Advanced Oncology Certified Nurse Practitioner Flashcards

A patient receiving FOLFOX chemotherapy develops grade 3 peripheral neuropathy. What is the most appropriate management?

Answer: Discontinue oxaliplatin permanently

Grade 3 peripheral neuropathy from oxaliplatin warrants permanent discontinuation of oxaliplatin to prevent irreversible nerve damage.

Which tumor suppressor gene is most commonly mutated in hereditary breast-ovarian cancer syndrome?

Answer: BRCA1/BRCA2

BRCA1 and BRCA2 mutations account for the majority of hereditary breast-ovarian cancer syndrome cases.

A patient with metastatic melanoma is started on ipilimumab and develops colitis with diarrhea >7 stools/day above baseline. What is the first-line treatment?

Answer: IV methylprednisolone 1-2 mg/kg/day

Grade 3-4 immune-related colitis requires high-dose IV corticosteroids as initial therapy.

What is the mechanism of action of venetoclax in hematologic malignancies?

Answer: Blocks BCL-2 anti-apoptotic protein

Venetoclax is a selective BCL-2 inhibitor that restores apoptosis in cancer cells that overexpress this anti-apoptotic protein.

A postmenopausal woman with ER+/HER2- early breast cancer completes 5 years of tamoxifen. What is the recommended next step?

Answer: Switch to an aromatase inhibitor for up to 5 additional years

Extended adjuvant therapy with an aromatase inhibitor for up to 5 additional years after tamoxifen reduces late recurrence in postmenopausal patients.

Which laboratory finding is most consistent with tumor lysis syndrome?

Answer: Hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia

Tumor lysis syndrome is characterized by hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia from massive cell death.

A patient with newly diagnosed AML has FLT3-ITD mutation. Which targeted agent should be added to induction chemotherapy?

Answer: Midostaurin

Midostaurin, a FLT3 inhibitor, is added to standard 7+3 induction chemotherapy for FLT3-mutated AML to improve outcomes.