Haem/Onc

Question 1

heparin and warfain - intrinsic or extrinsic pathways affected?

Answer 1

heparin - intrinsic (+APTT)
warfarin extrinsic (+PT)

Question 2

action of heparin

Answer 2

activates antithrombin which decreases factors IIa (thrombin) and Xa

Question 3

action of warfarin

Answer 3

inhibits vitamin K epoxide reductase which results in inhibition of vitamin K dependant gamma-carboxylation of clotting factors II, VII, IX and X and potein C+S

Question 4

side effects of heparin

Answer 4

bleeding
heparin induced thrombocytopenia
osteoporosis (long term use)

Question 5

side effects of warfarin

Answer 5

bleeding
teratogenic
skin necrosis
initial hypercoaguable state

Question 6

what factor does LMWH act on?

Answer 6

factor Xa

Question 7

reversal of heparin

Answer 7

protamine sulphate
(charged peptide that binds negatively charged heparin)

Question 8

reversal of warfarin

Answer 8

vitamin K
FFP or PCC for rapid reversal

Question 9

dabigatran action and reversal

Answer 9

dabigatran inhibits factor IIa
reverse with idarucizumab

Question 10

apixaban action and reversal

Answer 10

inhibits factor xa
reverse with andexanet alpha

Question 11

action of clopidogrel, ticagrelor and prasugrel

Answer 11

blocks ADP (P2Y12) receptor which decreases ADP induced expresion of GpIIb/IIIa

Question 12

Ca therpies that target DNA synthesis

Answer 12

Because All Annoying People Date Every Indian
bleomycin
anthracyclines
alkylating agents
platinum compounds
dactinomycin
etoposide
irinotectan

Question 13

Ca therapies that target cellular division

Answer 13

occurs during M phase
Cells Target Vogue
taxanes
vinca alkaloids

Question 14

Ca therapies that target Nucleotide synthesis

Answer 14

occurs during S phase of cell cycle
My 5 Hydro Therapies
MTX
5-Fu
hydroxurea
thiopurines (flourouracil)

Question 15

ca drugs that can cause ototoxicity

Answer 15

cisplatin
carboplatin

Question 16

ca drugs that can cause peripheral neuropathy

Answer 16

vincristine

Question 17

ca drugs that can cause pulmonary fibrosis

Answer 17

bleomycin
busulfan

Question 18

ca drugs that can cause cardiotoxicity

Answer 18

doxorubicin
Daunorubicin

Question 19

ca drugs that can cause haemorrhagic cystitis

Answer 19

cyclophosphamide

Question 20

ca drugs that can cause nephrotoxicity

Answer 20

cisplatin
carboplatin

Question 21

cross linking in DNA

Answer 21

cisplatin

Question 22

definitive diagnostic modality for sickle cell

Answer 22

haemoglobin electrophoresis

Question 23

increased BCL transcription

Answer 23

follicular lymphoma

Question 24

how does prostate cancer spread to bone

Answer 24

via batson’s venous plexus

Question 25

what is found on blood film in DIC

Answer 25

schistocytes

Question 26

Ca therapies that work during metaphase

Answer 26

Many cells target vogue taxanes (doxetacel) vinkaloids (vincristine, vinblastine)

Question 27

mechanism of thrombolytics i.e. alteplase

Answer 27

directly or indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots

Question 28

does PT or APTT increase in warfarin

Answer 28

PT prolongs due to warfarin affecting the extrinsic pathway (heparin affects the intrinsic so causes prolonged APTT)

Question 29

Ca therapy drugs that inhibit microtubular formation

Answer 29

drugs that affect cellular division (M phase) vinka alkaloids (vincristine) taxanes (pacitaxel)

Question 30

Ca therapy that works by DNA strand breakage

Answer 30

bleomycin - targets DNA formation at G2 phase

Question 31

Ca therapy that works by inhibiting ribonucleotide reductase

Answer 31

hydroxyurea (nucleotide synthesis at M phase)

Question 32

toxicity with 5 mercaptopurine can occur with concomitant use with what drug

Answer 32

xanthin oxidase inhibitors (allopurinol) this is because 5 mercaptopurine is inactivated with xanthine oxidase

Question 33

what Ca drug can cause palmar - plantar erythrodysethesia

Answer 33

(hand foot syndrome) flourouracil (S phase - nucleotide synthesis)

Question 34

how can haemorrhagic cystitis and bladder cancer be prevented when taking cyclophosphamide

Answer 34

use of mesna

Question 35

what Ca drug can cause disulfiram like reactions

Answer 35

procarbazine

Question 36

what Ca are nitrosureas used in and side effects

Answer 36

i.e. carmustine, lomustine used in brain tumours side effects include convulsion, dizziness, ataxia

Question 37

how can nephrotoxicity be prevented in use of plastinum compounds i.e. cisplatin

Answer 37

use of amifostine

Question 38

vincristine and vinblastine side effects

Answer 38

(vinca alkaloids - M phase, microtubular inhibitors) vincristine - peripheral neuropathy (crisps the nerves) vinblastine - myelosuppression (blasts the bone marrow)

Question 39

target of rituximab

Answer 39

CD 20

Question 40

adverse effect of rituximab

Answer 40

infusion reaction due to cytokine release following interaction of its target on B cells

Question 41

tratzumab target

Answer 41

HER (dont TRAsT HER she will break your heart)

Question 42

tratzumab adverse effect

Answer 42

dilated cardiomyopathy

Question 43

alemtuzumab target

Answer 43

CD52

Question 44

bevacizumab target

Answer 44

VEGF

Question 45

cetuximab, panitumumab target

Answer 45

EGFR

Question 46

filgrastim and sargramostim mode of action and indication

Answer 46

graulocyte colony stimulating factor (G-CSF) used to prevent neutropenia in chaemotherapy patients)

Question 47

epoetin alfa mode of action and indication

Answer 47

recombinant erythropoeitin used in anaemia due to chaemotherapy agents

Question 48

dexrazoxane mode of action and indication

Answer 48

iron chelator prevent/treat cardiotoxicity due to anthracyclines (donorubicin)

Question 49

leucovorin (folinic acid) mode of action and indication

Answer 49

tetrahydrofolate precursor myelosuppression in MTX

Question 50

amifostine indication and mode of action

Answer 50

free radical scavanger nephrotoxicity from platnium compounds (cisplatin)

Question 51

what part of the cell cycle does daunorubicin act on

Answer 51

G2 phase

Question 52

mesna mode of action and indication

Answer 52

prevention of haemorrhagic cystitis and bladder cancer with treatment with cyclophosphamide detoxifies acrolein - toxic byproduct of cyclophosphamide

Question 53

mechanism by which tacrolimus causes hyperglycaemia

Answer 53

inhibition of beta cell insulin production