Williams Gynecology, Second Edition (Schorge,Williams Gynecology), 2nd Edition

Principles of Radiation Therapy

28–1. In gynecology, radiation therapy is most commonly used for which of the following?

a. Cervical cancer

b. Endometrial cancer

c. Epithelial ovarian cancer

d. Gestational trophoblastic neoplasia

28–2. Which is a clinically used radionuclide?

a. Cobalt-60

b. Iodine-125

c. Cesium-137

d. All of the above

28–3. Linear accelerators can produce which of the following?

a. Photon and electron beams

b. Photon beams and gamma rays

c. Neutron beams and gamma rays

d. Electron beams and gamma rays

28–4. When electromagnetic radiation impacts target tissues, this energy is transferred to the target tissues by several mechanisms. Which of the following mechanisms is shown here?


Reproduced, with permission, from Nguyen PD: Principles of Radiation Therapy. In Hoffman BL, Schorge JO, Schaffer JI, et al (eds): Williams Gynecology, 2nd ed. New York, McGraw-Hill, 2012, Figure 28-4B.

a. Poiseuille law

b. Compton effect

c. Werner equation

d. Bernoulli principle

28–5. For treatment of inguinal lymph node metastasis, which of the following modalities is preferred due to its energy-transfer properties?

a. Photon beam therapy

b. Electron beam therapy

c. Intracavity brachytherapy

d. Interstitial brachytherapy

28–6. When quantifying the absorbed dose of electromagnetic radiation, which of the following units of measure is currently preferred?

a. Rad

b. Gray

c. Curie

d. Becquerel

28–7. Within irradiated tissues, which of the following is the effective biologic target?

a. DNA

b. Ribosomes

c. Mitochondria

d. Endoplasmic reticulum

28–8. With radiation therapy, most tissue damage is caused by electromagnetic radiation impacting water to create which DNA-damaging molecule?

a. Nitric oxide

b. Carboxyl group

c. Hydroxyl radical

d. Hydrogen peroxide

28–9. The four Rs of radiation biology include which of the following?

a. Reassortment

b. Recavitation

c. Recolumnization

d. Restandardization

28–10. Radiation therapy simulation allows which of the following?

a. Maximize radiation dose to tumor

b. Minimize damage to late-responding normal tissue

c. Minimize damage to early-responding normal tissue

d. All of the above

28–11. By definition, during which of the following are radionuclides inserted directly into the cancer?

a. Interstitial brachytherapy

b. Intracavitary brachytherapy

c. Intralymphatic brachytherapy

d. Intraperitoneal brachytherapy

28–12. During brachytherapy with tandem and ovoid use, the tandem fits into which of the following?


Reproduced, with permission, from Nguyen PD: Principles of radiation therapy. In Schorge JO, Schaffer JI, Halvorson LM, et al (eds): Williams Gynecology, 1st ed. New York, McGraw-Hill, 2008, Figure 28-10.

a. Vagina

b. Uterus

c. Rectum

d. Posterior cul-de sac

28–13. The factor that most commonly leads to poor tumor control achieved by radiotherapy includes which of the following?

a. Hypertension

b. Hyperglycemia

c. Tissue hypoxia

d. Hyperlipidemia

28–14. In combination, carbogen and which other agent are used to improve tissue oxygenation and responsiveness to radiotherapy?

a. Nicotinamide

b. Nitric oxide

c. Nitroprusside

d. Nitroglycerin

28–15. For patients undergoing radiotherapy, improved tumor control has been associated with which of the following?

a. Hypertension control

b. Heparin anticoagulation

c. Antibiotic administration

d. Blood transfusion for anemia

28–16. Radiation therapy combined with cisplatin chemotherapy is the standard treatment for newly diagnosed, locally advanced cases of which cancer type?

a. Cervical

b. Clear cell endometrial cancer

c. Nongestational choriocarcinoma

d. None of the above

28–17. Regarding their response to radiotherapy, early-responding tissues include which of the following?

a. Lung

b. Brain

c. Kidney

d. Bone marrow

28–18. Long-term consequences of radiotherapy include which of the following?

a. Ovarian failure

b. Secondary malignancy

c. Vesicovaginal fistula

d. All of the above

28–19. An early skin response to radiotherapy includes which of the following?

a. Necrosis

b. Erythema

c. Ichthyosis

d. Depigmentation

28–20. Immediate vaginal changes following radiotherapy may include which of the following?

a. Mucositis

b. Synechiae

c. Shortening

d. None of the above

28–21. In premenopausal women, which of the following has been shown to reduce radiation exposure to the ovaries during treatment of gynecologic cancer?

a. Omental flap overlay

b. Ovarian transposition

c. Ovarian transplantation

d. None of the above

28–22. Following pelvic radiation, early bladder response includes which of the following?

a. Fistula

b. Cystitis

c. Stone formation

d. All of the above

28–23. Which of the following is commonly used to effectively relieve acute bladder symptoms from radiotherapy?

a. Oxybutynin

b. Prednisone

c. Nitroglycerin

d. Phenylpropanolamine

28–24. This patient suffered a postradiation small bowel obstruction. Preventative approaches to minimize radiotherapy-associated bowel injury include administration of which of the following?


Photograph contributed by Dr. David Miller.

a. Sulfasalazine

b. Erythropoietin

c. Hyperbaric oxygen

d. Third-generation cephalosporin

28–25. Later effects of radiotherapy on the rectosigmoid include all EXCEPT which of the following?

a. Fistula

b. Stricture

c. Hemorrhage

d. Diverticulum

28–26. For a cancer to be considered the secondary result of radiotherapy, which of the following criteria must be met?

a. Cancer should develop outside the irradiated area.

b. Cancer differs from the original tumor pathology type.

c. Cancer develops within the first year following treatment.

d. None of the above

Chapter 28 ANSWER KEY