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RO General Section > Misc & Others > Flashcards

Misc & Others Flashcards

0
Q

Concerning tumors of the digit, what is the most common tumor in the dog?

A

SCC

followed by melanoma, STS, MCT, OSA

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1
Q

In a study of 15 patients with ceruminous gland carcinomas (dogs and cats), patients treated with surgery and/or RT:
mean PFS?
1 yr PFS?

A

40 mos
56%
(27% local recurrence, 20% mets)

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2
Q

In what breed is melanoma the most common digital tumor?

A

Scottish terrier

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3
Q

List 3 drugs that have been used for treating insulinoma and their MOA.

A
  1. Streptozotocin - cytotoxic to ß cells
  2. Diazoxide - not cytotoxic, inhibits insulin secretion (not synthesis)
  3. Octreotide - somatostatin receptor ligand, inhibits synthesis & secretion of insulin
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4
Q

What is the ORR for non-splenic HSA involving soft tissues?

Which patients live longer, retroperitoneal mass or ST mass, MST?

A

70%

retroperitoneal mass…13 vs 3 mos

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5
Q

With stage II splenic HSA, using Sx + doxo vs Sx + low-dose cytoxan/etoposide/piroxicam, which group did better (MST/PFI)?

A

Incr. MST for low dose group

PFI not different

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6
Q

In cutaneous HSA treated with sx alone, what were the MSTs for dermal, SQ, muscle invasion?

A

26, 6, 10 mos

Invasion into SQ or muscle worse px

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7
Q

What are the staging criteria for cutaneous HSA?

A

I: confined to dermis √
II: extension into SQ
III: invades underlying muscle

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8
Q

Regarding cutaneous HSA?
Excision rate: Stage I = ____%, Stage II/III = ____%
Metastatic risk: Stage I = ____%, Stage II/III = ____%

A
  1. …23

30. …60

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9
Q

Regarding cutaneous HSA, the MST for Gr I is ____ mos and for Gr II/III is ___mos

A

26….5-10 mos

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10
Q

Answer the following for salivary gland tumors in cats AND dogs:
Most commonly affected glands?
LN met rates?
Distant met rates?

A

mandibular…parotid
39%….17%
16%…8%
(Sx + RT 17mos cat, 18 mos dog)

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11
Q

Thymoma paraneoplastic syndromes?

A

Myasthenia gravis w 2º megaesophagus (40% dogs)

Exfoliative dermatitis, erythema multiforme, hypercalcemia in cats

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12
Q

Flow cytometery of thymoma reveals:

A

Thymic lymphocytes simultaneously express CD4 & CD8 (vs peripheral lymphocytes)
(conventional histopath shows neoplastic epithelial cells dispersed w large # of small mature lymphs)

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13
Q

In the treatment of thymoma with RT, what % had MG and what % resolved post RT?

A

14-18%….67%
(MST RT in mos: dog 8, cat 24
MST SX in mos: dog 26, cat 61)

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14
Q

List 3 positive prognostic factors with thymoma

A
  1. Resectable w/o megaesophagus
  2. tumors with significant lymphocytic infiltrate
  3. cystic thymomas in cats
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15
Q

Aural tumors: in a study of 11 dogs/cats w ceruminous gland ACA, Sx +RT or RT alone, what was MST, local recurrance, met rate?

A

40 mos, 27%, 20%

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16
Q 
TVT:
How is it transmitted?
Metastatic rate?
Remission?
Genetic characteristic?
A

Horizontally - sexually
5-17%
spontaneous - can occur w/i 3-6 mos
All have a long interspersed nuclear element (LINE-1) upstream from c-myc (used in PCR for dx)

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17
Q

Treatment of TVT with course fx RT: protocol and cure rate?

A

orthovoltage: 10-30 Gy, 100% durable CR for >25 mos
√√ 10 Gy initial fx cures 88% of dogs √√
MV: 5 Gy x 3, 100% durable CR 24 mos

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18
Q

What are the ranges of local recurrence and metastatic rates for MLO?

A

47-58% local recurrence
56-58% metastatic rate
Both of these vary with tumor grade
(MST 21-26 mos)

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19
Q

Regarding px of MLO:
MST of mandible (____mos) vs. other sites(____mos)?
General effect of grade?
General effect of incomplete excision?

A
  1. Mandible better MST (50 vs 18 mos)
  2. Incr gr - decr MST, incr recurrence, incr mets
  3. mets & local recurrence more likely
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20
Q

In a study of 16 dogs w TCC & perianal ACA tx w Sx + IORT followed by fx RT:
What happened to ureters in field?
What happened to bladder?
IORT dose to ureters should be kept below what Gy?

A
  1. became stenotic, fibrotic, w º hydroueter & hydronephrosis (uniform at ≥ 25 Gy)
  2. fibrotic, inflamed, edematous….urinary incontinence
  3. 25 Gy
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21
Q

PVACs vs. SVAPs in 20 dogs w fx RT…which one prefered?

A

PVACs…decr time to implant, fewer complications

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22
Q

In 13 dogs w infiltrative lipoma tx w Co-60:
Formula for tumor volume?
% durable long-term control?
Effect of microscopic vs. gross on control?

A

(XxYxZ) x π/6
92%
micro have long-term control; gross have stable or PR

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23
Q

In 30 dogs treated for nasal tumors, STS, and other tumors of head with PROTONS, what % developed radiation-induced cataracts?

A

50%

MST 13 mos

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24
Q

In a study of 37 dogs & 7 cats, Sn & Sp of regional LN assessment for various tumors:
PE?
FNA?
Needle core bx?

A 
Sn and Sp:
1.  60/72
2.  100/96
3.  64/96
So LN FNA is best
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25
Q 
Regarding 2nd opinion histopathology:
agreement?
partial agreement?
complete disagreement?
% change in tx or px based on review?
A

70%
20%
10% (7% malignancy, 3% cell type)
17%

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26
Q

In a study of 80 dogs/cats, 4 Gy x 5 M-F, what was the response compared to historical palliative protocols?

A

Similar response, but shorter duration

27
Q

In a study of 51 cats/dogs re-treated w ortho, Co, brachy, tumor free time & MST were correlated w what 3 things?

A
  1. CR @ 2 mos
  2. reirradiation field size ≤ 10 cm2
  3. doses ≥ 40 Gy
28
Q

In a study of 51 cats/dogs re-treated w ortho, Co, brachy, what % had late complications:
moderate (fibrosis)?
severe?

A

43%

12%

29
Q

In a study of 51 cats/dogs re-treated w ortho, Co, brachy, the complication rate was increased with what tumor and what 2 other factors?

A
  1. SCC
  2. field size > 30 cm2
  3. time of < 5 mos between RT courses. **re-tx time should always be > 5 mos
30
Q

51 cats/dogs re-treated w ortho, Co, brachy resulted in a MST of ____ x longer than if no re-tx?

A

3.5

31
Q

In a study of 115 horses with periocular tumors treated w Ir192, what variable affected PFS

A

T-stage

T2 had 1.8x & T3 had 3.4x increase risk of recurrence vs T1

32
Q

In a study of 38 horses with corneolimbal SCC tx w Sx + Sr90:
Local control/mos?
Local recurrence/mos?

A

83% for 58 mos

17% at 15 mos

33
Q

In a study of 19 rabbits treated for thymoma w MV RT, what was the only prognostic factor found?

A

Rabbits w body wt < 1.57 kg on admission had MST 10 mos (vs 24 mos)

34
Q

In a study of 15 horses imaged w CT vs. radiographs for sinonasal tumors, what were two short-comings of radiographs:

A
  1. Rads do not identify masses in sphenopalatine sinus, cranium, retrobulbar space vs. CT. Rads are effective screening modality for identifying paranasal sinus masses in patients w clinical signs.
  2. Rads underestimate features of malignancy such as osteolysis osteoproliferation
35
Q

In a study of 15 horses imaged w CT vs. radiographs for sinonasal tumors, what tumor type comprised 1/3 of the neoplasms?

A

Neuroendocrine/neuroblastomas

36
Q

In a study of dogs treated w IORT + fx RT, what % developed RITs?

A

26%

37
Q

In a study of 119 dogs tx w DRT to appendicular sites using orthovoltage, what percent developed RITs?

A

8%

38
Q

In a study of dogs tx w MV RT for acanthomatous epulides, what % developed RITs?

A

3.5%

39
Q

Summary question of RIT % rates:
IORT + fx?
Ortho for appendicular?
MV for epulus?

A

26%
8%
3.5%

40
Q 
In a study of 29 dogs treated for nasal/orbital neoplasia w MV RT and eye in the field:
Cataracts developed when?
KCS developed more at \_\_\_Gy vs \_\_\_Gy?
\_\_\_% developed ocular complications
\_\_\_% were refractory to tx
A

9 mos
48 vs 40
75%
64%

41
Q

Regarding RT changes in bone:
In mature bone, cellular & vascular changes lead to _____.
Removal of dead bone leads to ______.
Deposition of new bone on dead trabeculae leads to ____ & ____.

A

osteopenia
decreased opacity
increased bone opacity; coarse trabeculae

42
Q

In a study of 37 dogs treated for nasal/intracranial neoplasms w Co60 RT, what % had ocular complications and what % were vision threatening?

A

84%

57%

43
Q

In a study of 37 dogs treated for nasal/intracranial neoplasms w Co60 RT, KCS occurs as an acute and late effect. Explain how this damage occurs at each time frame.

A

Acute: The direct effect of radiation on lacrimal tissue, meibomian glands, and conjunctival goblet cells.
Late: damage occurs due to atrophic or late radiation vascular & connective tissue changes.

44
Q

In a study of 37 dogs treated for nasal/intracranial neoplasms w Co60 RT, damage to eyes was discussed. Damage to the lens may not be clinically apparent for 2-3 months because….

A

of slow lens epithelial turn-over rate after radiation damage

45
Q

In a study of 37 dogs treated for nasal/intracranial neoplasms w Co60 RT, anterior uveal changes were discussed. They occur as a late effect due to…

A

vascular damage and breakdown in blood ocular barrier rather than true inflammation. Poor response to medical tx because of this.

46
Q

In a study of 37 dogs treated for nasal/intracranial neoplasms w Co60 RT, it was discussed that vision loss by posterior segment lesions result from….

A

damage to blood vessels rather than direct effect on resistant retina/optic nerve

47
Q

Radiation pneumonitis in 3 dogs following MV RT.
Radiographic signs developed when?
What were they?

A

1-2 mos post RT (normal at end of RT)
bronchiactasis, alveolar infiltrate, decr lung volume, unsturctured interstitial pattern
all dogs clinically normal

48
Q

Radiation pneumonitis in 3 dogs following MV RT:
acute pneumonitis due to damage to _______(cell type) & _______
____% pneumonitis at ____Gy
___% increase incidence w ___% increase in RT dose

A

alveolar epithelium (type II pneumocytes)……vascular endothelium

  1. …33
  2. ….5
49
Q

Radiation pneumonitis in 3 dogs following MV RT:
Late fibrosis: ____months post-RT
less than ____% of the lung can be safely irradiated to high doses

A

2-24

25

50
Q

In a study of 16 dogs given MV RT to the pelvis:
___% had diarrhea post RT, ____% had colitis
___% had chronic colitis
___% had GI perforation (all received OPLA-Pt)
Incidence of severe effect incr with incr __________.
All dogs w severe or life-threatening side effects received ___ or ___Gy/fx and ____% received radiation potentiators

A 
8....75
56
19
dose/fx
3...3.3....80
51
Q

In a study of 16 dogs given MV RT to the pelvis, it was concluded that to minimize risk, what 2 things should be done?

A

Give < 3 Gy fx

No RT potentiators

52
Q

In 9 dogs treated for brain tumors comparing photon vs. proton 3D plans:
NTCP was always smaller for photon or proton plans?
At 5% NTCP, ____Gy for photons and ___Gy for protons could be achieved.
For a complex PTV shape, degree of conformity clearly superior for…?

A

proton
50.2…..58.3
protons

53
Q

In a study of 10 cats and 15 dogs given 50-53 Gy M-F w twice weekly gemcitabine IV:
___% of dogs required decr or postponed drug, ___% hemo toxicity
___% of dogs had to stop RT early d.t. local tissue tox (___GI tox)
40% of cats required decr or posptpone due to _____.
20% of cats required dose reduction/postpone due to ________.

A

80…..73
67……no
hemotologic toxicity
decreased appetite/activity/clinical values

54
Q

In a study evaluating cutaneous mucosal flaps in RT fields,
List the 3 complications in decreasing order of occurrence.
Risk of complication incr in dogs receiving ____ flapping procedure
Increased severity of complication if ___Gy/fx vs ___Gy/fx
Dogs w tumors in what body location had incr severity of complications

A
  1. dehiscense (62%), necrosis (35%), infection (27%)
  2. salvage
  3. 4….3
  4. oral cavity
55
Q

In a study evaluating cutaneous mucosal flaps in RT fields,
Complication risk difference in pre vs post op RT?
Complication severity difference in pre vs post op RT?

A

No difference

Pre-op RT increased severity; post-op RT decreased severity

56
Q

In a review article of skin reactions, list the skin changes in order:

A

erythema - inflammation - dry desquamation - moist desquamation

57
Q

In a study of 22 dogs comparing prednisone to placebo for radiation-induced dermatitis:

  1. difference between 2 groups w respect to acute rad. morbidity?
  2. 94% developed ___ ___.
  3. 45% developed ___ ___.
  4. Effect of pred on decreasing ARID severity, clinically or histopath
A
  1. none
  2. bacterial infection
  3. yeast dermatitis
  4. none
    (no literature to support any specific tx for ARID)
58
Q

In a review article of acute oropharyngeal effects:

  1. Order of acute changes
  2. Cause of increased susceptibility to dental caries
A
  1. injection w/o inflam - patchy mucositis - confluent mucositis - ± necrosis, hemorrhage, ulceration
  2. decreased salivary function post-RT
59
Q

In a study of 7 dogs w incompletely excised tumor on forelimbs tx w DRT, comparing ARS (VTOG) and VAS/GCMPS:

  1. As ARS incr w incr rad dose, did VAS/GCMPS?
  2. Was ARS a sig predictor of VAS/GCMPS scores?
  3. Can ARS predict a range of VAS/GCMPS values?
  4. What do these finding suggest?
A

1-3: yes

4: Because ARS ~=VAS/GCMPS, suggest need for more effective pain managment.

60
Q

In a study of 51 dogs receiving DRT on the pelvis:

  1. ___% had complications.
  2. dogs w _____ tumors were more likely to have a complication.
  3. the median E.S. field size was _____ in dogs w complications.
A
  1. 39%
  2. perianal
  3. larger (12.5 vs 9.9 cm2)
    (Arthur paper)
61
Q

In a study looking at VAPs in dogs receiving RT:

  1. 17% were ______
  2. 36% were associated w ___ ___, 13% had ___ ___, 7% had ___ ____, 4% had ___ ____.
  3. can use _____ to position VAP
  4. Induction time shorter for VAP in what location
  5. ___% grew Staph, ___% with withdrawal occlusion grew Staph
A
  1. malpositioned
  2. seroma formation, sutures break, partial occlusion, fatal septicemia
  3. fluoro
  4. jugular (vs. lateral saphenous)
  5. 33….80
62
Q

In a study of 65 dogs evaluating adverse effects of RT + carbo in spontaneous tumors:
41% developed ___ and 61% developed _____.
8% of dogs were tx for presumptive ____.
___% did not finish RT protocols; ___% experienced delays in RT delivery.
10% had grade ____GI toxicity

A

neutropenia…thrombocytopenia
sepsis
8….43
III - V

63
Q

In a study of 172 dogs & cats using SVAPs during RT:
___% had infections.
1. (M/F) were 5x more likely to have major complications.
2. (receiving/not receiving) propofol 19x more likely to have a major complication.
3. 5% of animals w complication requiring _____.
4. __% had complication that made SVAP unusable
5. 3 complications?

A

less than 1%

  1. F
  2. not receiving
  3. second surgery
  4. 6
  5. perm. loss of patency, temporary lose of patency, seroma formation
64
Q

Regarding Heinz formation in cats, formation is caused by? What stain shows Heinz bodies?

A

oxidative injury to Hb due to limited glucuronide conjugation capability in cats.
New methylene blue

65
Q

In a study of 31 dogs using IV propofol for induction for DRT, what were the changes in PCV, RBC, Hb, MCHC, and MCV?

A

all decreased, except MCV increased

RO General Section (17 decks)

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