AOCNP Cheat Sheet 2026

The 30 highest-yield AOCNP facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which obesity-related mechanism most directly increases the risk of postmenopausal breast cancer? → Conversion of androgens to estrogens in adipose tissue via aromatase
2. The USPSTF recommends against which cancer screening test due to insufficient evidence of benefit in average-risk asymptomatic adults? → Annual CA-125 for ovarian cancer screening in average-risk women
3. A male patient completes prostate radiation therapy and reports erectile dysfunction 18 months later. The MOST likely etiology of this late effect is: → Radiation-induced fibrosis of the neurovascular bundles and penile vasculature
4. A patient with multiple myeloma receiving bortezomib develops new-onset tingling and burning pain in bilateral feet. The MOST appropriate next step is to: → Switch to carfilzomib and initiate gabapentin
5. A 55-year-old woman with a family history of Lynch syndrome undergoes genetic counseling. Which cancers are primarily associated with Lynch syndrome? → Colorectal and endometrial cancer
6. Radiation pneumonitis typically presents within which timeframe after thoracic radiation? → 1–6 months after completion of radiation
7. A patient on capecitabine develops palmar-plantar erythrodysesthesia (hand-foot syndrome). Which management strategy is most appropriate? → Dose reduce capecitabine and initiate pyridoxine and urea-based cream
8. Which statement best describes the mechanism of resistance to imatinib in chronic myeloid leukemia (CML)? → Point mutations in the BCR-ABL kinase domain, particularly T315I
9. A patient with polycythemia vera (PV) develops a new stroke. Which mutation drives the majority of PV cases and is used for diagnosis? → JAK2 V617F
10. Radiation-induced fatigue is best managed with which evidence-based intervention during active treatment? → Moderate aerobic exercise (walking program)
11. Fertility preservation counseling is a standard of care recommendation that should be offered: → To all patients of reproductive age BEFORE initiation of potentially gonadotoxic therapy
12. Which biomarker must be tested before initiating trastuzumab (Herceptin) therapy for breast cancer? → HER2 overexpression or gene amplification
13. Which tumor suppressor gene is most commonly mutated in hereditary breast-ovarian cancer syndrome? → BRCA1/BRCA2
14. Radiation-induced mucositis in the oral cavity is best managed with: → Frequent saline rinses, pain assessment, and nutritional support
15. Which toxicity is most specifically associated with bleomycin and requires monitoring with pulmonary function tests? → Pulmonary fibrosis and pneumonitis
16. Irinotecan causes severe delayed diarrhea through which mechanism? → Active SN-38 metabolite inhibiting topoisomerase I in intestinal epithelium
17. Which cancer type is most commonly associated with disseminated intravascular coagulation (DIC) in adults? → Acute promyelocytic leukemia (APL)
18. Which dosimetric parameter best predicts the risk of radiation-induced pneumonitis in a lung cancer patient receiving thoracic radiotherapy? → Mean lung dose (MLD)
19. Secondary prevention in oncology differs from primary prevention in that secondary prevention focuses on: → Detecting cancer early in asymptomatic individuals
20. Lynch syndrome increases lifetime risk of which cancer most significantly? → Colorectal cancer
21. Which class of immunotherapy works by blocking the PD-1/PD-L1 checkpoint pathway to restore anti-tumor T-cell activity? → Checkpoint inhibitors
22. A patient on long-acting opioids reports breakthrough pain. The appropriate breakthrough dose is approximately: → 10–15% of the total daily opioid dose
23. Which lab value change in the immediate postoperative period after major cancer surgery most warrants notification of the surgical team? → Serum lactate >2 mmol/L with tachycardia and hypotension
24. Which grading system is used by oncology nurses to assess and document radiation-induced side effects including mucositis and dermatitis? → CTCAE (Common Terminology Criteria for Adverse Events)
25. Cardiotoxicity monitoring in cancer survivors who received anthracyclines includes which primary surveillance modality? → Echocardiogram or MUGA scan to assess left ventricular ejection fraction (LVEF)
26. What is the primary mechanism by which ionizing radiation kills cancer cells? → Inducing DNA double-strand breaks leading to apoptosis or mitotic catastrophe
27. Which biologic agent works by depleting CD20-positive B cells and is used in certain lymphomas? → Rituximab
28. Opioid rotation is indicated when a patient experiences: → Inadequate analgesia or intolerable side effects despite dose optimization
29. The BRCA1/2 mutation confers the highest lifetime risk for which two cancers? → Breast and ovarian cancer
30. Which of the following is a CTLA-4 checkpoint inhibitor used in the treatment of melanoma? → Ipilimumab