Chapter 20: Antineoplastic Drugs

The phase of the cell cycle before mitosis and after the deoxyribonucleic acid (DNA) synthesis phase is

A. G0.

B. M.

C. G1.

D. S.

E. G2.

E. G2

Immune checkpoints are activated when ______ on the immune checkpoint recognize and bind to partner proteins on the other cells.

A. B-cells

B. T-cells

C. monocytes

D. basophils

E. neutrophils

B. T-cells

Antimetabolites such as methotrexate attack the cells at the S phase of the cell cycle because they interfere with purine and pyrimidine biosynthesis.

A. Both statements are true.

B. Both statements are false.

C. The first statement is true, the second is false.

D. The first statement is false, the second is true.

A. Both statements are true.

An example of a cell-cycle nonspecific antineoplastic agent is

A. bleomycin.

B. cisplatin.

C. methotrexate.

D. vincristine.

B. cisplatin.

Each of the following normal tissues is especially susceptible to the actions of antineoplastic drugs except one. Which is the exception?

A. Hair follicles

B. Bone marrow

C. Liver

D. Gastrointestinal tract

C. Liver

Antineoplastic agents will have the greatest negative effect on which of the following tissues?

A. Integumentary tissue

B. Lungs, heart, and liver

C. Gastrointestinal tract, bone marrow, and hair follicles

D. Sensory tissue such as those for smell, sight, and hearing

C. Gastrointestinal tract, bone marrow, and hair follicles

Which antineoplastic drug is a potent cardiotoxin?

A. Methotrexate

B. Vincristine

C. Tamoxifen

D. Mechlorethamine

E. Doxorubicin

E. Doxorubicin

Neurologic adverse effects are prevalent in all of the following antineoplastic agents except which one?

A. Asparaginase (Elspar)

B. Methotrexate (Amethopterin)

C. Vincristine (Oncovin)

D. Procarbazine (Matulane)

B. Methotrexate (Amethopterin)

Which of the following are symptoms of adverse reactions caused by bone marrow suppression: (1) susceptibility to infection, (2) bleeding, (3) high blood pressure, (4) fatigue?

A. 1, 2, 3, 4

B. 1, 2, 4

C. 1, 3, 4

D. 1, 2

E. 3, 4

B. 1, 2, 4

The majority of cases of osteonecrosis have been reported in patients with cancer who are receiving _____ bisphosphonates.

A. oral

B. intravenous

C. intramuscular

D. subcutaneous

B. intravenous

Medication-related osteonecrosis of the jaw (MRONJ) is an area of bone that has been exposed in the mouth

A. for more than 8 weeks to a bisphosphonate.

B. following radiation therapy for head and neck cancer.

C. as a consequence of necrotizing ulcerative periodontitis (NUP).

D. under an ill-filling partial or complete denture

A. for more than 8 weeks to a bisphosphonate.

Which of the following is characteristic of Stage 2 medication-related osteonecrosis of the jaw (MRONJ)?

A. Exposed bone in the mouth

B. Bone fracture

C. A painful area of exposed bone

D. No evidence of disease or soft tissue inflammation of the soft tissue around the bone

C. A painful area of exposed bone

Medication-related osteonecrosis of the jaw (MRONJ) is most likely to occur after which of the following dental procedures?

A. Crown preparation

B. Endodontic treatment

C. Tooth extraction

D. Prophylaxis

C. Tooth extraction

Dental procedures should be performed for a patient taking bisphosphonates

A. during bisphosphonate-free holidays.

B. before starting bisphosphonate therapy or within 3 months of beginning therapy.

C. only when the course bisphosphonate therapy has been completed.

D. at any time deemed necessary.

B. before starting bisphosphonate therapy or within 3 months of beginning therapy.

Nausea and vomiting caused by antineoplastic agent therapy can be managed by administration of

A. procarbazine.

B. codeine.

C. omeprazole.

D. prochlorperazine.

E. cisplatin.

D. prochlorperazine.

Liver problems are most likely to occur with which of the following groups of antineoplastic agents?

A. Alkylating agents

B. Antimetabolites

C. Antibiotics

D. Hormones

E. Immune modulators

B. Antimetabolites

_____ effects are associated primarily with administration or vincristine (Oncovin) or vinblastine (Velban).

A. Gastrointestinal

B. Dermatologic

C. Neurologic

D. Immunosuppressant

C. Neurologic

Each of the following will have the action prolonged and toxicity increased by allopurinol, which is used to prevent hyperuricemia, except one. Which is the exception?

A. 5-Fluorouracil

B. Azathioprine

C. Cyclophosphamide

D. Mercaptopurine

A. 5-Fluorouracil

What is the intraoral appearance of oral mucositis as a consequence of chemotherapy for cancer?

A. Lacy white lines that represent Wickham striae

B. Mouth sores on the soft tissue of the tongue and inside the mouth

C. Single or small clusters of vesicles that quickly rupture, forming painful ulcers

D. Chronic, multiple oral ulcerations and a history of oral and skin blisters

B. Mouth sores on the soft tissue of the tongue and inside the mouth

Which of the following is a treatment option to alleviate symptoms of mucositis?

A. Injection of corticosteroids

B. Oral rinse of 2% viscous lidocaine

C. A 1-week course of oral antibiotics

D. Use of a chlorhexidine rinse

B. Oral rinse of 2% viscous lidocaine

One major concern of the dental health care worker is thrombocytopenia in patients undergoing antineoplastic therapy because this can lead to an increased risk of infections.

A. Both parts of the statement are true.

B. Both parts of the statement are false.

C. The first part of the statement is true; the second part is false.

D. The first part of the statement is false; the second part is true.

C. The first part of the statement is true; the second part is false.

The appointment should be scheduled _____ chemotherapy when providing oral care for patients on antineoplastic agents.

A. just before starting

B. after the first few days of

C. during the course of

D. only after

A. just before starting

Each of the following neoplastic diseases has high sensitivity to chemotherapy except one. Which is the exception?

A. Acute lymphocytic leukemia

B. Acute myelocytic leukemia

C. Burkitt lymphoma

D. Melanoma

E. Hodgkin disease

D. Melanoma

Which antineoplastic agent is used to manage breast cancer?

A. Plant alkaloid

B. Antibiotic

C. Steroid

D. Estrogen

E. Tamoxifen

E. Tamoxifen

The most serious difficulty in antineoplastic therapy occurs due to a lack of selectivity between tumor tissue and normal tissue. Some normal cells have a faster cell cycle than slowly growing tumor cells.

A. Both statements are true.

B. Both statements are false.

C. The first statement is true, the second is false.

D. The first statement is false, the second is true.

A. Both statements are true.

Antineoplastic agents will affect bone marrow, leading to

A. leukopenia and thrombocytopenia.

B. leukocytosis and thrombocytopenia.

C. leukopenia and polycythemia.

D. leukocytosis and polycythemia.

A. leukopenia and thrombocytopenia

Bisphosphonates work to reduce osteoporosis by

A. stimulating hemopoiesis.

B. stimulating osteoblasts to produce new bone.

C. binding to osteoclasts.

D. remodeling cortical into cancellous bone.

E. increasing blood flow within the osteon.

C. binding to osteoclasts.

Which folic acid analog antimetabolite antineoplastic drug is also used to treat rheumatoid arthritis?

A. Bleomycin (Blenoxane)

B. Methotrexate (Amethopterin, MTX)

C. Interferon alpha-n3 (Alferon N)

D. Vincristine (Oncovin)

E. Fluorouracil (5-FU)

B. Methotrexate (Amethopterin, MTX)

Antineoplastic agents may be selected according to the type of cancer and how advanced it is.

True

False

True

The current philosophy for the use of antineoplastic agents involves treating the initial stages of the disease very aggressively.

True

False

True

Slowly growing cells are more susceptible to inhibition or destruction by antineoplastic agents.

True

False

False

Bisphosphonate-free holidays are not recommended before a dental procedure because these drugs stay in the bone for years.

True

False

True

Antineoplastic agents stimulate the immune system.

True

False

False

The dental health care worker should not recommend any products containing alcohol to patients taking antineoplastic agents because antineoplastic agents produce a disulfiram reaction.

True

False

False