RTPM EXAM 2026
Chemotherapy common side effects—ANSWER--Physical pain, Extravasation, Systemic effects
Cytotoxic agents include 2 types—ANSWER--Vesicant: severe & irreversible damage, resulting
in necrosis;
Irritant: local inflammation, unlikely to cause permanent damage
Extravasation injury depends on—ANSWER--Type, Concentration & Quantity (Leakage &
Involuntary injection)
Need adequate guideline, training & correct treatment
Central/ Hickman—ANSWER--Allow for multiple administration, single insertion under
anesthesia & painless during infusion
Hickman line destination—ANSWER--Superior vena cava near right atrium
Hickman line complication—ANSWER--Hemorrhage, thrombosis, infection
4 major systemic effects—ANSWER--Nausea & Vomiting, Myelosuppression, Mucositis, Hair
loss
Mechanism of CINV—ANSWER--1) Direct activation of medullary chemoreceptor trigger
zone (5-HT3, Dopamine)
2) Cell damage of GI tract, serotonin releases, activate 5-HT3 receptors, send impulse to
medulla, stimulate vomiting centre
, CINV medications—ANSWER--1) Dopamine antagonist- Metoclopramide
2) 5-HT3 antagonist- Ondansetron
3) Corticosteroid- Dexamthasone
Myelosuppression leads to immunosuppression—ANSWER--Anaemia, Neutropenia,
Thrombocytopenia
Grade I and II oral mucositis—ANSWER--Grade I: painless ulcer, erythema, mild soreness in
absence of lesion
Grade II: painful ulcer, erythema, edema but can eat & shallow
Grade III and IV oral mucositis—ANSWER--Grade III: painful ulcer, erythema, edema
requiring IV hydration
Grade IV: severe ulceration, require parenteral nutritional support/ prophylactic intubation
Good mouth care—ANSWER--1) Avoid spirits & spices
2) use soft toothbrush & alcohol-free mouthwash
3) Maintain oral hygiene
Management of oral mucositis—ANSWER--1) Soluble aspirin/ paracetamol for pain relief
2) Protective gels, antibiotics
Alopecia—ANSWER--Cytotoxic drug attacks rapidly dividing hair matrix cells
Characteristics of Vegetative intermitotic VIM and Differentiating inter mitotic DIM—
ANSWER--VIM: divide regularly & rapidly, undifferentiated (erythroblasts)
DIM: divide actively, more differentiated (myelocytes)
© 2026 Copyright. All Rights Reserved. This document is
protected by copyright law, Copyrighted By Brittie Donald
Chemotherapy common side effects—ANSWER--Physical pain, Extravasation, Systemic effects
Cytotoxic agents include 2 types—ANSWER--Vesicant: severe & irreversible damage, resulting
in necrosis;
Irritant: local inflammation, unlikely to cause permanent damage
Extravasation injury depends on—ANSWER--Type, Concentration & Quantity (Leakage &
Involuntary injection)
Need adequate guideline, training & correct treatment
Central/ Hickman—ANSWER--Allow for multiple administration, single insertion under
anesthesia & painless during infusion
Hickman line destination—ANSWER--Superior vena cava near right atrium
Hickman line complication—ANSWER--Hemorrhage, thrombosis, infection
4 major systemic effects—ANSWER--Nausea & Vomiting, Myelosuppression, Mucositis, Hair
loss
Mechanism of CINV—ANSWER--1) Direct activation of medullary chemoreceptor trigger
zone (5-HT3, Dopamine)
2) Cell damage of GI tract, serotonin releases, activate 5-HT3 receptors, send impulse to
medulla, stimulate vomiting centre
, CINV medications—ANSWER--1) Dopamine antagonist- Metoclopramide
2) 5-HT3 antagonist- Ondansetron
3) Corticosteroid- Dexamthasone
Myelosuppression leads to immunosuppression—ANSWER--Anaemia, Neutropenia,
Thrombocytopenia
Grade I and II oral mucositis—ANSWER--Grade I: painless ulcer, erythema, mild soreness in
absence of lesion
Grade II: painful ulcer, erythema, edema but can eat & shallow
Grade III and IV oral mucositis—ANSWER--Grade III: painful ulcer, erythema, edema
requiring IV hydration
Grade IV: severe ulceration, require parenteral nutritional support/ prophylactic intubation
Good mouth care—ANSWER--1) Avoid spirits & spices
2) use soft toothbrush & alcohol-free mouthwash
3) Maintain oral hygiene
Management of oral mucositis—ANSWER--1) Soluble aspirin/ paracetamol for pain relief
2) Protective gels, antibiotics
Alopecia—ANSWER--Cytotoxic drug attacks rapidly dividing hair matrix cells
Characteristics of Vegetative intermitotic VIM and Differentiating inter mitotic DIM—
ANSWER--VIM: divide regularly & rapidly, undifferentiated (erythroblasts)
DIM: divide actively, more differentiated (myelocytes)
© 2026 Copyright. All Rights Reserved. This document is
protected by copyright law, Copyrighted By Brittie Donald
