APHON CHEMO CERTIFICATION WITH ACCURATE
QUESTIONS AND ANSWERS GRADED A+ AND A
GUARANTEED PASS 2026-2027
Biotherapy
modality of tx: agents that resemble body's own defense and surveillance systems. can
augment/modulate/restore host's immune response, direct antitumor activity, other biological
effects. side effects typically hypersensitivity rx
Immune surveillance
tumor cells express abnormal tumor antigens on surface that can be recognized/destroyed by
immune system
Natural killer cells
lymphocyte that recognizes/kills malignant cells
Cytotoxic t cells
recognize tumor-assosiated antigens and kills cells
Interferons
multiple moa's & produced w/ recombinant dna.
protein capable of protecting other cells from viral infections by interfering w/ viral
replication.
family of glycoproteins include: antiviral, antiproliferative, potent immunomodulatory effects
Cytokines
products of immune cells to enhance cytotoxic activity of cells and increase immune response
,Alpha-interferon
leukocyte-derived. tx: hairy cell leukemia, melanoma, chronic myeloid leukemia, follicular
lymphoma, multiple myeloma, cutaneous t-cell lymphoma
Beta-interferon
fibroblast-derived. tx MS
Gamma-interferon
t-lymphocyte derived. tx chronic granulomatus disease
Interleukin-2
produced by t-helper cells & stimulate growth/maturation of t-cell subsets, cytotoxic t-cells,
production of lymphokines & cytokines.
act as chemical signals b/w wbc's (revs up immune system)
Retinoids
immunomodulators that facilitate differentiation & suppress proliferation of cancer cells
All-trans retinoic acid (atra)
tx: aml, aml m3 subtype, apl
increase maturation of promyelocytic blasts and rapid resolution of coagulopathy r/t tx.
Isotretinoin (accutane)
retinoid tx neuroblastoma.
,have antitumor activity unknown moa. TERATOGENIC. male/female pt must register
iPledge (fetal exposure). can also affect hearing & vision
Antibodies
proteins produced by b-lymphocytes. part of humoral immunity of adaptive system. includes
immunoglobulins (igG, igA, igM, igE, igD)
Murine
mouse-derived MoAbs. pt develops human antimouse antibodies creating high risk of
hypersensitivity rx
end in -momab
Monoclonal antibodies
very specific. directed against single antigenic determinant on cell surface causing antibody-
dependent cellular toxicity, direct cell death, elimination of antigen/target cell that expresses
the antigen
low toxicity
Neuroblastoma
primary tumor - ct of abd/pelvis, urine catecholamines (hva, vma), ldh
metastases - ct brain/chest, bone scan, mibg scan, bma/biopsy, cbcd, plt
staging scale - international neuroblastoma staging system
wilms' tumor
primary tumor - ct abd/pelvis, urinalysis
metastases - ct chest/brain, bone scan (unfavorable histology or clear cell kidney sarcoma)
staging scale - ntl wilms tumor study-v
hodgkins lymphoma
, primary tumor - ct primary tumor (neck, chest, abd, pelvis), cxr, erythrocyte sedimentation
rate, ldh
metastases - ct abd/pelvis, pet/gallium scan, bone scan, bma/biopsy, cbcd, plt
staging scale - ann arbor classification
non-hodgkins lymphoma
primary tumor - ct primary tumor (neck chest, abd, pelvis), cxr, ldh
metastases - bma/biopsy, cbcd, ptl, bone scan, pet/gallium scan
staging scale - murray classification
bone tumors: osteosarcoma, ewings sarcoma
primary tumor - plain xray, ct, mri of affected site (extremity)
metastases - ct chest/abd, bone scan, bma/biopsy, cbcd, ptl
hepatoblastoma
primary tumor - mri or ct scan of abd, lft, afp
metastases - ct chest
germ cell tumors
primary tumor - mri or ct primary site, aft, BhCG
metastases - ct chest, bone scan
x-ray
lymphomas - mediastinal mass, pulmonary mets, pleural effusion.
abd mass, constipation, intestinal obstruction, gas patters
soft tissue tumors - rhabdo, bone tumors, osteosarcoma, ewings
QUESTIONS AND ANSWERS GRADED A+ AND A
GUARANTEED PASS 2026-2027
Biotherapy
modality of tx: agents that resemble body's own defense and surveillance systems. can
augment/modulate/restore host's immune response, direct antitumor activity, other biological
effects. side effects typically hypersensitivity rx
Immune surveillance
tumor cells express abnormal tumor antigens on surface that can be recognized/destroyed by
immune system
Natural killer cells
lymphocyte that recognizes/kills malignant cells
Cytotoxic t cells
recognize tumor-assosiated antigens and kills cells
Interferons
multiple moa's & produced w/ recombinant dna.
protein capable of protecting other cells from viral infections by interfering w/ viral
replication.
family of glycoproteins include: antiviral, antiproliferative, potent immunomodulatory effects
Cytokines
products of immune cells to enhance cytotoxic activity of cells and increase immune response
,Alpha-interferon
leukocyte-derived. tx: hairy cell leukemia, melanoma, chronic myeloid leukemia, follicular
lymphoma, multiple myeloma, cutaneous t-cell lymphoma
Beta-interferon
fibroblast-derived. tx MS
Gamma-interferon
t-lymphocyte derived. tx chronic granulomatus disease
Interleukin-2
produced by t-helper cells & stimulate growth/maturation of t-cell subsets, cytotoxic t-cells,
production of lymphokines & cytokines.
act as chemical signals b/w wbc's (revs up immune system)
Retinoids
immunomodulators that facilitate differentiation & suppress proliferation of cancer cells
All-trans retinoic acid (atra)
tx: aml, aml m3 subtype, apl
increase maturation of promyelocytic blasts and rapid resolution of coagulopathy r/t tx.
Isotretinoin (accutane)
retinoid tx neuroblastoma.
,have antitumor activity unknown moa. TERATOGENIC. male/female pt must register
iPledge (fetal exposure). can also affect hearing & vision
Antibodies
proteins produced by b-lymphocytes. part of humoral immunity of adaptive system. includes
immunoglobulins (igG, igA, igM, igE, igD)
Murine
mouse-derived MoAbs. pt develops human antimouse antibodies creating high risk of
hypersensitivity rx
end in -momab
Monoclonal antibodies
very specific. directed against single antigenic determinant on cell surface causing antibody-
dependent cellular toxicity, direct cell death, elimination of antigen/target cell that expresses
the antigen
low toxicity
Neuroblastoma
primary tumor - ct of abd/pelvis, urine catecholamines (hva, vma), ldh
metastases - ct brain/chest, bone scan, mibg scan, bma/biopsy, cbcd, plt
staging scale - international neuroblastoma staging system
wilms' tumor
primary tumor - ct abd/pelvis, urinalysis
metastases - ct chest/brain, bone scan (unfavorable histology or clear cell kidney sarcoma)
staging scale - ntl wilms tumor study-v
hodgkins lymphoma
, primary tumor - ct primary tumor (neck, chest, abd, pelvis), cxr, erythrocyte sedimentation
rate, ldh
metastases - ct abd/pelvis, pet/gallium scan, bone scan, bma/biopsy, cbcd, plt
staging scale - ann arbor classification
non-hodgkins lymphoma
primary tumor - ct primary tumor (neck chest, abd, pelvis), cxr, ldh
metastases - bma/biopsy, cbcd, ptl, bone scan, pet/gallium scan
staging scale - murray classification
bone tumors: osteosarcoma, ewings sarcoma
primary tumor - plain xray, ct, mri of affected site (extremity)
metastases - ct chest/abd, bone scan, bma/biopsy, cbcd, ptl
hepatoblastoma
primary tumor - mri or ct scan of abd, lft, afp
metastases - ct chest
germ cell tumors
primary tumor - mri or ct primary site, aft, BhCG
metastases - ct chest, bone scan
x-ray
lymphomas - mediastinal mass, pulmonary mets, pleural effusion.
abd mass, constipation, intestinal obstruction, gas patters
soft tissue tumors - rhabdo, bone tumors, osteosarcoma, ewings
