Walls Gyn Onc

Question 1

What are wound classifications?

Answer 1

Class 1: clean (eg laparotomy, sterile, no abx needed)
Class 2: clean contaminated (eg hysterectomy, intentional entry into GI/GI tract)
Class 3: Contaminated (eg. enterotomy, acute inflammation or non-sterile debris in field)
Class 4: Dirty infected (eg. ruptured TOA, surgical management of abscess or perforated bowel)

Question 2

What is G0?

Answer 2

Resting phase
- no cellular activity so no chemo treatments

Question 3

What is G1?

Answer 3

Gap 1 phase
- interval between mitosis and DNA replication
- Hormonal agents: Tamoxifen and megestrol act here

Question 4

What is S?

Answer 4

synthesis, DNA replication
the A groups:
Alkylating: cytoxan, ifosfamide, leukeran
Anti-metabolites: 5-FU, methotrexate (myelosuppression)
Anti-tumor abx:belomycin, actinomycin D, doxorubicin

Question 5

What is G2?

Answer 5

gap 2 phase
-interval where protein synthesis occurs and cell grows to prepare of mitosis

Question 6

What is Mitosis?

Answer 6

Prophylase, metaphase, anaphase, telophase, cytokinesis
- Drugs: Vinca alkaloids (peripheral neuropathy), taxol

Question 7

What are alkylating agents?

Answer 7

Cyclophosphamide
- intercalcalates DNA
- S phase

Question 8

What are antimetabolites?

Answer 8

• methotrexate (Dihydrofolate reductase inhibition depletes thymidine and inhibits purine)
• Gemcitabine (gemzar): inhibits DNA synthesis
• S phase

Question 9

What are platinums?

Answer 9

• Cysplatin (DNA helix distortion)
• Carboplatin
• nephrotoxic and ototoxic

Question 10

What are anti-tumor antibiotics?

Answer 10

Doxorubicin (adriamycin): inhibits topi-isomerase, DNA breaks (causes skin necrosis!)
- Bleomycin: uses copper and iron to create superoxide free radicals
- act in G1 and G2 phase

Question 11

What are plant derived agents?

Answer 11

• Vincristine/Vinblastin: bind tubulin causing mitotic arrest (inhibit mitotic spindle): act in mitosis!
• Etoposide: inhibit topoisomerase: G2 phase
• Topetecan: bind topoisomerase: G2 phase
• Paclitaxel/taxol: stablize microtubules - Mitosis!

Question 12

What are hormonal agents?

Answer 12

• Megestrol acetate: down regulates estrogen receptors
• Tamoxifen: SERM
• G1 phase

Question 13

What are monoclonal antibodies?

Answer 13

• Bevacizumab: inhibits VegF/angiogenesis
• Olaparib: PARP-inhibitor, impairs DNA repair