Slide 1:Effects of Initial Exposure to Radiation By: Tina Wall


Objectives :Objectives What is Acute Radiation Syndrome List the Conditions for Acute Radiation Syndrome Discuss the four stages for each Acute Radiation Syndrome Describe Hematologic Syndrome Describe Gastrointestinal Syndrome Describe Central Nervous System Syndrome


Acute Radiation Syndrome :Acute Radiation Syndrome What is Acute Radiation Syndrome (ARS) ? An acute illness caused by irradiation of the entire body by a high dose of penetrating radiation in a very short period of time. Conditions for Acute Radiation Syndrome: The radiation dose must be large The dose usually must be external The radiation must be penetrating The entire body The dose must have been delivered in a short time


Slide 4:3 Types of Acute Radiation Syndrome are: Hematologic Syndrome Gastrointestinal (GI) Syndrome Central Nervous System (CNS) Syndrome The 4 stages of Acute Radiation Syndrome are: Prodromal stage- 1st set of symptoms occurs. (nausea, vomiting, diarrhea) Latent stage- patient looks and feels generally healthy Manifest illness stage- prodromal stage symptoms reoccur along with additional symptoms Recovery or death stage- Most patients who do not recover will die within several months of exposure.


Hematologic SyndromeAlso known as Bone Marrow Syndrome :Hematologic SyndromeAlso known as Bone Marrow Syndrome Occurs between 100 and 1,000 R Death occurs within 6-8 weeks at doses of 200R for some individuals Death is caused by reduction of: red blood cells white blood cells platelets Death results from anemia and infection


Slide 6:Prodromal Stage: Occurs 1 hour to 2 days after exposure Symptoms are anorexia, nausea and vomiting. Stage lasts for minutes to days Latent Stage: Occurs from a few days up to 3 weeks after exposure Stem cells in bone marrow are dying, even though the patient may look and feel well Manifest Illness Stage: Reduction in blood cell count Occurs 3-5 weeks after exposure Symptoms are cytopenia, which causes anemia and infections


Slide 7:Recovery or death stage: 100 – 300R bone marrow cells will begin to repopulates enough to sustain an individuals life span. During the 3rd week – 6 months a large percentage of these individuals will fully recover. 400-600R will have fewer survivors 1,000R no survivors Survival decreases with increase in dose


Gastrointestinal Syndrome :Gastrointestinal Syndrome Occurs due to damage of the GI tract lining and bone marrow occurs with a dose of 1000 rads Symptoms appear at a threshold dose of 600R Survival time does not vary with dose Death happens at the same time regardless of the dose received GI Tract Lining: Lining is covered with small finger-like projections called villi Villi absorb nutrients Crypts of Lieberkuhn, located at the base of the villi are deleted when exposed to radiation Causes the villi to lose cells, become shortened, flattened and partly or completely removed


Slide 9:Absorption of materials across the wall of the intestine decreases as a result of the villi being flattened Dehydration occurs from fluids leaking into the GI tract lumen Infection results from bacteria entering the blood stream There’s a reduction of white blood cells due to the bacteria entering the blood stream Villi 


Slide 10:Prodromal Stage: Occurs within hours after exposure Symptoms are nausea, vomiting, cramps and diarrhea Latent Stage: Occurs though the fifth day Stem cells in bone marrow and cells lining GI tract are dying, even though patient may look and feel well. Manifest Illness Stage: Reoccurrence of nausea, vomiting and diarrhea along with a fever Occurs from the fifth through the tenth days Recovery or death stage: GI tract attempts regeneration after irradiation Death results from infection, dehydration and electrolyte imbalance Death occurs within 2 weeks of exposure


Central Nervous System Syndrome :Central Nervous System Syndrome Occurs at radiation doses of 5,000R Death occurs in hours or sometimes 2-3 days after exposure CNS damage results from damage to the blood vessels that supply the system, causing: Edema- (swelling) in the cranial vault Vasculitis- inflammation of blood vessels Meningitis- inflammation of the spinal cord and brain membranes Death is caused by increased pressure in the cranial vault as a result of elevated fluid content Edema 


Slide 12:Prodromal Stage: lasts for minutes to a few hours Symptoms are nervousness, confusion, severe nausea, vomiting, diarrhea, loss of consciousness, and burning sensations of the skin Latent Stage: Last for several hours Patient may return to partially functional state Manifest Illness Stage: Occurs 5-6 hours after exposure Symptoms are diarrhea, convulsions, coma and death Recovery or death stage: No recovery is expected Death occurs within 3 days Meningitis  Vasculitis 


Summary… :Summary… Hematologic Syndrome is the destruction of bone marrow caused by a reduction in production of red blood cells, white blood cells and platelets resulting from radiation exposure. Death may occur as a result of anemia and infection. Gastrointestinal syndrome is exhibited by nausea , vomiting, diarrhea as a result of damage to the villi in the small intestine which leads to lack of absorption. Resulting in dehydration and Infection. Central Nervous System Syndrome is exhibited by nervousness, confusion, nausea, vomiting, loss of consciousness, and a burning sensation of skin which are the result of damage to blood vessels and increased intracranial pressure.


References :References Steve Forshier(2002).Essentials of Radiation Biology and Protection. Canada. Thomson Learning Inc. www.bt.cdc.gov/radiation/arsphysicalfactsheet.asp . Acute Radiation Syndrome. www.nlm.nih.gov/.../ ency/fullsize/12665.jpg . Medline Plus


Questions ??? :Questions ??? Death from hematologic syndrome is a result of destruction of _____ . 2. T/F …Acute Radiation Syndrome is an acute illness caused by irradiation of the entire body by a high dose of penetrating radiation in a very short period of time. 3. Which stage of Acute Radiation Syndrome is when the patient looks and feels generally healthy? a) recovery stage b) latent stage c) prodromal stage d) manifest illness stage 4. During Hematologic syndrome death results from____ and ______. 5. Which of the three syndromes do the symptoms appear at a threshold dose of 600R ?


Questions ??? :Questions ??? T/F….There’s a reduction of white blood cells due to the bacteria entering the blood stream. 7. Which stage of the GI Syndrome does death results from infection, dehydration and electrolyte imbalance? a) recovery/death stage b) latent stage c) prodromal stage d) manifest illness stage 8. What word/ term means inflammation of blood vessels. 9. Which of the three syndromes in the recovery/death stage is expected no recovery a) Hematologic Syndrome b) Gastrointestinal Syndrome c) Central Nervous System Syndrome 10. What are the 3 types of Acute Radiation Syndromes ?


Answers !!! :Answers !!! Bone Marrow True B Anemia and infection Gastrointestinal Syndrome True A Vasculitis C Hematologic Syndrome GI Syndrome CNS Syndrome