Haematology and oncology: cisplatin toxicity: practice question

A General Medicine 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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General Medicine · Haematology and oncology: cisplatin toxicity

Sample item

A man on cisplatin-based chemotherapy for testicular cancer develops a rising creatinine, hypomagnesaemia and high-frequency hearing loss. Which measure reduces the nephrotoxicity?

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

The answer and the reasoning

B. Vigorous saline pre-hydration

Cisplatin damages proximal tubular cells, causing renal magnesium wasting and AKI, and also causes ototoxicity and neuropathy. Aggressive hydration with saline, sometimes with mannitol, reduces tubular exposure.

Option by option

  • A. Mesna co-administration with each cycle

    Mesna protects the bladder from cyclophosphamide and ifosfamide metabolites.

  • B. Vigorous saline pre-hydration (correct)

    Correct. Pre-hydration dilutes cisplatin in the tubules and reduces injury.

  • C. Allopurinol prophylaxis

    Allopurinol prevents urate nephropathy in tumour lysis, not cisplatin injury.

  • D. Leucovorin (folinic acid) rescue

    Leucovorin rescues the effect of methotrexate.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Vigorous saline pre-hydration. Cisplatin damages proximal tubular cells, causing renal magnesium wasting and AKI, and also causes ototoxicity and neuropathy.

Why is "Mesna co-administration with each cycle" not the answer?

Mesna protects the bladder from cyclophosphamide and ifosfamide metabolites.

Why is "Allopurinol prophylaxis" not the answer?

Allopurinol prevents urate nephropathy in tumour lysis, not cisplatin injury.

Why is "Leucovorin (folinic acid) rescue" not the answer?

Leucovorin rescues the effect of methotrexate.

What concept does this question test?

It tests Haematology and oncology: cisplatin toxicity in General Medicine. Aggressive hydration with saline, sometimes with mannitol, reduces tubular exposure.

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 Haematology and oncology: cisplatin toxicity?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.