AOCNP Test Review – questions
and correct solutions
Treatments that place individuals at increased risk for infection
- ANS-Chemotherapy treatments including high-dose
cyclophosphamide, doxorubicin, docetaxel, or alemtuzumab.
Colony stimulating factors (CSF) - ANS-**GM-CSF : growth
factor for hematopoietic stem cells and granulocyte/monocytes
**M-CSF (macrophage): essential for macrophage production
**G-CSF (granulocyte) :essential for neutrophils
**Erythropoietin (EPO): growth factor for RBC
Filgrastim (Neupogen)
Pegfilgrastim (Neulasta)
,Tbo-filgrastim (Granix) - ANS-Common side effects: mild to
moderate bone pain
Used to patients at risk of experiencing treatment induced
neutropenia
Major benefit: reducing the possibility of myelosuppression and
permitting the continuation of therapeutic chemotherapy
doses
Filgrastim (Neupogen) - ANS-Dose: 5 µg per kilogram per day.
Begin 24 to 72 hours after completion of chemotherapy and
continue through the post nadir period.
Pegfilgrastim (Neulasta) - ANS-That was: 6 mg per cycle. Again 1
to 3 days post chemotherapy. Administer as a single 6 mg
injection once per cycle. Do not administer in the period
beginning 14 days before until 24 hours after administration of
chemotherapy.
Antimicrobial prophylaxis for infection - ANS-Low risk: no
prophylaxis Recommended unless the patient has prior herpes
simplex virus episode.
Intermediate risk:
,Bacterial: consider Fluoroquinolone
Fungal: consider fluconazole during neutropenia and if
mucositis is anticipated
Viral: during neutropenia and at least 30 days after
transplantation
High risk:
Bacterial: consider fluoroquinolone
Fungal: consider fluconazole or other anti-fungal agent
Viral: during neutropenia and at least 30 days after
transplantation
Graft versus host disease: penicillin
andtrimethroprim/sulfamethoxazole (tmp/smx) Or equivalent
for allogenic heamatopoetic Stem cell transplant recipients
Alemtuzumab: TMP/SMX
Complete diagnostic work up for neutropenic fever - ANS-Blood
cultures: bacterial, viral, and fungal
BUN, electrolytes, and creatinine
Chest x-ray
CBC and differential
Liver function test
, Pulse oximetry
Site-specific cytology and cultures
Urinanalysis
ANC calculation - ANS-WBC x [(% segs + % bands)/100]
aplastic anemia - ANS-a normocytic-normochromic type of
anemia characterized by the failure of bone marrow to produce
red blood cells
hemolytic anemia - ANS-characterized by an inadequate
number of circulating red blood cells due to the premature
destruction of red blood cells by the spleen
deficiency anemia - ANS-anemia caused by lack of necessary
nutrients
B12, folate, and iron
Anemia # of RBC/ MCV - ANS-Microcytic. Normocytic.
Macrocyctic.
and correct solutions
Treatments that place individuals at increased risk for infection
- ANS-Chemotherapy treatments including high-dose
cyclophosphamide, doxorubicin, docetaxel, or alemtuzumab.
Colony stimulating factors (CSF) - ANS-**GM-CSF : growth
factor for hematopoietic stem cells and granulocyte/monocytes
**M-CSF (macrophage): essential for macrophage production
**G-CSF (granulocyte) :essential for neutrophils
**Erythropoietin (EPO): growth factor for RBC
Filgrastim (Neupogen)
Pegfilgrastim (Neulasta)
,Tbo-filgrastim (Granix) - ANS-Common side effects: mild to
moderate bone pain
Used to patients at risk of experiencing treatment induced
neutropenia
Major benefit: reducing the possibility of myelosuppression and
permitting the continuation of therapeutic chemotherapy
doses
Filgrastim (Neupogen) - ANS-Dose: 5 µg per kilogram per day.
Begin 24 to 72 hours after completion of chemotherapy and
continue through the post nadir period.
Pegfilgrastim (Neulasta) - ANS-That was: 6 mg per cycle. Again 1
to 3 days post chemotherapy. Administer as a single 6 mg
injection once per cycle. Do not administer in the period
beginning 14 days before until 24 hours after administration of
chemotherapy.
Antimicrobial prophylaxis for infection - ANS-Low risk: no
prophylaxis Recommended unless the patient has prior herpes
simplex virus episode.
Intermediate risk:
,Bacterial: consider Fluoroquinolone
Fungal: consider fluconazole during neutropenia and if
mucositis is anticipated
Viral: during neutropenia and at least 30 days after
transplantation
High risk:
Bacterial: consider fluoroquinolone
Fungal: consider fluconazole or other anti-fungal agent
Viral: during neutropenia and at least 30 days after
transplantation
Graft versus host disease: penicillin
andtrimethroprim/sulfamethoxazole (tmp/smx) Or equivalent
for allogenic heamatopoetic Stem cell transplant recipients
Alemtuzumab: TMP/SMX
Complete diagnostic work up for neutropenic fever - ANS-Blood
cultures: bacterial, viral, and fungal
BUN, electrolytes, and creatinine
Chest x-ray
CBC and differential
Liver function test
, Pulse oximetry
Site-specific cytology and cultures
Urinanalysis
ANC calculation - ANS-WBC x [(% segs + % bands)/100]
aplastic anemia - ANS-a normocytic-normochromic type of
anemia characterized by the failure of bone marrow to produce
red blood cells
hemolytic anemia - ANS-characterized by an inadequate
number of circulating red blood cells due to the premature
destruction of red blood cells by the spleen
deficiency anemia - ANS-anemia caused by lack of necessary
nutrients
B12, folate, and iron
Anemia # of RBC/ MCV - ANS-Microcytic. Normocytic.
Macrocyctic.
