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Small Animal Medicine > Oncology - Intro + Lymphoma > Flashcards

Oncology - Intro + Lymphoma Flashcards

1
Q

True or False: Cancer is a leading cause of death for dogs and cats.

A

True

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2
Q

What are some things that clients will want to know when you tell them their animal has cancer?

A

Diagnosis, prognosis, quality of life, treatment options, cost, and ‘what to do’

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3
Q

Multimodal treatment is often need for neoplasia. What are the four main treatments?

A

Chemotherapy, surgery, radiation, immunotherapy

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4
Q

What are some general categories that you need to know when treating neoplasia?

A 
What is it? Cytology, biopsy
Where is it? Location, staging
How is it likely to behave? locally, systemically
Treatment options
Expected outcomes/prognosis
Clients' goals/expectations
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5
Q

What are the most common side effects of chemotherapy?

A

Myelosuppression and GI side effects

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6
Q

How does myelosuppression due to chemotherapy present?

A

neutropenia and thrombocytopenia

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7
Q

What GI signs are side effects of chemotherapy?

A

Vomiting, inappetence, and diarrhea

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8
Q

Hair loss is an uncommon side effect of chemotherapy. However when it does occur, what breeds are more affected?

A

Breeds with continual hair growth

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9
Q

____% of chemotherapy patients experience some level of side effect(s).

A

~30%

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10
Q

~___-___% of patients that experience chemotherapy side effects are severe enough to require hospitalization.

A

~5-10%

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11
Q

What % of chemo side effects are severe enough to be life-threatening?

A

<1%

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12
Q

If your patient is febrile/neutropenic due to chemotherapy, what is the recommended treatment?

A

IV antimicrobials

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13
Q

If your patient is dehydrated due to chemotherapy, what is the recommended treatment?

A

IV fluid therapy

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14
Q

What antiemetic works on the emetic center?

A

Cerenia

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15
Q

What antiemetic works on the chemoreceptor trigger zone?

A

Cerenia and metaclopramide

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16
Q

What antiemetic works on the afferent neurons?

A

Ondansetron

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17
Q

What is the antiemetic protocol for in-hospital chemotherapy patients?

A

Ondansetron 0.5 mg/kg SC 30 minutes prior to chemotherapy

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18
Q

What is the antiemetic protocol for at-home chemotherapy patients?

A

Cerenia 2 mg/kg PO q24 hours for 5 days

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19
Q

What are the rescue options for breakthrough vomiting in chemotherapy patients?

A

Ondansetron
Metoclopramide
Mirtazapine

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20
Q

Cerenia (maropitant) treats vomiting by preventing the binding of which ligand to its respective receptor in the emetic center?

a. Serotonin to 5HT3
b. Dopamine to D2
c. Substance P to NK1
d. Histamine to H2

A

c. Substance P to NK1

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21
Q

_______ is a key indicator of quality of life. It is often the first or only sign a pet is not feeling well.

A

Appetite

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22
Q

_______ is considered an acceptable side effect, but ______, ______ ____ and depression are considered unacceptable.

A

Vomiting, inappetence, and weight loss

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23
Q

What type of drug is mirtazapine?

A

Noradrenergic and specific serotonergic antidepressant

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24
Q

What does mirtazapine do on a physiological level?

A

Stimulates 5-HT1 receptors

Strongly antagonizes 5-HT2 and 5-HT3

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25
Q

On a clinical level, what does mirtazapine do?

A

Decreases nausea/vomiting, appetite stimulant, and possible prokinetic effect

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26
Q

What animal is Mirataz (mirtazapine transdermal ointment) FDA approved for use in?

A

Cats

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27
Q

What is the indication for Mirataz?

A

Management of weight loss in cats

28
Q

What animal is Entyce (capromorelin oral solution) FDA approved for use in?

A

Dogs

29
Q

What does entyce mimic the action of? What does that do?

A

Ghrelin - effect at appetite center to increase food intake

30
Q

What type of drug is entyce?

A

Potent and selective GHSR agonist to increase growth hormone secretion

31
Q

Entyce (capromorelin) increases appetite by mimicking the action of which endogenous hormone in the appetite center?

a. Serotonin
b. Dopamine
c. Leptin
d. Ghrelin

A

d. Ghrelin

32
Q

What is the most important consideration for palliative care?

A

Quality of life

33
Q

What factors does perceived quality of life encompass?

A

Level of pain, level of interaction, attitude/activity, appetite, and other (systemic signs)

34
Q

What are the therapeutic (general) options for palliative care?

A

Pain control, appetite stimulant, antiemetic, hydration, and hospice care

35
Q

What oral medications can be given for palliative care?

A

NSAID, gabapentin, tramadol, amantadine, and buprenorphine

36
Q

What appetite stimulants can be used for palliative care?

A

Entyce and mirtazapine

37
Q

What antiemetics can be used for palliative care?

A

Cerenia and ondansetron

38
Q

Approximately what % of dogs and cats experience clinical side effects following chemotherapy, and what % potentially require hospitalization?

a. 10%; <1%
b. 30%; 5-10%
c. 50%; 20%
d. 75%; 30%

A

b. 30%; 5-10%

39
Q

Where do neoplastic cells originate in canine lymphoma?

A

in the periphery - NOT in the bone marrow

40
Q

What terms are interchangeable with lymphoma? Which term should be used?

A

malignant lymphoma and lymphosarcoma

Lymphoma should be used

41
Q

What is the incidence of lymphoma?

A

It is the most common hematopoietic neoplasm - 80-90% of hematopoietic neoplasms

42
Q

What are the ways to classify lymphoma?

A

Histopathology, cytology, and anatomic site

43
Q

How do we histopathologically classify lymphoma?

A

High/intermediate grade or low grade

44
Q

How is lymphoma cytologically classified?

A

Lymphoblastic (large/intermediate cell) or small cell

45
Q

True or False: High/intermediate grade = large/intermediate cell = indolent

A

False - High/intermediate grade = large/intermediate cell = lymphoblastic

46
Q

True or False: Low grade = small cell = indolent

A

True

47
Q

Lymphoblastic lymphoma is typically biologically ______ and rapidly _______. It requires ________, more ________. therapy.

A

aggressive, progressive, aggressive, intense

48
Q

True or False: Indolent lymphoma is typically slowly progressive and may not require any therapy.

A

True

49
Q

What are the anatomical sites of lymphoblastic lymphoma? What is the most common?

A

Generalized nodal (most common- 83%), gastrointestinal, cutaneous, mediastinal, and extranodal

50
Q

What is the most common clinical sign of multicentric lymphoblastic lymphoma?

A

Generalized lymphadenopathy

51
Q

What are the substages of multicentric lymphoblastic lymphoma?

A

A - clinically normal

B - not feeling well

52
Q

What are the clinical signs associated with stage B lymphoblastic lymphoma patients?

A

Inappetence, weight loss, vomiting, diarrhea, dyspnea, fever, and PU/PD

Signs vary by anatomical site

53
Q

How do tumors cause hypercalcemia of malignancy?

A

Ectopic production of parathormone (PTH) or PTH-related peptide (PTH-rp)

This is the most important - there are others

54
Q

What clinical signs are associated with lymphoblastic GI lymphoma?

A

Weight loss and lethargy, vomiting and diarrhea, and blood may be present in vomitus or stool

55
Q

What breeds are overrepresented in GI lymphoblastic lymphoma?

A

Boxer and Shar-Pei

56
Q

What clinical signs are associated with lymphoblastic mediastinal lymphoma?

A

Respiratory signs, precaval syndrome, and PU/PD (due to increased Ca)

57
Q

Of what origin are mediastinal lymphoblastic lymphomas more likely to be?

A

T-cell origin

58
Q

What clinical signs are associated with lymphoblastic epitheliotropic (cutaneous) lymphoma?

A

Single or multiple lesions, flat plaques to nodular disease
+/- systemic involvement
~50% are pruritic

59
Q

Of what phenotype are epitheliotropic lymphoblastic lymphoma?

A

T-cell

60
Q

What diagnostic method is usually adequate for diagnosis of lymphoblastic lymphoma?

A

Cytology

61
Q

How can you diagnose lymphoma via cytology (what to look for since you aren’t a pathologist)?

A

Cells are larger than a neutrophil
Absence of plasma cells
Variability in nucleolar size/number

62
Q

What are other common methods for lymphoblastic lymphoma diagnosis?

A

Fine needle aspirate, punch biopsy or remove node, and pathology

63
Q

What will you see on hematology in patients with lymphoblastic lymphoma?

A

Anemia, thrombocytopenia, leukopenia, and blasts (stage V)

64
Q

What will you see on chemistry panel in patients with lymphoblastic lymphoma?

A

Hypercalcemia and hepatic involvement (ALT)

65
Q

What would be the indication to do a bone marrow aspirate in a lymphoblastic lymphoma patient?

A

Determine if it is a stage V

66
Q

Hypercalcemia is most commonly associated with which form of canine lymphoma?

a. Multicentric
b. Extranodal
c. Mediastinal
d. Cutaneous
e. Alimentary/GI

A

c. mediastinal

Small Animal Medicine (100 decks)

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