DR Arpit Agarwal Pharma Capsule 1 Anti Cancer

NEET PG
Educators Notes
Dr Arpit Agarwal
Pharma CAPSULE 1
Anti-Cancer Drugs
NEET PG
Educators Notes
1. Which of the following Anti cancer drug acts via methylation of DNA?
A. Procarbazine
B. Decitabine
C. Azacytidine
D. Cyclophosphamide
NEET PG
Educators Notes
2. Which of the following drug acts via hypomethylation of DNA

A. Gemcitabine
B. Capecitabine
C. Decitabine
D. Cytosine arabinoside
NEET PG
Educators Notes
3. All are cell cycle specific anticancer drug that acts mainly in the M
phase of the cycle EXCEPT:
A. Eribulin
B. Ixabepilone
C. Irinotecan
D. Paclitaxel
NEET PG
Educators Notes
4. Which of the following anticancer drug acts mainly in the S phase of the
cell cycle :
A. Estramustine
B. Hydroxyurea
C. Bleomycin
D. Paclitaxel
NEET PG
Educators Notes
5. All of these are G-2 phase blockers except:

a) Etoposide
b) Daunorubicin
c) Paclitaxel
d) Bleomycin
NEET PG
Educators Notes
6. Radiosensitizer for head and neck cancer is

a) Gefitinib
b) Cisplatin
c) Oxaliplatin
d) docetaxel
NEET PG
Educators Notes
7. Which of the following drug is used in sickle cell anemia?

(A). Hydroxyurea
(B). Carmustin
(C). Paclitaxel
(D). Daunorubicin
New Drugs For Sickel Cell Anemia
Voxelotor
1. MoA- HbS polymerization inhibitor
• binds to HbS & prevents polymerization
• reduces sickling & hemolysis
2. RoA – ORAL
Crizanlizumab
1. MoA- MAB against P-selectin on endothelium & platelets.
• It blocks adhesions b/w endothelium, platelets, RBC & leukocyte.
2. RoA - IV once in 2 to 4 week
L-Glutamine
1. MoA- Oxidative stress causes sickling & leads to hemolysis & vaso-occlusion
• L-Glutamine increases NAD+ & NADH in RBC & reduces oxidative damage
2. ROA- ORAL
Dr Arpit Agarwal
PhrmaGuru
NEET PG
Educators Notes
8. The drug of choice in choriocarcinoma is:

(a) Methotrexate
(b) Actinomycin-D
(c) Vincristine
(d) 6-Thioguanine
NEET PG
Educators Notes
9. Methotrexate is used in all except-

[A]. Sickle cell anemia
[B]. Psoriasis
[C]. Rheumatoid arthritis
[D]. Ankylosing spondylitis
NEET PG
Educators Notes
10. High dose methotrexate is used for the treatment of:

(a) Osteosarcoma
(b) Rhabdomyosarcoma
(c) Retinoblastoma
(d) Ewing's sarcoma
NEET PG
Educators Notes
11. All are used as 1st line treatment for AML except
A. Cytarabine
B. Idarubicin
C. All Trans retinoic Acid [ATRA]
D. Arsenic Di Oxide
NEET PG
Educators Notes
12. Cytarabine use for Acute Pro-Myelocytic leukemia [M3] increases
risk of
A. DIC
B. Differentiation syndrome
C. Hand foot syndrome
D. All of the above
NEET PG
Educators Notes
13. Resistance to Methotrexate develops due to?

A. Rapid Cancer cell multiplication
B. Deficiency of thymidylate kinase
C. Deficiency of thymidylate synthetase
D. Increased production of dihydrofolate reductase
NEET PG
Educators Notes
14. A cancer cell that is resistant to both vincristine and

methotrexate probably has developed that resistance as a result of
(A) Changes in properties of a target enzyme
(B) Decreased activity of an activating enzyme
(C) Increase in expression of a P-glycoprotein transporter
(D) Increase in proteins that are involved in DNA repair
NEET PG
Educators Notes
15. All of the following anticancer drugs are poor substrate for p-gp
EXCEPT:
A. Eribulin
B. Paclitaxel
C. Ixabepilone
D. Cabazitaxel
NEET PG
Educators Notes
16. Which of the following causes delayed and persistent leucopenia?

A.) Cisplatin
B.) Vinblastine
C.) Doxorubicin
D.) Carmustine
NEET PG
Educators Notes
17. Anticancer drug implicated in causing gynecomastia and

impotence
A. Procarbazine
B. Estramustine
C. Paclitaxel
D. L-asparaginase
NEET PG
Educators Notes
18. A 50-year-old woman has been diagnosed with locally

advanced breast cancer and recommended for chemotherapy. She
has five years history of myocardial infarction and congestive
heart failure. Which antineoplastic drug should be best avoided?
(a) Anthracycline
(b) Alkylating agent
(c) Platinum compound
(d) Bisphosphonates
NEET PG
Educators Notes
19. All cause myelosuppression except:

(a) Docetaxel
(b) Vincristine
(c) Methotrexate
(d) Irinotecan
NEET PG
Educators Notes
20. SIADH is caused by all EXCEPT:

(a) Vincristine
(b) Vinblastine
(c) Actinomycin D
(d) Cyclophosphamide
NEET PG
Educators Notes
21. Cerebellar toxicity is seen with:

(a) Cisplatin
(b) Cytarabine
(c) Bleomycin
(d) Actinomycin D
NEET PG
Educators Notes
22. A patient on treatment for leukemia, develops chest pain,

pulmonary infiltrates and pleural effusion. The likely cause
(a) Daunorubicin
(b) Hydroxyurea
(c) Cytarabine
(d) Tretinoin
NEET PG
Educators Notes
23. Hand and Foot' syndrome can be caused by all except:

(a) Sunitinib
(b) Pemetrexed
(c) Capecitabine
(d) Mitomycin-C
NEET PG
Educators Notes
24. All of the following steps reduce the risk of cisplatin induced
nephrotoxicity
A. Saline diuresis
B. Mannitol
C. Amifostine
D. Alkaline diuresis
.
NEET PG
Educators Notes
25. A patient is suffering from Methotrexate toxicity. All of the following are
useful in the treatment of toxicity except?
a) Glucarpidase
b) Leucovorin
c) Amifostine
d) Alkalinization of urine
.
NEET PG
Educators Notes
26. A patient on cisplatin therapy develops intractable vomiting on

the third day of treatment. DOC for controlling this vomiting is:
A. Aprepitant
B. Ondansetron
C. Metoclopramide
D. Prochlorperazine
NEET PG
Educators Notes
27. Drug that is radioprotective is:

(a) Paclitaxel
(b) Vincristine
(c) Etoposide
(d) Amifostine
NEET PG
Side effect Treatment Educators Notes
Neutropenia Filgrastim = G-CSF [DOC]
Sargramostim = GM-CSF
Thrombocytopenia IL-11 (oprelvekin) [DOC].
Romiplostim & Eltrombopag -Used in ITP
Chemotherapy Induced Nausea & DOC for CINV -Palonosetron].
Vomiting [CINV] DOC for Acute Phase– 5-HT3 Antagonist.
DOC for Delayed phase - NK1 Antagonist
[Aprepitant]
Cyclophosphamide induced Mesna
cystitis
Ifosfamide induced Neurotoxicity Methylene Blue
Cisplatin induced Nephrotoxicity Amifostine & Osmotic diuresis using Mannitol
Doxorubicin cardiotoxicity Dexrazoxane [iron chelator]

Side effect NEET PG Treatment
Educators Notes
Paclitaxel induced Hypersensitivity Replace with Protein-Bound Paclitaxel
Methotrexate toxicity prevention Folinic acid [Leucovorin or tetrahydrofolate]
Methotrexate Crystalluria Urinary alkalization
Methotrexate toxicity in Renal Glucarpidase

failure patient
Pemetrexed toxicity Folic acid & Vitamin B 12

Irinotecan induced Diarrhoea Loperamide of Octreotide
NEET PG
Educators Notes
28. Which of the following is not true about purine analogues?

a) Azathioprine is used as immunosuppressant
b) Drugs are activated by hypoxanthine guanine phosphoribosyl
transferase [HGPRTase]
c) Fludarabine is the drug of choice for CLL
d) Cladribine is degraded by adenosine deaminase
NEET PG
Educators Notes
29. All of following statements about are true about 6-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
NEET PG
Educators Notes
30. Drug that requires dose reduction when used along with Febuxostat is
a) 6-Thioguanine
b) Azathioprine
c) Methotrexate
d) 5-FluoroUracil
NEET PG
Educators Notes
31. Drug requires dose reduction or avoided in Criggler nazar syndrome is

a) Irinotecan
b) Topotecan
c) Cefotizoxime
d) Thiazides
NEET PG
Educators Notes
32. Pemetrexed differs from MTX in all of the following except

A. It is more potent inhibitor of Thymidylate synthase than DHFR
B. Toxicity can be reduced by giving Folic acid and B12
C. It is more effective in treatment of ALL than MTX
D. All of the above

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NEET PG

2. Which of the following drug acts via hypomethylation of DNA

5. All of these are G-2 phase blockers except:

6. Radiosensitizer for head and neck cancer is

7. Which of the following drug is used in sickle cell anemia?

8. The drug of choice in choriocarcinoma is:

9. Methotrexate is used in all except-

10. High dose methotrexate is used for the treatment of:

13. Resistance to Methotrexate develops due to?

14. A cancer cell that is resistant to both vincristine and

16. Which of the following causes delayed and persistent leucopenia?

17. Anticancer drug implicated in causing gynecomastia and

18. A 50-year-old woman has been diagnosed with locally

19. All cause myelosuppression except:

20. SIADH is caused by all EXCEPT:

21. Cerebellar toxicity is seen with:

22. A patient on treatment for leukemia, develops chest pain,

23. Hand and Foot' syndrome can be caused by all except:

26. A patient on cisplatin therapy develops intractable vomiting on

27. Drug that is radioprotective is:

Cisplatin induced Nephrotoxicity Amifostine & Osmotic diuresis using Mannitol

Doxorubicin cardiotoxicity Dexrazoxane [iron chelator]

Methotrexate toxicity prevention Folinic acid [Leucovorin or tetrahydrofolate]

Methotrexate Crystalluria Urinary alkalization

Methotrexate toxicity in Renal Glucarpidase

Pemetrexed toxicity Folic acid & Vitamin B 12

28. Which of the following is not true about purine analogues?

29. All of following statements about are true about 6-mercaptopurine

31. Drug requires dose reduction or avoided in Criggler nazar syndrome is

32. Pemetrexed differs from MTX in all of the following except

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