Chemotherapy: cytarabine cerebellar toxicity: 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: cytarabine cerebellar toxicity

Sample item

A man receiving intensive consolidation for acute myeloid leukaemia develops slurred speech, nystagmus, ataxia and dysmetria on day 4. MRI of the brain is normal. Which drug is the likely cause?

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

The answer and the reasoning

A. Cytarabine

High-dose cytarabine causes dose-dependent cerebellar toxicity, especially with renal impairment or in older patients. Nystagmus and ataxia are early signs and the drug is stopped on their appearance. Daunorubicin and mitoxantrone are cardiotoxic, and thioguanine causes myelosuppression.

Option by option

  • A. Cytarabine (correct)

    Correct. High-dose cytarabine causes cerebellar toxicity.

  • B. Daunorubicin

    Daunorubicin causes cumulative cardiomyopathy, not cerebellar signs.

  • C. Thioguanine

    Thioguanine causes myelosuppression and hepatic toxicity.

  • D. Mitoxantrone

    Mitoxantrone causes cardiotoxicity and blue discolouration of urine.

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 A, Cytarabine. High-dose cytarabine causes dose-dependent cerebellar toxicity, especially with renal impairment or in older patients.

Why is "Daunorubicin" not the answer?

Daunorubicin causes cumulative cardiomyopathy, not cerebellar signs.

Why is "Thioguanine" not the answer?

Thioguanine causes myelosuppression and hepatic toxicity.

Why is "Mitoxantrone" not the answer?

Mitoxantrone causes cardiotoxicity and blue discolouration of urine.

What concept does this question test?

It tests Chemotherapy: cytarabine cerebellar toxicity in Pharmacology. Nystagmus and ataxia are early signs and the drug is stopped on their appearance. Daunorubicin and mitoxantrone are cardiotoxic, and thioguanine causes myelosuppression.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: cytarabine cerebellar toxicity?

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.