Lecture 3 Flashcards
(32 cards)
definition of cancer cachexia
Profound state of malnutrition and weight loss despite adequate nutrition
clinical significance of cancer cachexia
–Decreased quality of life
–Decreased response to treatment
–Decreased survival time
Mechanism of cancer cachexia
–Glucose is preferred substrate for cancer cells
–Tumor cells incomplete glucose metabolism- 2 molecules of ATP (vs. 36 in normal cells)
–Lactate is produced as an end product
–Energy expended converting lactate back to glucose
–Gluconeogenesis»_space;> net energy loss by host
–Protein degradation (for gluconeogenesis)
•muscle wasting
•decreased immune function
•decreased wound healing
–Lipolysis occurs to provide energy for host
Clinical signs of hypercalcemia
anorexia or vomiting, PU/PD, muscle
weakness
goals of hypercalcemia treatment
– Increase renal excretion of calcium
– Inhibit bone reabsorption
– Prevent calcium deposition in tissues
– Promote external loss of Calcium
Treatment strategies for hypercalcemia
• Saline diuresis (0.9% NaCl IV) • Furosemide – inhibits reabsorption at loop of Henle ****Bisphosphonates - Pamidronate • Glucocorticoids – only after diagnostic sampling
Causes of hypoglycemia
- Insulinoma- pancreatic islet cell neoplasia
- Hepatic tumors
- Leiomyoma / Leiomyosarcoma
- Oral melanoma
- Lymphosarcoma, plasma cell tumors
clinical signs of hypoglycemia
weakness, tremors, seizures
Treatment of hypoglycemia
–Feed frequently- high protein better than high carbohydrate
–Glucose solutions IV or orally
•Careful with insulinoma
–Glucocorticiods ( hepatic gluconeogenesis)
Medications use to manage hypoglycemia
–Diazoxide
–Hydrochlorthiazide
–Propanolol
–Somatostatin (octreotide)-
mechanism of action of diazoxide
Epi-induced glycogenolysis, inhibits insulin release and uptake $$$
mechanism of action of hydrochlorothiazide
potentiates diazoxide
mechanism of action of propanalol
blocks beta receptors at the level of pancreatic beta cell-insulin release
mechanism of action of somatostatin
theoretically controls hormone hypersecretion and clinical symptoms
downside of streptozotocin for hypocalcemia
- Nephrotoxic, must be administered with saline diuresis
* May induce diabetes mellitus
chemotherapeutic that might help with insulinoma
palladia
tumors associated with polycythemia
–Renal cell tumors
–Lymphosarcoma
–Hepatic tumors
–Nasal fibrosarcoma
clinical signs of polycythemia
–Neurologic- motor or sensory depression, dullness, lethargy, seizures
–Hemorrhage (epitaxis, hyphema)
treatment of polycythemia
–Phlebotomy
–Remove or treat primary tumor
–Hydroxyurea
hydroxyurea uses
Will help with heart patients but tachyphylaxis will occur
definition of hypertrophic osteopathy
Periosteal proliferation of new bone along the
shafts of long bones
clinical signs of hypertrophic osteopathy
Pain, reluctance to move, “swollen legs, or
swollen joints”
hypertrophic osteopathy is associated with what type of tumors?
large thoracic or
abdominal cavity mass
treatment for hypertrohic osteopathy
– Treat or remove primary tumor – Corticosteroids – NSAIDS – Bisphosphonates – Vagotomy (not really done anymore)
