E2: Sarcoids, Melanoma, Stapling

Question 1

What is the most commo tumor in horses?

Answer 1

Sarcoid

Spontaneous, locallly invasive, fibrobastic skin tumor

Question 2

While metastasis does not occur with equine sarcoids, _______ is extremely common.

Answer 2

Recurrence

Question 3

What is the suspected cause of equine sarcoids?

Answer 3

Bovine Papilloma Virus

Question 4

What are the forms of equine sarcoids?

Answer 4

Fibroblastic (proud flesh-like)

Verrucous (warty)

Combination of both

Occult (Slightly raised)

Question 5

What form of sarcoid is this?

Answer 5

Verrucous

Question 6

The equine sarcoid is a neoplasm that

a. ls locally invasive
b. Can metastasize internally
c. Is well encapsulated and benign
d. Can invade blood vessels and lymphatics
e. occurs most commonly in the summer

Answer 6

a. ls locally invasive

Question 7

Which of the following statements is NOT a distinguishing feature of the histopathology of equine sarcoids?

a. hyperplastic and hyperkeratotic epidermis
b. Fibroblasts and fibrocytes arranges in an organized pattern perpendicular to the surface
c. Irregularly arranged fibroblasts and fibrocytes arranged in a whorl or bundle formation
d. No invasion of the underlying muscle
e. marked rete-peg formation

Answer 7

b. Fibroblasts and fibrocytes arranges in an organized pattern perpendicular to the surface

Question 8

Most authorities believe the equine sarcoids are the result of

a. bacterial infection
b. viral infection
c. chronic infections
d. chronic granulation tissue
e. nonspecific carcinogens

Answer 8

b. viral infection

Question 9

What chemotherapy agent is used for sarcoids?

Answer 9

Cisplatin

+ Sesame oil

Question 10

Which of the following statements about equine sarcoids is NOT true?

a. Histologically, the sarcoid resembles habronemiasis
b. Grossly sarcoids can resemble exuberant granilation tissue, cutaneous habronemiasis, SCC, equine papillomas, and dermatophytosis
c. Occult sarcoids may be confused with neurofibromas
d. Verrucos sarcoids can transform into fibroblastic sarcoids
e. Surgical exicision has been reportedly followed by a 50% recurrence rate.

Answer 10

a. Histologically, the sarcoid resembles habronemiasis

Question 11

Cryosurgery results in tissue destruction by

a. cellular hydration resulting in cell-membrane destruction
b. changing cell-membrane integrity by denaturing lipoprotein complexes, resuting in impermiability
c. Thermal shock after freezing takes place
d. Formaiton of intra- and extra-cellular ice crystals
e. All of the above

Answer 11

e. All of the above

Question 12

Which of the following statements about cryosurgery is FALSE?

a. Maximum lethal effecrs are achieved using a fast-freeze, fast-thaw method
b. Liquid nitrogen is the most popular cryogen and requires the least equipment
c. Therocouple needles are considered invaluable
d. The temperature of the lesion should be taken down to -20 to -30C
e. The surrounding healthy tissue should be protected from freezing

Answer 12

a. Maximum lethal effecrs are achieved using a fast-freeze, fast-thaw method

Fast-freeze, slow-thaw is desired; repeated twice (at least)

Question 13

Which of the following statements is FALSE about post-freezing care?

a. Routine tetanus prophylaxis should be given
b. Tissue undergoing cryonecrosis forms a leathery scar afrer the intial edema and hyperemia
c. The frozen tissue may take up to 8 weeks to slough
d. Healing time varies, but healing is always by first intention
e. The healed lesions usually have some white hairs present.

Answer 13

d. Healing time varies, but healing is always by first intention

Second intention

Question 14

Which treatment regimen has NOT been recommended for sacoid therapy after proper excision?

a. 20% 5-fluorouracil daily q30-90 days
b. Radiation therapy using various programs
c. Podophyllin mixed with a carrier applied at 3- to 4-day intervals
d. Benzoin mixed with a carrier applies at 3- to 4-day intervals for 30-90 days
e. BCG injected regionally

Answer 14

d. Benzoin mixed with a carrier applies at 3- to 4-day intervals for 30-90 days

Question 15

Whihc of the following statements is NOT true about BCG therapy?

a. BCG is an attenuated strain of Mycobacterium bovis
b. BCG has a specific effect on cell-mediated immunity
c. BCG is a recnstituted vaccine
d. The vaccine is a cell-wall product with an oil adjuvant
e. An anti-inflammatory response is expected with BCG therapy, but remission may take several months

Answer 15

b. BCG has a specific effect on cell-mediated immunity

Non-specific effect on CMI

Question 16

T/F: Melanoma is always benign.

Answer 16

False

Question 17

What melanoma treatment is being shown here?

Answer 17

Intratumoral chemotherapy (Cisplatin) and local hyperthermia (microwaves)

Question 18

What horses are predisposed to melanoma?

Answer 18

Gray horses

Question 19

T/F: Standard local treatment options can be used to treat solitary early-stage lesions but do
not address the underlying risk of recurrent tumor formation or the transformation to a malignant
phenotype.

Answer 19

True

Question 20

In order to slide skin for removal of a melanoma, what is the maximum amount of skin that can be undermined?

Answer 20

4cm

Question 21

The graying process. which occurs around 5-8 years of age,
is an autosomal _______trait that is associated with an increased risk of
both melanoma and _____.

Answer 21

Dominant

Vitiligo

Question 22

The most common
external locations for melanocytic tumors include the: (5-6 locations)

Answer 22

Perineal region

The ventral surface of the tail

The prepuce

The commissures of the lips

The head/neck

Question 23

How can skin staplers be resterilized?

Answer 23

Using ethylene oxide gas

Question 24

T/F: The stapler should make a palpable and audible click to signal the staple formation is complete.

Answer 24

True

Question 25

What type of stapler is this?

Answer 25

EEA

(End-End Anastomosis)

Question 26

What type of stapler is this?

Answer 26

GIA/ ILA

(Gastro-Intestinal Anatomosis / Intra-Luminal Anastomosis)

Question 27

How many staple lines are required for a TA (thoracoabdominal) stapler?

Answer 27

2 lines, offset (for proper closure)

Question 28

What does the “90” in the stapler TA-90 indicate?

Answer 28

Staple line is 90mm/9cm long

Question 29

What does a LDS do that a TA does not?

Answer 29

Ligate and divide

Question 30

Which stapler makes a circular staple line? Can it be used in large animals?

Answer 30

EEA

No, too small

Question 31

What is inside the circle? What type of stapler is being used?

Answer 31

The “good-night stitch”

Stay suture

GIA/ILA