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SAM. > Onco Q's. 2. > Flashcards

Onco Q's. 2. Flashcards

1
Q

Fluffy is an 8-year old MC chow.

He presents for a routine yearly evaluation which requires muzzling.

On examination, you find his right mandibular lymph node is firm and enlarged and a dark, pigmented oral mass.

You perform cytology and observe melanocytes on both the lymph node and oral
mass consistent with a highly aggressive malignant melanoma.

What type of radiation therapy is best indicated for palliative care in Fluffy?

A

Coarse fractionation radiation of oral mass and lymph nodes.

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2
Q

What mode of palliative care will result in death very quickly?

A

Fine fractionation of a mass and lymph nodes.

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3
Q

What is the most common nasal tumour of cat that if localized, has a MST of 18 months with radiation therapy?

A

Lymphosarcoma.

Lymphoblastic lymphoma.

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4
Q

Which of the following is not a feature of definitive radiation (fine fractionation) therapy?

A

Goal of providing pain relief, comfort and QOL.

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5
Q

What is a feature of coarse fractionation therapy?

A

Goal of providing pain relief, comfort and QOL.

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6
Q

Which of the following is NOT a feature of palliative radiation (coarse fractionation) therapy?

A

Goal of achieving long-term tumour control.

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7
Q

What is a feature of fine fractionation therapy?

A

Goal of achieving long-term tumour control.

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8
Q

You are highly suspicious of lymphoma in a dog.

However cytology is not diagnostic.

Before sending out lymph node aspirates for pathology, you quickly perform a SNAP4Dx test which comes back
positive for Ehrlichia.

What test is BEST to run in this case?

A

a. Histopathology and immunohistochemistry.

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9
Q

What 2 tests gives a false positive for E canis?

A

Flow cytometry.

PARR.

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10
Q

What is the most common paraneoplastic syndrome seen with Lymphoma?

A

Anaemia.

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11
Q

What tests are necessary in order to properly stage lymphoma prior to initiating therapy?

A

Thoracic x-rays, abdominal U/S, CBC, Chem, UA.

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12
Q

A dog presents for an annual wellness exam.

On physical exam you find with generalised lymphadenopathy.

The dog is otherwise clinically normal but cytology of the lymph nodes is consistent with Lymphoma.

Further diagnostics reveal liver involvement.

What stage of lymphoma does this dog have?

A

Stage IVa.

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13
Q

What does Stage 2b lymphoma indicate?

A

Lymphoma in lymph nodes cranial the diaphragm only, clinically unwell

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14
Q

What does stage 1a lymphoma indicate?

A

Lymphoma in single node, clinically well.

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15
Q

What does stage 3a lymphoma indicate?

A

Lymphoma in all lymph nodes, clinically well.

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16
Q

What does Stage 4b lymphoma indicate?

A

Lymphoma in all lymph nodes and spleen involvement, clinically unwell.

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17
Q

What does stage 5a lymphoma indicate?

A

Lymphoma in single node and blood, clinically well.

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18
Q

Which is associated with a better prognosis in response to lymphoma treatment in a dog?

A

Past history of glucocorticoids administered 6 months prior to diagnosis.

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19
Q

What is the best protocol and corresponding remission rate and prognosis (MST) for the treatment of B-cell Lymphoma?

A

CHOP, 80-90% remission, 12 months MST.

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20
Q

What is the % remission for re-induction of the CHOP protocol in a dog with recurrent LSA?

A

70% remission.

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21
Q

What is the typical presentation for Lymphoma in a FIV/FeLV ( – ) cat?

A

Older, alimentary form.

MST = 6 months.

22
Q

What is not associated with a better prognosis to treatment of feline LSA?

A

B-cell type.

23
Q

What is not associated with a better prognosis to treatment of canine LSA?

A

B-cell type.

24
Q

Which of the following is not a granule found in Mast Cell Tumors?

A

Citrate.

25
Q

What is recommended in order to best achieve clean margins of MCT tumour excision?

A

2 cm lateral, 1 fascial plane deep.

26
Q

What is recommended in order to best achieve clean margins of soft tissue sarcoma excision?

A

3 cm lateral, 1 fascial plane deep.

27
Q

You are supportively treating a dog with a measurable MCT.

You may have to poke it.

How can you block H1 receptors?

A

Diphenhydramine.

28
Q

What drug can you use to block H2 receptors?

A

Famotidine.

29
Q

What drug prevents GI ulceration?

A

Famotidine.

30
Q

How do you decrease gastric acid production?

A

Proton pump inhibitor (omeprazole).

31
Q

You perform surgery on a grade 1 low grade MCT and obtain complete margins.

What do you do
next?

A

Monitor.

32
Q

You perform surgery on a grade 1 low grade MCT and obtain incomplete margins. What do you do
next?

A

Monitor, radiation or 2nd surgery.

33
Q

You see a grade 2 low grade MCT, what do you do?

A

Monitor, radiation or 2nd surgery.

34
Q

You see a grade 2 high grade MCT, what do you do?

A

Staging.

35
Q

You do surgery on a grade 2 high grade MCT.

You get complete margins and stages clean, what do you recommend?

A

Chemotherapy as the risk of metastasis is much higher, if not clean.

36
Q

You treat a grade 2 high grade MCT.

You get incomplete margins.

What do you recommend?

A

Surgical excision or RT, followed by chemotherapy.

37
Q

Which of the following chemotherapy protocols is NOT indicated for MCT?

A

Vinblastine alone.

38
Q

You diagnose cutaneous MCT on the head of a cat.

As part of your investigation, you perform cytology
of the spleen and find the primary tumour (splenic MCT) had metastasised to the skin.

What treatment is indicated and what is the MST accompanying it?

A

Splenectomy, 12-19 months.

39
Q

Based on what you know about Soft tissue sarcomas in dogs.

What do histopathologic grade and margins predict?

A

Metastasis, recurrence.

40
Q

Does chemotherapy have any effect in delaying metastasis?

A

No.

41
Q

The common route of metastasis in soft tissue sarcomas is through the hematogenous route.

Thus staging in dogs is done via what method?

A

Bloodwork, thoracic x-rays, cytology of regional lymph nodes, abdominal ultrasound.

42
Q

A soft-tissue sarcoma with 40% necrosis in a dog is given what histopathologic grade?

A

Grade 2, below 50% necrosis.

43
Q

What kind of tumour is given a grade 1?

A

A tumour with no necrosis and 10-19 mitoses per 10 hpf.

44
Q

What kind of tumour is given a grade 3?

A

Over 50% necrosis and below 20 mitoses per 10hpf.

45
Q

A dog is diagnosed with a grade II soft tissue sarcoma and complete margins are obtained via surgical
excision.

What is indicated next?

A

Monitor site and chest x-rays regularly.

S.ame for grade 1.

46
Q

What grade of tumours are given radiation therapy?

A

Grade I + 2 with incomplete margins.

47
Q

What is contraindicated in the diagnosis of a suspected vaccine-induced sarcoma in cats?

A

Excisional biopsy.

48
Q

What is indicated for the best control of a vaccine-induced soft tissue sarcoma in cats?

A

Aggressive surgery with 5 cm margins with radiation therapy.

49
Q

What is the MOST common site of primary HSA?

A

Spleen.

50
Q

What are the typical findings on a CBC for hemangiosarcoma?

A

Anaemia, schistocytes, neutrophillic leukocytosis, thrombocytopenia.

SAM. (10 decks)

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