Intro to Onc
Which of the following fast growing, non-cancerous cells would be affected by cytotoxic chemotherapy?
a. Cardiomyocytes
b. Adipose cells
c. Osteoclasts
d. Neutrophils
a. Cardiomyocytes
b. Adipose cells
c. Osteoclasts
*d. Neutrophils
Chemotherapy is based on _________ and dose ___________ should be maintained to maximize response.
Chemotherapy is based on cycles and dose intensity should be maintained to maximize response.
Which of the following are possible causes of supportive care needs for patients with cancer? (SELECT ALL THAT APPLY)
a. Chemotherapy treatments
b. Radiation treatments
c. The cancer itself
*a. Chemotherapy treatments
*b. Radiation treatments
*c. The cancer itself
Which of the following organ system categories is the oncologic emergency febrile neutropenia best associated with?
a. Cardiovascular
b. Infectious
c. Metabolic
d. Hematologic
a. Cardiovascular
*b. Infectious
c. Metabolic
d. Hematologic
Which of the following are known risk factors for breast cancer? (SELECT ALL THAT APPLY)
a. Obesity
b. Nulliparity (never having given birth)
c. Alcohol abstinence
d. Large breast size
*a. Obesity
*b. Nulliparity (never having given birth)
c. Alcohol abstinence
d. Large breast size
Which of the following accurately includes symptoms typical in the clinical presentation for hematologic cancers?
a. Stabbing/aching pain in breast, painless lumps
b. Wheezing, persistent cough, coughing up phlem
c. Fatigue, malaise, lymphadenopathy, weight loss
a. Stabbing/aching pain in breast, painless lumps
b. Wheezing, persistent cough, coughing up phlem
*c. Fatigue, malaise, lymphadenopathy, weight loss
The TNM staging criteria uses features for staging solid tumor cancers included in which of the following options?
a. Tumor size, lymph nodes, metastasis
b. Time, nodes, mutations
c. Tumor location, nodules, metastasis
d. Time, lymph nodes, metastasis
*a. Tumor size, lymph nodes, metastasis
b. Time, nodes, mutations
c. Tumor location, nodules, metastasis
d. Time, lymph nodes, metastasis
Which of the following is the mechanism of action for the systemic anti-cancer agent vincristine?
a. Inhibits synthesis of folate
b. Inhibit microtubule function
c. Inhibits topoisomerase I
a. Inhibits synthesis of folate
*b. Inhibit microtubule function
c. Inhibits topoisomerase I
Which of the following accurately describes the mechanism of action of ondansetron?
a. First generation antipsychotic
b. 5-HT3 receptor antagonist
c. Muscarinic antagonist
d. Phenothiazine antipsychotic
a. First generation antipsychotic
*b. 5-HT3 receptor antagonist
c. Muscarinic antagonist
d. Phenothiazine antipsychotic
Which of the following are possible lab values that would appear elevated in cases of tumor lysis syndrome (TLS)? (SELECT ALL THAT APPLY)
a. Phosphorus
b. Chloride
c. Uric acid
d. Calcium
*a. Phosphorus
b. Chloride
*c. Uric acid
d. Calcium
Several mutations can occur in lung cancer. The awareness of these mutations has allowed for the development of immunotherapy. Which of the following drug classes are a type of immunotherapy?
a. Immune checkpoint inhibitors (e.g. PD-1)
b. Alkylating agents (e.g. carboplatin)
c. Antifolate (pemetrexed)
*a. Immune checkpoint inhibitors (e.g. PD-1)
b. Alkylating agents (e.g. carboplatin)
c. Antifolate (pemetrexed)
Which of the following hematologic cancers utilizes the chemotherapy regimen known by the acronym “ABVD”?
a. Hodgkin lymphoma (HL)
b. Chronic lymphocytic leukemia (CLL)
c. Chronic myeloid leukemia (CML)
d. Non-Hodgkin lymphoma (NHL)
*a. Hodgkin lymphoma (HL)
b. Chronic lymphocytic leukemia (CLL)
c. Chronic myeloid leukemia (CML)
d. Non-Hodgkin lymphoma (NHL)
Which of the following statements correctly describes a key mechanism of cancer cell growth?
a. Metabolism changes to decrease replication and increase longevity
b. Immune modulation hides cancer cells from the immune system
c. Solid tumors disconnect from the circulatory system to avoid immune detection
d. Increased apoptosis signaling of surrounding cell structures
a. Metabolism changes to decrease replication and increase longevity
*b. Immune modulation hides cancer cells from the immune system
c. Solid tumors disconnect from the circulatory system to avoid immune detection
d. Increased apoptosis signaling of surrounding cell structures
Which of the following agents is classified as a highly emetogenic chemotherapy (HEC) chemotherapy agent?
a. Cisplatin
b. Methotrexate
c. Doxorubicin
*a. Cisplatin
b. Methotrexate
c. Doxorubicin
Which of the following agents are reasonable first-line treatments of venous thromboembolism (VTE) in patients with cancer? (SELECT ALL THAT APPLY)
a. Apixaban
b. Low-molecular weight heparin (LWMH)
c. Rivaroxaban
d. Warfarin
*a. Apixaban
*b. Low-molecular weight heparin (LWMH)
*c. Rivaroxaban
d. Warfarin
Which of the following is an appropriate dose of rasburicase when used for treatment of tumor lysis syndrome (TLS)? (SELECT ALL THAT APPLY)
a. 1-2 mg/kg daily over 30 minutes for up to 7 days
b. 0.1-0.2 mg/kg daily over 30 minutes for up to 7 days
c. 3-6 mg IV as a single dose (repeat as needed)
d. 0.3-0.6mg IV as a single dose (repeat as needed)
a. 1-2 mg/kg daily over 30 minutes for up to 7 days
*b. 0.1-0.2 mg/kg daily over 30 minutes for up to 7 days
*c. 3-6 mg IV as a single dose (repeat as needed)
d. 0.3-0.6mg IV as a single dose (repeat as needed)
At what age does the National Comprehensive Cancer Network (NCCN) recommend women of average risk begin mammography screening?
a. 30
b. 40
c. 50
d. Individual decision
a. 30
*b. 40
c. 50
d. Individual decision
Which of the following accurately describes the mechanism of action for the agent lenalidomide?
a. Bruton’s tyrosine kinase inhibitor (BTKi)
b. Immunomodulatory drug (IMiDs)
c. Purine antagonist
a. Bruton’s tyrosine kinase inhibitor (BTKi)
*b. Immunomodulatory drug (IMiDs)
c. Purine antagonist
Which of the following options appropriately describes the first-order cell kill theory?
a. A given dose of chemotherapy kills the first cancer cell identified
b. A given dose of chemotherapy kills a constant percentage of cancer cells
c. A given dose of chemotherapy kills a constant number of cancer cells
d. A given dose of chemotherapy kills all detectable cancer cells
a. A given dose of chemotherapy kills the first cancer cell identified
*b. A given dose of chemotherapy kills a constant percentage of cancer cells
c. A given dose of chemotherapy kills a constant number of cancer cells
d. A given dose of chemotherapy kills all detectable cancer cells
Which of the following agents produces a metabolite which can cause encephalopathy (treated with intravenous methylene blue)?
a. Tamoxifen
b. Olaparib
c. Ifosfamide
d. Etoposide
a. Tamoxifen
b. Olaparib
*c. Ifosfamide
d. Etoposide
You are an inpatient pharmacist verifying prescriptions on the oncology floor. You come across an order for promethazine 12.5mg IV q4-6h PRN for nausea. You notice a safety alert generated by the electronic medical record system. Which of the following is the most likely reason for the safety alert?
a. Increased risk for gastric ulcers
b. Increased risk for QTc prolongation
c. Severe tissue injury possible
a. Increased risk for gastric ulcers
b. Increased risk for QTc prolongation
*c. Severe tissue injury possible
Jake is a 49 y/o male diagnosed with colon cancer, currently receiving oxaliplatin, leucovorin, and 5-FU as his chemotherapy treatment. Which of the following is the appropriate acronym belonging to this chemotherapy regimen?
a. FOLFOX
b. CAPEOX
c. FOLFIRI
d. FOLFIRINOX
*a. FOLFOX
b. CAPEOX
c. FOLFIRI
d. FOLFIRINOX
Steve is a 20 y/o male diagnosed with prostate cancer. His disease is localized, and his oncology care team has decided to use radioactive seeds to treat his cancer, inserted directly into the prostate. Which of the following is the correct classification of this treatment strategy for prostate cancer?
a. Active surveillance
b. EBRT
c. Brachytherapy
a. Active surveillance
b. EBRT
*c. Brachytherapy
Henry is a 82 y/o male diagnosed with acute lymphocytic leukemia (ALL) currently receiving the following agents as part of his cancer treatment: dexamethasone, asparaginase. Which of the following stages of ALL treatment is he receiving?
a. Induction
b. Consolidation
c. Interim maintenance
D. Delayed intensification
*a. Induction
b. Consolidation
c. Interim maintenance
D. Delayed intensification
Which of the following components is specifically involved to help induce angiogenesis for cancer cells?
a. Vascular endothelial growth factor (VEGF)
b. Epidermal growth factor (EGFR)
c. Tumor suppressor proteins (e.g. p53)
D. Cell adhesion molecules (e.g. CAMS)
*a. Vascular endothelial growth factor (VEGF)
b. Epidermal growth factor (EGFR)
c. Tumor suppressor proteins (e.g. p53)
D. Cell adhesion molecules (e.g. CAMS)
Luke is a 37 y/o male diagnosed with testicular cancer being treated with ifosfamide. Which of the following strategies should be used to prevent the severe side effect known as hemorrhagic cystitis? (SELECT ALL THAT APPLY)
a. Hydration
b. Mesna
c. Lecuovorin
d. Acetaminophen
*a. Hydration
*b. Mesna
c. Lecuovorin
d. Acetaminophen
Jane has active breast cancer, for which she receives chemotherapy, and presents to her primary care physician (PCP) for evaluation of severe pain (rates her pain as a 9). Her PCP does an x-ray and diagnoses her with a vertebral fracture. Which of the following is the most appropriate next step to take to manage Jane’s pain?
a. Send prescription for non-opioid analgesics
b. Send prescription for short-acting opioid analgesics
c. Send prescriptions for non-opioid and short-acting opioid analgesics
d. Refer Jane to hospital for further assessment and management
a. Send prescription for non-opioid analgesics
b. Send prescription for short-acting opioid analgesics
c. Send prescriptions for non-opioid and short-acting opioid analgesics
*d. Refer Jane to hospital for further assessment and management
Which of the following is the most appropriate option which indicates how long treatment for febrile neutropenia (FN) should last for a patient with an unknown origin of fever?
a. Until the absolute neutrophil count is ≥1500 uL
b. Until the absolute neutrophil count is ≥500 uL
c. Until a G-CSF is added to antibiotic treatments
a. Until the absolute neutrophil count is ≥1500 uL
*b. Until the absolute neutrophil count is ≥500 uL
c. Until a G-CSF is added to antibiotic treatments
Lance is a 33 y/o male diagnosed with prostate cancer, currently being treated with goserelin, flutamide, and docetaxel. He has started to experience symptoms of decreased libido and was diagnosed with osteoporosis after starting treatment for his prostate cancer. Which of the following agents is most likely to be the cause of these symptoms?
a. Docetaxel
b. Flutamide
c. Goserelin
a. Docetaxel
b. Flutamide
*c. Goserelin
Which of the following acute lymphocytic leukemia (ALL) treatment stages utilizes the medication mercaptopurine for low-risk patients?
a. Consolidation
b. Interim maintenance
c. Delayed intensification
d. Interim maintenance II
*a. Consolidation
b. Interim maintenance
c. Delayed intensification
d. Interim maintenance II