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RACP Written Exam > Oncology > Flashcards

Oncology Flashcards

1
Q

Bleomycin MoA

A

induces free radical formation -> breaks DNA strands
Acts G2/M phase

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2
Q

Bleomycin used in?

A

testicular ca and hodgkins lymphoma

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3
Q

bleomycin ADRs

A

pulmonary fibrosis, skin hyperpigmentation, mucositis

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4
Q

Dactinomycin moa

A

intercalates into DNA -> prevents RNA synthesis

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5
Q

Uses of dacinomycin

A

wilms tumour, ewing sarcoma, rhabdomyosarcoma

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6
Q

Dactinomycin ADR

A

myelosuppression

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7
Q

Anthracyclines (doxorubicin and daunorubicin) MoA and use

A

generates free radicals
intercalates in DNA -> DNA breaks -> reduced DNA replication
inhibits topoisomerase 2
used in solid tumours, leukaemias, lymphoma

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8
Q

Anthracyclines (doxorubicin and daunorubicin) ADRs

A

dilated cardiomyopathy
myelosuppresion
alopecia

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9
Q

thiopurines MoA

A

purine analogs -> reduced de novo purine synthesis
AZA converted to 6-MP and activated by HGPRT
- inhibits PRPP-synthase and aminotransferase

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10
Q

thopurines ADRs

A

myelosuppression, GI/liver toxicity
6-MP inactivated by xanthine oxidase and TPMT (increased toxicity with allopurinol or feboxustat

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11
Q

Cladribine and pentostatin MoA

A

purine analogs -> unable to be processed by ADA -> reduced DNA synthesis and blocks DNA strand elongation

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12
Q

Cladribine and pentostatin use and ADR

A

in hairy cell leukaemia
ADR: myelosuppresion

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13
Q

Cytarabine MoA and use, ADR

A

pyrimidine analog -> DNA chain termination, inhibits DNA pol
used in AML, lymphoma
ADR: myelosuppresion

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14
Q

5-FU MoA

A

pyrimidine analog -> activated to 5-FdUMP which reduces DNA synthesis
capcitabine is a prodrug

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15
Q

what is used as 5-FU antidote

A

Uridine

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16
Q

What can enhance effects of 5-FU

A

folinic acid

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17
Q

ADRs of 5FU

A

myelosuppresion, hand-foot syndrome, photosensitivity

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18
Q

hydroxyurea MoA

A

inhibits ribonucleotide reductase -> reducing DNA synthesis

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19
Q

hydroxyurea ADRs

A

severe myelosuppresion, megaloblastic anameia

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20
Q

Methotrexate MoA

A

folic acid analog which inhibits dihydrofolate reductase -> reducing DNA synthesis

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21
Q

Methotrexate ADRs

A

myelosuppression
hepatotoxicity -> bx macrovesicular change
mucositis
pulmonary fibrosis
folate def
nephrotoxicity

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22
Q

busulfan MoA and use

A

cross links DNA -> cell death
used to ablate BM prior to transplant

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23
Q

busulfan ADRs

A

myelosuppression, pulmonary fibrosis, hyperpigmentation

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24
Q

cyclophosphamide, ifosfamide MoA

A

cross links DNA, needs activation in liver

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25
cyclophosphamide, ifosfamide ADRs
myelosuppresion, SIADH, fanconi syndrome (ifosfamide - inadequate reabsorption in proximal tubules, reduced K and acidosis) Haemorrhagic cystitis and bladder cancer (prevent with mesna)
26
carmustine, lomustine MoA and uses
cross link DNA, activates in liver crosses BBB so used for brain tumours
27
carmustine, lomustine ADRs
CNS toxicity (dizziness, ataxia, seizures)
28
procarbazine MoA and ADRs
alkylating agent ADR: myelosuppression, pulmonary fibrosis, leukaemia, disulfiram like reaction
29
platinum compounds MoA (cisplatin, carboplatin, oxaliplatin)
cross linsk DNA cell cycle non-specific
30
platinum compounds ADRs
nephrotoxicity (fanconi) peripheral neuropathy ototoxicity
31
what prevents nephrotoxicity of platins
amifostine - detoxifies reactive metabolites
32
taxanes (docetaxel, paclitaxel) MoA
microtuble inhibitors M-phase hyperstabilises polymerised microtubles - prevents mitotic spindle breakdown
33
taxanes (docetaxel, paclitaxel) ADRs
myelosuppression neuropathy hypersensitivity
34
vinca alkaloids (vincristine, vinblastine) MoA
microtubule inhibitors m-phase bind beta-tubulin and inhibits it polymerisation into microtubles -> prevent mitotic spindle formation
35
vincristine ADRs
neuropathy (axonal), constipation
36
vinblastine ADRs
myelosuppression
37
topoisomerase inhibitors work in which cell cycle?
G2 and S phase
38
irinotecan, topotecan MoA and ADR
inibit topo 1 ADR - myelosuppression and diarrhoea
39
etoposide and teniposide MoA and ADR
inhibit topo 2 ADR: myelosuppression, alopecia
40
Tamoxifen MoA
selective estrogen receptor modulator - antagonist at breast tissue - partial agonist in endometrium and bone (reduces bone resorption) blocks binding of estrogen to ER in ER positive cells
41
Tamoxifen MoA
hot flushes increased DVT risk endometrial cancer
42
Alemtuzumab target
CD52
43
Bevacizumab target
VEGF
44
Bevacizumab ADRs
haemorrhage, clots, impaired wound healing
45
Cetuximab target
EGFR
46
Trastuzumab target
HER2
47
Trastuzumab ADR
dilated cardiomyopathy (reversible)
48
pembrolizumab, nivolumab target
PD1
49
Atezolizumab target
PD-L1
50
Ipilimumab target
CTLA-4
51
Alectinib, crizotinib target
ALK
52
Erlotinib target
EGFR
53
imantinib, dasatinib target
BCR-ABL, plus other tyrosine kinases (c-kit in GIST)
54
Ruxolitinib target
JAK1/2
55
Bortezomib, ixazomib, carfilzomib target
proteasome (induces arrest at G2-M phase -> apoptosis)
56
Vemurafenib, dabrafenib target
BRAF
57
Palbociclib target
cyclin dependant kinases 4/6 (induces arrest at G1-S phase)
58
olaparib target
poly (ADP-ribose) polymerase -> reduces DNA repair
59
Aprepitant MoA
NK1 receptor antagonist
60
Ondansetron MoA
5-HT3 receptor antagonist
61
prochlorperazine/metochlopramide MoA
D2 receptor antagonist
62
Degree of mutation severity
frameshift > nonsense > missense >> silent
63
silent mutations
swap for same amino acid
64
missense mutations
swap for different amino acid sickle cell
65
nonsense mutations
early stop codon
66
splice site mutations
retained intron (gaucher, marfans)
67
frameshift mutations
one deletion leading to all AA moving over (duchenne, MD, Tay-sachs)
68
Role of topoisomerase and drugs that inhibit
1 - breaks single stranded DNA 2 - double stranded 1 inhibited by irinotecan and topotecan 2 inhibited by etoposide and teniposide
69

RACP Written Exam (14 decks)

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