Oncology Certified Nurse (OCN) Nursing Practice Test

What is Veno-occlusive disease associated with high-dose chemotherapy before a bone marrow transplant?

1. Increased risk of infections

2. Obstruction of small veins in the liver

3. Myelosuppression

4. Cardiac complications

The correct answer is: Obstruction of small veins in the liver

Veno-occlusive disease (VOD), also known as sinusoidal obstructive syndrome, is a significant complication following high-dose chemotherapy, particularly prior to a bone marrow transplant. The correct answer highlights that VOD is primarily characterized by the obstruction of small veins in the liver. This obstruction is due to damage to the endothelial cells that line the small veins, which leads to inflammation and subsequent clot formation. As a result, there is hepatic venous congestion and, eventually, the potential for liver dysfunction. The pathophysiology ties back to the toxic effects of certain chemotherapeutic agents used at high doses, which initiate these complications. While increased risk of infections, myelosuppression, and cardiac complications can be associated with high-dose chemotherapy and its systemic effects, they are not specific to veno-occlusive disease. The hallmark of VOD specifically focuses on the venous obstruction in the liver and its resultant effects on liver function, making this the correct answer in the context of the question posed.