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VetMed Year 3-Term 2 > b) w/c 13-Jan-14 Tumour/Repro > Flashcards

b) w/c 13-Jan-14 Tumour/Repro Flashcards

1
Q

Definition of Neoplasia (3 things)

A
  1. Uncontrolled proliferation of cells
  2. Proliferation continues in absence of the inciting cause
  3. Neoplastic cells original from a single cell that has undegone mutation
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2
Q

Gross Characteristics of benign tumours

A

Growth by expansion, low/moderate growth rate, well demarcated from surrounding tissue, smooth, surrounding connective tissue, homogenous cut surface (cystic in glandular)

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3
Q

Microscopic characteristics of benign tumours

A

Often similar to tissue of origin, well organised, surrounding connective tissue capsule, generally no haemorrhage or necrosis

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4
Q

How do malignant tumours grow?

A

Growth by invasion of adjacent tissue.

Usually not encapsulated, usually not mobile on palpation.

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5
Q

Difference between haemangioma and haemangiosarcoma?

A

Haemangioma: Benign tumour of endothelial origin
Haemangiosarcoma: Malignant tumour of endothelial origin

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6
Q

What are benign tumours of epithelial origin known as?

A

Surface epithelia: Skin- Papilloma
Glandular epithelia: Adenoma
e.g. skin epithial benign: Squamous papilloma

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7
Q

What are malignant tumours of epithelial origin known as?

A

Malignant tumour of epithelial origin: Carcinoma
Malignant tumour of glandular epithelia: Adenocarcinoma
e.g. mammary adenocarcinoma

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8
Q

What are skeletal muscle tumours known as? (Benign and Malignant)

A

Both mesenchymal origin
Benign: Rhabdomyoma
Malignant: Rhabdomyosarcoma

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9
Q

What is a Chondrosarcoma?

A

A mesenchymal malignant tumour of the cartilage (c.f. with chondroma which is BENIGN)

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10
Q

What is the origin of Lymphomas?

A

Round cell tumours of lymphoid system. Normally malignant therefore should be LYMPHOSARCOMA

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11
Q

What is the ‘proper’ name for Sarcoids?

A

Low grade fibrosarcomas commonly seen in skin of horses. Caused by bovine papillomavirus infection.

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12
Q

4 types of metastasis

A
  1. Lymphatic
  2. Vascular
  3. Trans-cavity
  4. Local
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13
Q

Lymphatic metastasis is typical of _____

A

Carcinoma. Therefore check drainage lymph nodes

epithelial origin

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14
Q

Vascular metasistasis is typical of _______

A

Sarcoma

mesenchymal origin

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15
Q

Example of tumour that spreads by trans-cavity metastasis

A

Mesothelioma (RARE)
Ovarian Carcinoma
Pancrastic Carcinoma
All have close association with omentum. Poor prognosis

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16
Q

How does Fibrosarcoma spread?

A

Local metastasis therefore reoccur at site of excision

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17
Q

Are mammary adenocarcinomas more metastatic in cats or dogs?

A

Much more metastatic in cats.Advice unilateral mastectomy as the minimum
Adenocarcinoma= Malignant, Glandular epithelium

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18
Q

How does immunohistochemistry help in tumour diagnosis?

A

Some poorly differentiated tumours cannon be identifed on morphological grounds alone.
Immunohistochemistry for intermediate filaments or cell surface markets assist identification.
Cytokeratin- epithelial marker for carcinom

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19
Q

Which immunohistochemistry market can be used to help identify a sarcoma tumour?

A

Mesenchymal market Vimentin

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20
Q

How are t and b cell lymphomas differentiated? Why would be want to do this?

A

Different prognosis depending on type.
T cell marker is CD3
B cell marker is CD79a

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21
Q

When does tumour grading by immunohistochemistry become more difficult?

A

As tumour becomes more poorly differentiated (high grade) they loose expression of expected tissue markers.
e.g. Cytokeratin (carcinoma), Vimentin (Sarcoma)

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22
Q

Normally necrotic and cavitated areas should not be sent off to the pathologist. The exception is___

A

Bone tumours where a sample from the area of maximal bone lysis is most helpful e.g. osteosarcoma or osteoma (mesenchymal origin)

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23
Q

When fixing specimens for delivery, it is important to:

A

Not put more than 2 cm in (not adequately fixed)
Neutral buffered formalin
Indelible labels

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24
Q

Which type of neoplasm is chemotherapy indicated for?

A

Disseminated disease e.g. Lymphoma. If removal possible = surgery

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25
Q

What is adjuvant therapy?

A

Following removal of a tumour e.g. splenic haemangiosarcoma or amputation of osteosarcoma then chemotherapy is given to slow growth of metastatic disease (used for highly malignant tumours)
LET WOUND HEAL FIRST!! DIVING WOUND CELLS

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26
Q

What is neo-adjuvant therapy?

A

To shrink size of tumour prior to surgery

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27
Q

Why are cytotoxic drugs most useful in the early stages of disease?

A

Most chemotherapy drugs work when tumour cells are diving most rapidly i.e. start of disease.

28
Q

The cell kill hypothesis states that tumour cells follow ___ kinetics

A

First order kinetics i.e. a given dose of cytotoxic drug will kill a fixed percentage of the tumour population e.g. 90% of population

29
Q

Why is the maximum tolerated dose stated in mg/m2?

A

Maximum tolerated dose tends to correlate better with body surface area rather than body weight.
Animals <10kg = dose at mg/kg basis

30
Q

What is metronomic chemotherapy?

A

Continuous low dose of cytotoxic drug given combined with a NSAID.
Slow growth by inhibiting angiogenesis and immunomoduatory effects (decreasing circulating T-cells)
Will not remove tumour but will slow growth/ stable disease

31
Q

Which tumours are a) resistant to chemo b) susceptible to chemo?

A

Relatively resistant: Pancrreatic/Renal carcinomo

Sensitive: Lymphoma

32
Q

What is the significant of P-glycoprotein (Pgp) in anti-cancer therapy?

A 
MDR1 gene (multi drug resistant gene) leads to increased Pgp expression which pumps cytotoxic drugs out of the cell
This MDR1 gene can be activated by glucocorticoids
33
Q

Which normal body systems are most affected by anti-cancer therapy?

A

Systems which have rapidly dividing cells e.g. Bone marrow (Myelosuppression), Gastrointestinal toxicity, Hair growth

34
Q

Significance of Drug extravasation in anti-cancer therapy

A

Many of IV chemotherapy drugs are irritant if extravated e.g. vincristine, vinblastine, doxorubicin)
Always use catheter and use saline to check patency of vein

35
Q

What are the effects of myelosuppression on the haemtopoietic system?

A

Neutropenia, Thrombocytopenia
Neutropenia is the dose limiting effect of many agents.
For neutrophil count drops below 1 x 109 Give prophylactic antibiotics e.g. TMS

36
Q

When does neutrophil nadir normally occur?

A

nadir= low point. i.e. most likely point to get infection

Neutrophil nadir normally occurs 7days post treatment

37
Q

What does platelet nadir normally occur

A

Maximum thrombocytopenia normally occurs 10 days post treatment

38
Q

If extravastion occurs, what emergency treatment can you do?

A

Aspirate as much as possible away from site
For VINCRISTINE: Heat (vasodilation) + Hyaluronidase
For DOXORUBICIN: Ice (vasoconstriction)

39
Q

Which chemotherapy drug should be avoided in animals with heart disease?

A

Doxorubicin can cause dysrhythmias during administration. Give SLOWLY.
Mast cell degranulation can occur during administration (urticaria, pruitis, shock etc due to histamine release)
Nephorotoxicity recorded in cats

40
Q

What side effect does Cyclophosphamide have in dogs?

A

Haemorrhagic cystitis. Irritant to the to bladder lining

Can give furosamide at the same time to increase excretion time

41
Q

Which chemo-therapy drug can cause ileus/constipation in the cat?

A

Vincristine

42
Q

Which chemotherapy drug should NEVER be used in cats?

A

Cisplatin (causes fatal pulmonary oedema)

43
Q

Mechanism of action for:

a) Vincristine
b) Doxorubicin
c) Cyclophosphamide

A

VINCRISTINE: Mitotic spindle inhibitor. CC specific
DOXORUBICIN: Prevent DNA and RNA synthesis. not CC specific
CYCLOPHOSPHAMIDE: alkylating agent, break DNA strand. Not CC specific

44
Q

Is mammary neoplasia more common in cats or dogs?

A

More common in DOGS.

But when it does occur in CATS, 90% are MALIGNANT!!

45
Q

What is the significance of oestrogen and progesterone receptors on malignant mammary tumours?

A

(feline tumours normally only progesterone receptors)
Can be used for immunohistochemistry (but not used in vet medicine)
More receptors = good prognosis as well differentiated

46
Q

How does the relative risk of developing a mammary tumour change depending on time of spaying in DOGS?
and in CATS?

A

If spayed before first season: 0.05%
After first season: 8%
After second season: 26%

Less protective in cats. before 6 months 9%. >1 yr = no protective effect

47
Q

Why would a rectal examination be useful after finding a mammary tumour?

A

Rectal exam may reveal enlarged sublumber lymph nodes

48
Q

Which type of mammary tumour is the most aggressive and has a very poor prognosis (<30days)

A

Inflammatory carcinoma. (Incisional biopsy)
Don’t try operating.
Not always clear that it is a mass, more of a diffuse swelling; massive oedema, erythema, pain.
BIOPSY

49
Q

Antimicrobial of choice for mastitis?

A

Broad spectrum, time-dependent bactericidal CEPHALOSPORIN.

Likely bacteria: E-coli

50
Q

What is Galactostasis?

A

Accumulation and stasis of milk within mammary gland.
Warm, firm, swollen, painful but secretions NOT infected (c.f. mastitis)
Self resolving

51
Q

Lactation that is not associated with pregnancy and parturition i.e. during a false pregnancy is known as

A

Galactorrhea
(due to increased prolactin secretion, stimulated by falling progesterone)
Doesn’t require treatment

52
Q

In cats 2-4 weeks after oestrus, rapid growth of mammary tumour could be:

A

Mammary neoplasm, but given that it is close to oestrous probably mammary hyperplasia.
Benign condition that resolves once progesterone levels decline. Neutering prevents reoccurrence

53
Q

Mastitis can be confused with what very serious neoplasm?

A

Inflammatory carcinoma (prognosis <30 days)

54
Q

Blood suppy with the mammary glands

A

Cranial and Caudal ligate epigastric. Branches off internal thoracic

55
Q

LN drainage of the lymph nodes

A

4,5 drain to inguinal LN
1,2 drain to axillary LN
3 can drain in either direction, normally to axillary

56
Q

What is the normal skin margin when excising a tumour (excisional)

A

2-3cm.
Excise underlying abdominal wall fascia if tumour is attached to it.
Ligate branches of epigastric if encountered

57
Q

Minimum recommended treatment for a) dog b) cat with mammary tumour

A

Cats: Unilateral mastectomy
Dogs: Excise all tumour using simplest surgery

58
Q

Possibly complication of performing a regional mastectomy of the caudal two mammary glands?

A

Often excised together with inguinal LN. Could cause hind limb oedema (self-correcting by collateral drainage)
Ligate caudal epigastric artery

59
Q

How do the prognostic factors vary between sarcomas and carcinomas in DOGS?

A

Sarcomas= worse prognosis
3cm 85% reoccurance (ACT QUICKLY!)
Poorly differentiated 90% mortality at 2 yr

60
Q

How does the mammary tumour size in CATS determine prognosis?

A

> 3cm median survival <2cm: 3 yrs

61
Q

Which factors are NOT PROGNOSTIC in mammary neoplasm?

A

Site of tumour, type of surgery in dogs, number of tumours, performing OHE at time

62
Q

How long does it take to alter the BCS by 1.0?

A

BCS change by 1.0 in 6 weeks

63
Q

When does a distance examination of a bull for a fertility visit, straight legs could indicate…

A

Potential problem with with joints in later life/.
Probably fine if only needs to service 1 or 2 cows.
If needs to service 10+ then BAD

64
Q

What should the circumference of a bull/ram scrotum be?

A

Bull and Ram should both be 34cm
if 32cm - okay depending on how many needs to service.
Rams: Seasonal breeders (measure at breeding time)

65
Q

Which parts of the epididymus are palpable?

A

Head of epididymis is not normally palpable unless diseases

Tail of epididymis is normally palpable

66
Q

What should the normal testicular tone be in the breeding season?

A

Flexed bicep tone

67
Q

What is broken penis and what is the prognosis?

A

Broken penis is haemtoma in the area of the sigmoid flexure.

Very poor prognosis

VetMed Year 3-Term 2 (11 decks)

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