Surgery MCQ 170

A 55-year-old woman is undergoing chemotherapy for breast cancer. During her treatment, she develops complications that necessitate a change in her chemotherapy regimen. Her oncologist evaluates her condition to determine the most appropriate course of action.

The most common complication that requires alteration of planned chemotherapy regimens is which of the following?

A. Pulmonary fibrosis  
B. Gastrointestinal ulceration  
C. Hematologic suppression  
D. Hepatotoxicity  


Answer:

The Correct Answer is: C. Hematologic suppression

Explanation:

Hematologic suppression (C):

– Hematologic suppression, also known as myelosuppression, is the most common and significant complication of chemotherapy that often requires alteration of treatment regimens.

– Myelosuppression involves the decreased production of blood cells, leading to conditions such as anemia, leukopenia (low white blood cell count), and thrombocytopenia (low platelet count). These conditions can result in fatigue, increased risk of infection, and bleeding complications.

– Because of the risk of severe infections, bleeding, and other complications, chemotherapy doses may need to be reduced, treatment schedules altered, or supportive therapies like growth factors (e.g., G-CSF) administered.

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Explanation of Incorrect Options:

Pulmonary fibrosis (A):

– Pulmonary fibrosis is a serious but less common complication of certain chemotherapy drugs (e.g., bleomycin). It can lead to respiratory issues but is not the most common reason for altering chemotherapy regimens.

Gastrointestinal ulceration (B):

– Gastrointestinal ulceration and mucositis can occur with some chemotherapy agents and can cause significant discomfort and nutritional issues. While it may require supportive care and sometimes dose adjustments, it is not as common a reason for altering regimens as hematologic suppression.

Hepatotoxicity (D):

– Hepatotoxicity, or liver damage, can result from certain chemotherapy drugs. It requires monitoring of liver function tests and may necessitate dose adjustments or discontinuation of the offending agent. However, it is less common than hematologic suppression as a reason for altering chemotherapy regimens.

In conclusion, hematologic suppression is the most common complication that requires alteration of planned chemotherapy regimens, making option C the correct answer.