CATEGORIES, TYPES, INCREASES, AND DECREASES

Sustained Proliferative Signaling

What category of cancer hallmark is addressed by strategies that target pathways causing more proliferation, such as EGFR inhibitors and HER2 antibodies?

Evade Growth Suppressors

What cancer hallmark is targeted by employing agents that inhibit cell-cycle regulators, such as CDK4/6 inhibitors?

Resist Cell Death (Apoptosis)

What cancer hallmark is addressed by administering medications that promote apoptosis, such as BCL-2 inhibitors?

Induce Angiogenesis

What cancer hallmark is addressed by strategies that block the growth of new blood vessels, such as VEGF inhibitors?

Dysregulated Cellular Energetics

What cancer hallmark is addressed by strategies that disrupt the metabolism of tumors, such as glycolysis inhibitors and metabolic modulators?

Avoid Immune Destruction

What cancer hallmark is addressed by strategies that call on or sensitize T cells to kill cancer cells, such as immune checkpoint inhibitors like PD-1, PD-L1, and CTLA-4 inhibitors?

Genomic Instability and Mutations

What cancer hallmark is addressed by strategies that exploit DNA damage pathways, such as PARP inhibitors in BRCA-mutant cancers?

Monoclonal antibodies, Small molecule inhibitors, Hormonal Therapy, Immune checkpoint inhibitors

What are the four types of targeted therapy?

Direct killing, Carrying a toxin or a drug, CDC (Complement-dependent cytotoxicity), Phagocytosis, ADCC (Antibody-dependent cellular cytotoxicity), Immune checkpoint inhibitors, BiTEs (Bispecific T-cell engagers)

What are the mechanisms of action for Monoclonal Antibodies?

Immunotherapy and Drug-antibody conjugate

What are the two types of Monoclonal Antibodies?

Signaling inhibitors and Angiogenesis inhibitors

What are the two types of Small Molecule Inhibitors?

Manipulating the gonadal-pituitary axis

What is the function of Hormonal Therapy in cancer?

Transcription of genes

What is the result of the activation of downstream signaling pathways, such as RAS/MAPK and PI3K/AKT, which are needed for cellular proliferation, evasion of apoptosis, and cellular differentiation?

Transcription of factors in the nucleus

Activation of pathways such as RAS, PI3K, and JAK/STAT ultimately leads to this action?

Dimerize

What action must EGFRs take after ligand attachment, before they are phosphorylated and activated, to cause downstream signaling activation?

Phosphorylate

What action do tyrosine kinases perform on pathways needed for proliferation, differentiation, evasion of apoptosis, and evasion of DNA repair mechanisms?

Conversion from androgens (androstenedione or testosterone), Ovarian synthesis from cholesterol, Peripheral fat

What are the three sources from which Estradiol can be derived, a hormone that breast cancer is responsive to?

Decreased Estrone, Decreased Estradiol, Decreased Estrogen

What are the three subsequent effects resulting from blocking Aromatase enzyme in breast cancer treatment?

Estrogen Agonist Effects

What category of effects does Tamoxifen have on the uterus, liver, and bone?

Estrogen Antagonist Actions

What category of effects does Tamoxifen have on breast tissue and the Central Nervous System?

Increase

What happens to LH and FSH secretion with intermittent administration of a GnRH analog like Leuprolide?

Decrease

What happens to LH and FSH secretion with prolonged continuous administration of a GnRH analog like Leuprolide?

Negative feedback

What mechanism does Leuprolide use when administered continuously to inhibit FSH and LH secretion, which is desired in treating prostate and breast cancer?

DNA cross-links

What primary effect of Alkylating Agents disrupts DNA base pairing?

Hydrogen peroxide (oxygen-free radical)

What substance is formed by Procarbazine and Dacarbazine that generates free radicals, causing DNA strand scission?

Pulmonary fibrosis

What major toxicity is primarily caused by both Busulfan and Bleomycin (B for Baga)?

Duodenum

Where is Folate absorbed?

Terminal Ileum

Where is Vitamin B12 absorbed?

Pure Red Cell Aplasia (PRCA)

What condition is caused by the development of antibodies against red cell precursors due to Epoetin, resulting in a drop in the Red Blood Cell count?

Thrombosis

What is a toxicity precaution associated with increasing too much hemoglobin via Epoetin?

Bone pains (flu-like symptoms)

What toxicity is associated with G-CSF/GM-CSF due to stimulation of the bone marrow to produce more cells?

Myeloid cells

What category of cells have receptors stimulated by G-CSF/GM-CSF for proliferation and differentiation?

Platelets

What category of cells have their production and proliferation stimulated by Thrombopoietin and TPOR mimetics through activation of Mpl receptors?

Gamma radiation

What type of treatment is applied to cellular blood components, at 20 centigrays, to inactivate leukocytes and prevent transfusion associated graft versus host disease?

Filter

What apparatus is used to remove white blood cells in Leukodepleted Packed RBCs?

Plasma protein reduced

What category of blood product is Washed Packed RBCs, indicating the removal of antibodies attached to Red Blood Cells?

Coagulation factor deficiency

What is the primary indication for transfusing Fresh Frozen Plasma (FFP)?

35 days

What is the shelf life of Whole blood when stored at 1 to 6 degrees Celsius?

5 days

What is the shelf life of Platelets when stored at room temperature (around 22 degrees Celsius)?

1 year

What is the shelf life of Fresh Frozen Plasma when stored ultrafrozen (-18 to -25 degrees Celsius)?

Red cells, Platelets, Plasma

What are the three components produced from one unit of whole blood donation?

Fe2+ (Ferrous) iron

What form is iron liberated into inside the enterocyte from heme-bound iron?

Fe3+ (Ferric) iron

What form does iron exit the duodenal cell in, after conversion by Hephaestin, to be transported through the blood by Transferrin?

Fe3+ (Ferric) iron

What is the usual form in which free (nonheme) iron is ingested and absorbed?

Fe2+ (Ferrous) iron

What form of iron is co-transported with H+ proton into the enterocyte by Divalent Metal Transporter 1 (DMT1)?

Heme-bound iron and Free (nonheme) iron

What are the two forms in which iron can come into the duodenal lumen?

Antimetabolites

What category of chemotherapeutic drug mimics purines and pyrimidines, affecting DNA synthesis and acting selectively on tumor stem cells when traversing the cell cycle?

Alkylating Agents

What category of chemotherapeutic drug sticks to or destroys the actual DNA by binding to DNA bases, but does not look like purines/pyrimidines, and acts on cells regardless of the phase (Cell Cycle Nonspecific)?

Natural Products

What category of chemotherapeutic drug comes from plants and mostly acts on the Mitosis phase?

Antitumor Antibiotics

What category of chemotherapeutic drug has anti-tumor properties and generally interferes with DNA, acting on cells regardless of the phase?

Hormonal

What category of chemotherapeutic drug is used when cancer is hormone-dependent, such as in breast and prostate cancers?

M Phase (Mitosis Phase)

What cell cycle phase is targeted by agents involved in microtubule synthesis and assembly, such as Vinblastine and Vincristine?

S Phase (DNA Synthesis)

What cell cycle phase is where antimetabolites (e.g., Cytarabine, Methotrexate) act to inhibit purine and pyrimidine synthesis, and where replication of the DNA Genome occurs?

G2 Phase

What cell cycle phase is most specifically targeted by Bleomycin, and involves the synthesis of cellular components for mitosis?

G0 Phase (Quiescent Phase)

What cell cycle phase is targeted by Cell Cycle Nonspecific drugs like Alkylating Agents and Antitumor Antibiotics, and is typically absent in tumor cells?

Log-kill hypothesis

What concept explains that anticancer drugs kill a fixed proportion of a tumor cell population, not a fixed number?

Primary Induction Chemotherapy

What cancer treatment modality involves drug therapy administered as the primary treatment, usually seen in blood cancers like lymphomas or leukemias?

Neoadjuvant Chemotherapy

What cancer treatment modality involves the use of chemotherapy in patients with localized cancer before performing local therapy (surgery), often for tumor debulking?

Adjuvant Chemotherapy

What cancer treatment modality involves chemotherapy done after local treatment procedures such as surgery or radiation, aimed at reducing the risk of local and systemic recurrence?

Rescue Therapy

What cancer treatment modality involves the alleviation of toxic effects by giving rescue drugs (e.g., Mesna for Cyclophosphamide-induced hemorrhagic cystitis)?

Neurolytic techniques/Neural blockade

What are invasive pain treatments involving blocking certain parts of the body in severe pain, examples of which include Celiac plexus block and Hypogastric plexus block?

Intravenous Infusion or Patient-Controlled Analgesia (PCA) Machine

What are the best methods for administering parenteral opioid therapy?

Intrathecally (Through the Spine)

What route is used for Intraspinal Opioid Therapy in refractory pain cases?

Non-opioid, weak opioid, strong opioid, invasive treatments

What are the four steps of the Modified WHO Analgesic Ladder, in order of increasing pain severity?

Titration

What pharmacologic principle involves the adjustment of drug dosage (milligram or frequency) or rate of solution infusion based on the assessment of the patient, which for cancer pain, continues upwards until adequate analgesia is reached or side effects are encountered?

Opioid rotation

What common method is used to address poor opioid responsiveness and to prevent developing tolerance to side effects, involving changing the drug or its route of administration to an equianalgesic dose?

Breakthrough pain

What type of pain occurs when a patient suddenly experiences high intensity pain during the maintenance period, requiring immediate-acting opioids?

Idiopathic or spontaneous, Pointing towards disease progression, An incident, End-of-dose failure

What are four possible causes of Breakthrough pain?

Immediate-acting opioids (Morphine Sulfate, Oxycodone, Hydromorphone)

What type of medication is needed for breakthrough treatment, with a dose of one-sixth of the total daily around the clock opioid dose, given every 1 to 2 hours PRN?

Acute Pain

What category of pain is nearly always nociceptive, has a rapid onset and short course, and is characterized by objective physical signs like increased HR, RR, and BP?

Chronic Pain

What category of pain persists beyond the usual course of an acute disease, may be nociceptive, neuropathic, or both, and is often characterized by rare objective physical signs and prominent sleep, appetite, and affective disturbances?

Nociceptive Pain

What category of pain is due to the activation or sensitization of peripheral nociceptors, serves to detect, localize, and limit tissue damage, and is described as “tender, deep, aching, spasms, cramping”?

Neuropathic Pain

What category of pain is the result of injury or acquired abnormalities of peripheral or central neural structures, does not involve nociceptor stimulation, and is described as “shooting, stabbing, burning”?

Epicritic

What category of sensation is non-noxious, including light touch, pressure, and proprioception, characterized by low-threshold receptors and conducted by large myelinated nerve fibers?

Protopathic

What category of sensation is noxious or harmful, including pain, subserved by high-threshold receptors, and conducted by smaller, lightly myelinated (A) and unmyelinated (C) nerve fibers?

Paresthesia, Hypoesthesia, Allodynia

What are the three kinds of Neuropathic Pain mentioned in the sources?

Physiologic and Psychological

What are the two major harmful effects of unrelieved pain?

Ask what has worked in the past, Believe what they tell you, Choose an appropriate intervention

What are the three ABCs of planning for pain management?

Health Care and Legal System, Health Care Professionals, Patients

What are the three categories of barriers to pain management?

Adolescents (aged 10 years and above) and Adults

What age group is the Numerical Rating Scale (NRS) generally used for?

Pediatric patients

What patient population is the Wong-Baker FACES® Pain Rating Scale best used for?

Unidimensional

What characteristic describes the Visual Analog Scale (VAS), meaning it only indicates intensity but not quality?

Cinching of the heart and Puffy face

What two signs are associated with Doxorubicin toxicity in the Chemo-tox man mnemonic?

Ears

What organ is associated with Cisplatin/Carboplatin toxicity in the Chemo-tox man mnemonic?

Lungs/Baga

What organ is associated with Bleomycin/Busulfan toxicity in the Chemo-tox man mnemonic?

Arms & Legs

What body part is associated with Vincristine toxicity in the Chemo-tox man mnemonic?

Urinary bladder

What organ is associated with Cyclophosphamide toxicity in the Chemo-tox man mnemonic?

Bone marrow

What tissue is associated with Methotrexate, 5-Fluorouracil, and 6-Mercaptopurine toxicity in the Chemo-tox man mnemonic?

Erythrocytic cycle

What life stage of Plasmodium includes the human blood stages: ring stage, trophozoite, schizont, and merozoite, where the parasite digests hemoglobin for growth and asexual reproduction?

Exo-erythrocytic cycle

What life stage of Plasmodium includes the human liver stages: hypnozoite and sporozoite?

Carbon-centered free-radical formation

What is the main mechanism of action for Artemisinins (Artemether, Artesunate, Dihydroartemisinin)?

RTSg (Ring stage, Trophozoite, Schizont, Gametes)

What are the life cycle stages targeted by Artemisinins, which are mainly the blood stages?

Heme accumulation

What is the main mechanism of action for Quinolines, where they block the conversion of toxic heme to non-toxic hemozoin by forming a heme-quinoline complex?

Blocking of folic acid synthesis

What is the general mechanism of action for Synthesis Inhibitors like Sulfadoxine-Pyrimethamine and Proguanil?

Blocking of protein synthesis

What is the general mechanism of action for Synthesis Inhibitors like Mefloquine, Doxycycline, and Clindamycin?

Interference of electron transport chain

What is the mechanism of action for Atovaquone, which competes with Ubiquinone in the Plasmodium mitochondria, collapsing the mitochondrial complex?

H2O2 formation (Hydrogen Peroxide formation)

What is the mechanism of action for Primaquine, which is activated in the liver to generate a cytotoxic substance that kills the parasite directly?

All life cycle stages

What life cycle stages of Plasmodium are targeted by Proguanil and Atovaquone?

Hypnozoites, Gametocytes, Blood

What life cycle stages of Plasmodium are targeted by Primaquine (HGb)?

Ring stage and Trophozoites

What life cycle stages of Plasmodium are targeted by Mefloquine (when acting as a protein synthesis inhibitor)?