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AOCNP Test Review 2024 Study Guide Solutions Updated 2024 Treatments that place individuals at increased risk for infection - ANSWER-Chemotherapy treatments including high-dose cyclophosphamide, doxorubicin, docetaxel, or alemtuzumab. Colony stimulating factors (CSF) - ANSWER-**GM-CSF : growth ...

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  • November 3, 2024
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  • 2024/2025
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Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024




AOCNP Test Review 2024 Study Guide

Solutions Updated 2024


Treatments that place individuals at increased risk for infection - ANSWER✔✔-Chemotherapy

treatments including high-dose cyclophosphamide, doxorubicin, docetaxel, or alemtuzumab.


Colony stimulating factors (CSF) - ANSWER✔✔-**GM-CSF : growth factor for hematopoietic stem cells

and granulocyte/monocytes


**M-CSF (macrophage): essential for macrophage production


**G-CSF (granulocyte) :essential for neutrophils


**Erythropoietin (EPO): growth factor for RBC


Filgrastim (Neupogen)


Pegfilgrastim (Neulasta)


Tbo-filgrastim (Granix) - ANSWER✔✔-Common side effects: mild to moderate bone pain


Used to patients at risk of experiencing treatment induced neutropenia


Major benefit: reducing the possibility of myelosuppression and permitting the continuation of

therapeutic chemotherapy doses


Filgrastim (Neupogen) - ANSWER✔✔-Dose: 5 µg per kilogram per day. Begin 24 to 72 hours after

completion of chemotherapy and continue through the post nadir period.




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Pegfilgrastim (Neulasta) - ANSWER✔✔-That was: 6 mg per cycle. Again 1 to 3 days post chemotherapy.

Administer as a single 6 mg injection once per cycle. Do not administer in the period beginning 14 days

before until 24 hours after administration of chemotherapy.


Antimicrobial prophylaxis for infection - ANSWER✔✔-Low risk: no prophylaxis Recommended unless the

patient has prior herpes simplex virus episode.




Intermediate risk:


Bacterial: consider Fluoroquinolone


Fungal: consider fluconazole during neutropenia and if mucositis is anticipated


Viral: during neutropenia and at least 30 days after transplantation




High risk:


Bacterial: consider fluoroquinolone


Fungal: consider fluconazole or other anti-fungal agent


Viral: during neutropenia and at least 30 days after transplantation


Graft versus host disease: penicillin andtrimethroprim/sulfamethoxazole (tmp/smx) Or equivalent for

allogenic heamatopoetic Stem cell transplant recipients


Alemtuzumab: TMP/SMX


Complete diagnostic work up for neutropenic fever - ANSWER✔✔-Blood cultures: bacterial, viral, and

fungal

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BUN, electrolytes, and creatinine


Chest x-ray


CBC and differential


Liver function test


Pulse oximetry


Site-specific cytology and cultures


Urinanalysis


ANC calculation - ANSWER✔✔-WBC x [(% segs + % bands)/100]


aplastic anemia - ANSWER✔✔-a normocytic-normochromic type of anemia characterized by the failure

of bone marrow to produce red blood cells


hemolytic anemia - ANSWER✔✔-characterized by an inadequate number of circulating red blood cells

due to the premature destruction of red blood cells by the spleen


deficiency anemia - ANSWER✔✔-anemia caused by lack of necessary nutrients


B12, folate, and iron


Anemia # of RBC/ MCV - ANSWER✔✔-Microcytic. Normocytic. Macrocyctic.


Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin. -

ANSWER✔✔-cells smaller than normal


Iron deficiency




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macrocytic anemia - ANSWER✔✔-due to folate or vitamin B12(cobalamin) deficiency (megaloblastic

anemia), THF-M --> VitB12-M --> Methionine, (transfer of methyl groups)


erythrpoietin (EPO) - ANSWER✔✔-Stimulates development of RBC production


Triggered to release by reduced oxygen level of RBC mass trigger from the kidney


Labs to check in anemia - ANSWER✔✔-CBC with diff


Peripheral smear


Reticulocyte count


Iron studies: serum iron, total iron binding capacity, ferritin


Vitamin B 12


Full eight red cell




If these are not diagnostic these may be added


Fractionated Bilirubin


Occult stool


Coombs test


Haptoglobin level


Hemoglobin electrophoresis

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