Oncology Quiz #1

Question 1 of 10

1

A 78-year-old patient with small cell lung cancer is ready to begin cycle 2 of cisplatin 80 mg/m2 intravenously on day 1 and etoposide 80 mg/m2/day intravenously on days 1–3. His laboratory values are creatinine 1.4 mg/dl with an estimated creatinine clearance of 40 mL/minute. Which will require a dose reduction?

Select one of the following:

Cisplatin
Etoposide
Cisplatin and etoposide
No dose reduction needed

Explanation

Question 2 of 10

1

Large cell lymphoma is considered intermediate (between indolent and highly aggressive) in tumor growth and biology. Large cell lymphoma is sensitive to chemotherapy and potentially curable. Metastatic colorectal cancer is considered slow growing. Although responses to chemotherapy commonly occur and chemotherapy can prolong survival (by months), metastatic colorectal cancer is not generally considered curable with chemotherapy. Based on these differences between large cell lymphoma and metastatic colorectal cancer, which one of the following statements is most accurate?

Select one of the following:

Patients with large cell lymphoma should receive allopurinol beginning before the first cycle of chemotherapy because they are at an increased risk of developing tumor lysis syndrome.
Patients with metastatic colorectal cancer should receive allopurinol beginning before the first cycle of chemotherapy because they are at an increased risk of developing TLS
Patients with large cell lymphoma should receive pamidronate beginning before the first cycle of chemotherapy because they are at an increased risk of developing hypercalcemia.
Patients with metastatic colorectal cancer should receive pamidronate beginning before the first cycle of chemotherapy because they are at an increased risk of developing hypercalcemia.

Explanation

Question 3 of 10

1

A 63-year man with metastatic prostate cancer presents to the emergency department with severe bone pain (pain rating 9 on a 10-point scale). He has been taking acetaminophen 650 mg orally every 6 hours around the clock at home without much pain relief.

Select one of the following:

Increase the frequency of acetaminophen to every 4 hours around the clock.
Discontinue acetaminophen and order a fentanyl transdermal patch to be changed once every 72 hours.
Continue the current acetaminophen dose and add gabapentin orally twice daily
Discontinue acetaminophen and order morphine immediate release orally every 6 hours around the clock

Explanation

Question 4 of 10

1

A 62-year-old man recently received a diagnosis of hepatocellular carcinoma. He will be initiated on sorafenib 400 mg twice daily. Which one of the following treatment recommendations is most appropriate regarding this patient's therapy?

Select one of the following:

This patient should receive lorazepam as part of his antiemesis regimen to prevent anticipatory nausea/vomiting.
This patient should receive antiemesis prophylaxis including aprepitant, palonosetron, and dexamethasone because this is a highly emetogenic regimen.
This patient should not receive antiemesis prophylaxis because this oral chemotherapy agent causes minimal to low nausea/vomiting, but he should be assessed for potential drug interactions with other medications.
This patient should receive antiemesis prophylaxis because this is a moderate emetogenic regimen.

Explanation

Question 5 of 10

1

A 57-year-old woman was recently given a diagnosis of non-Hodgkin lymphoma. She is treated with six cycles of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). At her most recent treatment, she developed a red, swollen area around her intravenous site while being administered vincristine. Which one of the following statements is most appropriate?

Select one of the following:

The patient is experiencing an extravasation from vincristine. Treatment with amifostine should be initiated.
The patient is experiencing a hypersensitivity reaction to vincristine. This agent should be discontinued immediately.
The patient is experiencing an extravasation from vincristine. Heat therapy should be initiated.
The patient is experiencing an extravasation from vincristine. Treatment with dexrazoxane should be initiated.

Explanation

Question 6 of 10

1

A 71-year old man has metastatic castrate-resistent prostate cancer. The main site of metastatic disease is the bone (femur lesion). On reviewing his chart, the oncologist notes that the patient has a history of falls and he has chronic kidney disease (creatinine clearance of 35 ml/minute). Because of his increased risk of fractures, the physician would like to initiate a medication to decrease his risk of SREs (skeletal-related events). Which treatment recommendation is most appropriate regarding this patient’s therapy?

Select one of the following:

Initiate Zoledronic acid 4 mg intravenously
Initiate Zoledronic acid 8 mg intravenously
Initiate denosumab 60 mg subcutaneously
Initiate denosumab 120 mg subcutaneously

Explanation

Question 7 of 10

1

If GE had an echocardiogram indicating an ejection fraction (EF) of 35% prior to initiation of the dose-dense portion of the doxorubicin and cyclophosphamide (AC) chemotherapy regimen, which of the following is correct?

Select one of the following:

She should proceed with chemotherapy as scheduled with no need to monitor her EF
She should proceed with chemotherapy as scheduled and her EF should be monitored at least once every 3 months
She should receive chemotherapy with a non-anthracycline-containing regimen
She should not receive chemotherapy of any type until her EF improves

Explanation

Question 8 of 10

1

GE comes to the clinic one week after 3 cycles of doxorubicin and cyclophosphamide, and you are alerted by the lab that her INR today is 4. After talking to GE who is having no significant bruising or bleeding, you determine that the probable cause of her INR elevation is her:

Select one of the following:

3 days of nausea and vomiting after chemotherapy
Initiation of ondansetron for nausea management
Drug-drug interaction with chemotherapy
Initiation of lorazepam for nausea treatment

Explanation

Question 9 of 10

1

Which of the following prophylactic antiemetic therapies should GE receive prior to her first dose of weekly paclitaxel?

Select one of the following:

Ondansetron 8 mg orally 30 minutes prior to chemotherapy
Ondansetron 8 mg orally and dexamethasone 12 mg orally 30 minutes prior to chemotherapy
Ondansetron 8 mg orally and fosaprepitant 150 mg IV 30 minutes prior to chemotherapy
No prophylactic therapy is required before paclitaxel

Explanation

Question 10 of 10

1

GE called into the clinic to report breakthrough nausea and vomiting with two episodes of emesis (although she denies dehydration) after receiving dose-dense doxorubicin and cyclophosphamide (AC) yesterday. She received appropriate prophylaxis with a neurokinin-NK1 antagonist (fosaprepitant 150 mg IV on day 1), 5HT3 antagonist (ondansetron 8 mg IV on day 1), and corticosteroid (dexamethasone 12 mg IV on day 1 followed by 4 mg orally twice daily on days 2-4). Which of the following would you recommend to treat her breakthrough nausea and vomiting?

Select one of the following:

Add aprepitant 80 mg orally once daily
Add palonosetron 0.25 mg IV X 1 in clinic
Add prochlorperazine 10 mg orally every 6 hours
Increase her oral dexamethasone dose to 10 mg twice daily

	Created by Mostapha Abdelkader over 8 years ago