Pathology 5 - Systemic Affects

Front 1

(1) why are systemic effects important in diagnosis? (2) what predicts the systemic effects?

Back 1

may be noted before tumor is recognized

Hint 1

som predicted by tumo but others are difficult to associate with a particular tumor

Front 2

(1) what are the types of effects a tumor can have?

Back 2

direct effects or paraneoplastic syndromes

Front 3

(1) what effect does location have on tumor? (2) what are the local effects of tumors?

Back 3

brain = compresses neural contents, pedunculated lipomas in horses = intestinal strangulation, ciliary body tumors of eye = blindness, endocrine organs = loss of function (pancreatic islet cell adenoma). Locations in brain, GI, urinaty tract may be melena hematuria

Hint 3

location dependent, hemorrhage (hemangiomas or hemangiosarcomas may rupture), ulceration (2' infection with systemic consequences, rupture of GI or urinary tract)

Front 4

(1) what are paraneoplastic effects? (2) name paraneoplastic effects?

Back 4

whole body physiologic effects that are byproducts of tumor products

Hint 4

cachexia and FUO

Front 5

(1) what is cachexia? (2) what is the effect of cachexia?

Back 5

weight loss (not starvation), loss of muscle tone and fat, weakness, anorexia, diminished immune function

Hint 5

cause of death in 1/3 of cases vs direct tumor effects

Front 6

(1) what are the general causes of cachexia? (2) what are the mechanisms of cachexia?

Back 6

not proportional to size or type of tumor, include disturbances of metabolism of protein, carbohydrates and lipids (insulin resistance, increased lactate levels, protein loss from gluconeogenesis)

Hint 6

TNF-alpha (from MP), IFN-gamma, IL-1 or IL-6 (fever)

Front 7

(1) what does FUO stand for? (2) what are the causes of FUO in neoplasia?

Back 7

fever of unknown origin (common in animals with neoplasia)

Hint 7

related to release of IL-1 or IL-6

Front 8

(1) what is an example of a tumor that features excessive release of cell contents? (2) what syndrome symptoms would this result in?

Back 8

mast cell tumor (histamine and heparin)

Hint 8

bleeding and gastric ulceration

Front 9

what is the apperance on histology of mast cell tumors?

Back 9

fried egg nucleus, toluidine blue > see granules

Front 10

(1) what are endocrinopathies? (2) which neoplasms are most functional?

Back 10

overproduction of hormones by endocrine neoplasms > illness/fatal

Hint 10

benign

Front 11

(1) what occurs with a neoplasm of the B-cells of the pancreatic islets? (2) what occurs with a neoplasm of the pituitary gland?

Back 11

endocrinopathology of fatal hypoglycermia precede by episodes of seizures due to hypoglycemia

Hint 11

endocrinopathology of overproduction of ACTH which over stimulates the adrenals (Chushing's disease)

Front 12

(1) what occurs with an adenoma of the adrenal cortex? (2) what occurs with a neoplasm of the thyroid glands (TSH)/parathyroid glands (PTH)/ thyroid C-cells (calcitonin)?

Back 12

endocrinopathology of overproduction of cortisol due to adrenocortical excess

Hint 12

endocrinopathology of excess hormones yielding syndromes of hyperthyroidism, hypercalcemia, hypocalcemia, (respectively)

Front 13

what causes hyperthyroidism in older cats?

Back 13

most often thyroid hyperplasia, possibly resulting from thyroid neoplasia

Front 14

(1) what is polycythemia? (2) what tumors may cause polycythemia?

Back 14

excessive erythropoietin synthesis by renal neoplasms or erythropoietin release secondary to hypoxia

Hint 14

tumors in the kidney, tumors causing pulmonary damage, tumors causing bone marrow damage

Front 15

(1) what are the symptoms of feminization? (2) what causes it?

Back 15

pigmentation of skin, symmetrical hair loss, attractiveness to male dogs, squamous metaplasia of prostate

Hint 15

neoplastic sertoli cells (sustentacula cells of the seminiferous tubules) secrete estrogen (or similarly acting substances)

Front 16

(1) what tumors can cause hypoglycemia? (2) what are the possible mechanisms?

Back 16

hepatocellular carcinoma, hemangiosarcoma, leiomyosarcoma

Hint 16

insulin secretion, increased use of glucose, other metabolic effects

Front 17

(1) name some skeletal syndromes? (2) what is hypertrophic osteopathy?

Back 17

hypertrophic osteopathy, hypercalcemia

Hint 17

proliferation of periosteal bone and fibrous tissue at the distal extremities; most pronounced at digits and metatarsal or metacarpal bones due to increased blood flow mediated by hormonal or neural influences

Front 18

(1) how is hypertrophic osteopathy resolved? (2) how is hypertrophic osteopathy triggered?

Back 18

cut the vagal nerve

Hint 18

neoplasms in thoracic cavity (lung, esophageal, pericardial, mets to lungs) or the bladder (rhabdomyosarcoma)

Front 19

(1) what is another term for hypercalcemia? (2) what is it?

Back 19

humoral hypercalcemia of malignancy (HHM)

Hint 19

increased serum calcium and hypophosphatemia

Front 20

(1) what causes hypercalcemia? (2) what are the mechanisms of hypercalcemia?

Back 20

lymphosarcoma (canine, up to 25%), apocring gland carcionmal of the ana sac (canine, middle aged female), occasionally other carcinomas (nasal, pulmonary, mammary, squamous cell carcinoma)

Hint 20

must distinguish hormonal causes from neoplasms causing bone destruction. Circulationg parathyroid hormone-related protein (PTHrP) is the primary humoral factor in dogs with spontaneous HHM due to neoplasias. It shares N-terminal homoloy with PTH, binds to, activates PTHrP/PTHrP PTH receptors in bone and kidney > osteoclastic bone resorption & renal reabsorption of calcium (other cytokines can play a role)

Front 21

(1) name vascular and hematologic syndromes? (2) what is hyperviscosity caused by?

Back 21

hyperviscosity, thrombosis, neurologic syndromes

Hint 21

neoplasms of B-cells lineage (plamsa cells) overproduce immunoglobulin that leads to an increase of blood viscosity (thickness) which leads to renal damamge and latered blood clotting and can result in polycythemia rubra (too many red bolld cells in circulation) some renal carcionmas overproduce erythropoietin

Front 22

(1) what is thrombosis? (2) what neurologic syndromes occur?

Back 22

tumor cells shed fibronectin > circulation > stimulate thrombosis. Areas of necrosis release tissue factors that stimulate thrombosis

Hint 22

myasthenia gravis; muscle weakness due to autoimmunity to acetylcholine recptors at the neuromuscular synapse associated with thymomas and neuropathy; abnormal nerve function/muscle innervation

Front 23

(1) what cutaneous syndromes may occur due to neoplasia? (2) what are the hematologic disorders due to neoplasia?

Back 23

alopecia, rash, immune mediates skin conditions

Hint 23

leucocytosis, leucopenia, thrombocytosis, anemia, eosinophilia, coagulopathies