Anticancer drugs: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Anticancer drugs

Sample item

A patient receiving high-dose methotrexate for osteosarcoma develops severe mucositis and myelosuppression. Which agent is used to rescue normal cells, and how does it work?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Leucovorin, by bypassing dihydrofolate reductase inhibition

Methotrexate inhibits dihydrofolate reductase and depletes reduced folates. Leucovorin (folinic acid) is already in the reduced form and replenishes the folate pool in normal cells without requiring the enzyme. It is given with high-dose therapy and in overdose.

Option by option

  • A. Dexrazoxane, by chelating iron in myocardium

    Dexrazoxane reduces anthracycline cardiotoxicity.

  • B. Mesna, by binding toxic metabolites in the urine

    Mesna protects the bladder from acrolein produced by cyclophosphamide and ifosfamide.

  • C. Leucovorin, by bypassing dihydrofolate reductase inhibition (correct)

    Correct. Leucovorin is a reduced folate that does not need dihydrofolate reductase.

  • D. Amifostine, by scavenging free radicals in the kidney

    Amifostine reduces cisplatin nephrotoxicity and radiation xerostomia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Leucovorin, by bypassing dihydrofolate reductase inhibition. Methotrexate inhibits dihydrofolate reductase and depletes reduced folates.

Why is "Dexrazoxane, by chelating iron in myocardium" not the answer?

Dexrazoxane reduces anthracycline cardiotoxicity.

Why is "Mesna, by binding toxic metabolites in the urine" not the answer?

Mesna protects the bladder from acrolein produced by cyclophosphamide and ifosfamide.

Why is "Amifostine, by scavenging free radicals in the kidney" not the answer?

Amifostine reduces cisplatin nephrotoxicity and radiation xerostomia.

What concept does this question test?

It tests Anticancer drugs in Pharmacology. Leucovorin (folinic acid) is already in the reduced form and replenishes the folate pool in normal cells without requiring the enzyme. It is given with high-dose therapy and in overdose.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anticancer drugs?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.