Oncology

Question 1

What class of drug is cyclophosphamide? What is its major side effects and contraindications?

Answer 1

Alkylating agent. Side effects; Sterile hemorrhagic cystitis (acrolein metabolite), myelosuppression, GI upset. Contraindications: Caution with hepatic or renal impairment, caution in TCC breeds (Scottish terrier)

Question 2

What class of drug is melphalan? What is its MOA and side effects?

Answer 2

Alkylating agent, which effects DNA and RNA so also effects resting cells. Does not require hepatic activation and excreted in the urine unchanged. Side effect are myelosuppression, GI upset, pulmonary infiltrates and neurotoxicity

Question 3

what class of drug is lomustine? what are its side effects and contraindications?

Answer 3

Alkylating agent, classified as non-cell cycle phase specific and will cross the blood brain barrier which is desirable for CNS neoplasia. Side effects; Myelosuppresion (nadir is @ 1-3 weeks, hepatotoxicity (LE increase in 29% of dogs, 6% experience clinical signs), GI upset, pulmonary infiltrates and nephrotoxicity,

Question 4

What is the treatment for doxorubicin extra-vasation? What is a doxorubicin side effect specific to cats?

Answer 4

Dexrazoxane. Renal toxicity

Question 5

How do the vinca alkaloids work and what part of the cell cycle does this effect?

Answer 5

Vincristine and vinblastin - inhibit microtubule assembly and so inhibit M phase.

Question 6

Protocols for which neoplasia may feature carboplatin? What is its side effect profile?

Answer 6

Osteosarcoma, UCC, AGASACA, Melanoma. Carcinomas in general. Can be given intra-cavitary. Platinum, like Cisplatin, but not nephrotoxic and doesn’t cause fatal pulmonary oedema (cisplatin does this to cats). Side effects are GI and myelosuppresion (14-28 days in). Do suggest dose adjustment for cats with renal disease, as renal excretion means that if GFR is reduced then risk of myelosuppression is increased

Question 7

what is the MOA of cytarabine?

Answer 7

inhibits DNA polymerase via competing with deoxycytidine triphosphate; S phase specific.

Question 8

What chemotherapeutics are contraindicated in MDR 1 (ABCB1) mutants? What aspect of their pharmacokinetics is effected?

Answer 8

Vincristine, Vinblastine, Doxorubicin, Paclitaxel. Reduced biliary excretion so increased risk of side effects. Rare report (vincristine) of neurotoxicity

Question 9

What are the T cell markers?

Answer 9

CD 3, CD 5 and then subtypes CD 4 and CD 8

Question 10

What are the B cell markers?

Answer 10

CD 21, CD 22 and if activated CD 25

Question 11

What is the haematopoietic stem cell marker?

Answer 11

CD 34

Question 12

What receptors are the malignant histiocytic diseases associated with?

Answer 12

CD11c and CD18+ve. Haemophagocytic: CD11d and CD18+ve

Question 13

What is an example of a drug that could theoretically increase the risk of toxicity of some chemotherapeutics?

Answer 13

P glycoprotein inhibiting medications can induce a risk similar to ABCB1 mutants (MDR-1 mutants): eg ketoconazole, cyclosporine. Both drugs also inhibit cytochrome p450 metabolism so can also increase vinblastine toxicity this way

Question 14

What % of dogs developed BP 160+ on toceranib?

Answer 14

JVIM 2016: 37%

Question 15

What was the effect of toceranib on fT4 and TSH?

Answer 15

VIM 2018: Stayed within RI but fT4 decreased and TSH increased

Question 16

What increases your risk of developing doxorubicin induced cardio toxicity? What clinical changes can predict?

Answer 16

JVIM 2019: High risk breed (15% developed vs 3% of others), higher BW, higher cumulative dose. Clinical changes predictive were decreased FS% after 5 doses and premature contractions

Question 17

What is the utility of ultrasound compared to CT for detecting LN metastases in AGASACA dogs?

Answer 17

JVIM 2016: Ultrasound detected all enlarged nodes in only 30% BUT it could identify one enlarged node in all affected dogs - so can be used as a screening test

Question 18

Are canine mammary masses usually benign or malignant? Does the number of masses impact this?

Answer 18

JAVMA 2019: 85% benign, multiple masses made no difference

Question 19

Does OHE at the time of mammary mass removal influence risk of recurrence?

Answer 19

JVIM 2016: In general no but in dogs with Grade 2 Eostrogen Positive receptor tumours it did

Question 20

To which LN can an oral melanoma or SCC go to?

Answer 20

Mandibular, retropharyngeal and can also go to the contralateral node

Question 21

What is the MST for thyroid carcinoma post thyroidectomy? What are the most common side effects of surgery?

Answer 21

JAVMA 2019: MST 911 days, 19% can complications, most common being haemorrhage and aspiration pneumonia

Question 22

What is the incidence of UTI in dogs with UCC? What increases the risk?

Answer 22

JVIM 2015: 55%. Female sex and urethral involvement increases the risk

Question 23

What are the ultrasonographic features of malignant LN?

Answer 23

JVIM 2019:Mixed vascular distribution, higher resistivity and elasticity

Question 24

What is the typical phenotype of CLL in cats?

Answer 24

CD4+

Question 25

What chemotherapeutic can be used for GIST

Answer 25

JVIM 2018: Toceranib, median PFI 110 weeks

Question 26

How may osteosarcoma evade the immune system?

Answer 26

JVIM 2016: decreased monocyte chemokine receptor expression, reduced chemotaxis

Question 27

What is the accuracy of cytology for OSA?

Answer 27

JVIM 2017: ACCURARY 83% (SN 83, SP80) SIMILAR to hist (thogh histo more specific)

Question 28

How may PET be prognostic for OSA?

Answer 28

JVIM 2019: Increased standard uptake value -ve