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VTS > Oncology > Flashcards

Oncology Flashcards

1
Q

What is the most common malignancy that causes hypercalcemia?

A

Lymphoma

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2
Q

What is the most common clinical manifestation of hypercalcemia?

A
  • PU/PD
  • Calcium inhibits vasopressin receptors in kidney and prevents free water absorption, creating a nephrogenic DI
  • The hypercalcemic pt is often dehydrated due to inability to concentrate urine; dehydrated pts have a decreased GFR which further exacerbates hypercalcemia
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3
Q

Hypercalcemia primarily affects what 4 body systems?

A
  • Renal
  • GI
  • Neuro
  • Cardiovascular
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4
Q

What is calcitriol?

A
  • The active product of Vit D metabolism
  • Leads to increased GI absorption of Ca and increased release of Ca from bone
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5
Q

What drugs can be used to promote Ca excretion?

A
  • Furosemide (Na utilizes the same pump as Ca)
  • Glucocorticoids
  • Bisphosphonates (inhibit bone osteoclast activity)
  • NaHCO3 (correction of acidosis will result in increased binding of Ca to albumin)
  • Calcitonin (inhibits osteoclasts)
  • EDTA (chelates Ca)
  • Mithramycin (cytotoxic to osteoclasts)
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6
Q

What complication can arise from L-asparaginase administration?

A

Lspar is a protein so a reaction is more likely after 1st use

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7
Q

What complications can arise from doxorubicin administration?

A
  • Head shaking, salivation
  • Reactions secondary to degranulation of mast cells
  • Cardiotoxic
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8
Q

What is the antidote that should be instilled in the case of extravasation of doxorubicin?

A
  • Vesicant
  • Dexrazoxane or DMSO
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9
Q

What is the antidote that should be instilled in the case of extravasation of vincristine/vinblastine?

A
  • Vesicants
  • Hyaluronidase
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10
Q

What is the antidote that should be instilled in the case of extravasation of mechlorethamine?

A
  • Severe vesicant
  • Thiosulfate
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11
Q

What is the antidote that should be instilled in the case of extravasation of cisplatin?

A
  • Irritant
  • Thiosulfate
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12
Q

What is the nadir?

A

The point at which chemo has its greatest effects on the number of circulating neutrophils and they are at their lowest population

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13
Q

How long after chemo administration does neutropenia commonly occur?

A

5-10 days

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14
Q

Neutropenia grading scale in chemo

A
  • Grade 1 = normal to 1500/uL
  • Grade 2 = 1500 - 1000/uL
  • Grade 3 = 1000 - 500/uL
  • Grade 4 = <500/uL
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15
Q

Which chemo drug is most commonly associated with vomiting?

A

Cisplatin

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16
Q

What drug blocks both the CRTZ and vomiting center?

A

Butorphanol

17
Q

What chemo drug is most commonly associated with anorexia?

A

Doxorubicin

18
Q

What chemo drug causes paralytic ileus?

A

Vincristine

19
Q

Tachyarrhythmia is an early sign of toxicity of which chemo drug?

A

Doxorubicin

20
Q

Which chemo drug can cause a sterile hemorrhagic cystitis?

A

Cyclophosphamide

21
Q

Which chemo drug is nephrotoxic?

A

Cisplatin

22
Q

Which chemo drug is hepatotoxic?

A

CCNU/Lomustine

23
Q

Cardiac HSA are almost always found on the ___?

A

Right atrium

24
Q

Female dogs are more at risk than male dogs for which type of cancer?

A

TCC

25
Q

What is tumor lysis syndrome?

A
  • Rupture of the cancer cells which then releases their intracellular contents into tissues and blood. The rapid release of byproducts overwhelms the body’s ability to clear waste
  • Ca, nucleic acids, K, phos
  • Tumor cells can contain up to 4x normal quantity of Phos due to their increased need for ATP
  • The hyperphos causes hypoCa
  • The hyperK + hypoCa can lead to life threatening arrhythmias
  • AKI results from Ca + phos precipitation
  • English bulldogs and dalmations more at risk
26
Q

What is paraneoplastic syndrome (PNS)?

A
  • Any systemic illness that is induced by neoplasia but occurs in a body system from from, and unrelated to, the primary tumor
  • Most common PNS in dogs are caused by production of hormones (insulin, calcitonin, PTH etc) that leads to endocrine-like effects
27
Q

Which cancer is a common cause of PNS?

A

Lymphoma

28
Q

What are the most common chemistry abnormalities from PNS?

A
  • Hypercalcemia and hypoglycemia
29
Q

What is the most common metabolic emergency seen in veterinary cancer patients?

A

Hypercalcemia

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