SDL of chemotherapeutic agents

1. Chemotherapeutic agents-
Self Directed
Brainstorming ?
Dr.lokendra Sharma
Professor of Pharmacology
SMS Medical College
Jaipur

2. 1. Which of the following is a radioprotector?
a. Colony stimulating factor
b. Amifostine
c. Cisplatin
d. Methotrexate
(b)

3. 2. Topical mitomycin-C is used in
a. Sturge-Weber syndrome
b. Laryngotracheal stenosis
c. Endoscopic angiofibroma
d. Skull base osteomyelitis
(b)

4. 3. Hemorrhagic cystitis is caused by
a. Cyclophosphamide
b. 6 Mercaptopurine
c. 5 Fluorouracil
d. Busulfan
(a)

5. 4.Methotrexate is used for the management of
all of these conditions except
a. Rheumatoid arthritis
b. Psoriasis
c. Sickle cell anemia
d. Organ transplantation
(c)

6. 5. Which of the following drug is used for
the is treatment of sickle cell anemia?
a.Hydroxyurea
b. Cisplatin
c. Paclitaxel
d. Carboplatin
(a)

7. 6. Use of tamoxifen in carcinoma of breast
patients does not lead to the following side
effects
a. Thromboembolic events
b. Endometrial carcinoma
c. Cataract
d. Cancer in opposite breast
(d)

8. 7. Which group of anticancer drugs
Temozolomide belong to
a. Oral alkylating agent
b. Antitumor Antibiotic
c. Antimetabolite
d. Mitotic Spindle Inhibitor
(a)

9. 8. Alkalinisation of urine ameliorates the
toxicity of which of the following drugs?
a. Arabinoside-cytosine
b. Ifosfamide
c. Cisplatin
d. Methotrexate
(d)

10. 9. All of the following are true regarding
ifosfamide EXCEPT
a. Metabolised by cytochrome p450 enzymes
b. Less neurotoxic than cyclophosphamide
c. Chloracetaldehyde is the metabolite of
ifosfamide
d. It is a nitrogen mustard
(b)

11. 10. All are alkylating agents, except
a. 5-Fluorouracil
b. Melphalan
c. Cyclophosphamide
d. Chlorambucil
(a)

12. 11. Pulmonary fibrosis is seen with
a. Bleomycin
b. Cisplatin
c. Methotrexate
d. Actinomycin D
(a)

13. 12. Which of the following drug is used in
the treatment of estrogen dependent
breast carcinoma?
a. Tamoxifen
b. Methotrexate
c. Paclitaxel
d. Adriamycin
(a)

14. 13. Methotrexate resistance is due to:
a. Depletion of Folate
b. Overproduction of DHFRase
c. Overproduction of Thymidylate kinase
d. Decreased DHFRase
(b)

15. 14. Which of the following is widely used
in the management of carcinoma breast?
a. Actinomycin D
b. Bleomycin
c. Doxorubicin
d. Dacarbazine
(c)

16. 15. Thalidomide is used in all of the
following except
a. HIV associated peripheral neuropathy
b. HIV associated aphthous (mouth) ulcers
c. Behcet syndrome
d. Erythema Nodosum Leprosum
(a)

17. 16. Most common dose-limiting toxicity of
cancer chemotherapy is
a. Gastrointestinal toxicity
b. Neurotoxicity
c. Bone marrow suppression
d. Nephrotoxicity
(c)

18. 17. Which of the following parameters is not
monitored in a patient on methotrexate
therapy?
a. Liver function tests
b. Lung function test
c. Eye examination
d. Hemogramz
(c)

19. 18. All of the following are true about
thalidomide except
a. Used in pregnancy as anti-emetic but
withdrawn due to teratogenicity
b. Can be used in multiple myeloma as primary
treatment as well as in refractory disease
c. Causes euphoria and diarrhea
d. Can be used in erythema nodosum leprosum
(c)

20. 19. Which of the following drug acts by
inhibiting tyrosine kinase activated by EGF
receptor as well as HER2?
a. Imatinib
b. Geftinib
c. Erlotinib
d. Lapatinib
(d)

21. 20. Tyrosine kinase inhibitors are first line
treatment in
a. Gastrointestinal stromal tumors
b. Receptor mediated neuroendocrine
tumors
c. Breast cancer
d. Renal cell carcinoma
(a)

22. 21. Drug locally used for tracheal stenosis
is
a. Mitomycin C
b. Doxorubicin
c. Bleomycin
d. Clindamycin
(a)

23. 22. Cetuximab (an EGFR antagonist) can
be used in
a. Palliation in head and neck cancer
b. Anal canal carcinoma
c. Gastric carcinoma
d. Lung carcinoma
(a)

24. 23. Most emetogenic anticancer drug is
a. Cisplatin
b. Carboplatin
c. High dose cyclophosphamide
d. High dose methotrexate
(a)

25. 24. Cerebellar toxicity is seen with
a. Cisplatin
b. Cytarabine
c. Bleomycin
d. Actinomycin D
(b)

26. 25. Proliferation independent agents
include all the following except
a. Vincristine
b. Carmustine
c. Melphalan
d. Cyclophosphamide
(a)

27. 26. Which of the following can be given
orally?
a. Cytosine arabinoside
b. Cisplatin
c. Doxorubicin
d. Mesna
(d)

28. 27. In treatment of osteosarcoma, all of the
following are used EXCEPT
a. High dose methotrexate
b. Cyclophosphamide
c. Vincristine
d. Doxorubicin
©

29. 28. 'Hand and Foot' syndrome can be
caused by
a. Cisplatin
b. Vincristine
c. Capecitabine
d. Mitomycin-C
(c)

30. 29. Which of the following anti-cancer
drugs is cell cycle specific?
a. Ifosfamide
b. Melphalan
c. Vinblastine
d. Cyclophosphamide
©

31. 30. The drug of choice for chronic myeloid
leukemia, is
a. Chlorambucil
b. Busulfan
c. Vincristine
d. Procarbazine
(b)

32. 31. Amifostine is protective to all EXCEPT
a. Salivary glands
b. Skin
c. CNS
d. GIT
©

33. 32. Bleomycin toxicity affects which type
of cells
a. Type-I pneumocytes
b. Type-II pneumocytes
c. Endothelial cells
d. Pulmonary alveolar macrophages
(b)

34. 33. SIADH is caused by all EXCEPT
a. Vincristine
b. Vinblastine
c. Actinomycin D
d. Cyclophosphamide
(c)

35. 34. Imatinib is used in the treatment of?
a. Chronic myelomonocytic leukemia
b. Myelodysplastic syndrome
c. Acute lymphoid leukemia
d. Gastro intestinal stromal tumors
(d)

36. 35. Sustained neutropenia is seen with?
a. Vinblastine
b. Cisplatin
c. Carmustine
d. Cyclophosphamide
©

37. 36. Rituximab is used in all EXCEPT
a. Non Hodgkin lymphoma
b. Paroxysomal nocturnal hemoglobinurea
c. Rheumatoid arthritis
d. Systemic lupus erythematosis
(b)

38. 37. All cause myelosuppression except
a. Docetaxel vincristine
b. Vincristine
c. Methotrexate
d. Irrnotecan
(b)

39. 38. Chemotherapy is not useful in
a. Chondrosarcoma
b. Wilm’s tumor
c. Choriocarcinoma
d. All
(a)

40. 39. Which of the following anticancer drug
is excreted by lungs?
a. 5-Fluorouracil
b. Cyclophosphamide
c. Doxorubicin
d. Cisplatin
(a)

41. 40. Which of the following drugs is used for the
treatment of refractoty histiocytosis?
a. High dose methotrexate
b. High dose cytarabine
c. Cladribine
d. Fludarabine
(c)

42. 41. Thalidomide, used for multiple myeloma, is
a. Associated with diarrhea
b. Characterized by enantiomeric intercon-
versions
c. Metabolized extensively by hepatic CYP
system
d. Safe for use in pregnant females
(b)

43. 42. A patient on treatment for leukemia,
develops chest pain, pulmonary infiltrates and
pleural effusion. The likely cause is.
a. Daunorubicin
b. Hydroxyurea
c. Cytarabine
d. Tretinoin
(d)

44. 43. Mechanism of action of paclitaxel is
a. Topoisomerase inhibition
b. Increases the polymerization of tubulin
c. Inhibits protein synthesis
d. Alkylation of DNA
(b)

45. 44. Which antineoplastic drug is a peptide?
a. Bleomycin
b. Asparteme
c. Valinomycin
d. Dactinomycin
(a)

46. 45. Leucovorin is used to decrease the
toxicity of
a. Methotrexate
b. Mercaptopurine
c. Thio-TEPA
d. Cytosine arabinoside
(a)

47. 46. All-trans-retinoic acid is used in
treatment of
a. Acute promyelocytic leukemia
b. A.L.L.
c. CML
d. Transient myeloproliferative disorder
(a)

48. 47. Treatment of choice for chronic
myeloid leukemia is
a. Imatinib
b. Hydroxyl-urea
c. Interferon-alpha
d. Cytarabine
(a)

49. 48. Which of the following anticancer drugs
can cause hypercoagulable state?
a. 5-FU
b. L-asparaginase
c. Melphalan
d. Carmustine
(b)

50. 49. Anticancer drug causing SIADH as an
adverse effect is
a. Vincristine
b. Paclitaxel
c. Dacarbazine
d. Cyclophosphamide
(a)

51. 50. Which of the following anticancer
drugs acts by hypomethylation?
a. Gemcitabine
b. 5-FU
c. Decitabine
d. Homoharringotonine
(c)

52. 51. High dose methotrexate is used for the
treatment of
a. Osteosarcoma
b. Rhabdomyosarcoma
c. Retinoblastoma
d. Ewing's sarcoma
(a)

53. 52. Which of the following drugs is
topoisomerase 1 inhibitor?
a. Doxorubicin
b. Irinotecan
c. Etoposide
d. Vincristine
(b)

54. 53. All of the following anticancer agents
cause bone marrow suppression EXCEPT
a. Chlorambucil
b. Daunorubicin
c. Doxorubicin
d. Flutamide
(d)

55. 54. All the following are hormonal agents
used against breast cancer EXCEPT
a. Letrozole
b. Exemestane
c. Taxol
d. Tamoxifen
(c)

56. 55. Which is the most active single
chemotherapeutic agent in the treatment of
leiomyosarcoma?
a. Adriamycin
b. Daunorubicin
c. Methotrexate
d. Cisplatin
(a)

57. 56. Gemcitabine is effective in
a. Head and neck cancers
b. Pancreatic cancer
c. Small-cell lung cancer
d. Soft tissue sarcoma
(b)

58. 57. All of the following statements about
methotrexate are correct EXCEPT
a. Folinic acid enhances the action of
methotrexate
b. Methotrexate inhibits dihydrofolate reductase
c. Non-proliferative cells are resistant to
methotrexate
d. Methotrexate is used in the treatment of
psoriasis
(a)

59. 58. Mesna is given with cyclophosphamide
to
a. Increase absorption
b. Decreased excretion
c. Ameliorate hemorrhagic cystitis
d. Decrease metabolism
(c)

60. 59. A 35 yr old patient is having carcinoma lung
with a past history of lung disease. Which of
the following drugs should not be given?
a. Vinblastine
b. Bleomycin
c. Mithramycin
d. Adriamycin
(b)

61. 60. Arsenic is useful in the treatment of
a. Acute promyelocytic leukemia
b. Myelodysplastic syndrome
c. Transient myeloproliferative disorder
d. All of the above
(a)

62. 61. Which of the following is an anti-
metabolite?
a. Methotrexate
b. Cyclosporine
c. Etoposide
d. Vinblastine
(a)

63. 62. Mechanism of action of imatinib mesylate is
a. Increase in metabolism of P glycoprotein
b. Blocking the action of P glycoprotein
c. Blocks the action of chimeric fusion protein of
bcr-abl
d. Non-competitive inhibition of ATP binding
site
(c)

64. 63. Which of the following drugs is associated
with untoward side effect of renal tubular
damage?
a. Cisplatin
b. Streptozocin
c. Methysergide
d. Cyclophosphamide
(a)

65. 64. Which of the following
chemotherapeutic agents is associated
with secondary leukemia?
a. Vinblastine
b. Paclitaxel
c. Cisplatin
d. Bleomycin
(c)

66. 65. The drug imatinib acts by the inhibition
of
a. Tyrosine kinase
b. Glutathione reductase
c. Thymidylate synthetase
d. Protein kinase
(a)

67. 66. The new drug pemetrexed useful in breast
cancer belongs to which of the following
category of the drugs?
a. Antitumor agent
b. Alkylating agent
c. Hormonal agent
d. Antimetabolite
(d)

68. 67. All are alkylating agents except
a. Cyclophosphamide
b. Lomustine
c. Busulfan
d. Zalcitabine
(d)

69. 68. Drug that is radioprotective is
a. Paclitaxel
b. Vincristine
c. Etoposide
d. Amifostine
(d)

70. 69. “Stocking and glove” neuropathy is
seen in
a. Vinblastine
b. Paclitaxel
c. Etoposide
d. Mitroxantrone
(b)

71. 70. Which one of the following alkaloids is
used as anticancer agent?
a. Vincristine
b. Papaverine
c. Ephedrine
d. Atropine
(a)

72. 71. Sodium 2-mercapto ethane sulfonate is
used as a protective agent in
a. Radiotherapy
b. Cancer chemotherapy
c. Lithotripsy
d. Hepatic encephalopathy
(b)

73. 72. Pulmonary fibrosis is a common
complication after treatment with
a. 6-Mercaptopurine
b. Vincristine
c. Bleomycin
d. Adriamycin
(c)

74. 73. A patient receiving allopurinol requires
dose reduction of
a. 6-Meracaptopurine
b. Cyclophosphamide
c. 6-Thioguanine
d. Climetidine
(a)

75. 74. Which of the following are alkylating
agents?
a. Cyclophosphamide
b. Ifosfamide
c. Methotrexate
d. Vincristine
(a)

76. 75. Anticancer drugs of plant origin
is/are
a. Vincristine
b. Isotretinoin
c. Bleomycin
d. Methotrexate
(a, b)

77. 76. Alkylating agents are
a. Vincristine
b. Actinomycin-D
c. Chlorambucil
d. 5-Fluorouracil
e. Cyclophosphamide
(c, e)

78. 77. Which of the following drugs are anticancer
antibiotics?
a. Vancomycin
b. Actinomycin D
c. Bleomycin
d. Mithramycin
e. Vincristine
(b, c, d)

79. 78. Metaphase arrest is caused by
a. Griseofulvin
b. Vincristine
c. Paclitaxel
d. Colchicine
e. Etoposide
(b, c, d)

80. 79. The mechanism of anticancer action of fluorouracil
is
a. Cross linking of double stranded DNA and the
resulting inhibition of DNA replication and
transcription
b. Cytotoxicity resulting from a metabolite that
interferes with the production of dTMP
c. Irreversible inhibition of dihydrofolic acid reductase
d. Selective action on DNA polymerase
(b)

81. 80. A cell cycle specific anticancer drug that acts
mainly in the M phase of the cycle is
a. Cisplatin
b. Etoposide
c. Methotrexate
d. Paclitaxel
(d)

82. 81. Maintenance of high urinary pH is important during
methotrexate treatment because
a. Bladder irritation is reduced
b. It decreases renal tubular secretion of methotrexate
c. Leucovorin toxicity is increased in a dehydrated
patient
d. Methotrexate is a weak acid
(d)

83. 82. All of the following statements about
methotrexate are true Except
a. It is cell cycle specific and kills in the S phase
b. Its toxicity primarily affects bone marrow and
epithelial structures
c. Folic acid reverses its toxic effects
d. It is the drugs of choice for choriocarcinoma
(c)

84. 83. Mechanism of action of vincristine in the treatment
of All is
a. Inhibition of topoisomerase II to cause breaks in
DNA strands
b. Alkylation and cross linking DNA strands
c. Inhibition of DNA mediated RNA synthesis
d. Inhibition of polymerization of tubulin to form
microtubules
(d)

85. 84. All of the following statements about
vincristine are true EXCEPT
a. It acts by inhibiting mitosis
b. Its prominent adverse effect is peripheral
neuropathy
c. It does not suppress bone marrow
d. It is a drug of choice for solid tumors
(d)

86. 85. All of following statements about are true
about mercaptopurine EXCEPT
a. It is metabolized by xanthine oxidase
b. It does not cause hyperuricemia
c. Its dose should be reduced when allopurinol is
given concurrently
d. It is an active metabolite of azathioprine
(b)

87. 86. Which of the following
immunosuppressants is not used for the
treatment of cancers?
a. Cyclophosphamide
b. Cyclosporine
c. Methotrexate
d. 6-Mercaptopurine
(b)

88. 87. Which of the following drugs is not
used in prostate carcinoma?
a. Finasteride
b. Diethylstilbesterol
c. Testosterone
d. Flutamide
©

89. 88. Pentostatin acts by inhibiting
a. RNA dependent DNA polymerase
b. Aldolase
c. Adenosine deaminase
d. Adenylyl cyclase
(c)

90. 89. Hand and foot syndrome is an adverse
effect of
a. 5-Fluorouracil
b. Bleomycin
c. Etoposide
d. Actinomycin D
(a)

91. 90. Side effects of cisplatin include all of
the following EXCEPT
a. Nausea and vomiting
b. Nephrotoxicity
c. Blindness
d. Ototoxicity
(c)

92. 91. Most common side effect of 5-
fluouracil is
a.G.I. toxicity
b.Bone marrow depression
c. Cardiotoxicity
d. Neurotoxicity
(a)

93. 92. Sterility is caused by
a. Vinca alkaloids
b. Alkylating agents
c. Antimetabolites
d.Actinomycin Ds
(b)

94. 93. Neoadjuvant chemotherapy is used in
all except
a. Esophageal carcinoma
b. Breast carcinoma
c. Thyroid carcinoma
d. Non- small cell carcinoma of lung
©

95. 94.Which of the following anticancer drugs
can cross blood brain barrier?
a. Cisplatin
b. Nitrosourea
c. Vincristine
d. Vinblastine
(b)

96. 95. Which of the following drugs produce
significant nephrotoxicity?
a. Cisplatin
b. Carboplatin
c. Vinblastine
d. Vincristine
(a)

97. 96. Toxicity of nitrogen mustards can be
decreased by
a. Amifostine
b. Folinic acid
c. GM-CSF
d. MESNA
©

98. 97. Folinic acid counteracts the
toxicity of
a. Doxorubicin
b. Methotrexate
c. Cyclophosphamide
d. Fluorouracil
(b)

99. 98. The drug of choice in choricarcinoma is
a. Methotrexate
b. Actinomycin –D
c. Vincristine
d. 6-thioguanine
(a)

100. 99. Which of the following anticancer drug
is not ‘S’-phase specific?
a. Methotrexate
b. Meracaptopurine
c. Ifosfamide
d. Thiouanine
©

101. 100. Cisplatin does not cause
a. Cardiomyopathy
b. Nephrotoxicity
c. Neuropathy
d. Tinnitus
(a)

102. 101. Which of the following is not an
antineoplastic antibiotic?
a. Actinomycin D
b. Doxorubicin
c. Bleomycin
d. Spiramycin
(d)

103. 102. Leucovorin rescue is related to
a. Methotrexate toxicity
b. Cyclophosphamide toxicity
c. Oncovin toxicity
d. Cisplatin toxicity
(a)

104. 103. People with high risk for development of
breast cancer should be treated by prophylactic
administration of
a. Tamoxifen
b. Aminoglutethimide
c. Diethyistibesterol
d. Flutamide
(a)

105. 104. Rituximab is used in
a. Hodgkin,s disease
b. Acute myeloid leukemia
c. Non-Hodgkin lymphoma
d. Multiple myeloma
©

106. 105. Alkylating agengts include
a. Doxorubicin
b. Cholorambucil
c. Vinblastine
d. Busulfan
e. Methotrexate
(b, d)