ONS/ONCC Chemotherapy Immunotherapy Certification Exam | Actual Exam Questions and Answers, Exams of Immunology

Download ONS/ONCC Chemotherapy Immunotherapy Certification Exam | Actual Exam Questions and Answers and more Exams Immunology in PDF only on Docsity! ONS/ONCC Chemotherapy Immunotherapy Certification Exam | Actual Exam Questions and Answers | Brand New Version! What 6 patient characteristics make CINV more likely? -Answer✅ 1. Younger than 50 years 2. Hx of low alcohol intake 3. Female gender 4. Hx of morning sickness during pregnancy 5. Prone to motion sickness 6. Previous chemotherapy Types of CINV: -Answer✅ Acute Delayed Breakthrough Anticipatory Refractory Define acute CINV -Answer✅ Occurring within 24 hours of chemotherapy Define delayed CINV -Answer✅ Occurring from 24 hours to 5 days after treatment Define breakthrough CINV -Answer✅ Occurring despite treatment related to chemotherapy Define refractory CINV -Answer✅ Occurring during subsequent cycles when treatment failed in earlier cycles Define neoadjuvant therapy -Answer✅ Treatment given prior to surgery to shrink the tumor Define adjuvant therapy -Answer✅ Additional cancer treatment given after the primary treatment to lower the risk that the cancer reoccur Define conditioning/preparative therapy -Answer✅ Treatments used to prepare a patient for stem cell transplantation 3 major phases of cell division: -Answer✅ Interphase Mitotic phase Cytokinesis 3 steps of interphase: -Answer✅ First growth phase (G1) Synthesis phase (S phase) Second growth phase (G2) 4 phases of mitosis: -Answer✅ Prophase Metaphase Anaphase Telophase Innate immunity: -Answer✅ Non-specific response, either: 1. Barrier (skin, mucous membranes, flora of skin/gut) 2. Cellular components (phagocytes, natural killer cells, granulocytes, macrophages) Define anticipatory CINV -Answer✅ Triggered by taste, odor, memories, visions, or anxiety Instruct pts receiving to avoid exposure to cold air and consuming cold fluids for 3-4 days following treatment -Answer✅ Oxaliplatin How do antimetabolites function? -Answer✅ By blocking DNA and RNA growth by interfering with enzymes needed for normal cell metabolism Antimetabolites work in the phase. -Answer✅ S What types of cells are best affected by antimetabolites? -Answer✅ Cells with high division rates Common side effects of antimetabolites: -Answer✅ Myelosuppression GI toxicities Photosensitivity Hand-foot syndrome Common antimetabolite drugs: -Answer✅ Azacitidine Capecitabine 5-FU Cytarabine Decitabine Methotrexate The institute for Safe Medication Practices recommends what route of administration for vincristine? -Answer✅ IV piggyback via gravity Anthracycline antitumor abx work by: -Answer✅ Interfering with enzymes necessary for DNA to replicate in ALL phases of the cell cycle The two major classifications of antitumor antibiotics are: -Answer✅ Anthracyclines Non-anthracyclines Common anthracycline antitumor abx: -Answer✅ Daunorubicin Doxorubicin Epirubicin Idarubicin The antitumor abx is not an anthracycline, but has anthracycline-type properties. -Answer✅ Mitoxantrone Common non-anthracycline antitumor abx: -Answer✅ Actinomycin D Mitomycin C Bleomycin Monitoring necessary with doxorubicin: -Answer✅ Vesicant --> extravasation Cardiac function Lifetime dose tracking (cardiotoxicity) Lifetime dose of doxorubicin should not exceed: -Answer✅ 550 mg/m^2 What cardiac protectant medication can be administered prior to doxorubicin? -Answer✅ Dexrazoxane Significant side effects of doxorubicin are: -Answer✅ Cardiotoxicity N/V Mucositis Diarrhea Severe myelosuppression Hepatic impairment Secondary cancers Monitoring necessary with bleomycin: -Answer✅ Pulmonary toxicity Hypersensitivity reactions (esp. in lymphoma patients) Cutaneous reactions Lifetime dose tracking (pulmonary toxicity) Pulmonary fibrosis is possible when the lifetime dose of bleomycin exceeds: -Answer✅ 400 units Highly emetogenic chemo (HEC) causes CINV in more than % of patients -Answer✅ 90 Moderately emetogenic chemo (MEC) causes CINV in patients % to % of the time - Answer✅ 30-90 Patients on low-potential emetogenic chemo develop CINV % to % of the time - Answer✅ 10-30 Minimal-risk emetogenic chemo causes CINV less than % of the time -Answer✅ 10 Common IV HEC drugs include: -Answer✅ Carmustine Cisplatin Cyclophosphamide Dacarbazine Mechlorethamine Streptozosin Common IV MEC drugs include: -Answer✅ Carboplatin Cytarabine Daunorubicin Doxorubicin Epirubicin RBCs, WBCs and platelets If severe: myeloablation The most common dose-limiting toxicity of chemotherapy -Answer✅ Myelosuppression Define nadir, and when does it occur? -Answer✅ The point at which blood cell counts are at their lowest following a treatment cycle. Typically occurs 7-10 days following cycle NCCN defines neutropenia as an ANC < /mm^3 -Answer✅ 500 Risk factors for developing neutropenia include: -Answer✅ > 65 years old Hx of neutropenia with previous chemotherapy Hx of chemotherapy or radiation treatment Hematologic malignancy Uncontrolled/advanced cancer Lung cancer Define neutropenic fever -Answer✅ Fever of 101 F or greater one time OR Fever of 100.4 F lasting one hour or longer ANC calculation -Answer✅ (% polys + % bands) x (WBC)/100 Normal WBC count -Answer✅ 4,500-10,000 Define myelosuppression -Answer✅ Bone marrow activity is decreased, resulting in fewer Normal neutrophil count -Answer✅ 54%-62% of WBC An ANC of less that is considered a risk for infection -Answer✅ 1,000 Define thrombocytopenia -Answer✅ Low platelet count Symptoms of thrombocytopenia -Answer✅ Petechiae or easily bruising Headaches Hypotension and tachycardia Prolonged bleeding (gums, menstruation) Define anemia -Answer✅ Deficiency of RBC or hemoglobin in the blood Symptoms of anemia -Answer✅ Dyspnea Fatigue Dizziness Headaches Acute diarrhea lasts: -Answer✅ 1-2 days and resolves on its own Persistent diarrhea lasts: -Answer✅ 2-4 weeks Chronic diarrhea lasts: -Answer✅ > 4 weeks Common constipation-causing agents: -Answer✅ Vinca alkaloids (vincristine and vinorelbine) Thalidomide Lenalidomide Bortezomib from mouth to anus Define stomatitis -Answer✅ Inflammatory conditions of the mouth specifically AKA oral mucositis Define xerostomia -Answer✅ Dryness of the mouth caused by damage to or dysfunction of the salivary glands Common diarrhea-causing agents: -Answer✅ Irinotecan 5-FU Paclitaxel Dactinomycin Capecitabine Hypersensitivity reaction (HSR) versus anaphylaxis -Answer✅ HSR- localized tissue injury; generalized Anaphylaxis- severe inflammatory response; systemic; caused by histamine release Immediate HSR can occur: -Answer✅ Within 5 minutes of start of infusion to 6 hours following infusion Delayed HSR can occur: -Answer✅ Days or weeks after immediate HSR window Risk factors for HSR and anaphylaxis: -Answer✅ Administration of a known HSR causing agent Hx of allergies Define mucositis -Answer✅ Inflammation of the mucous membranes lining the digestive tract 2 types of aromatase inhibitors -Answer✅ 1. Steroidal (irreversible) 2. Nonsteroidal (reversible) 3 aromatase inhibitors -Answer✅ Anastrozole Letrozole Exemestane Common side effects of aromatase inhibitors (AI): -Answer✅ Fatigue N/V* Weakness HA* Insomnia Dizziness Hot flashes* Weight gain* Higher cholesterol Increased sweating* Bone/joint pain* Selective ER downregulators (SERDs) MOA -Answer✅ Binding to and degrading ER Common SERD -Answer✅ Fulvestrant Selective ER modulators (SERMs) MOA -Answer✅ Blocking and downregulating ERs *Can function as ER agonists, antagonists, or mixed agonist-antagonists *Can activate or block estrogen Common SERMs -Answer✅ Tamoxifen Raloxifine Bazedoxifine Antiandrogens MOA -Answer✅ Keeps androgens from binding to androgen receptors found in prostate cancer cells (and in some other tissue cells) Androgen synthesis inhibitors MOA -Answer✅ Stop the adrenal glands from producing androgens Common androgen synthesis inhibitors -Answer✅ Ketoconazole Aminoglutethimide Abiraterone acetate CYP17 inhibitors MOA -Answer✅ Inhibit the key enzyme that catalyzes biosynthesis of androgens from all sources Common CYP17 inhibitors -Answer✅ Abiraterone Orteronel Adrenolytic agents MOA -Answer✅ Suppress testicular and adrenal steroidogenesis, rapidly reducing testosterone levels Define receptor -Answer✅ Molecule inside/on surface of a cell that binds to a specific substance and causes a specific effect in that cell Define monomer -Answer✅ Molecule that can be bonded to other identical molecules to form a polymer Define ligand -Answer✅ Molecule that binds to a receptor to exert a biologic effect Define ligand bonding -Answer✅ Process by which ligand attaches to specific receptor site and activates receptor, activating the signaling pathway Define dimerization -Answer✅ 2 monomers that are side-by-side on cell surface are paired and activated by a ligand, which causes a series of signals Define kinase -Answer✅ Enzyme that adds phosphates to other molecules, causing other molecules in the cell to become either active or inactive Define phosphorylation -Answer✅ Activation of a chemical process to initiate signaling Targeted therapies work by: -Answer✅ 1. Blocking angiogenesis 2. Blocking signals inside or outside the cell 3. Delivering toxic substances to the cell 4. Simulating the body's immune system has been described as a way to "fire up the immune system's response to cancer" - Answer✅ Immunotherapy Immunotherapy works by the following 3 ways: -Answer✅ 1. Stopping or slowing the growth of cancer cells 2. Stopping cancer cells from spreading to other parts of the body 3. Helping the immune system recognize cancer cells and increase its effectiveness at eliminating cancer cells What sets immunotherapy apart from traditional chemotherapy? -Answer✅ Highly specific Trained to remember cancer cells Immune checkpoint inhibitors initially cause tumors to swell, making it appear as if the tumor is growing. This is called -Answer✅ Pseudoprogression 2 main types of cancer vaccines -Answer✅ Preventative/prophylactic Treatment/therapeutic Nonspecific immunotherapies MOA -Answer✅ Stimulating the immune system in a general way, hopefully leading to a better immune response against cancer cells Adoptive cell therapy MOA -Answer✅ T cells collected from patient T cells grown in laboratory *This increases amount of T cells able to kill cancer cells or fight infections* T cells given back to patient to help immune system Oncolytic virus therapy MOA -Answer✅ Naturally occurring or genetically engineered virus that can infect and kill a cancer call without harming normal cells Common side effects of immunotherapies -Answer✅ Fatigue Diarrhea Colitis Musculoskeletal pain Dermatitis Common treatment for immunotherapy side effects -Answer✅ Corticosteroids Results of immunotherapy agents most commonly occur between after starting therapy -Answer✅ 12-16 weeks Hierarchy of controls when controlling workplace hazards -Answer✅ Elimination Substitution Engineering controls Administrative controls PPE 4 different types of medication dosing: -Answer✅ 1. Fixed doses 2. Weight-based doses 3. Body surface area (BSA) doses 4. Area under the curve (AUC) doses Lesson 1: Foundations to Set the Stage Focusing on Cellular Structure and Function The Normal Cell Cycle -----CORRECT ANSWER------The cell cycle refers to the ordered seres of processes of DNA replication and mitosis, or cell division -Cell nucleus regulates these processes by gathering and processing complexes molecular information Interphase and Mitotic Phase -----CORRECT ANSWER-----Cell division produces two identical cells through these two major phases During interphase: -----CORRECT ANSWER-----Cell grows and DNA is replicated through the following three steps: 1: First growth phase (G1 or first gap) 2: Synthesis phase (S phase) 3:Mitotic Phse (M phase) First Growth Phase (G1 or first gap) -----CORRECT ANSWER------cells increase in size -reproduce RNA -"quality assurance" test that the cell will be ready to synthesis DNA -Length of time is variable, can be from hours to days Synthesis Phase (S phase) -----CORRECT ANSWER------DNA replicates -Results in the formation of identical pairs of DNA (chromatids) -which are attached a t the centromere -lasts 2-10 hours Mitotic Phase (M phase) -----CORRECT ANSWER------Replicated chromosomes are aligned, separated, and move into 2 new, identical daughter cells -takes about 30-60 minutes Major points of cell regulation are entry and exit from -----CORRECT ANSWER------G1 checkpoint -S Phase -G2 checkpoint -M phase Restriction Point -----CORRECT ANSWER------The transition from the resting phase into an actively dividing phase (G0-G1) is a point where cellular transformation can occur -During this time, cells pass through a transition phase known as a restriction point -Extracellular growth factors trigger reentry into G1, and GF are required to send the cells past the restriction point, or the point of no return G0 Phase (resting phase) -----CORRECT ANSWER------After mitosis, cells may enter back into the G1 phase or go into a resting phase, known as G0 -Most cells in the human body reside in G0 -Exceptions to this are those that are (Resting in G0 phase) -----CORRECT ANSWER------ Exceptions to this are those that are metabollically active, such as -granulocytes -and the epithelium of the GI tract Cell Cycling Time -----CORRECT ANSWER-----Amount of time from mitosis to mitosis (Cellular components such as phagocytes, natural killer cells, granulocytes, and macrophages) 1. Phagocytes 2. Natural Killer Cells 3. Granulocytes 4. Macrophages -----CORRECT ANSWER-----1.Cells that engulf and destroy invader 2. Cells that sense receptors on self and non-self to determine if they should kill or not 3. Type of WBC that have granules (Neutrophils Eosinophils - parasites Basophils - release histamine to stimulate immune response) 4. Large phagocytic cells stimulated by infection Adaptive Immunity -----CORRECT ANSWER------Stimulated if innate immunity is insufficient -leads to immune system memory -Humoral immunity -Cell-mediated immunity -Regulatory T-cells Humoral Immunity -----CORRECT ANSWER------B-Cells -Memory B-Cells -Plasma act to produce immunoglobulins (Igs) or antibodies B-Cell -----CORRECT ANSWER------each one is programmed to make one specific antibody -Can recognize antigens whether they are freely circulating in the blood or attached to surface of a microbe -When dividing, can become plasma cells which will then begin secreting antibodies that are unique to that antigen Plasma Cells -----CORRECT ANSWER------some plasma cells will undergo apoptosis -Some will go to the BM where they will continue to secrete antibodies sometimes for years Cell-Mediated Immunity -----CORRECT ANSWER-----Depends upon cytotoxic T cells and helper T cells and their cyokinds -more effective against antigens within cells Regulatory T-cells AKA suppressor T-Cells -----CORRECT ANSWER-----regulate the immune response to prevent autoimmune reactions and limit inflammatory responses T-Cell -----CORRECT ANSWER------Can only recognize antigens when they are presented to them by "presenting cells" -Recognize phagocytized fragments of an antigen that are put on the surface of antigen- presenting cells Helper T-Cells (CD4+) -----CORRECT ANSWER------help other T-Cells by secreting chemicals -Help B Cells to respond -rapidly divide, in an effort to stay ahead of the antigen dividsion -some will turn into effector cells, which secrete different kinds of cytokines -respond similarly to B-Cells Cytotoxic T-Cells (CD8+) -----CORRECT ANSWER------Directly kill cells for which they are activated to kill -rapidly divide, become mature cells, and start killing antigens Cytokines -----CORRECT ANSWER------Secreted by lymphocytes -Tasked with eliminating the antigen -Multifunctional subsances having proinflammatory, anti-inflammatory, and regulatory functions in the immune system Cytokines Include.. -----CORRECT ANSWER------Interferons (IFNs) -Tumor necrosis factors -Transforming GFs -Interleukins (IL -1, -2, -3, -4, -6, -8, -10, and -15) -These cytokines regulate antibody production and the functions of B and T cells as well as interact with antigen-presenting cells and NKCs Benign Tumors -----CORRECT ANSWER------encapsulated and grow in an orderly manner with smooth edges -Do not invade neighboring tissue -DO not metastasize to distant sites -the cells well differentiated in that they look like the parent cell Characteristics of Cancer Cells -----CORRECT ANSWER------Malignant tumors are not encapsulated -Cell structure is different from parent tissue (no as well differentiated) -Cell division is uncontrolled -Cells are loosely adherent without contact inhibition -Cells are able to invade neighboring tissue -Cells can migrate and metastasize to distant sites -Can stimulate the development of new blood vessels to supply the tumor (angiogenesis) Proto-oncogene -----CORRECT ANSWER------regulate normal cell growth and division -large family of genes that code for proteins and enzymes that turn on the cell cyle Oncogene -----CORRECT ANSWER-----when mistakes in copies of DNA can occur, if a mutation occurs next to a proto-oncogene, it can "turn on" and become a ______ Examples of oncogoenes -----CORRECT ANSWER-----1. EGFR or Erb-B1 (codes for an epidermal GF receptor in the receptor-tyrosine kinase family ad is associated with head and neck and colorectal cancers) -EGFR inhibitor therapies are known to cause cutaneous reactions 2. Erb-B2 or HER2/neu (codes for an EGFR protein in the tyrosine kinase family and is associated with some breast cancers) Tumor suppressor genes -----CORRECT ANSWER------act like brakes in a car, slowing down or stopping cell growth and division Oral Chemotherapy -----CORRECT ANSWER------greater challenge to adherence because the responsibility falls on the pt and caregiver Nonadherence -----CORRECT ANSWER------pt takes too few or too many pills Overadherence -----CORRECT ANSWER------when a pt believes a dose was missed or that "more is better", too much medication may be taken, leading to increased toxicity Factor affecting adherence -----CORRECT ANSWER------provider relationship -side effects -necessity -routinization -support -lifestyle fit -cost -medication knowledge -pill burden -regiment complexity Lesson 2: Alkylating Agents -----CORRECT ANSWER----- Alkylating Agents -----CORRECT ANSWER------function by causing a break in the DNA helix strand, causing interference with DNA replication, which results in cell death Alkylating Agent Subgroups -----CORRECT ANSWER------Nitrogen mustards (cyclophosphamide{Cytoxin}, ifosfamide{Ifex}, bendamustine{Treanda}) -Platinum-based (cisplatin{Planitol}, carboplatin{Paraplatin}): do not possess an alkyl group -nitrosoureas Nitrosoureas -----CORRECT ANSWER------subgroup of alkylating agents -able to cross the blood-brain barrier (effective in treating some brain tumors, melanomas, lymphomas) -Carmustine (BiCNU) -Lomustine (CeeNu) -Streptozocin (Zanosar) -pulmonary monitoring recommended Carboplatin (Paraplatin) -----CORRECT ANSWER------Alkylazing agent -possibility for a hypersensitivity reaction which is rash, urticaria, erythema, pruritis, rarely bronchospasm and hypotensision -notify RN if itching, scratchy throat, difficulty breathing, rash -Blood count, particularly platelets, monitored because thrombocytopenia is a dose- limiting toxicity -Oral dosage: 1-5mg/kg/day Cisplatin (Planitol) -----CORRECT ANSWER------Alkylating agent -nephrotoxic (IV hydration 2-3 L per day) -severe N/V -ovarian and testicular Cyclophosphamide (Cytoxin) -----CORRECT ANSWER------Alkylating agent) -hemorrhagic cystitis (dysuria, hematuria, hemorrhage) -DC treatment if hemorrhagic cystitis -adequate hydration Oxaliplatin -----CORRECT ANSWER------Alkylating agent -irritant and vesicant, extra caution with the IV site -peripheral neuropathy is a dose-limiting side effect (exacerbated by cold temperatures) -avoid cold drinks and foods, wearing gloves and warm shoes -avoid breathing cold air Intrathecal Chemotherapy -----CORRECT ANSWER------injects chemo directly into the subarachnoid space so it reaches the CNS -Often used to treat leukemia and lymphoma that has spread to the CNS since most IV chemo does not cross the blood-brain barrier -only MTX and cytarabine via this route -IT hydrocortisone is often given at the same time to reduce inflammation -MUST be preservative free to avoid CNS irritation Chemotherapy-Induced N/V (CINV) Risk factors -----CORRECT ANSWER------younger -have a hx of low or no alcohol consumption -are female -hx of morning sickness -prone to motion sickness -have had chemo previously Types of CINV -----CORRECT ANSWER------Acute: occurring within 24 hours -Delayed: from 24 hour - 5 days after -Breakthrough: Occurring despite treatment -Anticipatory: triggered by taste, odor, memories, visions, anxiety r/t chemo -Refractory: occurring despite subsequent cycles when treatment failed in earlier cycles Prevention/Treatment of hand foot syndrome -----CORRECT ANSWER------limit exposure of hands and feet to hot water -take cool showers -avoid exposure to sources of heat, such as using saunas or sitting in the sun -avoid activities that cause unnecessary force or friction on the hands or feet, such as running or aerobics -avoid contact with harsh chemicals used in detergents and household cleaning products -avoid activities that require you to press your hand against a hard surface -elevate your hands and feet when sitting or lying down -gently apply skin care creams to keep hands moist -wear loose-fitting, well ventilated shoes Nadir -----CORRECT ANSWER------point at which blood cell counts are at their lowest following treatment -typically, but not always, occurs 7-10 days after the cycle is administered When a vesicant extravasation occurs or is suspected, take the following steps: ----- CORRECT ANSWER-----1. Immediately STOP administering the vesicant and IV fluids 2. Disconnect the IV tubing from the IV device. Do not remove the IV device or noncoring port needle 3. Attempt to aspirate residual vesicant from the IV device or port needling use a small (1- 3 mL) syringe 4. Remove the peripheral IV device or port needle 5. Initiate appropriate management measures Managing Non-DNA Binding Vesicant Extravasation -----CORRECT ANSWER------Vinca Alkaloids (vincristine, vinblastine) -Do not bind to DNA in healthy cells when they extravasate into tissue. Indirect effect on healthy tissue -Treat with heat, elevation, and hyaluronidase local injection (spreads the vesicant through the tissue for faster metabolism of the vesicant agent) -Usually results in less tissue damage -Improves over a short period of time (days to weeks( Management of DNA-Binding Vesicant Extravasation -----CORRECT ANSWER------- Anthracyclines (doxorubicin, epirubicin, daunorubicin, idarubicin) -Binds to DNA in healthy cells when they extravasate into tissue -When not immediately treated with dexrazoxane, the vesicant remains in the tissue and invades adjacent healthy tissue -Likely to result in more tissue damage -Left untreated, extravasations become larger and deeper, worsening over time (weeks to months) Lesson 11: Targeted Therapy -----CORRECT ANSWER----- How targeted therapy and chemo differ -----CORRECT ANSWER------targeted therapies act on specific molecular targets on or within the cells that are associated with cancer, whereas standard chemo act on all rapidly dividing cells -chemo has more SEs -targeted therapy ae chosen and designed to interact with their target on or within the cells, whereas chemo were IDed becaused they kill cells -targeted therapies are often cytostatic (they block tumor cell proliferation) whereas chemo agents are cytotoxic (kill tumor cells) Goals of targeted therapy -----CORRECT ANSWER------disease cure when used as primary or adjuvant therapy -improving overall response or increase disease-free survival when used in combination with conventional therapies -controlling or stabilizing disease -maintaining or enhancing quality of life -decreasing the severity of toxicities from other therapies Receptor -----CORRECT ANSWER------molecule inside or on the surface of a cell that binds to a specific substance causes a specific effect in that cell Monomer -----CORRECT ANSWER-----molecule that can join with other identical monomers to form a structure called a polymer Ligand -----CORRECT ANSWER-----a substance that forms a complex with another biomolecule to exert a biologic effect Ligand Binding -----CORRECT ANSWER-----process by which the ligand attaches to a specific receptor site and activates that receptor, activating the signaling pathway Dimerization -----CORRECT ANSWER-----two monomers that are side-by-side on the surface of the cell are paired and activated by a ligand, which causes a series of signals Kinase -----CORRECT ANSWER-----type of enzyme that adds chemicals called phosphates to other molecules such as sugars or proteins causing other molecules in the cell to become either active or inactive phosphorylation -----CORRECT ANSWER-----activation of a chemical process to initiate signaling targeted therapies work by doing the following -----CORRECT ANSWER-----1. blocking angiogenesis 2. blocking signals inside or outside the cell 3. delivering toxic substances to the cell 4. stimulating the body's immune system BCR/ABL -----CORRECT ANSWER------fusion protein tyrosine kinase formed with a gene translocation occurs between gene 9 and 22 -gene abnormality called the Philadelphia chromosome seen in CML and ALL VEGF -----CORRECT ANSWER-----this is the primary angiogenic factor produced by cells mTOR -----CORRECT ANSWER------target of rapamycin -a protein that tells cells when to grow, divide, and survive Two ways that angiogenesis inhibitors work -----CORRECT ANSWER-----1. some intergere with action of VEGF which stimulates n ew blood vessel formation 2. others target their molecules that stimulate new blood vessel growth Small Molecule Compound Targeted Therapies -----CORRECT ANSWER------end in -ib -targets located inside the cell because these gents are able to enter cells more easily -intracellular -most given orally Monoclonal Antibody Targeted Therapy -----CORRECT ANSWER------ end in -mab -relatively large in size and therefore usually cannot enter cells -extracellular or transmembrane -man made version of antibodies that are designed to attack a very specific target on cancer cells -usually from mice Lesson 12: Immunotherapy -----CORRECT ANSWER----- 2. remove the gown 3. remove the face shield 4. properly dispose 5.remove inner gloves 6. wash hands True statements related to drug dose calculation and administration -----CORRECT ANSWER------the AUC calculation incorporates renal function as part of the equation -Pts who have had previous radiation therapy or chemo are considered special populations with regard to a potential need for dose modification -The AUC calculation is used for carboplatin dosing -Children may metabolize drugs differently than adults; dose modifications are possible What is a monoclonal antibody, and how is it different from chemo? -----CORRECT ANSWER------mAbs are agents that are derived from human or mouse antibodies or a combination of the two -mAbs search out proteins on the cells surface -mAbs recognize and bind to specific anatigens on the cells surface -natural killer cells and/or cytotoxic proteins of the immune system recognize and destroy the marked tumor cells -mAbs can also directly induce cell death as well -One of the biggest differences is that mAbs cause harm only to those cells that are marked or binded - Should I avoid my grandchildren and other family members when I am getting treatment? -----CORRECT ANSWER------it is perfectly safe for you to have contact with your loved ones while getting treatment -Hugging, kissing, and spending time together while eating are all safe activities -Safety with bodily fluids is necessary for the first 48 hours after receiving chemo Can I be intimate with my partner during treatment? -----CORRECT ANSWER------you should definiely check with your HCP first to be sure -traces of chemo may be present in vaginal fluid for up to 48 hours after treatment -use of a barrier is recommended for this reason for at least the first 48 hours