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Sem 6: SAM 2 > Oncology > Flashcards

Oncology Flashcards

1
Q

List the round cell tumors

A
  1. Plasmacytoma
  2. Histiocytoma
  3. Mast Cell tumor
  4. Lymphoma
  5. TVT

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2
Q

List the following in order of best to least diagnostic yield on cytopathology

  1. Round cell tumors
  2. Mesenchymal tumors
  3. Epithelial tumors
A

Round cell tumors > Epithelial tumors (carcinomas) > Mesechymal tumors (sarcomas)

(FNA not great for sarcomas)

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3
Q

List advantages and disadvantages of cytopathology in diagnosing cancer

A

Pros
- Highly specific ( a + result is a true positive)

Cons
- Low sensitivity (many false negs, can’t believe a neg result)

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4
Q

What tumors are more likely to result in false negatives on FNA?

A

Oral tumors, Liver tumors, Splenic tumors, or mammary carcinomas in cats

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5
Q

What is the only exception when considering an FNA sample on cancer? (when would you not FNA)

A

Urogenital carcinomas (TCC, prostatic cancers)

Don’t poke the bladder!!! Cancer can spread

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6
Q

FNA/cytology of the liver has a ____% accuracy

A

50%

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7
Q

FNA/cytology of the spleen has a ____% accuracy

A

60%

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8
Q

FNA/cytology of GI tumors has a ____% accuracy

A

70%

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9
Q

FNA/cytology of bone tumors has a ____% accuracy

A

97-100%

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10
Q

Aside from FNA, what diagnostic can be performed to diagnose osteosarcoma?

A

ALP staining (100% sensitivity)

(marker of osteoblastic lineage)

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11
Q

What is required to perform tumor grading?

A

Requires a biopsy - a block of tissue

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12
Q

What cancer types would lead you to collecting a blood sample for Liquid Biopsy?

A

Hermangiosarcoma (HSA) and Lymphoma only

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13
Q

What diagnostics can be used to find the sentinel LN?

A
  • Lipidiol contrast agent + 3 view rads
  • New methylene blue (morning prior of sx)
  • CT contrast studies ($$$$)
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14
Q

List tumors that cause paraneoplastic hypercalcemia of malignancy

A
  1. Lymphoma
  2. Anal gland adenocarcinoma
  3. Multiple myeloma
  4. Mammary tumors
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15
Q

List tumors that cause paraneoplastic hypoglycemia of malignancy

A
  1. Insulinomas
  2. Intestinal leiomyosarcomas
  3. LSA
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16
Q

List tumors that cause paraneoplastic myasthenia gravis

A

Thymoma (take 3 view chest rads if suspect)

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17
Q

List tumors that cause paraneoplastic cutaneous skin changes

A
  1. Renal cystadenocarcinoma (nodular dermatofibrosis)
  2. Feline thymoma associated exfoliative dermatitis (take chest rads if suspect)
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18
Q

What is adjuvant chemo?

A

Chemo given AFTER surgical removal of tumor (targets microscopic dz)

19
Q

What is neoadjuvant chemo?

A

Chemo given BEFORE surgical removal of tumor (Used to shrink tumor before surgery, Ex: MCT)

20
Q

What is maintenance/induction chemo used for?

A

Lymphoma and Leukemias that can’t be treated by surgical removal (bc in the blood)

21
Q

What is the Goldie Coldman hypothesis?

A
  • The bigger the tumor, the most cancer resistant cells present and the less effective chemo will be

(Chemo is best for smaller tumors!!)

22
Q

How is chemo dosing calculated based on weight?

A

Usually in BSA

smaller pets use mg/kg instead

23
Q

How is chemo therapy altered in dogs with MDR-1 resistant gene?

A

Decrease dose by 30-40%

(Esp if usually Vincristine, Vinblastine, Doxorubicin, or Paclitaxel)

24
Q

Main adverse clinical signs seen with chemotherapy?

A

BAG

  1. Bone marrow suppression
  2. Alopecia
  3. GI signs
25
Why is neutropenia and thrombocytopenia more common than anemia when taking chemo?
RBC lifespan is 120 days, neutrophils have shorter life span and are destroyed more rapidly
26
What is a significant adverse effect from chemo that warrants hospitalization?
Febrile neutropenia (pet on chemo with a fever is bad)
27
What is the protocol for admin of chemo
1. CBC first using jug vein 2. Give chemo dose if neuts > 3000 and PLTs > 100k 3. If lower, don't give chemo and reevaluate in 3-7 days 4. Recheck NADIR on CBC 7 days post chemo 5. If NADIR is <1500 for neuts or PLTs < 60k, decrease chemo by 20%
28
What adjunct medication needs to be given to a patient on chemo with neuts < 1000
Clavamox (@ risk of infection)
29
What can be given as a 1 time only use to stimulate bone marrow production in hopes to increase neutrophil count?
Nupogen
30
What 2 chemo drugs cause the most GI effects and should be given Cerenia or Metro to go home with?
- Doxorubicin - Cisplatin
31
Adverse effects of Vincristine?
- GI signs - Vesicant - Neuropathy
32
How to proceed if Vincristine/Vinblastine is injected outside of the vein into surrounding tissue?
- **DISPERSE AND DILUTE** - Warm compress - Hyaluronidase (pushes chemo back into boodstream)
33
How to proceed if Doxorubicin is injected outside of the vein into surrounding tissue?
- **LOCALIZE AND NEUTRALIZE** - (frozen) PEA on it!! - **Admin Dexrazoxane** (antidote)
34
Adverse effects of Mitoxantrone?
- Bone marrow suppression - GI effects (**B**A**G**)
35
Adverse effects of Cisplatin in cats vs dogs?
Cats: fatal pulmonary edema Dogs: Nephrotoxic (avoid if renal dz) - Bone marrow suppression and GI effects in dogs and cats
36
What is Tanovea-CA1 (Rabacfosadine) used for?
- 1st FDA approved chemo for lymphoma, but currently used as rescue therapy for lymphoma
37
What is Laverdia-CA1 (Verdinexor) used for?
- 1st FDA approved ORAL lymphoma tx in dogs - No neutropenia - Good option to have in GP if Owner declines referral
38
What is metronomic chemotherapy?
Continuous low dose of chemo (compared to giving dose then waiting 3 weeks for next dose)
39
What is the active metabolite responsible for sterile hemorragic cystitis?
Acrolein
40
How to avoid sterile hemorragic cystitis in patients on cyclophosphamide?
- Give in the morning with access to water - Frequent urinations - Give Mesna - **Give concurrent Furosemide or glucocorticoids**
41
List the drug used to target c-kit in MCT treatment?
-Toceranib phosphate (Palladia) - Also Mastinib (blocks tyrosine receptor kinase)
42
What chemo drug is commonly used in metronomic chemotherapy?
Continuous low dose of Cyclophosphamide
43
What type of cancer is tumor vaccines used for?
Oral melanoma - resistant to chemo Use the Oncept Canine Melanoma vax (or used for clients who don't want referral but want **adjuvant tx... Seen to help with metastatic splenic tumors**)
44
Mushroom therapy can be beneficial in treating what type of cancer?
Hermangiosarcomas

Sem 6: SAM 2 (34 decks)

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