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Low weighted and other topics > Immune system and malignancy > Flashcards

Immune system and malignancy Flashcards

1
Q

Which immunosuppressants are “anti-proliferative” ?

3 points

A

Azathioprine

Cyclophosphamide

Mycophenolate mofetil

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2
Q

True or false:

Prednisolone can stimulate appetite

A

TRUE

In end stage cancers they can be used to stimulate appetite

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3
Q

What class of drug is ciclosprin

A

A calcineurin inhibitor

As is tacrolimus

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4
Q

Which calcineurin inhibitor is more nephrotoxic ?

A

Tacrolimus

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5
Q

How long must contraception be continued after discontinuing:

a) Mycophenolate (hint: different in men and women)
b) Methotrexate
c) Statins
d) Isotretinoin

A

a) 6 weeks for women. 90 days for men
b) 6 months
c) 1 month
d) 1 month

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6
Q

Which drugs can be used as disease modifying drugs in multiple sclerosis

A

Interferon Beta

Peginterferon Beta

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7
Q

Which drugs can be used to treat spasticity associated with multiple sclerosis?
(2 points)

A

Baclofen

Gabapentin [unlicensed]

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8
Q

What class of drug is baclofen?

A

It is a centrally acting muscle relaxant

Centrally acting so can cause side effects e.g. hypotension, nausea and some antimuscarinic effects!

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9
Q

What are the cytotoxic handling guidelines?

6 points

A
  1. Only reconstituted by TRAINED personnel
  2. Reconstituted in DESIGNATED AREAS
  3. PROTECTIVE CLOTHING must be worn
  4. EYE PROTECTION must be worn
  5. PREGNANT staff should avoid exposure
  6. MONITOR staff exposure to cytotoxics
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10
Q

Oral mucositis is associated with which 3 cytotoxic drugs?

A
  1. Methotrexate
  2. Fluorouracil
  3. Anthracyclines (e.g. doxorubicin)
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11
Q

Which class of cytotoxics are known as cytotoxic antbiotics ?

A

Anthracyclines

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12
Q

What are the features of tumour lysis syndrome

A

Hyperkalaemia
Hyperuriceamia

Hypocalcaemia
Hypophosphatemia

May lead to renal damage

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13
Q

Management of hyperuricaemia associated with chemotherapy:

a) Prophylaxis
b) Treatment

A

a) Allopurinol - start 24 hours before treatment

b) Rasburicase - licensed for hyperuricaemia is haematological malignancy

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14
Q

All cytotoxics cause bone marrow suppression except _____ and ______

A

Vincristine and Bleomycin

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15
Q

True or false:

Alopecia caused by cytotoxics is irreversible

A

FALSE

Hair will grow back once treatment is stopped

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16
Q

True or false:

Cancer chemotherapy increases the VTE risk

A

TRUE

Though the risk may also be increased by the cancer itself

17
Q

Cyclophosphamide, Carmustine and Melphalan are examples of what class of cytotoxic ?

A

Alkylating agents

18
Q

What class of cytotoxic has a risk of permanent male sterility and premature menopause associated with it?

A

Alkylating agents e.g cyclophosphamide

19
Q

Mild, moderate or highly emetogenic:

(intermediate dose) Cyclophosphamide

A

Moderate

20
Q

Mild, moderate or highly emetogenic:

Dacarbazine

A

High

21
Q

Mild, moderate or highly emetogenic:

Fluorouracil

A

Mild

22
Q

Mild, moderate or highly emetogenic:

Taxanes e.g. Paclitaxel

A

Moderate

23
Q

Mild, moderate or highly emetogenic:

Vinca alkaloids e.g. vincristine

A

Mild

24
Q

Mild, moderate or highly emetogenic:

Doxorubicin

A

Moderate

25
Q

Mild, moderate or highly emetogenic:

High doses of methotrexate

A

Moderate

26
Q

Mild, moderate or highly emetogenic:

Platinum based chemotherapy e.g. Cisplatin

A

High

27
Q

Drugs used to prevent acute symptoms in low risk of emesis associated with chemo?
(2 options)

A

Lorazepam

OR

Dexamethasone

28
Q

Drugs used to prevent acute symptoms in high risk of emesis associated with chemo:
______ and _______ and _______

A

5HT3 receptor atagonist (e.g. ondansetron)
Dexamethasone
Aprepitant (a NK1 receptor antagonist)

29
Q

To prevent delayed symptoms of emesis with moderately emetogenic chemo: _____ and ______

A

Ondansetron + Dexamethasone

30
Q

To prevent delayed symptoms of emesis with highly emetogenic chemo: _____ and ______

A

Dexamethasone + Aprepitant

31
Q 
Which class of cytotoxics are known to be cardiotoxic ?
Give an example
A

Anthracyclines

e.g. Doxorubicin and Bleomycin

32
Q

What is used to counteract folate antagonism caused by methotrexate ?

A

Folinic acid (as Ca folinate)

note: It is also used in the management of methotrexate overdose

33
Q

What is used to prevent urothelial toxicity caused by cyclophosphamide and ifosfamide ?

A

Mesna

34
Q

Which drugs are aromatase inhibitors?

2 points

A

Letrozole

Anastrozole

35
Q

What is used as adjuvant therapy in men and PRE-menopausal women with ER+ breast cancer?

A

Tamoxifen

36
Q

What is 1st line for ER+ breast cancer in post-menopausal women

A

Aromatase inhibitors e.g. letrozole

Tamoxifen if CI or low risk of recurrence

37
Q

How long is chemo-prevention with tamoxifen given in familial breast cancer?

A

5 years

38
Q

Which bisphosphonates are used in malignant diseases?

2 points

A

Pamidronate

Zoledronic acid

Low weighted and other topics (6 decks)

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