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Board Review > OncologyFC > Flashcards

OncologyFC Flashcards

1
Q

What are the seven warning signs for cancer?

A

CAUTION
C change in bowel or bladder habbits
A sore that does not heal
U unusual bleeding or discharge
T thickenin or lump in breast or anywhere
I indigestion or difficulty swallowing
O obvious change in wart or mole
N nagging cough or hoarseness

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2
Q

when should women get screening for breast cancer?

A

mammogram every year after 40
clinical breast exam every 3 years 20-39, then at 40 every year
selfe exam every year starting at 20 if they want

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3
Q

when should ppl start checking for colorectal cancer?

A

age 50 guys and girls
-sigmoidoscopy q 5y
-colonoscopy q 10 y

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4
Q

women to start cervical cancer screening?

A

at 21-29 have pap test q 3 years
30-65 pap test plus HPV test q 5 years or pap q 3years
-after age 65, if had normal results all her life, no more need to test

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5
Q

men to start to test for prostate cancer?

A

info to be provided at 50 yo but benefits have not been shown yet for routine testing. If AF am or family history can start at age 45 .

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6
Q

what test is for the prostate cancer?

A

PSA blood test with or without a digital rectal exam

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7
Q

what is the purpose of induction therapy (neoadjuvant)

A

to shrink the tumor initially

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8
Q

what is the purpose of adjuvatn therapy

A

given after the main treatment to eradicate the remaining disease tissue

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9
Q

what are the three main SE for oncology meds?

A

Hair loss, GI toxicity and myelosupresion \

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10
Q

know how to calculate ANC

A

WBC x [segments (decimal from percentage) + bands (same as for segments) ]

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11
Q

what is the g2 phse of replication and which agents work there?

A

here is where the cell is preparing to divide so It proudces topoisomerase and RNA. Agents
Topoisomerase inhibitors

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12
Q

what is the S phase of a cell and which agents hit it

A

S is where the cell is replicateing its DNA and duplicating Agent antimetabolits (MTX, SFU), capecitabine, gemcitabine, cytoraline

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13
Q

which anticancers are not specific?

A

alkylating agents, antrhacycline , platinum , antimitotic, vinca alkaloids, taxanes

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14
Q

what is the dubois equation for BSA?

A

BSA = 0.007184 x kg^0.425x ht cm ^0.725

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15
Q

MOA of alkylators

A

cross link DNA preventing cell replication

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16
Q

cyclophosphamide - Brand and major side effect

A

alkylators: Cytoxan - bladder toxicity = give with MESNA AND adequate hydration to protect against hemorrhagic cystitis.

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17
Q

Ifosfamide - Brand and major side effects

A

Ifex - bladder toxicity = give with MESNA AND adequate hydration to protect against hemorrhagic cystitis.

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18
Q

temozolomide - brand and MOA

A

Temodar - alyklator =cross link DNA

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19
Q

what is MESNA Brand and function

A

Mesnex given as an adjuvant in cancer chemotherapy that prevents the damage to the bladder. MOA thought to be antioxidant

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20
Q

bicalutamide - Brand and major side effect

A

Casodex - gynecomastia, hepatotoxicit, hot flashes- antiandrogen given po usually with LHRH for prostate cancer

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21
Q

flutamide - Brand and major side effects

A

Eulexin - gynecomastia, hepatotoxicit, hot flashes
more GI toxicity and visual disturbances

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22
Q

Goserelin - Brand and major side effects- antiandrogen anti estrogen LHRH

A

Zoladex - hot flashes, bone pain, impotence, QT prolongation, gynecomastia,
decreased bone density / consider calcium + vitamin D

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23
Q

Leuprolide - Brand and major adr - LHRH agonist

A

Lupron - hot flashes, bone pain, impotence, QT prolongation, gynecomastia,
decreased bone density / consider calcium + vitamin D

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24
Q

are the aromatase inhibitors approved for all women?

A

NO just post menopausal woemen and also not for men with breast cancer

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25
Q

anastrazole - Brand and major side effects-aromatase inhibits that prevents conversion to active estrogen, androgen cotincosteroid

A

Arimidex - fatigue, menopause symptoms, decrease bone density / consider calcium + vitamin D

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26
Q

exemestane - brand and major side effects aromatase inhibitor

A

Aromasin - fatigue, menopause symptoms, decrease bone density / consider calcium + vitamin D
increased cardiovascular disease risk compared to SERMs

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27
Q

letrozole - brand and major side effects

A

aromatase inhibtorFemara - fatigue, menopause symptoms, decrease bone density / consider calcium + vitamin D
increased cardiovascular disease risk compared to SERMs

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28
Q

fulvestrant - brand / major side effects / BBW

A

Faslodex / menopausal symptoms, hot flashes, flushing, weight gain
BBW - increase risk of DVT,PE,MI,stroke with all SERMs

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29
Q

raloxifene - brand / major side effects / BBW

A

SERM
Evista / menopausal symptoms, hot flashes, flushing, weight gain
BBW - increase risk of DVT,PE,MI,stroke with all SERMs

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30
Q

tamoxifen - brand / major side effects / BBW

A

SERM
Nolvadex / menopausal symptoms, hot flashes, flushing, weight gain
BBW - increase risk of DVT,PE,MI,stroke with all SERMs

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31
Q

doxorubicin - Brand / major side effects

A

Anthracycline- intercalation into DNA, inhibits topoisomeriase, creates oxygen free radicals
Adriamycin / radiation recall rection, hand foot syndrome, CARDIOTOXICITY (dec. risk by not exceeding max lifetime dose)
consider using cardioprotective dexrazoxane when doses continue beyond 300mg/m2

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32
Q

major side effects of anthracycline

A

cardiotoxicity and turnks the body fluids red such as the urine

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33
Q

epirubicin - brand / major side effects

A

Anthracyclines
ellence / Adriamycin / radiation recall rection, hand foot syndrome, CARDIOTOXICITY (dec. risk by not exceeding max lifetime dose)

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34
Q

mitoxantrone MOA and side effects

A

anthracycline Mitoxantrhone is an antracenedione similar to anthracyclines and turns body fluids into blue rather than red.

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35
Q

MOA of methorexate

A

inhibits folate metabolism leading to prevention of DNA sysnthesis

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36
Q

methotrexate - brand and major side effects

A

folate antimetabolite: prevents DNA synthesis:
MTX, Trexall, Folex, Mexate -
myelosuppression, mucositis, hepatic/renal toxicity, hand-foot syndrome,
High doses require leucovorin rescue

active transport elimination by decreasing aspirin, penicillins, probenacids and nsaids, resulting in toxicity so dont use together

Drink Fluids

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37
Q

lenalidomide - side effects

A

immuno modulators: decrease angiogenesis
Revlimid - severe birth defects (X) - risk of DVT/PE
available under restricted program revassist- pt prescriber and pharmacist have to be registered with this.

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38
Q

bevacizumab - Brand and major side effects

A

Avasstin - GI pain, impairs wound healing, thrombosis risk
angiogenesis inhibitor: limit tumor supply

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39
Q

rituximab - brand and major side effects- monoclonal antibody

A

Rituxan - Infusions must be given in hospital because reaction can be fatal.
another one: tostidumomab: iodine inducer. emmits gamma and ebta with radiation. thyroid protective regiment needed PRIOR to tositumomamb

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40
Q

cetuximab - Brand and major side effects

A

Erbitux - EGFR positive expression correlates with better response rates. Kras mutation indicates poor response.
pharmogenics: colorectal cancer does not respond to cetuximab if they have kras mutation

41
Q

traztuzumab - Brand and targeted pt population - major side effects

A

Herceptin / Her2/neu+ gene/ cardiomyopathy
must be great than 2+ by immunohistochemical testing (IHC) to respond/use this.

42
Q

cisplatin - Brand and major side effects

A

Platinol / nephrotoxicity-vigorous hydration , SEVERE N/V
sometimes mannitol used to avoid renal failure, electrolyte wasting requiring magnesium and potassium supplementation.

amifostine may be used prophylactically.

high risk of N/V needs prophylaxis

43
Q

oxaliplatin - Brand and major side effects

A

Eloxatin - nuropathy exacerbated by exposure to COLD

44
Q

capecitabine - brand / major side effect / administration

A

Xeloda / mucositis, hand foot syndrome, large increase in INR due to 2C9 inhibition
pharmacogenomic testing for DPD deficiency (increase risk of severe toxicity)
prodrug of 5-FU PO taken with meals

45
Q

fluorouracil - brand / administration / testing

A

5-FU / given with leucovorin to increase efficacy /
pharmacogenics testing for DPD defieciey (dihydropyridimidine dehydrogenase deficiencty)

46
Q

floxuridine - administration

A

given via intra-hepatic artery or portal vein infusion for isolated hepatic metastases. less systemic side effects

47
Q

gemcitabine - brand

A

Gemzar

48
Q

tretinoin - brand

A

ATRA (all trans retinoic acid) - preg cat X
Lots of side effects

49
Q

docetaxel - brand and major side effects

A

Taxotere - cardiopulmonary: fluid retention
pretreat with dexamethasone

50
Q

paclitaxel - brand / major side effect / administration

A

Taxol / anaphylaxis, hypersensitivity rxns,
PRETREAT with dexamethasone, diphenhydramine, and H2 blocker

51
Q

irinotecan - brand / major side effects

A

topoisomerase 1 inhibitors
Camptosar / Acute diarrhea (treat with atropine / loperamide)

52
Q

etoposide - brand / major side effects

A

VePesid - neurotoxicity/neuropathy

53
Q

what is primary target of crizotinib?

A

ALK (anaplastic lymphoma kinase)

54
Q

imatinib - brand and prior testing?

A

Gleevac - Philadelphia chromosome + (Ph+) or CML, or cKIT

55
Q

erlotinib - brand, administration, major side effects.

A

Tarceva - PO 1 hr before or 2 hr after meal / hepatotoxicity

56
Q

vinblastine - Brand / major side effects

A

Velban - cumulative dose dependent nerve damage, vesication occurs when extravasated, DO NOT administer intrathecally.

57
Q

vincristine - brand / major side effects

A

Vincasar - cumulative dose dependent nerve damage, vesication occurs when extravasated, DO NOT administer intrathecally.

58
Q

vinorelbine - brand / major side effects

A

Navelbine - cumulative dose dependent nerve damage, vesication occurs when extravasated, DO NOT administer intrathecally.

59
Q

arsenic trioxide - brand and major side effects

A

Trisenox - QT prolongation: monitor ECG, keep Mg and K within normal range

60
Q

bleomycin - brand and major side effects

A

Blenoxane - Pulmonary reactions - pneumonitis, hypersensitivity reactions
Max lifetime dose = 400 units

61
Q

warning signs for cancer

A

CAUTION:
change in bowel habbits
a sore that does not heal
unusual bleeding
thickening or lump
indigestions
wart/mole
nagging cough

62
Q

mammograms how often

A

yearly starting at age 40

63
Q

clinical breast exam how often

A

every 3 years in 20s, every year after 40

64
Q

colorectal cancer

A

at age 50 gets tested for sigmioidoscopy, colonoscopy, enema or CT scan and a yearly fecal occult blood test (FOBT) to screen for colon cancer

65
Q

cervical cancer

A

3 years after sex and no later than 21 years old
screening should be done every year with the Pap test or every 2 years using liquid based pap test

66
Q

most cancer will not relapse if pt remains cancer free for x time

A

5 years

67
Q

primary treatment is usually

A

surgery, followed by chemo.

68
Q

neaadjuvant or induction therapy

A

before start of primary treatment(chemo) such as riadiation

69
Q

adjuvant therapy

A

is given after primary treatment (chemo) such as radiation or hormonal therapy

70
Q

BSA equation use what type of weight

A

ACTUAL- adjust to obeseiy if > 130% of IBW

71
Q

alkylators moa

A

cross link DNA- preventing replication: ex- benda mustin, chlorambucil (refrigerate)

72
Q

procarbazine

A

MAOI- neurologic and cardiovascular toxicity.

73
Q

antiandrogens which are they?

A

Bicalutamide, flutamide

74
Q

antiandrogens moa

A

block andorgens at the receptor site. given PO daily usually with LHRH agononists for prostate cancer

75
Q

antiandrogen GRH antagonist

A

Degarelex: gonadotoprin releasing hormon antognist used in prostate cancer

76
Q

antiandrogen antiestrogen LHRH agonist

A

leuteinizing hormone releasing hormone
Goserelein (Zoladex) Leuprolide (lupron)

used for prostate cancer in males and for endometriosis, fibroids and breast cancer in females. inc production of andorgen and estrogen then decrease gonadotropin releast (LH, FSH).

77
Q

aromatase inhibitors

A

anastrozole, exemestane, letrozole
prevents conversstion to active estrogen, androgen, corticosteroid, mineralcorticoid to reduce cell growth in breast cancer.

increased cardio vascular risk compared to serm

78
Q

thalidomide

A

pregnancy category X - severe birth defects. prescribers must be enrolled in the STEPS program to dispense.

79
Q

interferons adr

A

depression, suicidal ideation, flu like syndrome

80
Q

mercaptopurine

A

6MP
xanthine oxidase which can be inhibited by allopurinol. requires dose reduction..
testing for TPMP and IPTA deficiency required before starting therapy to properly dose/avoid toxicituy

81
Q

alitretinoin

A

pregnancy cateogry x. (retinoids?)

82
Q

nadir

A

lowest point that cells (wbc, rbc) reach abt 10-14 days after chemotherapy. then recover then second round of chemo starts

83
Q

ESA can

A

shorten survival and increase tumor progression in some cancers. SO dont use as much!.

84
Q

Epoeitin alpha (procrit or epogen)

A

SC weekly

85
Q

dRabepoitin

A

SC q 2-3 weeks

86
Q

In order to prescribe ESA for cancer prescriber must be enrolled in

A

ESA APRISE oncology programs. pt needs to sign form that states they received counseling.
GET MED GUIDES

ESA should only be used if hemoglobin level is < 10

87
Q

ANC less than X places pt at high risk

A

500,
< 100 screwed…severe risk

88
Q

colony stimulatin factors name and side effects

A

sargramostin, filgrastim, epgfilgrastim.
can be given prophylatcially in pts at high risk of febril eneutropenia.

side effect: BONE PAIN

89
Q

when do you start platelet trasnsfusions

A

BELOW 10,000

90
Q

high and mod N/V
and what drugs to use?

A

cisplatin high, anthracyclines, carboplatin and oxaliplatin are moderate risk
use : dexamethasone, ondasetron and aprepitant in combo
dont really want to use prochlorperazine, diphyhydramine, or metoclopramide b/c of dopaimein blocking could wrsen movement disoder, sedating cause cognitive dysfunction etc.

diphydramine can cause anticholinergic side effects

91
Q

dronabinol and nabilone can be used as 2nd line agents.

A

synthetic delta-9 tetrahydrocannabinol- naturally ocuring component of cannabis.

92
Q

ondansetron

A

zofran

93
Q

granisetron

A

kytril, sancuos transdermal patch

94
Q

dolasetron

A

anzemet

95
Q

palonsetron

A

aloxi

96
Q

prochlorperazine

A

do not use in children < 2- EPS, sedation, NMS

97
Q

aprepitant (Emend)

A

substance neurokinin 1 receptor antagonist

98
Q

mucosistitis

A

magic mouth wash, chlorhexidine

99
Q

hypercalcemia of malignancy

A

aggrestive hydration foreced diuretisis and IV bispohsphaonates used to treat. zoledronic acid and pamidronate are used to treat.

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