Question Bank Flashcards by Joseph Ricciutti

Max dose zofran I’m hepatic impairment

8 mg/day

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Busulfan

-Alkylating agent
-pulmonary damage/ lung fibrosis
-commonly used for HCT in CML

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Marker of choice for choriocarcinoma

HCG

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Which enzyme metabolizes 5FU

Dihydropyimidine dehydrogenase

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Nabilone moa

Binds CB1 and CB2

CB1 causes the psychoactive effects

CNS and non-competitive binding

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Cancer pain tips

-avoid opioids in elderly
-avoid opioids in asthma
-nsaids can be used for moderate pain

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Interferon alpha adr

Thyroid

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Denosumab fx

Atypical femoral fx from reduced osteoclast activity- prevents bone remodeling and result in fxs

Note: bone meta fx are d/t inc osteoclast and Dec osteoblast activity

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Familial adenomatousus polyposis

Polys on colon, can become cancerous

Give celecoxib

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Vincristine contraindication

Charcot Marie tooth disease

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Acquired angioedema

-from B-cell lymphoproloferative disorders
-Tx with C1 inhibitor concentrate or bradykinin blocker icatibant if resistant to c1 inhibitor

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Carcinoid syndrome

-large releases of 5HT3 and other peptides
-can happen with Neuroendocrine tumors
-flushing, diarrhea, heart dx
-tx with octreotide
-dx with 5-HIAA elevation

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Burkitts

Translocation if C-MYC gene and most common variant is t(8;14)

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Megestrol adr

Hyper cortisol

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Initial increase in tumor size with checkpoint inhibitor

This can happen in the first month due to influx of immune cells, just continue therapy

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Bisphosphonates moa

Binds hydroxyapatite crystals within eared if remodeling bone

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Bisphosphonate weird ADR

Uveitis, conjunctivitis, scleritis

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Noisy breathing at death

Give anticholinergics

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Doxorubicin weird contraindication

Hyperbaric oxygen therapy

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Delayed complication of anthracycline

-co-enzyme Q10 deficiency, can lead to cerebellar ataxia

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NTRk

Neurotrophic tyrosine kinase

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Imiquimod

-minimal systemic absorption
-excreted in urine
-flu like symptoms, fatigue, headache

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Common mechanism of tumor cell resistance

P-glycoprotein

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Pancreatic cancer itching

-due to high bilirubin
-use bile acid sequestrant

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Contraindication to CBD

-allergy to sea same oil or dronabinol Note CBD modulated effects of thc

Adrenal crisis

-can be caused by tki -persistent hypotension, tachy, hyponatremia, hyperkalemia -aggressive fluids, pressors, and IV hydrocortisone high dose

Treating diarrhea pearl

Get stool cultures before starting loperamide

Weird vincristine ADRs

-Vocal cord palsy: tx with pyridoxime or pyridostigmine -jaw pain, trigeminal neuralgia -VOD -intestinal necrosis

Gastrinoma

Goal is to treat symptoms and prevent complications of peptic ulcer disease: give high dose PPI I think associated with pancreatic cancer

Development of skin tumors while on BRAF/MEK

Don’t have to stop the drug, just continue and get biopsy

Dexrazoxane adr

Testicular atrophy and infertility

PegFilgrastim dosing is low body weight

Use wt based dosing if <45 kg

Velcade rare adr

Hearing loss

Mesna contraindication

Breastfeeding- benzyl etoh

Calculating chemo doses in pediatrics

If BSA is less than 0.5 m2, use body weight instead

Vincristine weird adr

VOD

How might a peripheral neuropathy present

Foot drop

Which 5HT3 antagonist is contraindicated in renal impairment

Granisetron if crcl<30

Interferon weird adr

Suicidal ideation

What does perechiae indicate

Myelosuppression/thrombocytopenia-plt<20k.

Drug of choice for pheochromocytoma

Phenoxybenzamine

Weird tamoxifen adr

Hepatotoxicity- peliosis hepatis

When I say putting edema, dyspnea, shortness of breath, you say….

Cardiotoxicity- trastuzumab or anthracycline!

5HT3 metabolism

2D6

Hiccups drug combo

Cisplatin + dex

Rare cetuximab adr

Aseptic meningitis

Bleomycin AUC goal

78-101 mg*h/L

Pyogenic granuloma

Pyrimidine analogs, taxanes, and EGFRs

Cancer related fatigue

-Ritalin -modafinil -***corticosteroids***

Fulvestrant weird adr

-Toxic epidermal necrosis (TEN) -does NOT increase risk of endometrial cancer -DOES increase risk of clots

Hypertrophic pulmonary osteoarthropathy with bronchgenic carcinoma drug of choice

Pamidronate or zolendronate

Gorlin syndrome

Nervous basal cell carcinoma syndrome Hedgehogs

Cisplatin adr

Salt wasting from renal damage, Fanconi syndrome

Carmustine or lomustine adr

“Hypoxia”- think pulmonary toxicity

Topical 5FU for which type of basal cell carcinoma

Superficial Could also use imiquimod

Biggest risk factor for severity of CRS in bite therapy

Disease burden

Absolute contraindication

Don’t jump at relative CI or precautionary stuff

Major tamoxifen ADR

Warfarin! Tamoxifen is cyp2C9 inhibitor- increases INR

Weird taxane adr

Immune mediated pneumonitis / pulmonary toxicity

Breast cancer in black women

-worse outcomes -***more TNBC***

Which antifungal has negative regulation of hedgehog pathway

Itraconazole

Which SRRI is a 2D6 inhibitor

SEETRALINE!

ICI concerns

-HCT- NO! GVHD -Worsen myasthenia gravis -don’t give with thalidomide

Bsa equation

Square Root of [(ht x wt)/3600]

Other drugs with infusion rxns

-Etoposide -liposomal doxorubicin -Asparginase -iv iron