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AOCNP review Latest recent and frequently tested exam with comprehensive questions and verified accurate solution (detailed & elaborated) GRADED A+.docx

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elaborated) GRADED A+

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,the risk for significant bone marrow suppression (8) - correct ans:advanced age (>65),poor nutritional
status, preexisting autoimmune disease, DM, GI disorders, liver disease, or hematopoietic disease, and
substance abuse.



Cancer-induced bone marrow suppression (3) - correct ans:a) dysfunctional hematopoietic cell within
the bone marrow, b) bone marrow infiltration with tumor c)general exhaustion of bone marrow
reserves



solid tumor malignancies with the highest propensity to infiltrate the bone marrow in the course of
metastasis - correct ans:melanoma, cancer of the breast, lung, kidney and prostate



Nitrosoureas (Carmustine, Lomustine) - correct ans:affect the pluripotent stem cell (affecting all cell
lines/cell cycle nonspecific agent) use for glioblastoma multiforme

severe myelosuppression may last up to 85 days, nadir of carmustine occurs in 26-60 days



Radiation induced bone marrow suppression occurs when (2) - correct ans:1. treatment field involves
marrow producing tissue or with dose greater than 15 Gy



CD 4 counts < 500/mm3 - correct ans:significant risk factor for oopotunisitic infections



Cyclosphosphamide - myelosuppression risk - correct ans:moderate



Paclitaxel - myelosuppression risk - correct ans:moderate



Doxorubicin (Adriamycin) - myelosuppression risk - correct ans:alkylating agnet, may produce severe
myelosuppression, the duration only about 21 days



Myelosupression secondary to radiation therapy peaks at - correct ans:week 3

Suppression may occur in all cell lines simultaneously rather than sequentially as seen with
chemotherapy

The recovery period also may be less predictable.

, Second malignancy : Acute leukemia - potential etiologic factor ? - correct ans:Alkylating agent,
especially with high doses or cumulative doses of antimetabolites

Antitumor antibiotics

Corticosteroids

Epipodophyllotoxins (i.e Etoposide)



Second malignancy : Bladder cancer- potential etiologic factor ? - correct ans:radiation therapy for
prostate cancer



Second malignancy : Brain tumors - potential etiologic factor ? - correct ans:therapeutic radiation for
other cancer



Second malignancy : hepatoma- potential etiologic factor ? - correct ans:Androgen therapy



Second malignancy : Kidney cancer - potential etiologic factor ? - correct ans:Brain tumor therapies

Cisplatin, especially in treatment for testicular cancer



Second malignancy : Leukemia - potential etiologic factor ? - correct ans:Antitumor antibiotics

Brest cancer treatment

Lymphoma treatment

Post transplant immunosuppression

Prostate cancer treatment



Second malignancy : Lung cancer - potential etiologic factor ? - correct ans:HIV infection

Theraputic radiation for other cancers



Second malignancy : Mesothelioma - potential etiologic factor ? - correct ans:Thoracic radiation for lung
neoplasms

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