BREAST CANCER COMPLICATIONS OF
CHEMOTHERAPY ACTUAL TEST PAPER
WITH VERIFIED ANSWERS
●● What rapidly dividing tissues are negatively affected in chemo?
Answer: Bone marrow (neutropenia), buccal mucosa (stomatitis), GI
(diarrhea, N&V), hair follicles (alopecia)
●● What types of pre-medications can be given before chemo?
Answer: antihistamines, antiemetics
●● What kinds of agents can cause secondary neoplasms?
Answer: Alkylating agents
●● Antimetabolite drug class mechanism
Answer: They inhibit DNA replication and repair by acting as a
nucleotide (A,T,C, G) that is incorporated into the DNA, resulting in
disruption.
●● What cell growth phase do antimetabolites act most effectively on?
Answer: S phase (DNA synthesis phase)
,●● What drugs fall into the antimetabolite class?
Answer: Methotrexate, pemetrexed, platrexate ---> These are all folate
inhibitors. 6-mercaptopurine and azathioprine (which is converted to 6-
mp) ---> these are nucleoside analogs that block DNA and RNA
synthesis. Fludarabine --> purine analogue
●● What drug is given with methotrexate to replenish the folate pool?
Answer: Leucovorin
●● Indications for antimetabolite drugs
Answer: Acute lymphocytic leukemia, Burkitt lymphoma in children,
breast cancer, bladder cancer, head and neck carcinoma.
●● Side effects of methotrexate
Answer: Crystalluria
●● Routes of MTX
Answer: IM, IV, IT (intrathecal because it can't cross blood brain barrier)
●● 6 mercaptopurine and azathioprine dose should be reduced with what
medication?
Answer: Allopurinol
, ●● Mechanism of fludarabine
Answer: Purine analog (antimetabolite)
●● Indications for fludarabine
Answer: Chronic lymphocytic leukemia, hairy cell leukemia, indolent
non-Hodgkin lymphoma
●● Pentostatin mechanism
Answer: Antimetabolite --> blocks DNA synthesis, which leads to cell
death.
●● Pentostatin adverse effects
Answer: Immunosuppression, which creates risk for opportunistic
infections
●● Pentostatin indication
Answer: Hairy Cell Leukemia
●● 5 Fluorouracil is given with what drug in order to increase 5-FU's
effect?
Answer: Leucovorin
●● 5-FU indications
CHEMOTHERAPY ACTUAL TEST PAPER
WITH VERIFIED ANSWERS
●● What rapidly dividing tissues are negatively affected in chemo?
Answer: Bone marrow (neutropenia), buccal mucosa (stomatitis), GI
(diarrhea, N&V), hair follicles (alopecia)
●● What types of pre-medications can be given before chemo?
Answer: antihistamines, antiemetics
●● What kinds of agents can cause secondary neoplasms?
Answer: Alkylating agents
●● Antimetabolite drug class mechanism
Answer: They inhibit DNA replication and repair by acting as a
nucleotide (A,T,C, G) that is incorporated into the DNA, resulting in
disruption.
●● What cell growth phase do antimetabolites act most effectively on?
Answer: S phase (DNA synthesis phase)
,●● What drugs fall into the antimetabolite class?
Answer: Methotrexate, pemetrexed, platrexate ---> These are all folate
inhibitors. 6-mercaptopurine and azathioprine (which is converted to 6-
mp) ---> these are nucleoside analogs that block DNA and RNA
synthesis. Fludarabine --> purine analogue
●● What drug is given with methotrexate to replenish the folate pool?
Answer: Leucovorin
●● Indications for antimetabolite drugs
Answer: Acute lymphocytic leukemia, Burkitt lymphoma in children,
breast cancer, bladder cancer, head and neck carcinoma.
●● Side effects of methotrexate
Answer: Crystalluria
●● Routes of MTX
Answer: IM, IV, IT (intrathecal because it can't cross blood brain barrier)
●● 6 mercaptopurine and azathioprine dose should be reduced with what
medication?
Answer: Allopurinol
, ●● Mechanism of fludarabine
Answer: Purine analog (antimetabolite)
●● Indications for fludarabine
Answer: Chronic lymphocytic leukemia, hairy cell leukemia, indolent
non-Hodgkin lymphoma
●● Pentostatin mechanism
Answer: Antimetabolite --> blocks DNA synthesis, which leads to cell
death.
●● Pentostatin adverse effects
Answer: Immunosuppression, which creates risk for opportunistic
infections
●● Pentostatin indication
Answer: Hairy Cell Leukemia
●● 5 Fluorouracil is given with what drug in order to increase 5-FU's
effect?
Answer: Leucovorin
●● 5-FU indications
