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Oncology Flashcards

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1
Q

Define carcinoma

A

cancer that starts in skin or in the tissues that line or cover internal organs

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2
Q

Define multiple myeloma

A

a type of bone marrow cancer

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3
Q

Define sarcoma

A

cancer in connective tissues including fat, muscle, blood vessels and bone

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4
Q

which type of skin cancer is the worst

A

melanoma

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5
Q

Define adjuvant

A

treatment given after the primary therapy or concurrent with other therapy

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6
Q

Define neoadjuvant

A

treatment given before the primary therapy to shrink the size of the tumor and make surgery more effective

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7
Q

What is bleomycin lifetime max dose and reason why

A

400 units

pulmonary toxicity

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8
Q

What is doxorubicin lifetime max dose and reason why

A

450-550 mg/m^2

cardiotoxicity

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9
Q

What is cisplatin max dose per cycle and reason why

A

100 mg/m^2

nephrotoxicity

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10
Q

What is vincristine single dose cap and reason why

A

2 mg

neuropathy

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11
Q

what drug prevents cardiac damage while taking doxorubicin

A

dexrazoxane

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12
Q

Which chemo agents do NOT cause myelosuppression

A 
asparaginase
bleomycin
vincristine
MABs
TKIs (tyrosine kinase inhibitors)
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13
Q

3 common chemo agents that cause N/V

A

cisplatin
cyclophosphamide
ifosfamide

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14
Q

2 common chemo agents that cause mucositis

A

MTX

fluorouracil

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15
Q

4 common chemo agents that cause diarrhea

A

irinotecan
capecitabine
fluorouracil
MTX

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16
Q

treatment for irinotecan early onset diarreha

A

atropine

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17
Q

common chemo agent that causes constipation

A

vincristine

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18
Q

common chemo agents (2) that cause QT prolongation

A

arsenic trioxide

TKI

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19
Q

4 common chemo agents that cause pulmonary fibrosis

A

bleomycin
busulfan
carmustine
iomustine

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20
Q

common chemo agent class that causes hepatoxicity

A

antiandrogens

  • bicalutmaide
  • flutamide
  • nilutamide
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21
Q

2 common chemo agents that cause nephrotoxicity

A

cisplatin

HD-MTX

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22
Q

what drug is given with cisplatin to prevent nephrotixicity

A

amifostine

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23
Q

2 common chemo agents that cause hemorrhagic cystitis

A

ifosfamide

cyclophosphamide

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24
Q

drug that’s given with ifosfamide and cyclophosphamide to prevent hemorrhagic cystitis

A

mesna

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25
3 chemo classes that cause neuropathy
``` vinca alkaloids -vincristine -vinblasstine -vinorelbine platinums -cisplatin -oxaliplatin taxanes -paclitaxel -docetaxel -cabazitaxel ```
26
major SE of oxaliplatin
causes cold-mediated sensory neuropathy | -pt should avoid cold temperatures and cold beverages
27
fluorouracil common adjuvant
leucovorin to increase efficacy as a cofactor
28
fluorouracil or capecitabine antidote
uridine triacetate
29
Define nadir
the lowest point that WBCs and platelets reach
30
when does nadir occur
7-14 days after chemotherapy
31
when will WBC and platelets return to normal after chemo
3-4 weeks
32
Define neutropenia
ANC < 1000
33
Define severe neutropenia
ANC < 500
34
Define profund neutropenia
ANC < 100
35
List colony stimulating factors
filgrastim | pegflgrastim
36
How to dx febrile neutropenia
Fever > 101 | ANC < 500
37
Which bacteria have the highest risk for causing sepsis in febrile neutropenia
Gram negative
38
Treatment for febrile neutropenia if patient is low-risk
Anti-pseudomonal - cipro + augmentin - cipro +/- clindamycin - levofloxacin
39
Treatment for febrile neutropenia if patient is high risk
IV anti-pseudomonal beta-lactams - cefepime - ceftazidime - meropenem - imipenem-cilastin - zosyn
40
normal Hgb level
12-16 females | 13.5-18 men
41
when are platelet transfusions recommended
when the count falls below 10,000
42
patient factors which increase N/V
``` female < 50 dehydration history of motion sickness history of N/V ```
43
treatment for delayed N/V
netupitant | palonostron
44
is cisplatin a high or low emetic risk drug
high
45
list 5-HT3-RA anti-emetic drugs
ondansetron granisetron dolasetron palonosetron
46
list NK1-RA anti-emetic drugs
aprepitant fosaprepitant rolapitant
47
Treatment for high-emetic risk regimens
NK1-RA + 5HT-3-RA + dexamethasone olanzapine + palonosetron + dexamethasone NK1-RA + 5HT-3-RA + olanzapine + dexamethasone
48
Treatment for moderate-emetic risk regimens
NK1-RA + 5HT-3-RA + Dexamethasone 5HT3-RA + Dexamehtasone Netupitant/palonosetrn + Dexamethasone Olanzapine + palonosetron + Dexamethasone
49
Treatment for low-emetic risk regimens
``` no NK1-RA 5HT3-RA Dexamethasone Prochlorperazine metoclopramide ```
50
MOA of NK1-RA anti-emetics
inhibit the substance P/neurokinin 1 receptor, therefore augmenting teh antiemetic activity of 5HT3 receptor antagonists and corticosteroids to inhibit acute and delyaed phases of CINV
51
List dopamine receptor antagonists anti-emetic drugs
prochlorperazine promethazine metoclopramide olanzapine
52
Which 2 chemo drugs cause Hand-foot syndrome
capecitabine | fluorouracil
53
Treatment for tumor lysis syndrome
allopurinol | rasburicase
54
antidote for vinca alkaloid and etoposide extravasation
hyaluronidase
55
ABCDE of skin cancer
``` asymmetry border-edges irregular color-not same consistency diameter: >6 mm evolving ```
56
BRCA 1/2 genes do what
normally suppress tumor growth
57
Define Klinefelter syndrome
men have one Y chromosome and 2 or more X chromosomes leading to increased estrogen and increased risk for breast cancer
58
Breast cancer treatment for hormone sensitive (ER+) in premenopausal women
tamoxifen
59
Tamoxifen MOA
binds to estrogen receptors on tumors, preventing estrogen from binding to the receptors "SERM"
60
Estrogen source in premenopausal and postmenopausal women
pre: estrogen from produced estrodiol post: estrogen from androgen conversion via aromatase
61
aromatase inhibitor moa
block the aromatase enzyme that catalyzes the conversion
62
Breast cancer treatment for hormone sensitive (ER+) in postmenopausal women
Aromatase inhibitors
63
Raloxifen MOA
SERM used for breast cancer prophylaxis not for treatment it increases bone density and indicated for osteoporosis
64
gonadotropin-releasing hormone agonist MOA
decreases LH and FSH which suppresses ovarian estradiol production thus putting a premenopausal women into menopause and an AI can be used at this time as well
65
Define oncogene
a protein that an turn a normal cell into a cancer cell
66
What does HER2 gene do
an oncogene that promotes breast tumor growth
67
List SERMs used in breast cancer
tamoxifen | fulvestrant
68
SE of a SERM
hot flashes | night sweats
69
What treatment to use for hot flashes if someone has breast cancer
normally estrogen, but this can't be used in breast cancer | instead use venlafaxine
70
boxed warning for SERMs
increased risk of uterine/endometrial cancer | increased risk of thromboembolic events
71
List aromatase inhibitors
anastrozole letrozole exemestane
72
2 major risks of using aromatase inhibitors
osteoporosis | CVD
73
primary treatment mechanism of prostate cancer
``` block testosterone via ADT: androgen deprivation therapy gondadotropin-releasing hormone agonist (GnRH) -leuprolide -Gosrelin ```
74
MOA of alkylating agents
cross-linking DNA strands and inhibiting protein synthesis and DNA synthesis
75
List alkylating agents
cyclophosphamide ifosfamide carmustine busulfan
76
SE of busulfan
pulmonary toxicity
77
platinum-based compounds MOA
cross-link DNA and interfere with DNA synthesis and cell replication
78
list platinum-based compounds
cisplatin carboplatin oxaliplatin
79
Antracyclines MOA
incalation into DNA inhibiting topoisomerase 2 creating oxygen free radicals that damage cells
80
List antracyclines
doxorubicin | mitoxantrone
81
unique concern for mitoxantrone
blue urine discoloration
82
vinca alkaloids MOA
inhibit function of microtubules during M phase
83
major SE of vinca alkaloids
peripheral sensory and autonomic neuropathies b/c microtubules play an important role in transport in neurons
84
List vinca alkaloids
vincristine | vinblastine
85
vincristine vs vinblastine major toxicities
vinCristine: CNS toxicity vinBlastine: bone marrow suppression
86
what happens if you give vinca alkaloids intrathecally
paralysis and death
87
MOA of taxanes
inhibit the function of microtubules during the M phase
88
list taxanes
paclitaxel | docetaxel
89
major boxed warning for taxanes
severe hypersensitivity reactions due to the solvent (Cremophor EL)
90
MOA of topoisomerase 1 inhibitors
block the coiling and uncoiling of the double stranded DNA helix during S phase; causes single and double strand breaks in DNA and prevents religation (sealing the DNA strands back together)
91
List topoisomerase 1 inhibitors
irinotecan | topotecan
92
topoisomerase 2 inhibitors MOA
block the coiling and uncoiling of double-stranded DNA during the G2 phase; this causes single and double strand breaks in the DNA and prevents religation
93
List topoisomerase 2 inhibitors
etoposide | bleomycin
94
pyrimidine analog antimetabolites MOA
inhibit pyrimidine synthesis during S phase; an active metabolite (F-UMP) is incorporated into RNA to replace uracil and inhibits cell growth, while another active metabolite (5-dUMP) inhibits thymidylate synthetase
95
list pyrimidine analog antimetabolites
fluorouracil capecitabine cytarabine gemcitabine
96
folate antimetabolites MOA
interfere with the enzymes involved in the folic acid cycle, blocking purine and pyrimidine biosynthesis during S phase
97
Major SE of folate antimetabolites
nephrotoxicty
98
list folate antimetabolites
MTX | pemetrexed
99
Bevacizumab MOA
VEGF inhibitor
100
Trastuzumab MOA
HER2 inhibitor

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