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RUSVM SAM II > Oncology Exam I > Flashcards

Oncology Exam I Flashcards

1
Q

What is the disease where abnormal cells grow uncontrollably by disregarding normal rules of cell division?

A

CANCER

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2
Q

How are cancer cells different from normal cells in terms of growth?

A

Cancer cells develop a degree of autonomy from cell division signals allowing for uncontrolled growth & proliferation

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3
Q

What are the three phases of cancer mechanism?

A

Initiation
Promotion
Progression

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4
Q

What is the initiation phase of cancer?

A

Rapid phase

Carcinogens induce DNA damage but not enough to induce neoplastic transformation

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5
Q

What is the promotion phase of cancer?

A

Original carcinogens or normal growth promoters/hormones cause reversible tissue & cellular changes

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6
Q

What is the progression phase of cancer?

A

Slow phase

Progressing agents irreversibly convert an initiated cell into a cell exhibiting malignancy

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7
Q

What are the 6 hallmarks of cancer cells?

A
  1. Self-sufficiency in growth signals
  2. Insensitivity to anti-growth signals
  3. Tissue invasion & metastasis
  4. Limitless replicative potential
  5. Sustained angiogenesis
  6. Evading apoptosis
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8
Q

When should you not perform diagnostic cytopathology for cancer dx?

A

Urogenital neoplasms

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9
Q

What are the three types of cell lines cancer comes from?

A

Round cells, mesenchymal cells and epithelial cells

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10
Q

What are the micro characteristics of round cell tumors?

A

Individualized round cells arranged in monolayer

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11
Q

What are the micro characteristics of mesenchymal tumors?

A

Spindle shaped arranged individually or in non-cohesive aggregates

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12
Q

What are the micro characteristics of epithelial tumors?

A

Round, cuboidal or columnar cells arranged in sheets or clusters

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13
Q

What are the DDx of round cell tumors

A 
Lymphoma
Mast cell tumor
Plasmacytoma
Histiocytoma
TVT
"Please Help Me Learn This"
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14
Q

What are the DDx of mesenchymal tumors?

A

Sarcomas (osteo, chondro, firbo, hemangio)

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15
Q

What are the DDx of epithelial tumors?

A

Carcinomas (squamous cell, adeno, undifferentiated)

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16
Q

Anisocytosis

A

Variation in cytoplasmic size

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17
Q

Anisokaryosis

A

Variation in nuclear size

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18
Q

What are the characteristics of malignancy?

A

Heterogenous, pleomorphic, hyperchromasia of cytoplasm, anisokaryosis

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19
Q

T/F: Cytopahtology is highly specific and low sensitivity

A

TRUE

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20
Q

Multiple similar splenic nodules is associated with what?

A

Malignancy

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21
Q

When bone cytology is positive- it is 100% sensitive for what?

A

OSA

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22
Q

What is the difference of staging vs. grading?

A

Staging: based on TNM system (tumor, node, metastasis system. NON-INVASIVE testing series required (MDB, LN sampling). promotes prognostication & appropriate planning
Grading: requires block of tissue (biopsy) and allows definitive prognostication & might alter therapeutic recommendations

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23
Q

LN sampling should be based on what?

A

The sentinel LN

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24
Q

T/F: LN that is normal size= non-metastatic

A

FALSE- just because it is normal size doesn’t mean that there is no metastasis

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25
Q

What is the minimum views needed to be taken on rads?

A

3

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26
Q

What is the most common location of blood borne metastasis?

A

Liver

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27
Q

What is the first sign of malignancy?

A

Paraneoplastic syndromes- tumor associated alterations in bodily structure or function distant from tumor

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28
Q

What are the ddx for hypercalcemia?

A

Anal sac ACA, LSA, multiple myeloma, mammary tumor

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29
Q

What is the ddx for hypoglycemia?

A

Intestinal leiomyosarcoma, insulinoma LSA

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30
Q

What is the ddx for hypertrophic osteopathy?

A

Primary lung tumors, esophageal tumors and metastatic tumors

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31
Q

What are the classic paraneoplastic syndromes?

A 
Hypercalcemia
Hypoglycemia
Neurologic
Cutaneous
Bone
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32
Q

What cells does chemotherapy target?

A

ALL rapidly dividing cells (even normal cells like GI, BM and hair follicles)

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33
Q

Fractionation

A

allows recovery of normal tissue between treatment intervals

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34
Q

What is a neoadjuvant?

A

Treatment used prior to definitive treatment in attempt to shrink tumor

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35
Q

T/F: Animals respond poorly to chemotherapy if sick

A

TRUE

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36
Q

What is dosing of chemotherapy based on?

A

Toxicity rather than efficacy-highest possible dose that will kill cancer but not the patient

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37
Q

T/F: Patient BW is used to predict physiologic function of patient in regards to chemotherapy?

A

FALSE- body surface area

38
Q

What is the leading cause of chemotherapy mistakes?

A

Dose calculation

39
Q

What gene codes for production of Pgp pumps acting to remove drugs from individual cells?

A

ABCB-1 gene (MDR-1 gene)

40
Q

What is recommended to be present in practices that perform chemotherapy treatments?

A

Biological safety cabinet and closed system drug transfer device

41
Q

What does BAG stand for in “BAG of side effects”

A

Common side effects of chemotherapy=BAG
B- bone marrow suppression-myelosuppression
A-alopecia: non-shedding breeds only
G- GI: crypt cells destroyed leading to vomiting and diarrhea

42
Q

At what level of neutrophils and platelet counts can you safely administer chemotherapy?

A

Neutrophils > 3000

PLT > 100,000

43
Q

Why can you not rely on chemo patients having fevers anytime they are sick?

A

Often times chemo patients won’t present with fever becuase they are not producing IL-1 and TNF because of the decreased WBC

44
Q

What are two chemo drugs that are commonly seen causing GI toxicity?

A

Cisplatin and doxorubicin

45
Q

What are the cell-cycle specific vs. cell-cycle nonspecific chemotherapy drugs?

A

Cell-cycle specific: antimitotics and antimetabolites

Cell-cycle nonspecific: alkylating agents and antibiotics

46
Q

How do antimitotic chemo drugs work?

A

Disrupt/immobilize mitotic spindle which plays a critical role in cell function/division

47
Q

What are examples of antimitotic chemo drugs?

A

vinca alkaloids and taxanes

48
Q

What is the chemo drug that can be seen causing skin necrosis if administered outside of vein?

A

Vincristine

Can use hyaluronidase to separate tissue planes and aids in improving absorption of extravasated drug into circulation

49
Q

What is the MOA of alkylating agent chemotherapy drugs?

A

bind DNA strands, insert alkyl group & change DNA structure to interfere w/ transcription, replication & repair machinery

50
Q

What are some alkylating chemotherapy agents?

A

Chlorambucil, cyclophosphamide, lomustine, melphalan, dacarbazine, ifosamide

51
Q

What are the two common antibiotic chemotherapy agents?

A

Doxorubicin and mitoxantrone

52
Q

What are two platinum chemotherapy agents?

A

L-asparaginase and cisplatin

53
Q

What is the first FDA approved lymphoma tx for dogs?

A

Tanovea CA1

54
Q

What cell cycle do antimetabolite chemotherapy drugs work on?

A

S-phase- DNA synthesis

55
Q

What is metronomic chemotherapy?

A

Requires a break period to allow recovery of cells

Greater chance of recurrence with this method

56
Q

What is critical for tumor expansion?

A

Blood vessels (angiogenesis)

57
Q

What upregulates endogenous angiogenesis inhibitor?

A

Thrombospondin-1

58
Q

How does antiangiogenesis (metronomic chemotherapy) work?

A

Blockade of COX and circulating endothelial progenitor cells

59
Q

what are the three MOA of metronomic chemotherapy drugs?

A

Antiangiogenesis
Immunomodulation
Direct targeting

60
Q

T/F: regulatory T-cells are increased by MC

A

FALSE- T-regs are decreased

61
Q

WHat is a common alkylating agent used int MC protocols?

A

Cyclophosphamide

62
Q

What is a uinque adverse effect of cyclophosphamide?

A

Sterile hemorrhagic cystitis

63
Q

How can SHC be avoided with cyclophosphamide therapy?

A

Give free access to water and encourage frequent urination

64
Q

When are tyrosine kinase inhibitors used?

A

Patnaik grade II or III, recurrent cutaneous mast cell tumors

65
Q

How does tyrosine kinase inhibitor work?

A

Inhibits the growth factor signal to keep cells from dividing

66
Q

What type of cancer are tumor vaccines labeled for?

A

Stage II/III oral melanoma

67
Q

What is the name of the listeria-based antigen delivery system tumor vaccine?

A

Pipeline

68
Q

What is the presenting complaint for nasal planum tumors?

A

Older light pigmented cats with history of erythema progressing to ulcers

69
Q

What are the ddx for nasal planum tumors in dogs and cats

A

Dogs: SCC, MCT and Sarcoma
Cat: SCC, LSA, eosinophilic granuloma, mast cell tumor

70
Q

T/F: Cytology is effective for nasal planum tumors?

A

FALSE

71
Q

What should be used for the workup/staging test?

A

Wedge/punch biopsy for tissue dx

72
Q

What are the tx options for nasal planum tumor patients?

A

LIMIT UV EXPOSURE

superficial lesions use cryoablation or photodynamic therapy/hyperthermia, RT, electrochemotherapy

73
Q

What is the presenting complaint for ear canal tumor patients?

A

Recurrent signs of infection w/ visible mass in ear

74
Q

What breeds are associated with ear canal tumors?

A

Cocker spaniels, poodles and GSD

75
Q

What are the DDx for ear canal tumors?

A

Ceruminous gland adenocarcinoma
Cats= malignant > benign
Dogs= 50/50 M:B

76
Q

What test is used for staging?

A

Shave/pinch biopsy

77
Q

What is the tx for ear canal tumors?

A

TECA-BO .

Total ear canal ablation and bulla osteotomy

78
Q

What are negative prognostic factors of ear canal tumors?

A

extension beyond ear canal (beyond soft tissue- in the middle ear doesn’t mean poor prognosis)
neuro signs at dx

79
Q

What are the presenting complaints of canine sinonasal tumors?

A

Older, large breed dolichocephalic breeds
Exposure to kerosene heaters
History of epistaxis, sneezing or facial deformity (advanced)

80
Q

What are the ddx for canine sinonasal tumors?

A

Carcinomas (ACA, Scc)= dogs
Sarcoma (fibro, osteo, chondro) = dogs
LSA= cats

81
Q

What radiographic evidence supports sinonasal tumors?

A

Ipsilateral turbinate loss, bone invasion, sinus infiltration

82
Q

What are tx options for canine sinonasal tumors?

A

NSAIDs
Chemo- Palladia
Hemorrhage control
RT

83
Q

What is pallitation?

A

percutaneous arterial embolization tx of intractable epistaxis in dogs
Carotid artery ligation

84
Q

What is the presenting complaint for salivary tumors?

A

Older spaniels and siamese

More aggressive in cats

85
Q

What salivary glands are commonly affected in salivary tumors?

A

Mandibular or parotid

86
Q

What is the ddx of salivary tumors?

A

Carcinomas

87
Q

What are the presenting complaints of a dog with a thyroid tumor?

A

Older goldens, beagles, boxers and huskies
Invasive= coughing, dysphagia, dyspnea, horner’s syndrome
Functional: signs of hyperthyroidism

88
Q

What are the presenting complaints of a cat with a thyroid tumor?

A

Older
HYPERTHYROIDISM
Siamese/Himalayan= DECREASED risk

89
Q

What are the ddx for thyroid tumors?

A 
Dogs= carcinomas (90:10 M:B)
Cats= adenomas (10:90- M:B)
90
Q

What size thyroid tumor is a negative prognostic factor?

A

Volume: >20 cm
Diameter: > 5 cm

91
Q

T/F: Bilateral thyroid carcinoma has greater risk for developing metastatic dz?

A

TRUE

92
Q

T/F: Non-medullary thyroid carcinomas may be more likely to develop metastatic disease?

A

TRUE

RUSVM SAM II (15 decks)

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