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IP4 > Cancer > Flashcards

Cancer Flashcards

1
Q

5 abnormality w/ TLS

A 
Hyperkalemia
Hyperphosphatemia
Hypocalcemia 
Hyperuricemia
ARF
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2
Q

Low risk TLS tx

A

hydration

allopurinol

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3
Q

Intermediate Risk TLS tx

A

hydration

allopurinol

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4
Q

High Risk TLS tx

A

hydration

Rasburicase

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5
Q

2 Rasburicase limitations

A

G6PD deficiency
–severe hemolysis
preganancy/breast-feeding

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6
Q

mild hypercalcemia tx

A

drink 3L/day

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7
Q

severe hypercalcemia tx

A

hydration
zolidronic acid
or
pamidronate

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8
Q

5 cancers w/affinity for bone

A 
breast
prostate
myeloma
lung
kidney
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9
Q

what is a lytic bone lesion

A

destroy bone material

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10
Q

what is a blastic bone lesion

A

fill bone with extra cells

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11
Q

bone mets tx

A

Denosumab

IV Bisphosphonates

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12
Q

MEC tx

–mod CINV

A

dolasteron
ondasetron
granisetron

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13
Q

MEC prophylaxis

A

Dexamethasone + Ondansetron

or Palonosetron if outpatient

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14
Q

HEC prophylaxis

–high CINV

A

Olanzapine +Palonosetron + Dexamethasone

Ondansetron + Fosaprepitant + Dexamethasone

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15
Q

Low Risk CINV prophylaxis

A

Prochlorperazine
OR
dexamethasone

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16
Q

Anemia defintion

A

Hbg < 13 in males

Hbg <12 in females

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17
Q

2 causes of macrocytic anemia

A

Folic acid deficiency

B12 deficiency

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18
Q

3 causes of microcytic anemia

A

thalassemia
Lead poisoning
Iron deficiency

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19
Q

What is haptoglobin

A

protein that binds to and transport free Hbg from lysed RBC to liver for recycling of iron

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20
Q

Tx of hemolytic anemia

A

Transfuse if Hbg <8

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21
Q

Which anemic cause shows up as target cells

A

thalassemia

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22
Q

4 drug classes that cause oxidatative stress to G6PD deficient RBC cause hemolysis

A

quinine’s
azo’s
nitro’s
sulfa’s

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23
Q

Iron deficiency

3 lab identifiers

A

dec. MCV
low Ferritin
TIBC high

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24
Q

B12 deficiency

2 lab identifiers

A

inc. MCV

dec. B12

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25
Q

3 major risk factors for B12 deficiency

A

vegans
long term metformin
gastric bypass

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26
Q

Folate deficiency

2 lab identifiers

A

inc. MCV

low folate

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27
Q

CKD anemia

2 lab identifiers

A

normocytic

burr cells

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28
Q

Anemia of chronic disease

4 lab identifiers

A

normocytic
serum iron low
ferritin normal or increased
TIBC low

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29
Q

when to give PRBC

A

Hbg <8

  • asymptomatic w/ comorbidity
  • symptomatic
  • high risk
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30
Q

When to initiate iron chelation therapy

A

serum ferritin levels >2500

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31
Q

3 indication for ESAs

A

Hbg <10
Dx of cancer
getting chemo for 2 months

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32
Q

3 major risks with ESAs

A

thromboembolism
increased mortality
tumor progression

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33
Q

normal WBC range

A

4.5-11

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34
Q

normal Hct

A

34-52

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35
Q

normal Plt range

A

150-450

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36
Q

define Thrombocytosis

A

platelets in excess of 150,000-450,000/uL

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37
Q

define Thrombocytopenia

A

platelets below normal range of 150,000-450,000

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38
Q

define erythrocytosis

A

Hemoglobin above normal Range

39
Q

3 causes of erythrocytosis

A

high altitude
chronic hypoxemia
smoking

40
Q

Define leukocytosis

A

WBC above normal range of 4000-10,000/uL

41
Q

define leukopenia

A

WBC below normal range

42
Q

define eosinophilia

A

eosinophils above the normal range of 0-5%

43
Q

ANC level for neutropenia

A

<1000

44
Q

Important point for elderly and immunocompromised and their WBC

A

may not elevate during infection

45
Q

important point for patients who are leukopenic at baseline

A

during infection their WBC may elevate to normal making it look like they are getting healthier

46
Q

4 Better prognostic factors for Breast cancer

A

> 50
Nodes negative
ER+ PR+
HER2-

47
Q

6 Worse prognostic factors for Breast Cancer

A 
pre-menopausal
Nodes +
Larger tumor
ER/PR-
HER2+
triple negative
48
Q

ER/PR+ treatment for everyone

A

pre-menopausal
-Tamoxifen
post-menopausal
–AI

49
Q

Triple Negative treatment

A

AC -> T

50
Q

Her2+ Low Risk identifiers

A

<2cm

node-

51
Q

length of treatment for breast cancer

A

3-6 months

52
Q

3 AI SE

A

Myalgia
vagnial dryness
Osteoporosis
adverse lipid profile

53
Q

Tamoxifen SE

A

Thrombosis

54
Q

Can you use AI in pre or peri-menopausal women

A

NO-may induce increased estrogen production

55
Q

2 tamoxifen antagonist @

A

Breast

CNS

56
Q

2 Tamoxifen agonist @

A

Bone

endometrium

57
Q

Ovarian suppression agents

A

LHRH

  • Goserelin
  • Leuprolide
58
Q

When should you add OS to Tam or AI

A

high risk patients receiveing chemo

59
Q

HER2+ High risk identifiers

A

> 2 cm and Node+

60
Q

name 3 CDK 4/6 inhibitor

A

Palbociclib
Ribociclib
abemaciclib

61
Q

Bevacizumab major SE

A

HTN

62
Q

Cervical Cancer tx

A

cisplatin/carbo + taxol +/- avastin

63
Q

main genetic mutation in melanoma

A

BRAF

64
Q

MOA of tamoxifen

A

CYP2d6 active metabolite endoxifen

65
Q

LHRH MOA

A

continuous stimulation of pituitary to ↓ FSH & LH secretion and ↓ estrogen from ovary

66
Q

Trastuzumab MOA

A
  • activates ADCC
  • inhibits HER-mediated signaling pathways
  • prevents HER2 domain cleavage
67
Q

Pertuzumab MOA

A
  • inhibits HER2 dimerization with other HER family receptors particularly HER3
  • activates ADCC (antibody-dependent cell-mediated cytotoxicity)
  • inhibits multiple HER-mediated signaling pathways
68
Q

PARP inhibitors SE

A

embryo-fetal toxicity
bone marrow suppression
Cardiovascular/HTN

69
Q

Nivolumab MOA

A

binds to programmed death receptor-1 (PDL-1) to prevent ligand PD-L1 and PD-L2 binding, thereby preventing T cell inhibition

70
Q

Dabrafenib/trametinib MOA

A

Dabrafenib- inhibits protein kinase BRAF

Trametinib- inhibits mitogen-activated extracellular kinase (MEK)

71
Q

ipilimumab MOA

A

anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4) antibody by binding to CTLA-4 so it can’t bind to CD80/CD86

72
Q

ipilimumab limitations

A

only give if healthy & fit, and willing to take on high risk of toxicity

73
Q

Regorafenib MOA

A

inhibits multiple cell signaling kinases including VEGF and EGFR pathways

74
Q

Regorafenib counseling

A

must take with low fat meal

75
Q

Trifluridine/Tipiracil MOA

A

thymidine-based nucleic acid analogue that gets phosphorylated intracellularyly and is incorporated into DNA leading to cytotoxicity

inhibits thymidine phosphorylase

76
Q

VEGF—inhibitors toxicities

A

HTN
impaired wound healing
* hold at least 28 days prior to planned surgery

77
Q

EGFR inhibitors toxicities

A 
Rash—acneiform
management
* use moisturizers and sunscreen
* do not use OTC acne products they often dry the skin and worsen EGFR induced rash
* Minocycline prior to cetuximab
* doxycycline prior to panitumumab
78
Q

ALK drugs and indication

A
  • Alectinib
  • Lorlatinib
  • -after failure during alectinib
79
Q

Osimertinib

MOA and indication

A
  • TKI
  • targets exon 19 deletion and exon 21 L858R mutation
  • also targets T790M resistance mutation
80
Q

Crizotinib (Xalkori) MOA

A

TKI target mutation ROS-1

81
Q

Dabrafenib + Trametinib MOA

A

BRAF V600E mutation

82
Q

Hodgkin lymphoma

A

Reed sternberg cells

83
Q

Non-Hodgkin lympoma

A

Chronic lymphocytic leukemia (CLL)
Follicular lymphoma (FL)
Burkitt’s lymphoma

84
Q

Indolent Lymphomas

A

MALT lymphoma
FL
CLL

85
Q

Intermediate Lymphomas

A

DLBCL

MCL

86
Q

Aggresive Lymphoma

A

Burkitt’s
Lymphoblastic
Aids-related

87
Q

S&S of lymphoma

A

lymphadenopathy (LAD)

Splenomegaly

88
Q

Rituximab
oftatumumab
obinutuzumab
MOA

A

binds to CD20 on B cells activates complement dependent celllysis and antibody dependent cell-mediated toxicity

89
Q

Rituximab
oftatumumab
obinutuzumab
SE

A

Hep B reactivatioin
—risk if HBsAg+ (active infeciton)
—risk if HBcAB+ (past infection)
—HBsAB= vaccination or acquired immunity

90
Q

Bendamustine

A

alkylating agent and purine analog, leads to cell death via single and double strand DNA cross-linking
cell cycle non-specific

91
Q

CLL hematopoiesis

A

Small lymphocytes
-B lymphocytes
-T lymphocytes
Nk cells

92
Q

Indication for treatment for CLL

A 
symptoms
end-organ function
bulky disease
--spleen >6cm
--Lymph nodes >10cm
93
Q

CML pathogenesis

A
  • shortened chromosome 22
    • BCR-ABL fusion gene
  • Elongated chromosome 9

IP4 (4 decks)

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