, makes sure the right patient is receiving the right dose to the right area
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list the components of a daily treatment record | show 🗑
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show | anatomic site, total dose, fractionation, treatment technique, beam energy, patient positon
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show | single line through incorrect information, wrie correct information, initial correction
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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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show | image taken to verify that the treatment is working and is treating the correct area
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show | port
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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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state the 2 techniques that can be used for beam shaping and the 2 shapes that an unblocked beam will appear as | show 🗑
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show | treatment prescription - the fractionated dose prescribed to a patient
treatment plan - dose the patient will be receiving along with patient setup, immobilization aids and specific details
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describe the role of the radiation therapist in treatment deliveryq | show 🗑
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show | gap - distance between the borders of 2 adjacent fields
hot spots - volumes of tissue that receive more radition than the prescribed dose
cold spot - tissue volumes that receive less than the prescribed dose
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discuss the purpose and application of beam modifiers, bolus, wedges | show 🗑
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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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show | superior vena cava syndrome - *best known*, lung tumor pressing on superior vena cava, lack of blood flow, blue lips, difficulty breathing, high dose radiation (no biopsy, just treat)
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pericarditis | show 🗑
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show | build up of fluid in pericardial space, from breast cancer, leukemia, dyspnea, shortness of breath, dyspnea, surgery or chemo
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show | fluid accumulation in the pleura (between outsie of lung lining and chest cavity), dyspnea, surgery
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spinal cord compression | show 🗑
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describe electron contamination | show 🗑
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show | POP - parallel opposed portals - 180 degrees apart
4 field - AP, PA, right lateral, left lateral
wedge-pair - 2 beam with a wedge (head & neck)
conformal - several beams, multiple fields (prostate)
arc therapy - treatment as gantry moves (beam on), ra
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show | stereotactic radiosurgery-fixing patient to table, treating with several angles, pencil thin line
TBI-total body irradiation, bone marrow transplant
IMRT-intensity modulated radiation therapy, high precision radiation therapy to conform to 3-D tumor vol
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show | cervical, vaginal, endometrial, breast, prostate, some head and neck
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show | treatment from a short distance
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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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define the radiobiology of brachtherapy with concern to the 4 R's | show 🗑
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describe the use of brachytherapy as an adjuvant modality | show 🗑
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list 3 benign conditions that brachytherapy can be used for | show 🗑
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show | radium-226
cesium-137
iridium-192
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show | fibrosis
stenosis
atrophy
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most common prostate seeds used | show 🗑
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show | within thetissue or tumor - breast, prostate
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define intracavitary | show 🗑
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define intraluminal | show 🗑
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define intravascular | show 🗑
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show | placing source on the area to be treated - eye, keloids
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show | need source strength for prescription, allows us to identify quantities, helps create the dose - stronger source, less time needed in the body
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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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show | total number of atoms that decay per unit time
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show | .693/t(1/2) = decay constant
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source activity formula | show 🗑
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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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show | 74 days (beta)
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show | 59 days (beta)
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half life of Au-198 | show 🗑
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half life of radon-222 | show 🗑
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half life of copper-64 | show 🗑
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show | 14.3 days (beta)
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show | 8 days (beta)
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half life od strontium-90 | show 🗑
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show | cobalt60 - 1.25MeV
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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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show | average lifetime for decay
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describe 137Cs | show 🗑
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describe 192Ir | show 🗑
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describe 60Co | show 🗑
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show | 2.8 day half life
412 KeV energy
seeds - brain, prostate
encapsulated in platinum
permanent implant - leave it in
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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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describe and differentiate between low dose rate and high dose rate brachytherapy | show 🗑
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advantages to high dose rate brachytherapy | show 🗑
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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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describe an intracavitary applicator and list its use | show 🗑
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show | esophagus and trachea
seeds or implants placed in tubes
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describe an endobronchial applicator and list its use | show 🗑
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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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show | intracavitary implants - patient must hold still
interstitial implants - painful (head and neck) swelling in that area
unsealed I131 - no capsule, excreted through sweat, blood, feces, urine
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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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show | patient is put in the pressurized tube, they breath in pure oxygen for 30 minutes to 2 hours
patient may feel tired, light headed
can get oxygen toxicity, can't go in if have lung issues
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state the genetic material used for gene therapy | show 🗑
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list the 6 general ways in which gene therapy is used | show 🗑
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describe risks of gene therapy | show 🗑
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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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state the physical property that makes a proton useful | show 🗑
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describe how a proton is made | show 🗑
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What is DART | show 🗑
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Dart techniques | show 🗑
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show | beam on/beam off, sensor on chest to account for patient breathing
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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:
Kayleeh18