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MK ACVD Exam > Internal Medicine and Oncology > Flashcards

Internal Medicine and Oncology Flashcards

1
Q

Hypothyroidism usually result in hairs being arrested in which phase of the hair cycle?

A

Telogen

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2
Q

What changes occur in hypothyroidism, resulting in the clinical presentation of alopecia and a dry coat?

A

Sebaceous gland atrophy
Follicular atrophy

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3
Q

What changes to the pinnae might prompt you to evaluate a dog for hypothyroidism?

A

Pinnal margin seborrhea

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4
Q

A Rhodesian Ridgeback presents with non-pruritic “tiger striping” alopecia. What is a top differential for this?

A

Hypothyroidism

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5
Q

Besides dogs, what is the only other species known to develop calcinosis cutis secondary to hyperadrenocorticism?

A

Chinchillas

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6
Q

What makes up the mineral in calcinosis cutis?

A

Apatite crystals

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7
Q

What 4 dog breeds are predisposed to developing calcinosis cutis?

A

Labs
Rottweilers
Boxers
Staffordshire terriers

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8
Q

How does hyperestrogenemia cause alopecia?

A

It inhibits anagen initiation

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9
Q

What digit is often affected in feline lung-digit syndrome?

A

P3

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10
Q

What type of tumors have been associated with linear preputial hyperpigmentation/erythema?

A

Testicular tumors (seminoma,
Leydig/interstitial cell tumor,
Sertoli cell tumor)

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11
Q

What tumors have been associated with feline paraneoplastic alopecia?

A

Pancreatic adenocarcinoma
Bile duct carcinoma

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12
Q

What condition is nodular dermatofibrosis associated with?

A

Renal cystadenocarcinomas

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13
Q

What is the mode of inheritance of nodular dermatofibrosis in GSDs?

A

Autosomal dominant

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14
Q

What gene is mutated in nodular dermatofibrosis in GSDs?

A

FLCN (folliculin)

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15
Q

Besides renal cystadenocarciomas, what neoplastic condition might be seen in intact female GSDs with nodular dermatofibrosis?

A

Uterine leiomyoma

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16
Q

What underlying causes have been associated with cutaneous xanthomas?

A

Diabetes mellitus
Megestrol acetate

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17
Q

What breed is predisposed to SLE?

A

GSD

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18
Q

What dog breeds are predisposed to hypothyroidism (6)?

A

Dobermans
Beagles
English Setters
Rhodesian ridgebacks
Goldens
Labs

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19
Q

What breeds have thyroid hormone concentrations below the standard reference ranges?

A

Sighthounds

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20
Q

What is the effects of thyroglobulin autoantibodies on TT4 concentrations?

A

They falsely increase TT4

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21
Q

You are doing a LDDST on a dog and are using dexamethasone SP for the test. When calculating the dose, what concentration of dex should be utilized?

A

3 mg/ml

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22
Q

What criteria on LDDST would be consistent with a diagnosis of PDH?

A

4 hr cortisol < lab cutoff
4 or 8 hr cortisol <50% of baseline

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23
Q

Which test for Cushing’s is less impacted by stress and nonadrenal illness?

A

ACTH stim

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24
Q

Describe the interpretation of a UCCR for Cushing’s

A

Negative: HAC very unlikely (high sensitivity)
Positive: HAC not confirmed (low specificity)

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25
Q

What dose of cosyntropin should be given when trying to diagnose HAC?

A

5 mcg/kg

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26
Q

What is the most common cause of hyperthyroidism in cats?

A

Benign adenomatous hyperplasia

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27
Q

What serum chemistry abnormalities may be seen in a cat with hyperthyroidism?

A

Elevated ALT +/- ALP
Azotemia

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28
Q

What subtype of thyroid hormone is most active in the body?

A

T3

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29
Q

What are the 2 classes of hormone receptors (based on their location in the cell)?

A

Membrane hormone receptors
Nuclear receptors

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30
Q

Do steroids have membrane hormone receptors or nuclear receptors?

A

Nuclear (steroid hormones are hydrophilic and can cross the cell membrane)

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31
Q

Do thyroid hormones have membrane hormone receptors or nuclear receptors?

A

Nuclear (thyroid hormones are hydrophilic and can cross the cell membrane)

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32
Q

What amino acid is essential for thyroid hormone synthesis?

A

Tyrosine

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33
Q

What enzyme converts T4 to T3/rT3?

A

iodothyronine deiodinase

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34
Q

What mineral is needed for thyroid hormone synthesis?

A

iodine

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35
Q

Where it thyroglobulin synthesized?

A

the thyroid follicular epithelial cell

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36
Q

What happens to thyroglobulin after it is synthesized?

A

It is secreted into the thyroid follicular lumen

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37
Q

Name the functions of thyroid peroxidase in the synthesis of thyroid hormones

A

1) Oxidizes iodide ions to I2
2) Iodinates tyrosine on thyroglobulin to produce monoiodotyrosine (MIT) and diiodotyrosine (DIT) (=organification)
3) Coupling of MIT and DIT to produce T4 (2 DIT) and T3 (1 DIT + 1 MIT) on thyroglobulin

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38
Q

Why does the thyroid gland produce more T4 than T3?

A

Thyroid peroxidase is more efficient at coupling 2 DIT molecules than it is at coupling one DIT and one MIT

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39
Q

What occurs to thyroglobulin once it has been processed by thyroid peroxidase?

A

It is endocytosed into the thyroid follicular epithelial cell and broken down by lysosomes into T4, T3, MIT, and DIT

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40
Q

What occurs to uncoupled MIT and DIT during thyroid hormone synthesis?

A

They are transported back into thyroid follicular lumen as iodide

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41
Q

Is most of the thyroid hormone in the circulation protein-bound or free?

A

Protein-bound to thyroxine-binding globulin (+ albumin, transthyretin)

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42
Q

What form of thyroid hormone has endocrine activity: bound or free?

A

Free

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43
Q

What organ system produces thyroxine binding globulin?

A

Liver

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44
Q

What hormone acts directly on the thyroid gland to regulate hormone release and where does the hormone come from?

A

TSH, anterior pituitary

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45
Q

The thyroid gland produces more T4 than T3. What must occur in target tissues in order to have the endocrine effects of thyroid hormones?

A

iodothyronine deiodinase in the target tissue converts T4 to T3 (and to rT3)

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46
Q

What is the most important effect of TSH when stimulating thyroid hormone release?

A

Induces endocytosis of the peroxidase-processed thyroglobulin into the follicular cell (so it can be lysed and made into T4+T3 to be excreted)

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47
Q

What hormone stimulates release of TSH from the anterior pituitary and where does the hormone come from?

A

TRH, hypothalamus

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48
Q

What provides negative feedback on the anterior pituitary to reduce TSH secretion?

A

Free T3

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49
Q

What are the regulatory steps in thyroid hormone release?

A

1) action of free T3 to reduce TSH from anterior pituitary
2) change in ratio of T3: rT3 that is produced by tissue iodinase

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50
Q

What aspect of the nervous system is enhanced by thyroid hormones?

A

Sympathetic (esp in heart –> increased HR and cardiac outpu)

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51
Q

What is the effect of hypothyroidism on the GIT?

A

Constipation (thyroid hormone responsible for enhanced GI motility)

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52
Q

What allows for iodide to concentrate in thyroid follicular cells?

A

Sodium iodide symporter (present on basolateral membrane of thyroid follicular cell)

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53
Q

What allows for iodide to enter the thyroid follicular lumen?

A

pendrin

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54
Q

What protein allows for T4+T3 to be released into the circulation?

A

Monocarboxylate transporter 8 (MCT8)

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55
Q

What thyroid hormone is known as thyroxine?

A

T4

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56
Q

How do glucocorticoids affect thyroid hormones?

A

Decreased TSH production, decreased iodothyronine deiodinase activity –> less TT4, TT3, fT4, TSH

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57
Q

How does phenobarbital affect thyroid hormones?

A

Decreased thyroid hormone secretion, increases hepatic metabolism –> less TT4, TT3, fT4

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58
Q

How do NSAIDs affect thyroid hormones?

A

Displaces T4 and T3 from their plasma protein carriers (mainly aspirin and phenylbutazone; most other NSAIDs do not impact thyroid)

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59
Q

How do sulfonamides affect thyroid hormones?

A

inhibit thyroid peroxidase –> less thyroid hormone secretion

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60
Q

How do tyrosine kinase inhibitors affect thyroid hormones?

A

Impair uptake of iodine
Inhibit thyroid peroxidase
Reduce capillaries in thyroid gland

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61
Q

How does amiodarone affect thyroid hormones?

A

Reduced iodothyronine deiodinase activity

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62
Q

How do TCAs affect thyroid hormones?

A

Decreased TSH production
Decreased thyroid hormone secretion

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63
Q

What is another name for the pituitary gland?

A

Hypophysis

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64
Q

What is another name for the anterior pituitary?

A

Pars distalis
Adenohypophysis

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65
Q

What species lacks thyroxine binding globulin?

A

Cats

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66
Q

Once T3 is in the cell nucleus, what does it bind to?

A

Retinoid X receptor (RXR)

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67
Q

What is the pathogenesis of lymphocytic thyroiditis?

A

Antibodies targeting thyroglobulin

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68
Q

What dog breeds have a familial form of hypothyroidism?

A

Great Danes
Dobermans
GSPs

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69
Q

What breed is most likely to have a myxedematous coma due to hypothyroidism?

A

Doberman

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70
Q

What dog breeds tend to have an earlier age of onset of hypothyroidism (i.e. 2-3 years)?

A

Large/giant breeds
Dobermans
Goldens

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71
Q

A hypothyroid dog begins excessively shedding following initiation of levothyroxine. Why does this occur?

A

Normalization of the hair cycle –> loss of telogenized hairs

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72
Q

How long does it take for dermatologic abnormalities to respond to thyroid supplementation?

A

2-4 months

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73
Q

What would be the expected effect of exercise/training on equine T4 and T3?

A

Decreased

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74
Q

What is another name for growth hormone?

A

Somatotropin

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75
Q

What gland secretes growth hormone?

A

Pituitary

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76
Q

What hormones regulate the production of growth hormone and where do they come from?

A

GHRH, somatostatin
Hypothalamus

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77
Q

What hormones stimulate growth hormone production?

A

Norepi
Dopamine
Progestogens
GHRH

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78
Q

What hormone inhibits growth hormone production?

A

Somatostatin

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79
Q

What can be evaluated and serves as an indirect measurement of growth hormone?

A

Insulin-like growth factor (IGF-1); this protein is stimulated by GH

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80
Q

What dog breeds are predisposed to pituitary dwarfism?

A

GSD
Karelian bear dog

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81
Q

What is the typical cause of pituitary dwarfism in dogs?

A

Rathke cleft cysts

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82
Q

When do clinical signs of pituitary dwarfism typically become apparent?

A

2-3 months of age

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83
Q

A 4 month old GSD is presented with a soft, wooly coat (retention of secondary hairs), symmetrical alopecia, comedones, and stunted growth. IGF-1 levels are dramatically decreased. What is the most likely diagnosis?

A

Pituitary dwarfism (resulting in reduced GH secretion)

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84
Q

What is the pathogenesis of acromegaly?

A

Increased growth hormone secretion –> overgrowth of connective tissue, viscera, bone

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85
Q

What is the primary cause of acromegaly in cats?

A

Pituitary tumor

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86
Q

What is the gender distribution of acromegaly in dogs and cats?

A

Cats: overwhelmingly male
Dogs: usually intact females

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87
Q

What is usually a comorbidity in dogs and cats with acromegaly?

A

Insulin-resistant diabetes

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88
Q

What is the hallmark test for acromegaly in dogs and cats?

A

Measurement of IGF-1 (Growth hormone suppression test hallmark in humans

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89
Q

Besides the anterior pituitary, where else does growth hormone originate in dogs?

A

Mammary gland

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90
Q

What is the effect of increased IGF-1 on somatostatin?

A

It increases somatostatin –> reduced GH secretion from pituitary

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91
Q

What is the mode of inheritance of pituitary dwarfism in Karelian Bear dogs and GSDs?

A

Autosomal recessive

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92
Q

What likely causes the symptoms of lethargy, dullness, and appetite loss in dogs with pituitary dwarfism?

A

Concurrent deficiency in TSH

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93
Q

What gene is mutated in GSDs and Karelian bear dogs with pituitary dwarfism?

A

LHX3 (encodes pituitary and nervous system development)

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94
Q

What 4 diagnostic tests can be used to diagnose pituitary dwarfism in dogs?

A

GHRH stimulation test
Clonidine stimulation test
Xylazine stimulation test
Ghrelin stimulation test
(all should stimulate GH release in health dogs)

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95
Q

What is a common oral cavity symptom associated with acromegaly in cats?

A

Prognathism of lower jaw

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96
Q

What is the primary cause of acromegaly in dogs?

A

Endogenous/exogenous progestogens

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97
Q

Define what is meant by the “sensitivity” of a test

A

Percent of individuals with the disease who test positive

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98
Q

Define what is meant by the “specificity” of a test

A

Percent of individuals without the disease who test negative

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99
Q

What test for Cushing’s has a higher sensitivity: LDDST or ACTH stim?

A

LDDST (95% sensitivity)

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100
Q

What test for Cushing’s has a higher specificity: LDDST or ACTH stim?

A

ACTH stim (64-86% specificity)

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101
Q

What breeds are overrepresented in Alopecia X?

A

Nordic breeds
Pomeranians
Chows

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102
Q

What is the effect of LH hormone and where does it come from?

A

Stimulates Leydig cells to increase testosterone production
Comes from anterior pituitary

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103
Q

What is the effect of GnRH and where does it come from?

A

Increases LH and FSH production in anterior pituitary
Comes from hypothalamus

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104
Q

What hormones have negative feedback to reduce FSH secretion?

A

Estradiol
Testosterone
Inhibin (from Sertoli cells)

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105
Q

What is the primary cause of canine hypothyroidism?

A

Lymphocytic thyroiditis

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106
Q

What is the best thyroid monitoring test for a dog known to have thyroglobulin autoantibodies?

A

FT4 by ED

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107
Q

What is the upper limit of allowable iodine in the diet if treating a hyperthyroid cat with dietary therapy?

A

<0.32 ppm

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108
Q

What is the primary pathophysiology of HAC in dogs?

A

Pituitary macroadenoma –> CRH hypersecretion –> adrenal gland hypertrophy

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109
Q

What hormones are deficient in GSDs with pituitary dwarfism (hyposomatotropism)?

A

GH
TSH
Prolactin
Gonadotropin

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110
Q

What hormone is normal in dogs with pituitary dwarfism?

A

ACTH

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111
Q

What iatrogenic causes can result in hyperestrogenism in dogs?

A

Diethylstilbestrol (used for urinary incontinence)
Exposure to human hormone replacers

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112
Q

What physiologic problem is usually the cause of hyperestrogenism in male dogs?

A

Sertoli cell tumor

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113
Q

What physiologic problem is usually the cause of hyperestrogenism in female dogs?

A

Cystic ovaries>granulosa-thecal cell tumors

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114
Q

What skin changes can occur with estrous cycles?

A

Hair loss at the time of estrus

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115
Q

What mutation in MCT allows some of them to be susceptible to tyrosine kinase inhibitors?

A

C-kit

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116
Q

What IHC stains can be used to highlight canine mast cell tumors?

A

KIT (CD117)
tryptase

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117
Q

Is the N:C ratio in lymphoma typically high or low?

A

High (little cytoplasm)

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118
Q

What type of tumors typically appear in clusters of sheets?

A

Epithelial

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119
Q

Name the major round cell tumors

A

Lymphoma
Plasmacytoma
MCT
Histiocytoma
TVT

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120
Q

What species commonly develops trichofolliculomas?

A

Guinea pigs

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121
Q

What dog breed is predisposed to tricholemmomas?

A

Afghan hounds

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122
Q

What cat breed is predisposed to trichoepitheliomas?

A

Persians

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123
Q

From what structure are tricholemmomas derived?

A

Outer root sheath

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124
Q

What dog breeds are predisposed to trichoblastomas?

A

Poodles
Cocker spaniels

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125
Q

From what structure are pilomatricomas derived?

A

Follicular bulb

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126
Q

What dog breeds are predisposed to pilomatricomas?

A

Kerry blue terriers**
Poodles
Old English sheepdogs

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127
Q

Which follicular tumors tend to have a low expression of p27?

A

Pilomatricomas

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128
Q

Which follicular tumors have a high expression of p27?

A

trichoblastomas
trichoepitheliomas

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129
Q

What type of sebaceous gland neoplasm is most common in dogs and cats?

A

Nodular sebaceous gland hyperplasia

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130
Q

What is the recommended treatment for perianal gland adenomas?

A

Neuter

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131
Q

From what sweat glands are apocrine gland tumors usually derived?

A

Epitrichial sweat glands

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132
Q

What type of tumors are the most common tumor in pigs?

A

Melanocytic

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133
Q

What body locations are associated with high rates of metastasis for melanomas?

A

Digital
Mucocutaneous

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134
Q

Which dog breeds are predisposed to subungual melanomas?

A

Irish Setters
Scottish Terriers
Schnauzers

135
Q

A dog with a melanoma has a mitotic index <3. What is the associated prognosis?

A

Good (>3 is poor prognosis)

136
Q

What stains could be used to diagnose an amelanotic melanoma?

A

Melan A
PNL2
TRP-1
TRP-2

137
Q

What is the primary inflammatory cell infiltrate in fibropruritic nodules?

A

Eosinophils

138
Q

What tumor type is often associated with flea allergies in GSDs?

A

Fibropruritic nodules

139
Q

What infectious condition has been associated with feline sarcoids?

A

BPV-14

140
Q

What type of stain could be used to highlight a firosarcoma?

A

vimentin

141
Q

What breeds are predisposed to fibrovascular papillomas?

A

Large/giant breeds (Dobermans, Labs)

142
Q

What is the medical term for skin tags?

A

fibrovascular papillomas

143
Q

What tumor is more common in cats: hemangioma or hemangiosarcoma?

A

Hemangiosarcoma

144
Q

What is a stage 3 hemangiosarcoma?

A

One that has invaded into the muscle

145
Q

What is a stage 2 hemangiosarcoma?

A

One that has invaded into the SQ

146
Q

What is a stage 1 hemangiosarcoma?

A

One that is limited to the dermis

147
Q

How does the body distribution differ for hemangiosarcoma between cats and dogs?

A

Dogs: trunk and extremities
Cats: Head and pinnae

148
Q

What type of aggressive vascular tumor is more common in young animals and usually affects the ventral abdomen and limbs?

A

Lymphangiosarcoma

149
Q

What cat breed is predisposed to MCT?

A

Siamese

150
Q

What breed of dog is usually younger when they develop MCT and may have gross distension of the limbs?

A

Shar Pei

151
Q

What is the most common site for feline MCT?

A

Head

152
Q

What is the most common site for canine MCT?

A

trunk > extremities&raquo_space; head

153
Q

Describe what qualifies as a high-grade MCT using the Kiupel grading system

A

> 7 mitotic figures/10 hpf
3 multinucleated cells/10 hpf
3 bizarre nuclear/10 hpf
karyomegaly in >10% of cells

154
Q

What transcription factor is expressed by plasmacytomas?

A

MUM-1

155
Q

What is the most common cutaneous tumor in horses?

A

T-cell-rich B-cell lymphoma

156
Q

What is the treatment of TVT if spontaneous remission does not occur?

A

Vincristine

157
Q

What is the primary tumor in feline lung-digit syndrome?

A

Metastatic bronchogenic carcinoma

158
Q

What is the inheritance pattern of dermoid cysts?

A

Autosomal recessive

159
Q

What is the mutation in dermoid cysts?

A

FGF 3, 4, 19

160
Q

A cat is presented with a cutaneous horn. What diagnostic test should be run to check for an underlying cause?

A

FeLV testing

161
Q

Name the 6 types of equine sarcoid

A

1) Occult
2) Verrucose
3) Nodular
4) Fibroblastic
5) Mixed
6) Malevolent/malignant

162
Q

Which subtypes of equine sarcoids can transform into fibroblastic types if traumatized?

A

Verrucose
Nodular

163
Q

Multiple histiocytic mast cell tumors are identified in a cat. What is the most likely age and breed of this patient?

A

Siamese
6-8 weeks old (young)

164
Q

What protein is mutated in canine and feline MCT and SCC?

A

p53

165
Q

Which immunohistochemical marker can be used to diagnose MCT?

A

C-kit

166
Q

How many tiers are in the Kiupel grading scheme for canine MCT?

A

2 (high and low)

167
Q

How many tiers are in the Patnaik grading scheme for canine MCT?

A

3 (grade 1, 2, 3)

168
Q

Define a Patnaik grade I MCT

A

Grade 1: well differentiated, located in dermis and interfollicular spaces

169
Q

Define a Patnaik grade II MCT

A

Grade II: rare mitotic figures, infiltration into lower dermis and SQ

170
Q

Define a Patnaik grade III MCT

A

Grade III: anaplastic, 1 or more nucleoli, 3-6 mitotic figures/hpf, SQ and deeper invasion

171
Q

Where on the body would you be more likely to find an aggressive MCT?

A

Oral/perioral

172
Q

What is the typical behavior of feline MCT?

A

Benign

173
Q

What is the cell that makes up cutaneous histiocytomas in dogs?

A

Langerhans cell

174
Q

What dog breeds are predisposed to histiocytomas?

A

Boxers
Dachshunds
Cocker Spaniels
Great Danes
Shelties
Bull Terriers

175
Q

What are the most common sites of MCT mets in dogs?

A

LN
Spleen
Liver

176
Q

What type of cell predominates in regressing histiocytomas?

A

CD8+ T-cells

177
Q

Where are lesions of histiocytic sarcomas usually found?

A

Extremities close to joint (originating from dendritic cells of synovial lining)

178
Q

What breeds are predisposed to histiocytic sarcoma?

A

Bernese Mt Dogs (225x relative risk)
Rottweilers (26x relative risk)
Flat-coated Retrievers (3.7x relative risk)

179
Q

What markers can be used to help differentiate histiocytic sarcoma from cutaneous reactive histiocytosis?

A

Histiocytic sarcoma: Low CD4/Thy1 expression

180
Q

What markers can be used to help differentiate histiocytic sarcoma from histiocytoma?

A

Histiocytic sarcoma: Low E-cadherin expression

181
Q

What is the prognosis for histiocytic sarcoma?

A

Poor - few months even with tx

182
Q

What cell types make up malignant fibrous histiocytomas?

A

Fibroblasts
Histiocytic cells
MNGCs

183
Q

Are feline plasmacytomas usually associated with an underling systemic cause?

A

Yes - extension from bone and viscera

184
Q

Are canine plasmacytomas associated with an underlying systemic cause?

A

No

185
Q

What IHC stains can be used to diagnose a plasmacytoma?

A

IgG
Vimentin
CD79a

186
Q

What breeds have an increased risk of melanocytomas?

A

Airedales
Bostons
Chihuahuas
Chows
Cocker Spaniels
Dobermans
Mini Schnauzers
Scotties

187
Q

What IHC stains are positive in melanoma?

A

Vimentin
+/- S-100, neuron-specific enolase

188
Q

What has been inserted into the c-myc oncogene and leads to amplified gene transcription in TVTs?

A

LINE (long interspersed nuclear elements)

189
Q

What is the most common lesion location for TVT in dogs?

A

External genitalia (prepuce would need to be retracted in many male dogs to see the tumor)

190
Q

Cytology from a nodule from the glans penis in a male intact dog from Texas is shown in this image. What is the most likely diagnosis?

A

TVT

191
Q

What type of cells make up cutaneous epitheliotropic lymphoma?

A

T-cells only (CD8+/CD4-)

192
Q

What type of cells make up cutaneous nonepitheliotropic lymphoma?

A

B- OR T-cells

193
Q

What form of cutaneous lymphoma is most common in cats?

A

Non-epitheliotropic

194
Q

What is the MST for cutaneous nonepitheliotropic lymphoma?

A

4-8 months

195
Q

True or false: Many cats with CETL are FeLV-positive

A

False (most are negative)

196
Q

What type of T-cells are usually present in canine CETL?

A

CD8+, gamma/delta

197
Q

How does the T-cell infiltrate in canine CETL differ from that in human CETL?

A

Canine is CD4-/CD8+ predominantly
Human is CD4+/CD8- predominantly

198
Q

What is the best described topical therapy for CETL in dogs and humans?

A

Mechlorethamine (Mustargen)

199
Q

What are the most commonly used protocols to treat CETL?

A

CHOP (cyclophosphamide, doxorubicin, vincristine, pred)
COP (cyclophosphamide, vincristine, pred)

200
Q

What is the prognosis for CETL if diagnosed early and treated?

A

~12 months

201
Q

What is the prognosis for CETL if diagnosed late (even with treatment)?

A

4-6 months

202
Q

What are the 3 forms of cutaneous epitheliotropic lymphoma?

A

1) Pagetoid reticulosis
2) Mycosis fungoides
3) Sezary syndrome

203
Q

What are Lutzner cells better known as?

A

Sezary cells (as seen in CETL- Sezary syndrome)

204
Q

What is the prognosis for CETL in horses?

A

Grave

205
Q

Where are melanomas most commonly found in gray horses?

A

Perianal region and under tail

206
Q

What infectious condition has been associated with lymphosarcoma in cows?

A

Bovine leukemia virus

207
Q

What % of BLV-infected cattle develop lymphosarcoma?

A

~5%

208
Q

What are the 3 forms of lymphosarcoma in cattle?

A

Juvenile
Thymic
Cutaneous

209
Q

What is the typical age of onset of melanocytic tumors in cattle?

A

Young (unlike other animals which tend to have older age of onset)

210
Q

What is the ligand for KIT on mast cells?

A

Stem cell factor

211
Q

What percent of canine MCTs have a C-kit mutation?

A

15-40%

212
Q

What breeds are at exceptional increased risk of developing MCTs?

A

Boxers
Boston Terriers

213
Q

What is the body site predilection for MCT in Rhodesian Ridgebacks

A

Tail

214
Q

What is the body site predilection for MCT in Boxers and and Pugs?

A

Hind limbs

215
Q

What is the body site predilection for MCT in Bostons and American Staffordshire terriers?

A

Hind limbs

216
Q

What is the body site predilection for MCT in English Setters?

A

Head and hind limbs

217
Q

What breeds are more likely to have multiple MCT rather than a solitary MCT?

A

Weimeraners
Goldens
Shar Peis
Boxers
Pugs

218
Q

What clinical appearances of cutaneous MCT have been associated with worse prognosis?

A

Ulceration
Erythema
Pruritus

219
Q

What breeds tend to have more aggressive forms of MCT?

A

Shar Peis
Labs

220
Q

True or false: Chest x-rays are always indicated when a MCT diagnosis is made

A

False- rarely mets to lungs

221
Q

What color do mast cell granules stain with H+E?

A

Gray-blue

222
Q

Which grade of MCT tends to have poorest granulation?

A

Grade 3/anaplastic

223
Q

What IHC markers can be helpful to dx a poorly-granulated MCT?

A

antitryptase antibodies
chyase

224
Q

What cell proliferation markers have been used to predict behavior of MCTs?

A

AgNORs (higher #=worse prog)
PCNA (not correlated with prog)
Ki67 (high expression=worse prog)

225
Q

Which prognostic factor is independent of histologic grade?

A

Ki67 expression

226
Q

True or false: p53 immunoreactivity is associated with survival/recurrence in MCT

A

False

227
Q

Which MMPs are secreted by canine MCTs?

A

MMP 2 + 9

228
Q

What are the currently recommended surgical margins for cutaneous MCTs?

A

2 cm lateral and 1 fascial plane deep

229
Q

What tx provides the best outcome for patients with intermediate-grade and well-differentiated MCT with LN mets?

A

Sx + radiation

230
Q

What chemotherapy protocol is commonly used for tx of canine MCT?

A

Prednisone + vinblastine (+/- cyclophosphamide)
Palladia

231
Q

What staging should be done for a dog diagnosed with a MCT?

A

LN aspirates
Abdominal imaging

232
Q

What phase of the cell cycle do most chemotherapeutics work to treat cancers?

A

S phase (DNA replication)

233
Q

How does UV Light lead to cancer?

A

Formation of thymidine dimers

234
Q

Is c-kit a proto-oncogene or oncogene?

A

Proto-oncogene (needs to be mutated to be an oncogene: gain-of-function mutation in exon 8 or 11)

235
Q

What proto-oncogene serves as a prognostic indicator in canine MCT?

A

c-kit

236
Q

What proto-oncogene is mutated in most human cancers?

A

c-myc

237
Q

What is the most frequently mutated protein in all human cancers?

A

p53

238
Q

What is the function of p53?

A

It is a tumor suppressor protein - It regulates apoptosis in response to genotoxic or cellular stress

239
Q

What allows for cancer cells to have replicative immortality?

A

Telomerase protein - utilized to maintain length of telomeres to continue dividing

240
Q

What is the Warburg effect?

A

Aerobic glycolysis in which cancer cells convert glucose to lactate

241
Q

What is the differentiating step between pre-cancerous neoplasia and malignant neoplasia?

A

Invasion through the basement membrane

242
Q

How do sarcomas usually spread and where do they usually met?

A

Through blood, mets to lungs

243
Q

How do carcinomas usually spread, ad where do they usually met?

A

Through blood and lymph, met to lung, spleen, liver, LN

244
Q

How do round cell tumors usually spread and where do they usually met?

A

Through lymph, mets to LN, liver, spleen

245
Q

What is the MOA of cancer caused by papillomavirus?

A

Viral protein E6 destabilizes p53 and viral protein E7 inhibits pRB (another tumor suppressor protein)

246
Q

What cancers has papillomavirus been associated with in dogs?

A

SCC

247
Q

What cancers has papillomavirus been associated with in cats?

A

SCC
Bowen’s in situ carcinoma
Viral plaques
Feline sarcoids/fibropapillomas

248
Q

What is the paraneoplastic syndrome of renal cystadenocarcinoma/leiomyoma in GSDs?

A

Nodular dermatofibrosis

249
Q

What is the paraneoplastic syndrome associated with thymoma in cats?

A

Exfoliative dermatitis

250
Q

What is the paraneoplastic syndrome associated with pancreatic adenocarcinoma/bile duct carcinoma in cats?

A

Paraneoplastic alopecia

251
Q

What is the paraneoplastic syndrome associated with pancreatic glucagonoma?

A

Superficial necrolytic dermatitis

252
Q

What is the paraneoplastic syndrome associated with multicentric lymphoma or adrenal tumors in cats?

A

Skin fragility syndrome

253
Q

What is the paraneoplastic syndrome associated with multicentric follicular lymphoma in cats?

A

Bilateral ischemic necrosis of the hind paws

254
Q

What type of cells are highlighted using vimentin?

A

Mesenchymal

255
Q

What type of tumor are melanocytic tumors?

A

Mesenchymal

256
Q

In what case would you use toluidine blue or Giemsa stain on a tumor?

A

To highlight mast cell granules

257
Q

In what cases would you use Fontana Masson on a tumor?

A

To highlight melanin in lightly pigmented melanomas

258
Q

What IHC marker is used for carcinomas?

A

Cytokeratin

259
Q

What IHC marker is used for sarcomas?

A

Vimentin

260
Q

What IHC markers are used for hemangiosarcomas?

A

Factor VIII-related antigen
Claudin 5
CD 31

261
Q

What combination of IHC markers are used for melanomas?

A

melan-A
PNL2
TRP-1
TRP-2
+/-S100

262
Q

What IHC markers are used for skeletal muscle tumors?

A

myogenin D
sarcomeric actin
desmin

263
Q

What IHC markers are used for smooth muscle tumors?

A

smooth muscle actin
desmin

264
Q

What IHC markers are used for mast cell tumors?

A

CD117/c-kit

265
Q

What IHC marker is used for plasma cell tumors?

A

MUM1

266
Q

What IHC marker is used for T-cell lymphoma?

A

CD3

267
Q

What IHC markers are used for B-cell lymphoma?

A

CD79a
CD20
PAX5

268
Q

What IHC markers are used for neuroendocrine tumors?

A

chromogranin A
synatophysin

269
Q

What IHC markers are used for histiocytomas?

A

CD18
CD204
IBA-1

270
Q

Would you expect a reactive process to be polyclonal or monoclonal on PARR?

A

Polyclonal

271
Q

Would you expect a neoplastic process to be polyclonal or monoclonal on PARR?

A

Monoclonal

272
Q

What type of cells can PARR be performed on?

A

Lymphoid cells only

273
Q

What types of cancers is imiquimod useful for?

A

actinic keratoses
SCC

274
Q

What species has a higher prevalence of malignant skin tumors?

A

Cats

275
Q

What are the top 4 skin tumors in cats?

A

Basal cell tumors
MCT
SCC
Fibrosarcoma

276
Q

You see the cell shown on cytology from a solitary, smooth, pink mass on a dog. What is the name of the cell in the photo and what tumor is it associated with?

A

Mott cell (containing Russell bodies)
Associated with plasma cell tumors

277
Q

What bloodwork/UA parameters should you pay attention to in a patient with a plasma cell tumor?

A

Renal parameters
Serum calcium

278
Q

On what part of the body are plasmacytomas usually found in dogs?

A

Limbs
Head

279
Q

Where do mast cells mature?

A

In the tissue (released from bone marrow as precursors)

280
Q

Describe the paraneoplastic syndromes associated with MCTs?

A

1) Darier’s sign (degranulation due to manipulation)
2) GI ulceration (due to histamine binding to H2 receptors)
3) Coagulation abnormalities (due to heparin release from granules)
4) Delayed wound healing
5) Hypotension
6) Hypereosinophilia

281
Q

What should you tell the owner about the prognosis for a dog diagnosed with a grade 3 MCT?

A

Prognosis poor- most dogs die from disease within a year

282
Q

What body locations carry a worse prognosis for MCT?

A

Subungual
Oral/mucous membrane
Preputial
Scrotal

283
Q

True or false: SQ MCT tend to have a better prognosis

A

True

284
Q

What dog breeds have a better prognosis for MCT?

A

Boxer/other brachycephalic

285
Q

What type of MCT is not accurately prognosticated with the Kiupel/Patnaik grading systems?

A

SQ

286
Q

Name 3 chemotherapy protocols for treatment of canine MCT

A

1) Prednisone
2) tyrosine kinase inhibitors (Palladia, Masivet, Gleevec)
3) Stelfonta

287
Q

Stelfonta is indicated for which types of MCT?

A

Non-met SQ MCT on DISTAL LIMBS
Non-met cutaneous MCT anywhere on the body

288
Q

What 3 MCT presentations are present in cats?

A

1) Cutaneous
2) Splenic/visceral
3) Intestinal

289
Q

What are the 2 subtypes of feline cutaneous MCT?

A

1) Histiocytic
2) Mastocytic

290
Q

What subtype of feline cutaneous MCT typically appears at a younger age?

A

Histiocytic subtype (esp Siamese)

291
Q

What is the typical age of onset of urticaria pigmentosa?

A

Young (often <1 year)

292
Q

What cat breeds are predisposed to urticaria pigmentosa?

A

Sphynx
Devon Rex

293
Q

A cat is presented with cutaneous lymphoma affecting the tarsi. What is the likely prognosis?

A

Poor – this area tends to be associated with an aggressive subtype of non-epitheliotropic lymphoma

294
Q

What is the MST for CETL in dogs?

A

6 months (few mo-2 yr)

295
Q

What type of lymphocyte is associated with a better prognosis in non-epitheliotropic lymphoma?

A

B-cell (important to do immunophenotyping)

296
Q

What type of T-cells are usually present in canine cutaneous lymphocytosis?

A

alpha/beta T-cells (this differentiates it from CETL)

297
Q

What organ is usually involved in lymphoid granulomatosis?

A

Lung

298
Q

What dog breeds are predisposed to multiple IKAs?

A

Norwegian elkhounds
Lhasas
Keeshonds

299
Q

What dog breeds are predisposed to multiple trichoepitheliomas?

A

Basset hounds
English springer spaniels

300
Q

What cell lineage is histiocytic sarcoma derived from?

A

Interstitial dendritic cells

301
Q

What marker is expressed by Langerhans cells and can be assessed on formalin-fixed tissue?

A

E-cadherin (they also express CD1a but this cannot be assess on formalin-fixed tissue)

302
Q

What infectious disease has been associated with SCC development in cats?

A

FIV

303
Q

What is the most common neoplasia of the digit?

A

SCC

304
Q

What dog breeds are predisposed to multiple digital SCC?

A

Giant Schnauzers
Large black dogs (Rottweilers, Standard Poodles, Black Labs, GSDs)

305
Q

What marker can be used to identify SCC?

A

cytokeratin (carcinomas are cytokeratin +)

306
Q

What is the typical behavior of SCC?

A

Locally invasive, slow to met (exception- digital SCC)

307
Q

True or false: Subungual SCC has a better prognosis than SCC elsewhere on the digit

A

True

308
Q

What is a cat with FeSV-induced fibrosarcoma going to test positive for?

A

FeLV (FeSV is a mutant of FeLV)

309
Q

What is the most common hair follicle tumor in dogs?

A

Trichoblastoma

310
Q

What HF neoplasms express cytokeratin 15?

A

trichoblastomas
trichoepitheliomas
tricholemmomas

311
Q

Expression of cytokeratin 15 in HF neoplasms suggests they originated where?

A

From follicular stem cells

312
Q

What markers can be used to differentiate basal cell carcinomas from trichoblastomas?

A

SOX9
LGR5
LGR6
(all are higher in trichoblastomas)

313
Q

What marker is variably expressed in all HF tumors?

A

SOX9 (strongest in trichoblastomas)

314
Q

What dog breed is particularly predisposed to develop IKAs?

A

Norwegian Elkhounds

315
Q

A HF tumor from a dog reveals a cyst wall consisting of squamous, stratified epithelium with keratohyalin granules. What part of the HF did the tumor originate from?

A

Infundibulum (KH granules)

316
Q

From what part of the HF do tricholemommas originate?

A

Isthmus

317
Q

What are the two types of tricholemmoma?

A

Isthmic type
Inferior/bulb type

318
Q

From what part of the HF do trichoblastomas originate?

A

Hair germ

319
Q

True or false: Trichoblastomas are frequently pigmented

A

True

320
Q

What is the typical body region distribution for trichoblastomas in dogs and cats?

A

Dogs: Head and neck
Cats: Head and cranial trunk

321
Q

What are the 5 subtypes of trichoblastomas?

A

1) Ribbon/medusoid (most common in dogs)
2) Trabecular (most common in cats)
3) Spindle
4) Trichoblastoma with ORS differentiation
5) Granular cell

322
Q

From what part of the HF are pilomatricomas derived?

A

Inferior portion (matrix of hair bulb)

323
Q

What HF tumors arise from all 3 portions of the HF?

A

Trichoepitheliomas
Trichofolliculomas

324
Q

What breeds are predisposed to dermoid cysts?

A

Rhodesian Ridgebacks
Boxers

325
Q

What dog breeds are predisposed to follicular cysts?

A

Boxers
Shih Tzus
Mini Schnauzers
Basset Hounds
Old English Sheepdogs

326
Q

From what part of the HF are matrical cysts derived?

A

Inferior portion

327
Q

Ghost cells are consistent with HF tumors arising from what part of the follicle?

A

Inferior portion

328
Q

True or false: Oral lesions are common in cats with CETL

A

False

329
Q

True or false: CELT in cats often involves infiltration of adnexal glands

A

False (UNLIKE dogs)

330
Q

What dog breeds are predisposed to nodular sebaceous hyperplasia?

A

Poodles
Cocker Spaniels
Manchester Terriers
Wheaten Terriers

331
Q

What is the inheritance pattern for pituitary dwarfism?

A

Autosomal recessive

332
Q

What viral disease has been associated with SCC in horses?

A

Equine papillomavirus-2

333
Q

What horse breed is predisposed to getting SCC on eyelid and sclera?

A

Paint

MK ACVD Exam (17 decks)

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