A. Patients do not present with classic MF symptoms of anemia, fatigue, and splenomegaly B. It is a positive risk factor and is associated with the best outcomes in MF C. The common driver mutations of JAK2, CALR, and MPL are not present D. The common driver mutations of ASXL1, SRSF2, and U2AF1Q157 are not present E. Unsure

A. Neuropathy and night sweats B. Anemia and fatigue C. Hair loss and fatigue D. Splenomegaly and anemia E. Unsure

A. The Dynamic International Prognostic Scoring System (DIPSS) can only be used at the time of diagnosis B. A score of 4 to 9 on the Mutation-enhanced International Prognostic Scoring System Version 2 (MIPSS70+v2) is considered lower-risk disease C. Anemia severity values are the same for males and females in the MIPSS70+v2 scoring system D. MIPSS70+v2 is a 5-tiered system using molecular, karyotype, and clinical variables to determine risk E. Unsure

A. To mitigate thalidomide toxicity, it can be given with a prednisone taper initiated at 0.5 mg/kg/day B. Pomalidomide is the treatment of choice, as it has the best outcomes of the 3 available IMiDs C. Lenalidomide is the best tolerated IMiD, as it showed a low incidence of myelosuppression in clinical trials D. If her patient has a del 5q, then thalidomide is the drug of choice over other IMiDs E. Unsure

A. Pay careful attention to and report any changes in skin integrity, as hydroxyurea can cause lower extremity ulcerations B. You will most likely be on hydroxyurea therapy for an extended period of time, as the median duration of response is 36 months C. Report any mood changes to your oncologist, as hydroxyurea treatment can exacerbate or cause depression D. Once you are on a stable dose of hydroxyurea, you will only need blood draws to check for cytopenias every 6 months E. Unsure

A. Continue ruxolitinib at the current dose and recheck platelets in 2 to 4 weeks B. Decrease the ruxolitinib dose to 5 mg twice daily and recheck platelets in 2-4 weeks C. Decrease the ruxolitinib dose to 10 mg twice daily and recheck platelets in 2-4 weeks D. He is experiencing toxicity that warrants a change in therapy; switch to fedratinib E. Unsure

A. The risk of Wernicke's encephalopathy (WE) is a Boxed Warning with fedratinib B. WE with fedratinib can include symptoms of ataxia, mental status changes, and confusion C. Thiamine deficiency must be corrected prior to fedratinib therapy initiation to prevent WE D. If WE is suspected, the fedratinib dose should be reduced to 100 mg daily E. Unsure

A. A slow taper of ruxolitinib is the best way to prevent ruxolitinib withdrawal syndrome B. Patients at highest risk of ruxolitinib withdrawal syndrome are those with a high dose, low platelets, and a large spleen size at the time of discontinuation C. If ruxolitinib withdrawal syndrome occurs, management strategies include the initiation of systemic steroids and treatment of any tumor lysis syndrome or hyperproliferative symptoms D. Fedratinib therapy should overlap with ruxolitinib therapy to prevent withdrawal syndrome E. Unsure

A. Inhibits JAK 1 and 2, thereby inhibiting cell signaling via the JAK-STAT pathway B. Stops transforming growth factor-β ligands from binding to activin IIB receptors C. Directly stimulates erythropoietin progenitor cells D. Inhibits ACVR1/ALK2 which upregulates hepcidin synthesis to ameliorate anemia E. Unsure

A. Change fedratinib to ruxolitinib and restart fedratinib when the voriconazole is discontinued B. Reduce the fedratinib dose to 200 mg orally daily and return to 400 mg orally daily when the voriconazole is discontinued C. Reduce fedratinib dose to 200 mg orally daily, then increase to 300 mg orally daily for 2 weeks, then 400 mg orally daily thereafter when the voriconazole is discontinued D. Reduce the fedratinib dose to 300 mg orally daily and return to 400 mg orally daily when the voriconazole is discontinued E. Unsure