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SAM2 > Exam 1 Onco > Flashcards

Exam 1 Onco Flashcards

1
Q

What are environmental factors that can cause cancer?

A

diet (high fat, low fiber)
exposure (carcinogens)
viruses (hep B, HIV, papilloma)
age

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2
Q

What are the 3 steps of carcinogenesis?

A

initiation–rapid
promotion–reversible tissue and cellular changes
progression–slow. cell exhibits malignancy

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3
Q

What are the 6 hallmarks of a cancer cell?

A 
self-sufficiency in growth signals
insensitivity to anti-growth signals
tissue invasion + metastasis
limitless replicative potential
sustained angiogenesis
evading apoptosis
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4
Q

What are the 3 distinct cell types?

A

round, mesenchymal, epithelial

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5
Q

Which of the 3 cell types do not exfoliate well?

A

mesenchymal

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6
Q

What are 5 ddx of round cell tumors?

A 
Plasmacytoma
Histiocytoma
Mast cell tumor
Lymphoma
TVT
sometimes melanoma
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7
Q

What are the ddx of mesenchymal cell tumors?

A

sarcomas

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8
Q

What are the ddx of epithelial cell tumors?

A

carcinomas

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9
Q

What are the 4 characteristics of malignancy?

A

Heterogenous–inflammation
pleomorphic–variable morphology
anisocytosis–variation in size
anisokaryosis—variation in nucleus size

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10
Q

What are the advantages of cytopathology?

A

highly specific, non-invasive, rapid cell turnover

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11
Q

What are the disadvantages of cytopathology

A

low sensitivity, can’t evaluate tissue architecture

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12
Q

Which needle technique is preferred for an FNA?

A

needle off (coring)

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13
Q

True/false: needle bx specimens of liver are accurate and reliable

A

False, <50% are accurate. Interpret with caution.

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14
Q

What is staging a tumor based on?

A

size, lymph node involvement, metastasis

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15
Q

What does grading a tumor do?

A

gives definitive px and may alter therapy recommendations.

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16
Q

True/false: you can grade a tumor with cytopathology.

A

False. You need a block of tissue.

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17
Q

What is the minimum size a nodule has to be in order to be seen on rads?

A

7-9 mm

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18
Q

How many views do you need when taking rads to check thoracic metastasis?

A

3

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19
Q

Which organ is the most common receptacle of blood-borne metastasis?

A

The liver

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20
Q

Explain the sentinel lymph node concept

A

Metastasis occurs in an orderly progression within the lymph system. Tumor cells drain into a specific LN in a regional lymphatic field before draining into other regional LNs (this is the SNL).

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21
Q

True/false: Normal sized LNs can be metastatic, and abnormal sized LNs don’t mean metastasis.

A

True

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22
Q

What are the paraneoplastic syndromes?

A 
HyperCa (ACA, LSA, MM, mammary tumor)
HypoGLU (intestinal leiomyosarcoma)
Neuro (myasthenia gravis)
Cutaneous
Bone (hypertrophic osteopathy)
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23
Q

What does fractionation of dosing do?

A

Allows recovery of normal tissue between tx intervals

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24
Q

What is an adjuvant?

A

An adjunct to normal therapy

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25
What is a neoadjuvant?
Tx prior to definitive tx. Example: shrinking tumor before radiation.
26
What is induction/maintenance?
Chemo as sole tx (LSA)
27
What is palliative?
Goal is to improve quality of life by helping alleviate signs. No cure :( just make pt feel better.
28
What drugs would you not give to a pt with an MDR-1 gene mutation?
Vincristine, vinblastine, paclitaxel, doxrubracin
29
What are common adverse events of cytotoxic chemo?
Bone marrow suppression Alopecia (non-shedding breeds only) Gastrointestinal
30
What do neutrophils and platelets need to be at before administering chemo?
Neuts: >3000 PLTs: >100,000
31
What is the NADIR?
Expected low point
32
How do you use the NADIR to interpret drug dosage in chemo?
If neutro count at NADIR is <1,500 or PLT <60,000 you decrease drug dose by 20-25%
33
How low do the neutrophils have to be before you prescribe prophylactic antibiotics?
<1,000 if clinically well. <3,000 if sick.
34
What cell cycles are targeted by cell-cycle specific drugs?
M phase--cell division | S phase--DNA synthesis
35
What drug is an anti-mitotic drug (M phase)?
Vincristine
36
How you treat vincristine extravasation?
Heat it up + hyaluronidase
37
What drugs are anti-metabolites (S-phase)?
Cytosine arabinoside, gemcitabine/5-fluorouracil
38
What categories are non-cell cycle specific?
Alkylating agents, Abx agents, platinum, l-asparaginase
39
What drugs are alkylating agents?
Melphalan, cyclophosphamide, CCNU, cholorambucil
40
What drugs are Abx agents?
Doxorubicin, mitoxantrone
41
What drugs are platinum agents?
Cisplatin, carboplatin
42
What is a major side effect of cyclophosphamide?
Sterile hemorrhagic cytitis (acrolein accumulation in bladder)
43
How do you tx doxorubicin extravasation?
Cold compress
44
What is metronomic chemotherapy?
When you give continuous low dose of chemo instead of maximum tolerable dose with a break period.
45
How would you avoid SHC from giving cyclophosphamide?
Free water access, concurrent glucocortioids/furosemide. KEEP THEM PEEING.
46
What is the MoA of toceranib (palladia)?
Tyrosine kinase inhibitor.
47
What is the signalment for nasal planum tumors?
Older, light skin cats (solar induced)
48
What is the ddx for nasal planum tumors?
Cats--LSA, eosinophilic granuloma, MCT | Dogs--SCC (MCT, FSA)
49
How do you tx nasal planum tumors?
Cryoblation, nasal planectomy, electrochemo
50
What is the signalment for ear canal tumors?
Cockers, poodles, GSDs Young cats (benign), older (malignant) Recurring ear infection
51
What is the ddx for ear canal tumors?
Ceruminous gland adenocarcinoma--painful! Cats--cyst (multifocal) Dogs--SCC/undifferentiated
52
What are negative px factors for ear canal tumors?
Extension beyond ear canal Dx of SCC/undifferentiated carcinoma Neuro signs at dx
53
How do you tx ear canal tumors?
Aggressive sx
54
What is the signalment for canine sinonasal tumors?
Old, meduium-large breed, DOLICEPHALIC, males
55
What is a common clinical sign seen with canine sinonasal tumors?
Unilateral epistaxis
56
How do you tx canine sinonasal tumors?
Nothing (95d mst), NSAIDs, low dose RT, chemo alone (paladia), hem control (palliation), curative intent RT
57
What are negative px factors for canine sinonasal tumors?
``` >10 years old Longer hx of CS Tumor stage--cribriform plate involvment Metastasis SCC/undiff carcinomas ```
58
What is the dx/ddx of feline sinonasal tumors?
90% malignant LSA | lymphiplasmocytic rhinitis
59
What is the signalment for salivary tumors?
Dogs--old spaniels | Cats--siamese
60
What are the CS for salivary tumors?
mandibular, locally invasive, FIRM, painless swelling at gland
61
What is the ddx for salivary tumors?
Carcinoma
62
Is sx alone curative for salivary tumors?
NO. Need adjuvant RT for margins.
63
What is a post op complication of thyroid tumors?
Hypocalcemia (parathyroid gone) | Tx with calcitriol/T4
64
What are negative px factors for thyroid tumors?
Size: vol >20cm, diameter >5cm Movability: invasion of adjacent tissues Bilateral--more likely to mets non-medullary thyroid carcinoma
65
What kind of thyroid tumors do dogs/cats get?
Dogs--carcinomas | Cats--adenomas
66
Explain the 90:10, 10:90 rule for dogs and cats
Dogs (90:10)--Malignant:benign, non-functional:functional | Cats (10:90--Malignant:benign, non-functional:functional
67
What tumors cause hyperCa as a paraneoplastic syndrome?
ACA, LSA, MM, mammary tumors

SAM2 (9 decks)

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