Deck 20: Antineoplastic Drugs

Question 1

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

Answer 1

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

Question 2

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

Answer 2

intravenous

Question 3

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

Answer 3

Liver

Question 4

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 5

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.

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

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 8

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 9

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.

Question 10

Bisphosphonate-related osteonecrosis of the jaw (BRONJ)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.

Question 11

Which antineoplastic drug is a potent cardiotoxin?

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

Question 12

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 13

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)

Question 14

An example of a cell-cycle nonspecific antineoplastic agent is

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

Question 15

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

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

Question 16

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

Question 17

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

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

Question 18

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 19

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 20

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 21

Antineoplastic agents stimulate the immune system.

Question 22

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.

Question 23

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 24

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 25

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 26

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

Question 27

Which antineoplastic agent is used to manage breast cancer?

A)Plant alkaloid
B)Antibiotic
C)Steroid
D)Estrogen
E)Tamoxifen

Question 28

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

Question 29

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.

Question 30

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

Question 31

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

Question 32

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)

Question 33

Antineoplastic agents will affect bone marrow,leading to

A)leukopenia and thrombocytopenia.
B)leukocytosis and thrombocytopenia.
C)leukopenia and polycythemia.
D)leukocytosis and polycythemia.

Question 34

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