Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SA DX & TX II > Exam 4 - Tumors of the Urinary System > Flashcards

Exam 4 - Tumors of the Urinary System Flashcards

1
Q

what is the most common type of human bladder cancer? what are the 2 distinctions of this type?

A

TCC

invasive - involves deep layers of the bladder

non-invasive - involves only the transitional epithelium

most humans will have lower levels - will go to a doctor quicker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the occurrence of metastasis of dogs with urinary bladder tumors at the time of diagnosis? what is important to consider about this causing mortality?

A

relatively low at the time

16% nodal metastasis

14% distant metastasis

at time of death, 50% had distant mets

most patients met their end due to local disease - not metastatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

where are canine bladder tumors most commonly located?

A

trigone region

56% have urethral involvement
29% have prostate involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the most common bladder tumor that occurs in canines? what are some others that have been reported?

A

urothelial cell carcinoma - intermediate to high grade papillary infiltrative tumors (most all higher grades)

others - SCC, adenocarcinoma, rhabdomyosarcoma, lymphoma, & hemangiosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the TNM for staging bladder cancer?

A

T - primary tumor

N - regional LN

M - distant metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what does TisNoMo mean for staging bladder cancer?

A

Tis - carcinoma in situ

No - no regional lymph node involvement

Mo - no evidence of metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does ToN1M1 mean for staging bladder cancer?

A

To - no evidence of primary tumor

N1 - regional lymph node involvement

M1 - evidence of distant metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does N2 mean for staging bladder cancer?

A

regional lymph node & juxtaregional lymph node involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does T2 mean for staging bladder cancer?

A

tumor is invading the bladder wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does T3 mean for staging bladder cancer?

A

tumor is invading neighboring organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: 78% of dogs have T2 tumors at diagnosis & 20% have T3 tumors at diagnosis of bladder cancer

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what breeds are at risk for bladder cancer?

A

scottish terrier - 18x the risk compared to all other breeds

shelties & beagles - 4.5x the risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some known risk factors for bladder cancer in dogs?

A

exposure to older generation flea control products

lawn chemicals

obesity

cyclophosphamide exposure - chemo/metronomic long term

sex (female > male, neutered > entire rest of population) - male dogs pee on more things so less time for carcinogens to hang out in the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what did the study on herbicide exposure & risk of transitional cell carcinomas in scottish terriers find?

A

significantly higher risk in dogs that were exposed to lawn herbicides alone or herbicides & insecticides

dogs that ate veggies at least 3x a week had a reduced risk

very weak data lol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the common clinical signs seen with bladder cancer?

A

hematuria, dysuria, pollakiuria, & stranguria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what should be done when working up a patient for bladder cancer?

A

physical exam

cbc, chem, ua - free catch or catheter

staging - thoracic rads/abdominal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T/F: it is okay to do cystocentesis for collecting urine in a dog with suspected bladder cancer

A

nope - avoid this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are some differentials you should have for bladder cancer?

A

other neoplasia

chronic cystitis/polypoid cystitis

fibroepithelial polyps

granulomatous cystitis

calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how may you get histopathology for diagnosing bladder cancer in dogs?

A

cystotomy, cystoscopy, or traumatic catheterization (rare)

avoid surgical biopsy (high risk of seeding!!!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

why do you need to do further diagnostics if you see neoplastic cells in a urine sample from a dog you believe has UCC?

A

these are indistinguishable from reactive epithelial cells associated with inflammation!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the CADET BRAF urine test? why is it helpful?

A

DNA based diagnostic test that is able to detect the presence of the BRAF gene in malignant cells shed into the urine of tumor bearing dogs!

90-95% of dogs that have UCC have the BRAF mutation gene - the mutation is not found in the urine of healthy dogs or dogs with other non-UCC forms of bladder disease!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what would you run a CADET BRAF test on?

A

voided urine sample!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the advantages of using a CADET BRAF urine test?

A

convenient, non-invasive option that is very sensitive - diagnosis in > 95% of cases with bladder & prostate cancer

afforable, $220

robust test that is highly specific

24
Q

how is cystoscopy used to diagnose bladder cancer?

A

biopsy is done via transurethral cystoscopy & cystotomy for diagnosing TCC in the bladder & urethra - may not get diagnostic samples

diagnostic sample obtained in 96% of female dogs & 65% of male dogs - females have a larger urethra, so easier for them

in poorly differentiated carcinomas, uroplakin III may be helpful in distinguishing TCC from other carcinomas (expressed in > 90% of cases)

25
Q

what are the disadvantages of using ultrasound for diagnosing bladder cancer in dogs?

A

measurements of bladder tumors are affected by the changes in operator of the ultrasound & bladder volume

this is significant enough to change response criteria!!!

use CT instead preferably

26
Q

what are some indications for surgical treatment of bladder cancer?

A

need to obtain a tissue diagnosis - your last resort!!

removal of the mass from the bladder if not affecting the trigone!!

maintaining or restoring urine flow!!!

27
Q

T/F: field carcinogenesis limits the beneficial effect of surgery in dogs with bladder cancer

A

true

28
Q

what are the major risks of surgery for a patient with bladder cancer?

A

without strict surgical oncology principles, the risk for seeding the disease in the abdominal cavity & abdominal wall is very high

29
Q

what is the median survival time for patients receiving surgery as treatment for bladder cancer?

A

57 days

30
Q

T/F: patients undergoing cystotomy with bladder cancer are significantly more likely to have abdominal wall metastasis

A

true

31
Q

what are the complications associated with urethral stenting as a treatment for bladder cancer?

A

incontinence (30% of cases)

re-obstruction

stent migration

32
Q

what is the median survival time for patients receiving non-surgical urethral stenting as treatment for bladder cancer?

A

78 days

addition of chemo following stent placement increased MST to 250 days

33
Q

when may you use urethral stenting in a dog with bladder cancer? what is the advantage of using this approach?

A

indicated in dogs with urethral obstruction

resolution of the obstruction can be achieved in approximately 98% of cases

34
Q

what is the median survival time for patients receiving non-surgical palliative ultrasound guided endoscopic diode laser ablation as treatment for bladder cancer?

A

MST 360 days - a lot of animals in this study developed resistant UTIs

35
Q

what complications are seen with palliative ultrasound guided endoscopic diode laser ablation as treatment for bladder cancer?

A

stranguria, hematuria, stenosis, spread of tumor into urethra, urethral perforation, bacterial cystitis (50%, 36% resistant UTI)

36
Q

what medical therapy may be used for treating bladder cancer in dogs?

A

single agent COX inhibitor - piroxicam & deracoxib, want a COX2 inhibitor (piroxicam may be too hard on the gi tract with chemo)

chemotherapy - using it to try & slow down & stop tumor growth, not to shrink it

mitoxantrone & piroxicam

cisplatin

carboplatin

37
Q

what clinical signs are seen in cats with bladder tumors?

A

hematuria, stranguria, pollakiuria, & concurrent UTI

38
Q

what is the median age of diagnosis of cats with bladder tumors? what was the median survival time at diagnosis?

A

15.4 years

MST 261 days

rarely treat them other than symptomatically because of so many comorbidities - likely slowly progressive in cats

39
Q

what is the most common primary renal tumor in dogs?

A

renal cell carcinoma - 50-60% of all primary tumors

others - hemangiosarcoma, nephroblastoma, TCC, sarcoma, & lymphoma (often bilateral)

40
Q

T/F: primary tumors are more common in the kidneys than tumors that metastasize from other locations

A

false - mets are more common

41
Q

what are the characteristics of canine renal tumors in german shepherds?

A

inherited disorders - legs covered in fibrotic dermal lesions, if you see this, check their kidneys!!!

dermal fibrosis & fibromas

renal cyst adenocarcinoma

42
Q

why do we see renal tumors more commonly in german shepherds?

A

dominantly inherited missense mutation in a tumor suppressor gene - FLCN (folliculin) similar to birt-hogg-dube syndrome in humans

43
Q

what clinical signs are seen with canine renal tumors?

A

usually non-specific - anorexia, weight loss, polyuria, lethargy, hematuria, & back pain

44
Q

what clinical staging is indicated for renal tumors in dogs?

A

cbc, chem, ua - look for anemia or polycythemia

thoracic rads - look for mets

abdominal ultrasound/ct - ct preferred over ultrasound

gfr via scintigraphy

45
Q

what treatment is typically indicated for canine renal tumors? what was the median survival time with this treatment?

A

nephrectomy

16 months

46
Q

what is the most common prostate tumor? what is their origin? what breeds are predisposed?

A

carcinomas most common - adenocarcinoma & TCC

urothelial or ductal in origin - androgen independent (humans acinar origin & androgen dependent!)

scottish terriers

shetland sheepdogs

47
Q

T/F: castrated dogs may be at an increased risk of prostatic tumors & metastasis

A

true

48
Q

what are some common clinical signs associated with prostatic tumors in dogs?

A

prostatomegaly, hematuria, dysuria, stranguria, dyschezia, tenesmus, & bacteriuria

severe bone pain & pathological factors

prostate will feel very irregular

49
Q

what are some differentials you should consider for prostatic tumors?

A

BPH

prostatic & paraprostatic cysts

prostatitis

other prostatic neoplasia

50
Q

how are prostate tumors characterized in dogs?

A

time of diagnosis characterized by local invasion with high propensity for regional & distant metastasis

51
Q

what staging is indicated for prostate tumors in dogs?

A

physical exam - enlarged on rectal exam, large, firm, irregular, asymmetrical, +/- painful prostate

cbc, chem, ua

thoracic rads

abdominal ultrasound

advanced imaging - ct scans

52
Q

what are your diagnostic options for prostatic masses in dogs?

A

ejaculation, traumatic catheterization, prostatic massage, prostatic wash, ultrasound guided FNA/cytology, surgical biopsy, & CADET BRAF urine test

53
Q

what are your options for local treatment of prostate tumors? why do we not recommend removal of the prostate?

A

electrosurgical transurethral resection - rapid palliation but side effects limit clinical application (short survival times)

incorporation of radiation therapy!!!! piggy back them with tyrosine kinase inhibitors

too many risks to the point that dogs that did survive had a much lower quality of life

54
Q

T/F: bladder cancer in humans is associated with smoking

A

true

55
Q

T/F: in intact dogs, or dogs that were castrated later in life, it can be normal to have mineralization of the prostate

A

true - not necessarily indicative of cancer in these cases

56
Q
A

SA DX & TX II (62 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions