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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
Q

Why is neutropenia and thrombocytopenia more common than anemia when taking chemo?

A

RBC lifespan is 120 days, neutrophils have shorter life span and are destroyed more rapidly

26
Q

What is a significant adverse effect from chemo that warrants hospitalization?

A

Febrile neutropenia

(pet on chemo with a fever is bad)

27
Q

What is the protocol for admin of chemo

A
  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
Q

What adjunct medication needs to be given to a patient on chemo with neuts < 1000

A

Clavamox (@ risk of infection)

29
Q

What can be given as a 1 time only use to stimulate bone marrow production in hopes to increase neutrophil count?

A

Nupogen

30
Q

What 2 chemo drugs cause the most GI effects and should be given Cerenia or Metro to go home with?

A
  • Doxorubicin
  • Cisplatin
31
Q

Adverse effects of Vincristine?

A
  • GI signs
  • Vesicant
  • Neuropathy
32
Q

How to proceed if Vincristine/Vinblastine is injected outside of the vein into surrounding tissue?

A
  • DISPERSE AND DILUTE
  • Warm compress
  • Hyaluronidase (pushes chemo back into boodstream)
33
Q

How to proceed if Doxorubicin is injected outside of the vein into surrounding tissue?

A
  • LOCALIZE AND NEUTRALIZE
  • (frozen) PEA on it!!
  • Admin Dexrazoxane (antidote)
34
Q

Adverse effects of Mitoxantrone?

A
  • Bone marrow suppression
  • GI effects

(BAG)

35
Q

Adverse effects of Cisplatin in cats vs dogs?

A

Cats: fatal pulmonary edema
Dogs: Nephrotoxic (avoid if renal dz)

  • Bone marrow suppression and GI effects in dogs and cats
36
Q

What is Tanovea-CA1 (Rabacfosadine) used for?

A
  • 1st FDA approved chemo for lymphoma, but currently used as rescue therapy for lymphoma
37
Q

What is Laverdia-CA1 (Verdinexor) used for?

A
  • 1st FDA approved ORAL lymphoma tx in dogs
  • No neutropenia
  • Good option to have in GP if Owner declines referral
38
Q

What is metronomic chemotherapy?

A

Continuous low dose of chemo

(compared to giving dose then waiting 3 weeks for next dose)

39
Q

What is the active metabolite responsible for sterile hemorragic cystitis?

A

Acrolein

40
Q

How to avoid sterile hemorragic cystitis in patients on cyclophosphamide?

A
  • Give in the morning with access to water
  • Frequent urinations
  • Give Mesna
  • Give concurrent Furosemide or glucocorticoids
41
Q

List the drug used to target c-kit in MCT treatment?

A

-Toceranib phosphate (Palladia)
- Also Mastinib

(blocks tyrosine receptor kinase)

42
Q

What chemo drug is commonly used in metronomic chemotherapy?

A

Continuous low dose of Cyclophosphamide

43
Q

What type of cancer is tumor vaccines used for?

A

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
Q

Mushroom therapy can be beneficial in treating what type of cancer?

A

Hermangiosarcomas

Sem 6: SAM 2 (26 decks)

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