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LATEST ONCOLOGY PRACTICE QUESTIONS 2025 -
2026 WITH CORRECT VERIFIED ANSWERS
Major vesicants - correct answer>>anthracyclines, vinca alkaloids Warm compress - correct answer>>vinca alkaloids, etoposide Antidotes for anthracycline extravasation - correct answer>>dexrazoxane or dimethyl sulfoxide Antidotes for vinca extravasation - correct answer>>hyaluronidase agents ok for IT administration - correct answer>>cytarabine, methotrexate, hydrocortisone, thiotepa ESA - correct answer>>erythropoietin, darbepoetin Granix - correct answer>>TBO-filgrastim Neulasta - correct answer>>Pegfilgrastim filgrastim biosimilars - correct answer>>Zarxio, Neupogen CAUTION - correct answer>>Change in bowel/bladder habits, A sore that doesn't heal, Unusual bleeding/discharge, Thickening/lump in breast or elsewhere, Indigestion/difficulty swallowing, Obvious change in wart or mole, Nagging cough or hoarseness leukemia - correct answer>>cancer of WBCs lymphoma - correct answer>>cancer of lymphatic system multiple myeloma - correct answer>>bone marrow cancer sarcoma - correct answer>>cancer of connective tissue carcinoma - correct answer>>cancer starting in skin or tissue lining internal organs screening for breast cancer - correct answer>>yearly mammograms starting at 45 y/o, may screen q2 years at 55 y/o and older
screening for cervical cancer - correct answer>>pap smear q3 years starting at 21 y/o, pap smear + HPV test q5 years at 30 y/o screening for colon cancer - correct answer>>start at 45 y/o, both stool-based tests and visual exams stool-based tests for colon cancer screening - correct answer>>yearly fecal occult blood test (FOBT) or stool DNA test q3 years visual exams for colon cancer screening - correct answer>>colonoscopy q10 years or flexible sigmoidoscopy (FSIG) q5 years requirements for annual CT scan for lung cancer screening - correct answer>>in good health, have at least a 30 pack-year smoking history, still smoking or quit smoking w/i past 15 years max lifetime cumulative dose for bleomycin - correct answer>>400 units d/t pulmonary toxicity max lifetime cumulative dose for doxorubicin - correct answer>> 450 - 550 mg/m2 d/t cardiotoxicity max dose per cycle for cisplatin - correct answer>>100 mg/m2 d/t nephrotoxicity max single dose for vincristine - correct answer>>2 mg per week recommended d/t neuropathy chemo agents that don't cause myelosuppression - correct answer>>asparaginase, bleomycin, vincristine and most TKIs chemo agents that cause N/V - correct answer>>cisplatin, cyclophosphamide, ifosfamide chemo agents that cause mucositis - correct answer>>fluorouracil, capecitabine, irinotecan, methotrexate, TKIs (-nibs) chemo agents that cause diarrhea - correct answer>>fluorouracil, capecitabine, irinotecan, TKIs (sorafenib, sunitinib)
dexrazoxane used as prophylaxis - correct answer>>Zinecard for cardiomyopathy d/t doxorubicin; consider for doxorubicin cumulative dose > 300 mg/m dexrazoxane used as treatment - correct answer>>Totect for extravasation d/t doxorubicin cofactor for fluorouracil - correct answer>>leucovorin or Fusilev Vistogard - correct answer>>uridine triacetate; antidote for fluorouracil or capecitabine to be used w/i 96 hours antidotes for methotrexate - correct answer>>leucovorin, glucarpidase Voraxaze - correct answer>>glucarpidase nadir for WBC and platelets - correct answer>> 7 - 14 days post chemotherapy recovery period for WBC and platelets - correct answer>> 3 - 4 weeks post chemotherapy ANC for neutropenia - correct answer>>< 1000 cells/mm ANC for severe neutropenia - correct answer>>< 500 cells/mm ANC for profound neutropenia - correct answer>>< 100 cells/mm CSF indicated for prevention of febrile neutropenia - correct answer>>G-CSF (filgrastim) and pegylated G-CSF (pegfilgrastim) CSF indicated for stem cell transplantation - correct answer>>GM-CSF (sargramostim) role of CSF in cancer patients - correct answer>>prophylaxis reduce mortality from from infections in patients at high risk of febrile neutropenia dosing for filgrastim - correct answer>>weight-based dose given daily via IV/SC dosing for pegfilgrastim - correct answer>>6 mg SC once per chemo cycle, at least 14 days before next cycle ADRs from G-CSFs - correct answer>>bone pain, fever, glomerulonephritis
ADRs from GM-CSF - correct answer>>fever, bone pain, arthralgias, myalgias, rash, dyspnea, peripheral edema administration period for G-CSF - correct answer>> 24 - 72 hrs after chemo counseling for CSF - correct answer>>store in fridge and protect from light; patient should report any signs of enlarged spleen (i.e. pain in left upper abdomen) febrile neutropenia - correct answer>>oral temp > 38.3 C (101 F) or oral temp > 38.0 C (100.4 F) sustained for > 1 hr with ANC < 500 or ANC expected to decrease to < 500 w/i next 48 hrs low-risk febrile neutropenia - correct answer>>ANC < 500 for 7 days or less, no comorbidities high-risk febrile neutropenia - correct answer>>ANC 100 or less for > 7 days, with comorbidities, or evidence of renal/hepatic impairment empiric antibiotics for low-risk febrile neutropenia - correct answer>>oral anti- pseudomonal agents empiric antibiotics for high-risk febrile neutropenia - correct answer>>IV anti- pseudomonal beta-lactams brands for erythropoietin - correct answer>>Epogen, Procrit, Retacrit brands for darbepoetin - correct answer>>Aranesp requirements for ESA use in cancer patients - correct answer>>avoid in patients under curative treatment, Hgb < 10 g/dL, adequate iron levels, lowest dose to avoid RBC transfusions, anemia caused by chemo in non-myeloid malignancies, at least 2 more months of planned chemo indications for platelet transfusions - correct answer>>plt < 10 kcells/mm3 or 20 if active bleed risk factors for CINV - correct answer>>female, < 50 y/o, dehydration, hx of motion sickness, hx of N/V from prior regimen
Anzemet - correct answer>>dolasetron (only PO used for CINV d/t QT prolongation w/ IV) Aloxi - correct answer>>palonosetron IV CI for 5HT3 RA - correct answer>>avoid use w/ apomorphine (Apokyn) d/t severe hypotension and loss of consciousness Sustol - correct answer>>granisetron SC MoA for DA antagonist for CINV - correct answer>>block DA receptors in chemoreceptor trigger zone of CNS Cesamet - correct answer>>nabilone, C-II Marinol - correct answer>>dronabinol, C-III boxed warning for promethazine - correct answer>>don't use in children < 2 y/o, don't administer via intra-arterial or SC administration, risk of extravasation w/ IV use boxed warning for metoclopramide - correct answer>>possibly irreversible TD boxed warning for droperidol - correct answer>>QT prolongation and serious arrhythmia antimotility agents for CID - correct answer>>loperamide, diphenoxylate + atropine max doses of loperamide - correct answer>>16 mg/day normally, 24 mg/day for CID delayed CID - correct answer>>fluorouracil, capecitabine, irinotecan symptoms of early onset diarrhea from irinotecan - correct answer>>diarrhea, cramping, rhinitis, lacrimation, salivation palmar-plantar erythrodysesthesia - correct answer>>hand-foot syndrome chemo agents that cause hand-foot syndrome - correct answer>>fluorouracil, capecitabine, cytarabine, liposomal doxorubicin
cancers commonly associated with hypercalcemia - correct answer>>breast cancer, lung cancer, multiple myeloma signs, symptoms of hypercalcemia - correct answer>>N/V, fatigue, dehydration, renal failure, mental status changes place of bisphosphonates, denosumab in metastatic disease - correct answer>>prevention of skeletal related events Miacalcin - correct answer>>calcitonin Zometa - correct answer>>zoledronic acid for hypercalcemia, 4 mg IV x1 and repeat in 7 days PRN Reclast - correct answer>>zoledronic acid for osteoporosis, annual 5mg IV Xgeva - correct answer>>denosumab for hypercalcemia, 120mg SC on days 1, 8, 15 of first month then monthly Prolia - correct answer>>denosumab for osteoporosis, 60mg SC q6 months MoA for denosumab - correct answer>>monoclonal antibody that blocks interaction b/w RANKL and RANK vincristine dispensing - correct answer>>don't dispense in syringe to avoid IT administration preferred treatment for breast cancer in postmenopausal women - correct answer>>aromatase inhibitors treatment for breast cancer in men - correct answer>>tamoxifen Selective Estrogen Receptor Modulators (SERMs) - correct answer>>tamoxifen, fulvestrant, raloxifene, toremifene Soltamox - correct answer>>tamoxifen Faslodex - correct answer>>fulvesetrant raloxifene indication - correct answer>>prophylaxis of breast cancer
CDKIs - correct answer>>palbociclib, abemaciclib, ribociclib serious but rare ADRs of tamoxifen to counsel about - correct answer>>endometrial cancer, blood clots, cataracts Evista - correct answer>>raloxifene raloxifene counseling - correct answer>>discontinue at least 72 hrs before and during prolonged immobilization AI contraindications - correct answer>>use with tamoxifen or any estrogen-containing medications castration-resistant prostate cancer (CRPC) - correct answer>>metastatic prostate cancer unresponsive to androgen deprivation therapy (ADT) GnRH agonists abbreviation - correct answer>>gonadotropin releasing hormone agonists, aka LHRH agonists LHRH agonists abbreviation - correct answer>>luteinizing hormone releasing hormone agonsits GnRH agonist MoA - correct answer>>mimic testosterone at hypothalamus to cause negative feedback in testosterone synthesis; need to be given antiandrogens for several weeks at initiation to prevent initial tumor flare in metastatic cancer Lupron Depot - correct answer>>leuprolide IM Eligard - correct answer>>leuprolide SC Zoladex - correct answer>>goserelin GnRH agonists - correct answer>>leuprolide, goserelin, histrelin, triptorelin GnRH agonists used with AI in premenopausal breast cancer - correct answer>>leuprolide, goserelin supplementation in GnRH agonists - correct answer>>calcium, vitamin D to prevent osteoporosis
GnRH agonists ADRs - correct answer>>hot flashes, impotence, gynecomastia, peripheral edema, bone pain, injection site pain, QT prolongation, dyslipidemia, hyperglycemia GnRH antagonist - correct answer>>degarelix Firmagon - correct answer>>degarelix degarelix ADRs - correct answer>>same as GnRH agonists + hypersensitivity reactions 1st generation antiandrogens - correct answer>>bicalutamide, flutamide, nilutamide Casodex - correct answer>>bicalutamide indication for 1st gen antiandrogens - correct answer>>in combo with GnRH agonists to prevent tumor flare 2nd gen antiandrogen - correct answer>>enzalutamide Xtandi - correct answer>>enzalutamide androgen biosynthesis inhibitor MoA - correct answer>>interferes with CYP-17 enzymes involved in biosynthesis of steroid hormones to decrease testosterone production androgen biosynthesis inhibitor - correct answer>>abiraterone; needs to be given with prednisone to prevent hyperaldosteronism commonly used BSA formulas - correct answer>>DuBois and DuBois, Mostellar cell cycle non-specific cytotoxic agents - correct answer>>alkylating agents, platinums, anthracyclines, cell cycle specific cytotoxic agents - correct answer>>vinca alkaloids, taxanes, topoisomerase inhibitors, pyrimidine analogs, folate antimetabolites, alkylating agents - correct answer>>cyclophosphamide, ifosfamide, carmustine, bendamustine, busulfan, melphalan, dacarbazine, procarbazine, altretamine, lomustine, mechlorethamine, temozolomide
docetaxel unique boxed warning - correct answer>>fluid retention, need to premedicate with dexamethasone Abraxane - correct answer>>paclitaxel albumin-bound; no hypersensitivity reaction d/t lack of solvent systems that cause reaction taxane drug interaction - correct answer>>elimination reduced when given after cisplatin/carboplatin; always give taxanes before platinums cytotoxic agents that target S phase - correct answer>>topoisomerase I inhibitors, pyrimidine analogs, folate antimetabolites topoisomerase I inhibitors - correct answer>>irinotecan, topotecan Camptosar - correct answer>>irinotecan Hycamtin - correct answer>>topotecan taxotere - correct answer>>docetaxel Taxol - correct answer>>paclitaxel topotecan boxed warning - correct answer>>myelosuppression, only use when ANC > 1500 and platelets > 100k topoisomerase II inhibitor - correct answer>>etoposide cytotoxic agents that target G2 phase - correct answer>>topoisomerase II inhibitor Toposar - correct answer>>etoposide IV Etopophos - correct answer>>etoposide phosphate; alternate to Toposar for concentrations of 0.4 mg/mL and higher VePesid - correct answer>>etoposide capsules; refrigerate Toposar preparation and administration - correct answer>>prepare concentrations < 0. mg/mL to avoid precipitation, use non-PVC IV bag and tubing, infuse over at least 30- 60 min to avoid hypotension
VePesid administration - correct answer>>give daily doses > 200 mg in divided doses to ensure absorption folate antimetabolites - correct answer>>methotrexate, pemetrexed, pralatrexate high-dose methotrexate - correct answer>>500 mg/m2 and higher, requires leucovorin and hydration + IV sodium bicarb methotrexate drug interactions - correct answer>>NSAIDs, salicylates, beta-lactams, PPI, sulfonamide antibiotics cause reduced clearance methotrexate boxed warnings - correct answer>>myelosuppression, renal damage, hepatotoxicity, interstitial pneumonitis, dermatologic reactions, diarrhea, stomatitis, immunosuppression, TLS, teratogenicity glucarpidase - correct answer>>to reduce methotrexate levels that are high despite hydration and urinary alkalinization Alimta - correct answer>>pemetrexed supplementation for pemetrexed - correct answer>>folic acid, vitamin B12, dexamethasone to reduce risk of ADR All-trans retinoic acid - correct answer>>aka tretinoin, first-line for acute promyelocytic leukemia (APL) boxed warnings for tretinoin - correct answer>>RA-APL differentiation syndrome, leukocytosis, pregnancy symptoms of RA-APL differentiation syndrome - correct answer>>fever, dyspnea, weight gain, edema, pulmonary infiltrates, pericardial/pleural effusions arsenic trioxide - correct answer>>Trisenox, second-line for APL boxed warnings for Trisenox - correct answer>>RA-APL differentiation syndrome, QT prolongation, AV block asparaginase - correct answer>>Erwinaze, used for leukemia
immunomodulators boxed warnings - correct answer>>fetal risk/pregnancy (REMS), thrombosis, hematologic toxicity (lenalidomide) proteasome inhibitors - correct answer>>bortezomib, carfilzomib bortezomib ADR - correct answer>>peripheral neuropathy, psychiatric disturbances, cardiotoxicity, pulmonary toxicity, neutropenia (antiviral for preventing herpes reactivation) carfilzomib ADRs - correct answer>>peripheral neuropathy, fatigue, pulmonary toxicity, hepatotoxicity VEGF inhibitors - correct answer>>bevacizumab, ramucirumab VEGF inhibitors MoA - correct answer>>inhibits growth of blood vessels VEGF inhibitors ADRs - correct answer>>HTN, proteinuria, nephrotic syndrome, heart failure, thrombosis, impaired wound healing (don't administer for 28 days before and after surgery) VEGF inhibitor boxed warnings - correct answer>>severe/fatal bleeding, GI perforation, surgical wound dehiscence HER2 inhibitors - correct answer>>trastuzumab, pertuzumab, Ado-trastuzumab emtansine Avastin - correct answer>>bevacizumab Cyramza - correct answer>>ramucirumab Herceptin - correct answer>>trastuzumab Kadcyla - correct answer>>Ado-trastuzumab emtansine HER2 inhibitors boxed warnings - correct answer>>heart failure (LVEF monitoring with ECG or MUGA scan), embryo-fetal death monocolonal EGFR inhibitors - correct answer>>cetuximab, panitumumab Erbitux - correct answer>>cetuximab
Vectibix - correct answer>>panitumumab monoclonal EGFR inhibitor administration - correct answer>>must be KRAS wild type, better efficacy with EGFR positive expression, premedicate first dose with Benadryl and use 0.22 micron filter EGFR inhibitor ADRs - correct answer>>acneiform rash (indicates better response), skin toxicities, ocular toxicities management of monoclonal EGFR inhibitor rash - correct answer>>avoid sunlight and use sunscreen, topical steroids, antibiotics for prophylaxis or treatment CD 20 antigen inhibitors - correct answer>>rituximab, ofatumumab, obinutuzumab Rituxan - correct answer>>rituximab CD 20 antigen inhibitors administration - correct answer>>must be CD20 positive; premedicate with Benadryl, APAP, steroid rituximab boxed warnings - correct answer>>hep B reactivation, progressive multifocal leukoencephalopathy, serious skin reactions, infusion-related reactions Blincyto - correct answer>>blinatumomab blinatumomab pharmacogenomics - correct answer>>must be positive for CD19 and 30 antigens PD-1 inhibitors - correct answer>>pembrolizumab, nivolumab, atezolizumab Keytruda - correct answer>>pembrolizumab Opdivo - correct answer>>nivolumab CTLA-4 Inhibitor - correct answer>>ipilimumab (Yervoy) CTLA-4 abbreviation - correct answer>>cytotoxic T-lymphocyte antigen- 4 Yervoy boxed warning - correct answer>>fatal immune-mediated reactions (requires REMS)
oral agents to be taken on an empty stomach - correct answer>>nilotinib, erlotinib, soratenib, temozolomide, abiraterone, pomalidomide teratogenic oral agents - correct answer>>thalidomide, pomalidomide, lenalidomide require 2 negative pregnancy tests and 2 forms of birth control agents requiring non-PVC bag/tubing - correct answer>>taxanes, etoposide (Toposar), temsirolimus
