This is Episode 14, Total Body Irradiation (TBI) Syndromes. Today, we're shifting our focus from the cellular level to the effects of radiation on the whole organism, specifically when the entire body is exposed to a significant dose of radiation. This can happen in radiation accidents, nuclear incidents, or unfortunately, in scenarios involving radiological terrorism, but also, in a controlled manner, during conditioning regimens for bone marrow transplantation. Understanding the sequence of events and the different syndromes that can arise is critical, not just for exam purposes, but because as radiation oncologists, we are often considered the first line of clinical defense and expertise in such emergencies. We'll be looking at the immediate symptoms, known as the prodromal syndrome, and then diving into the major acute radiation syndromes: hematopoietic, gastrointestinal, and cerebrovascular, including their dose thresholds, timelines, and the underlying organ system failures that lead to them. We will also discuss the LD50/60, or the lethal dose for 50% of an exposed human population, and the potential for late complications like pulmonary syndrome in survivors.

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