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sam2 > oncology > Flashcards

oncology Flashcards

1
Q

Disease in which a group of abnormal cells grow uncontrollably by disregarding the normal rules of cell division

A

cancer

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2
Q

frequency that normal DNA mutations arise

A

1 in every 20 million per gene per cell division

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3
Q

how many cells are replaced every second

A

10 million

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4
Q

avg number of cells formed in any individual in a lifetime

A

10^16

10 quadrillion

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5
Q

initiation/rapid phase of cancer

A

carcinogens induce DNA damage but not enough to induce neoplastic transformation

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6
Q

promotion phase of cancer

A

original carcinogens or normal growth promoters/hormones cause REVERSIBLE tissue and cellular changes

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7
Q

progression phase of cancer

A

this is slow

progressing agents are able to irreversibly convert and initiated cell into a cell exhibiting malignancy

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8
Q

6 hallmarks of cancer

A 
evading apoptosis 
self sufficiency in growth signals 
insensitivity to anti growth signals 
tissue invasion and metastasis 
limitless replicative potential 
sustained angiogenesis
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9
Q

three distinct cell types that cancer arises from

A

round cells
mesenchymal cells
epithelial cells

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10
Q

examples of diagnostic cytopathology

A

needle biopsy

cytology

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11
Q

differentials for round cell cancers

A 
plasmacytoma 
histiocytoma 
mast cell tumor 
lymphoma 
TVT
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12
Q

differentials for mesenchymals cancers

A

sarcomas

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13
Q

differentials for epithelial cancers

A

carcinomas - squamous cell

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14
Q

microscopically individualized in monolayers and usually can establish a firm tissue Dx

A

round cell cancers

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15
Q

spindle shaped, oval cells that are individual or in non cohesive aggregates

A

mesenchymal cells

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16
Q

round, cuboidal, or columnar cells arranged in cohesive sheets and clusters

A

epithelial

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17
Q

T/F

cytopathology has a high sensitivity and gives few false negatives

A

FALSE - low sensitivity and high false negatives

but has a HIGH specificity and a positive is a positive

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18
Q

when not to be cavalier

A

urogenital neoplasms/carcinomas

-needle tract spread

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19
Q

accuracy of liver needle biopsys

A

< 50%

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20
Q

single splenic lesions…

A

benign

multiple nodules is more likely to be malignant

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21
Q

accuracy at GI cytology to tell tumor vs not

A

72%

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22
Q

staining used for bone tumors

A

alkaline phosphate – required for osteoblasts for bone mineralization

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23
Q

T/F

ALP staining is 100% sensitive for OSA

A

TRUE

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24
Q

Answers the question: Is the tumor

localized, spread regionally or diffusely

A

tumor staging

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25
Q

T/F

grading requires a series of generally non-invasive testing

A

FALSE – this is staging

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26
Q

which requires a block of tissue:

grading or staging

A

grading

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27
Q

Establishes inherent aggressiveness of tumor using systematic approaches

A

grading

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28
Q

Allows definitive prognostication & may alter therapeutic recommendations

A

grading

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29
Q

TNM staging system

A

primary tumor
lymph nodes
metastasis

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30
Q

what are the classic staging tests

A
  • Minimum Data Base (CBC/CHEM/T4/UA/FIV & Felv)
  • Regional LN cytology
  • Three-view thoracic metastasis check (i.e. radiographs)
  • Abdominalultrasound(+/-imageguidedFNA)
  • Crosssectionalimaging(CT/MRI)
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31
Q

how many views in staging radiographs

A

3 thoracic views - to check for metastasis

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32
Q

what lymph node should locoregional LN sampling should be based on

A

sentinel node

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33
Q

T/F

normal sized lymph nodes means there is not metastasis

A

FALSE - never assume that

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34
Q

this is an important filter and barrier for disseminating tumor cells

A

sentinel Lymph node

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35
Q

Metastatic process occurs in an orderly progression w/in the lymphatic system w/ tumor cells draining into a specific LN (i.e., SLN) in a regional lymphatic field before draining into other regional or distant LN’s

A

SLN concept

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36
Q

minimum threshold of ___mm to reliably detect nodules on rads

A

7-9 mm

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37
Q

where is the most common receptacle of blood borne metastasis

A

liver

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38
Q

often the first sign of malignancy and can be a hallmark for others

A

paraneoplastic syndromes

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39
Q

Tumor associated alterations in bodily structure or fxn that occurs distant to the tumor

A

paraneoplastic syndromes (PNS)

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40
Q

list 5 classic PNSs

A 
hypercalceima 
hypoglycemia 
neurologic
cutaneous 
bone
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41
Q

what cancers cause hypercalcemia

A

anal sac ACA
LSA
multiple myeloma
mammary tumor

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42
Q

what cancers cause hypoglycemia

A

intestinal leiomyosarcoma
insulinoma
LSA

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43
Q

cancers/conditions that cause neurological PNS

A

myasthenia gravia

thymoma

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44
Q

cancers/conditions causes cutaneous PNS

A

nodular dermatofibrosis

renal cyadenocarcinoma

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45
Q

tumors that cause hypertrophic osteopathy

A

primary lung tumors
esophageal tumors
metastatic tumors

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46
Q

time alive with no disease

A

disease free interval (DFI)

47
Q

living with disease but not worsening

A

median progression free interval

48
Q

chance of surviving beyond time is 50%

A

median survival time - MST

49
Q

2 goals of chemotherapy

A

enhance or maintain quality of life and family bond

eliminate neoplastic process

50
Q

____ of chemotherapy dosing allows recovery of normal tissue between tx
intervals

A

fractionation

51
Q

T/F

chemotherapy targets all rapidly dividing cells

A

TRUE

52
Q

Tumor type that is known to respond to antineoplastic agents

A

accurate diagnosis

53
Q

what should be discussed with a client prior to chemo administration

A

cost
potential toxicities
logistics of visits

54
Q

T/F

chemotherapy dosing is based on the efficacy

A

FALSE – based on their toxicity

to lower treatment failures, drugs are administered at the highest possible tolerable dose

55
Q

how many individuals need to do dosing calculations before chemo administration

A

at least 2

56
Q

codes for the production of p-glycoprotein (Pgp) pumps, which act to remove drugs from individual cells

A

MDR-1 gene
aka
ABCB-1 gene

57
Q

common breeds with the ABCB1 gene mutation

A

australian shepherds
collies
long haired whippets

58
Q

what is the BAG of adverse effects in chemo

A

B - bone marrow suppression= myelosuppression
A- alopecia in non shedding breeds only
G- gastrointestinal - crypt cells are destroyed and there is vomiting and diarrhea

59
Q

what are the guidelines for the CBC for the day of treatment with chemo

A

neutrophils > 3000
PLTs > 100,00

also if too low – reduce there drugs by 2 - 2.5%
prophylactic abs

if too low recheck in 3-7 days

60
Q

NADIR

A

expected low point for bone marrow insult

61
Q

chemo dosages based on _____ rather than efficacy

A

toxicity – max tolerated dose

62
Q

smaller patients receive a higher dose of these 3 drugs based on the BSA calculations which is a risk factor—

A

doxorubracin
melphalan
carboplatin

63
Q

risk breeds of the abcb gene

A

collies
whippets
aussies

64
Q

4 chemo agents that are a risk factor to abcb-1 gene patients

A

vincristine
vinblastine
paclitaxel
doxorubracin

65
Q

prophylactic antibiotics to use in myelosuppression to help with systemic infection risk

A

clavamox
baytril
sulphadiazine-trimethoprim

66
Q

this stimulates bone marrow production of WBCS

A

granulocyte colony stimulating factor - g-csf

67
Q

antimitotic /microtubule toxins are cell-cycle-phase ___

A

specific

68
Q

this agent class disrupts or immobilizes the mitotic spindles

A

antimitotic /microtubule toxins

69
Q

how is vincristine given

A

IV

70
Q

why is vinblastine given with hyaluronidase

A

keeps it from extrasvasting into the surrounding tissue because necrosis will be caused
this draws it back into circulations

71
Q

indications to give vincristine

A

LSA

TVT

72
Q

vesicant

A

destroys tissue if it leaves the vessels

73
Q

what neuropathy does vincristine cause

A

pelvic limb dragging

74
Q

alkylating agents are especially hard on

A

bone marrow

75
Q

T/F

most alkylating agents are cell cycle specific

A

false - nonspecific

76
Q

how are most alkylating agents given

A

orally

77
Q

alkylating agent for multiple myeloma

A

melphalan

78
Q

alkylating agent for LSA and metronomics

A

cyclophosphamide

79
Q

cyclophosphamide toxic side effect on the bladder wall

A

sterile hemorrhagic cystitis – acreolein

80
Q

what is lomustine given with to lower side effects on the liver

A

denemarin

81
Q

lomustine and chloroambucil are what class

A

alkylating agents

82
Q

known as red death

A

doxorubricin (DOX) – antibiotic agent

83
Q

causes a dose related cardiotoxicity

A

doxorubricin (DOX) -

84
Q

screen these breeds with an echo before giving doxorubricin (DOX) -

A

doberman and rotties

85
Q

lowers the cardiotoxic effect of doxorubricin (DOX) and is given 10 doses in 3 hours of extravasation

A

dexrazoxane

86
Q

antimetabolites are specific to what cell cycle phase

A

the S phase – dna synthesis

87
Q

good for CNS tumors

A

cytosine arabinoside - cytosar

88
Q

blue thunder

A

mitoxantrone

89
Q

a cardiac sparing antibiotic that is used to treat TCC and LSA

A

mitoxantrone - blue thunder

90
Q

if you give this platinum agent IV there could be a hypersensitivity reaction

A

L-asparaginase (elspar)

91
Q

platinum agent - could cause pancreatitis and DIC

A

L-asparaginase (elspar)

92
Q

this SPLATS cats

A

cisplatin

93
Q

good for OSA in dogs

A

cisplatin

94
Q

toxic side effect of cisplatin

A

nephrotoxic – need to give high rate IV fluids

95
Q

T/F

carboplatin causes nephrotoxicity

A

false

96
Q

first approved lymphoma agent for dogs

A

tanovea CA1

97
Q

used as a rescue drug when normal lymphoma chemo fails in dogs

A

tanovea CA!

98
Q

revolves around the concept of eliminating “break” period by giving low dose continuous chemo

A

not designated to cure

metronomic chemotherapy

99
Q

CD4+CD25+regulatory T cells

A

T reg immunomoduclations

100
Q

metabolite in cyclophosphamide that contributes to sterile hemorhhagic cystisis

A

acrolein

101
Q

blocks a variety of receptor tyrosine kinases expressed on cell surface by acting as a reversible competitive inhibitor of adenosine triphosphate binding

A

toceranib phosphate - palladia

**treats mast cell tumors

102
Q

labeled for dogs with stage 2 or stage 3 oral melanoma

A

tumor vaccines – oncept

103
Q

contains PSP which causes cell cycle arrest at the G1/S checkpoint leading to an increase in apoptosis of cancer cells

A

C versicolor mushroom - turkey tail

104
Q

chinese herbal med shown to improve clotting and enhance platelet function

A

yunnan baiyao

105
Q

anecdotally prolongs survival of HSA in dogs

A

yunnan baiyao

106
Q

standard, accepted unit for radiation dose measurement

A

gray (gy)

107
Q

tissues that respond early to radiation

A

epithelial layers of skin and mucosa
bone marrow +/- organs

within a few weeks

108
Q

late responding tissues to radiation

A

effects seen in months to years

nervous tissue/bones/organs

109
Q

most common modality of radiation used

A

megavoltage – abdominal and deep seated tumors

110
Q

100% resolution of the tumor

A

complete response

111
Q

> 30% reduction in overall tumor size

A

partial response

112
Q

> 20% increase in overall tumor size

A

progressive disease

113
Q

<30% reduction, <20% reduction in tumor size

A

stable disease

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