Oncology, Hematology and Immunology

Question 1

9 yo with coombs negative hemolytic anemia, hypoalbuminemia, hypocholesterolemia, mildly elevated bilirubin. Most likely diagnosis?

Answer 1

Histiocytic neoplasia

Hemophagocytic histolytic sarcoma

Question 2

Which chemotherapeutic agent crosses BBB/reaches therapeutic concentrations in the CNS?

Answer 2

Cytosar (others include hydroxyurea, CCNU/lomustine, procarbazine)

Question 3

Collie needs chemo while awaiting MDR mutation testing. Which drug is safe to use?
Which is not safe?

Answer 3

Cyclophosphamide -> not p glycoprotein substrate

Doxorubicin, mitoxantrone, vincristine, taxanes

Question 4

First line of tx for a dog with splenic mass, HCT 35%, Plt 950000, mildly elevated PT/PTT between heparin, RBC transfusion, platt concentration.

Answer 4

IV fluids

Question 5

Mitoxantrone MOA

Answer 5

Inhibits topoisomerase II and also causes intercalation of DNA

Question 6

Most common tumor of cats (skin?)

Answer 6

Basal cell tumor

Question 7

Patient with suspected mast cell tumor that does not stain with aqueous quick stains, what is next step/stain?

Answer 7

Giemsa

Question 8

Feline blood typic - What is Type A compared to B?

Answer 8

Dominant

Question 9

Most antigenic blood type in the dog?

Answer 9

DEA 1.1

Question 10

Which disease can interfere with platelet function?

Answer 10

Multiple myeloma (not vWB?)

Question 11

Where is most of the body’s iron?

Answer 11

Hemoglobin

Question 12

If a patient has hemolysis of RBC following a transfusion, which type of HS is involved?
What are the other types of HS with examples?

Answer 12

Type II hypersensitivity - Ab mediated destruction. Other examples of Type II - IMHA + myasthenia. Type II is cytotoxic, IgG, NK cells + complement
Type I HS - anaphylaxis, IgE, mast cell activation
Type III HS - Immune complex, IgG, IMGN + leishmania
Type IV HS - delayed, T helper cells, TB reaction + allergic contact dermatitis

Question 13

What results in a high serum iron?

Answer 13

Hemolysis

Question 14

In which condition do you see microcytosis before hypochromia?

Answer 14

Iron deficiency

Question 15

Gompertzian growth: smaller tumors grow _____ than larger tumors and are _____ susceptible to chemotherapy.

Answer 15

Faster, more
Gompertzian growth curve - tumors start off with exponential growth that then slows as they get larger. Smaller tumors have cells that are rapidly dividing so they are more susceptive to chemo.

Question 16

What is more consistent finding in a patient with a stress leukogram?

Answer 16

Lymphopenia

Question 17

Which immunosuppressant medication targets mTOR?

Answer 17

Sirolimus (rapamycin)

Question 18

PARR results with multiple bands in a dog with lymphadenopathy

Answer 18

Inflammatory dz

Question 19

What determines the specificity of PCR?

Answer 19

Primers

Question 20

Where does oxygen bind to RBC?

Answer 20

Fe2+

Question 21

What is the most common secondary brain tumor?

Answer 21

Hemangiosarcoma

Question 22

Adult beagle with a 1 month history of vomiting and inappetence. BW shows hypoglycemia and au shows stomach mass. Most likely diagnosis?

Answer 22

Leiomyosarcoma

Question 23

Findings on a coag/blood panel with hemophilia A?
Mode of transmission?
Which factor is deficient?

Answer 23

Prolonged aPTT only
X-linked recessive - male only
Factor VIII

Question 24

Red blood cell changes with iron deficiency anemia?

Answer 24

Microcytosis first, then hypochromia

Question 25

MOA heparin

Answer 25

Potentiates Anti-thrombin

Question 26

Hemothorax with increased PTT and PT and mild thrombocytopenia

Answer 26

Rodenticide

Question 27

What change would you see in the red blood cells with chronic bleeding?

Answer 27

Microcytosis

Question 28

What is the endothelial anticoagulant

Answer 28

Thrombomodulin

Question 29

What is the morphology of RBC in IMHA and what type of hypersensitivity reaction is IMHA?

Answer 29

Spherocytes | Type II HS

Question 30

What is a potential clinical laboratory finding in a dog with thrombocytosis?

Answer 30

Pseudohyperkalemia if using serum to measure K

Question 31

Question about hemolytic transfusion due to what canine blood type

Answer 31

?

Question 32

Which cells are most sensitive to radiation?

Answer 32

Lymphoid

Question 33

What chemotherapy drug leads to arrest in metaphase?

Answer 33

Vinblastine (vinca-alkaloids, also vincristine)

Question 34

What is a marker for acute leukemia?

Answer 34

CD34

Question 35

What are some cytologic features of malignancy?

Answer 35

High N:C ratio

Question 36

Which chemotherapeutic agents may lead to allergic type reaction?

Answer 36

Elspar - pretreatment with benadryl | Doxorubicin - release of histamine

Question 37

What are some of the proposed mechanism of action of metronomic therapy?

Answer 37

Downregulation of Tregs cells. | Antiangiogenesis

Question 38

Most important factor for lymphoblastic lymphoma?

Answer 38

Immunophenotype

Question 39

What is a prognosis factor for pituitary macro adenoma post radiation?

Answer 39

Resolution of neuro clinical signs

Question 40

What is the treatment of choice for mastocytosis (splenic) in cats?

Answer 40

Splenectomy

Question 41

Eosinophils associated with what type of response

Answer 41

Th2* - produce IL-5 which increases eos release from marrow and activates them once at the site of interest

Question 42

Sensitive diagnosis of masticatory myositis 6 weeks after swollen head.

Answer 42

2M antibody

Question 43

What would support an iron deficiency anemia on an iron panel?

Answer 43

Decreased saturation of serum transferrin levels. | ?

Question 44

2yo dog with hemothorax - PT is more elevated than PTT, 80 000 platelets. Most likely dx?

Answer 44

Vitamin K antagonist toxicity

Question 45

Where is the site of NK stem cells?

Answer 45

Bone marrow

Question 46

What is produced in abundance by NK cells?

Answer 46

IFN-gamma

Question 47

What does cisplatin do to cats?

Answer 47

Pulmonary edema

Question 48

Type of immune molecule associated with IMHA?

Answer 48

IgG

Question 49

What does RDW represent on a CBC?

Answer 49

Red cell distribution width. Evaluates anisocytosis. | Measures how the sizes of red blood cells vary.

Question 50

What is a disease that can lead to decreased platelet function?

Answer 50

Multiple myeloma

Question 51

What is an indicator of neoplasia?

Answer 51

High N:C ratio

Question 52

In what phase of the cell cycle does cell division occur?

Answer 52

M phase

Question 53

What cell presents antigen to naive T cells?

Answer 53

Dendritic cells

Question 54

What endothelial property makes it anti thrombotic?

Answer 54

Expresses thrombomodulin (vs positively charges surface)

Question 55

Dog SQ mass cytology: clusters of polygonal cells with abundant cytoplasm, anisocytosis, anisokaryosis, etc. Diagnosis?

Answer 55

Carcinoma

Question 56

Life span of RBC in cat

Answer 56

70 days

Question 57

What are Pelger-huet and Chediak hidashi syndromes?

Answer 57

``` Pelger-Huet = lots of bands (abnormal neutrophils) Chediak= oculocutaneous - albinos with immune problems, prone to infections ```