Anticancer drugs: asparaginase: 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 · Anticancer drugs: asparaginase

Sample item

A 9-year-old boy in induction therapy for acute lymphoblastic leukaemia develops epigastric pain with raised lipase, a low fibrinogen and a cerebral venous sinus thrombosis. Which drug, acting by depleting circulating asparagine, is the likely cause?

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

The answer and the reasoning

A. Asparaginase

Leukaemic lymphoblasts lack asparagine synthetase and depend on circulating asparagine, which asparaginase hydrolyses. Because it also inhibits hepatic synthesis of proteins, it causes hypofibrinogenaemia and low antithrombin, thrombosis, pancreatitis, hypersensitivity and hyperglycaemia.

Option by option

  • A. Asparaginase (correct)

    Correct. Asparaginase causes pancreatitis and coagulation abnormalities through protein synthesis inhibition.

  • B. Daunorubicin

    Daunorubicin causes cardiomyopathy and myelosuppression.

  • C. Cytarabine

    Cytarabine causes myelosuppression and cerebellar toxicity at high dose.

  • D. Vincristine

    Vincristine causes neuropathy and constipation and has no asparagine-depleting action.

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.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Asparaginase. Leukaemic lymphoblasts lack asparagine synthetase and depend on circulating asparagine, which asparaginase hydrolyses.

Why is "Daunorubicin" not the answer?

Daunorubicin causes cardiomyopathy and myelosuppression.

Why is "Cytarabine" not the answer?

Cytarabine causes myelosuppression and cerebellar toxicity at high dose.

Why is "Vincristine" not the answer?

Vincristine causes neuropathy and constipation and has no asparagine-depleting action.

What concept does this question test?

It tests Anticancer drugs: asparaginase in Pharmacology. Because it also inhibits hepatic synthesis of proteins, it causes hypofibrinogenaemia and low antithrombin, thrombosis, pancreatitis, hypersensitivity and hyperglycaemia.

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 Anticancer drugs: asparaginase?

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.