oncology Flashcards
1
Q
Disease in which a group of abnormal cells grow uncontrollably by disregarding the normal rules of cell division
A
cancer
2
Q
frequency that normal DNA mutations arise
A
1 in every 20 million per gene per cell division
3
Q
how many cells are replaced every second
A
10 million
4
Q
avg number of cells formed in any individual in a lifetime
A
10^16
10 quadrillion
5
Q
initiation/rapid phase of cancer
A
carcinogens induce DNA damage but not enough to induce neoplastic transformation
6
Q
promotion phase of cancer
A
original carcinogens or normal growth promoters/hormones cause REVERSIBLE tissue and cellular changes
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
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
9
Q
three distinct cell types that cancer arises from
A
round cells
mesenchymal cells
epithelial cells
10
Q
examples of diagnostic cytopathology
A
needle biopsy
cytology
11
Q
differentials for round cell cancers
A
plasmacytoma histiocytoma mast cell tumor lymphoma TVT
12
Q
differentials for mesenchymals cancers
A
sarcomas
13
Q
differentials for epithelial cancers
A
carcinomas - squamous cell
14
Q
microscopically individualized in monolayers and usually can establish a firm tissue Dx
A
round cell cancers
15
Q
spindle shaped, oval cells that are individual or in non cohesive aggregates
A
mesenchymal cells
16
Q
round, cuboidal, or columnar cells arranged in cohesive sheets and clusters
A
epithelial
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
18
Q
when not to be cavalier
A
urogenital neoplasms/carcinomas
-needle tract spread
19
Q
accuracy of liver needle biopsys
A
< 50%
20
Q
single splenic lesions…
A
benign
multiple nodules is more likely to be malignant
21
Q
accuracy at GI cytology to tell tumor vs not
A
72%
22
Q
staining used for bone tumors
A
alkaline phosphate – required for osteoblasts for bone mineralization
23
Q
T/F
ALP staining is 100% sensitive for OSA
A
TRUE
24
Q
Answers the question: Is the tumor
localized, spread regionally or diffusely
A
tumor staging
25
T/F
| grading requires a series of generally non-invasive testing
FALSE -- this is staging
26
which requires a block of tissue:
| grading or staging
grading
27
Establishes inherent aggressiveness of tumor using systematic approaches
grading
28
Allows definitive prognostication & may alter therapeutic recommendations
grading
29
TNM staging system
primary tumor
lymph nodes
metastasis
30
what are the classic staging tests
* 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)
31
how many views in staging radiographs
3 thoracic views - to check for metastasis
32
what lymph node should locoregional LN sampling should be based on
sentinel node
33
T/F
| normal sized lymph nodes means there is not metastasis
FALSE - never assume that
34
this is an important filter and barrier for disseminating tumor cells
sentinel Lymph node
35
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
SLN concept
36
minimum threshold of ___mm to reliably detect nodules on rads
7-9 mm
37
where is the most common receptacle of blood borne metastasis
liver
38
often the first sign of malignancy and can be a hallmark for others
paraneoplastic syndromes
39
Tumor associated alterations in bodily structure or fxn that occurs distant to the tumor
paraneoplastic syndromes (PNS)
40
list 5 classic PNSs
```
hypercalceima
hypoglycemia
neurologic
cutaneous
bone
```
41
what cancers cause hypercalcemia
anal sac ACA
LSA
multiple myeloma
mammary tumor
42
what cancers cause hypoglycemia
intestinal leiomyosarcoma
insulinoma
LSA
43
cancers/conditions that cause neurological PNS
myasthenia gravia
| thymoma
44
cancers/conditions causes cutaneous PNS
nodular dermatofibrosis
| renal cyadenocarcinoma
45
tumors that cause hypertrophic osteopathy
primary lung tumors
esophageal tumors
metastatic tumors
46
time alive with no disease
disease free interval (DFI)
47
living with disease but not worsening
median progression free interval
48
chance of surviving beyond time is 50%
median survival time - MST
49
2 goals of chemotherapy
enhance or maintain quality of life and family bond
eliminate neoplastic process
50
____ of chemotherapy dosing allows recovery of normal tissue between tx
intervals
fractionation
51
T/F
| chemotherapy targets all rapidly dividing cells
TRUE
52
Tumor type that is known to respond to antineoplastic agents
accurate diagnosis
53
what should be discussed with a client prior to chemo administration
cost
potential toxicities
logistics of visits
54
T/F
| chemotherapy dosing is based on the efficacy
FALSE -- based on their toxicity
to lower treatment failures, drugs are administered at the highest possible tolerable dose
55
how many individuals need to do dosing calculations before chemo administration
at least 2
56
codes for the production of p-glycoprotein (Pgp) pumps, which act to remove drugs from individual cells
MDR-1 gene
aka
ABCB-1 gene
57
common breeds with the ABCB1 gene mutation
australian shepherds
collies
long haired whippets
58
what is the BAG of adverse effects in chemo
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
what are the guidelines for the CBC for the day of treatment with chemo
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
NADIR
expected low point for bone marrow insult
61
chemo dosages based on _____ rather than efficacy
toxicity -- max tolerated dose
62
smaller patients receive a higher dose of these 3 drugs based on the BSA calculations which is a risk factor---
doxorubracin
melphalan
carboplatin
63
risk breeds of the abcb gene
collies
whippets
aussies
64
4 chemo agents that are a risk factor to abcb-1 gene patients
vincristine
vinblastine
paclitaxel
doxorubracin
65
prophylactic antibiotics to use in myelosuppression to help with systemic infection risk
clavamox
baytril
sulphadiazine-trimethoprim
66
this stimulates bone marrow production of WBCS
granulocyte colony stimulating factor - g-csf
67
antimitotic /microtubule toxins are cell-cycle-phase ___
specific
68
this agent class disrupts or immobilizes the mitotic spindles
antimitotic /microtubule toxins
69
how is vincristine given
IV
70
why is vinblastine given with hyaluronidase
keeps it from extrasvasting into the surrounding tissue because necrosis will be caused
this draws it back into circulations
71
indications to give vincristine
LSA
| TVT
72
vesicant
destroys tissue if it leaves the vessels
73
what neuropathy does vincristine cause
pelvic limb dragging
74
alkylating agents are especially hard on
bone marrow
75
T/F
| most alkylating agents are cell cycle specific
false - nonspecific
76
how are most alkylating agents given
orally
77
alkylating agent for multiple myeloma
melphalan
78
alkylating agent for LSA and metronomics
cyclophosphamide
79
cyclophosphamide toxic side effect on the bladder wall
sterile hemorrhagic cystitis -- acreolein
80
what is lomustine given with to lower side effects on the liver
denemarin
81
lomustine and chloroambucil are what class
alkylating agents
82
known as red death
doxorubricin (DOX) -- antibiotic agent
83
causes a dose related cardiotoxicity
doxorubricin (DOX) -
84
screen these breeds with an echo before giving doxorubricin (DOX) -
doberman and rotties
85
lowers the cardiotoxic effect of doxorubricin (DOX) and is given 10 doses in 3 hours of extravasation
dexrazoxane
86
antimetabolites are specific to what cell cycle phase
the S phase -- dna synthesis
87
good for CNS tumors
cytosine arabinoside - cytosar
88
blue thunder
mitoxantrone
89
a cardiac sparing antibiotic that is used to treat TCC and LSA
mitoxantrone - blue thunder
90
if you give this platinum agent IV there could be a hypersensitivity reaction
L-asparaginase (elspar)
91
platinum agent - could cause pancreatitis and DIC
L-asparaginase (elspar)
92
this SPLATS cats
cisplatin
93
good for OSA in dogs
cisplatin
94
toxic side effect of cisplatin
nephrotoxic -- need to give high rate IV fluids
95
T/F
| carboplatin causes nephrotoxicity
false
96
first approved lymphoma agent for dogs
tanovea CA1
97
used as a rescue drug when normal lymphoma chemo fails in dogs
tanovea CA!
98
revolves around the concept of eliminating "break" period by giving low dose continuous chemo
not designated to cure
metronomic chemotherapy
99
CD4+CD25+regulatory T cells
T reg immunomoduclations
100
metabolite in cyclophosphamide that contributes to sterile hemorhhagic cystisis
acrolein
101
blocks a variety of receptor tyrosine kinases expressed on cell surface by acting as a reversible competitive inhibitor of adenosine triphosphate binding
toceranib phosphate - palladia
**treats mast cell tumors
102
labeled for dogs with stage 2 or stage 3 oral melanoma
tumor vaccines -- oncept
103
contains PSP which causes cell cycle arrest at the G1/S checkpoint leading to an increase in apoptosis of cancer cells
C versicolor mushroom - turkey tail
104
chinese herbal med shown to improve clotting and enhance platelet function
yunnan baiyao
105
anecdotally prolongs survival of HSA in dogs
yunnan baiyao
106
standard, accepted unit for radiation dose measurement
gray (gy)
107
tissues that respond early to radiation
epithelial layers of skin and mucosa
bone marrow +/- organs
within a few weeks
108
late responding tissues to radiation
effects seen in months to years
nervous tissue/bones/organs
109
most common modality of radiation used
megavoltage -- abdominal and deep seated tumors
110
100% resolution of the tumor
complete response
111
>30% reduction in overall tumor size
partial response
112
>20% increase in overall tumor size
progressive disease
113
<30% reduction, <20% reduction in tumor size
stable disease
