Oncology (SA) Flashcards
What is the gold standard method for solid tumour diagnosis?
Histopathology
Which biopsy technique should NOT be used in lymph nodes?
Needle Core
Which biopsy technique can be used for cutaneous/superficial lesions only?
Punch biopsy
Which 3 types of tumour should be examined using an excisional biopsy?
Mammary Tumour
Haemorrhagic splenic mass
Pulmonary tumour
What information does lymphangioprahy give you?
Which nodes a tumour drains to - NOT if mets present!
Which is the most sensitive test for LN mets?
FNA
What is the mot sensitive test for lung mets?
CT
What is the best method to test for mets to parenchymatous organs?
US (+FNA)
Which solid tumours are spread haematogenously?
– Sarcomas
– Malignant melanoma
Which solid tumours are spread via the lymphatic system?
– Mast cell tumours
– Carcinomas
– Malignant melanomas
Which types of cancer can be treated with single-agent therapy?
exquisitely sensitive tumours (Transmissible venereal tumour)
Platinum compounds in osteosarcoma
Doxorubicin in high grade STS
Below what Neutrophil count should chemo NOT be administered?
<3x109/l dog
<2.5x109/l cat
Which chemo drug may cause sterile haemorrhagic cystitis?
Cyclophosphamide
Which chemodrug is hepatotoxic?
Lomustine
Which chemo drug(s) is/are nephro toxic?
cisplatin, doxorubicin (cats), lomustine (dogs)
Which chemo drug causes peripheral neurotoxicity?
vincristine
Which chemo drug(s) cause(s) cumulative cardiotoxicity & DCM?
doxorubicin (&epirubicin)
Which chemo drug causes Fatal non-cadiogenic pulmonary oedema?
cisplatin - CATS
Which type of chemo protocol involves low dose cyclophosphamide with piroxicam?
Metronomic
Which 2 TKIs can be used in canine MCTs?
Toceranib
Mastinib
How are MCTs diagnosed?
FNA
How are MCTs graded?
Histopath
How are MCTs staged?
FNA local LN
US and Rx
What Should your surgical margins be for MCT removal?
3cm margins & 1 fascial plane
How is RT used in conjunction with surgery for MCTs?
target local nodes
for incompletely excised masses
Which chemo agents are often used alongside surgery in MCTs?
Vinblastine/preds
Lomustine
TKIs
How are feline MCTs best treated?
Sugrery - better Px than canine
Which tumour is the most common Ddx for splenic Dz in the cat?
SPlenic MCT - Sx best Tx
Are TCCs bening or malignant?
Highly metastatic to local LNs and liver/spleen/bones
How are TCCs treated?
NSAIDs alone - MST 181 days
Mitoxantrone and NSAIDs - MST 291 days
Which subtype of lymphoma may cause an altered position of PMI for cardiac auscultation and displacement of apex beat?
Craniomediastinal
Which subtype of lymphoma may cause weight loss, anorexia, pan-hypoproteinaemia (hypoalbuminemia),
evidence of malabsorption?
GI
Epitheliotrophic lymphoma is caused by which type of immune cell?
T cell
Non-Epitheliotrophic lymphoma is caused by which type of immune cell?
B cells
What are the 2 most common forms of extranodal lymphoma?
Hepatosplenic
CNS (w/eyes)
What are the 5 paraneoplastic syndromes associated with lymphoma
Hypercalcaemia Cachexia Monoclonal Gammopathy IM Dz Neuropathies
How do you assess lymphoma Clonality and phenotype?
PARR
How do you assess cell size, phenotype and expression of aberrant markers in lymphoma?
Flow Cytometry
What is the gold STD Tx for lymphoma?
multi drug chemotherapy
Which MD chemo protocol has the highest MST and response rate in canine lymphoma?
CHOP (12m MST, 90-95% RR)
Which lymphoma chemo protocol is easy to administer to dogs in general practice?
High dose COP (6m MST, 60-80% RR)
Which drugs can be used to target CNS lymphoma?
Cytarabine
Lomustine (CCNU)
Steroids
L-asparaginase
Which 2 chemo protocols can be used to improve QoL for Epitheliotrophic lymphoma patients?
COP or CCNU + Prednisolone.
+retinoids for symptoms
What are the 2 lymphoma rescue protocols?
DMAC (Dexamethasone, Melphalan, Actinomycin-D, Citarabine)
CCNU + L-asparginase + Preds
what can be done for patients with cancer cachexia?
low CHO high fat diet
Omega 3 supplement to reduce inflammation
What is the sequence of harm changes in a case of acute blood loss?
TP drops
then PCV drops
Which testicular tumour can cause BM hypoplasia in male dogs and how? Tx?
Sertoli Cell Tumour - hyperoestrogenism causes neutrophilia and prog to BM hypoplasia
tx: castration
What should be ruled out before treating ImHA/IMTP?
Lymphoproliferative disorders
What does schistocytosis indicate?
microangiopathic anaemia
how is a case of severe acute hypocalcaemia treated?
NaCl for rehydration (3-4x maintenance)
+Furosemide (inc Na loss)
Bisphosphonates (slow Ca bone release)
What are the 2 main signs of superficial necrolytic dermatitis?
footpad hyperkeratosis
Crusting dermatitis
What are the signs of paraneoplastic pemphigus?
ulceration of the mucosa and mucocutaneous jct - often symmetrical
Which forms of feline lymphoma are easy to diagnose from FNA?
Cranial Mediastinal
Extranodal
How are most forms of feline lymphoma diagnosed?
Biopsy - wedge. (trucut only for renal).
can also use PARR to identify monoclonal gammopathy.
Which chemo protocol offers the best chance for cats with lymphoma?
High dose COP
Apart from the COP/CHOP protocol, what other Tx can be given to ALL patients?
Blood transfusion
Antibiotics
cytarabine infusion
How is chronic lymphoid leukaemia treated?
Preds/Chlorambucil
1-3y MST
How is leukaemia diagnosed?
Haem + MDWBCC and smear evaluation
Which type of cancer causes hyperviscosity syndrome and subsequent CHF/neuro symptoms?
Multiple Myeloma (due to hyperproteinaemia)
Which 3 samples shoulf be analysed for cytology of MM?
Liver
Spleen
BM
Dogs must fill 2 of the following criteria to be considered MM+…
- Monoclonal gammopathy
- Rx evidence of osteolysis
- > 5% neoplasia plasma cells/>10-20% plasmacytosis in BM
- Bence-Jones Proteinuria
Which 2 drugs are used to treat MM?
Prednisolone
Melphalan
Which tumours often recieve neoadjunctive RT?
OSA
STS
Which 3 types of sarcoma have a high metastatic risk?
OSA
HSC
Histiocytic Sarcoma (not at joint)
How is OSA diagnosed?
Rx changes - lysis, swelling, palisades
+cytology/histology
What is the problem with limb sparing surgery compared with amputation of a limb with OSA?
Patient will NEVER be pain free if limb salvaged
Which drugs are best for OSA Tx?
Carboplatin/anthracyclines
+Toceranib for mets
How is STS diagnosed?
Biopsy
If STS surgery was unsusccesful - what are your other 4 options? Please list in order of suitability.
- Further, wider excision
- adjuvant RT
- Metronomic chemo (cyclo+NSAID)
- active monitoring
Whats the 321 rule of FISS?
Persists >3m after injection
>2cm
Inc in size >1m after injection
What is the best Tx protocol for FISS?
Surgical resection
RT
Chemo (doxorubicin)
What is the best Tx protocol for histiocytic sarcoma?
Surgery + RT + lomustine/anthracycline chemo
What is the best Tx protocol for HSA?
Surgical excision
Anthracycline based chemo
Which other structures should be checked in ALL cases of oral cancer?
Local LNs
What is the preferred Tx method for oral cancer?
Surgical resection (2cm margin)
Which Tx gives the best results for oral FSA?
Surgery + RT
How is oral melanoma diagnosed?
Melanin-containing mesenchymal cells
can also perform IHC
When would prophylactic ABs be indicated as an adjunct to tumour surgery?
Debilitated patient
Clean-Contaminated or dirtier surgery
Surgery >90min
When is LN removal indicated after 1e tumour removal?
Contains tumour cells on histology
Grossly abnormal at surgery
Closely associated w/margins
