Clinical Consequences of Neoplasia

Question 1

Name the 3 mechanisms of neoplastic disease

Answer 1

1. Paraneoplastic syndromes
2. Local tumour impact
3. Further tumour impact

Question 2

What are paraneoplastic syndromes?

Answer 2

Indirect symptoms that occur away from the site of the tumour

Question 3

Why are paraneoplastic syndromes important for cancer diagnosis and treatment (3)?

Answer 3

1. Assist with diagnosis
2. Effective cancer treatment may include dealing with the effects of the paraneoplastic syndrome
3. Severity of paraneoplastic syndrome may reflex tumour burden

Question 4

Name a systemic paraneoplastic syndrome

Answer 4

Anorexia/cachexia

Fever

Question 5

Name at least one endocrine paraneoplastic syndrome

Answer 5

Hypercalcaemia 
Hypoglycaemia
Hyperestrogenism
Cushing's disease
Thyrotoxicosis
And many more!

Question 6

Name a skeletal paraneoplastic syndrome

Answer 6

Myelofibrosis

Hypertrophic osteoarthropathy

Question 7

Name at least one vascular/haematopoietic paraneoplastic syndrome

Answer 7

Leukocytosis/penia
Thrombocytosis/penia
Anemia
Eosinophilia
Erythrocytosis
Disseminated intravascular coagulation
Hyperviscosity syndrome

Question 8

Name a neurologic paraneoplastic syndrome

Answer 8

Peripheral neuropathy

Myasthenia gravis

Question 9

Name a cutaneous paraneoplastic syndrome

Answer 9

Alopecia

Nodular dermatofibrosis

Question 10

Hyperadrenocorticism in dogs (canine Cushing’s) is usually associated with what type of tumour?

Answer 10

Adrenal or pituitary adenomas

Question 11

Hyperthyroidism in cats is commonly associated with what type of tumour?

Answer 11

Adenomas

Question 12

What type of tumour is humoral hypercalcaemia of malignancy in dogs associated with?

Answer 12

Anal sac carcinoma (90%)

Question 13

Monoclonal gammopathies are often associated with multiple ______

Answer 13

Monoclonal gammopathies are often associated with multiple myelomas

Question 14

Myasthenia gravis, immune-mediated myositis and dermatitis are often observed with what type of tumour?

Answer 14

Thymoma

Question 15

Why do some tumours become easily damaged and expose?

Answer 15

Faulty desmosomes
Necrotic cells (no blood supply)

Question 16

Name the 5 localised tumour impacts

Answer 16

1. Haemorrhage
2. Ulceration
3. Blood vessel damage
4. Invasion
5. Impingement

Question 17

What are the 3 impacts of impingement of a localised tumour on local structures?

Answer 17

1. Compression
2. Neurological
3. Interference with motion/movement

Question 18

A localised tumour can cause vascular blockage by ______ compression

Answer 18

A localised tumour can cause vascular blockage by external compression

Question 19

A localised tumour can cause vascular blockage via 2 mechanisms. What are they?

Answer 19

1. External compression

2. Thromboembolism

Question 20

What is an infarction?

Answer 20

Tissue death (necrosis) due to inadequate blood supply to the affected area.

Question 21

What are the 2 lymphatic impacts associated with tumour growth?

Answer 21

1. Localised oedema secondary to lymphatic obstruction

2. Lymph node enlargement

Question 22

What is lymphadenomegaly?

Answer 22

Lymph node enlargement

Question 23

What is the difference between lymphadenomegaly and lymphadenopathy?

Answer 23

Lymphadenomegaly = local enlargement of lymph nodes
Lymphadenopathy = systemic inflammation

Question 24

What 3 processes can lead to anaemia due to the presence of a tumour?

Answer 24

1. Chronic haemorrhage
2. Cachexia
3. Bone marrow suppression/replacement

Question 25

What 3 things contribute to cardiorespiratory compromise due to cancer?

Answer 25

1. Haemorrhage 2. Direct impact on heart/vessels 3. Metastases to the lungs

Question 26

A loss of function of the liver can be cause by cancer. Why does this happen (3)?

Answer 26

1. Jaundice 2. Coagulopathy 3. Hypoproteinuria

Question 27

Tumours can cause a loss of function to the CNS which in turn can lead to blindness and seizure. True/False?

Answer 27

True

Question 28

A loss of renal function due to the presence of a tumour causes azotaemia and anaemia. True/False?

Answer 28

True

Question 29

Pain is not an impact caused by tumours. True/False?

Answer 29

False - tumour invades nerves

Question 30

Name the 4 routes of metastasis

Answer 30

1. Haematogenous 2. Lymphatic spread 3. Transcoelomic 4. Bronchi and biliary systems

Question 31

Lymphatic spread is the route of metastasis of most sarcomas. True/False?

Answer 31

False - route of most carcinomas is lymphatic spread

Question 32

What is the route of metastasis of most sarcomas?

Answer 32

Haematogenous route

Question 33

Name 4 secondary infections and inflammation associated with cancer

Answer 33

1. Epithelial ulceration 2. Immunosuppressive effects 3. Hormonal 4. Tumour necrosis