RTPM UPDATED EXAM SCRIPT QUESTIONS AND ANSWERS
GRADED A+
✔✔Rate of response depends on - ✔✔Cell type, cycle & regeneration time
(RS is a function of the most sensitive cells it contain)
✔✔Regeneration and Repair - ✔✔Regeneration: replace of same cell type, VIM DIM,
desirable healing
Repair: different cell type (scaring fibrosis), RPM FPM, non-desirable
✔✔Radiation-induced SR - ✔✔Skin reaction, Fatigue, Radiation sickness, Change of
bowel habit (depend of site)
✔✔Skin reaction in increasing severity - ✔✔Erythema, Moist desquamation, Epilation,
Radiation necrosis, Pigmentation, Telangiectasia
✔✔Acute radiation dermatitis Grade I and Grade II - ✔✔Grade I: Faint erythema, dry
desquamation
Grade II: Moderate erythema, patchy moist desquamation
✔✔Acute radiation dermatitis Grade III and Grade IV - ✔✔Grade III: Moist
desquamation, bleeding
Grade IV: Necrosis/ ulceration, spontaneous bleeding
✔✔Management of acute radiation dermatitis - ✔✔Irradiated area:
1) Medicated cream
2) Mild soap + water
3) No hair remover
4) Avoid sun exposure & swimming
5) Deodorant and electric shaver ok
6) Maintain hygiene, clean & dry
✔✔Bolus effect - ✔✔Things on skin should not be applied before radiation Tx
A bolus effect
Increase radiation dose to epidermis
✔✔Skin care recommendation - ✔✔1) Protect fro sun exposure
2) No hot water but dryer on cool setting
3) Avoid skin friction and rubbing by wear loose-fitting cotton cloth
✔✔Radiation sickness - ✔✔Diversion of O2 and Nutrition supply to malignant cells
Accumulation of lactate from tumour lysis
Lead to fatigue, NV, Anorexia
, ✔✔"Crisis in life" phases - ✔✔Shock (Dx), Reaction (Tx), Work-through (Rehab),
Reorientation (Recovery)
5D: distance, dependence, disability, disfigurement, death
✔✔Challenges in oncology patients - ✔✔1) Normalization of distress
2) Pathoplastic effects
3) Stage-specific stressors & responses
4) Multidisciplinary teams & fragmentation of care
5) Perceived time constraints
✔✔How stress is associated with immunosuppression - ✔✔Stress-> Stimulation of
adrenocortical secretion-> Increased serum glucocorticoid-> Activation of sympathetic
nervous system-> Release of catecholamines
(increase infection risk & lower speed of recovery)
✔✔Four emotional stages of cancer - ✔✔Time of Dx Rx
End of Tx to rebuild
Transition & Exploration
New life/ End of life
(Bad feeling: life-threatening disease, pain & discomfort, frightening experience, change
of life-style)
✔✔Stress from surgery, chemo, RT - ✔✔Surgery: disfigurement, pain
Chemo: unpleasant experience, SE
RT: fear to radiation, potential SE
✔✔What is distress - ✔✔When stress exceeds ability to cope
✔✔What is anxiety and depression - ✔✔Anxiety: response to perceived threat
Depression: response to perceived loss
(Lead to poor Tx compliance, slow recover, poor QoL)
✔✔3 methods of screening - ✔✔1) Clinical observation
2) Reports from patient/ friends/ relatives
3) Standard questionnaires
(Chinese: embarrassing, not to seek help, hide feelings)
✔✔Psychological and somatic S/S of daily observation - ✔✔Psychological: Irritability,
suicidal thinking, reduced self-esteem
Somatic: Fatigue, reduced appetite, insomnia
✔✔Functions of communication - ✔✔Fostering healing relationships
Exchanging information
Responding to emotions
GRADED A+
✔✔Rate of response depends on - ✔✔Cell type, cycle & regeneration time
(RS is a function of the most sensitive cells it contain)
✔✔Regeneration and Repair - ✔✔Regeneration: replace of same cell type, VIM DIM,
desirable healing
Repair: different cell type (scaring fibrosis), RPM FPM, non-desirable
✔✔Radiation-induced SR - ✔✔Skin reaction, Fatigue, Radiation sickness, Change of
bowel habit (depend of site)
✔✔Skin reaction in increasing severity - ✔✔Erythema, Moist desquamation, Epilation,
Radiation necrosis, Pigmentation, Telangiectasia
✔✔Acute radiation dermatitis Grade I and Grade II - ✔✔Grade I: Faint erythema, dry
desquamation
Grade II: Moderate erythema, patchy moist desquamation
✔✔Acute radiation dermatitis Grade III and Grade IV - ✔✔Grade III: Moist
desquamation, bleeding
Grade IV: Necrosis/ ulceration, spontaneous bleeding
✔✔Management of acute radiation dermatitis - ✔✔Irradiated area:
1) Medicated cream
2) Mild soap + water
3) No hair remover
4) Avoid sun exposure & swimming
5) Deodorant and electric shaver ok
6) Maintain hygiene, clean & dry
✔✔Bolus effect - ✔✔Things on skin should not be applied before radiation Tx
A bolus effect
Increase radiation dose to epidermis
✔✔Skin care recommendation - ✔✔1) Protect fro sun exposure
2) No hot water but dryer on cool setting
3) Avoid skin friction and rubbing by wear loose-fitting cotton cloth
✔✔Radiation sickness - ✔✔Diversion of O2 and Nutrition supply to malignant cells
Accumulation of lactate from tumour lysis
Lead to fatigue, NV, Anorexia
, ✔✔"Crisis in life" phases - ✔✔Shock (Dx), Reaction (Tx), Work-through (Rehab),
Reorientation (Recovery)
5D: distance, dependence, disability, disfigurement, death
✔✔Challenges in oncology patients - ✔✔1) Normalization of distress
2) Pathoplastic effects
3) Stage-specific stressors & responses
4) Multidisciplinary teams & fragmentation of care
5) Perceived time constraints
✔✔How stress is associated with immunosuppression - ✔✔Stress-> Stimulation of
adrenocortical secretion-> Increased serum glucocorticoid-> Activation of sympathetic
nervous system-> Release of catecholamines
(increase infection risk & lower speed of recovery)
✔✔Four emotional stages of cancer - ✔✔Time of Dx Rx
End of Tx to rebuild
Transition & Exploration
New life/ End of life
(Bad feeling: life-threatening disease, pain & discomfort, frightening experience, change
of life-style)
✔✔Stress from surgery, chemo, RT - ✔✔Surgery: disfigurement, pain
Chemo: unpleasant experience, SE
RT: fear to radiation, potential SE
✔✔What is distress - ✔✔When stress exceeds ability to cope
✔✔What is anxiety and depression - ✔✔Anxiety: response to perceived threat
Depression: response to perceived loss
(Lead to poor Tx compliance, slow recover, poor QoL)
✔✔3 methods of screening - ✔✔1) Clinical observation
2) Reports from patient/ friends/ relatives
3) Standard questionnaires
(Chinese: embarrassing, not to seek help, hide feelings)
✔✔Psychological and somatic S/S of daily observation - ✔✔Psychological: Irritability,
suicidal thinking, reduced self-esteem
Somatic: Fatigue, reduced appetite, insomnia
✔✔Functions of communication - ✔✔Fostering healing relationships
Exchanging information
Responding to emotions
