Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Small Animal Medicine II > Paraneoplastic Syndromes > Flashcards

Paraneoplastic Syndromes Flashcards

1
Q

What are Paraneoplastic Syndromes?

A 
Systemic effects of cancer
May involve hormones/other factors
Usually unrelated to the tissue of origin 
May be more detrimental than the tumor
May be the first symptom
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Cancer Cachexia?

A

Profound state of malnutrition and weight loss despite adequate nutrition

A paraneoplastic syndrome

More common in cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical Significance of Cancer Cachexia

A

Decreased QOL
Decreased response to treatment
Decreased survival time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cancer Cachexia Mechanism

A

Cancer stealing all energy!
Glucose is preferred substrate for cancer cells
Tumor cells incomplete glucose metabolism; molecules of ATP
Lactate is produced as an end product
Energy expended converting lactate back to glucose
Gluconeogenesis increases; net energy loss by host –> protein degradation (muscle wasting, decreased immune function, decreased wound healing)
Lipolysis occurs to provide energy for host

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cancer Cachexia

Treatment

A

Provide 30-50% of non-protein calories as fat vs. CHO

Provide adequate calories (1.5 to 3 times that of normal animals)

Cannot decrease intake because cancer will cause hypoglycemia

Best to stick to regular diet and give them more of the food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Hills N/d

A

Cancer diet

Actually caused diarrhea in dogs; malabsorption

Not shown to improve outcome or maintain weight

Only tested on dogs with lymphoma (stage III)

Not shown to starve cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a common labwork abnormality in both dogs and cats with cancer?

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ectopic hormone production
Hypercalcemia
Tumor types

A

Lymphosarcoma
Anal sac Apocrine gland adenocarcinoma

Multiple myeloma
Thymoma
Parathyroid gland adenomas
Mammary carcinomas
SCC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ectopic hormone production
Hypercalcemia
Mechanisms

A

Ectopic tumor produced parathomone like peptides (PTHrp)

True hyperparathyroidism (PTH)

Vitamin D like factors

Tumor production of osteoclast activating factor

Direct bone lysis (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ectopic hormone production
Hypercalcemia
Clinical Signs

A

Anorexia
Vomiting
PU/PD
Muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ectopic hormone production
Hypercalcemia
Diagnosis

A

Can be difficult if concurrent disease (renal)
Careful search for potential neoplasia
Assays for PTH, PTHrp
Avoid symptomatic therapy that may interfere with diagnosis (glucocorticoids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Primary hyperparathyroidism
Serum Calcium
Serum Phos

A

Ca: slightly high
Ph: low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Vitamin D Toxicosis
Serum Calcium
Serum Phos

A

Ca: High to very high
Ph: High

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Malignant humoral hypercalcemia
Serum Calcium
Serum Phos

A

Ca: High to very high
Ph: Normal or low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bone lysis
Serum Calcium
Serum Phos

A

Ca: High
Ph: Normal or high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ectopic hormone production
Hypercalcemia
Treatment Goals

A

Increase renal excretion of calcium (diuresis)
Inhibit bone reabsorption
Prevent calcium deposition in tissue
Promote external loss of Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ectopic hormone production
Hypercalcemia
Treatment

A

Treat underlying disease!

Saline diuresis
Furosemide (inhibits reabsorption at loop of Henle)
Glucocorticoids

Bisphosphonates

18
Q

Bisphosphonates
Example
What they do

A

Pyrophosphate analogues (Pamidronate)

Keeps Ca in the bone
Helps patient when hypercalcemia is making them clinically ill

19
Q

Ectopic hormone production
Hypoglycemia
Causes

A 
Insulinoma
Hepatic tumors (not making glucose)
Leiomyoma/Leiomyosarcoma
Oral melenoma
Lymphosarcoma
20
Q

Hypoglycemia

Clinical Signs

A

Weakness
Tremors
Seizures

21
Q

Ectopic hormone production
Hypoglycemia
Treatment

A

Feed frequently; high protein better than high CHO but avoid giving too much sugar (hepatic overload)

Glucose IV or orally (careful with insulinoma)

Glucocorticoids; increase hepatic gluconeogenesis (okay to do this prior to diagnosis)

Eventually need to address tumor; stabilize first

22
Q

Ectopic hormone production

Treatment of Insulinoma

A

Causes hypoglycemia

Remove the underlying problem/tumor (prognosis; 14 months)

Streptozotocin; antineoplastic agent with affinity for pancreatic islet cells (nephrotoxic, must administer with fluids); could induce diabetes mellitus

+/-Tocernib (Palladia)

23
Q

Ectopic Hormone Production
Erythropoietin
Tumor examples

A

Causes polycythemia

Renal cell tumors
Lymphosarcoma
Hepatic tumors
Nasal fibrosarcoma

24
Q

Ectopic Hormone Production
Erythropoietin
Clinical Signs

A

Polycythemia

Neurologic; motor or sensory depression, dullness, lethargy, seizures

Hemorrhage (epitaxis, hyphema)

25
Q

Ectopic Hormone Production
Erythropoietin
Treatment

A

Polycythemia

Phelbotomy (bleed them)
Remove or treat primary tumor
Hydroxyurea (suppresses bone marrow; decreases RBC production)

26
Q

Hypertrophic Osteopathy

What is it?

A

Pain, reluctance to move, “swollen legs or swollen joints” – very painful

Periosteal proliferation of new bone along the shafts of long bones

27
Q

Hypertrophic Osteopathy

Radiographic findings

A

Thickening of long bones; proliferative bone

Associated with large thoracic or abdominal cavity mass (unknown mechanism)

28
Q

Hypertrophic Osteopathy

Treatment

A

Treat or remove primary tumor

Corticosteroids

NSAIDs; has been proven to help

Bisphosphonates

29
Q

Fever and Neoplasia

A

Cancer is always a DfDx for fever of unknown origin

Possible cytokine release by tumor or macrophages responding to tumor (IL-1, IL-2, IL-6, TNF-alpha)

30
Q

Cancer Hematologic Abnormalities (broad)

A

Failure of production
Loss
Sequestration (tumor or spleen)
Destruction

31
Q

Cancer Hematologic Abnormalities

Anemia

A 
Chronic inflammation
Blood loss
Microangiopathic hemolytic anemia (HSA0
IMHA
Chemotherapeutic drugs
Bone marrow infiltration with tumor
Hyperestrogenism (sertoli cell tumor)
32
Q

Cancer Hematologic Abnormalities

WBC

A

Leukocytosis
Common
Granulopoietic factors
Inflammation

Chronic inflammation

Note: rebound after chemotherapy leukopenia or anemia

33
Q

Cancer Hematologic Abnormalities

Platelets

A

Thrombocytopenia
35% of dogs with tumors
Mechanism: decreased production, sequestration, increased consumption, increased destruction

Thrombocytosis
Chronic inflammation

34
Q

Cancer Hematologic Abnormalities

Globulins

A

Hypergammaglobulinemia:
PU/PD, neurologic signs, bleeding, more signs secondary to tumor

Monoclonal gammopathy
Single clone of Ig-producing cells

35
Q

Cancer Hematologic Abnormalities
Globulins
Tumor types

A

Plasma cell tumors (sky high globulins)
Lymphoma
Leukemia

36
Q

Cancer: Neurologic Syndromes (3)

A

Myasthenia gravis

Peripheral neuropathies

Chemo related neurologic toxicity

37
Q

What causes Myasthenia gravis (cancer wise)

A

Thymoma

Anti-Ach receptor antibody

38
Q

Drug that should be avoided in cats

A

5 Flurouracil

Seizures and death

39
Q

Cancer Dermatologic Syndromes (3 main)

A

Cutaneous flushing

Nodular dermatofibrosis in German Shepherds

Alopeica

40
Q

Cancer Dermatologic Syndromes

What causes cutaneous flushing

A

Pheochromocytoma

Mast cell tumors (degranulation)

41
Q

Cancer Dermatologic Syndromes

Nodular dermatofibrosis

A

Rare

German Shepherds! Autosomal dominant inheritance

Lumps and bumps everywhere

Linked to renal cysts or cystadenocarcinomas

42
Q

Cancer Dermatologic Syndromes

What causes alopecia

A

Pancreatic carcinomas in cats – pathopneumonic

Small Animal Medicine II (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions