II Final Flashcards
PCV: Cat Normal
24-45%
PCV: Dog Normal
37-55%
Immune Mediated Dz: Blood Smear Abnormalities
spherocytes, agglutination
Anemia: Classifications
bone marrow dysfunction, destruction, loss
Immune Mediated Hemolytic Anemia: Pathophysiology
antibody attachment to RBC
What is main form of IMHA in dogs?
primary
IMHA: Dx
CBC/chem
IMHA: Tx
supportive, immunosuppression
T/F: Transfusing with Whole Blood will raise the platelet count
False
Transfusing with whole blood will NOT raise the platelet count
Tranfusion: Required Volume Equation
k x BW x (desired PCV-recipient PCV)/donor PCV
k=90 for dogs; =60 for cats
Thrombocytopenia: Forms
inadequate production, consumption, destruction, sequestration
Thrombocytopenia: Production DDx
ehrlichia, estrogen toxicity, drugs
Thrombocytopenia: Destruction DDx
immune mediated, infection, venom
Thrombocytopenia: Consumption DDx
acute hemorrhage, DIC
Thrombocytopenia: Sequestration DDx
splenomegaly
Immune Mediated Thrombocytopenia: Lab
platelet less than 50,000, inc. megakaryopoeisis, microthombocytosis
IMTP: Dx
rule out
IMTP: Tx
supportive
What clotting factors are Vit. K dependant?
II, VII, IX, X
DIC: Lab
inc. aPTT, PT, FDP
thrombocytopenia, schistocytes,
dec. antithrombin
DIC: Tx
treat primary dz, supportive
Paraneoplastic Syndrome: Examples
cancer cachexia, hypercalcemia, hyperhistaminemia, hypoglycemia
Cancer Cachexia: Definition
wt. loss despite adequate nutrition
Gastroduodenal Ulcers: Pathophysiology
excess histamine =>inc. gatric acid secretion
Hypercalcemia: Pathogenesis
ectopic production of PTH => extensive bone lysis
Hypoglycemia: Neoplastic Etiologies
insulinoma, hepatic neoplasia, leiomyoma
Hyperestrogenemia: Effects
feminisation syndrome, anemia, thrombocytopenia, neutropenia
Tumor: Dx
biopsy, FNA
Tumor: Grading Factors
degree of differentiation, mitotic index, necrosis
Tumor: Staging Factors
anatomical extent
primary, node, metastasis
When is a patient in Clinical Remission?
no detectable tumor
When is a patient in Partial Response?
dec. in tumor volume by 50%
When is a patient in Stable Dz?
the tumor is between 50% dec. in size and 10% inc. in size
When is a patient in Progressive Dz?
> 10% growth of tumor, new masses
Growth Fraction: Definition
ratio of G1/G2:G0 cells (higher fraction = greater chemo effect)
Alkylating Agent: MoA
creates cross-linked DNA
Antitumjor Antibiotics: MoA
DNA intercalation
Mitotic Inhibitors: MoA
inhibit mitosis
Platinum Compounds: MoA
cross-links DNA
Anti-Metabolites: MoA
interferes w/ transcription
Chemo Tx: Phases
induction, consolidation, maintenance, rescue
What is the order of tumors from most to least likely, to be affected by chemo?
hemopoietic, mast cell, solid carcinomas/sarcomas
Myelosuppression: Protocol Modifications
2-3x10^9/L - reduce dose by 25-50% -or- delay tx for 7d
1-2x10^9/L - non-pyrexic stop and monitor; pyrexic stop, give antibiotic
less than 1x10^9/L - hospitalize
What is Acute Tumor Lysis Syndrome?
rapid tumor cell death => ion release
Alkylating Drugs: Side Effects
mod.-severe myelosuppression, sterile hemorrhagic cystitis
Antitumor Antibiotics: Side Effects
sever myelosuppression, renal toxicity, GI, cardiomyopathy
Platinums: Side Effect
mild myelosuppression, GI, fatal pulmonary edema in cats, renal toxicity
Mitotic Inhibitors: Side Effects
mild myelosuppression, peripheral neuropathy
Radiation Therapy: MoA
DNA destruction, apoptosis
What are radiosensitive tumor types?
bone marrow, gonadal, embryonic
What are radioresistant tumor types?
bone, muscle, cartilage, connective tissue
Radiation: Acute Side Effects
mucositis, moist epidermal inflammation, alopecia, hyperpigmentation
Radiation: Fractionation Protocols
Palliative - high dose once weekly (hypofractionated)
Semi-Definitive - mod. dose 3x weekly
Definitive: low dose 5x weekly
Lymphoma: Sites and Signs
min. general malaise
Alimentary (cats) - v/d, inappetence
Mediastinal - cough, dyspnea, pleural effusion
Lymphoma: Dx
FNA, Biopsy, U/S, IHC
Lymphoma: Tx
Single agent - chlorambucil/ doxorubicin
Multi-agent - CHOP
Lymphoma: Stages
I - single node/lymphoid tissue II - several nodes in region III - generalized lymph node involvement IV - liver/spleen infiltration V - bone marrow/other organ infiltration
T/F: When a Lymphoma patient Relapses, continuing the protocol is the best coarse of action.
False
restart the original protocol
Leukemia: Acute vs Chronic Pathogenesis
Acute - transformation occurs early in the lineage => blasts
Chronic - transformation occurs late in the lineage => mature
Leukemia: Dx
bone marrow, flow cytometry
Leukemia: Acute Tx
pred + vincristine + L-asparaginase
Multiple Myeloma: Signs
progressive anemia, hyperviscocity (gamma globulin)
Multiple Myeloma: Dx
rads, CBC/chem, monoclonal gammopathy
Multiple Myeloma: Tx
melphalan + pred, supportive
Mast Cell Tumor: Dx
FNA, biopsy
Mast Cell Tumor: Staging
I - dermal mass, no regional LNN involvement
II dermal mass w/ regional LNN involvement
III - infiltrating/multiple dermal masses w/ regional LNN involvement
IV - spread to liver/spleen
Substage a - no systemic signs
Substage b - systemic signs
Mast Cell Tumor: Tx
sx, radiation, vinblastine
Hemangiosarcoma: Signs
pain, pale mm
Hemangiosarcoma: Lab
dec. HTC, thrombocytopenia, schistocytes
Hemangiosarcoma: Dx
U/S - demarcated herteroechoic mass w/ anechoic pockets