Anticancer drugs: cisplatin nephroprotection: 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: cisplatin nephroprotection

Sample item

A 45-year-old man with testicular germ cell tumour is to receive cisplatin. Which measure best reduces its dose-limiting nephrotoxicity?

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

The answer and the reasoning

B. Vigorous intravenous saline hydration

Cisplatin concentrates in proximal tubular cells and causes cumulative nephrotoxicity, and pre- and post-hydration with saline (with magnesium replacement) is standard prophylaxis. Other characteristic effects are severe emesis, irreversible high-frequency hearing loss and peripheral neuropathy.

Option by option

  • A. Mesna

    Mesna protects the bladder from acrolein with ifosfamide and cyclophosphamide.

  • B. Vigorous intravenous saline hydration (correct)

    Correct. Hydration promotes urine flow and lowers tubular platinum concentration.

  • C. Leucovorin

    Leucovorin rescues normal cells from methotrexate.

  • D. Dexrazoxane

    Dexrazoxane reduces anthracycline cardiotoxicity.

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.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Vigorous intravenous saline hydration. Cisplatin concentrates in proximal tubular cells and causes cumulative nephrotoxicity, and pre- and post-hydration with saline (with magnesium replacement) is standard prophylaxis.

Why is "Mesna" not the answer?

Mesna protects the bladder from acrolein with ifosfamide and cyclophosphamide.

Why is "Leucovorin" not the answer?

Leucovorin rescues normal cells from methotrexate.

Why is "Dexrazoxane" not the answer?

Dexrazoxane reduces anthracycline cardiotoxicity.

What concept does this question test?

It tests Anticancer drugs: cisplatin nephroprotection in Pharmacology. Other characteristic effects are severe emesis, irreversible high-frequency hearing loss and peripheral neuropathy.

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: cisplatin nephroprotection?

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.