Haematology and oncology: bleomycin lung toxicity: practice question

A General Medicine 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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General Medicine · Haematology and oncology: bleomycin lung toxicity

Sample item

A 28-year-old man is treated for a testicular germ cell tumour. After three cycles he develops a dry cough and progressive breathlessness, with bibasal fibrosis on imaging. Which drug in his regimen is the most likely cause?

AEtoposideBCisplatinCVincristineDBleomycin

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

The answer and the reasoning

D. Bleomycin

Bleomycin causes dose-related pulmonary fibrosis, and supplemental oxygen can worsen the lung injury. Cisplatin causes nephrotoxicity, ototoxicity and neuropathy. Etoposide causes myelosuppression, and vincristine causes peripheral neuropathy.

Option by option

A. Etoposide
Etoposide mainly causes myelosuppression and alopecia.
B. Cisplatin
Cisplatin is known for nephrotoxicity, ototoxicity and emesis.
C. Vincristine
Vincristine is mainly neurotoxic, with peripheral neuropathy and constipation.
D. Bleomycin (correct)
Correct. Bleomycin is the classic cause of drug-induced pulmonary fibrosis.

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.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Bleomycin. Bleomycin causes dose-related pulmonary fibrosis, and supplemental oxygen can worsen the lung injury.

Why is "Etoposide" not the answer?

Etoposide mainly causes myelosuppression and alopecia.

Why is "Cisplatin" not the answer?

Cisplatin is known for nephrotoxicity, ototoxicity and emesis.

Why is "Vincristine" not the answer?

Vincristine is mainly neurotoxic, with peripheral neuropathy and constipation.

What concept does this question test?

It tests Haematology and oncology: bleomycin lung toxicity in General Medicine. Cisplatin causes nephrotoxicity, ototoxicity and neuropathy. Etoposide causes myelosuppression, and vincristine causes 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 Haematology and oncology: bleomycin lung toxicity?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.