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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
Q

cyclophosphamide, ifosfamide ADRs

A

myelosuppresion, SIADH, fanconi syndrome (ifosfamide - inadequate reabsorption in proximal tubules, reduced K and acidosis)
Haemorrhagic cystitis and bladder cancer (prevent with mesna)

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26
Q

carmustine, lomustine MoA and uses

A

cross link DNA, activates in liver
crosses BBB so used for brain tumours

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27
Q

carmustine, lomustine ADRs

A

CNS toxicity (dizziness, ataxia, seizures)

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28
Q

procarbazine MoA and ADRs

A

alkylating agent
ADR: myelosuppression, pulmonary fibrosis, leukaemia, disulfiram like reaction

29
Q

platinum compounds MoA (cisplatin, carboplatin, oxaliplatin)

A

cross linsk DNA
cell cycle non-specific

30
Q

platinum compounds ADRs

A

nephrotoxicity (fanconi)
peripheral neuropathy
ototoxicity

31
Q

what prevents nephrotoxicity of platins

A

amifostine - detoxifies reactive metabolites

32
Q

taxanes (docetaxel, paclitaxel) MoA

A

microtuble inhibitors
M-phase
hyperstabilises polymerised microtubles - prevents mitotic spindle breakdown

33
Q

taxanes (docetaxel, paclitaxel) ADRs

A

myelosuppression
neuropathy
hypersensitivity

34
Q

vinca alkaloids (vincristine, vinblastine) MoA

A

microtubule inhibitors
m-phase
bind beta-tubulin and inhibits it polymerisation into microtubles -> prevent mitotic spindle formation

35
Q

vincristine ADRs

A

neuropathy (axonal), constipation

36
Q

vinblastine ADRs

A

myelosuppression

37
Q

topoisomerase inhibitors work in which cell cycle?

A

G2 and S phase

38
Q

irinotecan, topotecan MoA and ADR

A

inibit topo 1
ADR - myelosuppression and diarrhoea

39
Q

etoposide and teniposide MoA and ADR

A

inhibit topo 2
ADR: myelosuppression, alopecia

40
Q

Tamoxifen MoA

A

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
Q

Tamoxifen MoA

A

hot flushes
increased DVT risk
endometrial cancer

42
Q

Alemtuzumab target

A

CD52

43
Q

Bevacizumab target

A

VEGF

44
Q

Bevacizumab ADRs

A

haemorrhage, clots, impaired wound healing

45
Q

Cetuximab target

A

EGFR

46
Q

Trastuzumab target

A

HER2

47
Q

Trastuzumab ADR

A

dilated cardiomyopathy (reversible)

48
Q

pembrolizumab, nivolumab target

A

PD1

49
Q

Atezolizumab target

A

PD-L1

50
Q

Ipilimumab target

A

CTLA-4

51
Q

Alectinib, crizotinib target

A

ALK

52
Q

Erlotinib target

A

EGFR

53
Q

imantinib, dasatinib target

A

BCR-ABL, plus other tyrosine kinases (c-kit in GIST)

54
Q

Ruxolitinib target

A

JAK1/2

55
Q

Bortezomib, ixazomib, carfilzomib target

A

proteasome (induces arrest at G2-M phase -> apoptosis)

56
Q

Vemurafenib, dabrafenib target

A

BRAF

57
Q

Palbociclib target

A

cyclin dependant kinases 4/6 (induces arrest at G1-S phase)

58
Q

olaparib target

A

poly (ADP-ribose) polymerase -> reduces DNA repair

59
Q

Aprepitant MoA

A

NK1 receptor antagonist

60
Q

Ondansetron MoA

A

5-HT3 receptor antagonist

61
Q

prochlorperazine/metochlopramide MoA

A

D2 receptor antagonist

62
Q

Degree of mutation severity

A

frameshift > nonsense > missense&raquo_space; silent

63
Q

silent mutations

A

swap for same amino acid

64
Q

missense mutations

A

swap for different amino acid
sickle cell

65
Q

nonsense mutations

A

early stop codon

66
Q

splice site mutations

A

retained intron (gaucher, marfans)

67
Q

frameshift mutations

A

one deletion leading to all AA moving over (duchenne, MD, Tay-sachs)

68
Q

Role of topoisomerase and drugs that inhibit

A

1 - breaks single stranded DNA
2 - double stranded

1 inhibited by irinotecan and topotecan
2 inhibited by etoposide and teniposide

69
Q
A

RACP Written Exam (14 decks)

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