E2 unique things to look out for ig Flashcards
1
Q
enterochromaffin
A
cells in lining of GI tract with lots of serotonin
2
Q
substance P
A
one of two important neurotransmitters for CINV
3
Q
metoclopramide or prochlorperazine
A
low emetogenic regimen choices
4
Q
haloperidol
A
breakthrough option
5
Q
cannibinoids
A
breakthrough option
6
Q
acupuncture
A
prevention of anticipatory
7
Q
5Ht3 antag common toxicities (3)
A
headache, ekg changes, constipation
8
Q
hiccups
A
common tox of substance P antag
9
Q
topical anesthetics
A
relief for mucositis
10
Q
sucralfate
A
pain management mucositis
11
Q
< 0.5 x 103/µL
A
WBC value for neutropenia
12
Q
< 100 x 103/µL
A
platelet value for thrombocytopenia
13
Q
nadir
A
lowest absolute neutrophil count during a cycle of chemo
14
Q
WBC > 3 x103/µL OR
Absolute neutrophil count (ANC) of > 1.5 x103/µL AND
Platelet count > 100 x103/µL
A
guidelines to administer chemo safely
15
Q
ANC < 0.5 x 103/µL and a single oral temperature > 101F
A
febrile neutropenia
16
Q
when give CSF
A
chemo regimens with >20% incidence of febrile neutropenia or 10-20% for neutropenic fever. pretty sure this is just dose dense AC
17
Q
CSF with non-linear shit
A
pegfilgrastim
18
Q
20-kD and N-terminus
A
pegfilgrastim
19
Q
Tbo-Filgrastim
A
not a biosimilar
20
Q
start at least 24 hours after chemo
A
pegfilgrastim
21
Q
flu-like sxs, bone and joint pain, DVT
A
adverse effects of CSF
22
Q
loratidine
A
treatment of bone or joint pain from CSF
23
Q
splenic enlargement
A
rare adverse effect with long terme CSF use
24
Q
connect renal dysfunction and anemia
A
decreased erythropoietin production causes it
25
Hgb ≤ 11 g/dL or ≥ 2 g/dL
patients under this criteria should have a work-up before chemo for anemia
26
CKD and perisurgery
esa's increase risk of these
27
peripheral neuropathies
taxanes, vinka, platinums
28
morphine
metabolized in liver
renal excretion
29
hydromorphone
renally excreted
caution in liver dysfxn
30
oxycodone
cyp2d6
caution in liver dysfxn
no iV form
31
fentanyl
safe in liver and renal
head/neck/esophageal
32
opioid with rems
fent
33
true morphine allergy
methadone
34
neuropathic pain opioid
methadone
35
excreted urine and feces
methadone
36
opioid with qtc risk
methadone
37
low dose nalaxone
respiratory depression
38
hot flashes
endometrial cancer
DVT
toxicities of tamoxifen
39
ovarian suppression
required for use of aromatase inhibitors in pre meno women
40
toxicities aromatase inhibitors
osteoporosis
hot flashes
muscle aches
41
dose dense treatment follow up
36 months
42
trastuzumab duration of therapy
1 year
43
ado-trastuzumab
residual breast cancer
44
keynote
triple negative
45
pembrolizumab in breast cancer
triple negative
positive score >10
46
fam-trastuzumab deruxtecan
HER2 low
47
CDK4/6 inhibitors
in hormonal therapy metastatic breast cancer
48
monitoring parameter all CDK4/6
complete blood count
49
Ribociclib
qtc prolongation
also cdk
50
cdk4/6 all cause
diarrhea
51
tamoxifen
raloxifene
exemestane
prevention breast cancdr
52
gleason score
scale 2-10
prostate cancer
53
psa >10ng/ml
highly sus for cancer
54
external beam or brachytherapy
radiation therapy in localized prostate cancer
55
ADT (prostate)
LHRH agonist +/- anti-androgene or orchiectomy
56
goal for inducing castrate levels of testosterone
<50 after 1 month of therapy
57
LHRH agonists irreversible or reversible
reversible
58
acute LHRH toxicity
tumor flare
59
long term LHRH agonists toxicities
increase fat
increase insulin
increase cholesterol
60
oral LHRH agonist
Relugolix
61
Relugolix
oral LHRH
less cardiovascular events
62
anti androgens (drugs)
- lutamides
abiraterone
63
side effect of all anti-androgens
diarrhea
64
2 orchiectomy toxicities
impotence
hot flashes
65
men with biochemical failure only
able to consider intermittent ADT
66
abiraterone
not used in M0
67
decrease warfarin conc
avoid cyp2c8
caution in pts with seizure history
enzalutamide
68
non-steroidal
qt prolongation
thyroid dysfunction
cyp shit
apalutamide
69
less adverse effects than other androgen receptor antagonists
darolutamide
70
high volume m1HSPC
multiple organ systems
71
abiraterone + prednisone
added to regimen for m1HSPC
72
CYP17
abiraterone
73
must give with predisone
abiraterone
74
cyp3a4
take on empty stomach
abiraterone
75
first line chemo drug m1HSPC
docetaxel
76
cabazitaxel
2nd line m1CRPC
77
mdr proteins
cabazitaxel
78
radium 223
prostate cancer
CRPC with bone metasteses
79
pembrolizumab in prostate cancer
expressing dMMR or MSI-H
80
DRE and TRUS
screening prostate
81
annual prostate screen
psa >2.5
82
every 2 years screen prostate
psa <2.5
83
finasteride
prostate cancer prevention
84
increases gleason score
finasteride
85
FAP HNPCC
haha
hereditary syndrome risk factor for colorectal
86
jaundice
hepatomegaly
weight loss
presentation of colorectal
87
dMMR or MSI-H tumor colorectal
decreased benefit from 5-FU in stage II
can benefit from 5-FU in stage III
88
surgery alone is definitive therapy
stage I and II colorectal
89
when chemo will not work in stage II colorectal
MSI-H or dMMR
90
paresthesia
neutropenia
GI
toxicities oxaliplatin
91
requires port
folfox
92
KRAS mutation colorectal
lack of response to anti-EGFR mabs
(dont use cetuximab and panitumumab)
93
KRAS and BRAF
predictive biomarkers for colorectal
94
KRAS WT metastatic colorec tal
use cetuximab or panitumumab
95
dMMR/MSI-H in colorectal
pembro OR
use Nivolumab + ipilimumab
96
bevacizumab in colorectal
its VEGF (falls under no targetable mutations)
metastatic in combo with FOLFIRI or FOLFOX
97
FOBT and FIT
primarily detect colon cancer
98
detects hemoglobin
fecal immunochemical test (FIT)
99
1st degree relative with colon cancer
screen at 40 or 10 years younger than youngest age of diagnosis in family
100
thymidylate synthase
DPD
5-FU
101
early and late onset diarrhea
irinotecan
102
give atropine
with irinotecan for early onset diarrhea
103
SN-38
UGT1a1
irinotecan
104
cold intolerance
oxaliplatin
105
cross-links DNA, inhibiting dna replication
oxaliplatin
106
hand-foot syndrome and diarrhea
capecitabine
107
binds to extracellular domain of EGFR
Cetuxima b
108
only used in KRAS WT pts colorectal
cetuximab + panitumumab
109
acneform rash
hypomagnesemia
cetuximab and panitumumab
110
premedicate with H1 antagonist
cetuximab
111
recombinant igG2 mab
panitumumab
112
bleeding and hypertension
bevacizumab + many black box warnings
113
metabolic derangements
from death of malignant cells
tumor lysis syndrome
114
urine output 80-100 ml/hr
hydration for TLS
115
urate oxidase and allantoin
hyperuricemia -> TLS
116
causes direct tubular injury
hyperuricemia from tls
117
pt cant take allopurinol what do you give
rasburicase
118
rasburicase Ci
pregnant or breastfeed
119
electrolyte changes TLS
everything hyper except hypocalcemia
120
MSCC diagnosis
MRI
121
immediately start what if sus of MSCC
steroids
122
Kyphoplasty
balloon in spine
123
bone cement injected into fractured bone
vertbroplasty
124
bisphosphonates in MSCC
offered in pts w/ vertebral involvement to reduce fracture or collapse
125
SVC
superior vena cava syndrome
major blood vessel from head to neck and arms to heart and lungs and whatever
126
extrinsic compression
svs syndromee
127
adjunctive therapies svc syndrome
elevation of head
steroids
diuretics
128
malignant pleural effusion common in
lung
breast
lymphoma
129
CXR (chest x-ray)
diagnosis of MPE
130
thoracentesis
needle aspiration of fluid from pleural effusion
131
thoracentesis vs pleurodesis
thora -> <1-3 months to live
pleuro -> >1-3 months
132
pleurodesis drugs and administration of said drugs
talc
doxycycline
bleomycin
intrathecal (gross)
133
lynch II syndrome
risk factor ovarian
134
ascites
presenting symptom ovarian
135
debulking
ovarian cancer surgerey
136
optimally debulked
<1 cm of disease
137
sub-optimally debulked
>1 cm disease
138
AUC x (GFR+25)
carboplatin dosing * absolutely on exam
139
anaphylaxis
itching
rash
chest tightness
type I hypersens
140
erythema, induration
type IV hypersens
141
MHC and APC
t cells recognize antigens
something about type IV hypersens
142
pretty common drug for hypersens reaction
paclitaxel
mostly type I
143
cremophor EL
paclitaxel diluent -> hypersens
144
facial flushing
back pain
chest or throat tightness
taxane infusion reactions
145
premedicate paclitaxel with
dexamethasone
benadryl
famotidine
146
cutaneous sxs
vomiting
htn
carboplatin hypersens symptoms
147
parp inhibitors use
ovarian cancer
148
platinum sensitive
ovarian cancer
treat with initial regimen again
149
platinum resistant
salvage regimen
150
platinum progressive
ovarian cancer
no response or progression
151
effective screening tool ovarian cancer
none you fool
152
oral contraceptives
ovarian cancer prevention
153
NSCLC histology
mostly adenocarcinoma
154
SCLC
rapid proliferation
super common to cause brain metasteses
155
lung cancer:
highly sensitive to radiation and chemo
SCLC
156
cisplatin + etoposide
SCLC every time
157
prophylactic cranial radiation
limited stage SCLC
158
extensive stage SCLC shit
without radiation
rarely curable
159
Atezolizumab and Durvalumab seen where
extensive stage SCLC
160
pemetrexed
see only in NSCLC
161
pembro in NSCLC
unresectable
PD-L1 >1%
not candidates for surgery
162
exon 19 or 21
osimertinib
163
fevers
secondary skin cancers
dabrafenib
164
visual changes
retinal detachment
fevers
rash
trametinib
165
sotorasib
KRAS G12C mutation in NSCLC
166
albumin bound paclitaxel
seen in squamous NSCLC
167
nivolumab in melanoma
stage 3
168
pembro with low dose ipilimumab
metastatic 2nd line option in melanoma for those that progressed on prior anti pd-1 therapy
169
unique tox vemurafenib
development of squamous cell carcinoma
170
pro of encorafenib and binimetinib
less fevers
171
CTLA-4
ipilimumab
172
Reed-sternberg cells
hodgkins
173
90% are B cell
non-hodgkins
174
epstein-barr virus
global risk factor for myelomas
175
Ann arbor staging A and B
A-> asymptomatic
B -> B symptoms
176
ABVD
HL regimen
doxo, bleo, vinblastine, dacarbazine
177
relapsed hodgkins
brentuximab
stem cell transplant
178
malignant B or T lymphocytes and precursors
non hodgkin's lymphoma
179
PTHrp
increased parathyroid
part of HCM (calcium and bone shit)
180
severe HCM main sx
heart shit
181
corrected calcium
serum calcium + 0.8 (4-serum albumin)
normal calc is 8.5-10
182
<12
12-14
>14
degrees of hypercalcemia
mild moderate severe
183
T or F
hydration reduces calcium faster than bisphosphonates
true
184
calcitonin
used in severe HCM
185
refractory HCM
denosumab
186
RANK-L
kappa B
something with bone in cancer patients idk HCM shit
also denosumab has affinity for
187
men with prostate cancer
women with breast cancer
both risk factors for
fractures
188
drugs off top of my head that need renally adjusted
bisphosphonates
capecitabine
189
osteonecrosis of jaw
bisphos and deno
190
IPI >/= 2
NHL
use Pola-R-CHP instead of RCHOP
191
HepB anything
rituximab in NHL
192
entacavir
give to people that get hepB from rituximab in NHL
193
bendamustine
part of regimen for relapsed DLBCL/Aggressive NHL
with rituximab and polatuzumab
194
when to use CAR-T
relapsed DLBCL/Aggressive NHL
195
-leucel
car-t cells in NHL all end with
196
when to use bites NHL
third line after failing 2 lines of systemic, progressed on car-t or stem cell transplant
197
IL-6
tocilizumab
bite for NHL
198
bone marrow biopsy
required for CML diagnosis
199
allogenic hematopoetic stem cell transplant
only way to cure CML / leukemic clone i cant tell
200
avoid acid reducers
dasatinib
201
metabolic syndrome and qtc prolongation
nilotinib
202
t315 can be used in resistant cml
asciminib
203
deep molecular response
discontinue TKI
bcr-abl <0.1%
204
translocation chromosomes 9 and 22
CML
bcr-abl
philly
205
fludarabine
CLL
del(11q)
add alkylating agent
206
reflects loss of tp53
Del17p in CLL
207
Monoclonal B lymphocytes > 5 x 109 /L in peripheral blood
CLL diagnosis
208
RAI staging
CLL
209
treatment in CLL
stage III or IV
organ dysfunction
210
you see any BTK (-brut) what do you think
CLL first line option solo or add chemoimmuno
211
BLC-2 and BIM and PUMA
venetoclax
CLL
212
CYP3a4 and PGP
venetoclax drug interactions
213
venetoclax in CLL
when they have del 17p or p53 mutation
214
main toxicity with venetoclax*
tumor lysis syndrome
215
transient increase in absolute lymphocyte count
associated with btk inhibitors
216
FTL3 mutations
AML
TKIS can target this
217
induction and consolidation
AML, MM
218
cytarabine
intensive induction in AML
219
pyrimidine analog
cytarabine
220
cerebellar side effects
chemical conjunctivitis
cytarabine
221
t(15;17)
APL (subset of AML)
222
crowd out normal cells
ALL and maybe the other too idk
223
hide in balls and brain
ALL
224
HyperCVAD
ALL
cyclophosphamide, vincristine, doxorubicin, dexamethasone
225
hypomethylating agent
azacitidine
226
cd19 and cd3
blinatumomab
227
cytokine release syndrome
immune effector cell-associated neurotoxicity syndrome
blinatumomab?
228
asparaginase
ALL only?
229
IgG
MM pathology
230
lenalidomide
dexamethasone
bortezomib
MM 3 drug regimeen
231
crab
lymphoma lecture
hypercalcemia
renal dysfunction
anemia
bone lesions
