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Onc II final
Terms in this set (572)
The most common presentation of Hodgkin's disease is a enlarging mass in the
The peak incidence for Hodgkin's disease is:
The xiphoid is at the level of:
How would a stage lll Hodgkin's disease be treated?
mantle and inverted Y fields
T / F HD shows a second "peak" of incidence in old age. These patients generally have a poorer prognosis than younger patients.
Involvement of two or more lymph nodes on the same side of the diaphragm is classified as what stage of Hodgkins disease?
A benign tumor made of fat cells would be called a/an:
A patient presenting with HD in the cervical, axillary and para-aortic lymph node groups would be what clinical stage?
Clinically, what anatomical landmark may be used as the inferior border of a mantle field?
Kaposi's sarcoma is commonly associated with all of the following demographic groups EXCEPT:
South American descent
The lymphatic organs are the
spleen, tonsils, thymus, and lymph nodes
Structures in Waldeyers ring are seldom involved in patients with HD. However, with such involvement, what nodes must be treated in the Waldeyers ring field?
The most commonly occurring soft tissue sarcoma is:
A typical dose for HD would be how many Gray?
Sarcomas tend to spread via:
T / F Radiation therapy is the definitive treatment modality for most soft tissue sarcomas.
The single most important factor in the outcome (prognosis) of soft tissue sarcoma patients is:
histological grade (degree of cellular differentiation)
Though soft tissue sarcomas can arise anywhere in the body, they are most likely to occur in what area?
T / F Mantle fields may require extended SSD calcs due to field sizes larger than the maximum field size of the machine.
Subdiapgragmatic fields are most commonly used to treat what stage(s) of HD?
The Cisterna Chyli is located at the level of
A "mini-mantle" might be used to treat patients with involvement of all of the following nodes except:
mediastinal (including hilar)
Treatment fields used to treat Hodgkins disease (TNI) are known as
mantle and inverted Y
Which of the following is most clearly associated with the etiology of soft tissue sarcomas:
a.tobacco b.previous irradiation for brain tumors c.previous irradiation for Mantle field/breast treatment d.infection
C. previous irradiation for mantle field/breast tx
Multiple myeloma is a neoplastic proliferation of
The lateral borders of a mantle field must include the:
What tumors appear almost anywhere fat is present?
T / F MM is invariably an incurable disease but it can usually be controlled for long periods of time.
T / F Multiple Myeloma (MM) occurs most commonly in childhood/adolescence.
T / F Chondrosarcoma is rare in childhood but becomes more prevalent with advancing age.
What is the most frequent site of metastatic involvement of a soft tissue sarcoma?
What is the most common presenting symptom of multiple myeloma?
What is the primary modality in the treatment of multiple myeloma?
Which of the following is the least common site of incidence for Ewing's sarcoma and osteogenic sarcoma?
A possible late effect of MOPP chemotherapy for HD would most likely be:
The overall 5 year survival rate for HD is about ___%.
Mycosis fungoides is a type of
t cell lymphoma
The prognosis of lymphoma is least influenced by
ethnic background of pt
What ethnic group is multiple myeloma most common in?
The most common site of primary bone tumors is near the:
The staging system for Hodgkins disease is
A staging system for lymphoma is the
Hodgkins disease patients with "A" symptoms are
A Hodgkins patient presents with a 4 cm. mass in the left supraclavicular area, what is the clinical stage?
Which of the following primary bone tumors is most radiosensitive?
This is the life support sheath providing nutrient blood for bone cells and a source of bone developing cells during growth and after fracture:
Most primary bone cancers are:
The incidence of primary bone tumors is highest in what age group:
What study best shows a soft tissue sarcoma?
With what type of bone tumor do radiographs show a classical "moth-eaten" pattern to the cortex of a the bone?
What sarcoma originates in connective tissue of nerve sheaths?
What will therapeutic doses of radiation to growing bone and cartilage result in for children:
A marked retardation of bone growth
What is the most frequent primary bone tumor?
Which is the most radiosensitive of the soft tissue sarcomas?
T / F There is thought to be a viral etiology for NHL.
Which of the following is NOT a common site for NHL?
What lesions are the most lethal of the soft tissue sarcomas?
T / F Nodular NHL generally has a more aggressive course than diffuse lymphomas, and, therefore, a poorer prognosis.
The definitive treatment of choice for NHL is usually:
chemo with or without RTT
What is the most common site of presentation of a genitourinary sarcoma?
T / F The overall prognosis for NHL is better than for HD.
Radiation for NHL is generally used for: 1. low grade tumors; 2. high grade tumors; 3. early stage tumors (I&II); 4. late stage tumors (III,IV)
Which bone tumor is more susceptible to women than men?
TBI or HBI might most likely be used in palliating this cancer discussed in this section:
What should the borders be on a primary bone tumor of the femur?
the whole involved bone
Patients with this bone tumor often present with anorexia, weight loss, chills, fever, and malaise
What type of bones are typically found in the extremities?
What type of bones include those of the cranium, ribs and sternum?
What is the most frequent site of metastatic involvement of primary bonetumors?
A typical adult has how many bones?
Which of the following Is NOT a "B" symptom of Hodgkins disease?
all of these are HD "B" symptom
Which of the following Is NOT a "B" symptom of Hodgkins disease?
all of these are HD "B" symptoms
where do b cells mature?
The thymus gland functions in immunity by producing:
Which nodes are included in the inverted Y field? 1. Retroperitoneal; 2. Common iliac; 3. Inguinal; 4. Popliteal
In the treatment of Waldeyer ring for nonHodgkin lymphoma, the fields' delineation closely resembles that of carcinoma of the:
What is the Hodgkins disease (cell type) with the worst prognosis?
Name the most common type of Hodgkins disease
Name the second most common type of Hodgkins disease
What is the Hodgkins disease with the best prognosis, according to the podcast lecture?
What chemo regimen is most commonly used for NHL (initials are OK)?
Traditionally, what Chemo regimen has been commonly used to treat HD and has now, according to lecture, been pretty well replaced by ABVD (just give the initials)?
Lecture described two primary differences between lymphoma and Hodgkin's disease (two things that distinguish HD from NHL). One is presence of Reed-Sternberg cell. What is the other?
What is the name of the treatment position for HD whereby the patient has their arms at their sides, hands on hips, with their chin tilted up?
What is the name (or abbreviation) of the virus that may be associated with causing HD?
The superior border of a mantle field should enter the___________________and exit through the ______________________________________ (in essence, a line drawn from the (name of more anterior structure)__________ to the _(name of more posterior structure)_
mental point; mastoid tip
Name the two principal lymph nodes ducts
For diffuse involvement of one or more organs, the involved site should be identified by symbols used for pathologic staging. Identify what the following symbol stands for. P+
For diffuse involvement of one or more organs, the involved site should be identified by symbols used for pathologic staging. Identify what the following symbol stands for. D+
For diffuse involvement of one or more organs, the involved site should be identified by symbols used for pathologic staging. Identify what the following symbol stands for M+
Histologically, list the four types of Hodgkin's disease
Describe the blocking typically employed with a Mantle Field (what areas are blocked):
lungs, humeral head, throat/larynx, safety/cord
In a TNI field, the APPA para-aortics typically have an extension off to the patient's left side if the patient has had a splenectomy. What is that area commonly called?
T / F The CNS is primarily composed of gray matter and not white matter.
Substances that pass through the blood brain barrier must be water and/or ______soluble.
The inner meninges (or membrane) is called the:
This is a collection of white nerve fibers that connect the two hemispheres of the brain:
This is the largest part of the human brain:
The third ventricle leads to the fourth ventricle by means of a canal called the:
aqueduct of Sylvius
CSF is formed largely in the:
A pituitary patient is being treated with RTT. The patient lays supine on the table and the table is rotated ("kicked") to 90 degrees. The gantry is rotated to 240 (Varian). This portion of a multi-field technique field is termed:
Another name for the anterior pituitary is the:
This disorder is characterized by an elevated metabolic rate, abnormal weight loss, excessive perspiration, weakness, emotional instability, and exophthalmos:
Another name for adrenalin is:
Most childhood (CNS) tumors occur in this (be specific) lobe of the brain:
The area for language and speech development is called:
This brain stem area is located lateral to the third ventricle and is a crucial relay station for incoming and outgoing motor signals:
All sensory input to the brain, except that of smell, connects to this brain stem area:
Brain tumors are the ___leading cause of cancer death in children
AIDS patients are more inclined to have this type of CNS tumor
T / F In general, prognosis for CNS malignancies is better for younger patients than for older patients.
Which of the following is the most common endocrine cancer?
The 2nd most common symptom of a CNS tumor is:
This is the most common histological type of primary CNS tumor:
This portion of the brain is divided into a left and right hemisphere:
Metastatic lesions to the brain are most likely to come from what primary site?
This is the most common type of pediatric CNS tumor
Most pituitary tumors are:
Which of the following factors is most closely related to pituitary tumor etiology?
T / F Radiation to primary brain tumors never results in some degree of permanent or semi-permanent hair loss.
A chemotherapy drug that is most likely to be used for treating primary CNS tumors is:
The most common type of glioma is:
The most common location for a glioma to occur is in the:
This disease is also known as a grade IV astrocytoma:
Examples of hypoxic radiosensitizers include all of the following except:
Astrocytomas usually occur in what region of the brain?
Astrocytomas occurring in this area of the brain have the best prognosis of any astrocytoma:
Low grade (adult) astrocytomas have a 5 yr survival of about ___ %.
These tumors arise in cells that produce myelin, the fatty covering that protects the nerves:
Treating children less than ____ years old with CNS RTT is especially problematic because of the developing brain.
The primary treatment for accessible GBM tumors is:
The 5 yr survival for GBM is about ____ % .
less than 1
The dose for GBM is about ____ Gy.
The use of cytotoxic drugs activated by laser light during a surgical procedure is called:
Tumors arising from the star-shaped cells in the brain are called:
This CNS tumor may invade the vermis and/or the floor of the fourth ventricle:
These tumors (AKA suprasellar tumors)occur most frequently in children and young adults who present with adiposogenitalis (aka Frolich's syndrome)
These tumors may arise anywhere along the craniospinal axis but occur most commonly in the adrenal gland:
This is the most radiosensitive (and best cure rate) of any CNS tumor:
These tumors originate from the parenchyma of the pineal gland:
A striking feature of this tumor is its dissemination through the CNS pathways along the length of the spinal canal by means of what is known as "drop metastases":
This CNS tumor is most closely associated with the German Helmet radiation field:
These are congenital tumors that may be found anywhere along the vertebral column but occur predominantly at the base of the skull and in the sacrococcygeal area:
This is universally recognized as the most malignant type of CNS tumor:
T / F When intracranial tumors develop in the midbrain or brain stem regions, the prognosis is generally less favorable.
These are benign tumors that arise in the cells that produce the myelin which protects the acoustic nerve. These tumors are more common in women than men:
Which of the following CNS tumors is NOT associated with total spinal irradiation (TSI) as a treatment option?
Which of the following is NOT a possible late effect of CNS irradiation to children?
intellectual function deficit
visual and fine motor coordination and memory deficit
The WHO (World Health Organization) classifies this tumor as a distinct grade IV astrocytoma:
Which of the following is NOT a field arrangement commonly used for pituitary tumors?
3 field technique
Craniospinal axis fields typically treat all the way down to what spinal level?
In total spinal axis irradiation, the dose to the whole brain and spinal column would typically be about ___ Gy.
In total spinal axis irradiation, a boost of 10 Gy would typically be added to this area:
This chemo agent has been shown to enhance the effects of radiotherapy for medulloblastoma:
T / F All metastatic brain lesions respond the same to radiation, regardless of the primary site histology.
The dose associated with temporary epilation is about ____ Gy.
The dose associated with permanent epilation is about ____ Gy.
abnormal growth of hair
T / F RTT is rarely used to treat ca of the adrenal cortex due to its unfavorable therapeutic ratio.
The pituitary is situated within a structure called the:
This type of radioisotope has been indicated etiologically in thyroid ca.
Which of the following endocrine tumors has the poorest prognosis?
T / F Pituitary tumors usually occur in the elderly (RYI: "elderly" means retirement age and older).
Hypersecretion of the adrenal cortex can result in this syndrome:
Elongation and enlargement of various bones, especially in the face and jaw is a sign of what syndrome?
T / F Even benign pituitary tumors can be a threat to the patients life.
T / F Surgery is the only hope for cure (definitive tx) for pituitary patients.
What would be a typical field size for a pituitary tumor?
This cell type of thyroid ca has the worst prognosis.
This cell type of thyroid ca is the most radiosensitive.
T / F Suprasellar tumors are more common than intrasellar tumors.
What is the recommended surgical technique for a pituitary tumor?
This is the most common cell type for thyroid ca.
A typical dose for a pituitary adenoma might be:
The thyroid partially surrounds what cartilage?
This type of radioisotope has been shown to cure thyroid ca.
About _____% of goiters are malignant.
Which of the following is not an etiologic factor for thyroid ca?
previous radiation exposure
prolonged TSH stimulus
lack of dietary iodine intake
The area of the cerebrum responsible for sensory and association is the:
A glioma spreads by means of:
The primary management modality for primary brain tumor is:
The tolerance dose TD 5/5 for the optic nerve or chiasm is:
During primary brain tumor irradiation, dose to normal brain tissue should be kept below:
Describe exactly where the adrenal glands are located.
superior to kidneys
This lobe is the only one that is not readily accessible to the surgeon and does not have a name corresponding to a bone in the skull:
island of reil
This is the lobe that is primarily responsible for vision:
The most common initial symptom for a CNS tumor is:
PET scans are becoming increasingly popular for diagnosing CNS disease. What do the initials PET stand for?
positron emission tomography
This category of medications, which includes the drug Decadron, is used to control cerebral edema:
Another name for pituitary/master gland is:
What is a function of the thyroid?
produces hormones responsible for metabolic regulation
Briefly describe the Patterson-Farr technique
--what disease(s) it is used for, how many fields are used, what body parts are treated?
used for medulloblastoma/posterior fossa
whole brain and whole spine
Which cranial nerve number controls the inner ear?
Which cranial nerve number controls the ANTERIOR tongue?
What is cranial nerve #3 called?
What is cranial nerve #10 called?
What is cranial nerve #5 called?
Radiotherapy alone, without biopsy, is often given for tumors occurring in the?
What do the initials GBM stand for?
The spinal cord begins at the _________________________ and ends at _______ (spinal level)
foramen magnum; L4
The area of the lung in which the blood lymphatic vessels and nerves enter and exit each other:
The anatomy between the lungs that includes the heart, thymus, major blood vessels, etc. that help position the lungs:
Total dose for hyperfractionated lung fields is typically:
Dose to the lung is typically _______% higher than what is normally expected:
Esophagitis typically occurs at doses at or around ________ Gy.
Dysphagia typically occurs at doses at or around ________ Gy.
The esophagus is about __ cm long
The lower esophagus extends from the hilum to:
The most common presentation of esophageal cancer is
The location of most esophageal cancers is
Histologically, the vast majority of esophageal carcinomas are of this cell type.
squamous cell carcinoma
Which of the following lung cancer cell types would most likely be able to be treated with a "postage stamp" boost option?
Barrets esophagus is associated with what histologic cell type of cancer:
What is the most important factor in selection of the modality of treatment for an esophageal tumor?
Which esophageal site is best treated with radiation rather than surgery?
A ________ cm margin should be given superior and inferior to an esophageal tumor when planning radiation fields.
At which of the following primary sites is a squamous cell carcinoma most likely to develop?
Inflammation of the entire heart:
Which of the following has the poorest prognosis?
SVC occurs in about ___% of lung cancer patients.
Where in the stomach are most gastric carcinomas found?
Distal stomach on the lesser curvature
A Karnofsky Performance Rating of less than ____ is considered a poor prognostic factor.
Some lung cancers, as stated in the Misc. lung cancer info, are linked (etiologically) to chromosome # ____
What is the second leading cause of cancer mortality in the United States?
A radioprotectant for healthy lung tissue:
The longest segment of the small intestine is the:
Carcinoma of the small bowel usually involves the:
The most common symptom of small bowel ca is:
The most common symptom of colo/rectal cancer is:
The best single agent chemo for treating lung carcinoma is:
Colon cancers tend to be ____________ while rectal cancers tend to be__________ .
adenocarcinoma, squamous or carcinoid
Lymphatic spread of rectal ca tends to be via the _____ nodes.
peri-rectal; internal iliac, presacral
Metastasis of colorectal cancer most commonly involves the
Colorectal staging classification might use these staging systems
dukes staging, MAC
Colorectal staging depends on:
Depth of tumor invasion into the bowel
What is the most common anatomical site for a colo/rectal lesion?
The most commonly used modality to treat colo-rectal cancer is:
Colonoscopy is recommended every 10 years beginning at what age?
The most commonly used (conventional) field arrangement, giving the best dose distribution, for a colo-rectal lesion is:
3 fields w wedges
The superior border of an appa colo-rectal field is at:
The anterior border of a lateral colo-rectal field is typically at:
The primary dose limit thing structure in treating colorectal cancer is:
What chemotherapy drug might most likely be used to treat colo-rectal cancer?
The overall survival for colorectal cancer is about ___%.
Virchow's node is a classic sign of inoperability of what cancer?
Endocavitary therapy would most likely be used on what site?
Diarrhea developing during pelvic irradiation is most likely secondary to radiation induced injury to the
The esophagus begins at:
cricoid cartilage, C6
Which of the following is the most common symptom of lung cancer?
What type of lung cancer, along with squamous cell, tends to be located centrally?
What type of lung cancer arises from the surface epithelium?
Which diagnostic procedure is essential for oat cell carcinoma?
The most common (cell) type of lung cancer is ___________________________
Mitomycin C is one of two effective chemo agents used for treating cancer of the:
What type of lung cancer is also known as epidermoid cancer?
A variety of agents have been proven to be carcinogenic in humans. What is the dominant etiologic agent for lung cancer?
What type of lung carcinoma tends to be peripherally located?
What type of lung cancer is also known as oat cell carcinoma?
What lung cancer histology most commonly occurs in women?
These tumors have been the principle cell type described in uranium workers:
Which neoplastic lung disease is best etiologically related to exposure to certain types of asbestos?
What types of cancer are prone to invade the mediastinum?
squamous and small cell
Lung cancer most commonly spreads to all but which of the following nodes?
Which histological type of lung cancer does surgery play no important role in?
All of the following statements are true of patients having a Pancoast tumor EXCEPT:
a. Rib destruction is common
b. Itmay involve the brachial plexus
c. The patient usually has a mass in the lower lobe
d. It may present with severe pain in the shoulder and arm
e. Possible sensory or motor disturbances
c. The patient usually has a mass in the lower lobe
The most radiosensitive histologic type of lung cancer is:
What type of lung cancer is MOST clearly related to cigarette smoking?
Lung cancer tends to spread through the hilar nodes (among many others). Hilar nodes are also known as the _____ nodes
Identify the MOST serious complication (text interpretation) that a patient can have from receiving primary lung cancer irradiation.
Surgery is not indicated when a lesion is within 2 cm. of what structure?
Smoking is responsible for approximately what percentage of all cancer deaths?
The trachea extends from:
The "Major Complication" of lung irradiation is:
The trachea branches into the left and right bronchi at what level?
What lung cancer cell type could have, as part of the radiation treatment, prophylactic whole brain irradiation?
The tolerance dose the spinal cord is _____ Gy.
Familial adenomatous polyposis is an etiological factor for which cancer:
The definitive treatment modality for early state lung cancer is:
The posterior border of a lateral colo-rectal field is typically at:
1.5-2cm behind the anterior bony sacral margin
Doses for SCLC are typically:
Doses for NSCLC are typically:
what is the end portion of the GI tract?
A patient with middle lobe posterior lung tumor may be positioned prone to facilitate:
Easier alignment of off-cord obliques and boost fields directed posteriorly
The natural slope of the chest may cause high dose regions in the upper mediastinum. This area of increased dose may be managed by the use of a:
A radiation treatment field with and upper border above both clavicles and lower border approximately 5 cm below the Carina, including mediastinal lymphatics and blocking most of the left lung would likely be:
An initial field for treatment of an upper lobe right lung tumor
The most common histologic type for small bowel cancer is:
The curative treatment of choice for gastric carcinoma is:
Three-field technique for treatment of the rectum are weighted 2:1:1 PA:RT:LT. Total prescribed dose is 50 Gy. The posterior field contribution will be:
Patients scheduled for radiation therapy to the lower esophagus will likely experience:
Intestinal tumors grow progressively through the layers of the intestines in the following order:
Mucosa, sub mucosa, muscularis, serosa
In an anal cancer case, and electron boost will be required for the superficial inguinal nodes determined to be approximately 5 centimeter deep from the anterior surface. The appropriate electron energy beam would be:
The "Vermiform process" is also better known as the _____________________________
Crohn's disease is an ideological factor for what cancer site?
What is the Carina?
bifurcation of trachea
two other names for Virchow's node:
left supraclavicular node
Define Barrett's esophagus
when the esophagus is lined with culumnar epithelium instead of stratified squamous; condition usually worsens with acid reflux
Virtually all patients with this hereditary trait - no initials please - develop colon cancer:
familial adenomatous polyposis
A colorectal tumor invading the serosa without positive nodes would be what stage?
What do the initials HNPCC stand for?
herediatry nonpolyposis colon cancer
What do the initials FTT stand for?
false table top
T/ F Teeth decay more readily after radiation treatment whether they are in the treatment field or not.
Surgery is the definitive modality for what H&N cancers?
What is the most common histologic cell type for malignancies of the H&N?
squamous cell carcinoma
What is the most common primary site of cancer in the oropharynx?
What is the most common primary site for a lesion in the hypopharynx?
Changes in salivary gland function generally begin to occur after about _______ of radiation t reatments.
What is the most common site for H&N cancer?
What head and neck cancer is not associated with tobacco use?
The most important indications for pre-irradiation extractions include all of the following except:
a. advanced periodontal disease
b. changes in the oral microflora
c. high caries index
d. poor oral hygiene
b. changes in the oral microflora
For cancer of the oropharynx, what site has the best prognosis?
tonsil (and soft palate)
In general, H&N cancer prognosis: 1. decreases as you progress backwards from the lips to hypopharynx; 2. increases as you progress backwards from the lips to hypopharynx; 3. decreases as the lesion crosses over midline; 4. increases as the lesion crosses over midline
RTT doses for nasopharyngeal tumor are typically ___ Gy
What head and neck cancer has the highest incidence of positive nodes and distant metastasis at presentation?
What malignancy (site) would most likely be treated with a single en foss electron field or mixed-beam field?
The palatine tonsil is located in the:
Nearly ______ of the body's lymph nodes are located in the H&N area.
External beam doses for H&N cancers (in general) are usually around:
What is the only known etiologic factor for carcinoma of the salivary gland?
Furniture workers have a higher incidence of cancer of this site: 1. Nasal fossa; 2. Nasopharynx; 3. maxillary sinus
H&N cancers as a whole, tend to spread via:
direct extension and lymphatics
The major curative modalities for most H&N cancers is/are:
The pharyngeal tonsil is located in the:
what is in the oral cavity?
Retromolar trigone, floor of mouth, buccal mucosa
Chemodectomas occur most often at what site?
What is the lymphatic spread of the true vocal cords?
generally has no lymphatic spread
Leukoplakia is more common in this site of the oral cavity than any other:
Invasion of the mandible is often involved with this type of cancer:
Of cancers of the oral cavity, which site has a predominate female ratio?
In what head and neck site is facial nerve paralysis virtually diagnostic of cancer ?
The prognosis/staging of a true glottic cancer is best determined by :
In cancer of the oral tongue, lymphatic drainage is most likely to involve these nodes:
sub-maxillary and Jugulodigastric (jugular) node
T / F Hyperfractionation has shown to improve survival rates for many H&N cancer sites.
Another name for the retropharyngeal node is:
The majority of laryngeal lesions occur in what area?
The most common area of the oral tongue for cancer is:
The vast majority of salivary tumors occur in which salivary gland?
The true vocal cords are located within a cartilaginous structure called the:
Most lip cancers occur in:
T / F H&N patients undergoing RTT should avoid any fluoride treatments as they can be abrasive to the oral mucosa.
There is a strong relationship between nasopharyngeal cancer and what specific virus?
Ohngren's line is a line drawn from the:
inner canthus to gonion
Thrush is a sign of what microbial organism?
Chronic sinusitis and/or nasal polyps are etiologic factors for what H&N cancer?
What structure is in two separate regions of the H&N?
Which of the following areas should be included when irradiating a tumor of the nasopharynx? 1. Nasopharynx; 2. Retropharyngeal nodes; 3. Base of skull; 4. Posterior 1/3 of the orbit
The nasopharynx, anatomically, extends from the _________ to the ________.
zygomatic arch; EAM
Referred otalgia and sore throat are possible symptoms of carcinoma of the:
What type of therapy has shown the good potential for treatment of mixed malignanttumors of the parotid gland?
Which of the following locations in the H&N is least susceptible to mucositis?
What is the approximate dose that mucositis first appears in irradiated head and neck patients?
Mutation of gene 53 is a possible etiologic factor for which H&N cancer site?
Cancers in this region are the most lethal of H&N cancers:
Persistent hoarseness and sore throat are most indicative of carcinoma of the:
What is the primary etiology for a cancer of the buccal mucosa?
chewing tobacco and snuff usage
Small (T1,T2) laryngeal lesions should be treated with:
large laryngeal lesions (T4) are best managed with:
RTT and surgery
Furniture and woodworkers are at higher risk for what H&N cancer?
Which of the following nodes is NOT involved with cancer of the floor of the mouth:
Which of the following disease sites is LEAST likely to involve lymphatics?
This chemo drug is the most common single agent used for H&N cancers:
The superior (anatomical) border of the maxillary sinus is the:
floor of orbit
Plummer-Vinson syndrome is associated with which H&N cancers?
Malignant parotid tumors are primarily of this histology:
adenoid cystic with some mucoepidermoid and adenocarcinoma
A typical dose for glottic carcinoma would be:
How many cartilages make up the larynx?
The _____ nodal group, below the mastoid tip, receives nearly all of the lymph from the head and neck area and is often included in the treated area:
The jugulodigastric node may also be referred to as:
Which lymph node area has a very high risk for dissemination of disease, is inaccessible for surgery, and therefore must be included as the minimum target volume in treating the nasopharyngeal area?
In some head and neck cancers, the supraclavicular area is often treated if there is advanced disease or lower involved nodes. The normal dosage of irradiation to this area is:
The treatment field for a primary tumor in the hypopharynx includes the node of Rouviere. A sharp field edge is necessary to avoid and protect the:
Tumors of the head and neck may involve the cranial nerves that control our major senses. This may lead to signs and symptoms that can point to a possible location of the tumor. Which area would be the most common for involvement of cranial nerves?
The most common site of distant metastatic disease from the head and neck area is the:
The "conventional" wedge-pair technique often used in treatment of the parotid gland is:
Superior/inferior oblique combination
ringing of the ear
Painful swallowing of food
discharge from the ear
H&N cancers, worldwide, are etiologically related to "pan" chewing and the chewing of what else?
The larynx is divided into three regions, name them:
A viral infection of the salivary gland is known as:
Describe both the superior and inferior borders of a typical conventional larynx field:
Superior: top of hyoid bone
Inferior: cricoid cartilage
What is the most common site for cancers in the hypopharynx?
The larynx extends from the thyroid cartilage to the ______________________________
Osteoradionecrosis is most commonly a result of:
dental extractions after RTT
What is a dewlap?
How long should be allowed for healing after tooth extractions before starting radiation therapy treatments?
Main spread of nasopharyngeal cancer is to what three nodes:
List the TNM staging for larynx (true vocal cord) cancer.
I: Confined to larynx, normal cord mobility
II: Supra or sub-glottic extension, normal to impaired cord mobility
III. Still confined to larynx, fixed vocal cords
IV: Extension beyond larynx, and or cartilage destruction
Which of the following is a syndrome is an etiologic factor for leukemia:
About how many lobes are in each breast?
The most significant risk factor for breast cancer is:
Studies have shown that women with what type body shape appear to be at a 3 times increased risk rate for breast cancer?*
ER negative breast tumors have what type of response rate to hormonal manipulation?
What pathologic type of breast cancer, on the average, affects younger woman?
Tamoxifen is used for patients with an ER status of:
A female patient shows a right breast that is swollen, red, and warm. It is confirmed that the patient has a 5 cm mass. What is the diagnosis?
CLL that displays thrombocytopenia would be this stage:
Breast cancer is the number ____ cancer in terms of incidence for women.
Breast cancer is the number ____ cancer in terms of mortality for women.
Breast cancer affects one out of every ____ women.
T / F Breast cancer incidence increases with increasing age.
Which gene(s) is/are associated with breast cancer incidence?
A reservoir via a burr hole leading to the third ventricle by which methotrexate can be introduced directly into the CNS is called a __________ reservoir.
T / F Chronic leukemias tend to consist of larger, sticky cells than those seen in the acute leukemias.
T / F Bilateral breast cancer is unheard of in the medical literature.
At what age should a woman have a baseline mammogram?
At what age should a woman begin having mammograms every other year?
At what age should women begin having yearly mammograms?
50 and above
This is the only type of leukemia that is still considered incurable:
Lesions of the medial and central breast areas more frequently spread to what lymph node group?
Regarding flow cytometry, which of the following is associated with a poorer prognosis: 1. diploid tumors; 2. anuploid tumors; 3. M-phase; 4. S-phase
Estrogen receptors are found more commonly in:
post meno women
The most important prognostic indicator for breast cancer is:
axillary lymoh node status
What type of breast histology is termed "cancer of the breast"?
This breast cancer histology is associated with the symptom Peau d' Orange:
On average, this breast ca cell type is associated with younger, pre-menopausal women:
This histological classification of breast ca is characterized by rapid growth, poor prognosis, and a tendency to spread aggressively to a variety of different sites:
Male breast cancer accounts for about ___ % of all breast cancers.
T / F Male breast cancer has a better prognosis than female because it is easier to detect due to the lack of breast tissue to interfere with screening.
More than _____ positive axillary nodes implies a much more poor prognosis.
An anti-estrogen traditionally used by patients that are positive for hormone receptors is called:
T / F For intact breast treatment (assume intact on all questions unless I state otherwise), all ipsilateral breast tissue must be treated regardless of the size of the initial tumor.
The energy range best suited for breast treatment is:
Patients with this type of leukemia will present typically with a fever, anemia, etc. Generally present as being very acutely sick:
T / F The axilla area needs to be included in the tangential fields.
Patients with this type of leukemia will undergo a "blast crisis" and almost always die unless given a BMT
This person developed a staging system for CLL:
About how much flash is required on the tangential fields for breast treatment?
The dose to the entire breast should be ________ Gy.
If a boost field is used in breast treatment, the total dose should be about ______ Gy.
The dose to the chestwall of a post-mastectomy patients should be about ___ Gy.
The overall 5 year survival rate for breast carcinoma is about ___ %.
T /F Chronic leukemias tend to arise more from well differentiated cells while acute leukemias tend to arise from poorly differentiated cells.
Part of chromosome #22, also known as the _______ chromosome, is lost in detecting CML:
CLL that has an 8 year median survival and displays lymph node enlargement would be this stage:
This kind of leukemia is the most common form occurring in children (is most commonly referred to as "childhood" leukemia):
Unless treated with a bone marrow transplant, patients with this type of leukemia can live for several years before a second chromosome change occurs and the disease quickly becomes fatal:
This type of acute leukemia sometimes "hides" in sanctuary sites:
Down's syndrome is an etiological factor for which type of leukemia?
The Posterior Axillary Boost (PAB) field is intended to irradiate:
level 3 axillary nodes
When using a breast board for positioning, the optimal incline angle is influenced by:
the slope of the pts chest
When the supraclavicular fossa is treated along with opposing tangents, the supraclavicular field is best treated using:
half field technique
The acceptable amount of lung tissue included in tangential breast fields is 2.0 cm in order to decrease the changes of latent:
Ductal carcinoma in situ (DCIS) is classified as:
A breast cancer classified as T3 N1 M1 with the metastasis to the supraclavicular nodes only would be grouped as:
A sentinel lymph node biopsy involves the injection of a blue dye and radioactive:
When leukemic cells accumulate in the bone marrow, there is an impairment of the body's normal production of adequate supplies of:
red blood cells
Factors that lead to failure in bone marrow transplants include: 1. Recurrent disease; 2. Autologous donors; 3. Graft-versus-host disease
Patients with ________always exhibit lymphocytosis:
Which leukemia has the worst prognosis?
When treating a TBI, what might be used during the first treatment to check midline doses and are placed at specific areas such as the patient's ankles, knees, and thighs:
In a helmet field treatment, it is very important to cover the meninges and C2. Which of the following is not one of the layers of the meninges?
A "generic" cell that has a lot of growth potential is called a _________________ cell.
A bone marrow transplant (BMT) in which the patient receives marrow from someone other than themself is called what kind of BMT?:
If a BMT patient's body rejects the new bone marrow or immunity cells as being "foreign", this results in what specific non-malignant disease?
graft v host
What is the functional unit of the breast?
What is the typical presentation for a breast cancer?
lumo discovered by pt
What is the 2nd most common presentation for breast cancer?
non lactational discharge
Besides the two tangential fields, name three other treatment FIELDS associated with breast treatment:
What does ALL stand for?
acute lymphocytic leukemia
What does CML stand for?
chronic myelogenous leukemia
Breast cancer commonly spreads through three lymph node groups, name them:
Name two of the leukemia "sanctuary sites"
Describe the inferior border of a breast tangential field:
1-2 cm caudal to inframammory chain
Describe the lateral border of a breast tangential field:
CR at midaxillary line
For what pathologic type of breast cancer is induction chemotherapy given as an initial treatment?
What German physician coined the term "leukemia?"
What is the name of the person that developed the radical mastectomy surgical technique?
Lithotomy position, or "frog-leg" position, would most commonly be used to treat this site:
Spermatogenesis may be affected (inducing temporary sterility) with doses as low as ___cGy, while cumulative doses above ____ cGy will probably induce permanent sterility.
What is the MAJOR RISK FACTOR for endometrial cancer?
A double fold of peritoneum attached to the stomach is called the:
Which of the above characteristics are most closely related to high risk/etiologic factors for cervical cancer according to the lecture? 1. multiple sex partners; 2 obesity; 3. Nulliparity; 4. Smoking; 5. hypertension/diabetes
Surgery is the treatment of choice for what stages of cervical cancer?
A monthly exam beginning shortly after puberty would best apply to what male urologic ca?
The overall 5 year survival for cervical cancer is about:
Radiation therapy for endometrial cancer is typically performed post-operatively and is used for the medically inoperable as well as what common stages?
Instead of metastisizing distantly, ovarian carcinoma tends to spread locally, especially to what structure?
T / F Most cervical ca's aren't detected until they are advanced.
What is the most common cell type for endometrial ca?
The vast majority of ovarian cancers (90%) are of this histologic type:
For what stage(s) of cervical ca is RTT most often used definitively ?
The primary definitive treatment modality for ovarian carcinoma is:
T / F Seminomas have a poorer prognosis as compared to non-seminomas.
Gynecomastia would most commonly result from:
prostate ca treatment
ER+, PR + status has this effect on prognosis.
The overall survival rate of endometrial ca is about:
The inner portion of the ovary (or any organ for that matter) is called the:
T / F Ovarian ca usually presents in an advanced stage.
The first node group for cervical cancer spread is :
T / F Chemotherapy is more effective than RTT for non-seminomas.
The prognosis for seminomas is about _____% 5 yr survival.
Most vaginal carcinomas are squamous cell, but this cell type is seen in women exposed to DES and tend to occur in younger women (median age=19):
Cervical carcinoma extending to the pelvic wall and/or invading the lower 1/3 of the vagina describes what exact T stage?
Cervical carcinoma invading beyond the cervix but not to the pelvic wall or lower 1/3 of vagina describes what exact T stage?
Ca of the vagina usually occurs in this region of the vagina:
The moving strip technique is used to treat what type of ca?
What is the most radioresistant gynecological structure?
What nodes does the "stack" part of a smokestack field treat?
para aortic nodes
Staging for cervical (indeed, all GYN ) carcinoma is most commonly done using this system:
This is a small bowel coating agent used to decrease the effects of RTT to the small bowel (diarrhea):
"Disordered cellular development" describes what pre-malignant cervical disorder?
What is the most common cell type for cervical ca?
squamous cell carcinoma
The most common histology for renal cell carcinoma is:
Doses to the cervix (non-bulky disease) from external beam therapy are generally around _______ Gy.
Most endometrial ca patients present at diagnosis with this stage disease:
Which of the following male genital cancers would most likely involve gapped fields?
Besides ovarian can, Oral contraceptives have been shown to reduce the risk of this type of GYN ca:
2nd look surgery had been historically indicated for this type of GYN ca:
An Inverted "U" field is commonly used for treatment of which of the following:1. cervix with implant; 2. prostate with implant; 3.endometrium with implant; 4. testicular with implant
At what spinal levels are the kidneys generally located?
Which of the following ca's is not related to smoking?
What percent of bladder ca's occur in the area in the triangular shaped area of the bladder?
A bladder ca that infiltrates connective tissue would be a stage _____ lesion.
A bladder ca that invades deep muscle would be a stage _____ lesion.
A typical external beam dose for bladder ca is :
How many lobes does the prostate have?
Prostate ca is considered a disease of the:
Most prostate ca's are of this cell type:
What is the most common screening/diagnostic procedure for prostate ca?
Prostate ca is notorious for metastasizing to this area:
A typical dose for testicular ca would be ______ Gy.
Besides bladder ca, Which of the following male ca's would be considered "high dose" radiation therapy
The Gleason's system ranges from :
A grade 7 prostate lesion would have approximately what percent chance of having lymph node spread?
The overall 5 year rate for prostate ca is about
Testicular ca is more common in this age group
RTT is generally used to treat these stages of seminoma:
Late stage seminoma (stages III,IV) is best managed by:
This type of testicular ca has the best prognosis:
This type of testicular ca has the worst prognosis:
T / F Seminomas are generally considered to be radioresistant.
What single agent chemotherapy drug is commonly used in treating testicular ca (or cervical/ ovarian for that matter)?
What is the most common symptom for bladder ca?
Men over ____ (age) should have a yearly prostate exam, while men over ____ should have a yearly PSA test.
RTT is generally and commonly used as the ONLY definitive treatment for what stage prostate ca?
What is the most common site of hematologous mets from testicular ca?
Which of the following preoperative test might be used in detection of ovarian cancer?
If a patient with cervix cancer has periaortic nodal involvement, there is a 35% increase risk for spread to the:
Upon completion of a radiotherapy course for cervix cancer, a patient experiences abdominal distention and hyperactive bowel sounds that could indicate:
The most radiotolerant structure of the gynecologic organs is the:
A blood serum marker used in determining extent of testicular cancer is:
When irradiating seminoma states I, IA, IB, the following nodes should be included? 1. Para-aortic; 2. Ipsilateral iliac; 3. Mediastinal ; 4. Scalene
Brachytherapy in the management of prostate cancer would be:
Hormonal therapy for prostate cancer may include the administration of:
Cancers of the kidney usually arise in the:
Cancers manifesting in the renal pelvis are most commonly:
Cancers manifesting in the renal cortex are most commonly:
When treating a patient with bladder carcinoma preoperatively, the treatment portals should be large enough to include the:
Obturator, external, hypogastric, and presacral nodes
Topographic Anatomy for xiphoid process
Topographic Anatomy for thyroid cartilage
Topographic Anatomy for suprasternal notch
Topographic Anatomy for greater trochanter
Topographic Anatomy for diaphragm
Topographic Anatomy for ilaic crest
Topographic Anatomy for umbilicus
Describe the inferior border of a typical prostate field
Bottom of the ischial tuberosities
In staging bladder ca, tumor size is not an important factor. What is the single most important factor for staging bladder ca (and, as a result, for determining prognosis)?
Depth of penetration into bladder wall
number of pregnancies
Serous fluid in the peritoneal cavity
Describe (i.e.: where is) the superior border of a typical cervix field:
List 2 theoretical advantages of pre-operative RTT over post operative RTT.
sterilization of tumor bed
List one advantage of post operative RTT over pre-operative RTT.
What is the name of the most common sarcoma of the (corpus of the) uterus?
What is the functional unit of the kidney?
A triangular shaped area at the base of the bladder immediately behind the urethral orifice is called:
PSA is a possible screening tool for what type of ca AND what number range represents a normal PSA level?
What grading system is commonly used only for prostate ca?
An etiologic factor for testicular ca is undescended testicles at birth. What is the medical name for this condition?
In the management of prostate ca, RTT has less morbidity (side effects) than radical prostatectomy. What is the other primary side effect caused by the prostatectomy?
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