Chemotherapy: venetoclax and tumour lysis: 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 · Chemotherapy: venetoclax and tumour lysis

Sample item

Venetoclax, a BCL-2 inhibitor used for chronic lymphocytic leukaemia, is started at a low dose and escalated weekly over about five weeks. This schedule mainly reduces the risk of which complication?

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

The answer and the reasoning

D. Tumour lysis syndrome

Venetoclax restores apoptosis by displacing pro-apoptotic proteins from BCL-2, and CLL cells die rapidly. A high bulk of lymphocytes can release potassium, phosphate and uric acid, so a dose ramp-up with hydration and urate-lowering therapy is used.

Option by option

  • A. Cardiomyopathy

    Cardiomyopathy is the cumulative toxicity of anthracyclines.

  • B. Haemorrhagic cystitis

    Haemorrhagic cystitis follows acrolein exposure with cyclophosphamide or ifosfamide.

  • C. Pulmonary fibrosis

    Pulmonary fibrosis is a toxicity of bleomycin and busulfan.

  • D. Tumour lysis syndrome (correct)

    Correct. Rapid tumour cell death in CLL can cause tumour lysis syndrome.

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 D, Tumour lysis syndrome. Venetoclax restores apoptosis by displacing pro-apoptotic proteins from BCL-2, and CLL cells die rapidly.

Why is "Cardiomyopathy" not the answer?

Cardiomyopathy is the cumulative toxicity of anthracyclines.

Why is "Haemorrhagic cystitis" not the answer?

Haemorrhagic cystitis follows acrolein exposure with cyclophosphamide or ifosfamide.

Why is "Pulmonary fibrosis" not the answer?

Pulmonary fibrosis is a toxicity of bleomycin and busulfan.

What concept does this question test?

It tests Chemotherapy: venetoclax and tumour lysis in Pharmacology. A high bulk of lymphocytes can release potassium, phosphate and uric acid, so a dose ramp-up with hydration and urate-lowering therapy is used.

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 Chemotherapy: venetoclax and tumour lysis?

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.