Exam 1 Problem Set Questions

Question 1

Which of the following anticancer drugs are cell cycle-nonspecific?

a. vinca alkaloids
b. taxanes
c. epipodophyllotoxins
d. alkylating agents

Answer 1

d. alkylating agents

Question 2

Which of the following exerts its cyctotoxic effect by cross-linking DNA?

a. Vinorelbine
b. Fluorouracil
c. paclitaxel
d. teniposide
e. cyclophosphamide

Answer 2

e. cyclophosphamide

Question 3

Which of the following is used to minimize the risk of cardiotoxicity during doxorubicin therapy?

a. leucovorin
b. folic acid
c. daunorubicin
d. none of the above
e. a and b

Answer 3

d. none of the above

Dexrazoxane is used.

Question 4

Which of the following anticancer drugs is activated to FdUMP in cancer cells?

a. methotrexate
b. mercaptopurine
c. docetaxel
d. fluorouracil
e. cyclophosphamide

Answer 4

d. fluorouracil

Question 5

The main dose-limiting toxicity of vincristine is:

a. bone marrow depression
b. neurotoxicity
c. nephrotoxicity
d. cardiotoxicity

Answer 5

b. neurotoxicity

Question 6

Which of the following anticancer drugs binds to DNA through intercalation?

a. mitomycin
b. cyclophosphamide
c. daunorubicin
d. none of the above

Answer 6

c. daunorubicin

Question 7

Which of the following drugs exerts its cytotoxic effect by inhibiting topoisomerase II enzyme?

a. vinblastine
b. bleomycin
c. paclitaxel
d. doxorubicin

Answer 7

d. doxorubicin

Question 8

Which of the following is a mechanism of acquired resistance to the anticancer drug cyclophosphamide?

a. increased synthesis of dihydrofolate reductase
b. increased synthesis of glutathione-S-transferase
c. decreased synthesis of hypoxanthine-guanine phosphoribosyl transferase
d. increased synthesis of xanthine oxidase

Answer 8

b. increased synthesis of glutathione-S-transferase

Question 9

Which of the following anticancer drugs exerts its cytotoxic effect by inhibiting DNA synthesis?

a. raloxifene
b. degarelix
c. daunorubicin
d. fulvestrant
e. exemestane

Answer 9

c. daunorubicin

Question 10

Which of the following anticancer drugs are cell cycle-nonspecific?

a. vinca alkaloids
b. taxanes
c. epipodophyllotoxins
d. alkylating agents

Answer 10

d. alkylating agents

Question 11

Which of the following exerts its cyctotoxic effect by cross-linking DNA?

a. vinorelbine
b. fluorouracil
c. paclitaxel
d. teniposide
e. cyclophosphamide

Answer 11

e. cyclophosphamide

Question 12

Which of the following anticancer drugs is activated to FdUMP in cancer cells?

a. methotrexate
b. mercaptopurine
c. docetaxel
d. fluorouracil
e. cyclophosphamide

Answer 12

d. fluorouracil

Question 13

The main dose-limiting toxicity of vincristine is:

a. bone marrow depression
b. neurotoxicity
c. nephrotoxicity
d. cardiotoxicity

Answer 13

b. neurotoxicity

Question 14

When administered concomitantly, which of the following increases plasma levels and toxicity of the anticancer drug mercaptopurine?

a. colchicine
b. febuxostat
c. indomethacin
d. celecoxib

Answer 14

b. febuxostat

Xanthine Oxidase Inhibitor (allopurinol and febuxostat)

Question 15

Resistance to mercaptopurine has been attributed to which of the following mechanisms?

a. increased levels of alkaline phosphatase
b. increased levels of hypoxanthine-guanine phosphoribosyl transferase
c. decreased levels of xanthine oxidase
d. decreased levels of dihydrofolate reductase

Answer 15

a. increased levels of alkaline phosphatase

Question 16

Are bifunctional alkylating agents more effective than monofunctional alkylating agents at killing cancer cells? Explain.

Answer 16

Yes, because it is harder to repair than the damage done by bifunctional alkylating agents.

Question 17

Name all mechanisms of resistance to the alkylating agents.

Answer 17

a. increased glutathione production
b. increased glutathione s transferase production
c. increased DNA repair
d. decreased cell permeability

Question 18

How do we rescue normal cells from the toxicity of methotrexate? Explain

Answer 18

a. We use Leucovorin (or Levoleucovorin (S-enantiomer)) in combination with methotrexate in patients who are taking normal doses of methotrexate to restore DNA and purine synthesis in normal cells and act as a storage for methotrexate.
b. If the patient is taking high does, the patient must take Leucovorin and Glucarpidase. Glucarpidase will decrease plasma levels of methotrexate. Leucovorin will decrease intracellular levels of methotrexate.

Question 19

Name 4 anticancer drugs that can inhibit DNA synthesis in the cell.

Answer 19

a. methotrexate
b. cyclophosphoramide
c. fluorouracil
d. mercaptopurine

Question 20

Why do we need to decrease the dose of mercaptopurine when we use it in combination with allopurinol (treats hyperuricemia (high plasma levels of uric acid)/gout)? Explain

Answer 20

Allopurinol is a xanthan oxidase inhibitor. We must decrease the dose because mercaptopurine is metabolized by Xanthian oxidase to 6-zianthoric acid. Allopurinol will inhibit the metabolism of mercaptopurine, so decreasing the amount of mercaptopurine will prevent too much mercaptopurine in the body.

Question 21

What do we use dexrazoxane for? Explain.

Answer 21

One of the components used to minimize chronic cardiotoxicity. It binds to iron and prevents the formation of free radicals in the myocardial cells of the heart.

Question 22

Why do we use allopurinol during cancer chemotherapy? Explain

Answer 22

Patients who receive cytotoxic drugs will have elevated levels of uric acid. Allopurinol is given to decrease the plasma levels of uric acid. When cells are killed, purines are dumped into the plasma resulting in hyperuricemia