Solutions
Which chromosome is associated with chronic myelogenous leukemia (CML)?
a. chromosome 7
b. Philadelphia chromosome
c. chromosome 13
d. P53 b. Philadelphia chromosome
The Philadelphia chromosome is present in nearly all CML cases and is detected by cytogenic
analysis. In only 5-10% of CML cases is the Philadelphia chromosome absent. Chromosome 7 is
linked to leukemia, lymphomas, and MDS syndrome. Chromosome 13 is linked to
retinoblastoma and other types of cancer. P53 is a tumor suppressor protein.
A patient presents with a new diagnosis of non-small cell lung cancer. In the patient's medical
record you learn that the tumor in the right lung is 4 cm x 6 cm and has invaded the visceral
pleura. There is evidence of metastases in the mediastinal and subcarinal nodes as well as distant
metastasis in the liver. Based on TNM staging, you realize that the patient has which stage of
non-small cell lung cancer?
a. stage 2
b. stage 3a
,c. stage 3b
d. stage 4 d. stage 4
The TNM system for cancer staging outlined by the American Joint Committee on Cancer
(AJCC) assesses three basic components: size of the primary tumor, absence or presence of
regional lymph nodes, and the absence or presence of distant metastatic disease. Any evidence of
distant metastasis per TNM staging would classify the cancer as Stage 4.
Which of the following is an example of a "B symptom" associated with lymphoma?
a. headache
b. painful lymph nodes
c. night sweats
d. edema c. night sweats
"B symptoms" associated with a lymphoma diagnosis are a key factor in the staging of the
disease. The presence of B symptoms is associated with a poorer prognosis. Unexplained fever,
drenching night sweats, weight loss and pruritus are all B symptoms associated with lymphoma.
Headache, edema, and painful lymph nodes are not classified as B symptoms.
A 25-year-old female patient newly diagnosed with stage 4 Hodgkin's lymphoma presents to the
outpatient oncology unit for her first dose of chemotherapy. You receive orders to administer
,ABVD. Which of the following would be appropriate to teach the patient regarding her
chemotherapy?
a. "the chemotherapy will be administered intravenously. If you experience any pain or burning
at your IV site, notify me right away as some of the medications can cause tissue damage if they
leak out of the vein into the tissue."
b. "Your chemotherapy drugs are considered monoclonal antibodies and may cause an allergic
reaction. Please let me know if you experience fever, chills, nausea, or sweating during your
infusion"
c. "The chemotherapy you are receiving does not affect fertility. You can continue to family plan
as usual"
d. "the chemotherapy you are receiving is not likely to cause hair loss" a. ABVD are
vesicants
Vesicant chemotherapeutic agents such as those utilized in ABVD have the potential to cause
severe tissue damage if they leak into the subcutaneous tissue during an extravasation. ABVD
can cause infertility as well as birth defects. None of the medications in ABVD are classified as
monoclonal antibodies. ABVD will cause hair loss as a side effect.
Which of the following agents is classified as a tyrosine kinase inhibitor?
a. Rituximab
b. Bortezomib
, c. Trastuzumab
d. Sunitinib d. Sunitinib
Tyrosine kinase inhibitors are defined as antineoplastic agents that interfere with cell
communication and growth through inhibition of the tyrosine kinase enzymes. Sunitinib is a
tyrosine kinase inhibitor indicated in the treatment of gastrointestinal stromal tumors. Rituximab
and trastuzumab are classified as monoclonal antibodies. Bortezomib is a proteasome inhibitor.
One of the most common primary cancers with a high incidence of brain metastasis includes?
a. melanoma
b. non-Hodgkin's lymphoma
c. ovarian cancer
d. thyroid cancer a. melanoma
Approximately 170,000 cases of brain metastases are diagnosed in the United States each year.
Although any malignancy can lead to metastasis, malnoma and lung, breast, renal and colon
cancers account for the greatest majority of brain metastases. Sixty-five percent of melanomas
metastasize to the brain. Lymphoma, ovarian cancer and thyroid cancer are not common cancers
with brain metastases.
The malignancies most associated with cardiac tamponade include all of the following EXCEPT:
a. breast cancer