Medical Pharmacology: Chemotherapy Practice Questions

Factor(s) influencing/causing oncogenesis:
1. damage to tumor suppressor genes
2. type C RNA viruses
3. both
4. neither
Cancer treatment modality/modalities:
1. chemotherapy
2. surgery
3. radiation
4. B & C
5. A, B & C
Cure rate for cancer (1998):
1. 5%
2. 15%
3. 25%
4. 50%
5. 75%
Cancer type relatively resistant to treatment:
1. diffuse large cell lymphoma
2. Wilm's tumor
3. choriocarcinoma
4. colon cancer
5. testicular cancer
Cancer cell burden associated with widespread disease
1. 10^4 cells
2. 10^6 cells
3. 10^8 cells
4. 10^10 cells
5. 10^12 cells
Characteristic(s)/problem(s) associated with total cancer cell killed:
1. requires ultimate targeting of tumor stem cells
2. some cells may be resistant or may not be accessible to chemotherapeutic agents (such as those in the central nervous system)
3. both
4. neither
Combination chemotherapy:
1. should involve drugs with comparable mechanisms
2. may be used in combination with surgical and radiation intervention
3. should involve drugs with differing toxicity profiles
4. B & C
5. A, B & C
Examples of malignant disorders that are likely curable by a combination chemotherapy:
1. colon cancer
2. testicular cancer
3. both
4. neither
Chemotherapeutic (anticancer) dosing principles:
1. drug should be administered at law or the maximum doses but with increased frequency
2. drug should be administered infrequently to minimize side effects
3. drugs more beneficial if major toxicities are nonoverlapping
4. drugs rarely effective in combination
Characteristics of anticancer alkylating agents (Polly functional):
1. cell-cycle specific
2. example: chlorambucil (Leukeran)
3. both
4. neither
"Secondary" alkylating agent:
1. chlorambucil (Leukeran)
2. mechlorethamine (Mustargen)
3. thiopeta (Thioplex)
4. melphalan (Alkeran)
5. cyclophosphamide (Cytoxan)
Major mechanism of action:polyfunctional alkylating agents
1. alkyl group transfer to mitotic proteins
2. interaction with carboxyl, sulfhydryl, amino, hydroxyl, and phosphate groups of non-nuclear cellular constituents
3. alkylation of DNA
4. B & C
5. A, B & C
Nitrosourea-alkylating agent
1. melphalan (Alkeran)
2. chlorambucil (Leukeran)
3. lomustine (CCNU,CeeNU)
4. cyclophosphamide (Cytoxan)
5. ifofamide (Ifex)
Resistance to anticancer alkylating drugs:
1. associated with decreased glutathione synthesis
2. reduced ability to repair DNA defects
3. reduced cellular drug permeability
4. B & C
5. A & C
Toxicity/toxicities associated with polyfunctional alkylating anticancer drugs:
1. nausea and vomiting
2. bone marrow suppression
3. gonadal toxicity
4. A & B
5. A, B & C
Prodrug-requires activation by microsomal enzyme system:
1. chlorambucil (Leukeran)
2. semustine (methyl CCNU)
3. thiopeta (Thioplex)
4. cyclophosphamide (Cytoxan)
5. mechlorethamine (Mustargen)
Bone marrow suppression is worse when alkylating agents are combined with other myelosuppressive drugs and/or radiation
1. true
2. false
Common long-term consequence of alkylating agent treatment:
1. ovarian failure
2. acute leukemia
3. testicular failure
4. A & C
5. A, B & C
Most useful alkylating agent at present
1. busulfan (Myleran)
2. melphalan (Alkeran)
3. mechlorethamine (Mustargen)
4. cyclophosphamide (Cytoxan)
5. thiopeta (Thioplex)
Oral Route of Administration available:
1. melphalan (Alkeran)
2. busulfan (Myleran)
3. chlorambucil (Leukeran)
4. cyclophosphamide (Cytoxan)
5. all the above
Nitrosoureas:not cross-reactive (with respect to tumor resistance) with other alkylating drugs
1. true
2. false
Major route of elimination for nitrosoureas:
1. hepatic
2. pulmonary
3. renal
Characteristic(s) of nitrosoureas:
1. sparingly lipid-soluble
2. more effective against cells in exponential growth phase
3. acts by cross-linking DNA
4. B & C
5. A, B & C
Most likely to be effective in insulin-secreting islet cell pancreatic carcinoma and sometimes in non-Hodgkin's lymphoma:
1. busulfan (Myleran)
2. mechlorethamine (Mustargen)
3. cyclophosphamide (Cytoxan)
4. streptozocin (Zanosar)
5. thiopeta (Thioplex)
In combination with bleomycin (Blenoxane) and vinblastine (Velban)-curative for nonseminomatous testicular cancer:
1. dacarbazine (DTIC)
2. procarbazine (Matulane)
3. cisplatin (Platinol)
4. altretamine (Hexalen)