Chemotherapy

Question 1

What is Proliferation

Answer 1

B-cells making memory only (memory cells)

Question 2

What is Differentiation

Answer 2

B-cells killing, making antibodies and memory

Question 3

Main mechanism of innate immunity?

Answer 3

Inflammation

Question 4

3 components of innate immunity?

Answer 4

-mechanical (skin, mucus)

-biochemical (compliment, free radicals, interferons, etc.)

-Cellular (WBCs, neutrophils, monocytes, macrophages, NKTs)

Question 5

Steps of innate immunity?

Answer 5

1. compliment attracts phagocytes to infammatory site
2. compliment form membrane attack complex (lyses bacteria)
3. compliment opsinization

Question 6

What is opsonization?

Answer 6

-coating a pathogen by the compliment system to “tag” it to allow adaptive immune system to know to attack it. Basically alerts everything to kill the pathogen

Question 7

T-cells are responsible for ________ immunity

Answer 7

Cell mediated

Question 8

B-cells are responsible for ________ immunity

Answer 8

Humoral

Question 9

What are the 5 antibody complexes?

Answer 9

IgE - every

IgM - morning

IgA - abby

IgG - goes

IgD - deadlifting

Question 10

Example of type I hypersensitivity rx?

Answer 10

Anaphylaxis

Question 11

Tx for type I hypersensitivity rx?

Answer 11

Epi

Question 12

What antibody complex is responsible for type I hypersensitivity rx?

Answer 12

IgE

Question 13

Examples of type II hypersensitivity?

Answer 13

-Blood transfusion

-HIT

-Hemolytic reaction in newborn

-Drug allergies

*everything is being attacked

Question 14

What 2 antibody complexes for type II hypersensitivity rx?

Answer 14

IgM

IgG

Question 15

Examples of type III hypersensitivy rx?

Answer 15

-Vasculitis

-arthritis

-glomerulonephritis

*can be caused by vaccines, antivenoms, drugs, etc.

Question 16

Examples of type IV hypersensivity rx?

Answer 16

-poison ivy

-ORGAN REJECTION

-TB

-allergic contact dermatitis

*d/t cytotoxic t-cell, cell mediated exaggerated extreme response

Question 17

Name the airway joint concerns w/ RA

Answer 17

-cryco-arytenoids

-TMJ

-C-spine (atlantoaxial)

Question 18

Main s/s of lupus

Answer 18

Butterfly rash

Question 19

No ________ in MS pts

Answer 19

Spinals

Hypothermia

Question 20

MS pts have a destruction of _________ in neurons

Answer 20

Myelin

Question 21

Aids/HIV is the result of a depletion of ________ cells

Answer 21

CD4 T-helper cells

Question 22

Main presentation of DiGeorge’s syndrome

Answer 22

Low set ears

Question 23

What is the anesthesia implication for DiGeorge syndrome?

Answer 23

Difficult DL d/t underdeveloped chin

Question 24

In X-linked agammaglobulinemia, __-cells are nonfunctional while __-cells are functional

Answer 24

-Bcells nonfunctional

-Tcells functional

Question 25

In DiGeorge syndrome, __-cells are nonfunctional while __-cells are functional

Answer 25

-Tcells nonfunctional -Bcells functional

Question 26

In graft vs host, the _______ attacks the _______

Answer 26

Organ attacks the host

Question 27

Calcerine inhibitors block ___-cell activation

Answer 27

T-cell

Question 28

Glucocorticoids are used for what?

Answer 28

-asthma -premedication for blood products or chemotherapy -1st line immunosuppressive therapy for solid organ tumors & stem cell transplants

Question 29

Cyclosporins can cause higher incedence of _________ and other cancers

Answer 29

Lymphoma

Question 30

If pt getting calcineurin inhibitor pre transplant, what labs you gonna check?

Answer 30

-chem (K+) -UA *nephrotoxic drug class

Question 31

mTOR inhibitors block T-cell __________

Answer 31

proliferation

Question 32

What big adverse effect can you get with mTOR and therefore what should be done preop?

Answer 32

-Profound bone marrow suppression & Throbocytopenia *type and cross

Question 33

All pts taking chemo drugs should get a _____ and _____ preop d/t all the antibodies built up in their blood

Answer 33

Type & cross

Question 34

Main purpose of MMF (mycophenolate mofetil) drugs

Answer 34

Used in transplants to preserve vasculature of new organ *inhibits purines so you can't build DNA (so you can't make new blood vessels)

Question 35

What is Rh0 (D) Immune Globulin (Rhogam) used for?

Answer 35

When mom is Rh- and baby is Rh+ to keep mom from building antibodies against Rh+ baby if blood mixing happens

Question 36

When is Rhogam given?

Answer 36

-28wk of pregnancy -24-72hrs after birth

Question 37

Onset of hyperacute organ rejection?

Answer 37

hours

Question 38

Onest of accelerated organ rejection?

Answer 38

days

Question 39

Onset of acute organ rejection?

Answer 39

months

Question 40

Onset of chronic organ rejection?

Answer 40

months to years (anytime)

Question 41

What 2 organ rejection types can be reversed?

Answer 41

-Acute (months) -Chronic (months-years)

Question 42

What 2 organ rejection types cannot be reversed?

Answer 42

-hyperacute (hrs) -accelerated (a few days)

Question 43

Pt develops organ rejection in a month after transplant. What is your tx?

Answer 43

Give immunosuppressants

Question 44

Pt develops organ rejection in 2 days. What is your tx?

Answer 44

None, non-reversible, have to remove organ

Question 45

When are neoadjuvant chemotherapy durgs administered and what is their main goal?

Answer 45

Before surg/main tx to shrink tumor and maximum treatment success

Question 46

When is primary induction chemotherapy agents used?

Answer 46

In advanced cancers to prolong/improve life. Pallative in nature, not expected to cure

Question 47

When are adjuvant chemotherapy agents used and why?

Answer 47

After surgery/tx to make sure secondary tumor doesn't grow

Question 48

What type of resistance is in the absence of prior drug exposure?

Answer 48

Primary resistance

Question 49

What type of resistance occurs after drug exposure?

Answer 49

Acquired resistance

Question 50

(t/f) pts can have resistance to single drugs and/or entire drug classes

Answer 50

Yep

Question 51

Cancer cells undergo what type of cell division?

Answer 51

Mitosis

Question 52

carbonic anhydrase inhibitors prevent the reabsorption of what

Answer 52

HCO3 (bicarb)

Question 53

What 2 things cause downregulation of immune response (negative feedback)

Answer 53

IL-10 IFN-gamma

Question 54

Rx d/t imcompatable ABO transfusion. What type of hypersensitivity reaction?

Answer 54

Type II

Question 55

Vasculitis is caused from what hypersensitivity reaction?

Answer 55

Type III *antibodies (IgG) get circulated in blood and gets dropped in vasculature and organs and destroys them

Question 56

Which chemotherapy agent most known for causing cardiomyopathy

Answer 56

Doxarubicin

Question 57

Chemo pt SOB w/ pulmonary fibrosis. What drug are they taking?

Answer 57

Bleomycin *think bleo bleb in lungs

Question 58

What agent interferes w/ S-phase of cell cycle?

Answer 58

Cytarabine

Question 59

Which chemo agent blocks pyrimidines?

Answer 59

5-FU

Question 60

G2 phase of cell cycle is effected by what drug?

Answer 60

Bleomycin

Question 61

Pt has rejection 3 weeks after transplant. What type of rejection? What do we treat with?

Answer 61

Acute Immunosuppresants

Question 62

1st line tx for preventing chronic allograft vasculopathy in cardiac transplants?

Answer 62

Cell cept (Mycophenolate mofetil)

Question 63

Disease that results in failure of immature B-cells to mature and can't make antibody complexes

Answer 63

X-linked agammaglobulinemia

Question 64

What drug causes stomatitis (inflammation of mouth & lips)

Answer 64

Methotrexate

Question 65

What drug causes ototoxicity & nephrotoxicity?

Answer 65

Cisplastin

Question 66

What drug causes hemmorragic cystitis?

Answer 66

Cyclophosphamide

Question 67

What drugs causes peripheral neuropathy?

Answer 67

Vincristine & Vinblastine

Question 68

Cytarabine causes ______ ataxia

Answer 68

Cerebellar ataxia