AOCNP Test Review 2024 Latest
Questions And Answers Rated 100%
Correct!!
Treatments that place individuals at increased risk for infection Answer-
Chemotherapy treatments including high-dose cyclophosphamide, doxorubicin,
docetaxel, or alemtuzumab.
Colony stimulating factors (CSF) Answer- **GM-CSF : growth factor for
hematopoietic stem cells and granulocyte/monocytes
**M-CSF (macrophage): essential for macrophage production
**G-CSF (granulocyte) :essential for neutrophils
**Erythropoietin (EPO): growth factor for RBC
Filgrastim (Neupogen)
Pegfilgrastim (Neulasta)
Tbo-filgrastim (Granix) Answer- Common side effects: mild to moderate bone pain
Used to patients at risk of experiencing treatment induced neutropenia
Major benefit: reducing the possibility of myelosuppression and permitting the
continuation of therapeutic chemotherapy doses
Filgrastim (Neupogen) Answer- Dose: 5 µg per kilogram per day. Begin 24 to 72
hours after completion of chemotherapy and continue through the post nadir period.
Pegfilgrastim (Neulasta) Answer- That was: 6 mg per cycle. Again 1 to 3 days post
chemotherapy. Administer as a single 6 mg injection once per cycle. Do not
administer in the period beginning 14 days before until 24 hours after administration
of chemotherapy.
Antimicrobial prophylaxis for infection Answer- Low risk: no prophylaxis
Recommended unless the patient has prior herpes simplex virus episode.
Intermediate risk:
Bacterial: consider Fluoroquinolone
Fungal: consider fluconazole during neutropenia and if mucositis is anticipated
Viral: during neutropenia and at least 30 days after transplantation
High risk:
Bacterial: consider fluoroquinolone
Fungal: consider fluconazole or other anti-fungal agent
Viral: during neutropenia and at least 30 days after transplantation
,Graft versus host disease: penicillin andtrimethroprim/sulfamethoxazole (tmp/smx)
Or equivalent for allogenic heamatopoetic Stem cell transplant recipients
Alemtuzumab: TMP/SMX
Complete diagnostic work up for neutropenic fever Answer- Blood cultures:
bacterial, viral, and fungal
BUN, electrolytes, and creatinine
Chest x-ray
CBC and differential
Liver function test
Pulse oximetry
Site-specific cytology and cultures
Urinanalysis
ANC calculation Answer- WBC x [(% segs + % bands)/100]
aplastic anemia Answer- a normocytic-normochromic type of anemia characterized
by the failure of bone marrow to produce red blood cells
hemolytic anemia Answer- characterized by an inadequate number of circulating red
blood cells due to the premature destruction of red blood cells by the spleen
deficiency anemia Answer- anemia caused by lack of necessary nutrients
B12, folate, and iron
Anemia # of RBC/ MCV Answer- Microcytic. Normocytic. Macrocyctic.
Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal
or ↑ ferritin. Answer- cells smaller than normal
Iron deficiency
macrocytic anemia Answer- due to folate or vitamin B12(cobalamin) deficiency
(megaloblastic anemia), THF-M --> VitB12-M --> Methionine, (transfer of methyl
groups)
erythrpoietin (EPO) Answer- Stimulates development of RBC production
Triggered to release by reduced oxygen level of RBC mass trigger from the kidney
Labs to check in anemia Answer- CBC with diff
Peripheral smear
Reticulocyte count
Iron studies: serum iron, total iron binding capacity, ferritin
Vitamin B 12
Full eight red cell
If these are not diagnostic these may be added
Fractionated Bilirubin
Occult stool
,Coombs test
Haptoglobin level
Hemoglobin electrophoresis
Bone marrow biopsy
Grades of Anemia Answer- Grade 1 mile: hemoglobin of 10 to 12
Great to moderate: hemoglobin of 8 to 10
Grade 3 severe: hemoglobin of 6.707.9
Great for life-threatening: hemoglobin below 6.5
Treatments that cause thrombocytopenia More than 50% of the time: Answer-
Topotecan
MOPP
ESHAP
GEM/CIS
PCDE
Normal lifespan of a platelet Answer- 8-10 days
Normal platelet range Answer- 150,000-400,000/mm3
Thrombocytopenia Answer- low platelet count, Less than 100
Decrease platelet production can occur in patients with cancer as the result of colon
tumor invasion of the bone marrow or spleen, bone marrow suppression, aplastic
anemia
Herbal agents that can cause thrombocytopenia Answer- Ginkgo biloba, garlic,
ginger, turmeric
Medication that can cause anemia Answer- Aspirin
Heparin
Digoxin
Thiazide diuretics
NSAIDS
PHENYTOIN
quinine
Abx
Tricyclic anti depressant
Benzene
Interleukin-11 (platelet growth factor) Answer- Oprelvekin. Thrombocytopenia
related to chemotherapy
Steroids may also be used
Primary Cachexia Answer- Anorexia-Cachexia syndrome
Decreased gluconeogenesis
Alterations in glucose metabolism
Increased metabolic rate
Alterations in lipid, protein, and carbohydrate metabolism
, Secondary cachexia Answer- Involuntary weight loss caused by mechanical factors
such as obstruction or malabsorption.
Treatments for cachexia Answer- Progestins/megastrol
Reglan
Canaboid derivatives/ Medical marijuana
Cortico steroids: Prednisolone/Dexamethasone
High calorie, high protein oral supplements
Tube feedings
TPN feedings
Referral to dietitian
Patient education
Iatrogenic causes of nausea Answer- Related to medical treatmenrs
Disease related nausea Answer- Structural or metabolic problems
Vomiting Centers in Brain Answer- Medullary Reticular Formation
Chemoreceptor Trigger Zone in 4th ventricle
oral mucosa Answer- Oral mucosa and other areas of the G.I. tract can be affected
by to seven days Following chemotherapy and have a healing time of 7 to 10 days.
Five phases of Mucositis
One. Initiation: oxygen free radicals damage DNA
Two. Up regulation: transcription factors are activated
Three. Message generation: activation and damage progresses
Four. Ulceration: information, ulceration, and organism invasion of hers.
Five. Healing: spontaneous recovery occurs in mucosal tissue
Benzydamine Answer- Used for RDX and chemoradiation mucositis
Xerostomia Answer- Dryness of the mouth caused by reduction of saliva
2/3 of saliva production can be lost with RDX
dysphagia Answer- Sensation of difficulty swallowing
Motor or mechanical related
Odynophagia Answer- Difficult and painful swallowing
Achalasia Answer- absence of peristalsis of the lower esophagus resulting in
difficulty swallowing, regurgitation, and sometimes pain
Testing for swallowing difficulties Answer- Endoscopy
Barium swallow
Glucose or A-1 C
Thyroid studies
Albumin
Electrolytes
Questions And Answers Rated 100%
Correct!!
Treatments that place individuals at increased risk for infection Answer-
Chemotherapy treatments including high-dose cyclophosphamide, doxorubicin,
docetaxel, or alemtuzumab.
Colony stimulating factors (CSF) Answer- **GM-CSF : growth factor for
hematopoietic stem cells and granulocyte/monocytes
**M-CSF (macrophage): essential for macrophage production
**G-CSF (granulocyte) :essential for neutrophils
**Erythropoietin (EPO): growth factor for RBC
Filgrastim (Neupogen)
Pegfilgrastim (Neulasta)
Tbo-filgrastim (Granix) Answer- Common side effects: mild to moderate bone pain
Used to patients at risk of experiencing treatment induced neutropenia
Major benefit: reducing the possibility of myelosuppression and permitting the
continuation of therapeutic chemotherapy doses
Filgrastim (Neupogen) Answer- Dose: 5 µg per kilogram per day. Begin 24 to 72
hours after completion of chemotherapy and continue through the post nadir period.
Pegfilgrastim (Neulasta) Answer- That was: 6 mg per cycle. Again 1 to 3 days post
chemotherapy. Administer as a single 6 mg injection once per cycle. Do not
administer in the period beginning 14 days before until 24 hours after administration
of chemotherapy.
Antimicrobial prophylaxis for infection Answer- Low risk: no prophylaxis
Recommended unless the patient has prior herpes simplex virus episode.
Intermediate risk:
Bacterial: consider Fluoroquinolone
Fungal: consider fluconazole during neutropenia and if mucositis is anticipated
Viral: during neutropenia and at least 30 days after transplantation
High risk:
Bacterial: consider fluoroquinolone
Fungal: consider fluconazole or other anti-fungal agent
Viral: during neutropenia and at least 30 days after transplantation
,Graft versus host disease: penicillin andtrimethroprim/sulfamethoxazole (tmp/smx)
Or equivalent for allogenic heamatopoetic Stem cell transplant recipients
Alemtuzumab: TMP/SMX
Complete diagnostic work up for neutropenic fever Answer- Blood cultures:
bacterial, viral, and fungal
BUN, electrolytes, and creatinine
Chest x-ray
CBC and differential
Liver function test
Pulse oximetry
Site-specific cytology and cultures
Urinanalysis
ANC calculation Answer- WBC x [(% segs + % bands)/100]
aplastic anemia Answer- a normocytic-normochromic type of anemia characterized
by the failure of bone marrow to produce red blood cells
hemolytic anemia Answer- characterized by an inadequate number of circulating red
blood cells due to the premature destruction of red blood cells by the spleen
deficiency anemia Answer- anemia caused by lack of necessary nutrients
B12, folate, and iron
Anemia # of RBC/ MCV Answer- Microcytic. Normocytic. Macrocyctic.
Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal
or ↑ ferritin. Answer- cells smaller than normal
Iron deficiency
macrocytic anemia Answer- due to folate or vitamin B12(cobalamin) deficiency
(megaloblastic anemia), THF-M --> VitB12-M --> Methionine, (transfer of methyl
groups)
erythrpoietin (EPO) Answer- Stimulates development of RBC production
Triggered to release by reduced oxygen level of RBC mass trigger from the kidney
Labs to check in anemia Answer- CBC with diff
Peripheral smear
Reticulocyte count
Iron studies: serum iron, total iron binding capacity, ferritin
Vitamin B 12
Full eight red cell
If these are not diagnostic these may be added
Fractionated Bilirubin
Occult stool
,Coombs test
Haptoglobin level
Hemoglobin electrophoresis
Bone marrow biopsy
Grades of Anemia Answer- Grade 1 mile: hemoglobin of 10 to 12
Great to moderate: hemoglobin of 8 to 10
Grade 3 severe: hemoglobin of 6.707.9
Great for life-threatening: hemoglobin below 6.5
Treatments that cause thrombocytopenia More than 50% of the time: Answer-
Topotecan
MOPP
ESHAP
GEM/CIS
PCDE
Normal lifespan of a platelet Answer- 8-10 days
Normal platelet range Answer- 150,000-400,000/mm3
Thrombocytopenia Answer- low platelet count, Less than 100
Decrease platelet production can occur in patients with cancer as the result of colon
tumor invasion of the bone marrow or spleen, bone marrow suppression, aplastic
anemia
Herbal agents that can cause thrombocytopenia Answer- Ginkgo biloba, garlic,
ginger, turmeric
Medication that can cause anemia Answer- Aspirin
Heparin
Digoxin
Thiazide diuretics
NSAIDS
PHENYTOIN
quinine
Abx
Tricyclic anti depressant
Benzene
Interleukin-11 (platelet growth factor) Answer- Oprelvekin. Thrombocytopenia
related to chemotherapy
Steroids may also be used
Primary Cachexia Answer- Anorexia-Cachexia syndrome
Decreased gluconeogenesis
Alterations in glucose metabolism
Increased metabolic rate
Alterations in lipid, protein, and carbohydrate metabolism
, Secondary cachexia Answer- Involuntary weight loss caused by mechanical factors
such as obstruction or malabsorption.
Treatments for cachexia Answer- Progestins/megastrol
Reglan
Canaboid derivatives/ Medical marijuana
Cortico steroids: Prednisolone/Dexamethasone
High calorie, high protein oral supplements
Tube feedings
TPN feedings
Referral to dietitian
Patient education
Iatrogenic causes of nausea Answer- Related to medical treatmenrs
Disease related nausea Answer- Structural or metabolic problems
Vomiting Centers in Brain Answer- Medullary Reticular Formation
Chemoreceptor Trigger Zone in 4th ventricle
oral mucosa Answer- Oral mucosa and other areas of the G.I. tract can be affected
by to seven days Following chemotherapy and have a healing time of 7 to 10 days.
Five phases of Mucositis
One. Initiation: oxygen free radicals damage DNA
Two. Up regulation: transcription factors are activated
Three. Message generation: activation and damage progresses
Four. Ulceration: information, ulceration, and organism invasion of hers.
Five. Healing: spontaneous recovery occurs in mucosal tissue
Benzydamine Answer- Used for RDX and chemoradiation mucositis
Xerostomia Answer- Dryness of the mouth caused by reduction of saliva
2/3 of saliva production can be lost with RDX
dysphagia Answer- Sensation of difficulty swallowing
Motor or mechanical related
Odynophagia Answer- Difficult and painful swallowing
Achalasia Answer- absence of peristalsis of the lower esophagus resulting in
difficulty swallowing, regurgitation, and sometimes pain
Testing for swallowing difficulties Answer- Endoscopy
Barium swallow
Glucose or A-1 C
Thyroid studies
Albumin
Electrolytes
