Which statement best reflects the log-kill model of tumour growth?
Growth fraction of a tumour is constant, therefore, you cannot lower the dose and you can't get to zero cells because you're always killing a certain percentage.
Growth fraction of a tumour is not constant, therefore, dosing will be influenced by whether the tumour is in the early or late stage of growth.
The log-kill model is probably more accurate than the Gompertizian model because the log-kill model takes cell resistance into account.
The log-kill model only applies to terminal cancers.
What are the four most common sites of metastasis?
Lung, liver, bone, and brain
Lung, liver, spleen, and bone
Liver, bone, lymph nodes, and spleen
Spleen, lymph nodes, brain, and colon
You are caring for a client with primary colon cancer. You read on his chart that he is T1, N1, M0. You know that the TNM staging system stands for:
tumour size, nodal involvement, and metastases
tumour size, nuclear (cell division rate), and metastases
toxicity, nodal involvement, and metastases
tumour size, nuclear differentiation, and metasteses
What are the two elements that are taken into account when grading a cancer?
How differentiated the cancer cells are (well differentiated = low grade) and how quickly cells are dividing (slower = low grade)
The size of the tumour and the nodal involvement (regional spread)
How quickly the cells are dividing and the nodal involvement
The degree of aggressiveness of the tumour and how rapidly the cells are dividing
You are caring for a 43-year-old premenopausal woman with metastatic breast cancer. Which of the following cytotoxic agents is going to be most important in her treatment plan?
Tamoxifen
Aromatase inhibitors
Corticosteroids
Vinca alkaloids
You are caring for a 58-year-old male patient with testicular carcinoma. He is prescribed Etoposide, which is an epipodophyllotoxin. This drug is...
A cell-cycle specific drug, meaning it does not affect cells in G0 (resting stage).
A cell-cycle non-specific drug, meaning it affects cells at all stages of cell growth cycle.
A drug that is only effective for slow growing tumours.
A drug that works by targeting specific antigens on the cell surface, thereby blocking cell signaling and making cells more visible to the immune system.
You are caring for a 30-year-old female patient diagnosed with Hodgkin's Lymphoma. She is prescribed Doxorubicin, which is an antitumour antibiotic. Which statement most accurately describes the action of this drug?
It is a cell cycle non-specific drug that binds with DNA and interferes with the action of topoisomerase II.
It is a cell cycle specific drug that binds with DNA and interferes with the action of topoisomerase II.
It is a cell cycle non-specific drug that interferes with DNA replication through binding and cross-linking.
It is a highly toxic biologic response modifier that is only approved for experimental use.
You are caring for a 72-year-old male with bladder cancer. He is being given adjuvant therapy of BCG vaccine. Which statement most accurately describes the BCG vaccine?
It is a biologic response modifier (immunostimulant) that is given as an in situ instillation.
It is an antitumor antibiotic that binds with DNA and interferes with the action of topoisomerase II.
It is an antimetabolite that is effective for high growth fraction tumours.
It is a targeted therapy that has a controversial risk-benefit profile.
Which of the following statements best describes monoclonal antibodies?
A type of targeted therapy that interacts with specific antigens on the cell surface to block cell signalling and make cells more visible to the immune system.
A type of targeted therapy that crosses the cell membrane and interferes with enzymatic activity of target proteins.
A type of cell cycle non-specific drug that interferes with DNA replication via binding and cross-linking.
A type of cell cycle non-specific drug that binds with DNA and interferes with the action of topoisomerase II.
You are caring for a 45-year-old female patient with breast cancer. She is prescribed Trastuzumab. Which statement best describes this drug?
It works against HER2 to inhibit cell proliferation and stimulate apoptosis. The main side effect is cardiotoxicity.
It works against HER2 to inhibit cell proliferation and stimulate apoptosis. The main side effect is increased risk of thrombosis.
It binds to VEGF (vascular endothelial growth factor) receptors to inhibit tumour growth. The main side effect is risk of hemorrhage.
It binds to VEGF (vascular endothelial growth factor) receptors to inhibit tumour growth. The main side effect is cardiotoxicity.
What is the main draw back of using monoclonal antibodies, such as Cetuximab, Trastuzumab, and Bevacizumab?
These drugs can only be administered via the parenteral route.
These drugs have a controversial risk/benefit profile and are highly toxic.
These drugs all decrease neutrophils and platelets.
These drugs all come with the risk of cardiotoxicity.
You are caring for a 64-year-old male with chronic myeloid leukemia (CML). Which of the following drugs will he mostly likely be taking?
Imatinib
Trastuzumab
Bevacizumab
Cetuximib
Which of the following is the main side effect of Imatinib (small molecule drug, targeted therapy)?
Neutropenia and thrombocytopenia
Cardiotoxicity
Increased risk of thrombosis
Interstitial lung disease
You are caring for a patient who is experiencing nausea two days after receiving chemotherapy. What therapy will be most effective for this patient?
Gravol
Lorazepam
Prochlorperazine
Pharmacologic treatment will be ineffective for this patient because this is a case of delayed nausea, which is very difficult to treat
A patient is experiencing severe nausea and vomiting 12 hours after chemotherapy. Which treatment will be most effective for this patient?
Dexamethasone
Ginger chews
You are caring for a 64-year-old male patient with chronic myeloid leukemia. He is receiving Imatinib (small molecule drug) as part of his treatment. He calls the cancer centre and reports a temperature of 38.5 degrees C and abdominal pain. What is the likely cause of his symptoms?
Febrile neutropenia
Anemia
Thrombocytopenia
Hyper-sensitivity reaction
You are caring for a patient who has developed febrile neutropenia (FNE) as a result of their cancer therapy. This patient asks you how this will impact their course of treatment going forward. What is the best response?
"This is a normal part of the treatment process. The neutropenia will resolve on it's own before your next round of chemotherapy."
"Your oncologist will discuss the next steps with you. She may recommend that we decrease the dose of your next round of chemotherapy. Or, if she decides that the dose will stay the same, she may suggest that you be given a drug called Filgrastim prior to your next round of chemotherapy to prevent you from developing FNE again."
"It is very important that you increase the amount of iron-rich foods you are eating so that your body can heal before the next round of chemotherapy."
"Unfortunately, febrile neutropenia is a common side effect of some drugs. Your physician will likely prescribe an antibiotic for you to prevent infection before your next round of chemotherapy."
Your patient has been prescribed prophylactic Filgrastim (g-CSF) before his next round of chemo. Your patient has forgotten what this drug is for. What is the most appropriate explanation that you can offer to your patient?
"Filgrastim is a drug used to prevent patients from developing febrile neutropenia, which is a condition that increases your risk of infection. It stimulates the production and release of certain cells (neutrophils) from your bone marrow. Therefore, a side effect of this drug is that you may experience some bone pain."
"Filgrastim is a drug that is given as an injection. It stimulates your bone marrow to produce red blood cells."
"You will have to phone your physician and ask him or her to explain to you again why you were prescribed that drug."
"Filgrastim will alter the way that the chemotherapy is metabolized in your body. It will prevent you from developing side effects, such as febrile neutropenia."
Your patient has developed anemia as a side effect of chemotherapy. Select all appropriate treatments:
rest
oxygen therapy
RBC transfusion
epoetin alpha
filgrastim
You are administering a drug via infusion. The patient calls you over to report that they feel aching and tightness around the IV site. You notice some red streaking. What should you do first?
Stop the infusion, leave needle in place, and aspirate
Stop the infusion, remove the needle, and monitor the patient closely
Immediately refer to the extravasation kit available in the clinic
Continue the infusion. This is a typical reaction to certain chemotherapies.
