Chemotherapy: multi-targeted kinase inhibitors: 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: multi-targeted kinase inhibitors

Sample item

A 60-year-old man with metastatic clear cell renal carcinoma is started on an oral multi-targeted tyrosine kinase inhibitor that blocks VEGF and PDGF receptors. Which adverse effects should be monitored?

AHaemorrhagic cystitis and alopeciaBHypertension and hand-foot skin reactionCPulmonary fibrosis and hyperpigmentationDPeripheral neuropathy and constipation

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

The answer and the reasoning

B. Hypertension and hand-foot skin reaction

Sunitinib and sorafenib block VEGF and PDGF receptors, and their class effects include hypertension, hand-foot skin reaction, diarrhoea, hypothyroidism and bleeding. Haemorrhagic cystitis belongs to cyclophosphamide, neuropathy to vincristine and bortezomib, and pulmonary fibrosis to bleomycin.

Option by option

A. Haemorrhagic cystitis and alopecia
Haemorrhagic cystitis and alopecia are features of cyclophosphamide.
B. Hypertension and hand-foot skin reaction (correct)
Correct. Hypertension and hand-foot reaction are typical class effects of VEGF pathway inhibitors.
C. Pulmonary fibrosis and hyperpigmentation
Pulmonary fibrosis and pigmentation are features of bleomycin and busulfan.
D. Peripheral neuropathy and constipation
Neuropathy and constipation are features of vinca alkaloids.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Hypertension and hand-foot skin reaction. Sunitinib and sorafenib block VEGF and PDGF receptors, and their class effects include hypertension, hand-foot skin reaction, diarrhoea, hypothyroidism and bleeding.

Why is "Haemorrhagic cystitis and alopecia" not the answer?

Haemorrhagic cystitis and alopecia are features of cyclophosphamide.

Why is "Pulmonary fibrosis and hyperpigmentation" not the answer?

Pulmonary fibrosis and pigmentation are features of bleomycin and busulfan.

Why is "Peripheral neuropathy and constipation" not the answer?

Neuropathy and constipation are features of vinca alkaloids.

What concept does this question test?

It tests Chemotherapy: multi-targeted kinase inhibitors in Pharmacology. Haemorrhagic cystitis belongs to cyclophosphamide, neuropathy to vincristine and bortezomib, and pulmonary fibrosis to bleomycin.

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: multi-targeted kinase inhibitors?

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.