CHEMOTHERAPY CERTIFICATION EVALUATION EXAMS
2025/2026 ANSWERS AND QUESTIONS GRADED A+
✔✔myeloblation - ✔✔obliteration of bone marrow with chemo in prep for blood stem cell
or bone marrow trasnplant to destroy blood forming cells in the marrow and reduce
tumor burden - destroy immune system so it cannot attack donated cells after transplant
✔✔nonmyeloblative - ✔✔not as intense, chemo doses are not as intense
✔✔LESSON 2: Alkylating Agents - ✔✔-cytoxan
-ifosframide
-bendamustine
✔✔platinum based chemo - ✔✔consideration on age, kidney function, and concurrent
use of radiation. both can cause nausea, vomiting, hearting loss, kidney function
damage, electrlyte disturb. CBC chem panel and mag checked
-cisplatin: admin over longer period of time. nausea can last over a week
-carboplatin- risk with age >65, harder on kidney function. over shorter period of time,
nausea within first 24 hours. neuro tox
✔✔cyclophasmide - ✔✔hair loss 10-14 days post treatment
-can be given peripherally
-hemmorhagic cystitis - hydration is key, high dose may need bladder protection
-easier to give than iphosphamide
✔✔iphosphamide - ✔✔neuro changes can occur- personality changes can occur, neuro
checks before
central line only
-need a bladder protective agent 100% of the time
✔✔nitrosureas - ✔✔cross blood brain barrier - can treat brain tumors. alkylating agents
-pulmonary monitoring
✔✔Lesson 3: Antimetabolites - ✔✔-azacitidine
-capacitabine
-fluorouracil
-cytarabine
-decitabine
-methotrexate
inhibit DNA and RNA synthesis - can cause myelosuppression, GI toxicities,
phospotsensitiivty, hand foot syndrome, vigorous I V hydration to prevent tumor lysis
✔✔5 fluorouracil (5 FU) - ✔✔-IV oral topic and opthalmic formalation
, -can cause hyperpigmentation, increased mucositis, photosensitivity, diarrhea
-capcytobine is the oral form - needs to be taken 2x day, hand foot syndrome can occur
-INR monitoring
✔✔methotrexate - ✔✔antimetabolite, cell cycle specific to S phase
-cleared in kidneys - effects: hepatotox, renal tox, mucositis, nausea, myelosuppression,
pneumonitis, photosensitivity, neurotoxicity, infertility
-yellow in color. renal function, hydrate 2-3L/ day, no alcohol use, sun exposrue, folic
acid, avoid effusions
✔✔azacitidine - ✔✔for treatment of myelodysplastic syndrome: group of cancers in
which immature blood cells do not mature (SOB and fatigue are markers)
✔✔Lesson 4 A cautionary tale about routes - ✔✔intrathecal chemo- injects chemo
directly into the subarachnoid space so it reaches the CNA
-leukemia and lymphoma spreading to CNS since most chemo does not cross blood
brain barrier
✔✔intrathecal chemo - ✔✔ONLY methotrexate and cytarabine can be given IT
-IT hydrocorisone given at same time to reduce inflammation
✔✔vincristine - ✔✔dilute in 20mL minibag and infuse over short time- IVP not
reommended
vinblastine -dilute in 25-50 ns
✔✔Lesson 5 Antitumor Antibiotics - ✔✔-anthracyclines: interfere with enzymes for DNA
to replicate, work phases of the cell cycle
lifetime dose limites because they are cardiotoxic
-daunorubicin, doxorubicin, epirubicin, idarubicin
nonanthracycline: actinomycin, mitomycin, bleomycin
✔✔doxorubicin - ✔✔vesicant
extravasation possible- must eval cardiac funciton, ongoing cardiac monitoring,
hypersensitivity risk
-nausea/ vomiting, mucositis, diarrhea, myelosupression, hepatic impairment,
secondary cancer
-cardiac: SOB< skipped beats, weight gain
-myelosuppress: oral temp daily, report >100.5
GI: nausea vomiting diarrhea, inspect mucosa
neuro: numbness/ tingling, burning
GU: change in color of urine
2025/2026 ANSWERS AND QUESTIONS GRADED A+
✔✔myeloblation - ✔✔obliteration of bone marrow with chemo in prep for blood stem cell
or bone marrow trasnplant to destroy blood forming cells in the marrow and reduce
tumor burden - destroy immune system so it cannot attack donated cells after transplant
✔✔nonmyeloblative - ✔✔not as intense, chemo doses are not as intense
✔✔LESSON 2: Alkylating Agents - ✔✔-cytoxan
-ifosframide
-bendamustine
✔✔platinum based chemo - ✔✔consideration on age, kidney function, and concurrent
use of radiation. both can cause nausea, vomiting, hearting loss, kidney function
damage, electrlyte disturb. CBC chem panel and mag checked
-cisplatin: admin over longer period of time. nausea can last over a week
-carboplatin- risk with age >65, harder on kidney function. over shorter period of time,
nausea within first 24 hours. neuro tox
✔✔cyclophasmide - ✔✔hair loss 10-14 days post treatment
-can be given peripherally
-hemmorhagic cystitis - hydration is key, high dose may need bladder protection
-easier to give than iphosphamide
✔✔iphosphamide - ✔✔neuro changes can occur- personality changes can occur, neuro
checks before
central line only
-need a bladder protective agent 100% of the time
✔✔nitrosureas - ✔✔cross blood brain barrier - can treat brain tumors. alkylating agents
-pulmonary monitoring
✔✔Lesson 3: Antimetabolites - ✔✔-azacitidine
-capacitabine
-fluorouracil
-cytarabine
-decitabine
-methotrexate
inhibit DNA and RNA synthesis - can cause myelosuppression, GI toxicities,
phospotsensitiivty, hand foot syndrome, vigorous I V hydration to prevent tumor lysis
✔✔5 fluorouracil (5 FU) - ✔✔-IV oral topic and opthalmic formalation
, -can cause hyperpigmentation, increased mucositis, photosensitivity, diarrhea
-capcytobine is the oral form - needs to be taken 2x day, hand foot syndrome can occur
-INR monitoring
✔✔methotrexate - ✔✔antimetabolite, cell cycle specific to S phase
-cleared in kidneys - effects: hepatotox, renal tox, mucositis, nausea, myelosuppression,
pneumonitis, photosensitivity, neurotoxicity, infertility
-yellow in color. renal function, hydrate 2-3L/ day, no alcohol use, sun exposrue, folic
acid, avoid effusions
✔✔azacitidine - ✔✔for treatment of myelodysplastic syndrome: group of cancers in
which immature blood cells do not mature (SOB and fatigue are markers)
✔✔Lesson 4 A cautionary tale about routes - ✔✔intrathecal chemo- injects chemo
directly into the subarachnoid space so it reaches the CNA
-leukemia and lymphoma spreading to CNS since most chemo does not cross blood
brain barrier
✔✔intrathecal chemo - ✔✔ONLY methotrexate and cytarabine can be given IT
-IT hydrocorisone given at same time to reduce inflammation
✔✔vincristine - ✔✔dilute in 20mL minibag and infuse over short time- IVP not
reommended
vinblastine -dilute in 25-50 ns
✔✔Lesson 5 Antitumor Antibiotics - ✔✔-anthracyclines: interfere with enzymes for DNA
to replicate, work phases of the cell cycle
lifetime dose limites because they are cardiotoxic
-daunorubicin, doxorubicin, epirubicin, idarubicin
nonanthracycline: actinomycin, mitomycin, bleomycin
✔✔doxorubicin - ✔✔vesicant
extravasation possible- must eval cardiac funciton, ongoing cardiac monitoring,
hypersensitivity risk
-nausea/ vomiting, mucositis, diarrhea, myelosupression, hepatic impairment,
secondary cancer
-cardiac: SOB< skipped beats, weight gain
-myelosuppress: oral temp daily, report >100.5
GI: nausea vomiting diarrhea, inspect mucosa
neuro: numbness/ tingling, burning
GU: change in color of urine
