Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IHO Week 1 > Millikan B IHO Week 3 > Flashcards

Millikan B IHO Week 3 Flashcards

1
Q

3 reasons that we have not been able to cure more patients with chemotherapy?

A
  1. altered threshold for apoptosis 2. drug avoidance mechanisms 3. toxicity to the host
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What was the first drug to target Bcl-2 to restore pro-apoptotic signals

A

Venetoclax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What mimics the action of BH3 domain (an inhibitor of Bcl-2) to promote apoptosis

A

Venetoclax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Curative

A

only a fraction of patients will be cured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Control

A

treatment that has less than 5% chance of cure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the phrase for using agents of different mechanistic classes

A

non-cross resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name a large natural product that induces DNA strand breaks; MOA unkown

A

Bleomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes potentially fatal pulmonary fibrosis; higher is smokers and prohibitive in presence of pulmonary hemorrhage or pulmonary embolism?

A

Bleomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Combination used for germ cell tumors in Stage 2 ds

A

BEP (Bleomycin, Etoposide, Cisplatin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Combination that is standard tx for intermediate risk non-Hodgkin lymphoma, in favorable risk patients, 80% curative

A

R-CHOP (Rituximab, Cytoxan, Doxorubicin, Vincrisitne, Prednisone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Standard tx for Hodgkins’s, favorable risk cure is 90%

A

ABVD (Doxorubicin, Bleomycin, Vinblastine, Prednisone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Standard induction for AML, 20-30% cure

A

3+7 (Daunrubicin, Ara-C)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Standard adjuvant treatment for breast cancer

A

AC–>T (Doxorubicin, Cyclophosphamide, Taxane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What combines well with DNA damaging agents (including radiotherapy?)

A

Gemcitabine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is much safer from a cardiac perspective, but more prone to cause hand/foot syndrome and is the first liposomal cancer drug

A

Liposomal Doxorubicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Drug very active agains CD30 expressing lymphomas, built from antibody and a highly toxic anti-tubule drug that is too toxic to use non-targeted

A

Brentuximab Vedotin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Used in breast cancers that overexpress Her2, built from an antibody and a highly toxic anti-tubule drug that is way too toxic to be used in a non-targeted way

A

Trastuzumab-Maytansine (T-DM1) aka ado-trastuzumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A polymer with camptothecin

A

CRLX101

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

signal transduction inhibitor, ligand reduction, small, breast cancer

A

Anastrozole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

signal transduction inhibitor, receptor antagonist, MAB, Her2 over expressing Breast and upper GI cancers

A

Trastuzumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

signal transduction inhibitor, receptor antagonist, MAB, EGFR driven cancers of aerodigestive tract

A

Panitumumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

signal transduction inhibitor, receptor antagonist, small, breast cancer

A

Tamoxifen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

signal transduction inhibitor, receptor antagonist, small, Prostate

A

Enzalutamide

24
Q

signal transduction inhibitor, receptor antagonist, peptide, prostate and breast

A

Leuprolide

25
Q

signal transduction inhibitor, TKI, small, B cell malignancies, especially CLL

A

Ibrutinib

26
Q

signal transduction inhibitor, TKI, small, CML, GIST, Ph+ALL

A

Imatinib

27
Q

signal transduction inhibitor, TKI, small molecule, lung cancers with ALK or ROS1 activation, c-met overexpressing thyroid cancer

A

Crizontinib

28
Q

signal transduction inhibitor, TKI, small molecule, renal cell carcinma, C-kit driven cancers

A

Pazopanib

29
Q

3 ways to lower hormone concentration

A
  1. decrease synthesis (turn down synthesis stimulus, direct drug based inhibition) 2. increase catabolism 3. neutralizing antibody to ‘soak up’ all the hormone
30
Q

Decrease Testosterone

A
  1. remove testicles and/or adrenals 2. pituitary gland 3. remove pituitary gland 4. use LHRH antagonist 5. LHRH super-agonist or super-agonist or antagonist 6. inhibitor of steroid biosynthesis 7. use a neutralizing antibody
31
Q

what binds very strongly to the LHRH receptor and INCREASES in LH and testosterone for a couple of days and then paradoxical fall; nearly no side effects

A

LHRH (aka GnRH) superagonists

32
Q

What will you see iatrogenic osteoporosis consequences of worsening insulin resistance and intervention-requiring affective disorders in up to 30%?

A

LHRH super agonists (Leuporlide and Goserelin)

33
Q

What has no ‘flare’ but is a pure antagonist that results in castrate testosterone levels within 24 hours

A

Dagarelix

34
Q

what is a steroid analog expected to bind to several enzymes in metabolic pathway; must be given with physiologic replacement of adrenocorticoids?

A

Abiraterone (lyase inhibitor)

35
Q

How to block testosterone?

A

block conversion of T to DHT (5-alpha-reductase) and block androgen receptor (AR)

36
Q

What is a great target with minimal tweaking of all the other steroids would be expected (slightly higher androgen)?

A

The final step of estrogen synthesis (Aromatase)

37
Q

What is an aromatase inhibitor that causes arthralgia and myaligia sufficient for patients to stop taking the drug in about 20% of patients?

A

Anastrozole

38
Q

Name an aromatase inhibitor that is also a suicide substrate and can cause arthralgia and myalgia

A

Exemstande

39
Q

Name a selective estrogen recetpor modulator (SERM); it is not a full antagonist

A

Tamoxifen

40
Q

Name a pure estrogen receptor antagonist that generally outperforms tamoxifen

A

Fulvestrant

41
Q

What is a metabolite of Tamoxifen that is 100x more potent; how do you get to it?

A

Endoxifen; via CYP3A4/5 to CYP2D6

42
Q

TK

A

Tyrosine Kinase

43
Q

Ligan binding domain versus tyrosine kinase domain

A

extracellular versus intracellular

44
Q

Various adapter proteins connect the RTK phosphorylation event to various ‘second messengers.’ Name one specifically

A

SH2 domains-recognize phospho-tyrosine

45
Q

What causes degradation of HIFalpha

A

prolyl hydroxylase, vitamin C, a-ketoglutarate, oxygen all combine to cause ubiquitin attachment with help of E3 ligase activity

46
Q

What happens if HIF alpha is constitutively active (low oxygen state)?

A

induction of hypoxia-inducible genes (VEGF, PDGF)

47
Q

TKI

A

tyrosine kinase inhibitor

48
Q

AE of VEGFR inhibitors

A

htn, hypothyroidism, loss of hair pigmentation, rare: GI perforation, pericardial effusion, myelosuppression, hepatic toxicity

49
Q

Member of the EGFR family, marker of clinically aggressive ds, intracellular kinase activity w/NO LIGAND BINDING DOMAIN, effects different based on heterodimer

A

Her2 aka Erb-B2

50
Q

humanized antibody to the extracellular domain of the Her2 protein, combination with chemotherapy metastatic breast cancer improvement, used in adjuvant

A

Trastuzumab

51
Q

Blocks both the EGFR and Her-2 with more AE

A

Lapatinib (TKI)

52
Q

5% of patients with adenocarcinoma of the lung will have what issue

A

EGFR activating mutation or activated ALK signaling

53
Q

Who is most likely to respond to EGFR directed therapy

A

patients with del exon 19 or L858R

54
Q

in RTK drivers in lung cancer which patients are most likely to have resistance

A

T790M mutation

55
Q

Which meds to use in TKIs in lung cancer? Which do you use with a T790M mutation?

A

Gefitnib or erlotinib; with resistance use Osimertinib

IHO Week 1 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions