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Cancer chemotherapy(sparsh gupta) Flashcards

1
Q

Gompertzian model

A

Growth fraction peaks when tumor is approx 37% of its maximum size

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2
Q

Most susceptible atom to Alkylating agents

A

N7 of guanine

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3
Q

Mesna

A

Mercaptoethane sulfonic acid

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4
Q

Mechlorethamine is used in

A

Hodgkin lymphoma

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5
Q

Adverse effects of cyclophosphamide

A

Cardiac dysfunctionPulmonary toxicitySIADH

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6
Q

Anticancer drugs that cause delayed neutropenia

A

Nitrsoureas

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7
Q

Adverse effects of busulfan

A

Adrenal insufficiencyPulmonary fibrosisSkin hyperpigmentationHyperuricemia

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8
Q

CNS side effects of procarbazine

A

HypnosisVivid dreams

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9
Q

Drug used for CLL

A

ChlorambucilAs it spares myelocytes

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10
Q

Cisplatin nephrotoxicity can be prevented by

A

Chloride diuresis Doesnot help against ototoxicity

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11
Q

Cisplatin is inactivated by

A

Aluminium

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12
Q

Drug that can be given to prevent cisplatin induced nephrotoxicity

A

Amifostine

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13
Q

Electrolyte abnormalities associated with cisplatin

A

Reduces all ions Hypomagnesimia HypokalemiaHypophosphatemiaHypocalcemia

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14
Q

Anticancer drugs with strong vesicant properties

A

NitrosoureasMechlorethamine

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15
Q

Alkylating agent with less chance of secondary leukemia

A

Cyclophosphamide

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16
Q

Anticancer drugs causing veno occlusive disease

A

All Alkylating agents in high doses

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17
Q

Alkylating agents causing pulmonary fibrosis

A

All Alkylating agents

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18
Q

Mechanisms of MTX resistance

A

Decreased MTX transporterDecreased formation of MTX polyglutamateIncreased levels of DHFR due to GENE AMPLIFICATION altered DHFRIncreased drug efflux transporter

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19
Q

Enzyme required for activation of MTX and pemetrexed

A

Folylpolyglutamate synthase

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20
Q

MTX is DOC for

A

Choriocarcinoma

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21
Q

Pemetrexed is approved for treatment of

A

Mesothelioma

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22
Q

Citrovorum factor

A

N10 formyl THF

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23
Q

Rx of MTX toxicity

A

Citrovorum factor Alkalinisation of urineDialysis Glucarpidase

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24
Q

Glucarpidase

A

MTX cleaving enzyme

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25
Q

Pralatrexate is used for Rx of

A

Peripheral T cell lymphoma

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26
Q

Adverse effects of MTX

A

HepatotoxicityPulmonary infiltrates and fibrosisBone marrow supression Mucositis

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27
Q

DOC for CLL

A

Fludarabine

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28
Q

Purine analogs

A

6MP6TGCladribine Fludarabine

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29
Q

DOC for Hairy cell leukemia

A

Cladribine(resistant to degradation by ADA)

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30
Q

Drug that must be given to longterm purine analog users

A

Cotrimoxazole for PCP prophylaxis as long term purine analog use leads to Immunosuppression

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31
Q

Dose of which anti metabolites should be reduced when given along with allopurinol

A

6-MPazathioprine

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32
Q

Pyramidine analogs

A

5FUcytarabineCapecitabineGemcitabine5-azacytidineDecitabine

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33
Q

Single most effective agent for induction of remission in AML

A

Cytarabine

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34
Q

Anticancer drug eliminated by lungs

A

5FUconverted to CO2

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35
Q

Adverse effect of capecitabine

A

Hyperbilirubinemia

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36
Q

Metabolism of thiopurines

A

TPMTthiopurine methyl transferase

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37
Q

5FU is catabolised by

A

Dihydropyramidine dehydrogenase

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38
Q

5FU action is augmented by

A

Leukovorin

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39
Q

DOC for pancreatic cancer

A

Gemcitabine

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40
Q

Adverse effect of thiopurines

A

Hepatotoxicity

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41
Q

Adverse effects of 5FU

A

NeurotoxicityHand foot syndrome

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42
Q

Side effect of fludarabine

A

Arthralgia

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43
Q

Side effect of gemcitabine

A

Diarrhoea

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44
Q

Marrow sparing cytotoxic drugs

A

VincristineBleomycinL-asparaginase

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45
Q

Diff btw vincristine and vinblastine

A

Vinblastine causes bone marrow supressionVincristine has bone marrow sparing effect but dose limiting neurotoxicity

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46
Q

Use of vinblastine

A

Metastatic testicular tumors

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47
Q

Use of vincristine

A

Induction of remission in childhood leukemiasPediatric solid tumors-Wilms,neuroblastoma,rhabdomyosarcoma

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48
Q

Taxanes that causes hypersensitivity reactions

A

Paclitaxel

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49
Q

Taxanes that don’t cause hypersensitivity reactions

A

DocetaxelNabpaclitaxel(protein bound paclitaxel)

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50
Q

Adverse effect of Taxanes

A

Bone marrow suppressionNeurotoxicity

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51
Q

Taxanes drug interactions

A

Cisplatin decreases paclitaxel clearance Paclitaxel decreases doxorubicin clearance

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52
Q

Use of Cabazitaxel

A

Rx of refractory metastatic prostate cancer in combination with prednisone

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53
Q

MOA of action of Ixabepilone

A

Microtubule stabilisation

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54
Q

Estramustine is combination of

A

Estrogen and Mechlorethamine

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55
Q

Use of estramustine

A

Prostatic Ca

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56
Q

Side effects of estramustine

A

Gynacomastia Impotence

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57
Q

MOA of camptothecins

A

Inhibits topoisomerase 1

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58
Q

Elimination of camptothecins

A

Irinotecan eliminated in bileTopotecan eliminated by renal route

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59
Q

Rx of choice for advanced colorectal carcinoma

A

Irinotecan+5FU

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60
Q

Dose limiting toxicities of camptothecins

A

Irinotecan-diarrhoea Topotecan- neutropenia

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61
Q

Adverse effects of irinotecan

A

DiarrhoeaMyelosuppressionCholinergic syndrome(inhibits acetyl choline esterase)

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62
Q

MOA of etoposide and teniposide

A

Inhibit topoisomerase 2

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63
Q

Use of etoposide

A

Testicular Ca Prostate CaSmall cell Ca of lung

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64
Q

Etoposide induced secondary leukemia

A

Develops at short intervalNot preceded by myelodysplasiaIt’s acute non lymphocytic type

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65
Q

Toxicity of etoposide

A

Hepatotoxicity

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66
Q

All anti tumor antibiotics are obtained from

A

Streptomyces

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67
Q

Cardiotoxicity of anthracyclins can be reduced by

A

Alpha tocopherolDexrazoxane

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68
Q

MOA of anthracyclins

A

Inhibits topoisomerase 2

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69
Q

Less cardiotoxic anthracyclin

A

Mitoxantrone

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70
Q

Radiation recall reaction is seen with

A

Anthracyclins

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71
Q

Use of Mitoxantrone

A

Hormone resistant prostate cancerAMLSPMS(secondary progressive MS)

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72
Q

Leukemia caused by Mitoxantrone

A

Acute promyelocytic leukemia

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73
Q

Use of valrubicin

A

BCG refractory urinary bladder Ca insitu

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74
Q

Radiosensitizers

A

Hydroxy ureaGemcitabineMetronidazole5FUdactinomycin

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75
Q

Use of dactinomycin

A

Solid tumors in children

76
Q

Nature of Bleomycin

A

Glycopeptide

77
Q

Earliest indicator of adverse effect of Bleomycin

A

Decreased DLco

78
Q

Adverse effects of Bleomycin

A

Cutaneous Hyperpigmentation Hyperkeratosis Erythema UlcersPneumonitisPulmonary fibrosisHypersensitivity

79
Q

Bleomycin is metabolised by

A

Bleomycin hydrolaseIt’s concentration is less in skin and lungs

80
Q

Bleomycin toxicity is ________ dependant

81
Q

Hypoxic tumor cells can be killed by

82
Q

Adverse effect of mitomycin

A

HUSdelayed bronchospasm

83
Q

Use of mitomycin

A

Superficial Bladder CaAnal CaTracheal and laryngeal stenosis

84
Q

Adverse effects of docetaxel

A

Peripheral neuropathyFluid retention

85
Q

Imatinib is the drug of choice for

86
Q

MOA of Imatinib

A

Competitive inhibitor of ATP binding of the abl kinase

87
Q

Erlotinib pharmacokinetics

A

Food increases absorption by 100%Metabolised by CYP3A4

88
Q

Adverse effects of erlotinib

A

Skin rashDiarrhoeaAnorexia Fatigue

89
Q

Erlotinib is effective in

A

WomenNon smokersAsiansNon small cell lung CaAdenocarcinoma Bronchioalveolar Ca

90
Q

Use of erlotinib

A

Non small cell lung cancer with EGFR receptor mutationKRAS mutation cancers don’t respond to itPancreatic Ca

91
Q

Use of sorafenib and sunitinib

A

Sunitinib- RCC,GISTsorafenib-RCC,HCC

92
Q

Adverse effects of sorafenib and sunitinib

A

Hypertension

93
Q

Route of administration of tyrosine kinase inhibitors

94
Q

Use of lapatinib

A

Ca breastInhibits TK associated with her2/neu

95
Q

Use of pazopanib

A

Advanced RCCMulti targeted TK inhibitor against VEGF,PDGF,c kit

96
Q

Drug that inhibits TK activated by JAK

A

Tofacitinib

97
Q

Tofacitinib is used against

A

rheumatoid arthritis

98
Q

Tyrosine kinase inhibitors used in medullary Ca of thyroid

A

Vandetanib(VEGFR,EGFR)Cabozantinib(c-MET,VEGFR-2)

99
Q

TK inhibitor used in Rx of malignant melanoma

A

Vemurafenib(BRAF)

100
Q

TK inhibitor used in myelofibrosis

A

Ruxolitinib(JAK1,2)

101
Q

TK inhibitors used in CML

A

BosutinibDasatinibImatinibNilotinibPonatinib

102
Q

TK inhibitor used in colorectal cancer

A

Regorafenib(VEGFR2,TIE2)

103
Q

TK inhibitors used in non small cell carcinoma of lung

A

Crizotinib(cMET,ALK)Erlotinib(EGFR)Gefitinib(EGFR)

104
Q

TK inhibitors used in advanced RCC

A

Axitinib(VEGFR1,2,3)Pazopanib(VEGFR1,2,3;PDGFR A,B;cKIT)SorafenibSunitinib

105
Q

TK inhibitors used in pancreatic Ca

A

SunitinibErlotinib

106
Q

Dose limiting toxicity of transtuzumab

A

Cardiotoxicity

107
Q

CD52 antagonist

A

Alemtuzumab(low grade lymphomas and CLL)

108
Q

Monoclonal Ab against EGFR

A

CetuximabPanitumumabEGFR positive metastatic colorectal Ca

109
Q

CD33 Antagonist

A

Gemtuzumab ozogamycinCD33 positive AML

110
Q

CD 20 antagonists conjugated with radioisotopes

A

I131-tositumomabY90-ibritumomab tiuxetanUsed for relapsed lymphomas

111
Q

Recombinant IL-2 with diphtheria toxin

A

Denileukin diftitoxUsed for recurrent cutaneous T cell lymphoma

112
Q

Adverse effects of cetuximab

A

Rash Hypomagnesimia ILD

113
Q

Rituximab is used against

A

CLLAIHAITPNHLRACHINA

114
Q

Use of cetuximab

A

Colorectal CaHead and neck cancer

115
Q

Advantage of panitumumab

A

Fully human Mab No rash

116
Q

Adverse effects of bevacizumab

A

HypertensionThromboembolismImpaired wound healingGIT perforation

117
Q

Use of bevacizumab

A

ColorectalBreastGlioblastoma Metastatic RCCnon small cell lung Ca

118
Q

Adverse effects of flutamide

A

Hot flushes Gynacomastia Hepatic dysfunction

119
Q

Complete androgen blockade

A

AR blockersGnRH agonists

120
Q

MOA of abiraterone

A

17 A hydroxylase inhibitorProstate Ca

121
Q

Drugs that inhibit 17 A hydroxylase

A

EtomidateAbiraterone

122
Q

Drugs that inhibit 11 B hydroxylase

A

MetyraponeEtomidate

123
Q

SERD

A

Selective estrogen receptor downregulatorFulvestrant

124
Q

Aromatase inhibitors

A

1G-Aminoglutethimide2GFormestaneFadrozoleRogletimide3GExemestaneAnastrazoleLetrozoleVorozole

125
Q

Adverse effects of aminoglutethemide

A

Adrenal insufficiencyMyelosupression Rash

126
Q

Adverse effects of L asparaginase

A

Severe hypersensitivity reactions Acute pancreatitisCVT

127
Q

Asparaginase is used in treatment of

A

LeukemiasLymphomas

128
Q

MOA of pentostatin

A

Inhibits ADA

129
Q

Use of Plicamycin

A

Hypercalcemia of malignancyMetastatic testicular Ca

130
Q

Hydroxy urea is DOC for

A

Sickle cell anemiaEssential thrombocytosisPolycythemia Vera

131
Q

Second drug of choice in essential thrombocytosis

A

Anagrelide

132
Q

Route of administration of hydroxy urea

133
Q

Adverse effects of tretinoin

A

Vit A toxicity- headache,dryness,rash,pruritis,conjunctivitisRetinoic acid syndrome- pleural or pericardial effusion,pulmonary infiltrates,feverHypercholesterolemia Hypertriglyceridemia Abdominal pain and diarrhoea

134
Q

Adverse effects of arsenic trioxide

A

HyperglycaemiaProlonged QT interval

135
Q

Adverse effects of thalidomide

A

TeratogenicityConstipationPeripheral neuropathyRashHypothyroidismIncreased risk of DVT

136
Q

IMiD and selCID

A

Immunomodulatory derivatives of thalidomideSelective cytokine inhibitory drugs

137
Q

MOA of thalidomide

A

Inhibition of angiogenesis Inhibition of TNF AIncreased production of IL-10Reduces phagocytosisAlteration of adhesion molecule expression

138
Q

Use of thalidomide

A

MMENLskin manifestations of SLEHIV associated wasting CrohnConditioning before stem cell transplantationMDSkaposi sarcomaPrimary brain malignanciesRecurrent aphthous ulcersTBGVHD

139
Q

Histone deacetylase inhibitors

A

VorinostatRomidepsin

140
Q

Use of histone deacetylase inhibitors

A

Cutaneous T cell lymphoma

141
Q

Recombinant IL-2

A

Aldesleukin

142
Q

Use of aldesleukin

A

RCCmalignant melanoma

143
Q

Use of neoadjuvant chemotherapy

A

BladderBreastColorectalStomachEsophagusLung

144
Q

Recombinant IL-11

A

OprelevkinUsed to prevent thrombocytopenia

145
Q

Rx for radiation induced xerostomia

A

PilocarpinePalifermin

146
Q

Induction Rx for ALL

A

Intrathecal MTXasparaginaseDaunorubicinPrednisoloneVincristineMAD PV

147
Q

Drugs used during consolidation phase of ALL

A

Hyper CVAD alternated with cytarabine+MTXcyclophosphamide VincristineAdriamycinDexamethasone

148
Q

Rx of choice for AML

A

Cytarabine+Daunorubicin/idarubicin

149
Q

Rx of choice for CLL

A

FludarabineCyclophosphamide Rituximab FCR

150
Q

Rx of choice for Hodgkin

A

ABVDadriamycinBleomycinVinblastineDacarbazine

151
Q

Rx of choice for non hodgkin lymphoma

A

R-CHOPRituximabCyclophosphamide Hydroxydaunorubicin(doxorubicin)Oncovin(vincristine)Prednisone

152
Q

Rx of choice for multiple myeloma

A

BortezomibDexamethasone Lenalidomide

153
Q

Rx of choice for waldenstrom macroblobinemia

154
Q

Rx of choice for non small cell lung Ca

A

CisplatinVinorelbine+/- bevacizumab

155
Q

Rx of choice of small cell lung Ca

A

Cisplatin+etoposide

156
Q

Rx of choice of mesothelioma

A

Cisplatin+pemetrexed

157
Q

Rx of choice for head and neck cancer

A

Cisplatin+5FU

158
Q

Rx of choice for esophageal Ca

A

Cisplatin+5FU

159
Q

Rx of choice of ovarian cancer

A

Paclitaxel+carboplatin

160
Q

Rx of choice cervical Ca

A

Paclitaxel+cisplatin

161
Q

Adjuvant chemotherapy for Ca breast

A

DoxorubicinCyclophosphamide Docetaxel

162
Q

Rx of choice of uterine cancer

A

Progestin/tamoxifen/Aromatase inhibitorsCisplatin+doxorubicin+paclitaxel

163
Q

Rx of choice for choriocarcinoma

A

MTX/dactinomycin

164
Q

Rx of choice of testicular Ca

A

BEPBleomycin+etoposide+cisplatin

165
Q

Rx of choice for kidney cancer

166
Q

Rx of choice for bladder cancer

A

Gemcitabine+cisplatin

167
Q

Rx of choice for astrocytoma/GBM

A

Temozolamide

168
Q

Rx of choice for neuroblastoma

A

Cyclophosphamide DoxorubicinCisplatinEtoposide

169
Q

Rx of choice for thyroid Ca

A

I131Sorafenib

170
Q

Rx of choice for stomach cancer

A

EpirubicinCisplatin5FU

171
Q

Rx of choice for pancreatic Ca

A

GemcitabineGemcitabine+cisplatin/erlotinib

172
Q

Rx of choice for colon cancer

A

FOLFOX6+/- bevacizumabFOLFIRI+/- bevacizumabFOLinic acid+5FU+OXaliplatinFOLinic acid+5FU+IRInotecan

173
Q

Rx of choice for rectal cancer

A

Radiotherapy5FU

174
Q

Rx of choice for anal Ca

A

RT+5FU+mitomycin C

175
Q

Rx of choice for insulinoma

A

Interferon/Streptozocin

176
Q

Rx of choice for osteosarcoma

A

DoxorubicinCisplatinIfosfamide High dose MTXAny two of above drugs

177
Q

Rx of choice for soft tissue sarcoma

A

MAIDMesnaAdriamycinIfosfamide Dacarbazine

178
Q

Rx of choice for melanoma

A

Dacarbazine/temozolamide/IL2

179
Q

Rx of choice for HCC

180
Q

Rx of choice for kaposi sarcoma

A

Liposomal doxorubicin/Daunorubicin

181
Q

Rx of choice for adrenal Ca

182
Q

Rx of choice for carcinoid

A

Streptozocin+5FU

183
Q

Other name for Amifostine

184
Q

Dose limiting side effect of Amifostine

A

Hypotension

185
Q

Route of administration of Amifostine

186
Q

OER

A

Oxygen enhancement ratioAmount of radiation dose required before and after radiation

Hematology (9 decks)

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