Chemotherapy Flashcards
What is Proliferation
B-cells making memory only (memory cells)
What is Differentiation
B-cells killing, making antibodies and memory
Main mechanism of innate immunity?
Inflammation
3 components of innate immunity?
-mechanical (skin, mucus)
-biochemical (compliment, free radicals, interferons, etc.)
-Cellular (WBCs, neutrophils, monocytes, macrophages, NKTs)
Steps of innate immunity?
- compliment attracts phagocytes to infammatory site
- compliment form membrane attack complex (lyses bacteria)
- compliment opsinization
What is opsonization?
-coating a pathogen by the compliment system to “tag” it to allow adaptive immune system to know to attack it. Basically alerts everything to kill the pathogen
T-cells are responsible for ________ immunity
Cell mediated
B-cells are responsible for ________ immunity
Humoral
What are the 5 antibody complexes?
IgE - every
IgM - morning
IgA - abby
IgG - goes
IgD - deadlifting
Example of type I hypersensitivity rx?
Anaphylaxis
Tx for type I hypersensitivity rx?
Epi
What antibody complex is responsible for type I hypersensitivity rx?
IgE
Examples of type II hypersensitivity?
-Blood transfusion
-HIT
-Hemolytic reaction in newborn
-Drug allergies
*everything is being attacked
What 2 antibody complexes for type II hypersensitivity rx?
IgM
IgG
Examples of type III hypersensitivy rx?
-Vasculitis
-arthritis
-glomerulonephritis
*can be caused by vaccines, antivenoms, drugs, etc.
Examples of type IV hypersensivity rx?
-poison ivy
-ORGAN REJECTION
-TB
-allergic contact dermatitis
*d/t cytotoxic t-cell, cell mediated exaggerated extreme response
Name the airway joint concerns w/ RA
-cryco-arytenoids
-TMJ
-C-spine (atlantoaxial)
Main s/s of lupus
Butterfly rash
No ________ in MS pts
Spinals
Hypothermia
MS pts have a destruction of _________ in neurons
Myelin
Aids/HIV is the result of a depletion of ________ cells
CD4 T-helper cells
Main presentation of DiGeorge’s syndrome
Low set ears
What is the anesthesia implication for DiGeorge syndrome?
Difficult DL d/t underdeveloped chin
In X-linked agammaglobulinemia, __-cells are nonfunctional while __-cells are functional
-Bcells nonfunctional
-Tcells functional
In DiGeorge syndrome, __-cells are nonfunctional while __-cells are functional
-Tcells nonfunctional
-Bcells functional
In graft vs host, the _______ attacks the _______
Organ attacks the host
Calcerine inhibitors block ___-cell activation
T-cell
Glucocorticoids are used for what?
-asthma
-premedication for blood products or chemotherapy
-1st line immunosuppressive therapy for solid organ tumors & stem cell transplants
Cyclosporins can cause higher incedence of _________ and other cancers
Lymphoma
If pt getting calcineurin inhibitor pre transplant, what labs you gonna check?
-chem (K+)
-UA
*nephrotoxic drug class
mTOR inhibitors block T-cell __________
proliferation
What big adverse effect can you get with mTOR and therefore what should be done preop?
-Profound bone marrow suppression & Throbocytopenia
*type and cross
All pts taking chemo drugs should get a _____ and _____ preop d/t all the antibodies built up in their blood
Type & cross
Main purpose of MMF (mycophenolate mofetil) drugs
Used in transplants to preserve vasculature of new organ
*inhibits purines so you can’t build DNA (so you can’t make new blood vessels)
What is Rh0 (D) Immune Globulin (Rhogam) used for?
When mom is Rh- and baby is Rh+ to keep mom from building antibodies against Rh+ baby if blood mixing happens
When is Rhogam given?
-28wk of pregnancy
-24-72hrs after birth
Onset of hyperacute organ rejection?
hours
Onest of accelerated organ rejection?
days
Onset of acute organ rejection?
months
Onset of chronic organ rejection?
months to years (anytime)
What 2 organ rejection types can be reversed?
-Acute (months)
-Chronic (months-years)
What 2 organ rejection types cannot be reversed?
-hyperacute (hrs)
-accelerated (a few days)
Pt develops organ rejection in a month after transplant. What is your tx?
Give immunosuppressants
Pt develops organ rejection in 2 days. What is your tx?
None, non-reversible, have to remove organ
When are neoadjuvant chemotherapy durgs administered and what is their main goal?
Before surg/main tx to shrink tumor and maximum treatment success
When is primary induction chemotherapy agents used?
In advanced cancers to prolong/improve life. Pallative in nature, not expected to cure
When are adjuvant chemotherapy agents used and why?
After surgery/tx to make sure secondary tumor doesn’t grow
What type of resistance is in the absence of prior drug exposure?
Primary resistance
What type of resistance occurs after drug exposure?
Acquired resistance
(t/f) pts can have resistance to single drugs and/or entire drug classes
Yep
Cancer cells undergo what type of cell division?
Mitosis
carbonic anhydrase inhibitors prevent the reabsorption of what
HCO3 (bicarb)
What 2 things cause downregulation of immune response (negative feedback)
IL-10
IFN-gamma
Rx d/t imcompatable ABO transfusion. What type of hypersensitivity reaction?
Type II
Vasculitis is caused from what hypersensitivity reaction?
Type III
*antibodies (IgG) get circulated in blood and gets dropped in vasculature and organs and destroys them
Which chemotherapy agent most known for causing cardiomyopathy
Doxarubicin
Chemo pt SOB w/ pulmonary fibrosis. What drug are they taking?
Bleomycin
*think bleo bleb in lungs
What agent interferes w/ S-phase of cell cycle?
Cytarabine
Which chemo agent blocks pyrimidines?
5-FU
G2 phase of cell cycle is effected by what drug?
Bleomycin
Pt has rejection 3 weeks after transplant. What type of rejection? What do we treat with?
Acute
Immunosuppresants
1st line tx for preventing chronic allograft vasculopathy in cardiac transplants?
Cell cept (Mycophenolate mofetil)
Disease that results in failure of immature B-cells to mature and can’t make antibody complexes
X-linked agammaglobulinemia
What drug causes stomatitis (inflammation of mouth & lips)
Methotrexate
What drug causes ototoxicity & nephrotoxicity?
Cisplastin
What drug causes hemmorragic cystitis?
Cyclophosphamide
What drugs causes peripheral neuropathy?
Vincristine & Vinblastine
Cytarabine causes ______ ataxia
Cerebellar ataxia
