Bryan - Sa Med - Oncology - Fall 3Rd Year

Front 1

Choose hyperplasia or neoplasia...
...physiologically reversible condition.

Back 1

hyperplasia

Front 2

Choose hyperplasia or neoplasia...
...replication exceeds physiological need.

Back 2

neoplasia

Front 3

What is the fancy name for big synthetic chemicals?

Back 3

xenobiotics

Front 4

T or F:
Cancer is the leading cause of death in dogs and cats in the US.

Back 4

True!

Front 5

Living in urban areas is linked to _________ cancer in dogs.

Back 5

tonsillar

Front 6

Pesticide use is linked to ______________ cancer in dogs.

Back 6

bladder

Front 7

The point after which a cell must divide is the_____ point. Which phase occurs after this point?

Back 7

R point; followed by S phase

Front 8

Which proteins serve as check points for each phase in the cell cycle?

Back 8

CDKs (cyclin dependent kinases)

Front 9

What are the 3 steps required for carcinogenesis?

Back 9

Initiation
Promotion
Progression

Front 10

T or F:
An initiated cell is not a cancer cell.

Back 10

True!

Front 11

T or F:
Tumors cannot develop if the promotor is applied before the initiator.

Back 11

True

Front 12

What are the 6 characteristics of cancer cells?

Back 12

Sustaining proliferative signalling
Resistance to cell death
Inducing angiogenesis
Enabling replicative immortality
Activating invasion and metastasis
Evading growth suppressors

Front 13

What are the 4 modes of signalling that cancer cells may use?

Back 13

Endocrine, paracrine, autocrine, juxtacrine

Front 14

Choose apoptosis or necrosis...
...loss of membrane integrity.

Back 14

Necrosis

Front 15

Choose apoptosis or necrosis...
...condensation of nucleus.

Back 15

Apoptosis

Front 16

Choose apoptosis or necrosis...
...swelling of cytoplasm.

Back 16

Necrosis

Front 17

Choose apoptosis or necrosis...
...fragmentation of cell into smaller bodies.

Back 17

Apoptosis

Front 18

Choose apoptosis or necrosis...
...ATP-independent.

Back 18

Necrosis

Front 19

Choose apoptosis or necrosis...
...involves at least 2 independent pathways.

Back 19

Apoptosis

Front 20

What are some examples of normal angiogenesis?

Back 20

Estrus/menstrual cycles
Inflammation
Wound healing

Front 21

What are three characteristics of blood vessels induced by cancerous angiogenesis?

Back 21

Less organized
May lack one or several layers
Tortuous, dilated, and irregular
Intermittent blood pressure; may be slow or stagnant

Front 22

What aspect of cancerous angiogenesis may disrupt chemotherapy?

Back 22

Slow to stagnant or intermittent blood flow

Front 23

What cancer therapy directly impacts cancerous angiogenesis?

Back 23

Metronomic therapy

Front 24

What are the benefits of metronomic therapy?

Back 24

Normalize newly formed vessels (reduces hypoxia and improves drug delivery)
Works on tumors resistant to chemo
Reduce growth factor production
Lower toxicity

Front 25

What enzyme in cancer cells is responsible for replicative immortality?

Back 25

Telomerase

Front 26

What are the two theories of metastatic disease?

Back 26

1) Seed and soil (cells "prefer" a certain organ)
2) Cells get lodged in capillary beds

Front 27

Suppression of which two genes helps cancer cells to evade growth suppressors?

Back 27

Rb
P53

Front 28

What is the most common splenic tumor in the dog?

Back 28

HSA

Front 29

What is the signalment for cutaneous HSA?

Back 29

lightly pigmented breeds (beagles, white bulldogs, whippets...)

Front 30

What are the most common sites of PRIMARY HSA?

Back 30

Spleen > Liver > Right Atrium > Skin

Front 31

What are the two forms of hemangiosarcoma?

Back 31

Visceral
Cutaneous

Front 32

What are the common sites of HSA metastasis and what are the percentages?

Back 32

Lungs (65%)
Spleen & Kidneys (55%)
Liver (50%)

Front 33

Approximately ______% of patients with a splenic mass will have a right atrial mass.

Back 33

25%

Front 34

What is a common acute presentation of HSA and why?

Back 34

Dead or in baaaaaad shape;
due to splenic rupture, hemoabdomen, and cardiac tamponade

Front 35

What are three major signs of hypovolemic shock?

Back 35

Pale mucous membrane
Prolonged capillary refill
Dyspnea

Front 36

T or F:
2/3 of splenic masses are hemangiosarcoma in dogs.

Back 36

False!
It's technially 4/9! 2/3 of splenic masses are malignant and 2/3 of those are HSA.

Front 37

Which of the following laboratory findings are congruent with visceral hemangiosarcoma?
a) Anemia
b) Eosinophilia
c) Thrombocytopenia
d) Neutrophilia
e) Increased nRBC

Back 37

a) Anemia
c) Thrombocytopenia
d) Neutrophilia
e) Increased nRBC

Front 38

What are indications for biopsying a suspected splenic HSA?

Back 38

NOOOOOOOOOOOOO! Don't biopsy a HSA!!!

Front 39

What should be checked before performing a splenectomy in a HSA case?

Back 39

Check the right atrium for involvement!

Front 40

Predict the relative values of the following in a DIC case?
BMBT, FDP, Thrombocytes, PT, PTT

Back 40

BMBT, FDP, PT, PT (all increased)
Thrombocytes (decreased)

Front 41

What should be looked-for 24 hours post splenectomy?

Back 41

VPCs

Front 42

T or F:
30-50% of canine HSA is in the right atrium.

Back 42

True!
Don't get confused with the stat that 25% of splenic HSA has R atrial involvement

Front 43

What might be found in a cardiocentesis of a pericardial effusion in a dog with cardiac HSA?

Back 43

Troponin I (higher in HSA dogs than idiopathic effusion)
Malignant cells rarely seen

Front 44

What are the signs of cardiac tamponade?

Back 44

Restricted ventricular filling
Venous congestion and ascites
Muffled heart sounds
Arrthymias

Front 45

How is cardiac HSA treated?

Back 45

Pericardiocentesis + Doxorubicin
(maybe right atrial appendage resection)

Front 46

T or F:
If you see two cutaneous hemangiosarcoma lesions, it may represent metastatic disease.

Back 46

True!

Front 47

Describe the level of infiltration for stage 1 cutaneous HSA. What is the treatment?

Back 47

Stage 1 - skin only
WIDE surgical excision

Front 48

Describe the level of infiltration for stages 2 and 3 cutaneous HSA? How are these treated?

Back 48

Stage 2 (hypodermal)
Stage 3 (muscle)
Sx excision + doxorubicin

Front 49

What are the four classifications of cancers involving histiocytes?

Back 49

Cutaneous histiocytosis
Cutaneous histiocytoma
Systemic histiocytosis
Histiocytic sarcoma

Front 50

Which of the four classes of histiocytic cancer is characterized by...
...spontaneous regression.

Back 50

Cutaneous histiocytoma and histiocytosis

Front 51

Which of the four classes of histiocytic cancer is characterized by...
...lymphadenopathies.

Back 51

Systemic histiocytosis
Histiocytic sarcoma

Front 52

Which of the four classes of histiocytic cancer is characterized by...
...good response to immunosuppression.

Back 52

Cutaneous histiocytosis

Front 53

Which of the four classes of histiocytic cancer is characterized by...
...systemic involvement.

Back 53

Systemic histiocytosis
Histiocytic sarcoma

Front 54

Which of the four classes of histiocytic cancer is characterized by...
...overrepresentation of Bernese Mountain Dogs.

Back 54

Systemic histiocytosis
Histiocytic sarcoma

Front 55

Which of the four classes of histiocytic cancer is characterized by...
...most cases <2 years.

Back 55

Cutaneous histiocytoma

Front 56

What IHC tests can be diagnostic for histiocytic sarcoma?

Back 56

CD1, CD11, CD18

Front 57

Which of the four classes of histiocytic cancer is characterized by...
...rapid fatality.

Back 57

Histiocytic sarcoma

Front 58

Which of the classes of histiocytic cancer is characterized by...
...erythrophagocytosis.

Back 58

Splenic histiocytic sarcoma

Front 59

What are the types of soft tissue sarcomas?

Back 59

Liposarcoma
Rhabdomyosarcoma
Fibrosarcoma
Histiocytic sarcoma
Myxosarcoma
Peripheral nerve sheath tumor
Undifferentiated sarcoma

Front 60

T or F:
Most soft tissue sarcomas are encapsulated and locally invasive.

Back 60

False!
While they are locally invasive, they are PSEUDOENCAPSULATED

Front 61

Which dogs are predisposed to soft tissue sarcomas (large or small)?

Back 61

Large

Front 62

Hypoglycemia is a paraneoplastic syndrome involved with which soft tissue sarcomas?

Back 62

Leiomyoma
Leiomyosarcoma

Front 63

What does an FNA tell you about a soft tissue sarcoma?

Back 63

Not diagnostic; helps to rule-out lipoma or abscess.

Front 64

What are the rules for surgical excision of a soft tissue sarcoma?

Back 64

3 cm margins and 1-2 fascial planes deep!
Maybe 5cm margins in vaccine associated sarcomas!

Front 65

Which chemotherapeutic is most effective in post-op treatment of soft tissue sarcomas?

Back 65

None! Chemo doesn't increase survival! Use radiotherapy if you don't think you got it all.

Front 66

Which soft tissue sarcoma is the least responsive to radiotherapy?

Back 66

fibrosarcoma

Front 67

What is a common signalment and location for low/high soft tissue sarcomas?

Back 67

In the maxilla of goldens. (low grade benign tumors but highly aggressive biological behavior)

Front 68

What is a common signalment for osteosarcoma?

Back 68

Older (7yo), large to giant-breed, intact dogs OR young, female, spayed rottie

Front 69

Where are the 4 major places to find OSA on the appendicular skeleton? Which is most/least common?

Back 69

Distal radius (1st), proximal humerus (4th)
Proximal tibia, distal femur (Tied for 2nd)
"from the elbow, towards the knee" - for some reason this always makes me think of the "Get Low" Li'l Jon song...

Front 70

T or F:
OSA is found 4x more often in the front limbs than in the rear.

Back 70

False!
I'm gettin y'all Dr. Schlipf style! It's actually only 2x more prevalent in the front!

Front 71

Where is OSA most commonly found?
a) Epiphysis
b) Metaphysis
c) Diaphysis

Back 71

b) Metaphysis

Front 72

If OSA isn't in the limbs, where is it?

Back 72

the mouth! (27% mandible, 22% maxilla) or the spine (15%)

Front 73

If you see OSA in the diaphysis of the femur, what is the likely etiology?

Back 73

Fracture-associated

Front 74

Which of the following clinical signs can be associated with OSA?
a) chronic lameness
b) acute lameness
c) localized swelling
d) facial deformity with lack of pain

Back 74

a) chronic lameness
b) acute lameness (pathological fracture)
c) localized swelling
note - facial deformity is associated but its painful

Front 75

With appendicular OSA, how often will mets in the thorax be seen?
a) 10-15%
b) 25-40%
c) 75%
d) 95%

Back 75

a) 10-15%
(only 10-15% have detectable metastasis; almost ALL have micrometastasis and 75-95% will eventually develop mets to the lungs within 1 yr)

Front 76

What is the most accurate technique for OSA biopsy?
a) FNA
b) Bone aspirate
c) Jamshidi
d) Michele trephine

Back 76

d) Michele trephine

Front 77

What is the gold standard treatment for appendicular OSA?

Back 77

Amputation

Front 78

What is probably the BEST treatment regimen for appendicular OSA? What is the MST in this case?

Back 78

Amputation + Chemotherapy (Carboplatin)
MST = 321 d

Front 79

Which radiotherapeutic technique can minimize soft tissue damage when treating OSA?

Back 79

Stereotactic radiation

Front 80

Which non-chemo pharmaceutical can have some positive effect on OSA?

Back 80

Bisphosphonates

Front 81

What are good prognostic indicators for OSA survival?

Back 81

Low initial total ALP
Increased tumor necrosis

Front 82

What value is highly predictive of the eventual development of pulmonary metastases in OSA?

Back 82

intra-tumoral ALP