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NBME 17 Answers

nbme17/Block 2/Question#24 (4.9 difficulty score)
A 65-year-old woman with ovarian cancer is ...
DNA replication🔍

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submitted by cassdawg(580),

Cyclophosphamide is an alkylating agent which cross-links DNA at guanine and interferes with DNA replication (FA2020p441)

Other alkylating agents that interfere with DNA replication include busulfan, isofosfamide, nitrosureas and procarbazine (procarbazine is nonspecific).

Other answers:

  • Imatinib/dasatinib/nilotinib targets the BCR-Abl tyrosine kinase and are used for CML (p443)
  • Caspase 3 is not a direct target of any chemotherapeutic.
  • DNA histone deacetylase is the target of HDAC inhibitors, not in First Aid but approved for some T-cell lymphoma.
  • DNA polymerase alpha is one of the eukaryotic DNA polymerases. It is responsible for initiation and some synthesis of lagging strand but does not have the high processivity of Pol delta. It is not directly targeted in any therapy.
  • DNA topoisomerase II inhibitors include etoposide, teniposide (primarily solid tumor use, p442), doxorubicin, danorubicin (solid tumors, leukemia, lymphoma, p439). DNA Top I inhibitors are also important antitumor agents, including irinotecan and topotecan (p442)
  • Epidermal growth factor receptor tyrosine kinase (EGF tyrosine kinase) inhibitor is Erlotinib, and it is important in combatting non-small cell lung cancer (p442)