ONS Chemotherapy Immunotherapy Certificate 2025 Exam Questions and Verified Answers

3 major phases of cell division: - - Interphase Mitotic phase Cytokinesis 3 steps of interphase: - -First growth phase (G1) Synthesis phase (S phase) Second growth phase (G2) 4 phases of mitosis: - -Prophase Metaphase Anaphase Telophase Innate immunity: - -Non-specific response, either: 1. Barrier (skin, mucous membranes, flora of skin/gut) 2. Cellular components (phagocytes, natural killer cells, granulocytes, macrophages) Adaptive immunity: - -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 - -Variations in the nucleotide sequence of a gene 3 main goals of treatment: - -Cure Control Palliation Define neoadjuvant therapy - -Treatment is given prior to surgery to shrink the tumor Define adjuvant therapy - -Additional cancer treatment given after the primary treatment to lower the risk that the cancer reoccur Define conditioning/preparative therapy - -Treatments used to prepare a patient for stem cell transplantation ONS CHEMOTHERAPY ONS CHEMOTHERAPY 2 types of conditioning therapies: - -Myeloablative Nonmyeloablative Define dose density - -Drug dose per unit of time Define dose intensity - -Amount of drug delivered over time How is relative dose intensity (RDI) calculated? - -By comparing the dose that the patient ACTUALLY received to the planned dose of the standard regimen How do alkylating agents work? - -By causing a break in the DNA helix strand, interfering with DNA replication and causing cell death 3 subcategories of alkylating agents: - -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: - -Nitrogen mustards Common alkylating agents: - -Cyclophosphamide (Cytoxan) Ifosfamide (Ifex) Bendamustine (Treanda) Common platinum-based agents: - -Cisplatin (Platinol) Carboplatin (Paraplatin) What is unique about nitrosoureas agents? - -Able to cross the blood-brain barrier; can be effective in treating some brain tumors Common nitrosoureas agents: - -Carmustine (BiCNU) Lomustine (CeeNu) Streptozocin (Zanosar) Hypersensitivity can occur with late doses of: - -Carboplatin These agents are typically categorized as highly emetogenic: - -1. Alkylating agents 2. Nitrosoureas Pre-administration labs for alkylating agents and nitrosoureas: - -BUN Creatinine CBC w/ diff What is the medication Mesna used for? - -Bladder protectant with administration of cyclophosphamide or ifosfamide ONS CHEMOTHERAPY ONS CHEMOTHERAPY Instruct pts receiving ________ to avoid exposure to cold air and consuming cold fluids for 3-4 days following treatment - -Oxaliplatin How do antimetabolites function? - -By blocking DNA and RNA growth by interfering with enzymes needed for normal cell metabolism Antimetabolites work in the ___ phase. - -S What types of cells are best affected by antimetabolites? - -Cells with high division rates Common side effects of antimetabolites: - -Myelosuppression GI toxicities Photosensitivity Hand-foot syndrome Common antimetabolite drugs: - -Azacitidine Capecitabine 5-FU Cytarabine Decitabine Methotrexate The institute for Safe Medication Practices recommends what route of administration for vincristine? - -IV piggyback via gravity Anthracycline antitumor abx work by: - -Interfering with enzymes necessary for DNA to replicate in ALL phases of the cell cycle The two major classifications of antitumor antibiotics are: - -Anthracyclines Non-anthracyclines Common anthracycline antitumor abx: - -Daunorubicin Doxorubicin Epirubicin Idarubicin The antitumor abx ___________ is not an anthracycline, but has anthracycline-type properties. - -Mitoxantrone Common non-anthracycline antitumor abx: - -Actinomycin D Mitomycin C Bleomycin Monitoring necessary with doxorubicin: - -Vesicant -- extravasation Cardiac function Lifetime dose tracking (cardiotoxicity) ONS CHEMOTHERAPY ONS CHEMOTHERAPY Lifetime dose of doxorubicin should not exceed: - -550 mg/m^2 What cardiac protectant medication can be administered prior to doxorubicin? - Dexrazoxane Significant side effects of doxorubicin are: - -Cardiotoxicity N/V Mucositis Diarrhea Severe myelosuppression Hepatic impairment Secondary cancers Monitoring necessary with bleomycin: - -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: - -400 units What 6 patient characteristics make CINV more likely? - -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: - -Acute Delayed Breakthrough Anticipatory Refractory Define acute CINV - -Occurring within 24 hours of chemotherapy Define delayed CINV - -Occurring from 24 hours to 5 days after treatment Define breakthrough CINV - -Occurring despite treatment Define anticipatory CINV - -Triggered by taste, odor, memories, visions, or anxiety related to chemotherapy Define refractory CINV - -Occurring during subsequent cycles when treatment failed in earlier cycles ONS CHEMOTHERAPY ONS CHEMOTHERAPY Highly emetogenic chemo (HEC) causes CINV in more than ___% of patients - -90 Moderately emetogenic chemo (MEC) causes CINV in patients ___% to ___% of the time - -30-90 Patients on low-potential emetogenic chemo develop CINV ___% to ___% of the time - -10-30 Minimal-risk emetogenic chemo causes CINV less than ___% of the time - -10 Common IV HEC drugs include: - -Carmustine Cisplatin Cyclophosphamide Dacarbazine Mechlorethamine Streptozosin Common IV MEC drugs include: - -Carboplatin Cytarabine Daunorubicin Doxorubicin Epirubicin Idarubicin Ifosfamide Irinotecan Oxaliplatin Common low-potential IV emetogenic chemo drugs include: - -5-FU Cytarabine Docetaxel Etoposide Gemcitabine Methotrexate Mitomycin C Mitoxantrone Paclitaxel Pemetrexed Common minimal-risk IV emetogenic chemo drugs include: - -Bleom