PHRM 868 (Therapeutics IV) Exam 1 Sample Questions Flashcards
A 6 month-old boy is determined to have a systemic malignancy originating from precursor cells of the nervous system. The pathology report would state?
A. Adenocarcinoma
B. Neuroblastoma
C. Leukemia
D. Metastatic sarcoma
B. Neuroblastoma
What would the TNM staging be for: A breast cancer is found to be a large tumor that has spread outside the breast to nearby lymph nodes but not to other parts of the body
T3 N2 M0
What would the TNM staging be for: A prostate cancer is located only in the prostate and has not spread to the lymph nodes or any other part of the body
T2 N0 M0
A 48-year-old woman has a routine physical examination. A 4 cm diameter non-tender mass is palpated in her right breast. The mass appears fixed to the chest wall. Another 2 cm non-tender mass is palpable in the left axillary node. A chest radiograph reveals multiple 0.5 to 2 cm nodules in both lungs. Which of the following TNM classifications best indicates the stage of her disease?
A. T1 N1 M0
B. T1 N0 M1
C. T2 N1 M0
D. T3 N0 M0
E. T4 N1 M1
E. T4 N1 M1
Which of the following is potentially true of a tumor suppressor gene?
A. Allows unrestricted cell growth and proliferation
B. Promotes different phases of the cell cycle
C. Produces proteins that block the activity of cyclins
D. Is often overexpressed in cancer
C. Produces proteins that block the activity of cyclins
*note: cyclins promote the cell cycle
A chemotherapy that interferes with DNA synthesis is:
A. S-phase specific
B. G1-phase specific
C. Cell cycle non-specific
D. M-phase specific
A. S-phase specific
Which phase of the cell cycle do you think is targeted by Palbociclib (the CDK 4/6 inhibitor)?
A. G1
B. S
C. G2
D. M
A. G1
*What is the most common reason for resistance to MULTIPLE chemotherapies at once?
A. Decreased activation of prodrugs
B. Transport out of cells
C. Cell cycle changes
D. Mutations in drug targets
B. Drug transport out of cells
Which hormone is produced in the pituitary gland?
A. GnRH
B. LH
C. Estrogen
D. Progesterone
B. LH
Estrogen receptor primarily binds estrogen where in the cell?
A. On the plasma membrane
B. In the mitochondria
C. In the cytoplasm
D. In the nucleus
C. In the cytoplasm
(then moves to the nucleus once it is bound)
What enzyme converts androstenedione to estrone?
A. CYP19
B. 5 alpha-reductase
C. 17, 20 lyase
D. P450scc
A. CYP19
Which compound directly inhibits the activity of the estrogen receptor throughout the body?
A. Letrozole
B. Exemestane
C. Tamoxifen
D. Fulvestrant
D. Fulvestrant
Which compound is referred to as a SERM?
A. Letrozole
B. Exemestane
C. Tamoxifen
D. Fulvestrant
C. Tamoxifen
What are the Androgen Receptor Antagonists?
Enzalutamide
Apalutamide
Darolutamide
What is the MOA of the Androgen Receptor Antagonists?
Prevent the translocation of the androgen receptor (AR) to the nucleus
Inhibit AR binding to DNA
What do the Androgen Receptor Antagonists treat?
BOTH metastatic and non-metastatic prostate cancer
What is unique about the action of Tamoxifen compared to Fluvestrant?
A. It leads to ER degradation
B. It holds ER out of the nucleus
C. It ejects ER from the cell
D. It activates ER in bone
D. It activated ER in bone
Which of the following is not a hormone responsive cancer type?
A. Breast cancer
B. Ovarian cancer
C. Prostate cancer
D. Endometrial cancer
B. Ovarian cancer
Which of the following is only used in the postmenopausal setting?
A. Letrozole
B. Tamoxifen
C. Leuprolide
D. Raloxifene
A. Letrozole
Which compound acts directly on AR?
A. Leuprolide
B. Abiraterone
C. Degarelix
D. Enzalutamide
D. Enzalutamide
Which amino acid is not a target of phosphorylation?
A. Tyrosine
B. Serine
C. Threonine
D. Alanine
D. Alanine
What is the source of the phosphate that gets transferred onto a substrate by a kinase?
A. SAM
B. DNA
C. RNA
D. ATP
D. ATP
Which compound inhibits EGFR?
A. Gefitinib
B. Osmertinib
C. Afatinib
D. Lapatinib
E. All of the above
E. All of the above
What mutation in EGFR confers resistance to 1st and 2nd generation EGFR inhibitors?
A. L858R
B. Exon 19 deletion
C. Exon 14 deletion
D. T790M
D. T790M
Which of the following drugs targets HER2?
A. Sirolimus
B. Alectinib
C. Vemurafinib
D. Tucatinib
D. Tucatinib
Which of the following drugs targets a kinase that is produced by formation of the Philadelphia chromosome?
A. Alectinib
B. Gefitinib
C. Imatinib
D. Binimetinib
C. Imatinib
Which compound below is not a covalent kinase inhibitor?
A. Gefitinib
B. Osimertinib
C. Afatinib
D. Acalabrutinib
A. Gefitinib
Which type of kinase inhibitor can bind in the ATP binding site and stabilize the inactive conformation of a kinase?
A. Type I
B. Type II
C. Type III
D. Type IV
B. Type II
A CML patient initially tested positive for the Philadelphia chromosome and has enjoyed a 5-year response to imatinib. Unfortunately, the disease has recurred and now tests positive for the T315I mutation.
Describe how T315I prevents the efficacy of imatinib?
What is the next course of BCR-Abl-targeted therapy to include?
This mutation prevents compounds from binding in their binding pocket (why it is a very specific mutation and not a random mutation)
Ponatinib is indicated
Which drug is a NUCLEOSIDE analog?
A. 5-FU
B. Cytarabine
B. Cytarabine
(5-FU is a nucleobase that must undergo two conversions to reach an active nucleotide)
Which drug primarily interferes with purine biosynthesis?
A. 5-Fluorouracil
B. Capecitabine
C. 6-Mercaptopurine
D. Cytosine arabinoside
C. 6-Mercaptopurine
Anti-folates all share the following characteristics except:
A. They inhibit DHFR
B. They cause myelosuppression
C. They induce a G2/M cell cycle block
D. The toxic effects are “rescued” by Leucovorin
C. They induce a G2/M cell cycle block
(these drugs cause an S phase block)
What rescues a 5-FU overdose?
A. Leucovorin
B. Cytosine arabinose
C. Thymidine
D. Methotrexate
C. Thymidine
What increases the efficacy of 5-FU?
A. Leucovorin
B. Cytosine arabinoside
C. Thymidine
D. Methotrexate
A. Leucovorin
Which antimetabolite should not be given to patients being treated for gout?
A. Cytosine arabinoside
B. 6-mercaptopurine
C. Cladribine
D. 5-FU
B. 6-mercaptopurine
Which anti-metabolite does not directly inhibit DNA/RNA synthesis?
A. 5-fluorouracil
B. Cytosine Arabinoside
C. Nelarabine
D. Methotrexate
D. Methotrexate
Alkylating agents are potent…
A. Reducing agents
B. Electrophiles
C. Nucleophiles
D. Oxidizing agents
B. Electrophiles
Which of the following is a prodrug?
A. Mechlorethamine
B. Cyclophosphamide
C. Mitomycin C
D. Chlorambucil
B. Cyclophosphamide
To block hemorrhagic cystitis, Mesna is coadministered with which drug?
A. Methotrexate
B. Cyclophosphamide
C. Cisplatin
D. Mitomycin C
B. Cyclophosphamide
Which of the following is not a cross-linker?
A. Cytarabine
B. Cyclophosphamide
C. Carboplatin
D. Chlorambucil
A. Cytarabine (anti-metabolite)
Topoisomerase I inhibitors primarily halt cells in which phase of the cell cycle?
A. G0/G1
B. S
C. G2
D. M
B. S
A patient has a history of heart disease and poor cardiac function. Which topoisomerase inhibitor should not be prescribed?
A. Doxorubicin
B. Etoposide
C. Irinotecan
A. Doxorubicin
Which of the following microtubule inhibitors block the polymerization of tubulin?
A. Paclitaxel
B. Vincristine
C. Ixabepilone
B. Vincristine
Which of the following is used to describe a cancer derived from pigment producing cells of the eye?
A. Teratoma
B. Papilloma
C. Sarcoma
D. Melanoma
E. All of the above
D. Melanoma
Which of the following is not a hallmark of cancer?
A. Resisting cell death
B. Evading growth suppressors
C. Enabling replicative immortality
D. Activating invasion and metastasis
E. Increasing in cell size
E. Increasing in cell size
Molecular pathology is different from traditional pathology because?
A. It uses a numerical system to categorize tumor progression
B. It uses some kind of genetic testing to indicate therapy or predict for tumor recurrence
C. It uses stains that allow pathologists to visualize nuclear and cytoplasmic size and shape
D. It is not useful when determining a patient’s course of treatment
B. It uses some kind of genetic testing to indicate therapy or predict for tumor recurrence
Which of the following terms is associated with substitution of one tissue type for another?
A. Hyperplasia
B. Dysplasia
C. Metaplasia
D. Desmoplasia
C. Metaplasia
Which of the following antibodies targets HER2?
A. Neratinib
B. Cetuximab
C. Lapatinib
D. Pertuzumab
D. Pertuzumab
What was the first immunotherapy?
A. Pertuzumab
B. Keytruda
C. Coley’s Toxin
D. Trastuzumab
C. Coley’s Toxin
The antibody Fakeumab has just entered the market. What type of antibody is it?
A. Fully human
B. Humanized
C. Fully mouse
D. Chimeric
A. Fully Human
Which antibody is effective against metastatic melanoma and targets CTLA-4?
A. Ipilimumab
B. Trastuzumab
C. Daratumumab
D. Blinatumomab
A. Ipilimumab
Which of the following proteins is used as a cancer biomarker test to determine eligibility for treatment of NSCLC with pemrolizumab?
A. CD19
B. CTLA4
C. PDL1
D. PD1
C. PDL1
*note: PD1 is on the T-cell
Which of the following antigens is a common target for CAR-T therapy in B cell malignancy?
A. CD4
B. CD19
C. CD28
D. CTLA4
A. CD19
What is the primary mechanism of action of bispecific T cell engagers in cancer immunotherapy?
A. They inhibit the PD1/PDL1 interaction
B. They bring T cells and cancer cells in close proximity to facilitate T cell mediated cytotoxicity
C. They stimulate the innate immune system to recognize tumor cells
D. They increase neoantigens
B. they bring T cells and cancer cells in close proximity to facilitate T cell mediated cytotoxicity
Which of the following drugs acts by binding to HER2?
A. Trastuzumab
B. Pertuzumab
C. All of the above
C. All of the above
Which of the following drugs exerts antitumor effects by inhibiting the interaction between PD1 and PDL1?
A. Cetuximab
B. Ipilimumab
C. Atezolizumab
D. All of the above
C. Atezolizumab
What concept of immunity must be overcome for the immune system to successfully eliminate cancer cells?
A. Antibody-dependent cellular cytotoxicity
B. Central tolerance
C. T-cell activity
D. B-cell activity
B. Cental tolerance
What is the function of the cetuximab?
A. To block EGFR ligand binding
B. The same as panitumumab
C. To bind VEGF
D. The same as Pertuzumab
E. A and B
E. A and B
