American Board of Surgery Qualifying Exam (ABS QE) Practice Test

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What is the role of Mesna in chemotherapy?

It acts as a neuroprotector
It is an antiemetic
It is a uroprotector against chemotherapy-induced hemorrhagic cystitis
It enhances the toxicity of methotrexate

The correct answer is: It is a uroprotector against chemotherapy-induced hemorrhagic cystitis

Mesna plays a significant role in chemotherapy as a uroprotective agent specifically designed to protect the bladder from the harmful effects of certain chemotherapeutic agents, particularly when used in conjunction with ifosfamide and cyclophosphamide. These drugs can cause hemorrhagic cystitis, a condition characterized by inflammation and bleeding of the bladder, due to their metabolism into toxic metabolites. Mesna acts by binding to these toxic metabolites in the urine, thereby neutralizing their harmful effects and preventing damage to the bladder lining. Using Mesna effectively allows patients to undergo treatment with these chemotherapeutic agents while significantly reducing the risk of complications related to bladder toxicity. Its administration is carefully timed with the chemotherapeutic agent to maximize its protective effects. This targeted action is crucial in chemotherapy regimens where patients are at high risk for developing cystitis due to their treatment.