Deck 23: Antineoplastic Drugs

Question 1

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.

Answer 1

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

Question 2

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

A) procarbazine.
B) codeine.
C) omeprazole.
D) prochlorperazine.
E) cisplatin.

Answer 2

prochlorperazine.

Question 3

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)

Answer 3

Methotrexate (Amethopterin)

Question 4

Which antineoplastic drug is a potent cardiotoxin?

A) Methotrexate
B) Vincristine
C) Tamoxifen
D) Mechlorethamine
E) Doxorubicin

Question 5

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

A) Gastrointestinal
B) Dermatologic
C) Neurologic
D) Immunosuppressant

Question 6

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

Question 7

An example of a cell-cycle nonspecific antineoplastic agent is:

A) bleomycin.
B) cisplatin.
C) methotrexate.
D) vincristine.

Question 8

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

Question 9

A patient has a tumor that contains 10¹⁰ cancer cells. Treatment includes two consecutive courses of an antineoplastic regimen, and each course kills 99% of the existing cells. Assuming that the tumor did not have time to grow between the two courses, how many tumor cells are left?

A) 104 cells
B) 105 cells
C) 106 cells
D) 107 cells
E) 108 cells

Question 10

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

A) Lacy white lines that represent Wickham's 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

Question 11

All of the following normal tissues are especially susceptible to the actions of antineoplastic drugs except which one?

A) Hair follicles
B) Bone marrow
C) Liver
D) Gastrointestinal tract

Question 12

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

Question 13

Bisphosphonate related osteonecrosis of the jaw (BRONJ)is an area of bone that has been exposed in the mouth:

A) for more than eight 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.

Question 14

Allopurinol, used to prevent hyperuricemia, can prolong the action and increase the toxicity of all of the following except which one?

A) 5-Fluorouracil
B) Azathioprine
C) Cyclophosphamide
D) Mercaptopurine

Question 15

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.

Question 16

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 parts of the statement are true.
B) Both parts of the statement are false.
C) The first part of statement is true; the second part is false.
D) The first part of statement is false; the second part is true.

Question 17

Bisphosphonate related osteonecrosis of the jaw (BRONJ)is most likely to occur after which of the following dental procedures?

A) Crown preparation
B) Endodontic treatment
C) Tooth extraction
D) Prophylaxis

Question 18

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

Question 19

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

Question 20

Which of the following is characteristic of Stage 2 bisphosphonate related osteonecrosis of the jaw (BRONJ)?

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

Question 21

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

Question 22

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.

Question 23

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

Question 24

Antineoplastic agents stimulate the immune system.

Question 25

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

Question 26

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

Question 27

Antineoplastic agents may be used in the management of diseases with an inflammatory component.

Question 28

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