BCOP EXAM LATEST ACTUAL EXAM
QUESTIONS AND CORRECT
DETAILED ANSWERS
If del(5q) is present for MDS, what is the treatment of choice? - Answer- lenalidomide
What is the serum EPO cutoff to give ESAs for low risk MDS? - Answer- 500
What drug cause ubiquitination of remaining alleles of CK1 alpha? - Answer-
lenalidomide
Lenalidomide is used for which specific chromosomal deletion in MDS? - Answer-
del(5q)
Should you use lenalidomide for del(5q) if EPO level is > 500? - Answer- no (response
rate drops to ~10%)
What endpoint did lenalodimide show superiority to placebo in the MDS-004 trial? -
Answer- RBC transfusion independence (56% vs 6%)
Is the response rate to lenalidomide higher or lower for patients with complex karyotype
MDS? - Answer- lower
Is the response rate to lenalidomide higher or lower for patients with high percentage of
bone marrow blasts? - Answer- lower
What type of drug is azacitidine? - Answer- hypomethylating agent
What type of drug is decitabine? - Answer- hypomethylating agent
What 2 drugs are examples of hypomethylating agents? - Answer- azacitidine and
decitabine
How is azacitidine administered for lower-risk MDS? - Answer- SC
How is decitabine administered for lower-risk MDS? - Answer- IV
How many days per 28 day cycle do you give azacitidine for lower-risk MDS? - Answer-
7
How many days per 28 day cycle do you give decitabine for lower-risk MDS? - Answer-
5
,The CALGB9211 trial demonstrated improved response rate, QoL, reduced leukemic
transformation and survival vs supportive care for lower-risk MDS with what drug? -
Answer- azacitidine
What is the dose of azacitidine for lower-risk MDS? - Answer- 75 mg/m2 SC x 7 days
What is the dose of decitabine for lower-risk MDS? - Answer- 20 mg/m2 IV x 5 days
How long do you continue hypomethylating agents for lower-risk MDS? - Answer-
indefinitely
Are TPO agonists indicated in lower-risk MDS? - Answer- no
Are WBC growth factors indicated in lower-risk MDS? - Answer- no
What 2 immunosuppressant agents are used to treat lower-risk MDS? - Answer- horse
ATG and cyclosporine
What drug showed survival advantage of higher-risk MDS compared to conventional
therapy? - Answer- azacitidine
What type of drug can you use as a bridge to transplant for higher-risk MDS? - Answer-
hypomethylating agents
What type of transplant is used for higher-risk MDS? - Answer- allo
What type of drug used in MDS binds and sequesters TGF-beta ligands to inhibit
erythropoiesis? - Answer- luspatercept
Do you use luspatercept for MDS with a high or low EPO level? - Answer- high
What is the dose of luspatercept for MDS? - Answer- 1 mg/kg every 3 weeks
Can you titrate up the dose of luspatercept for MDS? - Answer- yes
Can you use luspatercept for patients who have failed ESAs for MDS? - Answer- yes
Does luspatercept alter the progression of MDS to AML? - Answer- no
What drug led to a significant increase in the number of patients that were transfusion
independent at 8 weeks vs placebo in the Medalist trial? - Answer- luspatercept
How many blasts in blood or bone marrow are required for diagnosis of AML? - Answer-
20%
,What are the 4 cytogenic abnormalities that automatically qualify you for an AML
diagnosis regardless of blast percentage? - Answer- t(15;17), inv(16), t(16;16), t(8;21)
What cytogenetic abnormality is also known as the PML-RARA gene fusion? - Answer-
t(15;17)
What cytogenetic abnormality is characteristic of APML? - Answer- t(15;17)
Is inv(16) considered favorable, intermediate, or poor risk for AML? - Answer- favorable
Is t(16;16) considered favorable, intermediate, or poor risk for AML? - Answer- favorable
Is t(8;21) considered favorable, intermediate, or poor risk for AML? - Answer- favorable
Are core binding factor abnormalities considered favorable, intermediate, or poor risk for
AML? - Answer- favorable
What are the 3 core binding factor abnormalities in AML? - Answer- inv(16), t(16;16),
t(8;21)
Is t(9;11) considered favorable, intermediate, or poor risk for AML? - Answer-
intermediate
Are more than 3 chromosomal abnormalities considered favorable, intermediate, or
poor risk for AML? - Answer- poor
Is monosomal karyotype considered favorable, intermediate, or poor risk for AML? -
Answer- poor
Is del(5q) considered favorable, intermediate, or poor risk for AML? - Answer- poor
Is del(17)p considered favorable, intermediate, or poor risk for AML? - Answer- poor
Is inv(3) or GATA2 considered favorable, intermediate, or poor risk for AML? - Answer-
poor
Are KMT2A rearrangements other than t(9;11) considered favorable, intermediate, or
poor risk for AML? - Answer- poor
Does favorable, intermediate, or poor risk AML have a 5-year OS of 50 - 80%? -
Answer- favorable
Does favorable, intermediate, or poor risk AML have a 5-year OS of 30 - 40%? -
Answer- intermediate
, Does favorable, intermediate, or poor risk AML have a 5-year OS of 5 - 20%? - Answer-
poor
Is the majority of breast cancer hormone positive or negative? - Answer- positive
Are ovaries the main source of estrogen in premenopausal or postmenopausal women?
- Answer- premenopausal
What class of drug is tamoxifen in? - Answer- SERM
Is tamoxifen an agonist or antagonist in breast tissue? - Answer- antagonist
Is tamoxifen an agonist or antagonist in vaginal tissue? - Answer- antagonist
Is tamoxifen an agonist or antagonist in endometrium? - Answer- agonist (causes
increased hyperplasia)
Is tamoxifen an agonist or antagonist in bone? - Answer- agonist (strengthens bone in
postmenopause)
Is tamoxifen an agonist or antagonist in the coagulation system? - Answer- agonist
(increases VTEs)
Is tamoxifen an agonist or antagonist in liver tissue? - Answer- agonist (decreases
lipids)
What 2 tissues does tamoxifen act as an antagonist for? - Answer- breast and vaginal
What 4 tissues does tamoxifen serve as an agonist for? - Answer- endometrium, bone,
coagulation system, and liver
What type of drug is raloxifene? - Answer- SERM
What type of drug is toremifene? - Answer- SERM
Is raloxifene an agonist or antagonist in breast tissue? - Answer- antagonist
Is raloxifene an agonist or antagonist in endometrial tissue? - Answer- antagonist
Is raloxifene an agonist or antagonist in bone? - Answer- agonist
Is raloxifene an agonist or antagonist in the coagulation system? - Answer- agonist
Is raloxifene an agonist or antagonist in the liver? - Answer- agonist
What 2 tissues is raloxifene an antagonist for? - Answer- breast and endometrial
QUESTIONS AND CORRECT
DETAILED ANSWERS
If del(5q) is present for MDS, what is the treatment of choice? - Answer- lenalidomide
What is the serum EPO cutoff to give ESAs for low risk MDS? - Answer- 500
What drug cause ubiquitination of remaining alleles of CK1 alpha? - Answer-
lenalidomide
Lenalidomide is used for which specific chromosomal deletion in MDS? - Answer-
del(5q)
Should you use lenalidomide for del(5q) if EPO level is > 500? - Answer- no (response
rate drops to ~10%)
What endpoint did lenalodimide show superiority to placebo in the MDS-004 trial? -
Answer- RBC transfusion independence (56% vs 6%)
Is the response rate to lenalidomide higher or lower for patients with complex karyotype
MDS? - Answer- lower
Is the response rate to lenalidomide higher or lower for patients with high percentage of
bone marrow blasts? - Answer- lower
What type of drug is azacitidine? - Answer- hypomethylating agent
What type of drug is decitabine? - Answer- hypomethylating agent
What 2 drugs are examples of hypomethylating agents? - Answer- azacitidine and
decitabine
How is azacitidine administered for lower-risk MDS? - Answer- SC
How is decitabine administered for lower-risk MDS? - Answer- IV
How many days per 28 day cycle do you give azacitidine for lower-risk MDS? - Answer-
7
How many days per 28 day cycle do you give decitabine for lower-risk MDS? - Answer-
5
,The CALGB9211 trial demonstrated improved response rate, QoL, reduced leukemic
transformation and survival vs supportive care for lower-risk MDS with what drug? -
Answer- azacitidine
What is the dose of azacitidine for lower-risk MDS? - Answer- 75 mg/m2 SC x 7 days
What is the dose of decitabine for lower-risk MDS? - Answer- 20 mg/m2 IV x 5 days
How long do you continue hypomethylating agents for lower-risk MDS? - Answer-
indefinitely
Are TPO agonists indicated in lower-risk MDS? - Answer- no
Are WBC growth factors indicated in lower-risk MDS? - Answer- no
What 2 immunosuppressant agents are used to treat lower-risk MDS? - Answer- horse
ATG and cyclosporine
What drug showed survival advantage of higher-risk MDS compared to conventional
therapy? - Answer- azacitidine
What type of drug can you use as a bridge to transplant for higher-risk MDS? - Answer-
hypomethylating agents
What type of transplant is used for higher-risk MDS? - Answer- allo
What type of drug used in MDS binds and sequesters TGF-beta ligands to inhibit
erythropoiesis? - Answer- luspatercept
Do you use luspatercept for MDS with a high or low EPO level? - Answer- high
What is the dose of luspatercept for MDS? - Answer- 1 mg/kg every 3 weeks
Can you titrate up the dose of luspatercept for MDS? - Answer- yes
Can you use luspatercept for patients who have failed ESAs for MDS? - Answer- yes
Does luspatercept alter the progression of MDS to AML? - Answer- no
What drug led to a significant increase in the number of patients that were transfusion
independent at 8 weeks vs placebo in the Medalist trial? - Answer- luspatercept
How many blasts in blood or bone marrow are required for diagnosis of AML? - Answer-
20%
,What are the 4 cytogenic abnormalities that automatically qualify you for an AML
diagnosis regardless of blast percentage? - Answer- t(15;17), inv(16), t(16;16), t(8;21)
What cytogenetic abnormality is also known as the PML-RARA gene fusion? - Answer-
t(15;17)
What cytogenetic abnormality is characteristic of APML? - Answer- t(15;17)
Is inv(16) considered favorable, intermediate, or poor risk for AML? - Answer- favorable
Is t(16;16) considered favorable, intermediate, or poor risk for AML? - Answer- favorable
Is t(8;21) considered favorable, intermediate, or poor risk for AML? - Answer- favorable
Are core binding factor abnormalities considered favorable, intermediate, or poor risk for
AML? - Answer- favorable
What are the 3 core binding factor abnormalities in AML? - Answer- inv(16), t(16;16),
t(8;21)
Is t(9;11) considered favorable, intermediate, or poor risk for AML? - Answer-
intermediate
Are more than 3 chromosomal abnormalities considered favorable, intermediate, or
poor risk for AML? - Answer- poor
Is monosomal karyotype considered favorable, intermediate, or poor risk for AML? -
Answer- poor
Is del(5q) considered favorable, intermediate, or poor risk for AML? - Answer- poor
Is del(17)p considered favorable, intermediate, or poor risk for AML? - Answer- poor
Is inv(3) or GATA2 considered favorable, intermediate, or poor risk for AML? - Answer-
poor
Are KMT2A rearrangements other than t(9;11) considered favorable, intermediate, or
poor risk for AML? - Answer- poor
Does favorable, intermediate, or poor risk AML have a 5-year OS of 50 - 80%? -
Answer- favorable
Does favorable, intermediate, or poor risk AML have a 5-year OS of 30 - 40%? -
Answer- intermediate
, Does favorable, intermediate, or poor risk AML have a 5-year OS of 5 - 20%? - Answer-
poor
Is the majority of breast cancer hormone positive or negative? - Answer- positive
Are ovaries the main source of estrogen in premenopausal or postmenopausal women?
- Answer- premenopausal
What class of drug is tamoxifen in? - Answer- SERM
Is tamoxifen an agonist or antagonist in breast tissue? - Answer- antagonist
Is tamoxifen an agonist or antagonist in vaginal tissue? - Answer- antagonist
Is tamoxifen an agonist or antagonist in endometrium? - Answer- agonist (causes
increased hyperplasia)
Is tamoxifen an agonist or antagonist in bone? - Answer- agonist (strengthens bone in
postmenopause)
Is tamoxifen an agonist or antagonist in the coagulation system? - Answer- agonist
(increases VTEs)
Is tamoxifen an agonist or antagonist in liver tissue? - Answer- agonist (decreases
lipids)
What 2 tissues does tamoxifen act as an antagonist for? - Answer- breast and vaginal
What 4 tissues does tamoxifen serve as an agonist for? - Answer- endometrium, bone,
coagulation system, and liver
What type of drug is raloxifene? - Answer- SERM
What type of drug is toremifene? - Answer- SERM
Is raloxifene an agonist or antagonist in breast tissue? - Answer- antagonist
Is raloxifene an agonist or antagonist in endometrial tissue? - Answer- antagonist
Is raloxifene an agonist or antagonist in bone? - Answer- agonist
Is raloxifene an agonist or antagonist in the coagulation system? - Answer- agonist
Is raloxifene an agonist or antagonist in the liver? - Answer- agonist
What 2 tissues is raloxifene an antagonist for? - Answer- breast and endometrial
