Onco Q's. Flashcards
You are performing ultrasound, blood work and radiographs after diagnosing a primary tumour on biopsy.
What is this called?
Staging.
Feline lymphoma usually affects what cats?
Usually young cats with FeLV associated disease.
What is a negative prognostic indicator associated with lymphoma in cats and dogs?
Hypercalcemia.
What is the most common location site for MCT in cats?
Cutaneous.
Where do you give the FeLV vaccine?
Left hindlimb.
What are the 2 vaccines most commonly implicated with vaccine-induced sarcomas in CATS?
Rabies and FeLV.
What is the 1-2-3 Rule of injection-site sarcomas in cats?
Still growing 1 month after vaccination.
If over 2 cm in size.
If it persists for over 3 months after vaccination.
Which of the following is not a proposed factor for vaccine-associated fibrosarcoma in cats?
Needle gauge, syringe reuse, vaccine temp, shaking of syringe, massaging site.
Following an incisional biopsy of a Soft tissue sarcoma in a cat, what is the most appropriate diagnostic test?
CT.
Cutaneous HSA has been associated with what?
UV light exposure.
What are 3 common locations for HSA?
Heart.
Spleen.
Subcutaneous tissues.
In an osteosarcoma, what liver enzyme should you measure for prognosis?
ALP.
What is the 90/10 rule with osteosarcomas?
90% die from metastatic disease.
Under 15% show metastasis at time of diagnosis.
With which chemo drug will you monitor ALT levels?
Lomustine.
Why do we monitor ALT levels when giving lomustine?
It is hepatotoxic in dogs.
It is also lipophilic and crosses the blood brain barrier.
What is the gold standard treatment for OSA in dogs?
Amputation and chemotherapy.
An owner asks you why the oncologist recommends continuing chemotherapy in their dog despite being told its cancer is in remission.
You tell the owner this is because?
Tumour cells are still present, below the level of clinical detection.
A 10-year-old female GSD presents for a 1 cm oral mass.
The mass was surgically excised with complete surgical margins and histopathology indicating oral malignant melanoma.
What do you suggest next?
Oncept vaccine.
What are the indications for the oncept vaccine?
Oral malignant melanoma.
It give locoregional control for an oral malignant melanoma.
When will we not use radiation therapy?
If the tumour has been removed with complete surgical margins.
Which of the following is not one of the 3 reasons why it important to always review your slide of an FNA sample prior to submitting for pathology?
Determining the type of neoplasia so you can start treatment ASAP.
Background inflammation with reactive cells in a cytology sample can interfere with your interpretation.
What type of neoplasia is this most problematic in?
TCC in the bladder.
Also MCT with fibroblasts in background.
You obtain the following slide (pic) from a FNA bladder mass.
You suspect it is TCC because of the mass shedding of epithelial cells.
However you also see lots of bacteria.
What do you do next?
Clear the infection first and then resample mass.
In which of the following scenarios is pre-treatment biopsy NOT recommended?
A. Large mass on the hock of a greyhound.
B. Small dermal mass on the flank of a dog.
C. Splenic mass.
C. Splenic mass.
Also: Spinal cord mass.
You diagnose an oral mass as malignant melanoma.
Where should you investigate for metastasis?
Lungs, submandibular lymph nodes.
What kind of metastasis do we get if there is metastasis to the lungs only?
Hematogenous (mesenchymal).
What kind of metastasis do we get if there is metastasis to the submandibular lymph nodes only?
Lymphatics (round cell).
What side effects of chemotherapy are MOST commonly observed?
Bone marrow suppression.
Alopecia.
GI upset.
What unique toxicity is associated with cyclophosphamide?
Sterile hemorrhagic cystitis.
What cancer drug causes hepatotoxicity in dogs?
Lomustine.
What is the MOST common side effect of cyclophosphamide?
Myelosupression.
What chemotherapy drug is nephrotoxic and known to cause fatal pulmonary oedema in cats?
Cisplatin.
How can we prevent renal toxicity in cats with cisplatin?
With diuresis.
What drug causes minimal renal toxicity and is safe to use in cats?
Carboplatin.
Which chemotherapy drug is contraindicated in cats as it can cause a fatal neurotoxicity?
5-fluorouracil
Which chemotherapy drug is a severe tissue vesicant that can cause a unique nephrotoxicity in cats and a cumulative dose-related cardiotoxicity in dogs?
Doxorubicin.
A 6-year-old MC collie presents for lymphadenopathy and cytology diagnoses lymphoma.
His owners would like to pursue combination chemotherapy (CHOP protocol), however you know that 70% of Collies are affected by the MDR-1 mutation.
Testing for MDR results can take 1-2 weeks.
Knowing that LSA can progress rapidly, you decide to start treatment with a drug not dependent on P-glycoprotein to
avoid potentially causing significant side effects.
What drug in the CHOP protocol do you start with?
Cyclophosphamide.
A 6 year old West Highland Terrier is diagnosed with multicentric lymphoma.
It presents to the ER 6 days after receiving the protocol for CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone).
It has a history of vomiting and diarrhoea for 2 days.
What do you suspect caused these signs?
Doxorubicin.
What drug causes visceral stimulation of CTZ normally seen 3-5 days after chemotherapy?
Doxorubicine.
This leads to vomiting and diarrhoea.
What anti-emetic is the 1st line of treatment for this doxorubicine induced vomiting?
Maropitant (cerenia).
What is metaclopromide used for?
To treat ileus from vincristine.
What treatment is indicated for this doxorubicine induced diarrhoea in a collie if the MDR-receptor status is unknown?
Metronidazole and a bland diet.
What 2 cell lines are you most concerned about with the side effects of myelosuppression following chemotherapy?
Neutrophils and platelets.
Rapidly divided cells.
When is emergency treatment of neutropenia caused by myelosuppression indicated?
When the patient is febrile and lethargic with a neutrophil count of 800.
Tanovea is an example of a chemotherapeutic that has conditional approval from the FDA.
What does this mean?
No extra-label use permitted.
Can lose license.
A 14-year-old FS DSH presents to you with weight loss and difficulty eating.
A large mass is present on the left maxilla.
Cytology diagnoses lymphoma.
What can you recommend to palliate this cat’s disease and provide quality of life prior to definitive therapy?
Single dose radiation therapy.
What type of radiation therapy is not radioactive following therapy?
External beam radiation therapy (Teletherapy).
What is the most important mechanism of action that we use radiation therapy for?
Indirect damage leading to free-radical formation.
Which of the following is not one of the R’s of Radiation therapy?
Resist.
What do the R’s of Radiation therapy determine?
How safely and effectively cancer can be treated with radiation therapy.
