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IP4 > Cancer > Flashcards

Cancer Flashcards

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1
Q

5 abnormality w/ TLS

A 
Hyperkalemia
Hyperphosphatemia
Hypocalcemia 
Hyperuricemia
ARF
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2
Q

Low risk TLS tx

A

hydration

allopurinol

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3
Q

Intermediate Risk TLS tx

A

hydration

allopurinol

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4
Q

High Risk TLS tx

A

hydration

Rasburicase

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5
Q

2 Rasburicase limitations

A

G6PD deficiency
–severe hemolysis
preganancy/breast-feeding

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6
Q

mild hypercalcemia tx

A

drink 3L/day

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7
Q

severe hypercalcemia tx

A

hydration
zolidronic acid
or
pamidronate

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8
Q

5 cancers w/affinity for bone

A 
breast
prostate
myeloma
lung
kidney
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9
Q

what is a lytic bone lesion

A

destroy bone material

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10
Q

what is a blastic bone lesion

A

fill bone with extra cells

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11
Q

bone mets tx

A

Denosumab

IV Bisphosphonates

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12
Q

MEC tx

–mod CINV

A

dolasteron
ondasetron
granisetron

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13
Q

MEC prophylaxis

A

Dexamethasone + Ondansetron

or Palonosetron if outpatient

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14
Q

HEC prophylaxis

–high CINV

A

Olanzapine +Palonosetron + Dexamethasone

Ondansetron + Fosaprepitant + Dexamethasone

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15
Q

Low Risk CINV prophylaxis

A

Prochlorperazine
OR
dexamethasone

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16
Q

Anemia defintion

A

Hbg < 13 in males

Hbg <12 in females

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17
Q

2 causes of macrocytic anemia

A

Folic acid deficiency

B12 deficiency

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18
Q

3 causes of microcytic anemia

A

thalassemia
Lead poisoning
Iron deficiency

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19
Q

What is haptoglobin

A

protein that binds to and transport free Hbg from lysed RBC to liver for recycling of iron

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20
Q

Tx of hemolytic anemia

A

Transfuse if Hbg <8

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21
Q

Which anemic cause shows up as target cells

A

thalassemia

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22
Q

4 drug classes that cause oxidatative stress to G6PD deficient RBC cause hemolysis

A

quinine’s
azo’s
nitro’s
sulfa’s

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23
Q

Iron deficiency

3 lab identifiers

A

dec. MCV
low Ferritin
TIBC high

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24
Q

B12 deficiency

2 lab identifiers

A

inc. MCV

dec. B12

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25
3 major risk factors for B12 deficiency
vegans long term metformin gastric bypass
26
Folate deficiency | 2 lab identifiers
inc. MCV | low folate
27
CKD anemia | 2 lab identifiers
normocytic | burr cells
28
Anemia of chronic disease | 4 lab identifiers
normocytic serum iron low ferritin normal or increased TIBC low
29
when to give PRBC
Hbg <8 - asymptomatic w/ comorbidity - symptomatic - high risk
30
When to initiate iron chelation therapy
serum ferritin levels >2500
31
3 indication for ESAs
Hbg <10 Dx of cancer getting chemo for 2 months
32
3 major risks with ESAs
thromboembolism increased mortality tumor progression
33
normal WBC range
4.5-11
34
normal Hct
34-52
35
normal Plt range
150-450
36
define Thrombocytosis
platelets in excess of 150,000-450,000/uL
37
define Thrombocytopenia
platelets below normal range of 150,000-450,000
38
define erythrocytosis
Hemoglobin above normal Range
39
3 causes of erythrocytosis
high altitude chronic hypoxemia smoking
40
Define leukocytosis
WBC above normal range of 4000-10,000/uL
41
define leukopenia
WBC below normal range
42
define eosinophilia
eosinophils above the normal range of 0-5%
43
ANC level for neutropenia
<1000
44
Important point for elderly and immunocompromised and their WBC
may not elevate during infection
45
important point for patients who are leukopenic at baseline
during infection their WBC may elevate to normal making it look like they are getting healthier
46
4 Better prognostic factors for Breast cancer
>50 Nodes negative ER+ PR+ HER2-
47
6 Worse prognostic factors for Breast Cancer
``` pre-menopausal Nodes + Larger tumor ER/PR- HER2+ triple negative ```
48
ER/PR+ treatment for everyone
pre-menopausal -Tamoxifen post-menopausal --AI
49
Triple Negative treatment
AC -> T
50
Her2+ Low Risk identifiers
<2cm | node-
51
length of treatment for breast cancer
3-6 months
52
3 AI SE
Myalgia vagnial dryness Osteoporosis adverse lipid profile
53
Tamoxifen SE
Thrombosis
54
Can you use AI in pre or peri-menopausal women
NO-may induce increased estrogen production
55
2 tamoxifen antagonist @
Breast | CNS
56
2 Tamoxifen agonist @
Bone | endometrium
57
Ovarian suppression agents
LHRH - Goserelin - Leuprolide
58
When should you add OS to Tam or AI
high risk patients receiveing chemo
59
HER2+ High risk identifiers
>2 cm and Node+
60
name 3 CDK 4/6 inhibitor
Palbociclib Ribociclib abemaciclib
61
Bevacizumab major SE
HTN
62
Cervical Cancer tx
cisplatin/carbo + taxol +/- avastin
63
main genetic mutation in melanoma
BRAF
64
MOA of tamoxifen
CYP2d6 active metabolite endoxifen
65
LHRH MOA
continuous stimulation of pituitary to ↓ FSH & LH secretion and ↓ estrogen from ovary
66
Trastuzumab MOA
* activates ADCC * inhibits HER-mediated signaling pathways * prevents HER2 domain cleavage
67
Pertuzumab MOA
* inhibits HER2 dimerization with other HER family receptors particularly HER3 * activates ADCC (antibody-dependent cell-mediated cytotoxicity) * inhibits multiple HER-mediated signaling pathways
68
PARP inhibitors SE
embryo-fetal toxicity bone marrow suppression Cardiovascular/HTN
69
Nivolumab MOA
binds to programmed death receptor-1 (PDL-1) to prevent ligand PD-L1 and PD-L2 binding, thereby preventing T cell inhibition
70
Dabrafenib/trametinib MOA
Dabrafenib- inhibits protein kinase BRAF Trametinib- inhibits mitogen-activated extracellular kinase (MEK)
71
ipilimumab MOA
anti-cytotoxic T-lymphocyte antigen 4 (CTLA-4) antibody by binding to CTLA-4 so it can’t bind to CD80/CD86
72
ipilimumab limitations
only give if healthy & fit, and willing to take on high risk of toxicity
73
Regorafenib MOA
inhibits multiple cell signaling kinases including VEGF and EGFR pathways
74
Regorafenib counseling
must take with low fat meal
75
Trifluridine/Tipiracil MOA
thymidine-based nucleic acid analogue that gets phosphorylated intracellularyly and is incorporated into DNA leading to cytotoxicity inhibits thymidine phosphorylase
76
VEGF—inhibitors toxicities
HTN impaired wound healing * hold at least 28 days prior to planned surgery
77
EGFR inhibitors toxicities
``` Rash—acneiform management * use moisturizers and sunscreen * do not use OTC acne products they often dry the skin and worsen EGFR induced rash * Minocycline prior to cetuximab * doxycycline prior to panitumumab ```
78
ALK drugs and indication
* Alectinib * Lorlatinib - -after failure during alectinib
79
Osimertinib | MOA and indication
* TKI * targets exon 19 deletion and exon 21 L858R mutation * also targets T790M resistance mutation
80
Crizotinib (Xalkori) MOA
TKI target mutation ROS-1
81
Dabrafenib + Trametinib MOA
BRAF V600E mutation
82
Hodgkin lymphoma
Reed sternberg cells
83
Non-Hodgkin lympoma
Chronic lymphocytic leukemia (CLL) Follicular lymphoma (FL) Burkitt’s lymphoma
84
Indolent Lymphomas
MALT lymphoma FL CLL
85
Intermediate Lymphomas
DLBCL | MCL
86
Aggresive Lymphoma
Burkitt's Lymphoblastic Aids-related
87
S&S of lymphoma
lymphadenopathy (LAD) | Splenomegaly
88
Rituximab oftatumumab obinutuzumab MOA
binds to CD20 on B cells activates complement dependent celllysis and antibody dependent cell-mediated toxicity
89
Rituximab oftatumumab obinutuzumab SE
Hep B reactivatioin —risk if HBsAg+ (active infeciton) —risk if HBcAB+ (past infection) —HBsAB= vaccination or acquired immunity
90
Bendamustine
alkylating agent and purine analog, leads to cell death via single and double strand DNA cross-linking cell cycle non-specific
91
CLL hematopoiesis
Small lymphocytes -B lymphocytes -T lymphocytes Nk cells
92
Indication for treatment for CLL
``` symptoms end-organ function bulky disease --spleen >6cm --Lymph nodes >10cm ```
93
CML pathogenesis
* shortened chromosome 22 * BCR-ABL fusion gene * Elongated chromosome 9

IP4 (4 decks)

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