ONS/ONCC Chemotherapy
Immunotherapy Certificate
Lesson 1: Foundations to Set the Stage correct answer
Focusing on Cellular Structure and Function correct answer
The Normal Cell Cycle correct answer-The cell cycle refers to the ordered seres of processes of DNA
replication and mitosis, or cell division
-Cell nucleus regulates these processes by gathering and processing complexes molecular information
Interphase and Mitotic Phase correct answerCell division produces two identical cells through these two
major phases
During interphase: correct answerCell grows and DNA is replicated through the following three steps:
1: First growth phase (G1 or first gap)
2: Synthesis phase (S phase)
3:Mitotic Phse (M phase)
First Growth Phase (G1 or first gap) correct answer-cells increase in size
-reproduce RNA
-“quality assurance” test that the cell will be ready to synthesis DNA
-Length of time is variable, can be from hours to days
Synthesis Phase (S phase) correct answer-DNA replicates
-Results in the formation of identical pairs of DNA (chromatids)
-which are attached a t the centromere
-lasts 2-10 hours
Mitotic Phase (M phase) correct answer-Replicated chromosomes are aligned, separated, and move into
2 new, identical daughter cells
-takes about 30-60 minutes
Major points of cell regulation are entry and exit from correct answer-G1 checkpoint
-S Phase
-G2 checkpoint
-M phase
Restriction Point correct answer-The transition from the resting phase into an actively dividing phase
(G0-G1) is a point where cellular transformation can occur
-During this time, cells pass through a transition phase known as a restriction point
-Extracellular growth factors trigger reentry into G1, and GF are required to send the cells past the
restriction point, or the point of no return
G0 Phase (resting phase) correct answer-After mitosis, cells may enter back into the G1 phase or go into
a resting phase, known as G0
-Most cells in the human body reside in G0
-Exceptions to this are those that are (Resting in G0 phase) correct answer-Exceptions to this are those
that are metabollically active, such as
-granulocytes
-and the epithelium of the GI tract
Cell Cycling Time correct answerAmount of time from mitosis to mitosis
Cell cycle video and image correct
answerhttp://highered.mheducation.com/sites/0072495855/student_view0/chapter2/
animation__how_the_cell_cycle_works.html
Check points in the Cell Cycle: Keeping it All Under Control correct answer-The cell cycle is carefully
controlled through a series of checkpoints
-Variation in duplication or distribution of chromosomes during cell division can alter the genetic
information passed on to daughter cells, leading to cellular dysfunction and disease, such as cancer
-These checkpoints monitor for DNA integrity and control progression through mitosis
Progression through the cell cycle is controlled through two proteins: correct answer1. cyclines (D, E, A,
B)
ONS ONCC Chemo Renewal
Neoadjuvant therapy does not increase survival when compared to adjuvant therapy. It only changes
the timing of treatment and can change surgical options if the tumor is shrunk enough. If this occurs, the
patient may only require a lumpectomy plus radiation therapy instead of needing a mastectomy correct
answerMain benefit of neoadjuvant chemotherapy (breast cancer patient)
A comprehensive geriatric assessment (CGA) is a multidisciplinary evaluation to assess life expectancy
and risk of morbidity and mortality in the older patient. This assessment tool would evaluate and include
the following areas: functional status, socioeconomic issues, psychosocial distress, comorbidities,
cognitive function, nutritional status, polypharmacy, and a medication review (NCCN Older Adult
Oncology Guidelines, version 1.2015). correct answerDue to Mrs. Turner’s age and comorbidities, her
oncologist performs a comprehensive geriatric assessment. You know that this assessment covers all but
which of the following:
65 correct answerThe NCCN Older Adult Oncology Guidelines (version 1.2015) provides information on
what is included in a comprehensive geriatric assessment. Currently, more than 60% of cancers in the
United States occur in people age ______and older and as the oncology world ages, nearly half (46%) of
cancer survivors are 70 years of age or older
Two of the agents (docetaxel and carboplatin) that Mrs. Turner will receive are categorized as irritants.
Docetaxel can cause a significant reaction if it extravasates. It can lead to edema, erythema, occasional
pain and blister formation (ONS Chemo/Bio guidelines, 2014). That is the most likely reason that Mrs.
Turner was given a port for her treatments. Some patients will receive their treatments through a
peripheral IV without incident. Just because they are intravenous agents does not mean that a port is
required and needing a port has nothing to do with her being older in age. Since none of these agents
are vesicants, they likely could have been given safely via peripheral route but having a port placed is OK
as well. correct answerWhat is your best explanation for why Mrs. Turner was given a port to receive
her chemotherapy?
Irrirtants correct answer_____________can cause inflammation, pain, and burning but rarely cause
tissue necrosis comparable to a vesicant (unless a large amount or a very high concentration of the
irritant is extravasated).
Vesicants correct answer_____________can cause blistering and significant pain and tissue damage and
destruction, leading to tissue death.
Non-DNA-binding solutions remain in the local area of the extravasation, which improves the possibility
of drug deactivation.
DNA-binding agents attach to DNA nucleic acids, causing the antagonist to be ingested cellularly, leading
to progressive tissue destruction correct answerA further classification of an antineoplastic agent’s
potential to cause damage is whether its mechanism of action includes DNA binding.
Bendamustinea
Dactinomycin
Daunorubicin
Doxorubicin
Epirubicin
Idarubicin
Mechlorethamine
Mitomycin correct answerDNA Binding Irritants
Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbine correct answerDNA Nonbinding vessicants
Sodium thiosulfate
Inject 2 ml of sodium thiosulfate for each milligram of
mechlorethamine extravasated.
Inject subcutaneously into extravasation site using a 25
gauge or smaller needle (change needle with each injection).
Monitor extravasation site according to the institution’s
ONS/ONCC Chemotherapy
Immunotherapy Certificate
G1 correct answerfirst growth phase (or first gap)
2 correct answerHow many cells are produced each time a cell divides?
mitosis correct answerthe process of cell division
interphase correct answerThe time when a cells grows and replicates DNA in preparation for cell
division.
G1 correct answermost important checkpoint in cell division
cell division correct answerPhases of include synthesis phase, G1, G2, M
phase
Chemotherapy and immunotherapy correct answerThese treatments are ALL developed to target
specific points in the cell division process.
cyclins and cyclin-dependent kinases correct answerProgression through the cell cycle is controlled by
these two proteins:
pluripotent correct answer_________________ stem cells are created in the bone marrow and can
differentiate into any type of cell (except embryonic tissue).
undifferentiated correct answerIs a pluripotent stem cell differentiated or undifferentiated?