Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Internal Medicine > Oncology > Flashcards

Oncology Flashcards

1
Q

Rate of fluids for tx of hypercalcaemia

A

Saline 3x maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tumours causing paraneoplastic hypoglycaemia

A

Insulinoma
Smooth muscle tumours
Hepatocellular carcinoma
Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment of hypoglycaemia when tumour is not resectable

A

Iv glucose in emergencies (risk if increase in insulin and rebound hypoglycaemia with insulinoma)
Prednisolone
Diazoxide
Glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Paraneoplastic production of ACTH by what tumours

A

Hepatic carcinomas
Abdominal neuroendocrine tumour
Primary lung tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Prognosis of patients with bone marrow suppression and pancytopaenia secondary to hyperoestrogenism

A

Poor - bone marrow takes months to recover

Broad spectrum abs required for pancytopaenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes hypertrophic oesteopathy

A

Primary intrathoracic masses

Space occupying lesions in abdomen or thorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes paraneoplastic glomerulonephritis

A

Immune complex formed by tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tumours causing peripheral neuropathy

A 
Lymphoma
Multiple myeloma
sarcomas
Carcinomas
Insulinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes paraneoplastic myasthenia gravis

A

Thymona

But has been reported with other tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment of myasthenia gravis

A

Anticholinesterase agents like Pyridostigmine bromide

Immunosuppression is controversial given risk of aspiration pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What tumour causes modular dermatofibrosis

A

Renal cystadenocarcinoma

Uterine leiomyomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Paraneoplastic causes of erythrocytosis

A

Excess EPO production by renal tumour or secondary increased renal EPO production due to tissue hypoxia as a result of tumour compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical signs of erythrocytosis/polycythaemia

A

Hypertension, hyperviscosity, seizures, ataxia, disorientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thymidine kinase

A

Can be used for monitoring tx of lymphoma but needs to be measured before tx

Becomes high again 3 weeks before coming out of remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Real time PCR for monitoring lymphoma

A

Measures amount of DNA in blood - lower at start better prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Alkylators

A

Chlorambucil
Cyclophosphamide
Lomustine
Melphalan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anti-tumour antibiotics

Anthracyclines

A

Doxorubicin
Epirubicin
Actinomycin-D
Mitoxantrone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vinca alkaloids

A

Vincristine and vinblastine

Cell cycle specific - inhibit Microtubules thus preventing motorists spindle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Platinating agents

A

Carboplatin

Inhibits protein synthesis and cell death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anti-metabolites

A

Cytosine arabinoside

Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

L-asparaginase

A

Malignant lymphocytes are dependant upon asparagine which l-asparaginase destroys leading to cell death

Much less effective in cats and asparagine is replaced much more quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Chemotherapy agents which penetrate the CNS

A 
Prednisolone
L-asparaginase
Cytosine arabinoside
CCNU
Methotrexate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Radiotherapy side effects

A

Dermatitis and moist desquamation
Mucositis/colitis/anusitis
Dry eye

Long term:
Dry eye
Alopecia and leucotrichia
Skin fibrosis and poor wound healing
Small increase in rate of de novo tumours
Degenerative brain lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Breeds with a mutation making them susceptible to side effects of anthracyclines and vinca alkaloids

A 
Sheltie
Westie
Rough collie
Border collie
Australian shepherd 
Long haired whippet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Consider dose reduction of which chemo drugs with liver dz

A

Anthracyclines
Vinca alkaloids
Cyclophosphamide

26
Q

Consider dose reduction of which chemo drugs with renal dz

A

Carboplatin
Methotrexate
Cyclophosphamide

27
Q

side effects of masitinib and toceranib

A

PLN, hypertension
Haemolytic anaemia
GI side effects
Hepatotoxicity

Drug holidays, reduction in doses
For hepatotoxicity - denamarin and drug holiday

Pancreatitis following toceranib

28
Q

When to treat as septic when on chemotherapy

A

If sick neutrophil count < 1x10^9/L

29
Q

Chemo drugs causing extravasation injury

A

Vinca alkaloids
Anthracyclines
Cisplatin

30
Q

Tx of extravasation injury

A

Consider immediate debridement for anthracycline extravasation

Local infiltration of Hyaluronidase

IV administration of dexrazoxane within three hours and again at 24 and 48

31
Q

Doxorubicin and epirubicin specific toxicity

A

Acute arrhythmias - give slowly and monitor ECG
Cumulative cardiotoxicity leading to DCM and heart failure - if heart problems use an alternative drug, pre-treatment echo and at high doses can consider dexrazoxane (protects heart against anthracycline toxicity)

Renal toxicity - particularly cats. Cumulative. Monitor urea/crea/USG and give fluids before and after tx in cats

32
Q

Lomustine specific toxicity

A

Hepatic toxicity - delayed and cumulative - monitor liver enzymes particularly ALT and bile acids. If alt is climbing stop this
Do not treat for longer than 6 months and consider SAMe

Highly myelosuppressive
Renal toxicity - give fluids before and after tx in cats

33
Q

Vincristine specific side effects

A

Neurotoxicity - peripheral neuropathy and hindlimb weakness that resolves when tx is stopped

34
Q

Chemotherapy for mast cell tumours

A

Vinblastine and prednisolone - 8 cycle protocol over 12 weeks

Lomustine

Tyrosine kinase inhibitors

35
Q

Chemotherapy for osteosarcoma and MST

A

Carboplatin following amputation

MST surgery alone 4 months
Surgery plus chemo - 11 months

36
Q

Chemotherapy for haemangiosarcoma and MSTs

A

Doxorubicin I/V every three weeks x five

MST 2 months surgery alone and 6 months w tx

Metronomic chemotherapy

37
Q

MST for MCTs with vinblastine and prednisolone

A

All - 570 days

Grade III - 330 days

38
Q

Visceral mast cell tumours MST

Bone marrow MST

A

90 days

Bone marrow 45 days - poor response to tx

39
Q

What pre-cancerous changes can be seen in cats prior to development of SCCs?

A

Actinic keratosis

40
Q

MST of nasal/pinnal SCC after surgery?

A

20 months

41
Q

Treatment of feline mast cell tumours

A

If compact surgery with narrow margins

If diffuse surgery with larger margins

Splenectomy if spleen involved

Preds can be used but not that effective
Vinblastine not to be used as assoc with severe neutropaenia in cats

42
Q

Treatment of feline squamous cell carcinoma

A

Surgery
Radiotherapy (strontium 90 plesiotherapy or sxternal bean radiatiotherapy
Photodynamic therapy
Cryotherapy

43
Q

How to tell if pleural effusion is idiopathic or secondary to haemangiosarcoma

A

High troponin with haemangiosarcoma (>0.25ng/ml)

If >2.45ng/ml cardiac involvement is likely in a dog with haemangiosarcoma elsewhere

Echo if between 0.07 and 0.25

44
Q

Why does detection of c-kit mutation help with mast cell tumours

A

Diagnosis

Determining relatedness between mast cell tumours (because the in tandem duplications May be different)

Prognosis (only found in grade I and II MCTs so if a round cell with an ambiguous origin is identified can search for c-kit)

Treatment monitoring

Could do PCR on tissue aspirates/blood to see if malignant mast cells are present (only need a small amount of dna) could guide treatment - more vs less aggressive

45
Q

Diagnosis of CML and ALL with PCR and monitoring

A

Detection of bcr-abl fusion gene

Can monitor response to tx - ratio of bcr-abl to regular bcr

46
Q

MST of feline injection site sarcoma
Nodulectomy v radical excision
Non-specialist v specialist

A

79 days v 325-419days

66 v 274days

47
Q

Most common site of metastasis of FISS

A

Lungs
Then regional LNs

Then abdomen - liver/spleen

48
Q

Advantages and disadvantages of pre-surgery neoadjuvant radiotherapy in tx of FISS

A

Cells not hypoxic so easier targets
Smaller radiation field
Improves surgical margins by reducing tumour size

More wound complications post-surgery
Not as good against macroscopic dz as it is against microscopic dz

49
Q

Advantages and disadvantages of post-surgery neoadjuvant radiotherapy in tx of FISS

A

Radiotherapy more effective against microscopic dz

Increased size of radiation field
More hypoxic cells
Risk of tumour cell repopulation

50
Q

Chemotherapy that can be used with FISS

A 
Doxorubicin
Carboplatin
Mitoxantrone
Cyclophosphamide
Vincristine

Only an option in cats with non-resectable disease where radiotherapy is not available

51
Q

Other adjunctive tx for FISS

A

Oncept-IL2 injections alongside surgery and radiotherapy

TKIs masitinib and toceranib (inhibit PDGF AND PDFR) / in vivtro activity shown

52
Q

Difference between injection site sarcomas and other feline sarcomas

A

In s/c tissues thought could be in muscular
Spread along fascial planes
Usually fibrosarcomas
More aggressive behaviour - marked cellular and nuclear pleomorphism, necrosis and high mitotic index
Rim of inflammatory cells
Higher metastic rate
Most high grade (60%)
May see vaccine adjuvant Material within cells in his top ATG

53
Q

Which types of feline lymphoma are commonly FeLV positive

A

Mediastinal in young cats and spinal in young cats

54
Q

Aim of immunohistochemistry in lymphoma

A

To determine phenotype and differentiate between cell types eg mast cells, undifferentiated carcinomas/sarcomas etc

55
Q

Treatment low grade intestinal lymphoma in cats

Primary and rescue

A

Chloambucil and pred

Rescue (if relapse or no response within 3-4 doses): cyclophosphamide single agent
Lomustine single agent
COP protocol

56
Q

Prognosis low grade

Alimentary LSA feline

A

Good to excellent 18-24
Months MST

(4.1 months without complete remission)

57
Q

Intermediate/high grade alimentary lymphoma in feline

Treatment

A

Cop / CHOP

RESCUE:
single agent doxorubicin is not effective in cats
L-asparaginase, lomustine, pred - 38% response
Mitoxantrone single agent

MOPP (mechloretamine, vincristine, procarbazine, pred)

TKIs in the future?

58
Q

Prognosis intermediate / high grade feline alimentary lymphoma

A

Median response 4-9 months longer if good initial response

59
Q

Chemotherapy for oral SCC with likelihood of mets (eg tonsilar)
And oral malignant melanoma

A

Piroxicam with cisplatin or carboplatin
Mitoxantrone with RT

Melanoma:

Carboplatin and intralesional cisplatin
Melphalan
Immunotherapy!

60
Q

Most common site of metastasis for canine oral malignant melanoma

A

Lungs

Internal Medicine (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions