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SAM II > Final > Flashcards

Final Flashcards

1
Q

Main Mechanism of Action that Causes Tumor Cell Damage with Radiation Therapy

A

Damage from DNA Interaction with Free Oxygen Radicals

*Ionization of Water within Tumor Cells lead to Release of Free Radicals which causes Breaks within DNA which are not able to be repaired

*The Biological Effect occurs slowly with Radiation Therapy- Weeks to Months

Important Point- This Damage is happening BOTH to the Cancer Cells as well as to the Host Cells (Surrounding Tissue)

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2
Q
A

Thrombocytopathy

*Reference Platelet Count in a Dog- 200,000-500,000/uL

*Anything Below 100,000/uL is Thrombocytopenia but Below 50,000/uL is considered Severe

If you have a Dog with Primary Hemostatic Abnormalities- It is most likely a Thrombocytopathy

Only Develop Spontaneous Hemorrhage below 30,0000/uL

While this is Thrombocytopenia, the Thrombocytopenia is NOT the reason for the Petechial Hemorrhage. You will not bleed Spontaneously with a Platelet Count of 64,000/uL

*Not a Factor Deficiency- Factor Deficiencies are normally associated with Body Cavity Bleeds and Hyphema

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3
Q

Treatment/Chemotherapy Protocol used in Patients with Sarcoma

A

Surgically Resect the Tumor to Increase Growth Fraction followed by Chemotherapy

*Use Surgery to Remove the Bulk of the Tissue and Stimulate Division of Residual Tumor Cells then use Chemotherapy

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4
Q

Chemotherapy Drugs that Specifically Target the Mitosis Phase of the Cell Cycle

A

Mitotic Inhibitors (Plant Alkaloids)

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5
Q

Name the Infectious Organisms seen in these Photos

A
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6
Q

In patients with Cancer:

Make a Diagnosis and do Anatomical/Clinical Staging ______ Deciding on the Treatment Options

A

BEFORE

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7
Q

Treatment for Sarcoptes

A

Topical Dips- Lime Sulfur Dips (Very Effective and Very Safe)

Topical Spot-on- Selemectin (Revolution) q 2 weeks

*Minimum of 6 weeks

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8
Q
A

D. Cytology of Discharge

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9
Q

Thrombocytopathy Described Below:

A

Von Willebrand’s Disease

*Hereditary Disease- Commonly in Dobermans

*These Patients Won’t Spontaneously Bleed but following Procedures such as Spay or Nail Clipping these Patients won’t Stop Bleeding

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10
Q

Mitotic Inhibitor used to Treat Lymphoma and Mast Cell Tumors

A

Vinblastine

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11
Q

Treatment for Hypoglycemia (Paraneoplastic Syndrome)

A

Dextrose Infusion

Curative Intent- Surgery in Combination of Chemotherapy (Streptozocin- Specific Chemotherapy)

*Severe Hypoglycemia may lead to Seizures

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12
Q

Disorder of Platelet Number Leading to Thrombocytopenia Described Below:

Acute Hemorrhage

DIC/Vasculitis

A

Increased Demand/Consumption

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13
Q
A

D. Admit Joey to the Isolation Facility and Start with Broad Spectrum Antibiotics

*Neutrophil Count is Incredibly Low- Case of a Dog that needs to be Hospitalized- Put into Chemotherapy Isolation Unit in order to Prevent Infection

*Because he has a FEVER he needs to be admitted to Isolation in Hospital and Given Broad Spectrum IV Antibiotics

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14
Q
A

Psychogenic Alopecia

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15
Q

How long should a Food Trial be Implemented in a Patient with Food Allergies

A

4 Weeks

*Food Trial has to last for at least 4 Weeks with NO Other Food source available- No Treats

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16
Q

When is Surgery Indicated in Cases of Chronic Otitis Externa

A

Severe Calcification of Cartilage

Irreversible Soft Tissue Pathology (Ex. Canal Hyperplasia)

Bony Changes in Tympanic Bulla

Persistent Otitis Media

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17
Q

Tumor Biopsy Technique Described Below:

Incisional- Biopsy Taken at the Junction of the Tumor and the Normal Surrounding Tissue

Excisional- Biopsy taken outside the mass to completely excise the mass (Never enter the Capsule of the Tumor)

A

Incisional/Excisional Biopsy

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18
Q
A

D. Giving the Drug at Night

*We Dose this Drug in the MORNING. We don’t want them to go to bed with Acrolein Sitting in the Bladder Overnight

*Giving Cyclophosphamide Orally and Giving Furosemide prior to Administration to Induce PU/PD will Reduce Side Effects

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19
Q

Given this Image, What Type of Pyoderma is This?

A

Surface Pyoderma

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20
Q

Chemotherapy Drug used as Single Drug Protocol in Combination with Surgery for the Treatment of Osteosarcoma

A

Carboplatin

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21
Q

Test Done during Examination of a Dog or Cat Suspected of having a Bleeding Disorder of either the Vascular Response and Platelet Function/Platelet Plug

Indications: Hemastatic Abnormalities but Platelet Count Greater than 70,000/ul

A

Oral Buccal Mucosal Bleeding Time

*Only indicated in Patients that don’t have severe Thrombocytopenia (> 70,000/ul)

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22
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Vesicle- Primary Skin Lesion

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23
Q

True/False: In Majority of Cases, Chemotherapy Drugs lead to Severe Side Effects in Patients

A

False

*In Majority of Cases, Side Effects are Minimal- Protocols adapted for Animals use Lower Dose of Chemotherapy Intensity than Humans

While Side Effects Rarely Occur, they can be Severe and Possibly Fatal- Less than 1% of Patients will succumb and Die due to Chemotherapy

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24
Q

Which Tissues are Resistant to Radiotherapy?

A

Bone

Muscle

Cartilage

Connective Tissue

Mature RBC

*These Structures are also very susceptible to Long term damage

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25
Q

Name the Highly Myelosuppressive Chemotherapy Drugs

A

Doxorubicin

Vinblastine- Severe Myelosuppression in Cats

Lomustine

Cyclophosphamide

*L-Asparaginase and Vincristine are Alternated with these Highly Myelosuppressive Drugs to give the Bone Marrow a Break when we are treating a patient with a High Intensity Induction Protocol

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26
Q
A

Primary Hemostasis

*Ventral Abdomen with Petechiation- Spontaneous Hemorrhage. Petechia is an Example of Primary Hemostasis- Thrombocyte Number or Function Abnormality

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27
Q

Screening Test Described Below:

Detects Yeast, Surface Parasites and Their Eggs

A

Acetate Tape Strip Impression Smear

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28
Q

Feline Dermatologic Disease Described Below:

Caudal Dorsal Alopecia BUT Could have Face, Limb, and Neck Involvment

May see Eosinophilic Complex Lesions

A

Flea Allergy

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29
Q

The ____ the Growth Fraction, the Greater the Efficacy of Chemotherapy

A

Higher

*The Higher the Ratio/Growth Fraction- Tumor that is very susceptible to the Effects of Chemotherapy because more Tumor Cells are in the Growth/Dividing Phase

The Lower the Ratio/Growth Fraction- The Tumor is Resistant to the Effects of Chemotherapy

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30
Q

Most Common Grade of Lymphoma in Canine Patients

A

High Grade: Lymphoblasts, Rapidly Dividing

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31
Q

Dermatologic Disease Described Below:

Very Common

Allergens Occur when Fleas Take Blood Meal: Antigen-Antibody Reaction occurs

Distribution of Pruritus- Caudal 1/3rd of Body

Primary Lesion- PAPULES

Secondary Lesion- Crusts

Self Inflicted Lesions- Excoriations and Alopecia

A

Flea Allergic Dermatitis

*Flea Saliva contains many Antigens- Amino Acids, Aromatic Compounds, ect.

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32
Q

How to Differentiate RBC Agglutination from Rouleaux Formation

A

Add 3-5 Drops of Saline and Examine under 40x Magnification

*Rouleaux Formation- RBC’s will Separate

Agglutination- RBC’s will NOT Separate

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33
Q

Supportive Therapy for Patients with IMHA:

Treat the Underlying Cause

Blood Transfusion Therapy: Usually ______\_

Fluid Therapy

A

Packed Red Blood Cells

*Don’t Give Whole Blood since Protein is usually Normal/Increased

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34
Q
A

C. Postpone Chemotherapy for 7 Days and Prescribe Antibiotics

*Most Patients hit NADIR around 7 Days, Postpone for a Couple Days and recheck to make sure that the Neutrophil Count Increases

*If we see Toxicity with One Chemotherapy Drug we should NOT make changes with an Unrelated Chemotherapy Drug- Don’t change the Dose of Vincristine (It has nothing to do with Cycophosphamide). DO NOT REDUCE VINCRISTINE DOSE

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35
Q

Tumor Biopsy Technique Described Below:

Approach Tumor with Needle and Advance the Stillette

The Outer Sheath will Slice off the Tissue

Pull out the Needle and Obtain the Biopsies

A

Needle Core Technique

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36
Q

Treatment for Dermatophytosis (Ringworm)

A

Topical Treatment:

Lime Sulfur (Safe and Effective)

Shampoo and Conditioner containing Miconazole

Systemic Therapy:

Itraconazole (Treatment of Choice)

*Continue Therapy until 1 or more NEGATIVE FUNGAL CULTURE

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37
Q

What Investigation would you Carry out to Determine if the Lesion is Localized or Affecting Other Sites?

A

Thoracic Radiographs and Abdominal Ultrasound

Palpate- All Peripheral Lymph Nodes

*First thing that you want to do is assess all the regional Lymph Nodes

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38
Q

Aim of using Chemotherapy Drugs in Animals

A

To Prolong Survival

To Maintain Good Quality Life

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39
Q

What is the Diagnosis in each Picture?

A
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40
Q

True/False: Feline Blood Donors and Recipients must ALWAYS be Blood Typed/Crossed Matched prior to Blood Transfusion

A

True

*Naturally Occuring Alloantibodies- Must be Blood Typed before First Transfusion

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41
Q

Prognosis for Mammary Tumors in Felines

A

Tumor > 3cm = Poor Prognosis

*Generally Feline Mammary Tumors carry a Poor Prognosis- Highly Malignant and Metastatic

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42
Q

How to Diagnose Notoedres

A

Skin Scrapings

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43
Q

Treatment for Impetigo (Puppy Pyoderma)

A

Topical Antibacterial Shampoos

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44
Q
A

Superficial Pyoderma

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45
Q

Antitumor Antibiotic Used to Treat Lymphoma and Osteosarcoma

A

Doxorubicin

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46
Q

Clinical Signs of which Dermatologic Disease:

A

Malassezia

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47
Q

Dermatologic Disease Described Below:

Repetitive Licking

Well Circumscribed, Raised, Firm, Alopecic, Ulcerated Plaque or Nodule

Common in Large Breed Dogs- Labs, Golden Retrievers ect.

Primary Etiology- Atopy (Underlying Allergy)

A

Lick Granuloma (Acral Lick Dermatitis)

*Atopy- Underlying Allergy is most Likely initiating the Licking

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48
Q

Hematopoietic Tumor Described Below:

Neoplastic Proliferation of Hematopoietic Stem Cells in the Bone Marrow

A

Leukemia

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49
Q

What Laboratory Tests will you Conduct in your Clinic?

A

Hematocrit- Microhematocrit Centrifuge

Total Solids- Refractometer

Measure Total Solids to determine if there is Blood Loss. If Blood Loss is occuring you would see a Decline in Total Proteins

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50
Q

Clinical Signs of _____Hemostatic Disorder:

Hematomas

Hemarthrosis

Bleeding into Cavities

A

Secondary Hemostatic Disorder

*Widespread Massive Cavity Bleeds

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51
Q

Form of Eosinophilic Granuloma Complex shown Below:

Commonly Located on Groin, Medial Thigh or Abdomen

A

Eosinophilic Plaque

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52
Q

Which Three Radiographic Views are Required for Assess Tumor Metastasis

A

ALWAYS Right Lateral

Left Lateral

ALWAYS Dorsal Ventral

*Recommended to take THREE Radiographic Views when looking for Metastasis

Usually do Both Right and Left Lateral because pathology can be missed if only one Lateral View is Taken. Right Lateral View is the MOST Sensitive for Metastasis

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53
Q

What Type of Tumors are Best Treated with Chemotherapy

A

Small, Rapidly Growing Tumors

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54
Q

Given this Image, What Type of Pyoderma is This?

A

Superficial Pyoderma

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55
Q

Chemotherapy has NO EFFECT on which Phase of the Cell Cycle

A

G<strong>0</strong> (Resting Phase)

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56
Q

Most Common Malignant Mammary Tumor of Canines

A

Mammary Carcinoma

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57
Q

Treatment for Chin Pyoderma

A

Mild Cases: Topical Benzoyl Peroxide

Severe Cases: Topical Benzoyl Peroxide with Systemic Antibiotics

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58
Q

True/False: Chemotherapy Drugs are Administered to Patients Off-Label

A

True

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59
Q

Treatment for Cheyletiella

A

Shampoos: Selenium Sulfide

Spot Ons- Selamectin q 2 Weeks

Treat ALL IN CONTACT- Contagious

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60
Q
A

E. All of the Above

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61
Q
A

Intravascular Hemolytic Anemia

*Even though this dog was Non-Regenerative, there is a Massive Decline in PCV. This dog is showing signs of shock due to an acute Hemolytic Crisis

This dog is in the Pre-Regenerative Phase- only been ill for 24 Hours

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62
Q

A Neoplasm associated Alteration in Bodily Structure or Function that occurs Distant to the Tumor

A

Paraneoplastic Syndromes

*Parallels the Underlying Malignancy- Usually preceeds the Onset of the Cancer by Several Weeks to Months

*Most Common Paraneoplastic Syndromes- Cancer Cachexia, Hypercalcemia, Hypothyroidism

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63
Q

_____ Factors of Otitis Externa:

Ear Anatomy- Conformation, Hair

Excessive Moisture

Obstruction (Ex. Tumor)

Systemic Illness and Immunosuppression

A

Predisposing Factors

*Increase the Likelihood of Disease

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64
Q

Feline Dermatologic Disease Described Below:

Crusted Papules, Erythema

Tiny Raised Lumps throughout the Body (Localized or Generalized)

Possible Causes- Flea Allergy, Food Allergy, Atopy, Parasited ect.

A

Miliary Dermatitis

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65
Q

Treatment for Vitamin K Antagonism/Deficiency leading to Secondary Hemostatic Disorder

A

Inject Vitamin K1 then Oral for 4-6 Weeks

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66
Q

Three Treatments used for Atopy (Allergic Dermatitis)

A

Allergen Specific Immunotherapy (ASIT)- Desensitization or Hyposensitization of the Patient (BEST TREATMENT)

Symptomatic Relief

Allergen Avoidance- Avoiding Allergen

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67
Q

Dermatologic Disease Described Below:

Hypersensitivity to Aeroallergens

Clinical Signs- Pruritus, Chronic/Relapsing (Often Seasonal)

Lesion Distribution- Face, Ears, Ventrum, Feet, Perineum

A

Atopy (Allergic Dermatitis)

*Sensitivity to Allergens that Break the Skin Barrier

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68
Q
A

Macule

*Epidermal Collarette is a result of a Pustule that Broke Open

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69
Q
A

Reinduce with CHOP, week 1

*If the dog Relapses in the Middle of his Protocol it means he has responded well- Lets go back to week 1 and Reinduce Him

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70
Q

Alternative Treatment for Hemangiosarcomas:

A

Metronomics

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71
Q
A

Hyperpigmentation

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72
Q

List Three Tumors that are Radioresistant and can be Treated with Radiation Therapy

A

Osteosarcomas- Pain Relief/Palliative Therapy

Soft Tissue Sarcomas

Brain/Spinal Cord Tumors

*Osteosarcomas- Palliative Therapy Only (Pain Relief)

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73
Q

Review Card: Tumor Staging Systems

*Anatomical Staging System is NOT always Relevant. Ex. Lymphoma stage is not an important prognosticator. We do NOT stage Feline Lymphoma

A
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74
Q

_____ Factors of Otitis Externa:

Secondary Infections: Bacterial, Malassezia (Yeast), Candida

Ear Pathology: Hyperplasia of Ear Canal, Fibrosis, Stenosis

A

Perpetuating Factors

*Exacerbate and Maintain Inflammation

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75
Q

Primary Lesion seen with Flea Allergic Dermatitis

A

Papules

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76
Q

Most Common Side Effects of Chemotherapy Drugs

A

Bone Marrow Suppression

Gastrointestinal Upsets (MAIN Clinical Sign)

*Gastrointestinal Upset- Anorexia, Vomiting, Diarrhea

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77
Q

Pathophysiology of ______:

Exposure of Previously Hidden or Previously Ignored Antigens

Loss of Self-Tolerance-auto-reactive T Lymphocytes

A

Immune Mediated Hemolytic Anemia (IMHA)

*Piecemeal Removal of parts of the RBC Membrane leading to Spherocytes

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78
Q

Three Types of Cytoplasmic Granules that are Released from Mast Cell Tumors

A

Histamine

Cathepsin

Heparin

*75% of Dogs with Dermal Mast Cell Tumors will have higher Concentrations of Histamine in Circulation

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79
Q

Most Common Form of Pemphigus Complex in Dogs and Cats

A

Pemphigus Foliaceus

*Most Common Immune-Mediated Dermatosis in Dogs and Cats

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80
Q

Stain Needed to Diagnose Heinz Body Anemia

A

New Methylene Blue Stain

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81
Q

Immunosuppressive Drug used in Treating IMHA Described Below:

A

Cyclosporin

*Extremely Popular Drug in Treating IMHA

*Suppress T Lymphocytes which are Recognizing Antigens on RBC’s

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82
Q

Three Presentations of Eosinophilic Granuloma Complex in Felines

A

Indolent Ulcer

Eosinophilic Plaque

Collagenolytic Granuloma

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83
Q

How to Treat Fur Mite

A

Lime Sulfur Dips, Ivermectin, Selamectin

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84
Q

Treatment for Notoedres

A

Lime Sulfur Dips (Best)

Ivermectin Injections

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85
Q

Large Tumors are No Longer Dividing with a Very Low Growth Fraction making them ____ to the Effects of Chemotherapy

A

Resistant

*Large Tumors enter into the Plateau Phase of Growth- No longer Rapidly Dividing therefore more resistant to the effects of Chemo

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86
Q

Review Card: Acute vs. Chronic Leukemia

Chronic Leukemia- Slow Developing and these Patients are NOT Systemically Ill. There may be some Paraneosplastic Syndromes. Diagnosis relies on a Bone Marrow Aspirate

Acute Leukemia- Patients are Systemically unwell and Blast Cells are obvious on Smears. Diagnosis Rarely Requires a Bone Marrow Aspirate. Do NOT develop Paraneoplastic Syndromes

A
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87
Q

When performing Blood Transfusions:

_____ ml/kg Donor Blood with Raise Recipient PCV by 1%

A

2.2 ml/kg

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88
Q

True/False: Most Cases of Generalized Demodicosis that occur at 2-4 Years of Age are Likely Undiagnosed Juvenile Onset Demodicosis

A

True

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89
Q

Most Common Autoimmune Skin Disease in Dogs

A

Pemphigus Foliaceus

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90
Q

Supportive Care for _____:

Padded Cage with Minimal Handling

NO Jugular Venipuncture

Desmopressin Acetate 30 min. Prior to Invasive Procedures

A

Immune Mediated Thrombocytopenia (IMTP)

*Handle these Dogs with Care

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91
Q

Clinical Signs of _____Hemostatic Disorder

Echymosis/Petechiation

A

Primary Hemostatic Disorder (Platelet Disorder)

*Three Sites to Check- Ventrum (Abdomen), Perineal Area, Gums

Primary Hemostatic Disorders- Vasculitis, Thrombocytopenia, and Thrombocytopathy

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92
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Callus- Secondary Skin Lesions

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93
Q

Treament for Lymphoma

A

1st- Stabilize Paraneoplastic Syndromes (Hypercalcemia)

2nd- Treat the Lymphoma: Steroids, Chemotherapy

*If we Don’t Treat- These patients will succumb to Lymphoma in Less than 6 Weeks

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94
Q

Feline Dermatologic Disease Described Below:

Symmetrical Truncal Alopecia

Easily Epilated Hairs

“Skin Fragility”

A

Hyperadrenocorticism (Cushings)

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95
Q

Classification of Lymphoma Described Below:

Most Common in Cats (Older, FeLV Negative)

Focal or Diffuse on Small Intestine

Vomiting, Diarrhea, Weight Loss, Inappetence

Palpable Abdominal Mass, Thickened Intestinal Loops

A

Ailmentary

*Cat Lymphoma

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96
Q
A

Packed Cells

*Dog is Severly Anemic. TSP is Normal, therefore No Blood Loss Anemia

Just need to Replace Oxygen Carrying Capacity- Give Packed RBC’s

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97
Q

In Felines, ____% of Mammary Gland Tumors are Malignant

A

80%

*Feline Mammary Tumors are HIGHLY Malignant and HIGHLY Metastatic

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98
Q

______ Hemostasis:

Fibrin Mesh Formation (Fibrin Clot)

A

Secondary

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99
Q

If Ears are Ulcerated, Hyperplastic or Stenotic, use 2-3 weeks of Topical ______, then Re-examine

A

Glucocorticoids

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100
Q

How to Diagnose Demodex

A

Deep Skin Scrapes

*Usually Positive if Mites are Causing Signs

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101
Q

Clinical Signs of ______:

Pale Mucous Membranes

Tachycardia

Bounding and Rapid Pulse

Weakness

Possible Hemic Murmur

Apparent Ataxia/Collapsing

A

Acute Anemia

Acute Anemia: Collapse, Pale Mucous Membranes, Dyspnea, Tachycardia ect. Normally when talking about Clinical Signs of Anemia, we are Refering to Severe ACUTE Anemia

Chronic Anemia: Compensatory Mechanisms decrease the Clinical Signs. Normally Eating, Drinking normally with a Normal Heart Rate

Ex. Patient with Pale Mucous Membranes and a Bounding Pulse- Very Characteristic for Anemia

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102
Q

Endocrine Disease Described Below:

“Rat Tail”

Dry Haircoat- Loss of Sheen/Luster, Dull, Brittle

Increased Ceruminous Ear Discharge

A

Hypothyroidism

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103
Q

Most Common Associated Clinical Sign of Multiple Myeloma

A

Progressive Non-Regenerative Anemia

*Plasma Cells Infiltrating the Bone Marrow

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104
Q

Two Leading Causes of Heinz Body Anemia

A

Acetaminophen Toxicity

Onion Poisoning

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105
Q

Most Important Prognosticator in Cases of Lymphoma

A

Substage

*Clinically Well Patients (Substage A)

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106
Q

Acanthocytes seen on a Canine Blood Smear are commonly Diagnostic for which Two Diseases?

A

Hypothyroidism

Hepathopathy

*If you see Acanthocytes in Geriatric Dogs- Think about Primary Liver Disease or anything that is Important for Regulating the Phospholipid Layer of the Red Blood Cell, such as Hypothyroidism

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107
Q

Indications for______:

Hemorrhagic Anemia

In Order to Increase Oxygen Carrying Capacity and Improve Tissue Oxygenation

A

Blood Transfusions

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108
Q

Dermatologic Disease Described Below:

Seasonal Follicular Dysplasia- Patchy Loss of Hair on Flank Area

Marked Hyperpigmentation

Common Breeds: Boxers, Bulldogs

A

Recurrent Flank Alopecia

*Has Been on Previous Exams

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109
Q

______ can Reduce Risk of Mammary Gland Tumors in both Cats and Dogs

A

Ovariohysterectomy

*Ovariohysterectomy prior to First Estrus- Relative Risk is essentially nonexistant

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110
Q

Disorder of Platelet Number Leading to Thrombocytopenia Described Below:

Megakaryocyte Hypoplasia

History: Tick Exposure/Drug Exposure

Differential Diagnosis: Chronic Ehrlichiosis, Estrogen Toxicity, Chemotherapy

A

Production Problem (Failure of Megakaryopoiesis)

*Megakaryocytes- Cells that Produce Platelets

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111
Q

Two Forms of Demodecosis

A

Localized

Generalized (Juvenile and Adult)

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112
Q

Dermatologic Condition Described Below:

Idiopathic Keratinization Disorder Manifested at Chin and Lips

Alopecia, Crusts, Comedones

A

Feline Acne

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113
Q

Heart Rate- 160 bpm (Extremely High)

Problem List: Abdominal Pain, Pale M/M, Collapse, Tachycardia

Hematocrit- 37% (Low)

Platelet Count: 87,000/uL (Low)

SCHISTOCYTES

Abdominal Imaging- Large Hyperechoic Tumor

What is the Diagnosis?

A

Hemangiosarcoma

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114
Q

Disorder of Platelet Number Leading to Thrombocytopenia Described Below:

SPLENOMEGALY

Primary Splenic Neoplasia

Tick-Borne Disease

Hemopoetic Neoplasia

A

Platelet Sequestration

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115
Q

Treatment for Extravasation of Chemotherapy Drugs

A

IMMEDIATELY Stop Injection

Suck Back as much as Possible

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116
Q

Most Common Presentation of Lymphoma in Canine Species

A

Multicentric

*80-85% of Lymphomas in Canines are Mulitcentric

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117
Q

Treatment for Superficial Necrolytic Dermatits

A

Amino Acid Infusions Weekly

*Guarded to Poor Prognosis- Survival Time < 1 Year

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118
Q

True/False: Following Acute onset of Anemia, Bone Marrow takes 3-5 Days to begin Releasing Reticulocytes

A

True

*Cannot Determine if Anemia is Regenerative or Not until 3-5 Days following Onset of Anemia. This phase is known as “Pre-Regenerative”

In Patients where Anemia has occured within the Past 24 Hours, there has not be enough Time for the Bone Marrow to Respond. You need to Repeat Hematology in 3 days in order to get Accurate Results

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119
Q

Treatment for Lick Granuloma

A

Screen Animal for Atopy/Allergies- Symptomatic Treatment

Long Term Antibiotics

Sock, Legging, E Collar

*Possible Exam Question: Primary Factor Treatment for Lick Granulomas- Treat the ALLERGY/ATOPY

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120
Q

Hematocrit = 11%

Total Solids = 68g/l

Is this Anemia Mild, Moderate or Severe?

A

Severe

*Hematocrit Less than 40% in a Dog is Considered Severe and usually associated with Acute Anemia in a Dog showing Clinical Signs

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121
Q
A

D. Characterized by Diffuse Thickening of the Muscularis Propria on Ultrasonography

*Feline Intestinal Lymphoma- Usually Low Grade, Lymphocytic in Elderly Patients

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122
Q

Breed of Dog that has Large Platelets (Macrothrombocytopenias)

A

King Charles Cavaliers

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123
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Erosion- Secondary Skin Lesion

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124
Q

Case of Suspected IMHA. In Saline Agglutination (ISA) test is Negative. What Immunological Test should be Performed Next to Confirm IMHA?

A

Direct Coombs Test

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125
Q

Review Card: Anemia Flowchart

  1. Patient is Showing Clinical Signs of Anemia- Measure Albumin (Total Solids)

2. If Albumin is LOW = Blood Loss from Hemorrhage (Ex. Spenic Hemangiosarcoma Rupture, Gastric Ulceration, HBC)

3. If Albumin is Normal/HIGH, measure Reticulocytes to see if Regenerative

If NOT Regenerative- Bone Marrow May be Exhausted or maybe there is such Severe Inflammation from IMHA that there is Myelonecrosis and Myelofibrosis

4. If Regenerative- Look at Serum

If Hemoglobinemia = Intravascualr Hemolysis

If NO Hemoglobinemia = Extravascular Hemolysis

A
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126
Q

Dermatologic Condition Described Below:

Etiology- Papilloma Virus or Idiopathic

A

Papillomatosis

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127
Q

Clinical Signs of _____ can Include Horners Syndrome and Facial Paralysis

A

Otitis Media

*Horners Syndrome and Facial Paralysis are two Neurological Signs that could Indicate Otitis Media

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128
Q

Reservoir for Microsporum Canis (Dermatophytosis)

A

Cat

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129
Q

Advantages and Disadvantages of which Method of Tumor Cell Collection for Cytology

A

Fine Needle Aspirate

*Always the Starting Point because it is Extremely Cheap and Easy to Obtain. There are Minimal Complications and very rarely requies anything more than Sedation

Disadvantage- You are sampling an area that is so fine that you may not get a good representation of the entire tumor. May not be Respresentative of the Tumor. This is why we should FNA Multiple Times- At least 10x’s per Tumor

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130
Q

Common Differentials for which Classification of Anemia:

External or Internal Hemorrhages

Coagulopathies

Ruptured Neoplasms (Ex. Hemangiosarcoma)

A

Anemia of RBC Loss

*Ex. Hit by Car

*Most Common Type of Anemia of RBC Loss- Cancers in Geriatric Patients: Ruptured Hemangiosarcoma

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131
Q

Feline Dermatologic Disease Described Below:

FELINE SCABIES

Pinne, Face, Neck Forelimbs

Alopecic, Thickened Wrinkled Skin with Papular Rash and Serocellular Crusts

A

Notoedres

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132
Q

How to Diagnose Acute Otitis Externa

A

CYTOLOGY (Most Important)

Otoscopic Exam

*Determine what is in the ear via Cytology

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133
Q

Classification of Lymphoma Described Below:

Common in Younger Cats (FeLV Positive)

Paraneoplastic Hypercalcemia (50%)

Cough, Dyspnea

Pleural Effusion- Muffled Lung Sounds

Precaval Syndrome

Cranial Mediastinal Mass on Imaging

A

Mediastinal (Thymic)

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134
Q

Any Time you see a Cat with Bilateral Symmetrical Alopecia, Miliary Dermatitis, or Eosinophilic Granuloma Complex, what should ALWAYS be on your Differential List?

A

Flea Allergic Dermatitis

Ringworm

*Always eliminate these causes First- They are the most common causes of all three of these Clinical Signs

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135
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Nodule- Primary Skin Lesion

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136
Q

Generalized Truncal Pyoderma- Pustules and Papules (Superficial Pyoderma)

What Diagnostics would you like to Discuss with the Owner?

A

Derm Diligence- Skin Scape, Cytology, DMT Culture

Surface Cytology- Should see Staphylococcus- Cocci

*Prednisolone- Steroids should NOT be used to Treat Superficial Pyoderma (Papules and Pustules throughout the Body)

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137
Q

Treament for GENERALIZED Demodex

A

Daily Oral Ivermectin or Weekly Mitaban Dips

*Spontaneous Remission Occurs in up to 50% of Cases in Young Dogs

*NO GLUCOCORTICSTEROIDS EVER!!

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138
Q

Adjunct to Immunosuppressive Therapy (Glucocorticoids) in Patients with IMHA with the Following Indications:

Intravascular Hemolysis

Non-Regenerative Anemia

Negative Side Effects of Glucocorticoids

A

Mycophenolate

*Used as Adjunctive Treatment to Glucocorticoids in Patients being Treated for IMHA

*Used in Patients that cannot Tolerate Steroids due to Side Effects ect.

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139
Q

Assessment of the Degree of Malignancy of a Tumor

A

Tumor Grade

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140
Q
A

A. No Mask, Eye Shield, Double Goving, Gloves Used

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141
Q

Paraneoplastic Syndrome described below:

Excess HISTAMINE seen in Mast Cell Tumors (75%), a negative Prognosticator, or Gastrin seen in Gastrinomas

Stimulates Gastric H2-Receptors leading to Increased Gastric Acid Secretion

A

Gastroduodenal Ulcers

*Every patient with a Mast Cell Tumor, needs to be on H1 and H2 Blockers until the Mast Cell Tumor is in Remission

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142
Q

Steps of _______:

A

Metastasis

*Tumor cells are usually not able to survive if they have lost contact with the Tissue of Origin. These Tumor Cells survive by invading the Immune System leading to Metastasis

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143
Q

Chemotherapy Drug of Choice for Mast Cell Tumors and Relapsed Lymphoma

A

Lomustine

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144
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Epidermal Collarette- Secondary Skin Lesion

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145
Q

How to Diagnose Sebaceous Adenitis

A

Skin Biopsy from Dorsal Surfaces

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146
Q

Dermatologic Condition Described Below:

Inherited Dysplasia of the Hair Follicle Resulting in Comedones on the Back

Breed Predisposition: Schnauzer

Secondary Folliculitis and Furuncolosis

A

Schnauzer Comedo Syndrome

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147
Q

Type of Lymphoma Described Below:

Cells that May Respond to Chemotherapy

Usually Develop Relapse Quickly with Short Clinical Remission

Poor Prognosis

A

T Cell Lymphoma

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148
Q

Dermatologic Disease Described Below:

Presence of More Demodectic Mites than what is Normal in Conjunction with Hair Loss, Folliculitis, Scales, Erythema, and Crusts

Two Forms- Localized and Generalized

A

Demodecosis

*Present on every dog

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149
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Bulla- Primary Skin Lesion

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150
Q

Minimum Treatment Time in Cases of Deep Pyoderma

A

3-12 Weeks

*Treat 2 Weeks beyond Resolution

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151
Q

Serum is Tinted a Red Color Indicating Intravascular Hemolysis. What are the Two most Common Causes of Intravascular Hemolysis?

A

Heinz Body Anemia

IGM Immune Mediated Hemolytic Anemia

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152
Q

Treatment for DIC

A

Early DIC with Hypercoagulable State- Heparin

Late DIC with Bleeding- Fresh Frozen Plasma (Most Common)

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153
Q

Normal Platelet Reference Range in Dogs and Cats

A

200-500 x 109 (Dog)

300-800 x 109 (Cat)

*Severe Thrombocytopenia: < 50 x 109. These Dogs will Normally have Petechiation due to Everyday Trauma

Spontaneous Bleeding not Due to Trauma happens when Platelet Count is Below 30 x 109

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154
Q
A

Plasma

*Plasma- No Value in Blood Transfusion at all

*VonWilibrands Disease- Only store Blood Products for 6 Hours. We like to see the word FRESH when we are using Blood Products for VonWilibrands Disease

*The Products that would be helpful to prevent Bleeding- Fresh Whole Blood, Fresh Frozen Plasma, Cryoprecipitate (IDEAL), and Desmopressin

*Cyroprecipitate- Very High Concentration of VonWillibrands Factor

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155
Q

Technique used in Radiotherapy that avoids acute Toxicity by Killing Tumor Cells but Avoiding Surrounding tissue

A

Fractionation

*We want to Kil the Tumor but Preserve the Surrounding Cells- we Utilize Fractionation

The Higher the Frequency and Smaller the Doses- Preserves the Surrounding Tissue

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156
Q

Hematology Findings for which Cause of Anemia:

Strongly Regenerative

Leukocytosis

Thrombocytopenia/DIC (25-70%)

Spherocytosis (Hallmark)

Agglutination

A

IMHA

*Almost Always Characterized by Inflammatory Leukogram- Leukocytosis due to Necrosis in the Body

Thrombocytopenia- Hemolysis releases the Cytoplasmic Components of the RBC leading to activation of Platelets/Coagulation

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157
Q

Top Differential in Geriatric Large Breed Dog

A

Hemangiosarcoma

*Erythrocyte Fragmentation

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158
Q

Classification of Lymphoma Described Below:

Middle Aged to Elderly Dogs

Only 10-20% are Clinical ill

Inappetence, Weight Loss, Lethargy

Enlarged Painless and Rubbery Lymph Nodes

A

Multicentric

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159
Q

Dermatologic Disease Described Below:

Abnormal Hairshafts and Distorted Hair Follicles Full of Keratin and Melanin

Hair Breakage and Loss

Color Diluted Breeds- Dobermans, Dachshunds ect.

A

Color Dilution Alopecia

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160
Q

True/False: Total Protein (Albumin) is usually Normal in Patients with Hemolytic Anemia (IMHA) and Non Regenerative Anemia

A

True

*Total Protein is usually Below Normal (Subnormal) in Blood Loss, HOWEVER Normal Total Protein levels do NOT Rule out Blood Loss

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161
Q

This Dog has Itching (Pruritus) over the Caudal Dorsum. What is the Number One Differential?

A

Flea Allergy

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162
Q

Reduced Red Blood Cell Count, Hemoglobin or Packed Cell Volume (PCV)

A

Anemia

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163
Q

Medical Therapy for Eosinophilic Granuoma Complex

A

Glucocorticoids

*High Dose Prednisolone

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164
Q

Canine Melanoma Vaccine is now Fully Licened for which Stages of Disease?

A

Stage II and III

*Dogs with Stage II or III Oral Melanoma receiving Four Biweekly Vaccinations Increases Survival time around 389 Days

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165
Q

Classification of Lymphoma Described Below:

Erythema, Pruritus, Ulceration, Skin Nodules

A

Cutaneous

*If the Cutaneous Lymphoma is a Localized Lesion then it can be cured with Surgery and Radiation. However if its Infiltrative then you have to use Systemic Chemotherapy

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166
Q

Two Methods used to Administer Allergen-Specific Immunotherapy (ASIT)

A

Subcutaneous- Inject with Allergen at Tiny Doses until Eventually Hyposensitized to Allergen (Allergy Shots)

Sublingual- “Allergy Drops” under the Tongue twice a day

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167
Q
A

C. CCNU (Lomustine) or LOPP, 40% RR, 5 Months Remission Time

*He Responded well to the Protocol and went into a 6 Month Remission Period prior to Relapse

*Rescue Protocol Takes 5 Months and the Response Rate is 40%

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168
Q
A

Immunophenotype (T Cell)

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169
Q

In Patients with Cancer Cachexia, what Dietary Restrictions are Recommended

A

High Protein, Low Carb Diets (N/D Diet)

*Cancer Cachexia- Body is Metabolizing its own Protein Sources leading to Muscle Atrophy. You need to Decrease the amount of Carbohydrate in the diet and Supplement Protein

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170
Q

True/False: Do NOT Rely upon Culture/Sensitivity to Give a Diagnosis of Otitis Externa. Bacterial Infections are almost ALWAYS Secondary to something else

A

True

*Bacteria/Yeast are usually NOT the Primary Cause of Acute Otitis Externa

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171
Q

Treatment for Acute Lymphoblastic Leukemia

A

Acute Lymphocytic Leukemia- Prednisolone + Vincristine + L-Asparaginase (6 months)

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172
Q

2/3rds of Splenic Masses are Malignant

2/3rds of Maliganancies are ______

A

Hemangiosarcomas

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173
Q
A

Current CHOP (19 Week Protocol)

*CHOP- Standard of Care for B and T Cell Lymphomas

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174
Q
A

Systemic Corticosteroids

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175
Q

When Treating Food Allergies, Perscribe a _____ Ingrediate Diet, such as Fish, Venison, Rabbit, or Kangeroo

A

Novel Ingredients

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176
Q

Majority of the Time when Mean Corpuscular Hemoglobin Concentration (MCHC) is Increased it will be due to _____

A

Artifact

*In Vitro Hemolysis

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177
Q
A

B.

*Point B- Where CT/MR Imaging is able to detect Tumor Cells

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178
Q

Ear Condition Described Below:

Common in Cavalier King Charles Spaniels

Clinical Signs- Head Tilt, Neck Pain, “Air” Scratching, Facial Paralysis

Bulging of Pars Flaccida

A

Primary Secretory Otitis Media (PSOM)

*BULGING PARS FLACCIDA

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179
Q

Treatment for Malassezia Dermatitis

A

Topicals: Anti-Yeast Shampoo (Ketoconazole, Miconazole)

*ALWAYS use Topicals if Possible to Normalize the Microenvironment. ONLY use Systemic Treatment if Infection is Extensive or Topical isn’t working

*Malassezia is usually Secondary, so there is a Primary Cause that we are going to have to Find and Manage

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180
Q

Two most Commonly used Topical Antibiotics used in Treatment of Pyoderma

A

Benzoyl Peroxide- Follicular Flushing activity

Chlorhexidine

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181
Q

Osteosarcomas commonly Metastasize to the _____, as well as other Bony Areas of the Body

A

Lungs

*Take Thoracic Radiographs to check for Metastasis

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182
Q

Dermatologic Disease Described Below:

Mild Pustular Rash in Axillary or Inguinal Areas of Young Animals

Often Associated with Dirty Environment, Parasitism ect.

A

Impetigo (Puppy Pyoderma)

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183
Q

Three Classifications of Anemia

A

Bone Marrow Dysfunction

RBC Destruction

RBC Loss (Hemorrhage)

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184
Q

Chronic Otitis Externa is Persistent Otitis Externa lasting for Greater than ____ Months

A

2 Months

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185
Q

Palliative Radiotherapy (Radiation) is used in Non-Operable Tumors when Patients are Predicted to live Less than ____ Months

A

6 Months

*Not applicable to use Palliative Radiotherapy for any animal that may survive longer than 6 months

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186
Q

What are the Three Fractionation Protocols that are used with Radiotherapy in the Treatment of Tumors

A

Palliative:

High Dose, Low Frequency (9Gys Once Weekly)

Hypofractionated

Very Susceptible to Acute Side Effects

Semi-Definitive

3Gys Mon-Wed-Friday

Definitive

Low Dose, High Frequency (1.5-2Gys 5 Days a Week)

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187
Q

Malignant proliferation of Peripheral Lymphoid Tissues that affects Lymph Nodes, Liver, Spleen and can affect Bone Marrow

A

Lymphoma

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188
Q

Treatment for Moderate Myelosuppression (1-2) during Chemotherapy

A

If Non-Pyrexic (No Fever): Stop Drugs and Monitor

If Pyrexic (Fever): Stop Drugs and Use Antibiotics

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189
Q

Mainstay of Treatment for Immune Mediated Thrombocytopenia (IMTP)

A

Prednisone (Immuno-Suppressants)

*Emergency Situation- Prednisone + Vincristine: Rapid Increase in Platelets

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190
Q

Blood Transfusions should be Given within _____ Hours

A

4-6 Hours

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191
Q

Screening Test for Dermatologic Cases Described Below:

NO PREP, NO SCRUB (Do NOT Distrub Lesions)

Gently Clip Hair

Handle Sample as Little as Possible

Put Sample in 10% Formalin

A

Skin Biopsy

*NO PREP, NO SCRUB

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192
Q

What Two Types of Tumors are Highly Radiotherapy Sensitive but have a High Recurrence Rate

A

Mast Cell Tumors

Hematopoetic Tumors

*Mast Cell Tumors Regress Quickly with Radiation Therapy but may Recur Quickly

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193
Q

Clinical Signs of which Hematopoietic Tumor:

ASYMPTOMATIC

Non-Specific: Lethargy, Inappetence, Fever, Weight Loss

Paraneoplastic Disease: Hypercalcemia, Hyperviscosity

A

Lymphoma

*Important to Remember with Lymphoma- Majority if Patients are ASYMPTOMATIC

*Only 20% of Patients with Lymphoma will present Clinically Unwell- Carries a Guarded Prognosis

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194
Q

Diagnosis Based on these Hematology Results

A

Immune Mediated Hemolytic Anemia (IMHA)

*Spherocytes and Agglutination

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195
Q

Dermatologic Disease Described Below:

BILATERALLY SYMMETRICAL Truncal Alopecia

Non Pruritic

A

Endocrine Alopecia

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196
Q
A

A. Age > 7 Year is Worse

*LESS than 7 Years of Age is Worse

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197
Q

Dermatologic Disease Described Below:

Surface Parasite- ZOONOSIS

Clinical Signs- Pruritus, Dorsal Scaling, Papular Crusts, Scratch Reflex

A

Cheyletiella (Walking Dandruff)

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198
Q

Most Common Blood Type in Felines

A

Type A

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199
Q
A

All of the Above

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200
Q
A

Atopy

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201
Q

How do we Diagnose Atopy (Allergic Dermatitis)

A

Clinical Signs: Seasonal Prutitus, Lesion Distribution

*No Other way to Diagnose Atopy- Must be Diagnosed based on CLINICAL SIGNS

*Diagnose Atopy based on Clinical Signs, NOT Interdermal Skin Testing

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202
Q

Review Card: Clinical Staging of Lymphoma

Stages I and II are very Rare- Single Node Lyphoma that can be Controlled with Surgery or Radiation (Ex. Nasal Lymphoma)

Majority of Dogs will be Stages III-V

Stage III- Lymph Node Involvment

Stage IV- Liver and Spleen Involvment

Stage V- Bone Marrow Involvment

A
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203
Q

True/False: Felines have Smaller Erythrocytes that Lack Central Pallor

A

True

*Difficult to Diagnose Spherocytes in Felines because Erythrocytes don’t have Biconcave Central Pallor

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204
Q
A

Three Thoracic Radiographs

*For Feline Tumors we DO NOT use FNA and we NEVER Biopsy

*Treatment of Choice- Radical Bilateral, Staged Mastectomy ONLY after Three Thoracic Radiographs to Determine the Stage. We would not persue any form of Treatment if there was any sign of Metastasis

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205
Q

Platinum Chemotherapy Drug used to Treat Osteosarcoma and Oral Malignant Melanoma

A

Cisplatin

*Mainstay of Therapy for Sarcomas

*Causes Fatal Pulmonary Edema in Felines (Cisplatin Splats Cats)

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206
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Lichenification- Secondary Skin Lesion

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207
Q

Gold Standard for Identifying Environmental Allergens

A

Intradermal Allergy Testing

*Mark Black Dot with Sharpie pen where we want to Inject the Allergen

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208
Q

______ Hemostasis:

Platelets

Vascular Factors- Platelet Plug attached to Site of Injury

A

Primary

*Hemostasis- Stopping of a Flow of Blood

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209
Q

Common Differentials for which Classification of Anemia:

IMHA

Babesia spp.

Mycoplasma spp

Heinz Body Anemia (Ex. Onion Ingestion)

A

Anemia of Increased RBC Destruction

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210
Q

How to Diagnose Sarcoptes Scabiei

A

Superficial Skin Scrapes

211
Q

Generalized Truncal Pyoderma- Pustules and Papules (Superficial Pyoderma)

How Would you Treat this Case?

A

Topical Antibiotics- Antibacterial Shampoos

Systemic Antibiotics- 1st Level Tier Antibiotics (Cephalosporins, Amoxicillin, Clindamycin)

*Superficial Pyoderma

212
Q

Pathophysiology of _____:

Infection of Middle Ears usually spreads from Otitis Externa, across Eardrum to Bulla

Initially the Ear Drum may appear Bulging but as material Increases within Bulla, the ear drum can rupture

A

Otitis Media

213
Q

Part of Anatomical Staging Described Below:

Asses if Lymph Nodes are Enlarged- Palpate (Enlarged, Hard, Fixed)

Image Body Cavities

Confirm there is Infiltrate- Aspirate/Biopsy

A

Local Lymph Nodes (N)

214
Q

Preferred Collection Site for Cytology in Cases of Otitis Externa

A

Horizontal Canal

215
Q

Local Treatment for Primary MALIGNANT Tumor which cannot be controlled by Surgery that is used for Curative Intent

A

Radiotherapy

*Adjunctive Radiation Therapy is commonly used in Combination with Surgery and Chemotherapy for Curative Intent

*Radiotherapy is commonly used After Surgery to Cytoreduce or “Clean” Tumor Edges

216
Q

What is Seen on Surface Cytology in Patients with Surface Pyoderma

A

Mixed Bacterial Population

217
Q

When Dosing Chemotherapy Drugs, Smaller Dogs have a Higher Metabolic Rate and should get a _____ Dose

A

Higher

*Dose on Body Surface Area (m2)

218
Q

Predisposing Factors for development of which Hematopoietic Tumor:

Retroviruses in Felines (FIV, FeLV)

Herbicidal Agents

Exposure to Magnetic Fields

Genetics and Age

A

Lymphoma

*Most common Predisposing Factor for Lymphoma- FIV and FeLV in Felines

219
Q

Identify the Cells pointed out with Arrows

A

Reticulocytes (Canine)

220
Q

How to Confirm Diagnosis of Mammary Gland Tumor in Felines

A

Perform Bilateral Strip/Stage

*DON’T Biopsy Mammary Tumors in Felines- We just Assume its Malignant

221
Q
A

Only A and B

*Intertrigo is Superficial

222
Q
A

Surface

223
Q

Lymphoma Cases with the Following Characteristics have a _____ Prognosis:

Substage A

B Cell Immunophenotype

Clinical Response to Treatment

Nasal Lymphoma

A

Good

224
Q

Form of Eosinophilic Granuloma Complex shown Below:

A

Collagenolytic Granuloma

225
Q
A

D.

*Old Food should NOT be mixed with new Food

226
Q

Feline Dermatologic Disease Described Below:

Excessive Grooming

NOT Barbering- Hair Tips are not Chewed off

A

Hyperthyroidism

227
Q

Type of Lymphoma Described Below:

Cells that Have a Fair Response to Chemotherapy

Once Remission Occurs- it is Durable

Much Higher Chance of Being Cured

A

B Cell Lymphoma

*65% of Canine Patients will have B-Cell Lymphomas

228
Q

Paraneoplastic Syndrome described below:

10-35% Of Dogs with Lymphoma

> 25% of Dogs with Anal Sac Apocrine Gland Adenocarcinoma

20% Dogs with Myeloma

Pathogenesis: Ectopic Production of PTH or PTH-rP, Extensive Lytic Bone Metastases

A

Hypercalcemia

*Neoplasia is Diagnosed in App. 2/3rds of Dogs with Hypercalcemia

*PTH-rP: Parathyroid Hormonal Related Protein

PTH and PTH-rP Stimulates the Reabsorption of Calcium from the Intestine, Bone and Kidney Tubules

229
Q

True/False: Patients with Primary IMHA are Icteric with a Poor Prognosis. While Most Patients with Secondary IMHA are NOT Icteric with Profoundly Low PCV

A

True

*Primary IMHA- 70% will Die within 2 Months of Diagnosis

When you see Icterus in a Patient with Primary IMHA, they have Liver Failure (Necrosis of Liver Cells)- Multiple Organ Dysfunction Syndrome

230
Q

Dermatologic Condition Described Below:

Underlying Conditions- Hepatic/Pancreatic Disease

Footpads 100% Involved- Hyperkeratotic, Crusty, Cracking Footpads

A

Superficial Necrolytic Dermatitis

231
Q

If we are doing a Food Trial Properly, we expect a ____% Reduction in Pruritus within 4 Weeks

A

50%

*Any Improvement in Pruritus- Continue Food Trial for another 4-8 weeks

232
Q

Enlarged Submandibular Lymph Node

FNA (Fine Needle Aspirate) Performed- Lymphoblasts

What is your Diagnosis?

A

Lymphoma

233
Q

Name this Dermal Lesion

A

Comedo

*Hair Follicle Plugged with Keratin

234
Q

Most Common Paraneoplastic Syndrome seen in Patients with Lymphoma

A

Hypercalcemia

235
Q

Chemotherapy Drug associated with a Good Response Rate and Durable Remmission in Patients with Lymphoma

A

Doxorubicin

*6-8 Months Survival with complete Remission in Majority of Patients with Lymphoma

*ALWAYS use Doxorubicin in Cats with Lymphoma because it is a Prognosticator

236
Q

Dermatologic Condition Described Below:

Autoimmune Skin Disease

Primary Lesions- Pustules, Vesicles, Bullae

A

Pemphigus

237
Q
A

Mycophenolate Mofetil

*Diabetic Patient CANNOT go on Prednisilone

*Mycophenolae Mofetil is as effective as Prednisilone with Fewer Side Effects

238
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Wheal- Primary Skin Lesion

239
Q

Clinical Sign of Hyperadrenocorticism(Cushings) Described Below:

Firm White Plaques, often Ulcerated

A

Calcinosis Cutis

*ON EXAM

*Treament- Topical DMSO: Can Accelerate the Resolution of Calcinosis Cutis

240
Q

Best Diagnostic Test for Leukemia

A

Bone Marrow Aspirate

241
Q
A

Schistocytes

242
Q

Classify these Three Types of Tumor Cells

A

*Sarcomas are more likely to Metastasize Hematoginously, while Carcinomas are more likely to Metastasize Lymphatically

243
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Nodule (Tumor)- Primary Skin Lesion

244
Q
A

B. No Corticosteroids for at least a month Prior to the Test

245
Q

Identify the Cells pointed out with Arrows

A

Reticulocytes (Feline)

*Two Form of Reticulocytes in Felines- ONLY Count Aggregate Reticulocytes

246
Q

Papules on Ventral Neck

Bilateral Periocular Alopecia and Erythema

Erythema and some Lichenification of Both Pinnae

Alopecia, Erythema, and Papules on Ventral Abdomen

Interdigital Erythema, Saliva Staining, and Alopecia

Erythem, Alopecia, and some Hyperpigmentation of Caudal Thighs and Perineum

What Test would you do next?

A

Skin Scrape, Surface Cytology, DTM Culture

*Multifocal Areas Affected

247
Q

Dermatologic Condition Described Below:

Excessive Epidermal Turnover: 7 days compared to 21 days Normally

Causes Abnormal Cornification and Desquamation

Follicular Casts Prominent

A

Primary Idiopathic Seborrhea (Vitamin A Responsive Dermatitis)

248
Q

Side Effects of which Chemotherapy Drugs:

Mild Myelosuppression

Renal Toxicity

Fatal Pulmonary Oedema in Felines

A

Platinum (Cisplatin)

249
Q

All Dogs in the Household where ____ has been Diagnosed should be Treated

A

Sarcoptic Mange

*Sarcoptic Mange is CONTAGIOUS

250
Q

Most Common Benign Mammary Tumor of Canines

A

Mixed Mammary Tumor

251
Q

Treatment for Osteosarcoma

A

Palliative Intent:

Radiation Therapy (Large Doses): < 6 Month Survival

Multimodal Pain Control- NSAIDs with Acetaminophen

Curative Intent:

Surgery (Amputation) with Chemotherapy (Doxorubicin)

*Since the Majority of these Dogs are Geriatric the Owners may want Palliative Intent rather than Curative

252
Q

List the Three Different Skin Lesions in a Feline

A

Bilaterally Symmetrical Alopecia (Non-Inflammatory)

Miliary Dermatitis- Small Bumps

Eosinophilic Granuloma Complex

253
Q

Mast Cell Tumors on the _____ are Biologically more Aggressive/Malignant

A

Muzzle

*Anything near the Mucocutaneous Junction is more likely to be a very aggressive/bad tumor- Muzzle and Nasal Area

254
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Alopecia- Primary or Secondary Lesion

255
Q

Most Common Presentation of Lymphoma in Feline Species

A

Alimentary

*Most common Form of Lymphoma in Felines- Geriatric Feline Population that suffers from Diffuse, Small cell Lymphocytic Lymphoma (Alimentary)

*These tend to be FeLV Negative

256
Q

Systemic Antibiotics that Make up the 3rd Tier (LAST RESORT) for Pyoderma

A

Fluoroquinolones

3rd Generation Cephalosporins

*ONLY use these Options if no other Antibiotics are a Feasible Option

257
Q

12 Year Old, Spayed Female, Domestic Shorthair

Primary Complaint: Acute Onset Lameness of the Left Hindlimb following minimal Trauma while Climbing off a Sofa

Recently the cat had become less active but maintained a good appetite with some weight gain

BCS: 3/9 with a Pot-Belly

Auscultation: Grade II Holosystolic Heart Murmur

Pale Mucous Membranes- Anemia

Left Hindlimb Tarsus was Swollen and Painful on Palpation

Abdominal Palpation: Mild Organomegaly (Splenomegaly)

What is the Diagnosis?

A

Multiple Myeloma

*# 1 Clinical Sign of Multiple Myeloma- Anemia

*50% of Cats Diagnosed with Multiple Myeloma will have a Heart Murmur

258
Q
A

Follicular Dysplasia

259
Q

Common Biochemistry Findings in Patients with Multiple Myeloma

A

Hypoalbuminemia

HYPERGLOBULINEMIA (Hyperviscosity Syndrome)

Proteinuria

260
Q
A

Sterile Hemorrhagic Cystitis

261
Q

Paraneoplastic Syndrome described below:

A

Cancer Cachexia

*Cancer Cachexia is a very Negative Prognosticator and associated with a Reduced Survival Time

*Weight Loss in the Presence of Adequate Nutritional Intake- The cancer is utilizing the Carbohydrates at the expensive of the Dog

262
Q

Minimum Treatment Time in Cases of Superficial Pyoderma

A

3-4 Weeks Minimum

263
Q

Lymphoma Cases with the Following Characteristics have a _____ Prognosis:

Substage B

T Cell Immunophenotype

Certain Anatomical Locations- CNS, Ocular

A

Bad

264
Q

Paraneoplastic Syndrome Described Below:

A

Hyperestrogenemia

*Ex. Sertoli Cell Tumors

265
Q

Screening Test Described Below:

Heat Fixed and Stain Slide

Surface Scraping- Micro-organisms

Direct Impression- Press Slide Onto Lesion

Q Tip- Ears, Moist Areas, Skin Fold

A

Surface Cytology

266
Q

Patient has Marked Thrombocytopenia (< 50). Secondary Diseases have been Ruled Out. What is the Main Differential?

A

Autoimmune Thrombocytopenia (IMTP)

267
Q

Secondary Hemostatic Disorder Described Below:

Inhibition of Vitamin K Epoxide Pathway (Reductase)

Within 36 Hours, PT will be Prolonged

Massive Fatal Hemorrhage

A

Vitamin K Antagonism or Deficiency (Ex. Warfarin)

*Vitamin K is an Important Factor in the Intrinsic and Extrinsic Pathway

*Within 36 Hours, PT will be Prolonged because that’s the Coagulation Factor with the shortest Half Life: Factor VII

Even a Small Amount of Vitamin K Antagonism can cause Massive Fatal Hemorrhage

268
Q

Name Three Contraindications for Pretreatment Biopy in Patients with Tumors

A

1. When the Surgical Extent would NOT Change despite the Type of Tumor (Ex. Testicular or Splenic Mass)

2. When Biopsy would Compromise the Patient (Ex. Spinal Cord)

3. Seeding the Tumor

269
Q

Dermatologic Condition Described Below:

Inflammed Subcutaneous FAT

A

Nodular Panniculitis (Steatitis)

270
Q

Treatment for Severe Myelosuppression (<0.5-1) during Chemotherapy

A

Barrier Nurse

Fluids

IV Antibiotics (Ex. Cefazolin)

*These Patients are Admitted into the Hospital

271
Q
A

C. Amputation/Limb Sparing + Chemotherapy Combination

272
Q

Review Card: Secondary Hemostasis

Vitamin K Dependent Factors (Intrinsic)- XII, XI, and IX

Extrinsic Pathway Factors- VII

*These factors ultimately Activate Prothrombin to Thrombin causing Fibin to Cross Link and form a Fibrin Clot

A
273
Q

Treatment for Von Willebrands Disease

A

Cryoprecipitate (BEST)

Desmopressin Acetate (DDAVP)

274
Q

Response to Chemotherapy in Canine and Felines with Lymphoma

A

Canines- 80-90% Response Rate

Felines- 50-70% Response Rate

*Canine Lymphomas respond Better to Chemotherapy than Cats

275
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Comedone- Primary or Secondary Skin Lesions

276
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Excoriation- Secondary Skin Lesion

277
Q

Symptomatic Therapy for Patients with Atopy (Allergic Dermatitis) Described Below:

Decreases Inflammatory Mediators and Cytokines that Cause Pruritus

Janus Kinase (JAK) Inhibitor

Negative Effects- May Increase Susceptibility to Infection and Demodicosis

A

APOQUEL

278
Q

Patient has Mild/Moderate Thrombocytopenia ( >50). Spontaneous Bleeding is Evident. What are the Three Differential Diagonsis?

A

DIC

Thrombocytopathy

Secondary Haemostasis Disorder

279
Q

What is the Top Differential in a Patient with the Following Findings:

Serum and Urine Monoclonal Gammopathy

Permeative Lysis of the Bone With Patholgical Fractures

Bence Jones Proteins in Urine (Proteinuria)

Bone Marrow Plasmocytosis

Hyperviscosity

A

Multiple Myeloma with Hyperviscosity Syndrome

280
Q

Most Common Mode of Chemotherapy Drug Administration

A

IV

*Most of these Drugs are Vesicants- If they Extravasate they will cause Severe Necrosis and Sloughing

281
Q

Chemotherapy Protocol Described Below:

Low Toxicity

Few Side Effects

Moderate Survival

A

COP

*Combination of: Cyclophosphamide, Vincristine, and Prednisilone

*This Protocol is now only considered PALLIATIVE

282
Q
A

Lick Granuloma

*Furunculosis- Rupture of Hair Follicle deep within Dermis. The Only Deep Pyoderma listed is Lick Granuloma

283
Q

Nodular Panniculitis/Steatitis is a Cutaneous Marker for _____ Disease

A

Systemic

*KNOW THIS

284
Q
A

A. 3 Weeks- 3 Months

*This Tumor has a very Grave Prognosis because of its Origin- It has Usually Metastasized by the Time of Diagnosis

285
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Cyst- Primary Skin Lesion

286
Q

Three Systemic Antibiotics that Make up the 1st Tier Empirical Treatment for Pyoderma

A

1st Generation Cephalosporin (Cephalexin)

Amoxicillin

Clindamycin

*ALWAYS ON EXAM

287
Q

You Perform a Fine Needle Aspirate of a Tumor. More than 50% of the Cells are Lymphoblasts. What is the Diagnosis?

A

Lymphoma

*Lymphoma- Homogenous Population of Large Lymphoblasts (50%)

*If you are unable to Diagnose a Tumor based on FNA, then it is best to Follow up with a Biopsy

288
Q

Severe Form of Thrombocytopenia Described Below:

Platelet Count < 50,000/uL

Increased Megakaryopoeisis (Strongly Regenerative)

Microthrombocytosis (Small Platelets)

A

Immune Mediated Thrombocytopenia (IMTP)

*The Majority of Dogs with IMTP have a Platelet Count of Less than 20,000/uL

*Hallmark Feature of IMTP- Low Platelet Counts with Small Platelets (Microthrombocytosis)

289
Q
A

E. B and D

290
Q

Dermatologic Disease Described Below:

Inflammation and Destruction of Sebaceous Glands

Long Coats- Alopecia, Adherent Scales on Pinnae, Follicular Casts

Short Coats- Moth Eaten Appearance

A

Sebaceous Adenitis

291
Q

Review Card: Staging of Mast Cell Tumors

Stage I- Dermal Mass with NO Lymph Node Involvment

Stage II- Dermal Mass with Lymph Node Involvment

Stage III- Infiltrating Dermal Mass

Stage IV- Systemic Spread of Cancer

A
292
Q

True/False: Takes only ONE Flea Bite to set off Allergic Response leading to Flea Allergic Dermatitis

A

True

*When you examine these animals there may not be any Fleas or Flea Dirt Present- Only takes the Bite of ONE Flea

293
Q

What are the Four Possible Responses to Chemotherapy

A

Complete Response- No Detectable Tumor (Clinical Remission)

Partial Response- Decrease in Tumor Volume of > 50%

Stable Disease- Disease that Does not Change in Size

Progressive Disease- > 10% Growth of the Tumor

294
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Papule- Primary Skin Lesion

295
Q
A

A. DFE and PF

296
Q

Drug Given to Patients in Cases of Non-Endocrine Alopecia:

Plays a Role in Photoperiod related Hair Growth and Coat Color in many Mammals

May Stimulate Hair Growth

A

Melatonin

297
Q

Match the Specific Side Effects to the Chemotherapy Drug:

1. Renal Damage

2. Cardiomypathy

3. Cystitis

4. Hypersensitivity

5. Neuropathy

A. Vincristine

B. Doxorubicin

C. L-Asparaginase

D. Cyclophosphamide

E. Cisplatin

A

Cisplatin- Renal Damage (Cisplatin Splats Cats)

Doxorubicin- Cardiomyopathy

Cyclophosphamide- Hemorrhagic Cystitis

L-Asparaginase- Hypersensitivity

Vincristine- Neuropathy

298
Q

Chemotherapy Drugs with the Following Pathological Mechanism:

Creates Cross-Liked DNA with Strand Breaks

A

Alkylating Agents (Ex. Cyclophosphamide)

*Traditional Rescue Drug- If you treated a Cancer and it went into Remission but Replases shortly after. Rather than Repeating the Protocal you would use Alklyating Agents for Chemotherapy

*Cyclophosphamide- Effective in 40% of the Cases of Lymphoma that Relapse

299
Q

Symptomatic Therapy for Patients with Atopy (Allergic Dermatitis) Described Below:

“Crisis Buster”- Patient is Driving the Owner Crazy because it is Itching

Strong Evidence of Efficacy

Use The Lowest, most Infrequent Dose that will Control Pruritus

A

Corticosteroids ( Oral Predisolone)

300
Q

Which of the Following about Flea Allergic Dermatitis is FALSE:

A. A Dog with FAD will ALWAYS have FAD

B. Flea’s Don’t have to be seen on Dog

C. Hypersentivitity to Flea Bite

D. Use Insect Growth Regulators in Environment and Adulticide on all In-Contacts

E. Use Predisolone (Steroid) to Stop Pruritus

A

All the Above are True about Flea Allergic Dermatitis

301
Q
A

C. Increased Epidermal Turnover

302
Q

Which Chemotherapy Drugs are NOT affected by Multi-Drug Resistance

A

Alkylating Agents

Carboplatin

*We Rely on Lomustine as a Rescue Drug

303
Q

Dermatologic Disease Described Below:

Follicular Damage Initially with Secondary Bacterial Infection

Deep Pyoderma- Usually Staphylococcus

Young Dogs < 1 year

Clinical Signs- Alopecia, Non-Painful, Non-Pruritic, Papules

A

Canine Acne (Chin Pyoderma)

*Deep Pyoderma

304
Q

Disorder of Platelet Number Leading to Thrombocytopenia Described Below:

Immune Mediated Thrombocytopenia

Infections

Toxins- Snake Envenomation

A

Platelet Destruction

305
Q

Prognosis for Leukemia

A

Chronic = Good Prognosis

Acute = Poor Prognosis

*Acute Lymphoblastic Leukemia is a very aggressive disease with a very Poor Prognosis and Poor response rate to chemotherapy

Chronic Lymphocytic Leukemia- May be an Incidental Diagnosis (50%) where these patients tend to do fairly well

306
Q

Best Diagnostic Tool In Terms of Predicting Outcome and Staging Mast Cell Tumors

A

Lymph Node FNA or Biopsy

*ALWAYS Aspirate

307
Q

Once you Obtain your Tumor Biopsy you obtain Fixation in ___% Formalin for 2-3 Days

A

10%

1:10 Ratio of Tissue:Formalin

308
Q

Juvenile Cellulitis:

Young Puppy (3 weeks - 6 months Old)

Clinical Signs- Swelling Face, Pyoderma, Pustules

Non Cutaneous Signs- Lethargy, Pyrexia, Anorexia

What is the Treatment?

A

Corticosteroids (Prednisolone)

309
Q

This Dog has Itching (Pruritus) over the Elbows and Ears. What is the Number One Differential?

A

Sarcoptic Mange

310
Q

True/False: In patients with Cancer, the Outcome will depend on Anatomical TNM Stage and Tumor Grade

A

True

311
Q

Dermatologic Disease Described Below:

INTENSE PRURITUS

Burrowing Mite- Contagious and Zoonotic

Predilection Sites- Ear Pinna, Elbows, Hocks

A

Sarcoptes Scabie (Scabies)

*If Dog is Scratching at Ears and Elbows- Think Sarcoptes

312
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Ulcer- Secondary Skin Lesion

313
Q

What is Considered the Primary Etiology leading to Lick Granuloma

A

Atopy/Allergy

*Lick Granuloma is most likely just another manifestation of Allergies

314
Q
A

15-25%

*Cure Rate for Osteosarcoma is around 20%

315
Q

Margins used for Surgical Resection of Mast Cell Tumors

A

Laterally 8.9 mm

Deep 5.3 mm

*Mean Lateral and Deep Surgical Margins around the Tumor should be 8.9 and 5.3mm

316
Q

Chemotherapy Drugs with the Following Pathological Mechanism:

Incorporated into DNA interfere with Transcription or Translation

A

Anti-Metabolites (Ex. Methotrexate)

*Produce Faulty Chromosomes

317
Q

Review Card: Ear Anatomy

Vertical Canal Connected to Horizontal Canal

A

Middle Ear = Tympanic Bulla

318
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Macule- Primary Skin Lesion

319
Q

The Larger the Tumor, the Lower the Growth Fraction and the _____ Susceptible the Tumor is to Chemotherapy and Radiation Therapy

A

Less

*If we have a Large Tumor, its not going to be as Radiosensative/Radioresponsive

The Dose of Radiation that is Required to Control a Larger Tumor is Larger, which is going to lead to surrounding tissue damage

320
Q

Dermatologic Condition Described Below:

Scaly Condition of Ear Margins

Poster Breed- Dachshund

A

Ear Margin Dermatosis

321
Q

Tumor Described below:

One of the Most Important Dermal Tumors

A

Mast Cell Tumor

*Most Common Cause of Cutaneous Mass in Canines

*Accounts for 29% of Cutaneous Tumors- Important Cause of Canine Cutaneous Dermal Tumors

Golden Retrievers are Over Represented

Chows and Shar Peis- Predisposed to very aggressive Mast Cell Tumors

322
Q

List Four Tumors that are Radiosensitive and can be Treated with Radiation Therapy

A

Lymphoma (Ex. Nasal Lymphoma)

Feline Nasal Squamous Cell Carcinoma

Canine Oral Squamous Cell Carcinoma

Mast Cell Tumors

*Squamous Cell Carcinomas- After Radiation Therapy you can see a Dramatic Response

Mast Cell Tumors- Radiotherapy combined with Surgery gives a 90% Survival Rate

323
Q

Three Vascular Diseases that Lead to Erythrocyte Fragmentation

A

Heartworm

Hemangiosarcoma

DIC/IMHA (Most Important)

* 33% of Patients with IMHA will have DIC leading to Fragmented Red Blood Cells (Schistocytes)

324
Q

Three Screening Tests that are ALWAYS Done on Dermatologic Cases (Derm Diligence)

A

Scrapings

Surface Cytology

Dermatophyte Culture (DTM Culture)

325
Q

True/False: Otitis Externa is Manageable but NOT Curable unless Primary Cause/Predisposing Factors are Addressed

A

True

*Warn Owner- Otitis Externa May Recur if Primary Cause is not Addressed

*If Recurrent Infections- Look for Possible Primary Diseases

326
Q

Specific Treatment for Low Grade Intestinal lymphoma in Felines

A

Chlorambucil and Prednisolone

327
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Patch- Primary Skin Lesion

328
Q

Dermatologic Disease Described Below:

Classic Presentation: Circular Alopecia, Central Healing, Peripheral Papules, Pustules, Crusts

Cutaneous Infection of ANAGEN Hairs

Spores Persist in Environment for Months

ZOONOTIC

A

Dermatophytosis (Ring Worm)

329
Q
A

Alopecia X

330
Q
A
331
Q

Form of Eosinophilic Granuloma Complex shown Below:

Upper Lip

A

Indolent Ulcer

332
Q

Clinical Signs of which Paraneoplastic Syndrome:

A

Hypercalcemia

*Most Notably- PU/PD

333
Q

Treatment for Gastrointestinal Upset caused by Chemotherapy Drugs

A

Dehydration: Intravenous Fluids

Vomiting: Anti-Emetic (Maropitant)

Diarrhea/ileus: Prokinetics (Metoclopramide)

334
Q

Review Card: Normal Hematology in Dogs and Cats

A

In Felines, Don’t Diagnose Anemia until PCV is below 24%

Dogs: Severe Anemia occurs when PCV < 15%

Felines: Severe Anemia occurs with PCV < 10%

335
Q

Rank the Following Tumors From Highest to Lowest Sensitivity to Chemotherapy:

Hemopoietic (Lyphosarcoma/Leukemia)

Mast Cell Tumors

Solid Carcinomas/Sarcomas

A

Hemopoietic Tumors- HIGHEST Sensitivity

Mast Cells Tumors

Sold Carcinomas/Sarcomas- LOWEST Sensitvity

*Hemopoietic Tumors (Lymphoma) have rapidly dividing cells and are very sensitive to the effects of Chemotherapy

*Solid Tumors have a very low Growth Fraction and therefore Low Sensitivity to Chemotherapy

336
Q
A

Allergies

337
Q

_____ Factors of Otitis Externa

Allergies- Main Cause of Otitis Externa in Dogs

Parasites- Otodectes is the Main Cause of Otitis Externa in Cats

A

Primary

_*Main Primary Factor of Otitis Externa in Canines- ALLERGY_

Main Primary Cause of Otitis Externa in Felines- Otodectes

338
Q

Side Effects of which Chemotherapy Drugs:

Mild Myelosuppression

Peripheral Neuropathy

Extravasation Reaction

A

Mitotic Inhibitors (Vincristine, Vinblastine)

*Vincristine is associated with Peripheral Neuropathies

339
Q

Review Card: Fungal Culture (DTM Culture)

Indicated in ALL CATS with Skin Disease

A

When we are Brushing these Patients, not only are we picking up Ringworm, but we are also picking up other Fungi, Including Saphorphytes that are going to grow on the Media

At the Time that the Ringworm starts growing, the color change should happen- The Media Turns Red

*We want to see the change in Color at the same time that the colony is Growing. Must check DTM Daily because Non-Pathogenic Fungi will use the Protein Source and turn the Media Red once Carbohydrates are Exhausted- This Colony would be Present for Days before the Color Change Occured

340
Q

Specific Treatment for High Grade Intestinal lymphoma in Felines

A

CHOP

341
Q

Poikilocytosis caused by Phospholipid Membrane Metabolism Aberration and Characterized by:

_______\_

Eliptocytes

Codocytes

A

Acanthocytes

*Not to be Confused with Artifact of Crenated RBC

342
Q

Dermatologic Disease Described Below:

Acute Moist Dermatitis

Cause- Self Induced Trauma to Skin Resulting in Alopecia, Erythema, and Pruritus

A

Pyotraumatic Dermatitis (Hot Spot)

343
Q

Given this Image, What Type of Pyoderma is This?

A

Deep Pyoderma

*Furunculosis

344
Q

Canine has a Patchy, Focal to Multifocal Moth-Eaten Alopecia. What are the Top Two Differentials?

A

Pyoderma

Infections/Parasitic

345
Q

How to Diagnose Fur Mite

A

Acetate Tape

346
Q

Prognosis for Osteosarcoma

A

BW > 40 kg - Worse Prognosis

Presence of Metastasis- Poor Prognosis

Elevated ALKP- Poor Prognosis

Proximal Humerus Location- Poor Prognosis

*Very Large Breed Dogs have Worse Prognosis

*Dogs that present at time of Diagnosis with an Elevated ALKP do NOT Survive as long

347
Q

Feline Dermatologic Disease Described Below:

“Salt and Pepper” Appearance due to Mites Clinging to Terminal Hair Shafts

Hairs Epilate Easily

A

Fur Mite

348
Q

Treatment for Mast Cell Tumors

A

Surgery (Ideal)- Resect Mass

Chemotherapy: High Grade Tumors (> Stage III) and Surgically Inoperable Tumors

ANTIHISTAMINES- H1 and H2 Blockers

*If you feel that You will not be able to Resect with Surgery then you can use Radiation either Before or After Surgery. Surgery together with Radiation has a 90% Cure Rate

*These Patients must be on Antihistamines in order to Counteract the negative effects of Histamine that is Released from Mast Cell Tumors

349
Q

Hallmark Erythrocytes found in Immune Mediated Hemolytic Anemia (IMHA)

A

Spherocytosis

*Due to Immune Opsinisation of RBC and Piecemeal Removal of the Membrane

350
Q

Common Differentials for which Classification of Anemia:

Ehrlichia Canis

FeLV/FIV

Toxicity- Estrogen

Erythropoetin Deficiency

Anemia of Chronic Disease

A

Anemia of Bone Marrow Dysfunction

351
Q

Alkylating Chemotherapy Drug used in High Intensity/Multimodal Protocol for Lymphoma

A

Cyclophosphamide

352
Q
A

C. Palliative, Hypofractionated, Neoadjuvant

6 Gy of Radiation Weekly- Low Frequency, High Dose. Only use this Type of Protocol for Palliative Control (Pain Control)

Neoadjuvant- Given Prior to Chemotherapy

353
Q
A

80%, 12 Months

354
Q

Predilection Site of Osteosarcomas in Large Breed Dogs

A

Distal Radius

*Away from the Elbow, Toward the Knees

355
Q

Treatment for Sebaceous Adenitis

A

Topical Shampoos- Baby Oil, Propylene Glycol

Topical Daily Spray- Propylene Glycol

356
Q

How Do Confirm Diagnosis in Multicentric Lymphoma

A

Fine Needle Aspirate (FNA)

*50% Lymphoblasts = Lymphoma

357
Q

Chemotherapy Drugs with the Following Pathological Mechanism:

Tyrosine Kinase Receptors are Resposible for Phosphorylation of a Pathway that will allow Cell Signaling which will cause the Tumor to Rapidly Divide

These Drugs Inhibit the Transmembrane Autophosphorylation Pathway and Prevent the Cell Signaling

A

TKI (Tyrosine Kinase Inhibitors)

*Ex. Toceranib

358
Q

With Patients on Chemotherapy Drugs how Should Excretion Products (Urine/Feces) be Handled?

A

Take Bottle of Water to Dilute Urine

Collect Feces and Dispose of as Chemical Waste

359
Q

True/False: Radiotherapy/Radiation can lead to New Tumor Formation in Patients

A

True

*Carcinogenesis from Radiotherapy can lead to New Tumor Formation- Ex. Nasal Tumors in Dog that have Recieved Radiation over the Head

360
Q

Two Goals of Chemotherapy

A

Curative Intent- Young Animal, No Metastasis

Palliation- Older Animal, Poor Prognosis (Ex. Metastasis)

*Combination of Surgery and Chemotherapy for a Low Stage Cancer, then we can recommend what is called Curative Intent, Mainly used in Young Animals with Tumors that don’t have Metastasis. Cure = Desease Free for 2 Years without Chemotherapy. Ex. Osteosarcoma treated with Amputation and Chemotherapy leads to a 20% Cure Rate

361
Q

Main Treatment for Mammary Tumors

A

Surgery- Mammary Gland Resection

Removal of Inguinal Lymph Nodes

*Chemotherapy is NOT used in Mammary Gland Tumors

362
Q

Chemotherapy Drugs with the Following Pathological Mechanism:

DNA Intercalation, Interfere with Topoisomerases

A

Antitumor Antibiotics (Ex. Anthracyclines)

*Oldest Form of Chemotherapy but they are Highly Effective- You can Improve the overall remission time by Including this Drug

363
Q

How is Malassezia Diagnosed?

A

Cytology- ESSENTIAL

364
Q

Treatment for Pemphigus Foliaceous

A

Localized Form:

Combination of Tetracycline and Niacinamide

Systemic Form:

Oral Prednisolone

365
Q

Large Breed Dogs that Present with Hemoabdomen. What is the Number one Differential?

A

Hemangiosarcoma

*Hemoabdomen is Most commonly caused by Ruptured Hemangiosarcomas

366
Q

Blood Typing for Which Species:

Naturally Occuring Alloantibodies

MUST be Blood Typed before First Transfusion

Crossmatching MUST be performed before Subsequent Transfusions

A

Feline

367
Q

Immunosuppressive Drug used in Treating IMHA Described Below:

FIRST LINE OF THERAPY

A

Mycophenolate Mofetil

368
Q

Normal Levels of Calcium, PTH, and PTH-rP in a Patient with Cancer

A

High Calcium

Low PTH

High PTH-rP

369
Q

Patient with IMHA showing Signs of Liver Dysfunction will Most Likely have ______ which comes with a Poor Prognosis (Death)

A

Thromboembolic Disease/DIC

370
Q

Skin Scaping Technique Described Below:

Moisten a Dulled Scalpel Blade with Liquid Paraffin or Mineral Oil

Scrape a Larger Area because Mites are Fewer in Number

Looking For SUPERFICIAL/SURFACE Mites

A

Superficial Skin Scraping

371
Q

Immunosuppressive Drug used in Treating IMHA Described Below:

A

Azathioprine

*Not Recommended for use in Cats due to Severe Bone Marrow Suppression

372
Q

Treatment for Discoid Lupoid Erythematosus

A

Localized Form- Tetracycline and Niacinamide

373
Q

How to Differentiate Acute Leukemia vs. Lymphoma

A

Acute Leukemia- Mild Lymphadenopathy, SPLENOMEGALY, > 30-40% Blasts in Bone Marrow

Lymphoma- MASSIVE Lymphadenopathy, < 30% Blasts in Bone Marrow

374
Q
A

Marbofloxacin

375
Q

Diagnostic Factors of which Secondary Hemostatic Disorder:

A

DIC

*Hallmark- Schistocytes

*IMHA- Classic Example of Causing DIC

Diagnostics- Increased FDPs or D-Dimers and Decline in Fibrinogen and Antithrombin

376
Q

Dermatologic Disease Described Below:

Deep Pyoderma Infection- Mainly Staphylococcus

Common in Long Nose Breeds- GSD, Border Collies

A

Nasal Folliculitis and Furunculosis

*Deep Pyoderma

377
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Pustule- Primary Skin Lesion

378
Q

This Dog is Feet Licking and Chewing. What are the Top Differentials?

A

Atopy

Food Allergy

379
Q

If you can’t see Intact _____, Avoid using Ceruminolytics, Cleaning Solutions and Drying Agents to Clean the Ear

A

Pars Tensa

*The Pars Tensa forms most of the tympanic membrane​

*We don’t like putting these Cleaning Solutions into the Ears without knowing if the Tympanic Membrane is Intact or Not

If you can’t see the Pars Tensa- Use Normal Saline to Clean Ear Canal

380
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Purpura- Primary Skin Lesion

381
Q

Tumor Biopsy Technique Described Below:

Very Common Biopsy Technique for Dermal and Cutaneous Tumors

A

Punch Biopsy Technique

382
Q

What is Seen on Surface Cytology in Patients with Deep Pyoderma

A

Mostly Staph, but can be Mixed

*ALWAYS Recommend a Culture in Cases of Deep Pyoderma

383
Q
A

C.

_*Human Immunoglobulin is NO Better than the use of Vincristine in a Hospitilized Patient. They work equally well and because Human Immunoglobulin is a Biological Product and Expensive its now considered that Vincristine is Preferred_

*Initial Therapy will definetly be Glucocorticoids (prednisolone)- First Line of Treatment

*Vincristine will benefit the patient and Reduce Hospitilization Time

*We should always consider Thromboprophylaxis. On Day Three of Treatment for IMTP you will have a massive Rebound of Platelets. These platelets will Aggregate and Become Activated Easily. These Dogs are at High risk of Developing Clots and Three Days following Initial Therapy you should add Thromboprophylaxis

384
Q

Endocrine Disease Described Below:

Systemic Signs- PU/PD, Weakness

Cutaneous Signs: Bilaterally Symmetric Truncal Alopecia, Poor Hair Regrowth, Hyperpigmentation, Calcinosis Cutis

A

Hyperadrenocorticism (Cushings)

385
Q

_Rescue Protoco_l used in Replase of Patients with Lymphoma

A

Lomustine

*Alkylating Agent

386
Q

Skin Scaping Technique Described Below:

Looking for FOLLICULAR Mites- Mainly Demodex

Scrape Small Focal Area with Dulled Blade to Induce Capillary Hemorrhage

A

Deep Skin Scrape

387
Q

Side Effects of which Chemotherapy Drugs:

Severe Myelosuppresion

Sterile Hemorrhagic Cystitis

A

Alkylating Drugs

*Cyclophosphamide: leads to Sterile Hemorrhagic Cystitis

*Prevent Sterile Hemorrhagic Cystitis by administering Furosemide on the day of Chemotherapy Administration

388
Q

What is Seen on Surface Cytology in Patients with Superficial Pyoderma

A

Overwhelming Staphylococcus

389
Q

Miniumum Treatment Length for Cheyletiella

A

Minimum 6 Weeks

390
Q

Part of Anatomical Staging Described Below:

Measure the Tumor Dimensions with a Ruler or Calipers

Assess whether there is Local Invasion: Physical Exam, Radiography, Ultrasonography, CT/MRI

Are there Multiple Primary Lesions?

A

Primary Tumor (T)

*Use Imaging to Assess Internal Masses- Radiography, US, CT

391
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Plaque- Primary Skin Lesion

392
Q

The Most Common Cause of Primary Otitis Externa

A

Atopy (Allergic Dermatitis)

393
Q

Dermatosis Described Below:

Decreased Capacity fo Absorb Zinc from Intestines

Breeds Related- Siberian Husky, Alaskan Malamute

Clinical Signs- Pruritus and Scales/Crust, Hyperkeratotic Footpads

A

Zinc- Responsive Dermatosis

394
Q

Strongest Prognosticators for Mast Cell Tumors

A

Grade

Systemic Signs (Ex. GI Ulcers)

Proliferation Markers- ki67, Mitotic Index

*Proliferation Markers- Anything that Indicates a High Mitotic Index. High Grade of Proliferation Index needs Locoregional Control to Prevent Recurrence

395
Q

Pathopneumonic Findings on Serum Protein Electrophoresis in Patients with Multiple Myeloma

A

Protein Light Chain Immunoglobulin (IgG)

_*MONOCLONAL GAMMOPATHY_

396
Q

Unconventional Cancer Therapy Described Below:

Repetitive Low Doses of Chemotherapy drugs designed to minimize Toxicity and Target the Endothelium/Tumor Angiogenesis as opposed to Targeting the Tumor

A

Metronomic Therapy

397
Q

The Dissemination of Neoplastic cells to Distant Secondary Sites where they Proliferate to form a Macroscopic Mass

A

Metastasis

398
Q

How to Diagnose Pemphigus Complex

A

Derm Diligence- Skin Scrapes, Cytology, Culture

Biopsy

399
Q

Side Effects of which Chemotherapy Drugs:

Severe Myelosuppression

Gastrointestinal Toxicity

Cardiomyopathy

A

Antitumor Antibiotics (Doxorubicin)

400
Q

Diagnosis of Ringworm (Dermatophytosis)

A

Fungal Culture (DTM Culture)

401
Q

Feline Dermatologic Disease Described Below:

Barbering of the Ventrum and Especially Medial Front Limbs

A

Atopy

402
Q

Ratio of G1/2:G0

A

Growth Fraction

*Ratio of tumor cells that are in the Growth Phase (G1 and G2) relative to the Cells in the G0 (Resting Phase)

403
Q

Chemotherapy Drugs with the Following Pathological Mechanism:

Inhibit Assembly or Disassembly

A

Mitotic Inhibitors (Ex. Vinca Alkaloids)

*AKA Plant Alkaloids

404
Q
A

Thrombocytopenia

*Hemothorax would be the Cause of the Thromobocytopenia, NOT the other way around. If Hemothorax Spontaneously Developed there is NO way that Thrombocytopenia could cause this. Low Platelet Count or Low Platelet Function is incapable of causing a massive Cavity Bleed

*Only Secondary Hemostatic Disorders are Capable of Causing a Major Cavity Bleed. Thromobocytopenia is a PRIMARY Hemostatic Disorder

405
Q

Review Card: Primary vs. Secondary Lesions

*KNOW THESE

A
406
Q

Treatment for Nasal Folliculitis and Furunculosis

A

Systemic Antibiotics for 6-8 Weeks

Topical Antibiotics- Wash/Soak

*2 Weeks Post Clinical Cure

407
Q

Chemotherapy Drug used for Single Drug Protocal in Cases of Transmissible Venereal Tumors (TVT)

A

Vincristine

408
Q

Hallmark Clinical Sign of Multiple Myeloma

A

Hyperviscosity (Hypergamaglobulinemia)

409
Q

How would you Approach this Case?

A

Palliative Treatment

*There is no point in Recommending a Splenectomy/Blood Transfusion and Chemotherapy because the Dog is Geriatric with Metastatic Disease. There is no Point at putting him at risk with Systemic Chemotherapies

410
Q
A

Scabies

411
Q

Feline Dermatologic Disease Described Below:

Alopecia, Crutsts, Scales, Itchy

Diagnoses: Skin Scrapings

A

Demodex Gatoi

412
Q

______IMHA:

Main Form in Dogs

Breed Predisposition- Cocker Spaniels

More Prevalent in Females

No Age Predisposition

A

Primary

*75% of Cases of IMHA are PRIMARY

413
Q
A

A. Multicentric, T Cell, Stage IV, Substage A

*Otherwise Healthy = Substage A

*Found in the Liver and Spleen but NOT Bone Marrow- Stage IV

414
Q

Form of Demodicosis Described Below:

A

Localized Demodicosis

*LESS than 5 Lesions

415
Q

True/False: In Patients with Cancer/Tumors we should ALWAYS be Aspirating the Regional Lymph Nodes

A

True

*Palpate Regional Lymph Node and perform FNA

416
Q

Dermatologic Disease Described Below:

Etiologies- Rabies and Lepto Vaccines

Hair Loss at Injection Site or in a Distant Location

Focal Alopecia

A

Injection Site Alopecia

*Usually caused by RABIES and LEPTO Vaccines

417
Q

Mitotic Inhibitor used to Treat Lymphoma and Transmissible Venereal Tumors (TVT)

A

Vincristine

418
Q

Hyperadrenocorticism (Cushings) is the MOST COMMON underlying Disease in Adult onset _______

A

Generalized Demodicosis

*ON EXAM

419
Q
A

B. Too Early to Make a Decision, the Tumor may Recur

Muzzle Mast Cell Tumor- Highly Aggressive and Not Easily Cured by Surgery

Pugs have Better Grade Mast Cell Tumors. In terms of Radiation Therapy, if you see a Rapid Response it does not necessarily mean it is a good prognosis

420
Q

Treatment for Primary Idiopathic Seborrhea

A

Oral Vitamin A

421
Q

Clinical Signs of ______:

A

Acute Otitis Externa

*Head Shaking can lead to Hematoma

422
Q

True/False: Investigation for Tumor Metastasis is usually going to Require Advanced Imaging

A

True

*If the Dog is > 15 kg you will Normally send the patient for a Full Body CT

423
Q

Portion of Treatment Protocol for IMHA Described Below:

Decreases Risk of Thromboembolism in Patients with Immune Mediated Disease

A

Thromboprophylaxis (Aspirin and Clopidogrel)

*Anytime that you diagnose an Immune Mediated Disease in a Patient and you get them on Steroids, make sure to add Thromboprophylaxis

Leading Cause of Death in Patients with IMHA- Thromboembolism

424
Q

Chemotherapy Drug that Most Commonly Causes Nausea

A

Cisplatin

*Cisplatin is a Very Powerful Emetogen- Dogs and Cats can have an associated Food Aversion

*Usually 24 Hours Prior to Cisplatin Therapy you will start with Maropitant

425
Q

True/False: Handeling of Chemotherapy Drugs should occur under a Laminar Flow Hood that causes Adequate Ventilation so that there is No Inhalation

A

True

426
Q

Treatment for Surface, Superficial, and Deep Pyoderma

A

Surface: Topical Antibiotic

Superficial: Systemic and Topical Antibiotic

Deep: Long Term Systemic and Topical Antiboitic

*Topical Therapy leads to Rapid Visual Improvement in Lesions

427
Q

Treatment for Multiple Myeloma

A

Melphalan and Prednisolone

428
Q

Treament of LOCALIZED Demodex

A

90% Usually Resolve without Treatment

*DO NOT USE GLUCOCORTICOIDS

429
Q

True/False: We can Raise the Number of Platelets in a Patient with a Blood Transfusion

A

False

*Blood Transfusion DOES NOT Raise Platelet Count

430
Q

Symptomatic Therapy for Patients with Atopy (Allergic Dermatitis) Described Below:

Very Effective for Atopy (Allergic Dermatitis)

Anti-Allergic and Immunosuppressive

Very Expensive

A

Cyclosporine A

431
Q

85% of Appendicular Bone Tumors are _____

A

Osteosarcoma

432
Q

Alkylating Chemotherapy Drugs used to treat Lymphoma Rescue and Mast Cell Tumors

A

Lomustine

*Used for Relapse/Rescue Lymphoma

433
Q

Feline Dermatologic Disease Described Below:

Persistent and Year Round Pruritus at ANY Site on Body, Especially Face and Head

A

Food Allergy

*Especially Head and Face Pruritus

434
Q

Normal Regenerative Absolute Reticulocyte Count

A

60,000 (Dogs)

42,000 (Cats)

*Ex. Canine Patient has a Reticulocyte Count of 35,000 and the patient is Acutely Collapsed, Hemoglobinemia, PCV of 10%. The Diagnosis would be a NON-Regenerative Anemia

435
Q

Treatment for Mild Myelosuppression (2-3) during Chemotherapy

A

Reduce Drug Dose by 25-50%

436
Q

How do we Diagnose Mast Cell Tumors

A

FNA/Biopsy

437
Q

Symptomatic Relief for Atopy (Allergic Dermatitis) that carries Strong Evidence

A

Glucocorticosteroids

Cyclosporine A

APOQUEL

438
Q

Dermatological Ear Condition Described Below:

Inflammation of the Outer Ear

Multifactoral Causes- Rarely due to a Single Cause

Three Factors: Primary, Predisposing, and Perpetuating

A

Otitis Externa

439
Q

How to Confirm Diagnosis of Mammary Gland Tumor in Canines

A

Excisional Biopsy

*If we Biopsy a Mammary Gland Tumor- Excisional

440
Q

Best Biopsy Method to Confirm Osteosarcoma

A

Needle Core Biopsy

*Take at least 2-4 Core Biopsies

441
Q

Treatment for Hypercalcemia of Malignancy (Paraneoplastic Syndrome)

A

Mild Hypercalcemia- Rehydration with Normosaline

Moderate Hypercalcemia- Rehydrate with Normosaline and then Treat with Furosemide

Severe Hypercalcemia- Salmon Calcitonin and Biphosphonates

442
Q

Hallmark of which Hematopoetic Tumor:

Very Large Lymph Nodes that are Rapidly Progressive

Painless Rubbery Lymph Nodes

A

Lymphoma

*Lymphomas grow very quickly

443
Q

Green Discharge from the Ear is usually Diagnostic for______

A

Pseudomonas

444
Q

What would you see on a Bone Marrow Aspirate in a Patient with Multiple Myeloma

A

> 30% Plasma Cells with Basophilic Cytoplasm and Eccentric Nuclei

*AKA Bone Marrow Plasmacytosis

445
Q

Name this Skin Lesion. Is it Primary or Secondary?

A

Fissure- Secondary Skin Lesion

446
Q

Treatment for Hemangiosarcoma

A

Surgery- Palliative (Coagulogram, Arrhythmias)

Chemotherapy- Doxorubicin

*Best Prognosis- Surgery Combined with Chemotherapy. Doxorubicin must be included in the Chemotherpy Protocol

447
Q

Chemotherapy Protocol that is used in Patients with Mast Cell Tumors

A

Vinblastine/Cyclophosphamide/Prednisone

or

TKI (Masitinib/Toceranib)

448
Q

Three Common Drug Types affected by Multidrug Resistance

A

Vinca Alkaloids

Anthracyclines (Doxorubicin)

Actinomycin D

*Mainstay of most of our Chemotherapies

449
Q

Treatment for B-Cell Intestinal Lymphoma (Ailmentary Lymphoma)

A

Chemotherapy (Chlorambucil with Prednisolone)

450
Q

Common Clinical Signs of which Ear Condition:

Vestibular Signs

Nystagmus

Circling

Head Tilt

A

Otitis Interna

451
Q

Prognosis for Mammary Tumors in Canines

A

Sarcoma and Inflammatory Carcinoma- Grave Prognosis

Tumor > 3cm- Poor Prognosis

452
Q
A

A. Size > 4 cm- Bad

*If Mammary Tumor is > 4cm there is a VERY HIGH chance that the Tumor is going to Recur

453
Q

Tests used to Assess _____ Hemostatic Disorders:

Activated Partial Thromboplastin Time (APTT)

Prothrombin Time (PT)

FDPs and D-Dimers

A

Secondary Hemostatic Disorders

454
Q

Chemotherapy Drugs are Excreted for _____ Days, therefore Handling of Urine, Feces, Vomit or Saliva should be Avoided

A

3-8 Days

455
Q

Acute Leukemia: Neoplastic Transformation EARLY in the Cell Lineage leading to Proliferation of ______

Chronic Leukemia: Neoplastic Transformation LATE in the Cell Lineage leading to Proliferation of _____

A

Lymphoblasts (Acute)

Mature Lymphocytes (Chronic)

456
Q

Primary Lesions associated with Pemphigus Complex

A

Pustules, Vesicles and Bullae

457
Q

Mainstay Chemotherapy for Most Tumors

A

Doxorubicin

458
Q
A

C. Palliative Steroid Therapy with H1 and H2 Blockers

459
Q

Feline Dermatologic Disease Described Below:

Self Induced Alopecia caused by ANXIETY- New Baby, Recent Move ect.

Common Locations- Medial Thighs, Ventral Abdomen, Medial Forelegs

A

Psychogenic Alopecia

460
Q

Dermatologic Disease Described Below:

Looks just Like Hypothyroidism and Hyperadrenocorticism

Difference: NO Systemic Signs, Normal Endocrine Tests

Primary Hairs on Trunk Lost and Slowly Progressive Hair loss

Head and Limbs Spared- Commonly ONLY have Hair on Head and Legs

Common Breed: Chows, Pomeranians

A

Alopecia X

*We DON’T know the Cause- Unkown Etiology

461
Q
A

Ringworm and Flea Allergic Dermatitis

462
Q

Chemotherapy Drugs that Specifically Target the S Phase of the Cell Cycle

A

Antimetabolites

463
Q

What Dermatologic Condition are we Testing for?

A

Microsporum Canis (Ringworm)

*Make sure the HAIR SHAFT Fluoresces

*ONLY HALF (50%) M. Canis will Fluoresce- Majority of Ring Worm Cases that you see will NOT Fluoresce

464
Q

Diagnosis based on Image

A

Heinz Body Anemia

465
Q

Treatment for Flea Allergic Dermatitis

A

Eliminate Fleas- Frontline, Monthly Spot On for Dogs, Advantage ect.

Predisolone (Steroids)- Reduces/Stops Pruritus

*95% of Flea Eggs, Larvae and Pupae are going to live in the Environment, not the Pet- Concentrate House and Yard Treatments on “Source Points” and areas where Pets spend the most time

Steroids- Use Lowest Dose that will Control Signs while Rigorously Implementing FLEA CONTROL

466
Q

Treatment for Papillomatosis

A

Some Regress

Crushing/Laser/Cryotherapy

467
Q

Four Phase Treatment/Chemotherapy Protocol used in Patients with Hemopoetic Tumors such as Lymphoma

A

Induction:

High Intensity, Risk of Toxicity

Greatest Change of Response

Consolidation:

Unrelated Drugs to Reduce Survival of Remaining Tumors

Maintenance:

Less Intense, No Effect on CR

Rescue:

No longer in Remission

Use Unrelated/Alkylating Drugs

*Lymphomas are VERY likely to Relapse

468
Q

Form of Demodicosis Described Below:

A

Generalized

*MORE than 5 Lesions

469
Q

Most Chemotherapy Drugs work on ______ Cells (Tumor and Normal Tissue)

A

Rapidly Dividing

470
Q
A

Immune Mediated Thrombocytopenia

*Breed with the Highest Risk of developing Immune Mediated Thrombocytopenia- Border Collie

IMTP- Differential of Pyrexia of Unknown Origin (Fever)

471
Q

2 yo Great Dane

Firm Enlarged Area on Metaphyseal Region of Limb

What is the Most Likely Diagnosis?

A

Osteosarcoma

*Large Breed Dogs- More Prevalent (Size and Height are Risk Factors)

Most Common Site in Large Breed Dogs- Distal Radius

472
Q

Treatment for Pyotraumatic Dermatitis (Hot Spot)

A

Eliminate Trigger (Fleas, Stress ect.)

Short Course Corticosteroids!!!!

*Needs a Steroid to Stop the Itching!- ON EXAM

473
Q

8 Year Old Golden Retriever. Fine Needle Aspirate Reveals Lymphoma ( > 50% Lymphoblasts)

What Treatement should you Suggest?

A

Systemic Chemotherapy

*Majority of Lymphomas in Dogs are Hematopoeitic and Require Systemic Chemotherapy

474
Q

Must Perform a ______ on ALL CATS with Skin Disease

A

Fungal Culture (Dermatophyte Culture)

*Pluck the Hairs that Fluoresce with Woods Lamp for DTM Inoculation

475
Q

Dermatologic Disease Described Below:

Food is the Trigger for Allergic Dermatitis

Nonseasonal Pruritus

Secondary Pyoderma

A

Cutaneous Adverse Food Reaction (CAFR) AKA Food Allergy

*Food can be a Trigger for Skin Disease

476
Q

In Patients with IMTP (Immune Mediated Thrombocytopenia) what Blood Product is most commonly used in Transfusion

A

Fresh Whole Blood

477
Q

Blood Typing for Which Species:

No Naturally Occuring Alloantibodies

First Transfusions RARELY Result in Serious Reactions (Even if Unmatched Donor)

Imperative to Cross Match Prior to Subsequent Transfusions

A

Canine

478
Q

How to Diagnose Superficial Necrolytic Dermatitis:

A

Derm Diligence- Skin Scraping, Cytology, DTM Culture

Ultrasound: Honey-Comb appearance to Liver

479
Q

Only Blood Product used for Felines during Transfusion

A

Fresh Whole Blood

480
Q

Secondary Hemostatic Disorder Described Below:

Systemic Coagulation and Fibrinolysis

Thrombosis and Bleeding

Due to Widespread Endothelial Damage/Release of Tissue Thromboplastins

A

DIC

Acute Form- Devastating Form where patient is spontaneously Bleeding

*Chronic or Compensated DIC may not show obvious Bleeding

481
Q

Chemotherapy Protocol Described Below:

High Toxicity

Severe Risk of Side-Effects

Better Survival

A

CHOP

*Side Effect- Higher Toxicity

482
Q

Leukemia Described Below:

Older Animals (> 10 years)

Incidental Finding (50%)

Leukocytosis- Small/Medium Lymphocytes

A

Chronic Lymphocytic Leukemia

483
Q

In Patients Recieving Chemotherapy Drugs, Give Prophylactic Antibiotics on Subsequent Dosing if Nadir is Less than ______ cells/uL

A

500 cells/uL

*Nadir = Low Point

*Ex. Doxorubicin causes Severe Myelosuppression, it has been shown that Prophylactic Antibiotics will Reduce the Side-Effects by preventing Severe Myelosuppression

484
Q

Treatment for Injection Site Alopecia

A

Oral Pentoxifylline

*Increases the Vascular Supply

485
Q

Gino: Cat with a Thick Gut

13 Year Old Castrated Male

Chief Complaint: Vomiting ( 2 day duration), Inappetent (1 Day Duration), Lethargy

Recent Introduction of Stray Cat to Household

Blood Pressure: 70mmHg (Hypotension)

Haemotology and Clinical Chemistry- Severe Leukocytosis, Moderate Azotemia

Abdominal Ultrasound- Thickened Muscularis Propris Layer of the Small Intestine

What is the Diagnosis?

A

B-Cell Intestinal Lymphoma (Ailmentary Lymphoma)

Massive Inflammatory Response (Severe Leukocytosis)- Must be either Cancer, Infectious Disease, or Immune Mediated Disease

Thickened Muscularis Propria Layer of Small Intestine = Ailmentary Lymphoma

486
Q

Common Clinical Findings of which Condition:

Horners Syndrome

Facial Paralysis

Bulging/Ruptured Tympanic Membrane

A

Otitis Media

487
Q

Mainstay of Therapy for Patients with Immune Mediated Hemolytic Anemia (IMHA)

A

Glucocorticoids (Prednisone 2mg/kg/day)

*There can be Delay of Effect of up to 14 days

488
Q

Defining the Anatomical Extent of the Tumor in Terms of Primary Site and Distant Spread using the TNM System

A

Anatomical Staging

*TNM Classification- Primary Tumor (T), Lymph Node (N) and Metastasis (M)

*The type of Tumor you have based on your Grade will dictate the Type of Staging that you are going to perform

489
Q

Dermatologic Disease Described Below:

Common Locations: Ear (Otitis Externa), Lip Folds, Ventral Neck, Interdigital, Perianal (CHECK FOLDS, CHECK EARS)

Frequently a Secondary Invader of Skin + Ears

Commonly Secondary to Allergic Dermatitis- Fleas, Food, ect.

A

Malassezia Dermatitis (Yeast)

*Malassezia = Foot Prints

490
Q

Dermatologic Condition Described Below:

Loss of Pigment and Cobblestone Texture to Nose

Depigmentation of Lips

Hyperkeratosis of Nose and Footpads

A

Discoid Lupoid Erythematosus

491
Q

True/Fase: Chemotherapy Tablets should NOT be Crushed or Broken for Administration

A

True

*These Tablets do NOT have Even Distribution of Drug throughout the Tablet- Would Not be able to Accurately dose the Drug with Broken Tablets

NEVER Crush or Break these Tablets

492
Q

How to Confirm Diagnosis of Osteosarcoma

A

FNA/Biopsy

*Once we have the Confirmation, we know that the Limb must be Amputated

493
Q

Most Common Blood Type in Canines

A

DEA 1.1 and DEA 1.2

494
Q
A

Cytology

495
Q

On Cytology you find Acantholytic Cells. What is you Number one Differential Diagnosis?

A

Pemphigus Complex

496
Q

Skin Scrapings: Superficial and Deep- Negative

Tape Preps- Cocci and Malassezia

Cytology of Papule- Cocci

Fungal Culture- Pending x 10 Days; Negative

What Kind of Pyoderma does this Patient have?

A

Superficial Pyoderma (Papules and Staph)

*Cocci = Superfical Pyoderma (Staph)

*Yeast (Malassezia) Like to Cause Hyperpigmentation and are very Pruritic

497
Q

Patient is Anemic with Spherocyte Formation and Agglutiation. What is the Diagnosis?

A

Immune Mediated Hemolytic Anemia (IMHA)

498
Q

Small Tumors undergo an Accelerated Rate of Division/Growth and are _____ to the Effects of Chemotherapy

A

Very Susceptible

*Small Tumors- Maximum Effect of Cytotoxic Drugs/Chemotherapy

499
Q
A

F. Thromboembolism

*These Patients suffer a Hypocoagulable State as a Result of Hyperglobulinemia- These Patients are at risk of Bleeding

*Main Complication of Multiple Myeloma- Hyperviscosity Sydrome (Hypergammaglobulinemia) leading to CVA, Retinal Detachment, CKD, and Hypertrophic Cardiomyopathy

500
Q

Combined Chemotherapy Treatment that leads to 80-90% Remission Rate with MST of 12 Months in Patients with Lymphoma

A

CHOP

501
Q
A

D. Surgery/Radiation for Loco-Regional Control and Chemotherapy for Distant and Long-Term Masivet

*Definitive Therapy for a Mast Cell Tumor that cannot be Controlled by Surgery because of Location

502
Q
A

E. All the Above except for B

503
Q

In Canines, ____% of Mammary Gland Tumors are Malignant

A

50%

*50% of Canine Mammary Tumors are Benign- Mixed Mammary Tumors

50% of Canine Mammary Tumors are Malignant- Carcinomas

504
Q

Specific Indications for Pretreatment _____ in Patients with Tumors:

A

Biopsy

*Only done if the Results of the Biopsy would change the way you would Manage the Case or change the way you would Perform Surgery

*If the Prognosis of this Tumor is going to Influence the Decision made by the owner- Would Biopsy change the Owners williness to Go Forward with Curative-Intent Treatment

505
Q

Paraneoplastic Syndrome Described Below:

Neuroglycopenia: Seizures (BG < 45 mg/dl)

Caused by Three Tumour Types- Insulinoma, Hepatic Neoplasia, and Leiomyoma

A

Hypoglycemia

*Neuroglycopenia- Blood Glucose is below 45 mg/dl at this point patients will Normally show Clinical Signs- Weakness and Seizures

506
Q

Tests used to Assess ______ Hemostatic disorders:

Platelet Count

Plateletcrit

Buccal Mucosal Bleeding Time

Vonwilibrand Factor Concentration (vWF Concentration)

A

Primary Hemostatic Disorders

507
Q

Erythrocyte Fragmentation is Caused by Increased Turbulence or Vascular Disease. Blister Cells, Keratocytes, and _____ are Signs of Fragmentation

A

Schistocytes

508
Q

Part of Anatomical Staging Described Below:

Look for Metastases

Direct Extension along Tissue Planes

A

Distant Metastases (M)

509
Q
A

Nystagmus

510
Q

Name Four Causes for Mean Corpuscular Volume (MCV) to Increase

A

Regenerative Anemia (Reticulocytes)

Toy Breeds

Cats with FeLV and Myeloid Dysplasia

Artifact (Agglutination)

*Increased MCV = Large Red Blood Cells

511
Q

Three Techniques used to Prevent Perivascular Reactions with Chemotherapy Drugs

A

Use a Catheter

Clean Stick

Flush after Chemo Agent

512
Q
A

C. Microcytic Hypochromic Anemia in a Dog due to Dermal Mast Cell Tumor

*Secondary to HIGH Histamine Concentrations from Mast Cell Tumor will cause Gastric Ulceration and Microcytic Hypochromic Anemia

*Discontinue Vincristine and see if Peripheral Neuropathy Persists

Intestinal Mast Cell Tumor- Gastrointestinal Blood Loss leads to Microcyctic Hypochromic Anemia due to DIRECT Ulceration

Thrombocytopenia due to Splenic Hemangiosarcoma- Sequestration

513
Q

Common Side Effects of Which Treatment Modality for Cancer:

A

Radiotherapy

*Alopecia- Initially you will see Loss of Hair and changes in Pigmentation of the Coat/Hair

Moist Epidermal Inflammation- Similar to “Sun Burn”

514
Q

Treatment for Demodex Gatoi

A

Lime Sulfur Dip

515
Q

Average Duration of Oral Ivermectin in Patients with Generalized Demodex

A

3 Months

516
Q

Systemic Treatment for _____ should continue until 2 Negative Cultures 1 Month Apart

A

Dermatophytosis (Ringworm)

517
Q

Four Disorders of Platelet Numbers leading to Thrombocytopenia

A

Failure of Megakaryopoiesis (Production Problem)

Increased Consumption/Demand

Platelet Destruction

Platelet Sequestration

518
Q

Treatment for Zinc-Responsive Dermatosis

A

Oral Zinc Supplementation

519
Q

Treatment for Acute Otitis Externa

A

Tresaderm- Topical Combination of Antibiotic, Steroid and Antifungal

*Recheck 7-10 days

520
Q

Side Effect of Chemotherapy Described Below:

Large Tumor Burden- Rapid Cell Kill

Rapid Relase of Ions

Leads to Hyperkalemia, Hyperphosphatemia, and Hypocalcemia

Acute Renal Failure

A

Acute Tumor Lysis Syndrome

521
Q

True/False: TNM Staging Asseses Actual Extent of the Disease

A

False

*Clinical “Stage” is not true Pathological Stage- Low Sensitivity of Detection

522
Q

Five Common Disorders of Secondary Hemostasis (Ex. Large Cavity Bleed)

A

Vitamin K Antagonism (Warfarin Toxins)

Vitamin K Deficiency- Liver Failure

Hereditary Coagulopathies- Hemophilia A (Factor VIII Deficiency)

Disseminated Intravascular Coagulation (DIC)

Infections

523
Q

Advantages and Disadvantages of which Method of Tumor Cell Collection for Cytology

A

Biopsy

*In Addition to Identifying the cell you can also Identify ARCHITECTURE with a Biopsy

*The Main Disadvantage is that it usually requires General Anesthesia

SAM II (3 decks)

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