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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
Q

What is a neoadjuvant?

A

Tx prior to definitive tx. Example: shrinking tumor before radiation.

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26
Q

What is induction/maintenance?

A

Chemo as sole tx (LSA)

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27
Q

What is palliative?

A

Goal is to improve quality of life by helping alleviate signs. No cure :( just make pt feel better.

28
Q

What drugs would you not give to a pt with an MDR-1 gene mutation?

A

Vincristine, vinblastine, paclitaxel, doxrubracin

29
Q

What are common adverse events of cytotoxic chemo?

A

Bone marrow suppression
Alopecia (non-shedding breeds only)
Gastrointestinal

30
Q

What do neutrophils and platelets need to be at before administering chemo?

A

Neuts: >3000
PLTs: >100,000

31
Q

What is the NADIR?

A

Expected low point

32
Q

How do you use the NADIR to interpret drug dosage in chemo?

A

If neutro count at NADIR is <1,500 or PLT <60,000 you decrease drug dose by 20-25%

33
Q

How low do the neutrophils have to be before you prescribe prophylactic antibiotics?

A

<1,000 if clinically well. <3,000 if sick.

34
Q

What cell cycles are targeted by cell-cycle specific drugs?

A

M phase–cell division

S phase–DNA synthesis

35
Q

What drug is an anti-mitotic drug (M phase)?

A

Vincristine

36
Q

How you treat vincristine extravasation?

A

Heat it up + hyaluronidase

37
Q

What drugs are anti-metabolites (S-phase)?

A

Cytosine arabinoside, gemcitabine/5-fluorouracil

38
Q

What categories are non-cell cycle specific?

A

Alkylating agents, Abx agents, platinum, l-asparaginase

39
Q

What drugs are alkylating agents?

A

Melphalan, cyclophosphamide, CCNU, cholorambucil

40
Q

What drugs are Abx agents?

A

Doxorubicin, mitoxantrone

41
Q

What drugs are platinum agents?

A

Cisplatin, carboplatin

42
Q

What is a major side effect of cyclophosphamide?

A

Sterile hemorrhagic cytitis (acrolein accumulation in bladder)

43
Q

How do you tx doxorubicin extravasation?

A

Cold compress

44
Q

What is metronomic chemotherapy?

A

When you give continuous low dose of chemo instead of maximum tolerable dose with a break period.

45
Q

How would you avoid SHC from giving cyclophosphamide?

A

Free water access, concurrent glucocortioids/furosemide. KEEP THEM PEEING.

46
Q

What is the MoA of toceranib (palladia)?

A

Tyrosine kinase inhibitor.

47
Q

What is the signalment for nasal planum tumors?

A

Older, light skin cats (solar induced)

48
Q

What is the ddx for nasal planum tumors?

A

Cats–LSA, eosinophilic granuloma, MCT

Dogs–SCC (MCT, FSA)

49
Q

How do you tx nasal planum tumors?

A

Cryoblation, nasal planectomy, electrochemo

50
Q

What is the signalment for ear canal tumors?

A

Cockers, poodles, GSDs
Young cats (benign), older (malignant)
Recurring ear infection

51
Q

What is the ddx for ear canal tumors?

A

Ceruminous gland adenocarcinoma–painful!
Cats–cyst (multifocal)
Dogs–SCC/undifferentiated

52
Q

What are negative px factors for ear canal tumors?

A

Extension beyond ear canal
Dx of SCC/undifferentiated carcinoma
Neuro signs at dx

53
Q

How do you tx ear canal tumors?

A

Aggressive sx

54
Q

What is the signalment for canine sinonasal tumors?

A

Old, meduium-large breed, DOLICEPHALIC, males

55
Q

What is a common clinical sign seen with canine sinonasal tumors?

A

Unilateral epistaxis

56
Q

How do you tx canine sinonasal tumors?

A

Nothing (95d mst), NSAIDs, low dose RT, chemo alone (paladia), hem control (palliation), curative intent RT

57
Q

What are negative px factors for canine sinonasal tumors?

A 
>10 years old
Longer hx of CS
Tumor stage--cribriform plate involvment
Metastasis
SCC/undiff carcinomas
58
Q

What is the dx/ddx of feline sinonasal tumors?

A

90% malignant LSA

lymphiplasmocytic rhinitis

59
Q

What is the signalment for salivary tumors?

A

Dogs–old spaniels

Cats–siamese

60
Q

What are the CS for salivary tumors?

A

mandibular, locally invasive, FIRM, painless swelling at gland

61
Q

What is the ddx for salivary tumors?

A

Carcinoma

62
Q

Is sx alone curative for salivary tumors?

A

NO. Need adjuvant RT for margins.

63
Q

What is a post op complication of thyroid tumors?

A

Hypocalcemia (parathyroid gone)

Tx with calcitriol/T4

64
Q

What are negative px factors for thyroid tumors?

A

Size: vol >20cm, diameter >5cm
Movability: invasion of adjacent tissues
Bilateral–more likely to mets
non-medullary thyroid carcinoma

65
Q

What kind of thyroid tumors do dogs/cats get?

A

Dogs–carcinomas

Cats–adenomas

66
Q

Explain the 90:10, 10:90 rule for dogs and cats

A

Dogs (90:10)–Malignant:benign, non-functional:functional

Cats (10:90–Malignant:benign, non-functional:functional

67
Q

What tumors cause hyperCa as a paraneoplastic syndrome?

A

ACA, LSA, MM, mammary tumors

SAM2 (9 decks)

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