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Flashcards in Clinical Workshops Deck (17)
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1

If somebodies tumour is T2 N1 M0...do they have metastatic cancer?

No as M=0

 

They do have one lymph node that is involved however

2

What is the FEC-T regime?

 

And what it is used to treat?

5-FU (TS inhibitor)

Epirubicin (anthracycline)

Chyclophosphomide (Mustard)

- All for 3 weeks, with 3-4 cycles

 

Docetaxol (anti-microtubule)

- Given for 3 weeks after FEC, with 3-4 cycles

 

 

Used to treat breast cancer

3

What is the MHRA advice on giving IV Ondansetron?

Can get potential QT prolongation

 

Under 75 --> Not exceed 16mg

 

Over 75 --> Not exceed 8mg

 

Over 65 and diluted --> All doses should be diluted in 50-100mL of saline

4

Why can dexamethasome be problemactic in diabetics?

Will increase glucose levels

5

Define the following....

 

Acute CINV

Delayed CINV

Anticipatory CINV

Acute --> Occurs quickly (less than 24hrs) after chemo is given

 

Delayed --> Occurs more than 24 hours after chemo

 

Anticipatory --> Occurs before the next cycle of chemo after already having a cycle (as they know what to expect)

6

What are the common visible effects of a low platelet count (eg, 38)?

Bleeding from the gums

 

More bleeding in general

 

More bruising

7

Why is Folinic Acid included in the FOLFOX chemotherapy regime?

 

And what is this used to treat?

To improve the clinical outcome by proloning the inhibition of TS (for 5-FU)

 

Treats colorectal cancer

8

What is a common syndrome that occurs as a result of capecitabine (5-FU pro-drug)?

 

And what OTC drug would interact with this

Hand-foot syndrome

 

Often results in delays of treatments

 

 

Interacts with folic acid --> Possibly increasing its toxicity

9

Name 4 pre-medications that should be given when a patient is given the pemetrexed (antimetabolite), pembrolizumab and carboplatin regimen?

Folic acid --> 5 doses per week

 

Hydroxycobalabin injection (1000mg) before first pemetrexed dose

 

Dexamethasone 4mg BD for 3 days --> For N+V

 

Steroids --> to prevent pemetrexed rashes

10

At what GFR is Pemetrexed not allowed to be given?

<45ml/min

11

In patients starting of Afatinib (an EGFR inhibitor), what advice should be given to prevent rashes/acne?

Moisturise with urea/aqueous based moisturisers (not alcohol based)

 

Avoid sunlight --> Use SPF 30 if subjected to it

 

Use soap substitutes

12

How does Palbociclib function?

A selective inhibitor of cyclin-dependent kinases (CDK4/6)

 

Prevents the phosphorylation of Rb, meaning that mitosis cannot occur

13

Why is there a maximum lifetime dose of anthracyclins (like doxorubicin/epirubicin)

To prevent cardiac side effects

14

What 3 types of pre-meds would be given to prevent hypersenstivity reactions in people taking paclitaxol?

Corticosteroid --> Dexamethasone

 

Antihistamine --> Chloramphenamine

 

H2 Antagonist --> Ranitidine

15

Why is bicalutamide taken with/after the single dose of goserlin?

To cover the period of time where the tumour may flare and symptoms worsen after taking goserlin

 

This is because goserlin is an LHRH agonist, and so will stimulate LH/androgen production....however after a few weeks the receptors become desensitised, so LH isn't stimulated and we dont need to give bicalutamide anymore 

16

Why must prednisolone always be given with Abiraterone?

As abiraterone is a CYP17A1 inhibitor, which is vital for the production of cortisol

 

So we need prednisolone to compensate

17

What are some of the side effects of enzalutamide?

Headache

Memory impairment

Anxiety

Restless legs

Fatigue

Risk of seziures (1%)