ONS Chemotherapy Immunotherapy Certificate exam with 100% correct Answers 2023

ONS Chemotherapy Immunotherapy Certificate exam with 100% correct Answers 2023 3 major phases of cell division: - Correct Answer-Interphase Mitotic phase Cytokinesis 3 steps of interphase: - Correct Answer-First growth phase (G1) Synthesis phase (S phase) Second growth phase (G2) 4 phases of mitosis: - Correct Answer-Prophase Metaphase Anaphase Telophase Innate immunity: - Correct Answer-Non-specific response, either: 1. Barrier (skin, mucous membranes, flora of skin/gut) 2. Cellular components (phagocytes, natural killer cells, granulocytes, macrophages) Adaptive immunity: - Correct Answer-Follows innate immunity if unsuccessful. Memory immunity, including: 1. Humoral immunity (production of antibodies or immunoglobulins) 2. Cell mediated immunity (dependent upon T cells) 3. Regulatory T -cells (prevent autoimmune reactions and limit inflammatory responses) Define mutations - Correct Answer-Variations in the nucleotide sequence of a gene 3 main goals of treatment: - Correct Answer-Cure Control Palliation Define neoadjuvant therapy - Correct Answer-Treatment is given prior to surgery to shrink the tumor Define adjuvant therapy - Correct Answer-Additional cancer treatment given after the primary treatment to lower the risk that the cancer reoccur Define conditioning/preparative therapy - Correct Answer-Treatments used to prepare a patient for stem cell transplantation 2 types of conditioning therapies: - Correct Answer-Myeloablative Nonmyeloablative Define dose density - Correct Answer-Drug dose per unit of time Define dose intensity - Correct Answer-Amount of drug delivered over time How is relative dose intensity (RDI) calculated? - Correct Answer-By comparing the dose that the patient ACTUALLY received to the planned dose of the standard regimen How do alkylating agents work? - Correct Answer-By causing a break in the DNA helix strand, interfering with DNA replication and causing cell death 3 subcategories of alkylating agents: - Correct Answer-1. Nitrogen mustards 2. Platinum-based agents (do not possess an alkyl group but still termed alkylating agents as they work similarly) 3. Nitrosoureas Most common subcategory of alkylating agents: - Correct Answer-Nitrogen mustards Common alkylating agents: - Correct Answer-Cyclophosphamide (Cytoxan) Ifosfamide (Ifex) Bendamustine (Treanda) Common platinum-based agents: - Correct Answer-Cisplatin (Platinol) Carboplatin (Paraplatin) What is unique about nitrosoureas agents? - Correct Answer-Able to cross the bloodbrain barrier; can be effective in treating some brain tumors Common nitrosoureas agents: - Correct Answer-Carmustine (BiCNU) Lomustine (CeeNu) Streptozocin (Zanosar) Hypersensitivity can occur with late doses of: - Correct Answer-Carboplatin These agents are typically categorized as highly emetogenic: - Correct Answer-1. Alkylating agents 2. Nitrosoureas Pre-administration labs for alkylating agents and nitrosoureas: - Correct Answer-BUN Creatinine CBC w/ diff What is the medication Mesna used for? - Correct Answer-Bladder protectant with administration of cyclophosphamide or ifosfamide Instruct pts receiving ________ to avoid exposure to cold air and consuming cold fluids for 3-4 days following treatment - Correct Answer-Oxaliplatin How do antimetabolites function? - Correct Answer-By blocking DNA and RNA growth by interfering with enzymes needed for normal cell metabolism Antimetabolites work in the ___ phase. - Correct Answer-S What types of cells are best affected by antimetabolites? - Correct Answer-Cells with high division rates Common side effects of antimetabolites: - Correct Answer-Myelosuppression GI toxicities Photosensitivity Hand-foot syndrome Common antimetabolite drugs: - Correct Answer-Azacitidine Capecitabine 5-FU Cytarabine Decitabine Methotrexate The institute for Safe Medication Practices recommends what route of administration for vincristine? - Correct Answer-IV piggyback via gravity Anthracycline antitumor abx work by: - Correct Answer-Interfering with enzymes necessary for DNA to replicate in ALL phases of the cell cycle The two major classifications of antitumor antibiotics are: - Correct AnswerAnthracyclines Non-anthracyclines Common anthracycline antitumor abx: - Correct Answer-Daunorubicin Doxorubicin Epirubicin Idarubicin The antitumor abx ___________ is not an anthracycline, but has anthracycline-type properties. - Correct Answer-Mitoxantrone Common non-anthracycline antitumor abx: - Correct Answer-Actinomycin D Mitomycin C Bleomycin Monitoring necessary with doxorubicin: - Correct Answer-Vesicant -- extravasation Cardiac function Lifetime dose tracking (cardiotoxicity) Lifetime dose of doxorubicin should not exceed: - Correct Answer-550 mg/m^2 What cardiac protectant medication can be administered prior to doxorubicin? - Correct Answer-Dexrazoxane Significant side effects of doxorubicin are: - Correct Answer-Cardiotoxicity N/V Mucositis Diarrhea Severe myelosuppression Hepatic impairment Secondary cancers Monitoring necessary with bleomycin: - Correct Answer-Pulmonary toxicity Hypersensitivity reactions (esp. in lymphoma patients) Cutaneous reactions Lifetime dose tracking (pulmonary toxicity) Pulmonary fibrosis is possible when the lifetime dose of bleomycin exceeds: - Correct Answer-400 units What 6 patient characteristics make CINV more likely? - Correct Answer-1. Younger than 50 years 2. Hx of low alcohol intake 3. Female gender 4. Hx of morning sickness during pregnancy 5. Prone to motion sickness 6. Previous chemotherapy Types of CINV: - Correct Answer-Acute Delayed Breakthrough Anticipatory Refractory Define acute CINV - Correct Answer-Occurring within 24 hours of chemotherapy Define delayed CINV - Correct Answer-Occurring from 24 hours to 5 days after treatment Define breakthrough CINV - Correct Answer-Occurring despite treatment Define anticipatory CINV - Correct Answer-Triggered by taste, odor, memories, visions, or anxiety related to chemotherapy Define refractory CINV - Correct Answer-Occurring during subsequent cycles when treatment failed in earlier cycles Highly emetogenic chemo (HEC) causes CINV in more than ___% of patients - Correct Answer-90 Moderately emetogenic chemo (MEC) causes CINV in patients ___% to ___% of the time - Correct Answer-30-90 Patients on low-potential emetogenic chemo develop CINV ___% to ___% of the time - Correct Answer-10-30 Minimal-risk emetogenic chemo causes CINV less than ___% of the time - Correct Answer-10 Common IV HEC drugs include: - Correct Answer-Carmustine Cisplatin Cyclophosphamide Dacarbazine Mechlorethamine Streptozosin Common IV MEC drugs include: - Correct Answer-Carboplatin Cytarabine Daunorubicin Doxorubicin Epirubicin Idarubicin Ifosfamide Irinotecan Oxaliplatin Common low-potential IV emetogenic chemo drugs include: - Correct Answer-5-FU Cytarabine Docetaxel Etoposide Gemcitabine Methotrexate Mitomycin C Mitoxantrone Paclitaxel Pemetrexed Common minimal-risk IV emetogenic chemo drugs include: - Correct Answer-Bleomycin Bevacizumab Bortezomib Busulfan Cetuximab Fludarabine Trastuzumab Vinca alkaloids The 2 most important neurotransmitters involved in vomiting are: - Correct Answer-1. Serotonin 2. Substance P Describe the peripheral pathway of CINV - Correct Answer-Primarily occurs in the GI tract Associated with acute CINV Neurotransmitter -- serotonin Describe the central pathway of CINV - Correct Answer-Primarily occurs in the brain Associated with delayed CINV Neurotransmitter -- Substance P Common serotonin 5-HT3 antagonists used for CINV: - Correct Answer-Dolasetron Granisetron Ondansetron Palonosetron Common neurokinin-1 antagonists used for CINV: - Correct Answer-Aprepitant Fosaprepitant Common steroids used for CINV: - Correct Answer-Dexamethasone 2 types of therapies that commonly have cutaneous reactions: - Correct Answer-1. EGFR inhibitor therapies 2. Antimetabolites Most-common cutaneous reaction seen with 5-FU and Capecitabine: - Correct AnswerPalmar-plantar erythrodysesthesia AKA hand-foot syndrome Antimetabolites that commonly cause cutaneous reactions: - Correct Answer-5-FU Capecitabine (Xeloda) Define myelosuppression - Correct Answer-Bone marrow activity is decreased, resulting in fewer RBCs, WBCs and platelets If severe: myeloablation The most common dose-limiting toxicity of chemotherapy - Correct AnswerMyelosuppression Define nadir, and when does it occur? - Correct Answer-The point at which blood cell counts are at their lowest following a treatment cycle. Typically occurs 7-10 days following cycle NCCN defines neutropenia as an ANC _______/mm^3 - Correct Answer-500 Risk factors for developing neutropenia include: - Correct Answer- 65 years old Hx of neutropenia with previous chemotherapy Hx of chemotherapy or radiation treatment Hematologic malignancy Uncontrolled/advanced cancer Lung cancer Define neutropenic fever - Correct Answer-Fever of 101 F or greater one time OR Fever of 100.4 F lasting one hour or longer ANC calculation - Correct Answer-(% polys + % bands) x (WBC)/100 Normal WBC count - Correct Answer-4,500-10,000 Normal neutrophil count - Correct Answer-54%-62% of WBC An ANC of less that _____ is considered a risk for infection - Correct Answer-1,000 Define thrombocytopenia - Correct Answer-Low platelet count Symptoms of thrombocytopenia - Correct Answer-Petechiae or easily bruising Headaches Hypotension and tachycardia Prolonged bleeding (gums, menstruation) Define anemia - Correct Answer-Deficiency of RBC or hemoglobin in the blood Symptoms of anemia - Correct Answer-Dyspnea Fatigue Dizziness Headaches Acute diarrhea lasts: - Correct Answer-1-2 days and resolves on its own