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VetMed Year 3-Term 2 > b) w/c 13-Jan-14 Tumour/Repro > Flashcards

b) w/c 13-Jan-14 Tumour/Repro Flashcards

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1
Q

Definition of Neoplasia (3 things)

A
  1. Uncontrolled proliferation of cells
  2. Proliferation continues in absence of the inciting cause
  3. Neoplastic cells original from a single cell that has undegone mutation
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2
Q

Gross Characteristics of benign tumours

A

Growth by expansion, low/moderate growth rate, well demarcated from surrounding tissue, smooth, surrounding connective tissue, homogenous cut surface (cystic in glandular)

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3
Q

Microscopic characteristics of benign tumours

A

Often similar to tissue of origin, well organised, surrounding connective tissue capsule, generally no haemorrhage or necrosis

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4
Q

How do malignant tumours grow?

A

Growth by invasion of adjacent tissue.

Usually not encapsulated, usually not mobile on palpation.

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5
Q

Difference between haemangioma and haemangiosarcoma?

A

Haemangioma: Benign tumour of endothelial origin
Haemangiosarcoma: Malignant tumour of endothelial origin

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6
Q

What are benign tumours of epithelial origin known as?

A

Surface epithelia: Skin- Papilloma
Glandular epithelia: Adenoma
e.g. skin epithial benign: Squamous papilloma

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7
Q

What are malignant tumours of epithelial origin known as?

A

Malignant tumour of epithelial origin: Carcinoma
Malignant tumour of glandular epithelia: Adenocarcinoma
e.g. mammary adenocarcinoma

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8
Q

What are skeletal muscle tumours known as? (Benign and Malignant)

A

Both mesenchymal origin
Benign: Rhabdomyoma
Malignant: Rhabdomyosarcoma

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9
Q

What is a Chondrosarcoma?

A

A mesenchymal malignant tumour of the cartilage (c.f. with chondroma which is BENIGN)

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10
Q

What is the origin of Lymphomas?

A

Round cell tumours of lymphoid system. Normally malignant therefore should be LYMPHOSARCOMA

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11
Q

What is the ‘proper’ name for Sarcoids?

A

Low grade fibrosarcomas commonly seen in skin of horses. Caused by bovine papillomavirus infection.

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12
Q

4 types of metastasis

A
  1. Lymphatic
  2. Vascular
  3. Trans-cavity
  4. Local
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13
Q

Lymphatic metastasis is typical of _____

A

Carcinoma. Therefore check drainage lymph nodes

epithelial origin

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14
Q

Vascular metasistasis is typical of _______

A

Sarcoma

mesenchymal origin

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15
Q

Example of tumour that spreads by trans-cavity metastasis

A

Mesothelioma (RARE)
Ovarian Carcinoma
Pancrastic Carcinoma
All have close association with omentum. Poor prognosis

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16
Q

How does Fibrosarcoma spread?

A

Local metastasis therefore reoccur at site of excision

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17
Q

Are mammary adenocarcinomas more metastatic in cats or dogs?

A

Much more metastatic in cats.Advice unilateral mastectomy as the minimum
Adenocarcinoma= Malignant, Glandular epithelium

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18
Q

How does immunohistochemistry help in tumour diagnosis?

A

Some poorly differentiated tumours cannon be identifed on morphological grounds alone.
Immunohistochemistry for intermediate filaments or cell surface markets assist identification.
Cytokeratin- epithelial marker for carcinom

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19
Q

Which immunohistochemistry market can be used to help identify a sarcoma tumour?

A

Mesenchymal market Vimentin

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20
Q

How are t and b cell lymphomas differentiated? Why would be want to do this?

A

Different prognosis depending on type.
T cell marker is CD3
B cell marker is CD79a

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21
Q

When does tumour grading by immunohistochemistry become more difficult?

A

As tumour becomes more poorly differentiated (high grade) they loose expression of expected tissue markers.
e.g. Cytokeratin (carcinoma), Vimentin (Sarcoma)

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22
Q

Normally necrotic and cavitated areas should not be sent off to the pathologist. The exception is___

A

Bone tumours where a sample from the area of maximal bone lysis is most helpful e.g. osteosarcoma or osteoma (mesenchymal origin)

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23
Q

When fixing specimens for delivery, it is important to:

A

Not put more than 2 cm in (not adequately fixed)
Neutral buffered formalin
Indelible labels

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24
Q

Which type of neoplasm is chemotherapy indicated for?

A

Disseminated disease e.g. Lymphoma. If removal possible = surgery

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25
What is adjuvant therapy?
Following removal of a tumour e.g. splenic haemangiosarcoma or amputation of osteosarcoma then chemotherapy is given to slow growth of metastatic disease (used for highly malignant tumours) LET WOUND HEAL FIRST!! DIVING WOUND CELLS
26
What is neo-adjuvant therapy?
To shrink size of tumour prior to surgery
27
Why are cytotoxic drugs most useful in the early stages of disease?
Most chemotherapy drugs work when tumour cells are diving most rapidly i.e. start of disease.
28
The cell kill hypothesis states that tumour cells follow ___ kinetics
First order kinetics i.e. a given dose of cytotoxic drug will kill a fixed percentage of the tumour population e.g. 90% of population
29
Why is the maximum tolerated dose stated in mg/m2?
Maximum tolerated dose tends to correlate better with body surface area rather than body weight. Animals <10kg = dose at mg/kg basis
30
What is metronomic chemotherapy?
Continuous low dose of cytotoxic drug given combined with a NSAID. Slow growth by inhibiting angiogenesis and immunomoduatory effects (decreasing circulating T-cells) Will not remove tumour but will slow growth/ stable disease
31
Which tumours are a) resistant to chemo b) susceptible to chemo?
Relatively resistant: Pancrreatic/Renal carcinomo | Sensitive: Lymphoma
32
What is the significant of P-glycoprotein (Pgp) in anti-cancer therapy?
``` MDR1 gene (multi drug resistant gene) leads to increased Pgp expression which pumps cytotoxic drugs out of the cell This MDR1 gene can be activated by glucocorticoids ```
33
Which normal body systems are most affected by anti-cancer therapy?
Systems which have rapidly dividing cells e.g. Bone marrow (Myelosuppression), Gastrointestinal toxicity, Hair growth
34
Significance of Drug extravasation in anti-cancer therapy
Many of IV chemotherapy drugs are irritant if extravated e.g. vincristine, vinblastine, doxorubicin) Always use catheter and use saline to check patency of vein
35
What are the effects of myelosuppression on the haemtopoietic system?
Neutropenia, Thrombocytopenia Neutropenia is the dose limiting effect of many agents. For neutrophil count drops below 1 x 109 Give prophylactic antibiotics e.g. TMS
36
When does neutrophil nadir normally occur?
nadir= low point. i.e. most likely point to get infection | Neutrophil nadir normally occurs 7days post treatment
37
What does platelet nadir normally occur
Maximum thrombocytopenia normally occurs 10 days post treatment
38
If extravastion occurs, what emergency treatment can you do?
Aspirate as much as possible away from site For VINCRISTINE: Heat (vasodilation) + Hyaluronidase For DOXORUBICIN: Ice (vasoconstriction)
39
Which chemotherapy drug should be avoided in animals with heart disease?
Doxorubicin can cause dysrhythmias during administration. Give SLOWLY. Mast cell degranulation can occur during administration (urticaria, pruitis, shock etc due to histamine release) Nephorotoxicity recorded in cats
40
What side effect does Cyclophosphamide have in dogs?
Haemorrhagic cystitis. Irritant to the to bladder lining | Can give furosamide at the same time to increase excretion time
41
Which chemo-therapy drug can cause ileus/constipation in the cat?
Vincristine
42
Which chemotherapy drug should NEVER be used in cats?
Cisplatin (causes fatal pulmonary oedema)
43
Mechanism of action for: a) Vincristine b) Doxorubicin c) Cyclophosphamide
VINCRISTINE: Mitotic spindle inhibitor. CC specific DOXORUBICIN: Prevent DNA and RNA synthesis. not CC specific CYCLOPHOSPHAMIDE: alkylating agent, break DNA strand. Not CC specific
44
Is mammary neoplasia more common in cats or dogs?
More common in DOGS. | But when it does occur in CATS, 90% are MALIGNANT!!
45
What is the significance of oestrogen and progesterone receptors on malignant mammary tumours?
(feline tumours normally only progesterone receptors) Can be used for immunohistochemistry (but not used in vet medicine) More receptors = good prognosis as well differentiated
46
How does the relative risk of developing a mammary tumour change depending on time of spaying in DOGS? and in CATS?
If spayed before first season: 0.05% After first season: 8% After second season: 26% Less protective in cats. before 6 months 9%. >1 yr = no protective effect
47
Why would a rectal examination be useful after finding a mammary tumour?
Rectal exam may reveal enlarged sublumber lymph nodes
48
Which type of mammary tumour is the most aggressive and has a very poor prognosis (<30days)
Inflammatory carcinoma. (Incisional biopsy) Don't try operating. Not always clear that it is a mass, more of a diffuse swelling; massive oedema, erythema, pain. BIOPSY
49
Antimicrobial of choice for mastitis?
Broad spectrum, time-dependent bactericidal CEPHALOSPORIN. | Likely bacteria: E-coli
50
What is Galactostasis?
Accumulation and stasis of milk within mammary gland. Warm, firm, swollen, painful but secretions NOT infected (c.f. mastitis) Self resolving
51
Lactation that is not associated with pregnancy and parturition i.e. during a false pregnancy is known as
Galactorrhea (due to increased prolactin secretion, stimulated by falling progesterone) Doesn't require treatment
52
In cats 2-4 weeks after oestrus, rapid growth of mammary tumour could be:
Mammary neoplasm, but given that it is close to oestrous probably mammary hyperplasia. Benign condition that resolves once progesterone levels decline. Neutering prevents reoccurrence
53
Mastitis can be confused with what very serious neoplasm?
Inflammatory carcinoma (prognosis <30 days)
54
Blood suppy with the mammary glands
Cranial and Caudal *ligate* epigastric. Branches off internal thoracic
55
LN drainage of the lymph nodes
4,5 drain to inguinal LN 1,2 drain to axillary LN 3 can drain in either direction, normally to axillary
56
What is the normal skin margin when excising a tumour (excisional)
2-3cm. Excise underlying abdominal wall fascia if tumour is attached to it. Ligate branches of epigastric if encountered
57
Minimum recommended treatment for a) dog b) cat with mammary tumour
Cats: Unilateral mastectomy Dogs: Excise all tumour using simplest surgery
58
Possibly complication of performing a regional mastectomy of the caudal two mammary glands?
Often excised together with inguinal LN. Could cause hind limb oedema (self-correcting by collateral drainage) Ligate caudal epigastric artery
59
How do the prognostic factors vary between sarcomas and carcinomas in DOGS?
Sarcomas= worse prognosis 3cm 85% reoccurance (ACT QUICKLY!) Poorly differentiated 90% mortality at 2 yr
60
How does the mammary tumour size in CATS determine prognosis?
>3cm median survival <2cm: 3 yrs
61
Which factors are NOT PROGNOSTIC in mammary neoplasm?
Site of tumour, type of surgery in dogs, number of tumours, performing OHE at time
62
How long does it take to alter the BCS by 1.0?
BCS change by 1.0 in 6 weeks
63
When does a distance examination of a bull for a fertility visit, straight legs could indicate...
Potential problem with with joints in later life/. Probably fine if only needs to service 1 or 2 cows. If needs to service 10+ then BAD
64
What should the circumference of a bull/ram scrotum be?
Bull and Ram should both be 34cm if 32cm - okay depending on how many needs to service. Rams: Seasonal breeders (measure at breeding time)
65
Which parts of the epididymus are palpable?
Head of epididymis is not normally palpable unless diseases | Tail of epididymis is normally palpable
66
What should the normal testicular tone be in the breeding season?
Flexed bicep tone
67
What is broken penis and what is the prognosis?
Broken penis is haemtoma in the area of the sigmoid flexure. | Very poor prognosis

VetMed Year 3-Term 2 (11 decks)

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