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NAPLEX > Oncology > Flashcards

Oncology Flashcards

1
Q

Define carcinoma

A

cancer that starts in skin or in the tissues that line or cover internal organs

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2
Q

Define multiple myeloma

A

a type of bone marrow cancer

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3
Q

Define sarcoma

A

cancer in connective tissues including fat, muscle, blood vessels and bone

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4
Q

which type of skin cancer is the worst

A

melanoma

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5
Q

Define adjuvant

A

treatment given after the primary therapy or concurrent with other therapy

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6
Q

Define neoadjuvant

A

treatment given before the primary therapy to shrink the size of the tumor and make surgery more effective

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7
Q

What is bleomycin lifetime max dose and reason why

A

400 units

pulmonary toxicity

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8
Q

What is doxorubicin lifetime max dose and reason why

A

450-550 mg/m^2

cardiotoxicity

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9
Q

What is cisplatin max dose per cycle and reason why

A

100 mg/m^2

nephrotoxicity

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10
Q

What is vincristine single dose cap and reason why

A

2 mg

neuropathy

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11
Q

what drug prevents cardiac damage while taking doxorubicin

A

dexrazoxane

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12
Q

Which chemo agents do NOT cause myelosuppression

A 
asparaginase
bleomycin
vincristine
MABs
TKIs (tyrosine kinase inhibitors)
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13
Q

3 common chemo agents that cause N/V

A

cisplatin
cyclophosphamide
ifosfamide

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14
Q

2 common chemo agents that cause mucositis

A

MTX

fluorouracil

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15
Q

4 common chemo agents that cause diarrhea

A

irinotecan
capecitabine
fluorouracil
MTX

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16
Q

treatment for irinotecan early onset diarreha

A

atropine

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17
Q

common chemo agent that causes constipation

A

vincristine

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18
Q

common chemo agents (2) that cause QT prolongation

A

arsenic trioxide

TKI

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19
Q

4 common chemo agents that cause pulmonary fibrosis

A

bleomycin
busulfan
carmustine
iomustine

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20
Q

common chemo agent class that causes hepatoxicity

A

antiandrogens

  • bicalutmaide
  • flutamide
  • nilutamide
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21
Q

2 common chemo agents that cause nephrotoxicity

A

cisplatin

HD-MTX

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22
Q

what drug is given with cisplatin to prevent nephrotixicity

A

amifostine

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23
Q

2 common chemo agents that cause hemorrhagic cystitis

A

ifosfamide

cyclophosphamide

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24
Q

drug that’s given with ifosfamide and cyclophosphamide to prevent hemorrhagic cystitis

A

mesna

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25
Q

3 chemo classes that cause neuropathy

A 
vinca alkaloids
-vincristine
-vinblasstine
-vinorelbine
platinums
-cisplatin
-oxaliplatin
taxanes
-paclitaxel
-docetaxel
-cabazitaxel
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26
Q

major SE of oxaliplatin

A

causes cold-mediated sensory neuropathy

-pt should avoid cold temperatures and cold beverages

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27
Q

fluorouracil common adjuvant

A

leucovorin to increase efficacy as a cofactor

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28
Q

fluorouracil or capecitabine antidote

A

uridine triacetate

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29
Q

Define nadir

A

the lowest point that WBCs and platelets reach

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30
Q

when does nadir occur

A

7-14 days after chemotherapy

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31
Q

when will WBC and platelets return to normal after chemo

A

3-4 weeks

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32
Q

Define neutropenia

A

ANC < 1000

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33
Q

Define severe neutropenia

A

ANC < 500

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34
Q

Define profund neutropenia

A

ANC < 100

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35
Q

List colony stimulating factors

A

filgrastim

pegflgrastim

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36
Q

How to dx febrile neutropenia

A

Fever > 101

ANC < 500

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37
Q

Which bacteria have the highest risk for causing sepsis in febrile neutropenia

A

Gram negative

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38
Q

Treatment for febrile neutropenia if patient is low-risk

A

Anti-pseudomonal

  • cipro + augmentin
  • cipro +/- clindamycin
  • levofloxacin
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39
Q

Treatment for febrile neutropenia if patient is high risk

A

IV anti-pseudomonal beta-lactams

  • cefepime
  • ceftazidime
  • meropenem
  • imipenem-cilastin
  • zosyn
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40
Q

normal Hgb level

A

12-16 females

13.5-18 men

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41
Q

when are platelet transfusions recommended

A

when the count falls below 10,000

42
Q

patient factors which increase N/V

A 
female
< 50
dehydration
history of motion sickness
history of N/V
43
Q

treatment for delayed N/V

A

netupitant

palonostron

44
Q

is cisplatin a high or low emetic risk drug

A

high

45
Q

list 5-HT3-RA anti-emetic drugs

A

ondansetron
granisetron
dolasetron
palonosetron

46
Q

list NK1-RA anti-emetic drugs

A

aprepitant
fosaprepitant
rolapitant

47
Q

Treatment for high-emetic risk regimens

A

NK1-RA + 5HT-3-RA + dexamethasone
olanzapine + palonosetron + dexamethasone
NK1-RA + 5HT-3-RA + olanzapine + dexamethasone

48
Q

Treatment for moderate-emetic risk regimens

A

NK1-RA + 5HT-3-RA + Dexamethasone
5HT3-RA + Dexamehtasone
Netupitant/palonosetrn + Dexamethasone
Olanzapine + palonosetron + Dexamethasone

49
Q

Treatment for low-emetic risk regimens

A 
no NK1-RA
5HT3-RA
Dexamethasone
Prochlorperazine
metoclopramide
50
Q

MOA of NK1-RA anti-emetics

A

inhibit the substance P/neurokinin 1 receptor, therefore augmenting teh antiemetic activity of 5HT3 receptor antagonists and corticosteroids to inhibit acute and delyaed phases of CINV

51
Q

List dopamine receptor antagonists anti-emetic drugs

A

prochlorperazine
promethazine
metoclopramide
olanzapine

52
Q

Which 2 chemo drugs cause Hand-foot syndrome

A

capecitabine

fluorouracil

53
Q

Treatment for tumor lysis syndrome

A

allopurinol

rasburicase

54
Q

antidote for vinca alkaloid and etoposide extravasation

A

hyaluronidase

55
Q

ABCDE of skin cancer

A 
asymmetry
border-edges irregular
color-not same consistency
diameter: >6 mm
evolving
56
Q

BRCA 1/2 genes do what

A

normally suppress tumor growth

57
Q

Define Klinefelter syndrome

A

men have one Y chromosome and 2 or more X chromosomes leading to increased estrogen and increased risk for breast cancer

58
Q

Breast cancer treatment for hormone sensitive (ER+) in premenopausal women

A

tamoxifen

59
Q

Tamoxifen MOA

A

binds to estrogen receptors on tumors, preventing estrogen from binding to the receptors “SERM”

60
Q

Estrogen source in premenopausal and postmenopausal women

A

pre: estrogen from produced estrodiol
post: estrogen from androgen conversion via aromatase

61
Q

aromatase inhibitor moa

A

block the aromatase enzyme that catalyzes the conversion

62
Q

Breast cancer treatment for hormone sensitive (ER+) in postmenopausal women

A

Aromatase inhibitors

63
Q

Raloxifen MOA

A

SERM used for breast cancer prophylaxis not for treatment it increases bone density and indicated for osteoporosis

64
Q

gonadotropin-releasing hormone agonist MOA

A

decreases LH and FSH which suppresses ovarian estradiol production thus putting a premenopausal women into menopause and an AI can be used at this time as well

65
Q

Define oncogene

A

a protein that an turn a normal cell into a cancer cell

66
Q

What does HER2 gene do

A

an oncogene that promotes breast tumor growth

67
Q

List SERMs used in breast cancer

A

tamoxifen

fulvestrant

68
Q

SE of a SERM

A

hot flashes

night sweats

69
Q

What treatment to use for hot flashes if someone has breast cancer

A

normally estrogen, but this can’t be used in breast cancer

instead use venlafaxine

70
Q

boxed warning for SERMs

A

increased risk of uterine/endometrial cancer

increased risk of thromboembolic events

71
Q

List aromatase inhibitors

A

anastrozole
letrozole
exemestane

72
Q

2 major risks of using aromatase inhibitors

A

osteoporosis

CVD

73
Q

primary treatment mechanism of prostate cancer

A 
block  testosterone via
ADT: androgen deprivation therapy 
gondadotropin-releasing hormone agonist (GnRH)
-leuprolide
-Gosrelin
74
Q

MOA of alkylating agents

A

cross-linking DNA strands and inhibiting protein synthesis and DNA synthesis

75
Q

List alkylating agents

A

cyclophosphamide
ifosfamide
carmustine
busulfan

76
Q

SE of busulfan

A

pulmonary toxicity

77
Q

platinum-based compounds MOA

A

cross-link DNA and interfere with DNA synthesis and cell replication

78
Q

list platinum-based compounds

A

cisplatin
carboplatin
oxaliplatin

79
Q

Antracyclines MOA

A

incalation into DNA
inhibiting topoisomerase 2
creating oxygen free radicals that damage cells

80
Q

List antracyclines

A

doxorubicin

mitoxantrone

81
Q

unique concern for mitoxantrone

A

blue urine discoloration

82
Q

vinca alkaloids MOA

A

inhibit function of microtubules during M phase

83
Q

major SE of vinca alkaloids

A

peripheral sensory and autonomic neuropathies b/c microtubules play an important role in transport in neurons

84
Q

List vinca alkaloids

A

vincristine

vinblastine

85
Q

vincristine vs vinblastine major toxicities

A

vinCristine: CNS toxicity
vinBlastine: bone marrow suppression

86
Q

what happens if you give vinca alkaloids intrathecally

A

paralysis and death

87
Q

MOA of taxanes

A

inhibit the function of microtubules during the M phase

88
Q

list taxanes

A

paclitaxel

docetaxel

89
Q

major boxed warning for taxanes

A

severe hypersensitivity reactions due to the solvent (Cremophor EL)

90
Q

MOA of topoisomerase 1 inhibitors

A

block the coiling and uncoiling of the double stranded DNA helix during S phase; causes single and double strand breaks in DNA and prevents religation (sealing the DNA strands back together)

91
Q

List topoisomerase 1 inhibitors

A

irinotecan

topotecan

92
Q

topoisomerase 2 inhibitors MOA

A

block the coiling and uncoiling of double-stranded DNA during the G2 phase; this causes single and double strand breaks in the DNA and prevents religation

93
Q

List topoisomerase 2 inhibitors

A

etoposide

bleomycin

94
Q

pyrimidine analog antimetabolites MOA

A

inhibit pyrimidine synthesis during S phase; an active metabolite (F-UMP) is incorporated into RNA to replace uracil and inhibits cell growth, while another active metabolite (5-dUMP) inhibits thymidylate synthetase

95
Q

list pyrimidine analog antimetabolites

A

fluorouracil
capecitabine
cytarabine
gemcitabine

96
Q

folate antimetabolites MOA

A

interfere with the enzymes involved in the folic acid cycle, blocking purine and pyrimidine biosynthesis during S phase

97
Q

Major SE of folate antimetabolites

A

nephrotoxicty

98
Q

list folate antimetabolites

A

MTX

pemetrexed

99
Q

Bevacizumab MOA

A

VEGF inhibitor

100
Q

Trastuzumab MOA

A

HER2 inhibitor

NAPLEX (65 decks)

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