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!Small Animal Medicine > The Big 5 > Flashcards

The Big 5 Flashcards

1
Q

What are the big 5 tumors?

A

Osteosarcoma
Lymphoma
Mast cell tumor
Melanoma
Mammary carcinoma

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2
Q

Signalment of Osteosarcoma

A

Older
Males
Large giant breeds

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3
Q

Which breeds are predisposed to osteosarcoma?

A

CDKN2A gene in rotties, Scottish deerhound
Great Dane, St. Bernard, greyhound

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4
Q

Where is osteosarcoma most common?

A

Metaphysis long bones: distal radius

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5
Q

Other places where osteosarcoma is common

A

Mandible better behavior: 70%- 1 yr survival sx alone, 20% met rate
Rib worst behavior (MST sx 3-4 m) + chemo 8 m

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6
Q

How is osteosarcoma dx?

A

FNA cytology and core bx (Combined (94%) and Jamshidi (92%))

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7
Q

Appendicular OSA Metastasis

A

> 90% micrometastases
<10% clinical met @ dx
Remove whole leg with tumor —> met to lungs
Leave primary tumor in place —> delay met

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8
Q

MST OSA with amputation alone

A

4-6 months

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9
Q

MST OSA with amputation + chemo OR limb- salvage + chemo

A

10-12m
Meds: cisplatin, carboplatin, doxorubcin, combo/ alternating

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10
Q

MST OSA with radiation, palliatively

A

4-6m
Pain management in 2-4m
Pathological fracture risk with use (patient uses leg more)

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11
Q

Medical tx for OSA

A

Biphosphanates: pamidronate (improvement in pain control in 4/10 dogs) and zoledronate (more potent)

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12
Q

Samarium

A

Medical tx of OSA
60% PR (mean ST 5m), 17% CR (mean ST 27 m)
Effect: BM suppression

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13
Q

What factors allow for Limb salvage in OSA

A

No Met
Location: distal radius/ ulna
<50% bone affected
Absence of pathologic fracture
<360° involvement soft tissues
15% catastrophic failure

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14
Q

OSA- stereotactic radiosurgery

A

High dose: 1-2d
Risk of fracture (50%)

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15
Q

Anatomic classification for K9 lymphoma

A

Multi-centric (80-85%)
GI: 5-7%
Mediastinal: 5%
Cutaneous: epitheliotropic and non
Atypical anatomical forms: hepatosplenic (aggressive), Intravascular, CNS, renal, ocular

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16
Q

Immunophenotypic Classification

A

B cell LSA: 60-80% K9 LSA
T cell LSA: 10-38%
Mixed B & T cell LSA: 22%
Null cell tumors (neither): <5%

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17
Q

Immunophenotyping

A

CD34: hematopoietic stem cells
CD45: LEUKOCYTES
CD3: T lymphocytes
CD4: T helper
CD8: T cytotoxic
CD21, CD79a/B: B lymphocytes
CD14: monocytes

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18
Q

Tx of choice for K9 lymphoma

A

C (cyclophosphamide)
H (hydroxydaunoribicin)
O (oncovin/ vincristine)
P (Pred)
12m for B cell, 6-8m for T cell

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19
Q

Other tx for lymphoma

A

None: 4-6w
Pred alone: 3-4m
Dox alone: 6-9m

20
Q

Low grade lymphoma tx

A

if needed tx!
+/- Chlorambucil and pred if needed
Wean pred first then q 48-72 hrs Chlorambucil

21
Q

Anatomic classification of feline lymphoma

A

Alimentary/ GI (large cell/ high grade or small cell/low grade)*
Extranodal (nasal*, renal, CNS, laryngeal & tracheal)

22
Q

Large cell alimentary feline lymphoma

A

CHOP, COP protocols
30-60% remission
MST: 1.5-3 m

23
Q

Small cell alimentary feline lymphoma

A

More common
Chlorambucil + prednisolone
70% remission
T cell is better
MST: >2 years

24
Q

Nasal feline lymphoma RT

A

Mass effect in front sinus (local) responds to RT
CR: 75-95%
MST: 1.5-3 years (4m if not CR)

25
Q

Nasal feline lymphoma CT

A

Systemic tumor
Response rate:75%
MST 2 yrs if CR

26
Q

Most common cutaneous tumors in dogs

A

Mast cell
Lipoma
Histiocytoma

27
Q

Most common cutaneous tumors in cats

A

Basal cell tumor
Mast cell tumor
Fibrosarcoma

28
Q

Breeds predisposed to mast cell tumors

A

Boxers, labs, Boston terriers, pugs, beagles, schnauzers

29
Q

C-kit mutations (mast cell)

A

Gain of function mutations in the extracellular domain of KIT, common in K9 MCT
Exon 8 &11(histologic high grade and high mitotic count)
Tandem duplications involving exon 11 and 12

30
Q

CT for mast cell tumors

A

Vinblastine + pred
Lomustine + pred
Pallida

31
Q

Stelfonta

A

Tx for MCT
Wound heals via seconds intention (necrotic tissue falls off)
No mets

32
Q

Prognosis of mast cell tumors

A

1: 100% survival with sx resection
2: median survival 500 days
3: 24% @ 1 yr
2 years for low grade and <4m for high grade

33
Q

What is the significance of splenomegaly in a cat?

A

Can causes V/D, WL → met to the skin

34
Q

What is the MST for a cat that undergoes splenectomy for a cat?

A

1.5 yr survival

35
Q

Oral melanoma

A

Must take bone to achieve complete margins

36
Q

Oral melanoma RT

A

Response rate 80%
MRT: 18 m
MST: 7-12m
Higher stage, shorter remission and survival
Die of mets

37
Q

Oral melanoma immunotherapy (oncept)

A

Transdermally IM and not preventative- xenogeneic DNA vaccine that targets tyrosinase
Dogs with stage 2 or 3 oral melanoma

38
Q

Oral melanoma immunotherapy (oncept) tx repsonse

A

MST not reached stage 1-3 with local control and vx (>3yr)
W/o local control MST 553d

39
Q

Oral melanoma prognosis

A

Sx alone: 6-8m
Radiation alone: 6-12 m
CT alone:6m
Radiation + chemo: 1 y
Sx or radiation + vx: >3y

40
Q

What causes mammary tumors?

A

Hormonally influenced
Spay b4 first heat (incidence 0.5%)
B4 seconds estrus (incidence 8%)
After second (incidence 26%)

41
Q

Dogs with mammary tumors

A

50% benign, malignant and met
Surgical tx- as much as needed
To remove tumor + OHE if intact

42
Q

Cats with mammary tumors

A

10-15% benign, 85-90% malignant
Sx tx bilateral: complete mastectomy + OHE if intact
Prevents recurrence

43
Q

Dog tx with mammary tumors

A

CT or RT offered when mets present, high grade, invasion lymphatics or blood vessels

44
Q

Cat tx with mammary tumors

A

Doxorubicin improved
CT always offered

45
Q

Inflammatory mammary carcinoma DD

A

Mastitis (litter or pseudopregnancy)
No sx

!Small Animal Medicine (32 decks)

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