WorksheetsExam 4 Cancer
Total questions: 15
Worksheet time: 30mins
What statement is true regarding colorectal cancer screening?
Colonoscopy is the gold standard and most reliable but is burdensome for patients
Flexible sigmoidoscopies are generally preferred and can be easily done every year
The best regimen is a flexible sigmoidoscopy paired with a fecal blood test every year
Occult guaiac tests are considered the lowest burden and are able to detect polyps
Which tests can remove polyps if found?
Colonoscopy
Flexible sigmoidoscopy
CEA test
FIT immunochemical
When using TNM staging for colon cancer, how many local lymph nodes must be assessed for an accurate reading?
>= 4
>= 8
>= 12
>= 10
What is the preferred treatment for colon cancer when applicable?
Capecitabine with oxaliplatin
Cisplatin + Carboplatin
Colectomy and possible lymphadenectomy
5-Fluorouracil with oxaliplatin
JH is a 50 year old caucasian male recovering from a colectomy to remove stage 1 colon cancer. Their physician believes they were able to resect all of the adenocarcinoma and they have asked you about chemotherapy. What do you respond with?
FOLFOX 6 - oxaliplatin 85 mg/m2 + leucovorin 400 mg/m2 + 5FU 400 mg/m2 q14d
5FU 500 mg/m2 IV with Leucovorin 500 mg/m2 qwk
Maintenance capecitabine 1000 mg/m2 IV qd
Chemotherapy is not typically needed for stage 1 colon cancer following resection.
AG is a 60 yr old Filipino woman being seen in your clinic for high risk stage 2 colon cancer following partial colectomy. AG states that she would prefer an oral only therapy if possible. What do you recommend?
wt: 72 kg, ht: 163 cm
Leucovorin 900 mg IV over 2 hrs; 5FU 900 mg IV bolus; repeat weekly for 6 wks then q8wks for 4 cycles
Day one: leucovorin 725 mg IV + 5FU 725 mg IV + oxaliplatin 150 mg IV
5FU 4250 mg IV over 46 hrs
Repeat q14d for 12 cycles
Capecitabine 1750 mg po BID for 2wks
Oxaliplatin 225 mg IV on d1
Repeat q21d for 8 cycles
Capecitabine 2250 mg po BID for 2 weeks, 1 week off
Repeat for 8 cycles
EO is a 63 yr AfAm male recently diagnosed with stage 3 colon cancer. They have would prefer a pump for drug infusions. He has HFrEF with a prior history of AFib with related clot. EO is currently taking lisinopril, metoprolol, furosemide, warfarin, and BiDil. What regimen do you recommend?
Ht: 180 cm, Wt: 105 kg
Oxaliplatin 200 mg IV + Leucovorin and 5FU 915 mg IV on day 1
5FU 5500 mg by pump for 46 hrs
Repeat q2wks for 12 cycles
Capecitabine 3000 mg po BID for 2 wks, one week off
Repeat for 8 cycles
Leucovorin + 5FU 1150 IV weekly for 6 doses, then q8wks for 4 cycles
5FU 6000 mg IV for 2 weeks, one week off
Repeat for 8 cycles
What medication for colon cancer should be avoided in patients >70 yrs old?
Oxaliplatin
Leucovorin
Capecitabine
5-Fluorouracil
Select all of the following that are major concerns for Oxaliplatin (Eloxatin) therapy:
Potentially fatal delayed hypersensitivity, sometimes appearing after 6 cycles
Acute laryngeal spasms and dysethesia when subjected to cold temperatures
Dose limiting neurotoxicity
Cumulative cardiotoxicity
Your patient TR has come in for complaints of chemotherapy-related side effect management. TR's palms are discolored and having some slight peeling that is not extending to the back of their hands. They're also complaining of oral pain. What can you suggest to help with TR's symptoms?
Switch 5FU/capecitabine to an equivalent dose of cisplatin
Increase leucovorin dose and frequency
Recommend a hand lotion and ice chips before chemo appointments
Immediately discontinue all chemo, administer epinephrine and benadryl IV and call 911
On your toxicology rotation, you receive a call from a new infusion center. A patient was receiving Leucovorin 500 mg/m2 and 5FU 500 mg/m2 IV infusions for their high risk stage 2 colon cancer for the first time. Two days after infusion, the patient is now experiencing severe abdominal pain and vomiting as well as signs of acute neurotoxicity. How should this patient be treated?
Uridine triacetate (Vistogard) 1 packet q6hrs for 20 doses
Uridine triacetate (Vistogard) 10g IV q6hrs for 4 days
Switch regimen to capecitabine only, the symptoms will pass
Leucovorin 2500 mg/m2 IV bolus
Your patient John is being started on FOLFOX 6 for his stage 3 colon cancer and he's concerned about how long they'll be on the chemo after surgery. What is the best answer?
The best plan is to give you a lot of chemo short term and then keep you on low-intensity maintenance for a few years
We'll likely keep you on the regimen for 3 months minimum and then reassess for another 3 months or not
In order to prevent recurrence, you will most likely be on these medications indefinitely
It takes chemo about 2 weeks to take effect
Which of the following is not a goal of metastatic colorectal cancer treatment?
Eliminating metastases
Reducing symptoms of tumors
Reducing tumor sizes for possible resection
Prolonging life
Which EGFR inhibitor has a lower risk of infusion reactions due to being fully humanized but has a very high rate of dermatologic toxicity?
Cetuximab
Erbitux
Vecitibix
Avastin
What is not true regarding breast cancer screening?
Self exams every month starting at 30 yrs
Clinician exam q1-3yrs if 20-39 yrs
Mammography q2yrs if >55 yrs
If the patient is high risk, get MRIs
