Onco Q's.

Question 1

You are performing ultrasound, blood work and radiographs after diagnosing a primary tumour on biopsy.

What is this called?

Answer 1

Staging.

Question 2

Feline lymphoma usually affects what cats?

Answer 2

Usually young cats with FeLV associated disease.

Question 3

What is a negative prognostic indicator associated with lymphoma in cats and dogs?

Answer 3

Hypercalcemia.

Question 4

What is the most common location site for MCT in cats?

Answer 4

Cutaneous.

Question 5

Where do you give the FeLV vaccine?

Answer 5

Left hindlimb.

Question 6

What are the 2 vaccines most commonly implicated with vaccine-induced sarcomas in CATS?

Answer 6

Rabies and FeLV.

Question 7

What is the 1-2-3 Rule of injection-site sarcomas in cats?

Answer 7

Still growing 1 month after vaccination.

If over 2 cm in size.

If it persists for over 3 months after vaccination.

Question 8

Which of the following is not a proposed factor for vaccine-associated fibrosarcoma in cats?

Answer 8

Needle gauge, syringe reuse, vaccine temp, shaking of syringe, massaging site.

Question 9

Following an incisional biopsy of a Soft tissue sarcoma in a cat, what is the most appropriate diagnostic test?

Answer 9

CT.

Question 10

Cutaneous HSA has been associated with what?

Answer 10

UV light exposure.

Question 11

What are 3 common locations for HSA?

Answer 11

Heart.

Spleen.

Subcutaneous tissues.

Question 12

In an osteosarcoma, what liver enzyme should you measure for prognosis?

Answer 12

ALP.

Question 13

What is the 90/10 rule with osteosarcomas?

Answer 13

90% die from metastatic disease.

Under 15% show metastasis at time of diagnosis.

Question 14

With which chemo drug will you monitor ALT levels?

Answer 14

Lomustine.

Question 15

Why do we monitor ALT levels when giving lomustine?

Answer 15

It is hepatotoxic in dogs.

It is also lipophilic and crosses the blood brain barrier.

Question 16

What is the gold standard treatment for OSA in dogs?

Answer 16

Amputation and chemotherapy.

Question 17

An owner asks you why the oncologist recommends continuing chemotherapy in their dog despite being told its cancer is in remission.

You tell the owner this is because?

Answer 17

Tumour cells are still present, below the level of clinical detection.

Question 18

A 10-year-old female GSD presents for a 1 cm oral mass.

The mass was surgically excised with complete surgical margins and histopathology indicating oral malignant melanoma.

What do you suggest next?

Answer 18

Oncept vaccine.

Question 19

What are the indications for the oncept vaccine?

Answer 19

Oral malignant melanoma.

It give locoregional control for an oral malignant melanoma.

Question 20

When will we not use radiation therapy?

Answer 20

If the tumour has been removed with complete surgical margins.

Question 21

Which of the following is not one of the 3 reasons why it important to always review your slide of an FNA sample prior to submitting for pathology?

Answer 21

Determining the type of neoplasia so you can start treatment ASAP.

Question 22

Background inflammation with reactive cells in a cytology sample can interfere with your interpretation.

What type of neoplasia is this most problematic in?

Answer 22

TCC in the bladder.

Also MCT with fibroblasts in background.

Question 23

You obtain the following slide (pic) from a FNA bladder mass.

You suspect it is TCC because of the mass shedding of epithelial cells.

However you also see lots of bacteria.

What do you do next?

Answer 23

Clear the infection first and then resample mass.

Question 24

In which of the following scenarios is pre-treatment biopsy NOT recommended?

A. Large mass on the hock of a greyhound.

B. Small dermal mass on the flank of a dog.

C. Splenic mass.

Answer 24

C. Splenic mass.

Also: Spinal cord mass.

Question 25

You diagnose an oral mass as malignant melanoma. Where should you investigate for metastasis?

Answer 25

Lungs, submandibular lymph nodes.

Question 26

What kind of metastasis do we get if there is metastasis to the lungs only?

Answer 26

Hematogenous (mesenchymal).

Question 27

What kind of metastasis do we get if there is metastasis to the submandibular lymph nodes only?

Answer 27

Lymphatics (round cell).

Question 28

What side effects of chemotherapy are MOST commonly observed?

Answer 28

Bone marrow suppression. Alopecia. GI upset.

Question 29

What unique toxicity is associated with cyclophosphamide?

Answer 29

Sterile hemorrhagic cystitis.

Question 30

What cancer drug causes hepatotoxicity in dogs?

Answer 30

Lomustine.

Question 31

What is the MOST common side effect of cyclophosphamide?

Answer 31

Myelosupression.

Question 32

What chemotherapy drug is nephrotoxic and known to cause fatal pulmonary oedema in cats?

Answer 32

Cisplatin.

Question 33

How can we prevent renal toxicity in cats with cisplatin?

Answer 33

With diuresis.

Question 34

What drug causes minimal renal toxicity and is safe to use in cats?

Answer 34

Carboplatin.

Question 35

Which chemotherapy drug is contraindicated in cats as it can cause a fatal neurotoxicity?

Answer 35

5-fluorouracil

Question 36

Which chemotherapy drug is a severe tissue vesicant that can cause a unique nephrotoxicity in cats and a cumulative dose-related cardiotoxicity in dogs?

Answer 36

Doxorubicin.

Question 37

A 6-year-old MC collie presents for lymphadenopathy and cytology diagnoses lymphoma. His owners would like to pursue combination chemotherapy (CHOP protocol), however you know that 70% of Collies are affected by the MDR-1 mutation. Testing for MDR results can take 1-2 weeks. Knowing that LSA can progress rapidly, you decide to start treatment with a drug not dependent on P-glycoprotein to avoid potentially causing significant side effects. What drug in the CHOP protocol do you start with?

Answer 37

Cyclophosphamide.

Question 38

A 6 year old West Highland Terrier is diagnosed with multicentric lymphoma. It presents to the ER 6 days after receiving the protocol for CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone). It has a history of vomiting and diarrhoea for 2 days. What do you suspect caused these signs?

Answer 38

Doxorubicin.

Question 39

What drug causes visceral stimulation of CTZ normally seen 3-5 days after chemotherapy?

Answer 39

Doxorubicine. This leads to vomiting and diarrhoea.

Question 40

What anti-emetic is the 1st line of treatment for this doxorubicine induced vomiting?

Answer 40

Maropitant (cerenia).

Question 41

What is metaclopromide used for?

Answer 41

To treat ileus from vincristine.

Question 42

What treatment is indicated for this doxorubicine induced diarrhoea in a collie if the MDR-receptor status is unknown?

Answer 42

Metronidazole and a bland diet.

Question 43

What 2 cell lines are you most concerned about with the side effects of myelosuppression following chemotherapy?

Answer 43

Neutrophils and platelets. Rapidly divided cells.

Question 44

When is emergency treatment of neutropenia caused by myelosuppression indicated?

Answer 44

When the patient is febrile and lethargic with a neutrophil count of 800.

Question 45

Tanovea is an example of a chemotherapeutic that has conditional approval from the FDA. What does this mean?

Answer 45

No extra-label use permitted. Can lose license.

Question 46

A 14-year-old FS DSH presents to you with weight loss and difficulty eating. A large mass is present on the left maxilla. Cytology diagnoses lymphoma. What can you recommend to palliate this cat’s disease and provide quality of life prior to definitive therapy?

Answer 46

Single dose radiation therapy.

Question 47

What type of radiation therapy is not radioactive following therapy?

Answer 47

External beam radiation therapy (Teletherapy).

Question 48

What is the most important mechanism of action that we use radiation therapy for?

Answer 48

Indirect damage leading to free-radical formation.

Question 49

Which of the following is not one of the R’s of Radiation therapy?

Answer 49

Resist.

Question 50

What do the R’s of Radiation therapy determine?

Answer 50

How safely and effectively cancer can be treated with radiation therapy.