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Chapter 99. Supportive Care in Oncology

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A patient has been prescribed crizotinib 250 mg twice daily for anaplastic lymphoma kinase (ALK)-positive NSCLC. This oral anticancer agent has a moderate/high risk for causing emesis. This patient does not have any additional risk factors for CINV. Which of the following is the best approach to manage CINV for this patient?

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A. NK1 antagonist, 5HT3 antagonist, and dexamethasone on the first 3 days of each cycle

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B. Prochlorperazine every 4 to 6 hours as needed

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C. Ondansetron daily before each dose of crizotinib

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D. Olanzapine and dexamethasone for the first 5 days of each cycle

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Which of the following ingredients should be part of a mouth rinse recommended for any patient who is at risk for developing mucositis to lessen its severity if it occurs?

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A. Chlorhexidine

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B. Hydrogen peroxide

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C. Salt water

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D. Alcohol

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Which of the following patients is at low risk for developing febrile neutropenia?

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A. A 45-year-old woman with depression, anxiety, and stage 2 breast cancer receiving adjuvant therapy with doxorubicin and cyclophosphamide who has temperature of 99.3°F (37.4 °C)

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B. A 75-year-old man with COPD and stage 4 esophageal cancer treated with cisplatin and fluorouracil who develops oral candidiasis from concurrent radiation and has temperature of 100.6°F (38.1 °C)

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C. A 65-year-old man with diabetes and blast phase CML treated with nilotinib for the past 4 months who has temperature 99°F (37.2 °C)

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D. A 73-year-old man with CHF and stage 4 prostate cancer treated with docetaxel who required pegfilgrastim 24 hours after each dose for the last three cycles 99.9°F (37.7 °C).

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How should a chemotherapy patient with ANC 1250/mm3 (1.25 × 109/L) and temperature 100°F (37.8°C) with adequate renal and hepatic function who is determined to be at low risk for infection according to the MAASC assessment tool be treated?

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A. Hospitalized for immediate parenteral administration of broad-spectrum antibacterials before culture results are obtained

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B. Treated as an outpatient with fluoroquinolones and granulocyte colony-stimulating factors

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C. Hospitalized and treated with granulocyte colony-stimulating factors while culture results are pending

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D. Treated as an outpatient with ...

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