OCN study questions
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| Paraplatin | Carboplatin
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| Platinol | Cisplatin
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| Cytoxan | Cyclophosphamide
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| Ifex | Ifosfamide
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| Xeloda | Capecitabine
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| 5-FU | Flourouracil
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| MTX | Methotrexate
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| Blenoxane | Bleomycin
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| Adriamycin | Doxorubicin
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| VP-16 | Etoposide
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| Camptosar | Irinotecan
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| Taxol | Paclitaxel
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| Rituxan | Rituximab
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| Herceptin | Trastuzumab
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| Tykerb | Lapatinib
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| Avastin | Bevacizumab
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| Erbitux | Cetuximab
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| Tarceva | Erlotinib
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| Oncovin | Vincristine
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| Velban | Vinblastine
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| Navelbine | Vinorelbine
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| Normal calcium (Ca) levels | 8.5-10.5 meq/L
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| Cancer patient would be more likely to have high or low serum Ca levels | High - Hypercalcemia
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| Normal serum Potassium K+) levels | 3.5-5.3 mEq/l
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| Normal Hgb levels | Adult Male 13.5-18 g/dl / Female 12-16 g/dl
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| Normal WBC levels | 5000-10,000 ul
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| What class of chemotherapy agents do you never give intrathecally | Vinca Alkaloids
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| 1) Cardiotoxic drug that has a lifetime cumulative dose limit. | Doxorubicin
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| Lifetime cumulative limit of Doxorubicin for normal patient | 550 mg/m2
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| Lifetime cumulative limit of Doxorubicin for a patient that has had prior chest irradiation or concomitant cyclophosphamide treatment | 450 mg/m2
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| What chemotherapy is ALWAYS administered with Mesa to prevent Hemorrhagic cystitis? | Ifosfamide
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| High doses are followed by leucovorin and vigorous hydration | Methotrexate
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| Chemotherapy agent that has a very high emetogenic potential - both acute and delayed | Cisplatin(>50mg/m2)
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| Chemotherapy agent that has a high risk of diarrhea | Irinotecan
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| Elevated K+ levels | Hyperkalemia
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| Low K+ levels | Hypokalemia
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| Pulmonary toxicity can develop when the lifetime dose of Bleomycin reaches what level | 450-500 units
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| cancer of originating from epithelial cells | carcinomas
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| cancers that originate in organs that fight infection | lymphomas
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| cancers that originate in organs that form blood | leukemias
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| cancers that originate in connective tissue (bone and muscle) | sarcomas
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| 4 main tumor classifications: | carcinoma, lymphoma, leukemia, sarcoma
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| stage of cancer where malignant cells are confined to the tissue of origin | Stage I
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| stage of cancer where cancer has spread to local area (usually the lymph nodes) | Stage II
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| stage of cancer where the tumor is larger or spread to surrounding tissues or both | Stage III
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| stage of cancer where cancer has metastasized to distant body parts | Stage IV
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| WORDWIDE - Leading sites for cancer deaths -in order | 1) Lung 2) Stomach 3)Liver
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| USA - Leading site for cancer death - #1 for both men and women | Lung
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| Skin cancer is a common cause of death - T/F | False - it is a common cancer but not leading cause of cancer death
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| 3 types of skin cancer: | basal cell carcinoma; squamous cell carcinoma; malignant melanoma
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| Trigger words for CML? | White blood cell count >50,000, Philadelphia chromosome, blast crisis, splenomegaly.
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| Trigger words for Hodgkin's disease? | Reed-Sternberg cells, cervical lymphadenopathy, night sweats
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| Most effective treatment for cancer is | Prevention or early detection
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| Colonoscopy beginning at age 40 for a high risk individual is an example of what type of prevention | Secondary - this is to detect disease before symptoms. (Primary prevention examples are eating healthy)
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| Clinical Trial Phase 1 | 20-25 people / Evaluate toxicity / Establish max dose without side effects / Determine route (PO or IV) / Variety of tumor types
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| Clinical Trial Phase 2 | More than 100 people / Determine if treatment has benefit / Groups of patients with same tumors will be used / Assess response rate /
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| Clinical Trial Phase 3 | 100-1000's of people / Compare new drug to current standard / Establish efficacy by assessing survival and time to progression / Last step before FDA consideration / Usually double blind trials
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| Clinical Trial Phase 4 | Can it do anything else? / Expand off label use / Assess toxicity and long term effects / Usually after FDA approval
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| CAUTION | Change in bowel or bladder / A sore that doesn't heal / Unusual bleeding / Thickening or lumps / Indigestion / Obvious changes in wart or mole / Nagging cough
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| Four electrolyte imbalances in TLS | Hyperkalemia, Hyperphosphatemia, Hyperuricemia, Hypocalemia
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| Sodium (Na) normal ranges | 135-145 meq/L
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| Which chemos have greatest potential for producing a secondary malignancy? | Alkylating agents
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| Amifostine | chemoprotectant against nephrotoxicity from cisplatin
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| Principal toxicity of vincristine | peripheral neuropathy
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| Dose limiting toxicity of cisplatin | nephrotoxicity
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| Clinical Trial Phase 0 | 10-12 people / Identify drugs that do not produce desired effect / Limited doses / Low doses / Less risk / /Useful for molecularly target drugs / Useful for drugs that require biomarker development
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| PLISSIT | Permission to discuss / Limitied Information / Specific Suggestion / Intensive Therapy
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| Define Apoptosis | programmed cell death
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| Mutations in p53 | increases risk of breast, leukemia, sarcoma and adrenal cancer
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| In-Situ Cancer | Noninvasive breast cancer
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| Most common sites of mets from breast cancer? | IN ORDER - Bone - Lung - Liver - Brain
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| What do biphosphonates do? | prevent the loss of bone mass, used to treat osteoporosis, hypercalcemia, bone pain, and prevention of fractures
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| Which cancers have highest incidence rates? | Men - Prostate / Women - Breast
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| CEA | tumor marker used to monitor the treatment of cancer patients, especially those with colon cancer
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| Most aggressive type of lung cancer | small cell lung cancer (SCLC)
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| Early symptoms of colorectal cancer | change in bowel habits / blood in stool
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| Risk factors for breast cancer | No children / First pregnancy after 30 / Early periods / Late menopause / Hormone replacement therapy
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| Adjuvant therapy | treatment given in addition to primary therapy
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| Neoadjuvant therapy | administration of therapeutic agents prior to the main treatment
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| Most common cancer among women | Breast
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| What age should mammograms start? | 40
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| Primary Prevention | protect healthy people from developing a disease / educate / screen / immunize
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| Tertiary prevention | helping people manage complicated, long-term health problems and maximize QOL / Rehab / Support Groups
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| Secondary Prevention | happen after an illness or serious risk factors have already been dx. Goal is to halt or slow the progress of disease (if possible) in its earliest stages
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| Trigger words for CNS B cell lymphoma | HIV positive patients, AIDS
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| What are the three cancers with the highest mortality in women? (list in order) | Lung / Breast / Colon
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| What are the three cancers with the highest incidence in women? (list in order) | Breast / Lung / Colon
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| What are the three cancers with the highest mortality in men? (list in order) | Lung / Prostate / Colon
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| What is the major modifiable risk factor for cancer? | Smoking
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| What types of paraneoplastic syndromes can be caused by small cell lung cancer? | Cushing's syndrome (from ACTH) / SIADH / Eaton-Lambert syndrome
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| What are the two main risk factors for prostate cancer? | Age--it's not seen in pts <40 years old. 60% of men older than 80 years have prostate cancer / Race--black>white>asian
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| Sx of bladder cancer | persistent painless hematuria, older than 40, smoker, worker in rubber or dye industry (aniline dye), h/o shistosomiasis
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| Explain ABCD's of melanoma | A--Asymmetry / B--Border irregularity / C--Color change or multicolor / D--Diameter increase
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| what cancers are associated with the tumor marker AFP? | hepatocellular carcinoma, yolk-sac tumors
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| what cancers are associated with the tumor marker CEA? | colon cancer, pancreas, other GI tumors
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| what cancers are associated with the tumor marker PSA? | prostate
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| what cancers are associated with the tumor marker CA-125? | Ovary
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| what cancers are associated with the tumor marker CA 19-9? | Pancreas
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| What med can be used to protect heart against effects of doxorubicin | Dexrazoxane
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| For which pulmonary toxicity does bleomycin have a high risk? | Pneumonitis
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| Which chemo has a high risk for pulmonary toxicity? | bleomycin (Blenoxane)
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| Tumors associated with malignant pericardial effusions | Lung
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| Solid tumors at risk for TLS (3) | SCLC, breast, neuroblastoma
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| Most common cancers associated with hypercalcemia (6) | Breast, lung, head and neck, MM, renal, lymphoma
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| Cushings Triad | HTN / bradycardia / abnormal respirations
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| Trigger words for Waldenstrom's macroglobulinemia | hyperviscosity, IgM spike, cold agglutinins, Raynaud's phenomenon with cold
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| Define paraneoplastic syndrome | condition caused by a malignancy but not due directly to destruction or invasion by the tumor
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| Pleural Effusion | fluid in pleural space
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| pneumothorax | air in the pleural space
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| Carcinoembryonic antigen (CEA) | Colorectal cancer, check for recurrence and monitoring.
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| at risk for TLS | Leukemia, lymphoma, Small cell lung cancer , multiple myeloma
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| Define Tumor Lysis Syndrome (TLS) | metabolic imbalance that occurs with rapid tumor kill
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| How does Allopurinol work? | decreases uric acid production and decreases uric acid deposits in kidney
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| How does Rasburicase work? | catalyses the conversion of uric acid to allantoin
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| Method to reduce hair loss | There are no research based methods to reduce hair loss
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| Ethnic group with highest incidence of cancer for all sites combined | African American male
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| Age prostate exams should begin digital rectal exams & PSATest at age... | 50 yrs
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| Men with strong family history of prostate cancer should begin annual screening at | 45 yrs
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| Lactose intolerance in common among these 2 groups. (recommending milk as a nutritional supplement might not be effective) | Asian & Pacific islanders / African Americans
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| Def. Fatalism | Belief that one has little control over personal health outcomes & death is inevitable with cancer
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| Late or long term effects of cancer treatments | Cardiomyopathy, pulmonary fibrosis and sterility
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| What is COBRA | Insurance if a person loses his job. Coverage is available foe 18 months for person & 36 months for dependents. Employee assumes payment for premiums
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| Which regimen is more likely to lead to infertility after chemotherapy - single chemo or combination chemo | Combination
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| What surgery can lead to sexual disfunction | Prostatectomy
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| Anorexia is | Wt loss due to decrease in appetite
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| Cachexia is | Fat, muscle and bone mineral content due to a metabolic syndrome associated with cancer
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| Head & neck patient who has dad surgery & radiation will need what type of therapy | Speech therapy rt chewing, swallowing, speech, saliva flow
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| 77% of all cancers occur in what age range | >55 years
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| Blood from an Autologous donor is | The patient donated their own blood for use
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| Gastroparesis | Impaired digestion-slowing of gastric contractions
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| Aminoglycosides are use to treat infections in cancer pts. Their major toxicity is | Nephrotoxicity
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| Some common 5-HT3 antagonist are | Ondonsetron (zofran), granisetron (kitril)
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| Medication given for pt with increased intracranial pressure (ICP) | Mannitol
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| Neutrophils come from what type of stem cell | Myeloid stem cells
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| What chemotherapy in high doses is usually administered with Mesa to prevent Hemorrhagic cystitis? | Cyclophosphamide (dose > 1000mg = up to 40% incidence of hemorrhagic cystitis
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| Patient is taking PO Cyclophosphamide. What time of the day should they take this pill - AM / Noon / PM -- Why? | AM - will have time to increase hydration and empty bladder frequently
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| Can cause ototoxicity | Cisplatin - good for pt to have baseline audiogram
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| Medication that is a renal protectant | Anifostine
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| What antibody does Rituximab bind to? | CD20 antibody on B cells
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| What type of precautions should be taken when handling Tositumomab I-131 | Radiation precautions - It is a conjugated MoAb - MoAb joined with radioactive iodine I-131
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| What antibody does Trastuzumab bind to? | Her2 antiboby
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| define - Autonomy | Self determination - Independent decision making
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| define - beneficence | the duty to act in the best interest of the patient
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| define - justice | equal distribution of resources - equal access to healthcare with SS, Medicare, Medicaid
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| define - nonmaleficence | duty to do not harm - example -balance treatment with risks
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| define - Veracity | Truth-telling
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| define - fidelity | Faithful to promises made
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