Final Flashcards
(523 cards)
1
Q
Main Mechanism of Action that Causes Tumor Cell Damage with Radiation Therapy
A
Damage from DNA Interaction with Free Oxygen Radicals
*Ionization of Water within Tumor Cells lead to Release of Free Radicals which causes Breaks within DNA which are not able to be repaired
*The Biological Effect occurs slowly with Radiation Therapy- Weeks to Months
Important Point- This Damage is happening BOTH to the Cancer Cells as well as to the Host Cells (Surrounding Tissue)
2
Q
A
Thrombocytopathy
*Reference Platelet Count in a Dog- 200,000-500,000/uL
*Anything Below 100,000/uL is Thrombocytopenia but Below 50,000/uL is considered Severe
If you have a Dog with Primary Hemostatic Abnormalities- It is most likely a Thrombocytopathy
Only Develop Spontaneous Hemorrhage below 30,0000/uL
While this is Thrombocytopenia, the Thrombocytopenia is NOT the reason for the Petechial Hemorrhage. You will not bleed Spontaneously with a Platelet Count of 64,000/uL
*Not a Factor Deficiency- Factor Deficiencies are normally associated with Body Cavity Bleeds and Hyphema
3
Q
Treatment/Chemotherapy Protocol used in Patients with Sarcoma
A
Surgically Resect the Tumor to Increase Growth Fraction followed by Chemotherapy
*Use Surgery to Remove the Bulk of the Tissue and Stimulate Division of Residual Tumor Cells then use Chemotherapy
4
Q
Chemotherapy Drugs that Specifically Target the Mitosis Phase of the Cell Cycle
A
Mitotic Inhibitors (Plant Alkaloids)
5
Q
Name the Infectious Organisms seen in these Photos
A
6
Q
In patients with Cancer:
Make a Diagnosis and do Anatomical/Clinical Staging ______ Deciding on the Treatment Options
A
BEFORE
7
Q
Treatment for Sarcoptes
A
Topical Dips- Lime Sulfur Dips (Very Effective and Very Safe)
Topical Spot-on- Selemectin (Revolution) q 2 weeks
*Minimum of 6 weeks
8
Q
A
D. Cytology of Discharge
9
Q
Thrombocytopathy Described Below:
A
Von Willebrand’s Disease
*Hereditary Disease- Commonly in Dobermans
*These Patients Won’t Spontaneously Bleed but following Procedures such as Spay or Nail Clipping these Patients won’t Stop Bleeding
10
Q
Mitotic Inhibitor used to Treat Lymphoma and Mast Cell Tumors
A
Vinblastine
11
Q
Treatment for Hypoglycemia (Paraneoplastic Syndrome)
A
Dextrose Infusion
Curative Intent- Surgery in Combination of Chemotherapy (Streptozocin- Specific Chemotherapy)
*Severe Hypoglycemia may lead to Seizures
12
Q
Disorder of Platelet Number Leading to Thrombocytopenia Described Below:
Acute Hemorrhage
DIC/Vasculitis
A
Increased Demand/Consumption
13
Q
A
D. Admit Joey to the Isolation Facility and Start with Broad Spectrum Antibiotics
*Neutrophil Count is Incredibly Low- Case of a Dog that needs to be Hospitalized- Put into Chemotherapy Isolation Unit in order to Prevent Infection
*Because he has a FEVER he needs to be admitted to Isolation in Hospital and Given Broad Spectrum IV Antibiotics
14
Q
A
Psychogenic Alopecia
15
Q
How long should a Food Trial be Implemented in a Patient with Food Allergies
A
4 Weeks
*Food Trial has to last for at least 4 Weeks with NO Other Food source available- No Treats
16
Q
When is Surgery Indicated in Cases of Chronic Otitis Externa
A
Severe Calcification of Cartilage
Irreversible Soft Tissue Pathology (Ex. Canal Hyperplasia)
Bony Changes in Tympanic Bulla
Persistent Otitis Media
17
Q
Tumor Biopsy Technique Described Below:
Incisional- Biopsy Taken at the Junction of the Tumor and the Normal Surrounding Tissue
Excisional- Biopsy taken outside the mass to completely excise the mass (Never enter the Capsule of the Tumor)
A
Incisional/Excisional Biopsy
18
Q
A
D. Giving the Drug at Night
*We Dose this Drug in the MORNING. We don’t want them to go to bed with Acrolein Sitting in the Bladder Overnight
*Giving Cyclophosphamide Orally and Giving Furosemide prior to Administration to Induce PU/PD will Reduce Side Effects
19
Q
Given this Image, What Type of Pyoderma is This?
A
Surface Pyoderma
20
Q
Chemotherapy Drug used as Single Drug Protocol in Combination with Surgery for the Treatment of Osteosarcoma
A
Carboplatin
21
Q
Test Done during Examination of a Dog or Cat Suspected of having a Bleeding Disorder of either the Vascular Response and Platelet Function/Platelet Plug
Indications: Hemastatic Abnormalities but Platelet Count Greater than 70,000/ul
A
Oral Buccal Mucosal Bleeding Time
*Only indicated in Patients that don’t have severe Thrombocytopenia (> 70,000/ul)
22
Q
Name this Skin Lesion. Is it Primary or Secondary?
A
Vesicle- Primary Skin Lesion
23
Q
True/False: In Majority of Cases, Chemotherapy Drugs lead to Severe Side Effects in Patients
A
False
*In Majority of Cases, Side Effects are Minimal- Protocols adapted for Animals use Lower Dose of Chemotherapy Intensity than Humans
While Side Effects Rarely Occur, they can be Severe and Possibly Fatal- Less than 1% of Patients will succumb and Die due to Chemotherapy
24
Q
Which Tissues are Resistant to Radiotherapy?
A
Bone
Muscle
Cartilage
Connective Tissue
Mature RBC
*These Structures are also very susceptible to Long term damage
25
Name the **Highly Myelosuppressive** _Chemotherapy Drugs_
**Doxorubicin**
**Vinblastine-** _Severe Myelosuppression in Cats_
**Lomustine**
**Cyclophosphamide**
**\***_L-Asparaginase and Vincristine are Alternated with these Highly Myelosuppressive Drugs to give the Bone Marrow a Break when we are treating a patient with a High Intensity Induction Protocol_
26
**Primary Hemostasis**
_**\***Ventral Abdomen with Petechiation- Spontaneous Hemorrhage. Petechia is an Example of **Primary Hemostasis- Thrombocyte Number or Function Abnormality**_
27
**Screening Test** Described Below:
_Detects **Yeast, Surface Parasites** and Their Eggs_
**Acetate Tape Strip Impression Smear**
28
**Feline Dermatologic Disease** Described Below:
_**Caudal Dorsal Alopecia** BUT Could have **Face, Limb, and Neck** Involvment_
_May see Eosinophilic Complex Lesions_
**Flea Allergy**
29
The ____ the **Growth Fraction**, the _Greater the Efficacy of_ **Chemotherapy**
**Higher**
**_\*The Higher the Ratio/Growth Fraction- Tumor that is very susceptible to the Effects of Chemotherapy because more Tumor Cells are in the Growth/Dividing Phase_**
_The Lower the Ratio/Growth Fraction- The Tumor is Resistant to the Effects of Chemotherapy_
30
Most Common Grade of **Lymphoma** in _Canine Patients_
**High Grade: Lymphoblasts, Rapidly Dividing**
31
**Dermatologic Disease** Described Below:
_Very Common_
**_Allergens Occur when Fleas Take Blood Meal:_** _Antigen-Antibody Reaction occurs_
_Distribution of Pruritus- **Caudal 1/3rd of Body**_
**_Primary Lesion- PAPULES_**
**_Secondary Lesion- Crusts_**
**_Self Inflicted Lesions- Excoriations and Alopecia_**
**Flea Allergic Dermatitis**
_**\***Flea Saliva contains many Antigens- Amino Acids, Aromatic Compounds, ect._
32
How to Differentiate _RBC Agglutination from Rouleaux Formation_
**Add 3-5 Drops of Saline and Examine under 40x Magnification**
_**\***Rouleaux Formation- RBC's will Separate_
_Agglutination- RBC's will NOT Separate_
33
Supportive Therapy for Patients with **IMHA**:
_Treat the Underlying Cause_
_**Blood Transfusion Therapy**: Usually \_\_\_\_\_\_\__
_Fluid Therapy_
**Packed Red Blood Cells**
_**\***Don't Give Whole Blood since Protein is usually Normal/Increased_
34
**C. Postpone Chemotherapy for 7 Days and Prescribe Antibiotics**
**_\*Most Patients hit NADIR around 7 Days, Postpone for a Couple Days and recheck to make sure that the Neutrophil Count Increases_**
_\*If we see Toxicity with One Chemotherapy Drug we should NOT make changes with an Unrelated Chemotherapy Drug- Don't change the Dose of Vincristine (It has nothing to do with Cycophosphamide). DO NOT REDUCE VINCRISTINE DOSE_
35
**Tumor Biopsy Technique** Described Below:
_Approach Tumor with Needle and Advance the Stillette_
_The Outer Sheath will Slice off the Tissue_
_Pull out the Needle and Obtain the Biopsies_
**Needle Core Technique**
36
Treatment for **Dermatophytosis (Ringworm)**
**Topical Treatment:**
**_Lime Sulfur_** _(Safe and Effective)_
_Shampoo and Conditioner containing Miconazole_
**Systemic Therapy:**
**Itraconazole (Treatment of Choice)**
_\*Continue Therapy until 1 or more NEGATIVE FUNGAL CULTURE_
37
**What Investigation would you Carry out to Determine if the Lesion is Localized or Affecting Other Sites?**
**Thoracic Radiographs and Abdominal Ultrasound**
**Palpate- All Peripheral Lymph Nodes**
_**\***First thing that you want to do is assess all the regional Lymph Nodes_
38
Aim of using **Chemotherapy Drugs** in Animals
**To Prolong Survival**
**To Maintain Good Quality Life**
39
**What is the Diagnosis in each Picture?**
40
True/False: **Feline** Blood Donors and Recipients must ALWAYS be Blood Typed/Crossed Matched prior to Blood Transfusion
**True**
_**\***Naturally Occuring Alloantibodies- Must be Blood Typed before First Transfusion_
41
_Prognosis_ for **Mammary Tumors in Felines**
**Tumor \> 3cm** = Poor Prognosis
_\*Generally Feline Mammary Tumors carry a Poor Prognosis- Highly Malignant and Metastatic_
42
How to Diagnose **Notoedres**
**Skin Scrapings**
43
Treatment for **Impetigo (Puppy Pyoderma)**
**Topical Antibacterial Shampoos**
44
**Superficial Pyoderma**
45
**Antitumor Antibiotic** Used to Treat **Lymphoma and Osteosarcoma**
**Doxorubicin**
46
Clinical Signs of which **Dermatologic Disease:**
**Malassezia**
47
**Dermatologic Disease** Described Below:
**_Repetitive Licking_**
**_Well Circumscribed, Raised, Firm, Alopecic, Ulcerated Plaque or Nodule_**
_Common in Large Breed Dogs- Labs, Golden Retrievers ect._
**_Primary Etiology- Atopy (Underlying Allergy)_**
**Lick Granuloma (Acral Lick Dermatitis)**
_**\***Atopy- Underlying Allergy is most Likely initiating the Licking_
48
Hematopoietic Tumor Described Below:
## Footnote
**Neoplastic Proliferation of Hematopoietic Stem Cells in the Bone Marrow**
**Leukemia**
49
What Laboratory Tests will you Conduct in your Clinic?
**Hematocrit**- _Microhematocrit Centrifuge_
**Total Solids**- _Refractometer_
_Measure Total Solids to determine if there is Blood Loss. If Blood Loss is occuring you would see a Decline in Total Proteins_
50
Clinical Signs of \_\_\_\_\_Hemostatic Disorder:
## Footnote
**_Hematomas_**
**_Hemarthrosis_**
**_Bleeding into Cavities_**
**Secondary Hemostatic Disorder**
_**\***Widespread Massive Cavity Bleeds_
51
Form of **Eosinophilic Granuloma Complex** shown Below:
**_Commonly Located on Groin, Medial Thigh or Abdomen_**
**Eosinophilic Plaque**
52
Which _Three Radiographic Views_ are Required for Assess **Tumor Metastasis**
**ALWAYS Right Lateral**
**Left Lateral**
**ALWAYS Dorsal Ventral**
_**\***Recommended to take THREE Radiographic Views when looking for Metastasis_
_Usually do Both Right and Left Lateral because pathology can be missed if only one Lateral View is Taken. **Right Lateral View is the MOST Sensitive for Metastasis**_
53
What Type of Tumors are Best Treated with **Chemotherapy**
**Small, Rapidly Growing Tumors**
54
Given this Image, What Type of **Pyoderma** is This?
**Superficial Pyoderma**
55
**Chemotherapy** has NO EFFECT on which _Phase of the Cell Cycle_
**G**0 (Resting Phase)
56
Most Common **Malignant Mammary Tumor of Canines**
**Mammary Carcinoma**
57
Treatment for **Chin Pyoderma**
**Mild Cases: _Topical Benzoyl Peroxide_**
**Severe Cases: _Topical Benzoyl Peroxide with Systemic Antibiotics_**
58
True/False: **Chemotherapy Drugs** are Administered to Patients **Off-Label**
**True**
59
Treatment for **Cheyletiella**
**Shampoos:** _Selenium Sulfide_
**Spot Ons- Selamectin q 2 Weeks**
**Treat ALL IN CONTACT-** Contagious
60
**E. All of the Above**
61
**Intravascular Hemolytic Anemia**
_**\***Even though this dog was Non-Regenerative, there is a Massive Decline in PCV. This dog is showing signs of shock due to an acute Hemolytic Crisis_
_This dog is in the Pre-Regenerative Phase- only been ill for 24 Hours_
62
A Neoplasm associated Alteration in Bodily Structure or Function that occurs Distant to the Tumor
**Paraneoplastic Syndromes**
_**\***Parallels the Underlying Malignancy- Usually preceeds the Onset of the Cancer by Several Weeks to Months_
_\*Most Common Paraneoplastic Syndromes- Cancer Cachexia, Hypercalcemia, Hypothyroidism_
63
\_\_\_\_\_ Factors of **Otitis Externa:**
**_Ear Anatomy- Conformation, Hair_**
**_Excessive Moisture_**
_Obstruction (Ex. Tumor)_
**_Systemic Illness and Immunosuppression_**
**Predisposing Factors**
_**\***Increase the Likelihood of Disease_
64
**Feline Dermatologic Disease** Described Below:
**_Crusted Papules, Erythema_**
**_Tiny Raised Lumps_** _throughout the Body (Localized or Generalized)_
_Possible Causes- Flea Allergy, Food Allergy, Atopy, Parasited ect._
**Miliary Dermatitis**
65
Treatment for **Vitamin K Antagonism/Deficiency** leading to Secondary Hemostatic Disorder
**Inject Vitamin K1 then Oral for 4-6 Weeks**
66
_Three Treatments_ used for **Atopy (Allergic Dermatitis)**
**Allergen Specific Immunotherapy (ASIT)-** _Desensitization or Hyposensitization of the Patient **(BEST TREATMENT)**_
**Symptomatic Relief**
**Allergen Avoidance-** _Avoiding Allergen_
67
**Dermatologic Disease** Described Below:
**_Hypersensitivity to Aeroallergens_**
_Clinical Signs**- Pruritus, Chronic/Relapsing (Often Seasonal)**_
_Lesion Distribution**- Face, Ears, Ventrum, Feet, Perineum**_
**Atopy (Allergic Dermatitis)**
_\*Sensitivity to Allergens that Break the Skin Barrier_
68
**Macule**
_**\***Epidermal Collarette is a result of a Pustule that Broke Open_
69
**Reinduce with CHOP, week 1**
_**\***If the dog Relapses in the Middle of his Protocol it means he has responded well- Lets go back to week 1 and Reinduce Him_
70
Alternative Treatment for **Hemangiosarcomas:**
**Metronomics**
71
**Hyperpigmentation**
72
List _Three Tumors_ that are **_Radioresistant_** and can be Treated with **Radiation Therapy**
**Osteosarcomas-** _Pain Relief/Palliative Therapy_
**Soft Tissue Sarcomas**
**Brain/Spinal Cord Tumors**
**\***_Osteosarcomas- Palliative Therapy Only (Pain Relief)_
73
**Review Card: Tumor Staging Systems**
_**\***Anatomical Staging System is NOT always Relevant_. Ex. Lymphoma stage is not an important prognosticator. **We do NOT stage Feline Lymphoma**
74
\_\_\_\_\_ Factors of **Otitis Externa:**
_**Secondary Infections: Bacterial, Malassezia (Yeast)**, Candida_
_Ear Pathology: **Hyperplasia of Ear Canal**, **Fibrosis, Stenosis**_
**Perpetuating Factors**
_**\***Exacerbate and Maintain Inflammation_
75
_Primary Lesion_ seen with **Flea Allergic Dermatitis**
**Papules**
76
Most Common Side Effects of **Chemotherapy Drugs**
**Bone Marrow Suppression**
**Gastrointestinal Upsets** (MAIN Clinical Sign)
_\*Gastrointestinal Upset- Anorexia, Vomiting, Diarrhea_
77
Pathophysiology of \_\_\_\_\_\_:
**_Exposure of Previously Hidden or Previously Ignored Antigens_**
**_Loss of Self-Tolerance-auto-reactive T Lymphocytes_**
**Immune Mediated Hemolytic Anemia (IMHA)**
_**\***Piecemeal Removal of parts of the RBC Membrane leading to Spherocytes_
78
Three Types of _Cytoplasmic Granules_ that are Released from **Mast Cell Tumors**
**Histamine**
**Cathepsin**
**Heparin**
_\*75% of Dogs with Dermal Mast Cell Tumors will have higher Concentrations of Histamine in Circulation_
79
_Most Common Form_ of **Pemphigus Complex** in Dogs and Cats
**Pemphigus Foliaceus**
_**\***Most Common Immune-Mediated Dermatosis in Dogs and Cats_
80
Stain Needed to Diagnose **Heinz Body Anemia**
**New Methylene Blue Stain**
81
Immunosuppressive Drug used in Treating **IMHA** Described Below:
**Cyclosporin**
_**\***Extremely Popular Drug in Treating IMHA_
_\*Suppress T Lymphocytes which are Recognizing Antigens on RBC's_
82
_Three Presentations_ of **Eosinophilic Granuloma Complex** in Felines
**Indolent Ulcer**
**Eosinophilic Plaque**
**Collagenolytic Granuloma**
83
How to Treat **Fur Mite**
**Lime Sulfur Dips, Ivermectin, Selamectin**
84
Treatment for **Notoedres**
**Lime Sulfur Dips (Best)**
**Ivermectin Injections**
85
**Large Tumors** are No Longer Dividing with a _Very Low Growth Fraction_ making them ____ to the Effects of **Chemotherapy**
**Resistant**
_**\***Large Tumors enter into the Plateau Phase of Growth- No longer Rapidly Dividing therefore more resistant to the effects of Chemo_
86
**Review Card: Acute vs. Chronic Leukemia**
_**Chronic Leukemia**- Slow Developing and these Patients are NOT Systemically Ill. There may be some Paraneosplastic Syndromes. Diagnosis relies on a Bone Marrow Aspirate_
_**Acute Leukemia**- Patients are Systemically unwell and Blast Cells are obvious on Smears. Diagnosis Rarely Requires a Bone Marrow Aspirate. Do NOT develop Paraneoplastic Syndromes_
87
When performing **Blood Transfusions**:
\_\_\_\_\_ ml/kg Donor Blood with Raise Recipient PCV by 1%
**2.2 ml/kg**
88
True/False: Most Cases of Generalized Demodicosis that occur at 2-4 Years of Age are Likely **Undiagnosed Juvenile Onset Demodicosis**
**True**
89
**Most Common Autoimmune Skin Disease in Dogs**
**Pemphigus Foliaceus**
90
Supportive Care for \_\_\_\_\_:
**_Padded Cage with Minimal Handling_**
**_NO Jugular Venipuncture_**
_Desmopressin Acetate 30 min. Prior to Invasive Procedures_
**Immune Mediated Thrombocytopenia (IMTP)**
_**\***Handle these Dogs with Care_
91
Clinical Signs of \_\_\_\_\_Hemostatic Disorder
**_Echymosis/Petechiation_**
**Primary Hemostatic Disorder (Platelet Disorder)**
_**\***Three Sites to Check- Ventrum (Abdomen), Perineal Area, Gums_
**_Primary Hemostatic Disorders- Vasculitis, Thrombocytopenia, and Thrombocytopathy_**
92
Name this **Skin Lesion**. Is it Primary or Secondary?
**Callus- Secondary Skin Lesions**
93
Treament for **Lymphoma**
**1st- Stabilize Paraneoplastic Syndromes (Hypercalcemia)**
**2nd- Treat the Lymphoma: Steroids, Chemotherapy**
_**\***If we Don't Treat- These patients will succumb to Lymphoma in Less than 6 Weeks_
94
**Feline Dermatologic Disease** Described Below:
## Footnote
**_Symmetrical Truncal Alopecia_**
**_Easily Epilated Hairs_**
**_"Skin Fragility"_**
**Hyperadrenocorticism (Cushings)**
95
Classification of **Lymphoma** Described Below:
_**Most Common in Cats** (**Older, FeLV Negative)**_
_Focal or Diffuse on Small Intestine_
**_Vomiting, Diarrhea, Weight Loss, Inappetence_**
_Palpable Abdominal Mass, Thickened Intestinal Loops_
**Ailmentary**
_**\***Cat Lymphoma_
96
**Packed Cells**
_**\***Dog is Severly Anemic. TSP is Normal, therefore No Blood Loss Anemia_
_Just need to Replace Oxygen Carrying Capacity- Give Packed RBC's_
97
In _Felines_, \_\_\_\_% of **Mammary Gland Tumors** are Malignant
**80%**
_**\***Feline Mammary Tumors are HIGHLY Malignant and HIGHLY Metastatic_
98
\_\_\_\_\_\_ Hemostasis:
## Footnote
**Fibrin Mesh Formation (Fibrin Clot)**
**Secondary**
99
If _Ears are Ulcerated, Hyperplastic or Stenotic_, use 2-3 weeks of Topical \_\_\_\_\_\_, then Re-examine
**Glucocorticoids**
100
How to Diagnose **Demodex**
**Deep Skin Scrapes**
_\*Usually Positive if Mites are Causing Signs_
101
Clinical Signs of \_\_\_\_\_\_:
**_Pale Mucous Membranes_**
**_Tachycardia_**
**_Bounding and Rapid Pulse_**
_Weakness_
_Possible **Hemic Murmur**_
_Apparent Ataxia/Collapsing_
**Acute Anemia**
_Acute Anemia: Collapse, Pale Mucous Membranes, Dyspnea, Tachycardia ect. **Normally when talking about Clinical Signs of Anemia, we are Refering to Severe ACUTE Anemia**_
_Chronic Anemia: Compensatory Mechanisms decrease the Clinical Signs. Normally Eating, Drinking normally with a Normal Heart Rate_
**_Ex. Patient with Pale Mucous Membranes and a Bounding Pulse- Very Characteristic for Anemia_**
102
**Endocrine Disease** Described Below:
**_"Rat Tail"_**
**_Dry Haircoat- Loss of Sheen/Luster, Dull, Brittle_**
_Increased Ceruminous Ear Discharge_
**Hypothyroidism**
103
Most Common Associated _Clinical Sign_ of **Multiple Myeloma**
**Progressive Non-Regenerative Anemia**
_**\***Plasma Cells Infiltrating the Bone Marrow_
104
Two Leading Causes of **Heinz Body Anemia**
**Acetaminophen Toxicity**
**Onion Poisoning**
105
Most Important _Prognosticator_ in Cases of **Lymphoma**
**Substage**
**\***Clinically Well Patients (Substage A)
106
**Acanthocytes** seen on a Canine Blood Smear are commonly Diagnostic for which Two Diseases?
**Hypothyroidism**
**Hepathopathy**
_**\***If you see Acanthocytes in Geriatric Dogs- Think about Primary Liver Disease or anything that is Important for Regulating the Phospholipid Layer of the Red Blood Cell, such as Hypothyroidism_
107
Indications for\_\_\_\_\_\_:
**_Hemorrhagic Anemia_**
_In Order to Increase Oxygen Carrying Capacity and Improve Tissue Oxygenation_
**Blood Transfusions**
108
**Dermatologic Disease** Described Below:
**_Seasonal Follicular Dysplasia-_** _Patchy Loss of Hair on Flank Area_
**_Marked Hyperpigmentation_**
Common Breeds: **Boxers, Bulldogs**
**Recurrent Flank Alopecia**
_**\***Has Been on Previous Exams_
109
\_\_\_\_\_\_ can Reduce Risk of **Mammary Gland Tumors** in both Cats and Dogs
**Ovariohysterectomy**
_**\***Ovariohysterectomy prior to First Estrus- Relative Risk is essentially nonexistant_
110
**Disorder of Platelet Number** Leading to **Thrombocytopenia** Described Below:
**_Megakaryocyte Hypoplasia_**
_History: **Tick Exposure/Drug Exposure**_
_Differential Diagnosis: **Chronic Ehrlichiosis**, Estrogen Toxicity, Chemotherapy_
**Production Problem (Failure of Megakaryopoiesis)**
_**\***Megakaryocytes- Cells that Produce Platelets_
111
_Two Forms_ of **Demodecosis**
**Localized**
**Generalized (Juvenile and Adult)**
112
**Dermatologic Condition** Described Below:
**_Idiopathic Keratinization Disorder Manifested at Chin and Lips_**
_Alopecia, Crusts, Comedones_
**Feline Acne**
113
**_Heart Rate- 160 bpm (Extremely High)_**
**_Problem List: Abdominal Pain, Pale M/M, Collapse, Tachycardia_**
_Hematocrit- 37% (Low)_
**_Platelet Count: 87,000/uL (Low)_**
**_SCHISTOCYTES_**
**_Abdominal Imaging- Large Hyperechoic Tumor_**
**_What is the Diagnosis?_**
**Hemangiosarcoma**
114
**Disorder of Platelet Number** Leading to **Thrombocytopenia** Described Below:
## Footnote
**_SPLENOMEGALY_**
**_Primary Splenic Neoplasia_**
**_Tick-Borne Disease_**
**_Hemopoetic Neoplasia_**
**Platelet Sequestration**
115
Treatment for **Extravasation of Chemotherapy Drugs**
**IMMEDIATELY Stop Injection**
**Suck Back as much as Possible**
116
Most Common Presentation of **Lymphoma** in _Canine Species_
**Multicentric**
_**\***80-85% of Lymphomas in Canines are Mulitcentric_
117
Treatment for **Superficial Necrolytic Dermatits**
**Amino Acid Infusions Weekly**
_**\***Guarded to Poor Prognosis- Survival Time \< 1 Year_
118
True/False: Following Acute onset of **Anemia**, Bone Marrow takes _3-5 Days_ to begin Releasing Reticulocytes
**True**
_**\*Cannot Determine if Anemia is Regenerative or Not until 3-5 Days following Onset of Anemia.** This phase is known as "Pre-Regenerative"_
_In Patients where Anemia has occured within the Past 24 Hours, there has not be enough Time for the Bone Marrow to Respond. You need to Repeat Hematology in 3 days in order to get Accurate Results_
119
Treatment for **Lick Granuloma**
**Screen Animal for Atopy/Allergies-** _Symptomatic Treatment_
**Long Term Antibiotics**
**Sock, Legging, E Collar**
_\*Possible Exam Question: Primary Factor Treatment for Lick Granulomas- Treat the ALLERGY/ATOPY_
120
**_Hematocrit = 11%_**
**_Total Solids = 68g/l_**
Is this Anemia Mild, Moderate or Severe?
**Severe**
_**\*Hematocrit Less than 40% in a Dog is Considered Severe** and usually associated with Acute Anemia in a Dog showing Clinical Signs_
121
**D. Characterized by Diffuse Thickening of the Muscularis Propria on Ultrasonography**
_\*Feline Intestinal Lymphoma- Usually Low Grade, Lymphocytic in Elderly Patients_
122
Breed of Dog that has **Large Platelets (Macrothrombocytopenias)**
**King Charles Cavaliers**
123
Name this **Skin Lesion.** Is it Primary or Secondary?
**Erosion- Secondary Skin Lesion**
124
Case of Suspected **IMHA**. _In Saline Agglutination (ISA) test is Negative_. What Immunological Test should be Performed Next to Confirm IMHA?
**Direct Coombs Test**
125
**Review Card: Anemia Flowchart**
1. Patient is Showing Clinical Signs of Anemia- Measure Albumin (Total Solids)
**_2. If Albumin is LOW = Blood Loss from Hemorrhage_** _(Ex. Spenic Hemangiosarcoma Rupture, Gastric Ulceration, HBC)_
_3. If Albumin is Normal/HIGH, measure Reticulocytes to see if Regenerative_
If NOT Regenerative- Bone Marrow May be Exhausted or maybe there is such Severe Inflammation from IMHA that there is Myelonecrosis and Myelofibrosis
_4. If Regenerative- Look at Serum_
**_If Hemoglobinemia = Intravascualr Hemolysis_**
**_If NO Hemoglobinemia = Extravascular Hemolysis_**
126
**Dermatologic Condition** Described Below:
_Etiology- **Papilloma Virus or Idiopathic**_
**Papillomatosis**
127
Clinical Signs of _____ can Include **Horners Syndrome** and **Facial Paralysis**
**Otitis Media**
_**\***Horners Syndrome and Facial Paralysis are two Neurological Signs that could Indicate Otitis Media_
128
_Reservoir_ for **Microsporum Canis (Dermatophytosis)**
**Cat**
129
_Advantages and Disadvantages_ of which Method of **Tumor Cell Collection** for Cytology
**Fine Needle Aspirate**
_**\***Always the **Starting Point** because it is Extremely Cheap and Easy to Obtain. There are Minimal Complications and very rarely requies anything more than Sedation_
_Disadvantage- You are sampling an area that is so fine that you may not get a good representation of the entire tumor. May not be Respresentative of the Tumor. **This is why we should FNA Multiple Times- At least 10x's per Tumor**_
130
Common Differentials for which **Classification of Anemia:**
**_External or Internal Hemorrhages_**
_Coagulopathies_
**_Ruptured Neoplasms (Ex. Hemangiosarcoma)_**
**Anemia of RBC Loss**
_**\***Ex. Hit by Car_
**_\*Most Common Type of Anemia of RBC Loss- Cancers in Geriatric Patients: Ruptured Hemangiosarcoma_**
131
**Feline Dermatologic Disease** Described Below:
**_FELINE SCABIES_**
_Pinne, Face, Neck Forelimbs_
**_Alopecic, Thickened Wrinkled Skin with Papular Rash and Serocellular Crusts_**
**Notoedres**
132
How to Diagnose **Acute Otitis Externa**
**CYTOLOGY (Most Important)**
**Otoscopic Exam**
_**\***Determine what is in the ear via Cytology_
133
Classification of **Lymphoma** Described Below:
**_Common in Younger Cats (FeLV Positive)_**
_Paraneoplastic Hypercalcemia (50%)_
**_Cough, Dyspnea_**
_**Pleural Effusion**- Muffled Lung Sounds_
_Precaval Syndrome_
**_Cranial Mediastinal Mass on Imaging_**
**Mediastinal (Thymic)**
134
Any Time you see a **Cat** with _Bilateral Symmetrical Alopecia, Miliary Dermatitis, or Eosinophilic Granuloma Complex,_ what should ALWAYS be on your Differential List?
**Flea Allergic Dermatitis**
**Ringworm**
_**\***Always eliminate these causes First- They are the most common causes of all three of these Clinical Signs_
135
Name this **Skin Lesion.** Is it Primary or Secondary?
**Nodule- Primary Skin Lesion**
136
_Generalized Truncal Pyoderma- Pustules and Papules (Superficial Pyoderma)_
## Footnote
**What Diagnostics would you like to Discuss with the Owner?**
**Derm Diligence- Skin Scape, Cytology, DMT Culture**
_Surface Cytology- Should see Staphylococcus- Cocci_
_\*Prednisolone- Steroids should NOT be used to Treat Superficial Pyoderma (Papules and Pustules throughout the Body)_
137
Treament for **GENERALIZED Demodex**
**Daily Oral Ivermectin or Weekly Mitaban Dips**
_\*Spontaneous Remission Occurs in up to 50% of Cases in Young Dogs_
**\*NO GLUCOCORTICSTEROIDS EVER!!**
138
Adjunct to Immunosuppressive Therapy (Glucocorticoids) in Patients with **IMHA** with the Following Indications:
_Intravascular Hemolysis_
_Non-Regenerative Anemia_
_Negative Side Effects of Glucocorticoids_
**Mycophenolate**
**\***_Used as Adjunctive Treatment to Glucocorticoids in Patients being Treated for IMHA_
_**\***Used in Patients that cannot Tolerate Steroids due to Side Effects ect._
139
Assessment of the **Degree of Malignancy** of a Tumor
**Tumor Grade**
140
**A. No Mask, Eye Shield, Double Goving, Gloves Used**
141
**Paraneoplastic Syndrome** described below:
_**Excess HISTAMINE seen in Mast Cell Tumors (75%)**, a negative Prognosticator, or Gastrin seen in Gastrinomas_
**_Stimulates Gastric H2-Receptors leading to Increased Gastric Acid Secretion_**
**Gastroduodenal Ulcers**
_**\***Every patient with a Mast Cell Tumor, needs to be on H1 and H2 Blockers until the Mast Cell Tumor is in Remission_
142
Steps of \_\_\_\_\_\_\_:
**Metastasis**
_**\***Tumor cells are usually not able to survive if they have lost contact with the Tissue of Origin. These Tumor Cells survive by invading the Immune System leading to Metastasis_
143
Chemotherapy Drug of Choice for **Mast Cell Tumors** and **Relapsed Lymphoma**
**Lomustine**
144
Name this **Skin Lesion**. Is it Primary or Secondary?
**Epidermal Collarette- Secondary Skin Lesion**
145
How to Diagnose **Sebaceous Adenitis**
**Skin Biopsy from Dorsal Surfaces**
146
**Dermatologic Condition** Described Below:
_Inherited Dysplasia of the Hair Follicle Resulting in **Comedones on the Back**_
_Breed Predisposition: **Schnauzer**_
_Secondary Folliculitis and Furuncolosis_
**Schnauzer Comedo Syndrome**
147
Type of **Lymphoma** Described Below:
_Cells that May Respond to Chemotherapy_
**_Usually Develop Relapse Quickly with Short Clinical Remission_**
**_Poor Prognosis_**
**T Cell Lymphoma**
148
**Dermatologic Disease** Described Below:
**_Presence of More Demodectic Mites than what is Normal in Conjunction with Hair Loss, Folliculitis, Scales, Erythema, and Crusts_**
**_Two Forms- Localized and Generalized_**
**Demodecosis**
_**\***Present on every dog_
149
Name this **Skin Lesion**. Is it Primary or Secondary?
**Bulla- Primary Skin Lesion**
150
_Minimum Treatment Time_ in Cases of **Deep Pyoderma**
**3-12 Weeks**
_**\***Treat 2 Weeks beyond Resolution_
151
Serum is Tinted a Red Color Indicating **Intravascular Hemolysis**. What are the Two most Common Causes of Intravascular Hemolysis?
**Heinz Body Anemia**
**IGM Immune Mediated Hemolytic Anemia**
152
Treatment for **DIC**
**Early DIC with Hypercoagulable State- Heparin**
**_Late DIC with Bleeding- Fresh Frozen Plasma (Most Common)_**
153
**Normal Platelet Reference Range** in Dogs and Cats
**200-500 x 109 (Dog)**
**300-800 x 109 (Cat)**
_**\***Severe Thrombocytopenia: \< 50 x 10_9_. These Dogs will Normally have Petechiation due to Everyday Trauma_
**_Spontaneous Bleeding not Due to Trauma happens when Platelet Count is Below 30 x 109_**
154
**Plasma**
_**\***Plasma- No Value in Blood Transfusion at all_
\*VonWilibrands Disease- Only store Blood Products for 6 Hours. **We like to see the word FRESH when we are using Blood Products for VonWilibrands Disease**
**\***_The Products that would be helpful to prevent Bleeding- Fresh Whole Blood, Fresh Frozen Plasma, Cryoprecipitate (IDEAL), and Desmopressin_
_\*Cyroprecipitate- Very High Concentration of VonWillibrands Factor_
155
Technique used in **Radiotherapy** that avoids acute Toxicity by _Killing Tumor Cells but Avoiding Surrounding tissue_
**Fractionation**
_**\***We want to Kil the Tumor but Preserve the Surrounding Cells- we Utilize Fractionation_
**_The Higher the Frequency and Smaller the Doses- Preserves the Surrounding Tissue_**
156
Hematology Findings for which Cause of **Anemia:**
**_Strongly Regenerative_**
_Leukocytosis_
_Thrombocytopenia/DIC (25-70%)_
**_Spherocytosis (Hallmark)_**
**_Agglutination_**
**IMHA**
_**\***Almost Always Characterized by Inflammatory Leukogram- Leukocytosis due to Necrosis in the Body_
_Thrombocytopenia- Hemolysis releases the Cytoplasmic Components of the RBC leading to activation of Platelets/Coagulation_
157
Top Differential in _Geriatric Large Breed Dog_
**Hemangiosarcoma**
_**\***Erythrocyte Fragmentation_
158
Classification of **Lymphoma** Described Below:
**_Middle Aged to Elderly Dogs_**
_Only 10-20% are Clinical ill_
_Inappetence, Weight Loss, Lethargy_
**_Enlarged Painless and Rubbery Lymph Nodes_**
**Multicentric**
159
**Dermatologic Disease** Described Below:
**_Abnormal Hairshafts and Distorted Hair Follicles Full of Keratin and Melanin_**
_Hair Breakage and Loss_
_Color Diluted Breeds- **Dobermans, Dachshunds ect.**_
**Color Dilution Alopecia**
160
True/False: **Total Protein (Albumin)** is usually _Normal_ in Patients with **Hemolytic Anemia (IMHA)** and **Non Regenerative Anemia**
**True**
_**\***Total Protein is usually Below Normal (Subnormal) in Blood Loss, HOWEVER Normal Total Protein levels do NOT Rule out Blood Loss_
161
This Dog has **Itching (Pruritus) over the** **Caudal Dorsum.** What is the Number One Differential?
**Flea Allergy**
162
**Reduced Red Blood Cell Count, Hemoglobin or Packed Cell Volume (PCV)**
**Anemia**
163
_Medical Therapy_ for **Eosinophilic Granuoma Complex**
**Glucocorticoids**
_\*High Dose Prednisolone_
164
**Canine Melanoma Vaccine** is now Fully Licened for which Stages of Disease?
**Stage II and III**
_**\***Dogs with Stage II or III Oral Melanoma receiving Four Biweekly Vaccinations Increases Survival time around 389 Days_
165
Classification of **Lymphoma** Described Below:
**_Erythema, Pruritus, Ulceration, Skin Nodules_**
**Cutaneous**
_\*If the Cutaneous Lymphoma is a Localized Lesion then it can be cured with Surgery and Radiation. However if its Infiltrative then you have to use Systemic Chemotherapy_
166
_Two Methods_ used to Administer **Allergen-Specific Immunotherapy (ASIT)**
**Subcutaneous-** _Inject with Allergen at Tiny Doses until Eventually Hyposensitized to Allergen (Allergy Shots)_
**Sublingual-** _"Allergy Drops" under the Tongue twice a day_
167
**C. CCNU (Lomustine) or LOPP, 40% RR, 5 Months Remission Time**
**\***He Responded well to the Protocol and went into a 6 Month Remission Period prior to Relapse
**_\*Rescue Protocol Takes 5 Months and the Response Rate is 40%_**
168
**Immunophenotype (T Cell)**
169
In Patients with **Cancer Cachexia**, what _Dietary Restrictions_ are Recommended
**High Protein, Low Carb Diets (N/D Diet)**
_**\***Cancer Cachexia- Body is Metabolizing its own Protein Sources leading to Muscle Atrophy. **You need to Decrease the amount of Carbohydrate in the diet and Supplement Protein**_
170
True/False: Do NOT Rely upon **Culture/Sensitivity** to Give a Diagnosis of **Otitis Externa.** Bacterial Infections are almost ALWAYS Secondary to something else
**True**
**_\*Bacteria/Yeast are usually NOT the Primary Cause of Acute Otitis Externa_**
171
Treatment for **Acute Lymphoblastic Leukemia**
**Acute Lymphocytic Leukemia-** _Prednisolone + Vincristine + L-Asparaginase_ (6 months)
172
**2/3rds of Splenic Masses are Malignant**
**2/3rds of Maliganancies are \_\_\_\_\_\_**
**Hemangiosarcomas**
173
**Current CHOP (19 Week Protocol)**
**\***_CHOP- Standard of Care for B and T Cell Lymphomas_
174
**Systemic Corticosteroids**
175
When Treating **Food Allergies**, Perscribe a _____ Ingrediate Diet, such as _Fish, Venison, Rabbit, or Kangeroo_
**Novel Ingredients**
176
Majority of the Time when **Mean Corpuscular Hemoglobin Concentration (MCHC)** is **Increased** it will be due to \_\_\_\_\_
**Artifact**
_**\***In Vitro Hemolysis_
177
**B.**
_**\***Point B- Where CT/MR Imaging is able to detect Tumor Cells_
178
**Ear Condition** Described Below:
_Common in **Cavalier King Charles Spaniels**_
_Clinical Signs- **Head Tilt, Neck Pain, "Air" Scratching, Facial Paralysis**_
**_Bulging of Pars Flaccida_**
**Primary Secretory Otitis Media (PSOM)**
_**\***BULGING PARS FLACCIDA_
179
Treatment for **Malassezia Dermatitis**
**Topicals: _Anti-Yeast Shampoo (Ketoconazole, Miconazole)_**
**\*ALWAYS use Topicals if Possible to Normalize the Microenvironment.** ONLY use Systemic Treatment if Infection is Extensive or Topical isn't working
_\*Malassezia is usually Secondary, so there is a Primary Cause that we are going to have to Find and Manage_
180
Two most Commonly used _Topical Antibiotics_ used in Treatment of **Pyoderma**
**Benzoyl Peroxide-** _Follicular Flushing activity_
## Footnote
**Chlorhexidine**
181
**Osteosarcomas** commonly Metastasize to the \_\_\_\_\_, as well as other Bony Areas of the Body
**Lungs**
_**\***Take Thoracic Radiographs to check for Metastasis_
182
**Dermatologic Disease** Described Below:
**_Mild Pustular Rash in Axillary or Inguinal Areas of Young Animals_**
_Often Associated with Dirty Environment, Parasitism ect._
**Impetigo (Puppy Pyoderma)**
183
Three Classifications of **Anemia**
**Bone Marrow Dysfunction**
**RBC Destruction**
**RBC Loss (Hemorrhage)**
184
**Chronic Otitis Externa** is Persistent Otitis Externa lasting for Greater than ____ Months
**2 Months**
185
**Palliative Radiotherapy (Radiation)** is used in Non-Operable Tumors when Patients are Predicted to live Less than ____ Months
**6 Months**
_\*Not applicable to use Palliative Radiotherapy for any animal that may survive longer than 6 months_
186
What are the Three **Fractionation Protocols** that are used with _Radiotherapy_ in the Treatment of Tumors
**Palliative:**
_**High Dose, Low Frequency** (9Gys Once Weekly)_
_Hypofractionated_
_Very Susceptible to Acute Side Effects_
**Semi-Definitive**
_3Gys Mon-Wed-Friday_
**Definitive**
**_Low Dose, High Frequency_** _(1.5-2Gys 5 Days a Week)_
187
**Malignant proliferation of Peripheral Lymphoid Tissues** that affects Lymph Nodes, Liver, Spleen and can affect Bone Marrow
**Lymphoma**
188
Treatment for **Moderate Myelosuppression (1-2)** during Chemotherapy
**If Non-Pyrexic (No Fever): Stop Drugs and Monitor**
**If Pyrexic (Fever): Stop Drugs and Use Antibiotics**
189
Mainstay of Treatment for **Immune Mediated Thrombocytopenia (IMTP)**
**Prednisone (Immuno-Suppressants)**
_**\*Emergency Situation- Prednisone + Vincristine:** Rapid Increase in Platelets_
190
**Blood Transfusions** should be Given within _____ Hours
**4-6 Hours**
191
_Screening Test_ for **Dermatologic Cases** Described Below:
**_NO PREP, NO SCRUB (Do NOT Distrub Lesions)_**
_Gently Clip Hair_
**_Handle Sample as Little as Possible_**
**_Put Sample in 10% Formalin_**
**Skin Biopsy**
_\*NO PREP, NO SCRUB_
192
What _Two Types of Tumors_ are **Highly Radiotherapy Sensitive** but have a **High Recurrence Rate**
**Mast Cell Tumors**
**Hematopoetic Tumors**
_**\***Mast Cell Tumors Regress Quickly with Radiation Therapy but may Recur Quickly_
193
_Clinical Signs_ of which **Hematopoietic Tumor:**
**_ASYMPTOMATIC_**
_Non-Specific: Lethargy, Inappetence, Fever, Weight Loss_
_Paraneoplastic Disease: Hypercalcemia, Hyperviscosity_
**Lymphoma**
_**\***Important to Remember with Lymphoma- Majority if Patients are **ASYMPTOMATIC**_
_**\***Only 20% of Patients with Lymphoma will present Clinically Unwell- Carries a Guarded Prognosis_
194
Diagnosis Based on these Hematology Results
**Immune Mediated Hemolytic Anemia (IMHA)**
_**\***Spherocytes and Agglutination_
195
**Dermatologic Disease** Described Below:
**_BILATERALLY SYMMETRICAL Truncal Alopecia_**
**_Non Pruritic_**
**Endocrine Alopecia**
196
**A. Age \> 7 Year is Worse**
_**\***LESS than 7 Years of Age is Worse_
197
**Dermatologic Disease** Described Below:
**_Surface Parasite- ZOONOSIS_**
_Clinical Signs- **Pruritus**, Dorsal Scaling, Papular Crusts, **Scratch Reflex**_
**Cheyletiella (Walking Dandruff)**
198
Most Common Blood Type in **Felines**
**Type A**
199
**All of the Above**
200
**Atopy**
201
How do we Diagnose **Atopy (Allergic Dermatitis**)
**Clinical Signs:** _Seasonal Prutitus, Lesion Distribution_
_\*No Other way to Diagnose Atopy- **Must be Diagnosed based on CLINICAL SIGNS**_
**_\*_**_Diagnose Atopy based on Clinical Signs, NOT Interdermal Skin Testing_
202
**Review Card: Clinical Staging of Lymphoma**
_Stages I and II are very Rare- Single Node Lyphoma that can be Controlled with Surgery or Radiation (Ex. Nasal Lymphoma)_
**_Majority of Dogs will be Stages III-V_**
_Stage III- Lymph Node Involvment_
_Stage IV- Liver and Spleen Involvment_
_Stage V- Bone Marrow Involvment_
203
True/False: **Felines** have Smaller Erythrocytes that Lack Central Pallor
**True**
_**\***Difficult to Diagnose Spherocytes in Felines because Erythrocytes don't have Biconcave Central Pallor_
204
**Three Thoracic Radiographs**
_**\***For Feline Tumors we DO NOT use FNA and we NEVER Biopsy_
**_\*Treatment of Choice- Radical Bilateral, Staged Mastectomy ONLY after Three Thoracic Radiographs to Determine the Stage._** _We would not persue any form of Treatment if there was any sign of Metastasis_
205
**Platinum Chemotherapy Drug** used to Treat **Osteosarcoma and Oral Malignant Melanoma**
**Cisplatin**
**_\*Mainstay of Therapy for Sarcomas_**
_**\***Causes Fatal Pulmonary Edema in Felines (Cisplatin Splats Cats)_
206
Name this **Skin Lesion.** Is it Primary or Secondary?
**Lichenification- Secondary Skin Lesion**
207
Gold Standard for Identifying **Environmental Allergens**
**Intradermal Allergy Testing**
**\***_Mark Black Dot with Sharpie pen where we want to Inject the Allergen_
208
\_\_\_\_\_\_ Hemostasis:
**Platelets**
**Vascular Factors**- _Platelet Plug attached to Site of Injury_
**Primary**
_**\***Hemostasis- Stopping of a Flow of Blood_
209
Common Differentials for which **Classification of Anemia:**
**_IMHA_**
**_Babesia spp._**
**_Mycoplasma spp_**
**_Heinz Body Anemia (Ex. Onion Ingestion)_**
**Anemia of Increased RBC Destruction**
210
How to Diagnose **Sarcoptes Scabiei**
**Superficial Skin Scrapes**
211
_Generalized Truncal Pyoderma- Pustules and Papules (Superficial Pyoderma)_
## Footnote
**How Would you Treat this Case?**
**Topical Antibiotics-** _Antibacterial Shampoos_
**Systemic Antibiotics- 1st Level Tier Antibiotics (Cephalosporins, Amoxicillin, Clindamycin)**
\*Superficial Pyoderma
212
Pathophysiology of \_\_\_\_\_:
## Footnote
**_Infection of Middle Ears usually spreads from Otitis Externa, across Eardrum to Bulla_**
**_Initially the Ear Drum may appear Bulging but as material Increases within Bulla, the ear drum can rupture_**
**Otitis Media**
213
Part of **Anatomical Staging** Described Below:
_**Asses if Lymph Nodes are Enlarged- Palpate** (Enlarged, Hard, Fixed)_
_Image Body Cavities_
**_Confirm there is Infiltrate- Aspirate/Biopsy_**
**Local Lymph Nodes (N)**
214
_Preferred Collection Site_ for Cytology in Cases of **Otitis Externa**
**Horizontal Canal**
215
Local Treatment for **Primary MALIGNANT Tumor** which cannot be controlled by Surgery that is used for **Curative Intent**
**Radiotherapy**
_**\***Adjunctive Radiation Therapy is commonly used in Combination with Surgery and Chemotherapy for Curative Intent_
_\*Radiotherapy is commonly used After Surgery to Cytoreduce or "Clean" Tumor Edges_
216
What is Seen on _Surface Cytology_ in Patients with **Surface Pyoderma**
**Mixed Bacterial Population**
217
When Dosing **Chemotherapy Drugs**, Smaller Dogs have a Higher Metabolic Rate and should get a _____ Dose
**Higher**
_\*Dose on Body Surface Area (m2)_
218
_Predisposing Factors_ for development of which **Hematopoietic Tumor:**
**_Retroviruses in Felines (FIV, FeLV)_**
_Herbicidal Agents_
_Exposure to Magnetic Fields_
_Genetics and Age_
**Lymphoma**
_\*Most common Predisposing Factor for Lymphoma**- FIV and FeLV in Felines**_
219
_Identify the Cells pointed out with Arrows_
**Reticulocytes (Canine)**
220
How to Confirm Diagnosis of **Mammary Gland Tumor in Felines**
**Perform Bilateral Strip/Stage**
_\*DON'T Biopsy Mammary Tumors in Felines- We just Assume its Malignant_
221
**Only A and B**
_**\***Intertrigo is Superficial_
222
**Surface**
223
**Lymphoma** Cases with the Following Characteristics have a _____ **Prognosis:**
## Footnote
**_Substage A_**
**_B Cell Immunophenotype_**
**_Clinical Response to Treatment_**
**_Nasal Lymphoma_**
**Good**
224
Form of **Eosinophilic Granuloma Complex** shown Below:
**Collagenolytic Granuloma**
225
**D.**
**\***_Old Food should NOT be mixed with new Food_
226
**Feline Dermatologic Disease** Described Below:
## Footnote
**_Excessive Grooming_**
**_NOT Barbering- Hair Tips are not Chewed off_**
**Hyperthyroidism**
227
Type of **Lymphoma** Described Below:
**_Cells that Have a Fair Response to Chemotherapy_**
_Once Remission Occurs- it is Durable_
**_Much Higher Chance of Being Cured_**
**B Cell Lymphoma**
_\*65% of Canine Patients will have B-Cell Lymphomas_
228
**Paraneoplastic Syndrome** described below:
**_10-35% Of Dogs with Lymphoma_**
**_\> 25% of Dogs with Anal Sac Apocrine Gland Adenocarcinoma_**
_20% Dogs with Myeloma_
_Pathogenesis: **Ectopic Production of PTH or PTH-rP,** Extensive Lytic Bone Metastases_
**Hypercalcemia**
_**\***Neoplasia is Diagnosed in App. 2/3rds of Dogs with Hypercalcemia_
_\*PTH-rP: Parathyroid Hormonal Related Protein_
**_PTH and PTH-rP Stimulates the Reabsorption of Calcium from the Intestine, Bone and Kidney Tubules_**
229
True/False: Patients with **Primary IMHA** are _Icteric with a Poor Prognosis_. While Most Patients with **Secondary IMHA** are _NOT Icteric with Profoundly Low PCV_
**True**
_**\***Primary IMHA- 70% will Die within 2 Months of Diagnosis_
**_When you see Icterus in a Patient with Primary IMHA, they have Liver Failure_** _(Necrosis of Liver Cells)_**_- Multiple Organ Dysfunction Syndrome_**
230
**Dermatologic Condition** Described Below:
_Underlying Conditions- **Hepatic/Pancreatic Disease**_
_Footpads 100% Involved- **Hyperkeratotic, Crusty, Cracking Footpads**_
**Superficial Necrolytic Dermatitis**
231
If we are doing a **Food Trial** Properly, we expect a \_\_\_\_% Reduction in Pruritus within 4 Weeks
**50%**
_**\***Any Improvement in Pruritus- Continue Food Trial for another 4-8 weeks_
232
_Enlarged Submandibular Lymph Node_
_FNA (Fine Needle Aspirate) Performed- **Lymphoblasts**_
**_What is your Diagnosis?_**
**Lymphoma**
233
Name this **Dermal Lesion**
**Comedo**
_**\***Hair Follicle Plugged with Keratin_
234
Most Common **Paraneoplastic Syndrome** seen in Patients with **Lymphoma**
**Hypercalcemia**
235
Chemotherapy Drug associated with a _Good Response Rate and Durable Remmission_ in Patients with **Lymphoma**
**Doxorubicin**
_**\***6-8 Months Survival with complete Remission in Majority of Patients with Lymphoma_
**_\*ALWAYS use Doxorubicin in Cats with Lymphoma because it is a Prognosticator_**
236
**Dermatologic Condition** Described Below:
**_Autoimmune Skin Disease_**
_Primary Lesions_**_- Pustules, Vesicles, Bullae_**
**Pemphigus**
237
**Mycophenolate Mofetil**
_**\***Diabetic Patient CANNOT go on Prednisilone_
_\*Mycophenolae Mofetil is as effective as Prednisilone with Fewer Side Effects_
238
Name this **Skin Lesion**. Is it Primary or Secondary?
**Wheal- Primary Skin Lesion**
239
Clinical Sign of **Hyperadrenocorticism(Cushings)** Described Below:
_**Firm White Plaques**, often Ulcerated_
**Calcinosis Cutis**
\*ON EXAM
_\*Treament- Topical DMSO: Can Accelerate the Resolution of Calcinosis Cutis_
240
Best Diagnostic Test for **Leukemia**
**Bone Marrow Aspirate**
241
**Schistocytes**
242
Classify these Three Types of **Tumor Cells**
_\***Sarcomas** are more likely to **Metastasize Hematoginously**, while **Carcinomas** are more likely to **Metastasize Lymphatically**_
243
Name this **Skin Lesion.** Is it Primary or Secondary?
**Nodule (Tumor)- Primary Skin Lesion**
244
**B. No Corticosteroids for at least a month Prior to the Test**
245
_Identify the Cells pointed out with Arrows_
**Reticulocytes (Feline)**
**\***Two Form of Reticulocytes in Felines- **_ONLY Count Aggregate Reticulocytes_**
246
_Papules on Ventral Neck_
_Bilateral Periocular Alopecia and Erythema_
_Erythema and some Lichenification of Both Pinnae_
_Alopecia, Erythema, and Papules on Ventral Abdomen_
_Interdigital Erythema, Saliva Staining, and Alopecia_
_Erythem, Alopecia, and some Hyperpigmentation of Caudal Thighs and Perineum_
**What Test would you do next?**
**Skin Scrape, Surface Cytology, DTM Culture**
_\*Multifocal Areas Affected_
247
**Dermatologic Condition** Described Below:
**_Excessive Epidermal Turnover: 7 days compared to 21 days Normally_**
_Causes Abnormal Cornification and Desquamation_
**_Follicular Casts Prominent_**
**Primary Idiopathic Seborrhea (Vitamin A Responsive Dermatitis)**
248
_Side Effects_ of which **Chemotherapy Drugs:**
_Mild Myelosuppression_
**_Renal Toxicity_**
**_Fatal Pulmonary Oedema in Felines_**
**Platinum (Cisplatin)**
249
**All Dogs in the Household** where ____ has been Diagnosed should be Treated
**Sarcoptic Mange**
_**\***Sarcoptic Mange is CONTAGIOUS_
250
Most Common **Benign Mammary Tumor of Canines**
**Mixed Mammary Tumor**
251
Treatment for **Osteosarcoma**
**Palliative Intent:**
_**Radiation Therapy** (Large Doses): \< 6 Month Survival_
_**Multimodal Pain Control**- NSAIDs with Acetaminophen_
**Curative Intent:**
**_Surgery (Amputation) with Chemotherapy (Doxorubicin)_**
_\*Since the Majority of these Dogs are Geriatric the Owners may want Palliative Intent rather than Curative_
252
List the _Three Different Skin Lesions_ in a **Feline**
**Bilaterally Symmetrical Alopecia (Non-Inflammatory)**
**Miliary Dermatitis-** _Small Bumps_
**Eosinophilic Granuloma Complex**
253
**Mast Cell Tumors** on the _____ are Biologically more _Aggressive/Malignant_
**Muzzle**
_**\***Anything near the Mucocutaneous Junction is more likely to be a very aggressive/bad tumor- Muzzle and Nasal Area_
254
Name this **Skin Lesion**. Is it Primary or Secondary?
**Alopecia- Primary or Secondary Lesion**
255
Most Common Presentation of **Lymphoma** in _Feline Species_
**Alimentary**
_**\***Most common Form of Lymphoma in Felines- **Geriatric Feline Population that suffers from Diffuse, Small cell Lymphocytic Lymphoma (Alimentary)**_
_\*These tend to be FeLV Negative_
256
_Systemic Antibiotics_ that Make up the **3rd Tier (LAST RESORT)** for **Pyoderma**
**Fluoroquinolones**
**3rd Generation Cephalosporins**
**\***_ONLY use these Options if no other Antibiotics are a Feasible Option_
257
**12 Year Old, Spayed Female, Domestic Shorthair**
_Primary Complaint: **Acute Onset Lameness of the Left Hindlimb following minimal Trauma** while Climbing off a Sofa_
_Recently the cat had become less active but maintained a good appetite with some weight gain_
**_BCS: 3/9 with a Pot-Belly_**
**_Auscultation: Grade II Holosystolic Heart Murmur_**
**_Pale Mucous Membranes- Anemia_**
_Left Hindlimb Tarsus was Swollen and Painful on Palpation_
_Abdominal Palpation: **Mild Organomegaly (Splenomegaly)**_
**_What is the Diagnosis?_**
**Multiple Myeloma**
_\*# 1 Clinical Sign of Multiple Myeloma- Anemia_
_\*50% of Cats Diagnosed with Multiple Myeloma will have a Heart Murmur_
258
**Follicular Dysplasia**
259
Common Biochemistry Findings in Patients with **Multiple Myeloma**
**Hypoalbuminemia**
**HYPERGLOBULINEMIA** (Hyperviscosity Syndrome)
**Proteinuria**
260
**Sterile Hemorrhagic Cystitis**
261
**Paraneoplastic Syndrome** described below:
**Cancer Cachexia**
_\*Cancer Cachexia is a very Negative Prognosticator and associated with a Reduced Survival Time_
_\*Weight Loss in the Presence of Adequate Nutritional Intake- The cancer is utilizing the Carbohydrates at the expensive of the Dog_
262
_Minimum Treatment Time_ in Cases of **Superficial Pyoderma**
**3-4 Weeks Minimum**
263
**Lymphoma** Cases with the Following Characteristics have a _____ **Prognosis:**
**_Substage B_**
**_T Cell Immunophenotype_**
_Certain Anatomical Locations- CNS, Ocular_
**Bad**
264
**Paraneoplastic Syndrome** Described Below:
**Hyperestrogenemia**
_**\***Ex. Sertoli Cell Tumors_
265
**Screening Test** Described Below:
**_Heat Fixed and Stain Slide_**
_**Surface Scraping**- Micro-organisms_
_**Direct Impression**- Press Slide Onto Lesion_
_**Q Tip**- Ears, Moist Areas, Skin Fold_
**Surface Cytology**
266
Patient has Marked **Thrombocytopenia (\< 50)**. **Secondary Diseases have been Ruled Out**. What is the Main Differential?
**Autoimmune Thrombocytopenia (IMTP)**
267
**Secondary Hemostatic Disorder** Described Below:
**_Inhibition of Vitamin K Epoxide Pathway (Reductase)_**
_Within 36 Hours, PT will be Prolonged_
_Massive Fatal Hemorrhage_
**Vitamin K Antagonism or Deficiency (Ex. Warfarin)**
_**\***Vitamin K is an Important Factor in the Intrinsic and Extrinsic Pathway_
_\*Within 36 Hours, PT will be Prolonged because that's the **Coagulation Factor with the shortest Half Life: Factor VII**_
**_Even a Small Amount of Vitamin K Antagonism can cause Massive Fatal Hemorrhage_**
268
Name Three _Contraindications_ for **Pretreatment Biopy** in Patients with Tumors
**1. When the Surgical Extent would NOT Change despite the Type of Tumor (Ex. Testicular or Splenic Mass)**
**2. When Biopsy would Compromise the Patient (Ex. Spinal Cord)**
**3. Seeding the Tumor**
269
**Dermatologic Condition** Described Below:
**_Inflammed Subcutaneous FAT_**
**Nodular Panniculitis (Steatitis)**
270
Treatment for **Severe Myelosuppression (\<0.5-1)** during Chemotherapy
**Barrier Nurse**
**Fluids**
**IV Antibiotics (Ex. Cefazolin)**
_**\***These Patients are Admitted into the Hospital_
271
**C. Amputation/Limb Sparing + Chemotherapy Combination**
272
**Review Card: Secondary Hemostasis**
_Vitamin K Dependent Factors (Intrinsic)- XII, XI, and IX_
_Extrinsic Pathway Factors- VII_
_\*These factors ultimately Activate Prothrombin to Thrombin causing Fibin to Cross Link and form a Fibrin Clot_
273
Treatment for **Von Willebrands Disease**
**Cryoprecipitate (BEST)**
**Desmopressin Acetate (DDAVP)**
274
_Response to Chemotherapy_ in Canine and Felines with **Lymphoma**
**Canines- 80-90% Response Rate**
**Felines- 50-70% Response Rate**
_**\***Canine Lymphomas respond Better to Chemotherapy than Cats_
275
Name this **Skin Lesion.** Is it Primary or Secondary?
**Comedone- Primary or Secondary Skin Lesions**
276
Name this **Skin Lesion**. Is it Primary or Secondary?
**Excoriation- Secondary Skin Lesion**
277
_Symptomatic Therapy_ for Patients with **Atopy (Allergic Dermatitis)** Described Below:
**_Decreases Inflammatory Mediators and Cytokines that Cause Pruritus_**
**_Janus Kinase (JAK) Inhibitor_**
_Negative Effects- May Increase Susceptibility to Infection and Demodicosis_
**APOQUEL**
278
Patient has **Mild/Moderate Thrombocytopenia ( \>50)**. **Spontaneous Bleeding is Evident.** What are the Three Differential Diagonsis?
**DIC**
**Thrombocytopathy**
**Secondary Haemostasis Disorder**
279
What is the Top Differential in a Patient with the Following Findings:
_Serum and Urine **Monoclonal Gammopathy**_
**_Permeative Lysis of the Bone With Patholgical Fractures_**
**_Bence Jones Proteins in Urine (Proteinuria)_**
**_Bone Marrow Plasmocytosis_**
**_Hyperviscosity_**
**Multiple Myeloma with Hyperviscosity Syndrome**
280
Most Common Mode of **Chemotherapy Drug Administration**
**IV**
_**\***Most of these Drugs are Vesicants- If they Extravasate they will cause Severe Necrosis and Sloughing_
281
**Chemotherapy Protocol** Described Below:
## Footnote
**_Low Toxicity_**
**_Few Side Effects_**
**_Moderate Survival_**
**COP**
\*Combination of: _Cyclophosphamide, Vincristine, and Prednisilone_
_\*This Protocol is now only considered PALLIATIVE_
282
**Lick Granuloma**
**\***_Furunculosis- Rupture of Hair Follicle deep within Dermis. The Only Deep Pyoderma listed is Lick Granuloma_
283
**Nodular Panniculitis/Steatitis** is a _Cutaneous Marker_ for _____ Disease
**Systemic**
_**\***KNOW THIS_
284
**A. 3 Weeks- 3 Months**
_**\***This Tumor has a very Grave Prognosis because of its Origin- It has Usually Metastasized by the Time of Diagnosis_
285
Name this **Skin Lesion**. Is it Primary or Secondary?
**Cyst- Primary Skin Lesion**
286
Three **Systemic Antibiotics** that Make up the _1st Tier Empirical Treatment_ for **Pyoderma**
**1st Generation Cephalosporin (Cephalexin)**
**Amoxicillin**
**Clindamycin**
_\*ALWAYS ON EXAM_
287
You Perform a **Fine Needle Aspirate** of a Tumor. More than **50% of the Cells are Lymphoblasts**. What is the Diagnosis?
**Lymphoma**
**_\*Lymphoma- Homogenous Population of Large Lymphoblasts (50%)_**
_**\***If you are unable to Diagnose a Tumor based on FNA, then it is best to Follow up with a Biopsy_
288
Severe Form of **Thrombocytopenia** Described Below:
**_Platelet Count \< 50,000/uL_**
_**Increased Megakaryopoeisis** (Strongly Regenerative)_
**_Microthrombocytosis (Small Platelets)_**
**Immune Mediated Thrombocytopenia (IMTP)**
_**\***The Majority of Dogs with IMTP have a Platelet Count of Less than 20,000/uL_
**_\*Hallmark Feature of IMTP- Low Platelet Counts with Small Platelets (Microthrombocytosis)_**
289
**E. B and D**
290
**Dermatologic Disease** Described Below:
**_Inflammation and Destruction of Sebaceous Glands_**
_Long Coats- Alopecia, Adherent Scales on Pinnae, **Follicular Casts**_
_Short Coats-_ **_Moth Eaten Appearance_**
**Sebaceous Adenitis**
291
**Review Card: Staging of Mast Cell Tumors**
_Stage I- Dermal Mass with NO Lymph Node Involvment_
_Stage II- Dermal Mass with Lymph Node Involvment_
_Stage III- Infiltrating Dermal Mass_
_Stage IV- Systemic Spread of Cancer_
292
True/False: Takes only ONE Flea Bite to set off Allergic Response leading to **Flea Allergic Dermatitis**
**True**
_**\***When you examine these animals there may not be any Fleas or Flea Dirt Present- Only takes the Bite of ONE Flea_
293
What are the _Four Possible Responses_ to **Chemotherapy**
**Complete Response-** _No Detectable Tumor (Clinical Remission)_
**Partial Response-** _Decrease in Tumor Volume of \> 50%_
**Stable Disease-** _Disease that Does not Change in Size_
**Progressive Disease-** _\> 10% Growth of the Tumor_
294
Name this **Skin Lesion**. Is it Primary or Secondary?
**Papule- Primary Skin Lesion**
295
**A. DFE and PF**
296
Drug Given to Patients in Cases of **Non-Endocrine Alopecia:**
_Plays a Role in Photoperiod related Hair Growth and Coat Color in many Mammals_
**_May Stimulate Hair Growth_**
**Melatonin**
297
Match the _Specific Side Effects to the Chemotherapy Drug:_
**1. Renal Damage**
**2. Cardiomypathy**
**3. Cystitis**
**4. Hypersensitivity**
**5. Neuropathy**
A. Vincristine
B. Doxorubicin
C. L-Asparaginase
D. Cyclophosphamide
E. Cisplatin
**Cisplatin- _Renal Damage_** _(Cisplatin Splats Cats)_
## Footnote
**Doxorubicin- _Cardiomyopathy_**
**Cyclophosphamide- _Hemorrhagic Cystitis_**
**L-Asparaginase- _Hypersensitivity_**
**Vincristine- _Neuropathy_**
298
**Chemotherapy Drugs** with the Following Pathological Mechanism:
## Footnote
**_Creates Cross-Liked DNA with Strand Breaks_**
**Alkylating Agents (Ex. Cyclophosphamide)**
_**\***Traditional Rescue Drug- If you treated a Cancer and it went into Remission but Replases shortly after. Rather than Repeating the Protocal you would use Alklyating Agents for Chemotherapy_
**_\*Cyclophosphamide- Effective in 40% of the Cases of Lymphoma that Relapse_**
299
_Symptomatic Therapy_ for Patients with **Atopy (Allergic Dermatitis)** Described Below:
_**"Crisis Buster"**- Patient is Driving the Owner Crazy because it is Itching_
_Strong Evidence of Efficacy_
**_Use The Lowest, most Infrequent Dose that will Control Pruritus_**
**Corticosteroids ( Oral Predisolone)**
300
Which of the Following about **Flea Allergic Dermatitis** is FALSE:
## Footnote
**A. A Dog with FAD will ALWAYS have FAD**
**B. Flea's Don't have to be seen on Dog**
**C. Hypersentivitity to Flea Bite**
**D. Use Insect Growth Regulators in Environment and Adulticide on all In-Contacts**
**E. Use Predisolone (Steroid) to Stop Pruritus**
**All the Above are True about Flea Allergic Dermatitis**
301
**C. Increased Epidermal Turnover**
302
Which Chemotherapy Drugs are NOT affected by **Multi-Drug Resistance**
**Alkylating Agents**
**Carboplatin**
_**\***We Rely on Lomustine as a Rescue Drug_
303
**Dermatologic Disease** Described Below:
_Follicular Damage Initially with Secondary Bacterial Infection_
_**Deep Pyoderma**- Usually Staphylococcus_
**_Young Dogs \< 1 year_**
**_Clinical Signs- Alopecia, Non-Painful, Non-Pruritic, Papules_**
**Canine Acne (Chin Pyoderma)**
_**\***Deep Pyoderma_
304
**Disorder of Platelet Number** Leading to **Thrombocytopenia** Described Below:
**_Immune Mediated Thrombocytopenia_**
**_Infections_**
**_Toxins- Snake Envenomation_**
**Platelet Destruction**
305
_Prognosis_ for **Leukemia**
**Chronic = Good Prognosis**
**Acute = Poor Prognosis**
**\***_Acute Lymphoblastic Leukemia is a very aggressive disease with a very Poor Prognosis and Poor response rate to chemotherapy_
_Chronic Lymphocytic Leukemia- May be an Incidental Diagnosis (50%) where these patients tend to do fairly well_
306
Best Diagnostic Tool In Terms of Predicting Outcome and **Staging Mast Cell Tumors**
**Lymph Node FNA or Biopsy**
_**\***ALWAYS Aspirate_
307
Once you Obtain your **Tumor Biopsy** you obtain Fixation in \_\_\_% Formalin for 2-3 Days
**10%**
_1:10 Ratio of Tissue:Formalin_
308
**Juvenile Cellulitis:**
**_Young Puppy (3 weeks - 6 months Old)_**
_Clinical Signs-_ **_Swelling Face, Pyoderma, Pustules_**
_Non Cutaneous Signs- **Lethargy, Pyrexia, Anorexia**_
**What is the Treatment?**
**Corticosteroids (Prednisolone)**
309
This Dog has **Itching (Pruritus) over the Elbows and Ears**. What is the Number One Differential?
**Sarcoptic Mange**
310
True/False: In patients with Cancer, the _Outcome_ will depend on **Anatomical TNM Stage and Tumor Grade**
**True**
311
**Dermatologic Disease** Described Below:
**_INTENSE PRURITUS_**
**_Burrowing Mite- Contagious and Zoonotic_**
_Predilection Sites_**_- Ear Pinna, Elbows, Hocks_**
**Sarcoptes Scabie (Scabies)**
_**\***If Dog is Scratching at Ears and Elbows- Think Sarcoptes_
312
Name this **Skin Lesion**. Is it Primary or Secondary?
**Ulcer- Secondary Skin Lesion**
313
What is Considered the **Primary Etiology** leading to **Lick Granuloma**
**Atopy/Allergy**
_**\***Lick Granuloma is most likely just another manifestation of Allergies_
314
**15-25%**
_**\***Cure Rate for Osteosarcoma is around 20%_
315
Margins used for Surgical Resection of **Mast Cell Tumors**
**Laterally 8.9 mm**
**Deep 5.3 mm**
_\*Mean Lateral and Deep Surgical Margins around the Tumor should be 8.9 and 5.3mm_
316
**Chemotherapy Drugs** with the Following Pathological Mechanism:
## Footnote
**_Incorporated into DNA interfere with Transcription or Translation_**
**Anti-Metabolites (Ex. Methotrexate)**
_\*Produce Faulty Chromosomes_
317
**Review Card: Ear Anatomy**
_Vertical Canal Connected to Horizontal Canal_
**Middle Ear = Tympanic Bulla**
318
Name this **Skin Lesion**. Is it _Primary or Secondary?_
**Macule- Primary Skin Lesion**
319
The **Larger the Tumor**, the **Lower the Growth Fraction** and the _____ Susceptible the Tumor is to Chemotherapy and Radiation Therapy
**Less**
_**\***If we have a Large Tumor, its not going to be as Radiosensative/Radioresponsive_
_The Dose of Radiation that is Required to Control a Larger Tumor is Larger, which is going to lead to surrounding tissue damage_
320
**Dermatologic Condition** Described Below:
## Footnote
**_Scaly Condition of Ear Margins_**
**_Poster Breed- Dachshund_**
**Ear Margin Dermatosis**
321
**Tumor** Described below:
_One of the Most Important Dermal Tumors_
**Mast Cell Tumor**
**_\*Most Common Cause of Cutaneous Mass in Canines_**
_\*Accounts for 29% of Cutaneous Tumors- Important Cause of Canine Cutaneous Dermal Tumors_
_Golden Retrievers are Over Represented_
_Chows and Shar Peis- Predisposed to very aggressive Mast Cell Tumors_
322
List _Four Tumors_ that are **_Radiosensitive_** and can be Treated with **Radiation Therapy**
**Lymphoma** (Ex. Nasal Lymphoma)
**Feline Nasal Squamous Cell Carcinoma**
**Canine Oral Squamous Cell Carcinoma**
**Mast Cell Tumors**
_**\***Squamous Cell Carcinomas- After Radiation Therapy you can see a Dramatic Response_
_Mast Cell Tumors- Radiotherapy combined with Surgery gives a 90% Survival Rate_
323
_Three Vascular Diseases_ that Lead to **Erythrocyte Fragmentation**
**Heartworm**
**Hemangiosarcoma**
**DIC/IMHA** (Most Important)
_\* 33% of Patients with IMHA will have DIC leading to Fragmented Red Blood Cells (Schistocytes)_
324
_Three Screening Tests_ that are ALWAYS Done on **Dermatologic Cases (Derm Diligence)**
**Scrapings**
**Surface Cytology**
**Dermatophyte Culture (DTM Culture)**
325
True/False: **Otitis Externa** is Manageable but NOT Curable unless Primary Cause/Predisposing Factors are Addressed
**True**
_**\***Warn Owner- **Otitis Externa May Recur** if Primary Cause is not Addressed_
_\*If Recurrent Infections- Look for Possible Primary Diseases_
326
Specific Treatment for **Low Grade Intestinal lymphoma** in _Felines_
**Chlorambucil and Prednisolone**
327
Name this **Skin Lesion**. Is it Primary or Secondary?
**Patch- Primary Skin Lesion**
328
**Dermatologic Disease** Described Below:
_Classic Presentation: **Circular Alopecia**, Central Healing, Peripheral Papules, Pustules, Crusts_
**_Cutaneous Infection of ANAGEN Hairs_**
**_Spores Persist in Environment for Months_**
**_ZOONOTIC_**
**Dermatophytosis (Ring Worm)**
329
**Alopecia X**
330
331
Form of **Eosinophilic Granuloma Complex** shown Below:
## Footnote
**_Upper Lip_**
**Indolent Ulcer**
332
Clinical Signs of which **Paraneoplastic Syndrome:**
**Hypercalcemia**
_**\***Most Notably- PU/PD_
333
Treatment for _Gastrointestinal Upset_ caused by **Chemotherapy Drugs**
**Dehydration: Intravenous Fluids**
**Vomiting: Anti-Emetic (Maropitant)**
**Diarrhea/ileus: Prokinetics (Metoclopramide)**
334
**Review Card: Normal Hematology in Dogs and Cats**
_In Felines, Don't Diagnose Anemia until PCV is below 24%_
## Footnote
**_Dogs: Severe Anemia occurs when PCV \< 15%_**
**_Felines: Severe Anemia occurs with PCV \< 10%_**
335
Rank the Following Tumors From _Highest to Lowest Sensitivity_ to **Chemotherapy:**
**_Hemopoietic (Lyphosarcoma/Leukemia)_**
**_Mast Cell Tumors_**
**_Solid Carcinomas/Sarcomas_**
**Hemopoietic Tumors-** _HIGHEST Sensitivity_
**Mast Cells Tumors**
**Sold Carcinomas/Sarcomas-** _LOWEST Sensitvity_
**_\*_**_Hemopoietic Tumors (Lymphoma) have rapidly dividing cells and are very sensitive to the effects of Chemotherapy_
_\*Solid Tumors have a very low Growth Fraction and therefore Low Sensitivity to Chemotherapy_
336
**Allergies**
337
\_\_\_\_\_ Factors of **Otitis Externa**
**_Allergies-_** _Main Cause of Otitis Externa in Dogs_
_**Parasites-** Otodectes is the Main Cause of Otitis Externa in Cats_
**Primary**
_**\*Main Primary Factor of Otitis Externa in Canines- ALLERGY**_
**_Main Primary Cause of Otitis Externa in Felines- Otodectes_**
338
_Side Effects_ of which **Chemotherapy Drugs:**
_Mild Myelosuppression_
**_Peripheral Neuropathy_**
_Extravasation Reaction_
**Mitotic Inhibitors (Vincristine, Vinblastine)**
_**\***Vincristine is associated with Peripheral Neuropathies_
339
**Review Card: Fungal Culture (DTM Culture)**
**_Indicated in ALL CATS with Skin Disease_**
_When we are Brushing these Patients, not only are we picking up Ringworm, but we are also picking up other Fungi, Including Saphorphytes that are going to grow on the Media_
**_At the Time that the Ringworm starts growing, the color change should happen- The Media Turns Red_**
_**\*We want to see the change in Color at the same time that the colony is Growing**. Must check DTM Daily because Non-Pathogenic Fungi will use the Protein Source and turn the Media Red once Carbohydrates are Exhausted- This Colony would be Present for Days before the Color Change Occured_
340
Specific Treatment for **High Grade Intestinal lymphoma** in _Felines_
**CHOP**
341
**Poikilocytosis** caused by _Phospholipid Membrane Metabolism Aberration_ and Characterized by:
_\_\_\_\_\_\_\_\__
_Eliptocytes_
_Codocytes_
**Acanthocytes**
_\*Not to be Confused with Artifact of Crenated RBC_
342
**Dermatologic Disease** Described Below:
_Acute Moist Dermatitis_
_Cause- **Self Induced Trauma to Skin Resulting in Alopecia, Erythema, and Pruritus**_
**Pyotraumatic Dermatitis (Hot Spot)**
343
Given this Image, What Type of **Pyoderma** is This?
**Deep Pyoderma**
_\*Furunculosis_
344
Canine has a Patchy, Focal to Multifocal **Moth-Eaten Alopecia**. What are the Top Two Differentials?
**Pyoderma**
**Infections/Parasitic**
345
How to Diagnose **Fur Mite**
**Acetate Tape**
346
Prognosis for **Osteosarcoma**
**BW \> 40 kg -** _Worse Prognosis_
**Presence of Metastasis-** _Poor Prognosis_
**Elevated ALKP-** _Poor Prognosis_
**Proximal Humerus Location-** _Poor Prognosis_
_**\***Very Large Breed Dogs have Worse Prognosis_
_\*Dogs that present at time of Diagnosis with an Elevated ALKP do NOT Survive as long_
347
**Feline Dermatologic Disease** Described Below:
_**"Salt and Pepper" Appearance** due to Mites Clinging to Terminal Hair Shafts_
_Hairs Epilate Easily_
**Fur Mite**
348
Treatment for **Mast Cell Tumors**
**Surgery (Ideal)- Resect Mass**
**Chemotherapy:** _High Grade Tumors (\> Stage III) and Surgically Inoperable Tumors_
**ANTIHISTAMINES- H1 and H2 Blockers**
\*_If you feel that You will not be able to Resect with Surgery then you can use Radiation either Before or After Surgery. **Surgery together with Radiation has a 90% Cure Rate**_
_**\***These Patients must be on Antihistamines in order to Counteract the negative effects of Histamine that is Released from Mast Cell Tumors_
349
Hallmark Erythrocytes found in **Immune Mediated Hemolytic Anemia (IMHA)**
**Spherocytosis**
_**\***Due to Immune Opsinisation of RBC and Piecemeal Removal of the Membrane_
350
Common Differentials for which **Classification of Anemia**:
**_Ehrlichia Canis_**
**_FeLV/FIV_**
**_Toxicity- Estrogen_**
_Erythropoetin Deficiency_
_Anemia of Chronic Disease_
**Anemia of Bone Marrow Dysfunction**
351
**Alkylating Chemotherapy Drug** used in High Intensity/Multimodal Protocol for **Lymphoma**
**Cyclophosphamide**
352
**C. Palliative, Hypofractionated, Neoadjuvant**
**_6 Gy of Radiation Weekly- Low Frequency, High Dose. Only use this Type of Protocol for Palliative Control (Pain Control)_**
**_Neoadjuvant- Given Prior to Chemotherapy_**
353
**80%, 12 Months**
354
Predilection Site of **Osteosarcomas** in Large Breed Dogs
**Distal Radius**
\*_Away from the Elbow, Toward the Knees_
355
Treatment for **Sebaceous Adenitis**
**Topical Shampoos- Baby Oil, Propylene Glycol**
## Footnote
**Topical Daily Spray- Propylene Glycol**
356
How Do _Confirm Diagnosis_ in **Multicentric Lymphoma**
**Fine Needle Aspirate (FNA)**
_**\***50% Lymphoblasts = Lymphoma_
357
**Chemotherapy Drugs** with the Following Pathological Mechanism:
_Tyrosine Kinase Receptors are Resposible for Phosphorylation of a Pathway that will allow Cell Signaling which will cause the Tumor to Rapidly Divide_
**_These Drugs Inhibit the Transmembrane Autophosphorylation Pathway and Prevent the Cell Signaling_**
**TKI (Tyrosine Kinase Inhibitors)**
_\*Ex. Toceranib_
358
With Patients on **Chemotherapy Drugs** how Should Excretion Products (Urine/Feces) be Handled?
**Take Bottle of Water to Dilute Urine**
**Collect Feces and Dispose of as Chemical Waste**
359
True/False: **Radiotherapy/Radiation** can lead to _New Tumor Formation_ in Patients
**True**
_**\***Carcinogenesis from Radiotherapy can lead to New Tumor Formation- Ex. Nasal Tumors in Dog that have Recieved Radiation over the Head_
360
_Two Goals_ of **Chemotherapy**
**Curative Intent-** _Young Animal, No Metastasis_
**Palliation-** _Older Animal, Poor Prognosis (Ex. Metastasis)_
_**\***Combination of Surgery and Chemotherapy for a Low Stage Cancer, then we can recommend what is called Curative Intent, Mainly used in Young Animals with Tumors that don't have Metastasis. **Cure = Desease Free for 2 Years without Chemotherapy.** Ex. Osteosarcoma treated with Amputation and Chemotherapy leads to a 20% Cure Rate_
361
Main Treatment for **Mammary Tumors**
**Surgery-** _Mammary Gland Resection_
**Removal of Inguinal Lymph Nodes**
_**\***Chemotherapy is NOT used in Mammary Gland Tumors_
362
**Chemotherapy Drugs** with the Following Pathological Mechanism:
## Footnote
**_DNA Intercalation, Interfere with Topoisomerases_**
**Antitumor Antibiotics (Ex. Anthracyclines)**
_**\***Oldest Form of Chemotherapy but they are Highly Effective- You can Improve the overall remission time by Including this Drug_
363
How is **Malassezia** Diagnosed?
**Cytology- ESSENTIAL**
364
Treatment for **Pemphigus Foliaceous**
**Localized Form:**
**_Combination of Tetracycline and Niacinamide_**
**Systemic Form:**
_Oral Prednisolone_
365
**Large Breed Dogs that Present with Hemoabdomen.** What is the Number one Differential?
**Hemangiosarcoma**
_**\***Hemoabdomen is Most commonly caused by Ruptured Hemangiosarcomas_
366
Blood Typing for Which Species:
## Footnote
**_Naturally Occuring Alloantibodies_**
**_MUST be Blood Typed before First Transfusion_**
**_Crossmatching MUST be performed before Subsequent Transfusions_**
**Feline**
367
Immunosuppressive Drug used in Treating **IMHA** Described Below:
## Footnote
**_FIRST LINE OF THERAPY_**
**Mycophenolate Mofetil**
368
Normal Levels of _Calcium, PTH, and PTH-rP_ in a Patient with **Cancer**
**High Calcium**
**Low PTH**
**High PTH-rP**
369
Patient with **IMHA** showing Signs of _Liver Dysfunction_ will Most Likely have ______ which comes with a Poor Prognosis (Death)
**Thromboembolic Disease/DIC**
370
**Skin Scaping Technique** Described Below:
_Moisten a Dulled Scalpel Blade with Liquid Paraffin or Mineral Oil_
_Scrape a Larger Area because Mites are Fewer in Number_
**_Looking For SUPERFICIAL/SURFACE Mites_**
**Superficial Skin Scraping**
371
Immunosuppressive Drug used in Treating **IMHA** Described Below:
**Azathioprine**
**_\*_**_Not Recommended for use in Cats due to Severe Bone Marrow Suppression_
372
Treatment for **Discoid Lupoid Erythematosus**
**Localized Form- Tetracycline and Niacinamide**
373
How to Differentiate **Acute Leukemia vs. Lymphoma**
**Acute Leukemia-** _Mild Lymphadenopathy, SPLENOMEGALY, **\> 30-40% Blasts in Bone Marrow**_
**Lymphoma-** _MASSIVE Lymphadenopathy, **\< 30% Blasts in Bone Marrow**_
374
**Marbofloxacin**
375
Diagnostic Factors of which **Secondary Hemostatic Disorder:**
**DIC**
**_\*Hallmark- Schistocytes_**
_**\***IMHA- Classic Example of Causing DIC_
**_Diagnostics- Increased FDPs or D-Dimers and Decline in Fibrinogen and Antithrombin_**
376
**Dermatologic Disease** Described Below:
**_Deep Pyoderma Infection- Mainly Staphylococcus_**
_**Common in Long Nose Breeds**- GSD, Border Collies_
**Nasal Folliculitis and Furunculosis**
_**\***Deep Pyoderma_
377
Name this **Skin Lesion**. Is it Primary or Secondary?
**Pustule- Primary Skin Lesion**
378
This Dog is **Feet Licking and Chewing**. What are the Top Differentials?
**Atopy**
**Food Allergy**
379
If you can't see Intact \_\_\_\_\_, Avoid using _Ceruminolytics, Cleaning Solutions and Drying Agents_ to **Clean the Ear**
**Pars Tensa**
_\*The Pars Tensa forms most of the tympanic membrane_
_\*We don't like putting these Cleaning Solutions into the Ears without knowing if the Tympanic Membrane is Intact or Not_
**_If you can't see the Pars Tensa- Use Normal Saline to Clean Ear Canal_**
380
Name this **Skin Lesion**. Is it Primary or Secondary?
**Purpura- Primary Skin Lesion**
381
**Tumor Biopsy Technique** Described Below:
_Very Common Biopsy Technique for Dermal and Cutaneous Tumors_
**Punch Biopsy Technique**
382
What is Seen on _Surface Cytology_ in Patients with **Deep Pyoderma**
**Mostly Staph, but can be Mixed**
_**\***ALWAYS Recommend a Culture in Cases of Deep Pyoderma_
383
**C.**
_**\*Human Immunoglobulin is NO Better than the use of Vincristine in a Hospitilized Patient. They work equally well and because Human Immunoglobulin is a Biological Product and Expensive its now considered that Vincristine is Preferred**_
_\*Initial Therapy will definetly be Glucocorticoids (prednisolone)- First Line of Treatment_
_\*Vincristine will benefit the patient and Reduce Hospitilization Time_
_\*We should always consider Thromboprophylaxis. On Day Three of Treatment for IMTP you will have a massive Rebound of Platelets. These platelets will Aggregate and Become Activated Easily. These Dogs are at High risk of Developing Clots and Three Days following Initial Therapy you should add Thromboprophylaxis_
384
**Endocrine Disease** Described Below:
_Systemic Signs- PU/PD, Weakness_
_Cutaneous Signs: **Bilaterally Symmetric** **Truncal Alopecia**, Poor Hair Regrowth, Hyperpigmentation, **Calcinosis Cutis**_
**Hyperadrenocorticism (Cushings)**
385
_Rescue Protoco_l used in Replase of Patients with **Lymphoma**
**Lomustine**
**\***Alkylating Agent
386
**Skin Scaping Technique** Described Below:
**_Looking for FOLLICULAR Mites- Mainly Demodex_**
**_Scrape Small Focal Area with Dulled Blade to Induce Capillary Hemorrhage_**
**Deep Skin Scrape**
387
_Side Effects_ of which **Chemotherapy Drugs:**
## Footnote
**_Severe Myelosuppresion_**
**_Sterile Hemorrhagic Cystitis_**
**Alkylating Drugs**
_**\***Cyclophosphamide: leads to Sterile Hemorrhagic Cystitis_
_\***Prevent Sterile Hemorrhagic Cystitis by administering Furosemide on the day of Chemotherapy Administration**_
388
What is Seen on _Surface Cytology_ in Patients with **Superficial Pyoderma**
**Overwhelming Staphylococcus**
389
Miniumum Treatment Length for **Cheyletiella**
**Minimum 6 Weeks**
390
Part of **Anatomical Staging** Described Below:
**_Measure the Tumor Dimensions with a Ruler or Calipers_**
_**Assess whether there is Local Invasion:** Physical Exam, Radiography, Ultrasonography, CT/MRI_
_Are there Multiple Primary Lesions?_
**Primary Tumor (T)**
_**\***Use Imaging to Assess Internal Masses- Radiography, US, CT_
391
Name this **Skin Lesion.** Is it Primary or Secondary?
**Plaque- Primary Skin Lesion**
392
The Most Common Cause of **Primary Otitis Externa**
**Atopy (Allergic Dermatitis)**
393
**Dermatosis** Described Below:
_Decreased Capacity fo Absorb Zinc from Intestines_
_Breeds Related- **Siberian Husky, Alaskan Malamute**_
_Clinical Signs- **Pruritus and Scales/Crust, Hyperkeratotic Footpads**_
**Zinc- Responsive Dermatosis**
394
_Strongest Prognosticators_ for **Mast Cell Tumors**
**Grade**
**Systemic Signs (Ex. GI Ulcers)**
**Proliferation Markers- ki67, Mitotic Index**
_**\***Proliferation Markers- Anything that Indicates a High Mitotic Index. High Grade of Proliferation Index needs Locoregional Control to Prevent Recurrence_
395
Pathopneumonic Findings on _Serum Protein Electrophoresis_ in Patients with **Multiple Myeloma**
**Protein Light Chain Immunoglobulin (IgG)**
_**\*MONOCLONAL GAMMOPATHY**_
396
Unconventional **Cancer Therapy** Described Below:
_**Repetitive Low Doses of Chemotherapy** drugs designed to minimize Toxicity and Target the **Endothelium/Tumor Angiogenesis** as opposed to Targeting the Tumor_
**Metronomic Therapy**
397
**The Dissemination of Neoplastic cells to Distant Secondary Sites where they Proliferate to form a Macroscopic Mass**
**Metastasis**
398
How to Diagnose **Pemphigus Complex**
**Derm Diligence- _Skin Scrapes, Cytology, Culture_**
**Biopsy**
399
_Side Effects_ of which **Chemotherapy Drugs:**
## Footnote
**_Severe Myelosuppression_**
**_Gastrointestinal Toxicity_**
**_Cardiomyopathy_**
**Antitumor Antibiotics (Doxorubicin)**
400
Diagnosis of **Ringworm (Dermatophytosis)**
**Fungal Culture (DTM Culture)**
401
**Feline Dermatologic Disease** Described Below:
**_Barbering of the Ventrum and Especially Medial Front Limbs_**
**Atopy**
402
**Ratio of G1/2:G0**
**Growth Fraction**
_\*Ratio of tumor cells that are in the Growth Phase (G1 and G2) relative to the Cells in the G0 (Resting Phase)_
403
**Chemotherapy Drugs** with the Following Pathological Mechanism:
## Footnote
**_Inhibit Assembly or Disassembly_**
**Mitotic Inhibitors (Ex. Vinca Alkaloids)**
_\*AKA Plant Alkaloids_
404
**Thrombocytopenia**
_\*Hemothorax would be the Cause of the Thromobocytopenia, NOT the other way around. If Hemothorax Spontaneously Developed there is NO way that Thrombocytopenia could cause this. Low Platelet Count or Low Platelet Function is incapable of causing a massive Cavity Bleed_
**_\*Only Secondary Hemostatic Disorders are Capable of Causing a Major Cavity Bleed. Thromobocytopenia is a PRIMARY Hemostatic Disorder_**
405
**Review Card: Primary vs. Secondary Lesion**s
_\*KNOW THESE_
406
Treatment for **Nasal Folliculitis and Furunculosis**
**Systemic Antibiotics for 6-8 Weeks**
**Topical Antibiotics-** _Wash/Soak_
_\*2 Weeks Post Clinical Cure_
407
**Chemotherapy Drug** used for _Single Drug Protocal_ in Cases of **Transmissible Venereal Tumors (TVT)**
**Vincristine**
408
Hallmark Clinical Sign of **Multiple Myeloma**
**Hyperviscosity** (Hypergamaglobulinemia)
409
**How would you Approach this Case?**
**Palliative Treatment**
_**\***There is no point in Recommending a Splenectomy/Blood Transfusion and Chemotherapy because the Dog is Geriatric with Metastatic Disease. There is no Point at putting him at risk with Systemic Chemotherapies_
410
**Scabies**
411
**Feline Dermatologic Disease** Described Below:
**_Alopecia, Crutsts, Scales, Itchy_**
**_Diagnoses: Skin Scrapings_**
**Demodex Gatoi**
412
\_\_\_\_\_\_IMHA:
**_Main Form in Dogs_**
_Breed Predisposition- Cocker Spaniels_
_More Prevalent in Females_
_No Age Predisposition_
**Primary**
_**\***75% of Cases of IMHA are PRIMARY_
413
**A. Multicentric, T Cell, Stage IV, Substage A**
_\*Otherwise Healthy = Substage A_
_\*Found in the Liver and Spleen but NOT Bone Marrow- Stage IV_
414
**Form of Demodicosis** Described Below:
**Localized Demodicosis**
_**\***LESS than 5 Lesions_
415
True/False: In Patients with **Cancer/Tumors** we should ALWAYS be Aspirating the Regional Lymph Nodes
**True**
_**\***Palpate Regional Lymph Node and perform FNA_
416
**Dermatologic Disease** Described Below:
_Etiologies- **Rabies and Lepto Vaccines**_
**_Hair Loss at Injection Site or in a Distant Location_**
**_Focal Alopecia_**
**Injection Site Alopecia**
_**\***Usually caused by RABIES and LEPTO Vaccines_
417
**Mitotic Inhibitor** used to Treat **Lymphoma** and **Transmissible Venereal Tumors (TVT)**
**Vincristine**
418
**Hyperadrenocorticism (Cushings**) is the MOST COMMON underlying Disease in Adult onset \_\_\_\_\_\_\_
**Generalized Demodicosis**
_**\***ON EXAM_
419
**B. Too Early to Make a Decision, the Tumor may Recur**
_Muzzle Mast Cell Tumor- Highly Aggressive and Not Easily Cured by Surgery_
_Pugs have Better Grade Mast Cell Tumors. In terms of Radiation Therapy, if you see a Rapid Response it does not necessarily mean it is a good prognosis_
420
Treatment for **Primary Idiopathic Seborrhea**
**Oral Vitamin A**
421
**Clinical Signs** of \_\_\_\_\_\_:
**Acute Otitis Externa**
_**\***Head Shaking can lead to Hematoma_
422
True/False: Investigation for **Tumor Metastasis** is usually going to Require _Advanced Imaging_
**True**
_**\***If the Dog is \> 15 kg you will Normally send the patient for a Full Body CT_
423
Portion of Treatment Protocol for **IMHA** Described Below:
_Decreases Risk of Thromboembolism in Patients with Immune Mediated Disease_
**Thromboprophylaxis (Aspirin and Clopidogrel)**
_**\***Anytime that you diagnose an Immune Mediated Disease in a Patient and you get them on Steroids, make sure to add Thromboprophylaxis_
**_Leading Cause of Death in Patients with IMHA- Thromboembolism_**
424
**Chemotherapy Drug** that Most Commonly Causes _Nausea_
**Cisplatin**
_**\***Cisplatin is a Very Powerful Emetogen- Dogs and Cats can have an associated Food Aversion_
**_\*Usually 24 Hours Prior to Cisplatin Therapy you will start with Maropitant_**
425
True/False: Handeling of **Chemotherapy Drugs** should occur under a Laminar Flow Hood that causes Adequate Ventilation so that there is No Inhalation
**True**
426
_Treatment_ for **Surface, Superficial, and Deep Pyoderma**
**_Surface:_** _Topical Antibiotic_
**_Superficial:_** _Systemic and Topical Antibiotic_
**_Deep:_** _Long Term Systemic and Topical Antiboitic_
_\*Topical Therapy leads to Rapid Visual Improvement in Lesions_
427
Treatment for **Multiple Myeloma**
**Melphalan and Prednisolone**
428
Treament of **LOCALIZED Demodex**
**90% Usually Resolve without Treatment**
_**\***DO NOT USE GLUCOCORTICOIDS_
429
True/False: We can Raise the Number of _Platelets_ in a Patient with a **Blood Transfusion**
**False**
_**\***Blood Transfusion DOES NOT Raise Platelet Count_
430
_Symptomatic Therapy_ for Patients with **Atopy (Allergic Dermatitis)** Described Below:
_Very Effective for Atopy (Allergic Dermatitis)_
**_Anti-Allergic and Immunosuppressive_**
**_Very Expensive_**
**Cyclosporine A**
431
**85% of Appendicular Bone Tumors** are \_\_\_\_\_
**Osteosarcoma**
432
**Alkylating Chemotherapy Drugs** used to treat **Lymphoma Rescue and Mast Cell Tumors**
**Lomustine**
_**\***Used for Relapse/Rescue Lymphoma_
433
**Feline Dermatologic Disease** Described Below:
## Footnote
**_Persistent and Year Round Pruritus at ANY Site on Body, Especially Face and Head_**
**Food Allergy**
_**\***Especially Head and Face Pruritus_
434
Normal _Regenerative_ Absolute **Reticulocyte Count**
**60,000 (Dogs)**
**42,000 (Cats)**
_\*Ex. Canine Patient has a Reticulocyte Count of 35,000 and the patient is Acutely Collapsed, Hemoglobinemia, PCV of 10%. The Diagnosis would be a NON-Regenerative Anemia_
435
Treatment for **Mild Myelosuppression (2-3)** during Chemotherapy
**Reduce Drug Dose by 25-50%**
436
How do we Diagnose **Mast Cell Tumors**
**FNA/Biopsy**
437
_Symptomatic Relief_ for **Atopy (Allergic Dermatitis)** that carries **Strong Evidence**
**Glucocorticosteroids**
**Cyclosporine A**
**APOQUEL**
438
**Dermatological Ear Condition** Described Below:
**_Inflammation of the Outer Ear_**
_Multifactoral Causes- Rarely due to a Single Cause_
_Three Factors: **Primary, Predisposing, and Perpetuating**_
**Otitis Externa**
439
How to Confirm Diagnosis of **Mammary Gland Tumor in Canines**
**Excisional Biopsy**
_**\***If we Biopsy a Mammary Gland Tumor- Excisional_
440
_Best Biopsy Method_ to Confirm **Osteosarcoma**
**Needle Core Biopsy**
_**\***Take at least 2-4 Core Biopsies_
441
Treatment for **Hypercalcemia of Malignancy (Paraneoplastic Syndrome)**
**_Mild Hypercalcemia_- Rehydration with Normosaline**
**_Moderate Hypercalcemia_- Rehydrate with Normosaline and then Treat with Furosemide**
**_Severe Hypercalcemia_****- Salmon Calcitonin and Biphosphonates**
442
Hallmark of which **Hematopoetic Tumor:**
## Footnote
**_Very Large Lymph Nodes that are Rapidly Progressive_**
**_Painless Rubbery Lymph Nodes_**
**Lymphoma**
_**\***Lymphomas grow very quickly_
443
**Green Discharge** from the **Ear** is usually Diagnostic for\_\_\_\_\_\_
**Pseudomonas**
444
What would you see on a _Bone Marrow Aspirate_ in a Patient with **Multiple Myeloma**
**\> 30% Plasma Cells with Basophilic Cytoplasm and Eccentric Nuclei**
_**\***AKA Bone Marrow Plasmacytosis_
445
Name this **Skin Lesion.** Is it Primary or Secondary?
**Fissure- Secondary Skin Lesion**
446
Treatment for **Hemangiosarcoma**
**Surgery- Palliative** (Coagulogram, Arrhythmias)
**Chemotherapy- Doxorubicin**
_\*Best Prognosis- Surgery Combined with Chemotherapy. Doxorubicin must be included in the Chemotherpy Protocol_
447
_Chemotherapy Protocol_ that is used in Patients with **Mast Cell Tumors**
**Vinblastine/Cyclophosphamide/Prednisone**
**or**
**TKI (Masitinib/Toceranib)**
448
Three Common Drug Types affected by **Multidrug Resistance**
**Vinca Alkaloids**
**Anthracyclines (Doxorubicin)**
**Actinomycin D**
_**\***Mainstay of most of our Chemotherapies_
449
Treatment for **B-Cell Intestinal Lymphoma (Ailmentary Lymphoma)**
**Chemotherapy (Chlorambucil with Prednisolone)**
450
Common _Clinical Signs_ of which **Ear Condition:**
## Footnote
**_Vestibular Signs_**
**_Nystagmus_**
**_Circling_**
**_Head Tilt_**
**Otitis Interna**
451
_Prognosis_ for **Mammary Tumors in Canines**
**Sarcoma and Inflammatory Carcinoma**- _Grave Prognosis_
**Tumor \> 3cm**- _Poor Prognosis_
452
**A. Size \> 4 cm- Bad**
_**\***If Mammary Tumor is \> 4cm there is a VERY HIGH chance that the Tumor is going to Recur_
453
Tests used to Assess _____ Hemostatic Disorders:
**Activated Partial Thromboplastin Time (APTT)**
**Prothrombin Time (PT)**
**FDPs and D-Dimers**
**Secondary Hemostatic Disorders**
454
**Chemotherapy Drugs** are Excreted for _____ Days, therefore Handling of Urine, Feces, Vomit or Saliva should be Avoided
**3-8 Days**
455
**Acute Leukemia:** Neoplastic Transformation EARLY in the Cell Lineage leading to Proliferation of \_\_\_\_\_\_
**Chronic Leukemia:** Neoplastic Transformation LATE in the Cell Lineage leading to Proliferation of \_\_\_\_\_
**Lymphoblasts (Acute)**
**Mature Lymphocytes (Chronic)**
456
_Primary Lesions_ associated with **Pemphigus Complex**
**Pustules, Vesicles and Bullae**
457
Mainstay **Chemotherapy** for Most Tumors
**Doxorubicin**
458
**C. Palliative Steroid Therapy with H1 and H2 Blockers**
459
**Feline Dermatologic Disease** Described Below:
**_Self Induced Alopecia caused by ANXIETY-_** _New Baby, Recent Move ect._
_Common Locations- **Medial Thighs, Ventral Abdomen, Medial Forelegs**_
**Psychogenic Alopecia**
460
**Dermatologic Disease** Described Below:
_Looks just Like Hypothyroidism and Hyperadrenocorticism_
**_Difference: NO Systemic Signs, Normal Endocrine Tests_**
_Primary Hairs on Trunk Lost and Slowly Progressive Hair loss_
_Head and Limbs Spared- **Commonly ONLY have Hair on Head and Legs**_
_Common Breed: **Chows, Pomeranians**_
**Alopecia X**
_**\***We DON'T know the Cause- Unkown Etiology_
461
**Ringworm and Flea Allergic Dermatitis**
462
**Chemotherapy Drugs** that Specifically Target the **S Phase** of the Cell Cycle
**Antimetabolites**
463
What **Dermatologic Condition** are we Testing for?
**Microsporum Canis (Ringworm)**
_**\***Make sure the HAIR SHAFT Fluoresces_
**_\*ONLY HALF (50%) M. Canis will Fluoresce_**_- Majority of Ring Worm Cases that you see will NOT Fluoresce_
464
Diagnosis based on Image
**Heinz Body Anemia**
465
Treatment for **Flea Allergic Dermatitis**
**Eliminate Fleas-** _Frontline, Monthly Spot On for Dogs, Advantage ect._
**Predisolone (Steroids)**_- Reduces/Stops Pruritus_
_\*95% of Flea Eggs, Larvae and Pupae are going to live in the Environment, not the Pet- Concentrate House and Yard Treatments on "Source Points" and areas where Pets spend the most time_
_Steroids- Use Lowest Dose that will Control Signs while Rigorously Implementing FLEA CONTROL_
466
Treatment for **Papillomatosis**
**Some Regress**
**Crushing/Laser/Cryotherapy**
467
**Four Phase Treatment/Chemotherapy Protocol** used in Patients with Hemopoetic Tumors such as **Lymphoma**
**Induction:**
_**High Intensity**, Risk of Toxicity_
_Greatest Change of Response_
**Consolidation:**
_Unrelated Drugs to Reduce Survival of Remaining Tumors_
**Maintenance:**
_Less Intense, No Effect on CR_
**Rescue:**
_No longer in Remission_
_Use Unrelated/Alkylating Drugs_
**_\*Lymphomas are VERY likely to Relapse_**
468
**Form of Demodicosis** Described Below:
**Generalized**
_**\***MORE than 5 Lesions_
469
Most **Chemotherapy Drugs** work on ______ Cells (Tumor and Normal Tissue)
**Rapidly Dividing**
470
**Immune Mediated Thrombocytopenia**
_**\***Breed with the Highest Risk of developing Immune Mediated Thrombocytopenia- Border Collie_
_IMTP- Differential of Pyrexia of Unknown Origin (Fever)_
471
_2 yo Great Dane_
## Footnote
**_Firm Enlarged Area on Metaphyseal Region of Limb_**
**What is the Most Likely Diagnosis?**
**Osteosarcoma**
_**\***Large Breed Dogs- More Prevalent (Size and Height are Risk Factors_)
_Most Common Site in Large Breed Dogs- Distal Radius_
472
Treatment for **Pyotraumatic Dermatitis (Hot Spot)**
**Eliminate Trigger** (Fleas, Stress ect.)
**Short Course Corticosteroids!!!!**
**\***_Needs a Steroid to Stop the Itching!- ON EXAM_
473
8 Year Old Golden Retriever. Fine Needle Aspirate Reveals Lymphoma ( \> 50% Lymphoblasts)
## Footnote
**What Treatement should you Suggest?**
**Systemic Chemotherapy**
_\*Majority of Lymphomas in Dogs are Hematopoeitic and Require Systemic Chemotherapy_
474
Must Perform a ______ on **ALL CATS with Skin Disease**
**Fungal Culture (Dermatophyte Culture)**
_**\***Pluck the Hairs that Fluoresce with Woods Lamp for DTM Inoculation_
475
**Dermatologic Disease** Described Below:
_Food is the Trigger for Allergic Dermatitis_
**_Nonseasonal Pruritus_**
**_Secondary Pyoderma_**
**Cutaneous Adverse Food Reaction (CAFR) AKA Food Allergy**
_**\***Food can be a Trigger for Skin Disease_
476
In Patients with **IMTP (Immune Mediated Thrombocytopenia)** what Blood Product is most commonly used in Transfusion
**Fresh Whole Blood**
477
Blood Typing for Which Species:
## Footnote
**_No Naturally Occuring Alloantibodies_**
**_First Transfusions RARELY Result in Serious Reactions (Even if Unmatched Donor)_**
**_Imperative to Cross Match Prior to Subsequent Transfusions_**
**Canine**
478
How to Diagnose **Superficial Necrolytic Dermatitis:**
**Derm Diligence- Skin Scraping, Cytology, DTM Culture**
**Ultrasound: Honey-Comb appearance to Liver**
479
Only Blood Product used for **Felines** during Transfusion
**Fresh Whole Blood**
480
**Secondary Hemostatic Disorder** Described Below:
**_Systemic Coagulation and Fibrinolysis_**
_Thrombosis and Bleeding_
**_Due to Widespread Endothelial Damage/Release of Tissue Thromboplastins_**
**DIC**
_Acute Form- Devastating Form where patient is spontaneously Bleeding_
_**\***Chronic or Compensated DIC may not show obvious Bleeding_
481
**Chemotherapy Protocol** Described Below:
## Footnote
**_High Toxicity_**
**_Severe Risk of Side-Effects_**
**_Better Survival_**
**CHOP**
_**\***Side Effect- Higher Toxicity_
482
**Leukemia** Described Below:
_Older Animals (\> 10 years)_
_Incidental Finding (50%)_
**_Leukocytosis- Small/Medium Lymphocytes_**
**Chronic Lymphocytic Leukemia**
483
In Patients Recieving _Chemotherapy Drugs_, Give **Prophylactic Antibiotics** on Subsequent Dosing if Nadir is Less than ______ cells/uL
**500 cells/uL**
_**\***Nadir = Low Point_
_\*Ex. Doxorubicin causes Severe Myelosuppression, it has been shown that Prophylactic Antibiotics will Reduce the Side-Effects by preventing Severe Myelosuppression_
484
Treatment for **Injection Site Alopecia**
**Oral Pentoxifylline**
_**\***Increases the Vascular Supply_
485
**_Gino: Cat with a Thick Gut_**
_13 Year Old Castrated Male_
**_Chief Complaint: Vomiting ( 2 day duration), Inappetent (1 Day Duration), Lethargy_**
_Recent Introduction of Stray Cat to Household_
_Blood Pressure: 70mmHg (Hypotension)_
_Haemotology and Clinical Chemistry- **Severe Leukocytosis, Moderate Azotemia**_
**_Abdominal Ultrasound- Thickened Muscularis Propris Layer of the Small Intestine_**
**What is the Diagnosis?**
**B-Cell Intestinal Lymphoma (Ailmentary Lymphoma)**
_Massive Inflammatory Response (Severe Leukocytosis)- Must be either Cancer, Infectious Disease, or Immune Mediated Disease_
**_Thickened Muscularis Propria Layer of Small Intestine = Ailmentary Lymphoma_**
486
Common Clinical Findings of which Condition:
**_Horners Syndrome_**
**_Facial Paralysis_**
**_Bulging/Ruptured Tympanic Membrane_**
**Otitis Media**
487
Mainstay of Therapy for Patients with **Immune Mediated Hemolytic Anemia (IMHA)**
**Glucocorticoids (Prednisone 2mg/kg/day)**
_\*There can be Delay of Effect of up to 14 days_
488
**Defining the _Anatomical Extent_ of the Tumor in Terms of Primary Site and Distant Spread using the _TNM System_**
**Anatomical Staging**
_**\***TNM Classification_- Primary Tumor (T), Lymph Node (N) and Metastasis (M)
\*The type of Tumor you have based on your Grade will dictate the Type of Staging that you are going to perform
489
**Dermatologic Disease** Described Below:
**_Common Locations: Ear (Otitis Externa), Lip Folds, Ventral Neck, Interdigital, Perianal (CHECK FOLDS, CHECK EARS)_**
_Frequently a **Secondary** Invader of Skin + Ears_
Commonly **_Secondary to Allergic Dermatitis- Fleas, Food, ect._**
**Malassezia Dermatitis (Yeast)**
_\*Malassezia = Foot Prints_
490
**Dermatologic Condition** Described Below:
**_Loss of Pigment and Cobblestone Texture to Nose_**
_Depigmentation of Lips_
_Hyperkeratosis of Nose and Footpads_
**Discoid Lupoid Erythematosus**
491
True/Fase: **Chemotherapy Tablets** should NOT be _Crushed or Broken_ for Administration
**True**
_**\***These Tablets do NOT have Even Distribution of Drug throughout the Tablet- Would Not be able to Accurately dose the Drug with Broken Tablets_
**_NEVER Crush or Break these Tablets_**
492
How to Confirm Diagnosis of **Osteosarcoma**
**FNA/Biopsy**
_**\***Once we have the Confirmation, we know that the Limb must be Amputated_
493
Most Common Blood Type in **Canines**
**DEA 1.1 and DEA 1.2**
494
**Cytology**
495
On Cytology you find **Acantholytic Cells.** What is you Number one Differential Diagnosis?
**Pemphigus Complex**
496
_Skin Scrapings: **Superficial and Deep- Negative**_
**_Tape Preps- Cocci and Malassezia_**
**_Cytology of Papule- Cocci_**
_Fungal Culture- Pending x 10 Days; Negative_
**What Kind of Pyoderma does this Patient have?**
**Superficial Pyoderma** (Papules and Staph)
**_\*Cocci = Superfical Pyoderma (Staph)_**
_\*Yeast (Malassezia) Like to Cause Hyperpigmentation and are very Pruritic_
497
Patient is Anemic with **Spherocyte Formation and Agglutiation.** _What is the Diagnosis?_
**Immune Mediated Hemolytic Anemia (IMHA)**
498
**Small Tumors** undergo an _Accelerated Rate of Division/Growth_ and are _____ to the Effects of **Chemotherapy**
**Very Susceptible**
_**\***Small Tumors- Maximum Effect of Cytotoxic Drugs/Chemotherapy_
499
**F. Thromboembolism**
**_\*These Patients suffer a Hypocoagulable State as a Result of Hyperglobulinemia- These Patients are at risk of Bleeding_**
_\*Main Complication of Multiple Myeloma- Hyperviscosity Sydrome (Hypergammaglobulinemia) leading to CVA, Retinal Detachment, CKD, and Hypertrophic Cardiomyopathy_
500
_Combined Chemotherapy Treatment_ that leads to 80-90% Remission Rate with MST of 12 Months in Patients with **Lymphoma**
**CHOP**
501
**D. Surgery/Radiation for Loco-Regional Control and Chemotherapy for Distant and Long-Term Masivet**
_\*Definitive Therapy for a Mast Cell Tumor that cannot be Controlled by Surgery because of Location_
502
**E. All the Above except for B**
503
In _Canines_, \_\_\_\_% of **Mammary Gland Tumors** are Malignant
**50%**
_**\***50% of Canine Mammary Tumors are Benign- Mixed Mammary Tumors_
**_50% of Canine Mammary Tumors are Malignant- Carcinomas_**
504
Specific _Indications_ for Pretreatment _____ in Patients with **Tumors:**
**Biopsy**
_**\***Only done if the Results of the Biopsy would change the way you would Manage the Case or change the way you would Perform Surgery_
_\*If the Prognosis of this Tumor is going to Influence the Decision made by the owner- Would Biopsy change the Owners williness to Go Forward with Curative-Intent Treatment_
505
**Paraneoplastic Syndrome** Described Below:
**_Neuroglycopenia: Seizures (BG \< 45 mg/dl)_**
_Caused by Three Tumour Types- Insulinoma, Hepatic Neoplasia, and Leiomyoma_
**Hypoglycemia**
_**\***Neuroglycopenia- Blood Glucose is below 45 mg/dl at this point patients will Normally show Clinical Signs- Weakness and Seizures_
506
Tests used to Assess ______ Hemostatic disorders:
## Footnote
**Platelet Count**
**Plateletcrit**
**Buccal Mucosal Bleeding Time**
**Vonwilibrand Factor Concentration (vWF Concentration)**
**Primary Hemostatic Disorders**
507
**Erythrocyte Fragmentation** is Caused by Increased Turbulence or Vascular Disease. _Blister Cells, Keratocytes_, and _____ are Signs of Fragmentation
**Schistocytes**
508
Part of **Anatomical Staging** Described Below:
**_Look for Metastases_**
_Direct Extension along Tissue Planes_
**Distant Metastases (M)**
509
**Nystagmus**
510
Name Four Causes for **Mean Corpuscular Volume (MCV)** to **Increase**
**Regenerative Anemia (Reticulocytes)**
**Toy Breeds**
**Cats with FeLV and Myeloid Dysplasia**
**Artifact (Agglutination)**
_**\***Increased MCV = Large Red Blood Cells_
511
Three Techniques used to Prevent **Perivascular Reactions** with **Chemotherapy Drugs**
**Use a Catheter**
**Clean Stick**
**Flush after Chemo Agent**
512
**C. Microcytic Hypochromic Anemia in a Dog due to Dermal Mast Cell Tumor**
**_\*Secondary to HIGH Histamine Concentrations from Mast Cell Tumor will cause Gastric Ulceration and Microcytic Hypochromic Anemia_**
_\*Discontinue Vincristine and see if Peripheral Neuropathy Persists_
_Intestinal Mast Cell Tumor- Gastrointestinal Blood Loss leads to Microcyctic Hypochromic Anemia due to DIRECT Ulceration_
_Thrombocytopenia due to Splenic Hemangiosarcoma- Sequestration_
513
Common **Side Effects** of Which Treatment Modality for _Cancer:_
**Radiotherapy**
_**\***Alopecia- Initially you will see Loss of Hair and changes in Pigmentation of the Coat/Hair_
_Moist Epidermal Inflammation- Similar to "Sun Burn"_
514
Treatment for **Demodex Gatoi**
**Lime Sulfur Dip**
515
_Average Duration of Oral Ivermectin_ in Patients with **Generalized Demodex**
**3 Months**
516
Systemic Treatment for _____ should continue until **2 Negative Cultures 1 Month Apart**
**Dermatophytosis (Ringworm)**
517
Four **Disorders of Platelet Numbers** leading to **Thrombocytopenia**
**Failure of Megakaryopoiesis (Production Problem)**
**Increased Consumption/Demand**
**Platelet Destruction**
**Platelet Sequestration**
518
Treatment for **Zinc-Responsive Dermatosis**
**Oral Zinc Supplementation**
519
Treatment for **Acute** **Otitis Externa**
**Tresaderm-** _Topical Combination of Antibiotic, Steroid and Antifungal_
_\*Recheck 7-10 days_
520
Side Effect of **Chemotherapy** Described Below:
**_Large Tumor Burden- Rapid Cell Kill_**
_Rapid Relase of Ions_
_Leads to **Hyperkalemia, Hyperphosphatemia, and Hypocalcemia**_
_Acute Renal Failure_
**Acute Tumor Lysis Syndrome**
521
True/False: **TNM Staging** Asseses Actual _Extent of the Disease_
**False**
_**\***Clinical "Stage" is not true Pathological Stage- Low Sensitivity of Detection_
522
Five Common Disorders of **Secondary Hemostasis** _(Ex. Large Cavity Bleed)_
**Vitamin K Antagonism (Warfarin Toxins)**
**Vitamin K Deficiency-** _Liver Failure_
**Hereditary Coagulopathies-** _Hemophilia A (Factor VIII Deficiency)_
**Disseminated Intravascular Coagulation (DIC)**
**Infections**
523
_Advantages and Disadvantages_ of which Method of **Tumor Cell Collection** for Cytology
**Biopsy**
_**\***In Addition to Identifying the cell you can also Identify ARCHITECTURE with a Biopsy_
_\*The Main Disadvantage is that it usually requires General Anesthesia_
