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RUSVM SAM 2 > Oncology > Flashcards

Oncology Flashcards

1
Q

How can you define cancer for your client?

A

Disease where a group of abnormal cells grow uncontrollably be disregarding the normal rules of cell division

Normal cells = subject to signals that dictate whether the cell should divide, differentiate into another cell or die

Cancer cells develop a degree of autonomy from these signals

  • > equals uncontrolled growth and proliferation
  • > if malignant eventually metastasis and death
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2
Q

What causes cancer?

A

DNA mutations -defect in regulatory circuits of a cell
—> disruption of normal cell proliferation and behaviour

LIFESTYE AND ENVIRONMENT
Diet - high fat, low fiber diets linked to bowel, pancreatic, breast, and prostate cancers

Exposure - carcinogens, mutagens (UV, cigarette smoke, and alcohol)

Viruses -HepB, FeLV, FIV

Age- alterations in the immune system (accumulation of random genetic mutations or lifetime carcinogen exposure; hormonal alterations or exposure

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3
Q

What is the mechanism of cancer development?

A

Initiation (rapid): carcinogens induce DNA damage but not enough to induce neoplastic transformation

Promotion: original carcinogens or normal growth promoters cause reversible tissue and cellular changes

Progression (slow): processing agents are able to irreversibly convert an initiated cell into a cell exhibiting malignancy

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4
Q

What are the 6 hallmarks of cancer?

A 
Self-sufficiency in growth signals 
Insensitivity to anti-growth signals 
Tissue invasion and metastasis 
Limitless replicative potential 
Sustained angiogenesis 
Evading apoptosis
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5
Q

A dog comes in with a mass on its limb, suspecting cancer, what is the first thing you should do?

A

Comprehensive history

  • rapid vs slow growth
  • tease out extent of involvement
  • co-morbidities

Signalment assessment
-breed specific neoplasms

Complete PE

DIAGNOSTIC CYTOLOGY —> establish a tissue diagnosis

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6
Q

When doing a cytopatholgoy, all (most) cancer comes from what three distinct cell types?

A

Round cell
Mesenchymal cell
Epithelial cell

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7
Q

Best to worst, when doing cytopathology, which cell type has the best yield(exfoliation)?

A

Round > epithelial > mesenchymal

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8
Q

What is the cell type?

Individualized round cells arranged in a monolayer

A

Round cells

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9
Q

What is the cell type?

Spindle-shaped, stellate or oval shaped cells arranged individually or in non-cohesive aggregates

A

Mesenchymal

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10
Q

What type of cells?

Round, cuboidal, columnar, or polygonal cells arranged in cohesive sheets or clusters

A

Epithelial

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11
Q

Round, cuboidal, columnar, or polygonal cells arranged in cohesive sheets or clusters

DDX?

A

Carconoma

Eg squamous cell, adenocarcinoma, undifferentiated

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12
Q

Spindle-shaped, stellate or oval shaped cells arranged individually or in non-cohesive aggregates

DDX?

A

Sarcoma

Eg osteo, chondro, fibro, hemangiosarcoma

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13
Q

Individualized round cells arranged in a monolayer

DDX?

A 
Lymphoma 
Mast cells 
Plasmacytoma 
Histiocytoma 
TVT

Melanoma (sometimes)

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14
Q

What are characteristics of malignancy?

A

Homogenous (cancer cell) vs heterogenous (inflamm)

Monomorphic (single lineage with uniform appearance) vs pleomorphic (malignant)

Cellular/cytoplasmic criteria - anisocytoisis (var in size), hyperchromasia, variable N:C ratio

Nuclear criteria - anisokaryosis (var in size), multiple nucleoli, increased mitosis

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15
Q

What are the advantages to cytopathology?

A 
Non-invasive, low risk 
Low cost 
Rapid turnover of results 
Ability to evaluate morphological appearance of individual cells 
Highly specific
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16
Q

What are the disadvantages of cytopathology?

A

Low sensitivity (false -)
Poor sample quality
Small sample size
Inability to evaluate tissue architecture

17
Q

In what cases can cytopathology not give you a diagnosis?

A

Oral and splenic tumors —> bleed a lot, may not get a good tissue spample

Feline mammary gland tumors -> may inflammatory cells (carcinomas generally have a lot of inflammation)

Mesenchymal tumors dont exfoliate well —> not always found with cytology

18
Q

T/F: there is a high rate of needle tract implantation of neoplasms

A

False

Very low incidence
**except in urogenital neoplasms

19
Q

What is the clinical techniques used for FNA?

A 
Needle off (coring) 
—> mass is grasped and stabilized in non-dominant hand between thumb and index finger

—> needle is advanced through the mass and is redirected several times to dislodge cells

—>coring diminishes blood contamination of the specimen in vascular tissues

Needle on (suction)

20
Q

What type of tumor is Alkaline Phosphate staining used??

A

Osteosarcoma

ALP is required for bone mineralization
Marker of osterobastic lineage

21
Q

What is the difference between staging and grading ?

A

Staging = is the tumor localized/spread OR is there any evidence of advanced stage disease

Grading= establishes aggressiveness of tumor

22
Q

T/F: cytology is used for grading tumors

A

False

Requires biopsy

23
Q

What are tests used for staging a tumor?

A 
MDB (CBC/chem/T4/UA/FeL/FIV) 
Regional LN cytology 
Three-view thoracic metastasis check (ie radiographs) 
Abdominal ultrasound (+/- FNA)
Cross sectional imaging (CT/MRI)
24
Q

When doing lymphnode cytology to stage cancer, you should be sampling the _______ node

A

Sentinel node -> not always the anatomic drainage pathway

25
Q

T/F: distant metastasis should not be present if the sentinel lymph node does not have evidence fo tumor

A

True

26
Q

How can a sentinel lymph node be found?

A

Peri-tumors injection of technectium-99 in the region of the right elbow showing an accumulation in the right periscapular and 2 axillary lymph nodes

—> X-rays 24hrs later

27
Q

How many views do you take when doing thoracic radiographs for met check?

A

3!

28
Q

What is the most specific method of determining metastasis?

A

CT

29
Q

What is the most common receptacle of blood-borne metastasis?

A

Liver

—> abdominal ultrasound

30
Q

What is paraneoplasic syndrome?

A

Tumor associated alterations in bodily structure or function —> secondary to small molecules (cytokines/hormones/peptides) secreted by tumor which mimic native substances causing effects

Often are the first sign of malignancy and can be a HALLMARK of certain malignancies

31
Q

What neoplasms are associated with hypercalcemia?

A

Anal sac adenocarcinoma
Lymphosarcoma
Multiple myeloma
Mammary tumor

32
Q

What type of tumor causes a paraneoplasic syndrome manifesting as neurological problems like myasthenia gravis?

A

Thymoma

33
Q

What tumor PNS results in a nodular dermatofibrosis?

A

Cutaneous

34
Q

What tumors can have a PNS that results in a hypoglycemia?

A

Intestinal leiomyosarcoma
Insulinoma
lymphosarcoma

35
Q

What tumor PNS results in hypertrophic osteopathy?

A

Primary lung tumors

Esophageal tumor
Metastatic tumor

RUSVM SAM 2 (44 decks)

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