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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
  • bone
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4
Q

Which type of skin cancer is the worst

A

Melanoma

Other types of skin cancer: Basal Cell and Squamous Cell Carcinoma

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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?

Why?

A

400 units

Pulmonary toxicity

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8
Q

What is Doxorubicin lifetime Max dose?

Why?

A

450-550 mg/m^2

Cardiotoxicity

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9
Q

What is Cisplatin max dose/cycle?

Why?

A

100 mg/m^2

Nephrotoxicity

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10
Q

What is Vincristine single dose cap?

Why?

A

2 mg

Neuropathy

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11
Q

What drug prevents cardiac damage while taking Doxorubicin

aka: Adjunctive treatment

A

Dexrazoxane

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12
Q

Which chemo agents do NOT cause Myelosuppression (decrease in bone marrow activity = fewer RBC, WBC, and platelets)

A
  • Asparaginase
  • Bleomycin
  • Vincristine
  • MABs (Monocolonal Antibodies)
  • 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

for Irinotecan only

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17
Q

Common chemo agent that causes Constipation

A

Vincristine

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18
Q

2 common chemo agents 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

What drug is given with Ifosfamide and Cyclophosphamide to prevent hemorrhagic cystitis?

aka: Adjunctive treatment

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 ADE of Oxaliplatin
Causes cold-mediated sensory neuropathy So.... pt. should avoid cold temperatures and cold beverages
27
Fluorouracil common adjuvant
Leucovorin to increase efficacy as a cofactor
28
Fluorouracil or Capecitabine antidote aka: Adjunctive treatment
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
Colony Stimulating Factors (GSF) MOA and Agents
MOA: stimulate the production of WBCs in the bone marrow Agents: - Filgrastim (G-CSF) - Pegflgrastim (pegylated G-CSF)
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 | Pseudomonas
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 in cause of Thrombocytopenia?
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 aka. N/V > 24 hours after chemotherapy
Netupitant + Palonosetron (Akynzeo)
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
Ends in -pitant - Fosaprepitant - Aprepitant - Rolapitant
47
Treatment for high-emetic risk regimens
- NK1-RA + 5HT-3-RA + dexamethasone - NK1-RA + 5HT-3-RA + Olanzapine + dexamethasone - Olanzapine + Palonosetron + dexamethasone
48
Treatment for moderate-emetic risk regimens
NK1-RA + 5HT-3-RA + Dexamethasone 5HT3-RA + Dexamehtasone Netupitant/palonosetrn(Akynzeo) + 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 the antiemetic activity of 5HT3 receptor antagonists and corticosteroids to inhibit acute and delayed phases of CINV
51
List dopamine receptor antagonists anti-emetic drugs
Prochlorperazine Promethazine Metoclopramide Olanzapine
52
Which 2 chemo drugs cause Hand-foot syndrome aka palmar-plantar erythrodysesthesia (PPE)
- Capecitabine | - Fluorouracil
53
Treatment for tumor lysis syndrome
- Allopurinol | - Rasburicase
54
Antidote for: - Vinca Alkaloid - Etoposide Extravasation
Hyaluronidase
55
ABCDE of skin cancer
``` Asymmetry Border; edges irregular Color; not same consistency Diameter; > 6 mm Evolving ```
56
What is the function of the BRCA1 and BRC2 genes
Normally suppress tumor growth
57
Define Klinefelter syndrome
A syndrome where men have one Y chromosome and 2 or more X chromosomes leading to: - increased estrogen - 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: conversion of androgen to estrogen via aromatase enzymes
61
Aromatase inhibitor MOA
Block the aromatase enzyme that catalyzes the conversion of androgen to estrogen in the peripheral tissue in order to get estradiol (which is what happens in postmenopausal women because they can no longer make their own estrogen)
62
Breast cancer treatment for hormone sensitive (ER+) in postmenopausal women
Aromatase inhibitors
63
Raloxifen Class and Indication
SERM Used for Breast cancer prophylaxis NOT for treatment Note: 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 now an Aromatase Inhibitor can be used at this time as well
65
# Define oncogene Example of an oncogene
A protein that can turn a normal cell into a cancer cell HER2 gen: An oncogene that promotes breast tumor growth
66
List SERMs used in breast cancer
- Tamoxifen - Fulvestrant - Raloxifene
67
ADE of a SERM
Hot flashes Night sweats
68
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
69
Boxed warning for SERMs
Increased risk of uterine/endometrial cancer Increased risk of thromboembolic events
70
List Aromatase Inhibitors
- Anastrozole - Letrozole - Exemestane
71
2 major risks of using aromatase inhibitors ADE
Osteoporosis CVD Hot flashes Night sweats Arthralgia/Myalgia (joint and muscle aches)
72
Primary treatment mechanism of Prostate cancer
Block testosterone via: Androgen deprivation therapy (ADT) aka chemical castration Gondadotropin releasing hormone agonist (GnRH) - Leuprolide - Gosrelin
73
MOA of Alkylating
Cross-linking DNA strands and inhibiting protein synthesis and DNA synthesis
74
List Alkylating agents
- Cyclophosphamide - Ifosfamide - Carmustine - Busulfan
75
ADE of Busulfan
Pulmonary toxicity
76
Platinum-based compounds MOA
Cross-link DNA and interfere with DNA synthesis and cell replication
77
Platinum-based compounds agents
- Cisplatin - Carboplatin - Oxaliplatin
78
Antracyclines MOA
Incalation into DNA Inhibiting topoisomerase 2 Creating oxygen free radicals that damage cells
79
List Antracyclines
- Doxorubicin | - Mitoxantrone
80
Unique concern for Mitoxantrone
Blue urine discoloration
81
Vinca Alkaloids MOA
Inhibit function of microtubules during M phase
82
Major ADE of vinca alkaloids
Peripheral sensory and autonomic neuropathies b/c microtubules play an important role in transport in neurons
83
List Vinca alkaloids
- Vincristine | - Vinblastine
84
Vincristine vs. Vinblastine major toxicities
- vinCristine: CNS toxicity | - vinBlastine: Bone marrow suppression
85
What happens if you give vinca alkaloids intrathecally
Paralysis and Death
86
MOA of Taxanes
Inhibit the function of microtubules during the M phase
87
List taxanes
- Paclitaxel | - Docetaxel
88
Major boxed warning for Taxanes
Severe hypersensitivity reactions due to the solvent (Cremophor EL)
89
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)
90
List topoisomerase 1 inhibitors
- Irinotecan | - Topotecan
91
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
92
Topoisomerase 2 inhibitors agents
- Etoposide | - Bleomycin
93
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
94
Pyrimidine analog antimetabolites agents
- Fluorouracil - Capecitabine - Cytarabine - Gemcitabine
95
Folate antimetabolites MOA
Interfere with the enzymes involved in the folic acid cycle, blocking purine and pyrimidine biosynthesis during S phase
96
Major ADE of folate antimetabolites
Nephrotoxicty
97
List folate antimetabolites
- MTX | - Pemetrexed
98
Bevacizumab MOA
VEGF inhibitor
99
Trastuzumab MOA
HER2 inhibitor
100
In the treatment of Anemia in cancer patients, can ESA be used? Why or Why not?
Rarely used because it can decrease survival and increase tumor progression. It is only used in patient's with non curative intent

Oncology (1 decks)

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