Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MODULE 17 - Urinary, Endocrine and Oncological Disease > ONCOLOGY - Paraneoplastic Syndromes > Flashcards

ONCOLOGY - Paraneoplastic Syndromes Flashcards

(89 cards)

Start Studying
1
Q

What are the three clinical presentations of neoplasia?

A

Superficial mass
Non-specific clinical signs
Paraneoplastic syndrome

Make sure to review your second year notes on the approach to superficial masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which dog breeds are predisposed to osteosarcomas?

A

Great Dane
Deerhound
Lurcher
Rottweiler

Typically giant/large breed dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which dog breeds are predisposed to histiocytic sarcomas?

A

Bernese Mountain Dogs
Flat coated Retrievers
Golden Retriever
Rottweilers
Miniture Schnauzers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which dog breeds are predisposed to lymphoma?

A

Boxers
Golden Retriever
Labrador
Mastiffs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which dog breeds are predisposed to mast cell tumours?

A

Boxers
Pugs
Shar Pei
Weimaraner
Labrador
Golden Retriever
Staffordshire Bull Terriers
Boston Terriers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which dog breed is predisposed to bladder transitional cell carcinoma?

A

Scottish Terrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which dog breeds are predisposed to gliomas?

A

Boxer
French Bulldog
Boston Terrier

Typically seen in brachycephalic breeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which dog breeds are predisposed to meningiomas?

A

Golden Retrievers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which dog breeds are predisposed to nasal tumours?

A

Labradors
Golden Retrievers
Flat-coated Retrievers
Collies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which dog breeds are predisposed to haemangiosarcomas?

A

German Shepherds
Golden Retriever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which dog breeds are predisposed to anal sac tumours?

A

Springer Spaniels
Cocker Spaniels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is paraneoplastic syndrome?

A

Paraneoplastic syndrome is the systemic, metabolic and endocrine effects that can be associated with some types of neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the endocrine diseases which result from neoplasia and thus paraneoplastic syndrome?

A

Hyperthyroidism
Hyperadrenocorticism (Cushing’s)
Acromegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some of the other paraneoplastic syndromes seen in small animals?

A

Hypercalcaemia
Hyperhistaminaemia
Hypoglycaemia
Hyperoestrogenaemia
Hypergastrinaemia (very rare)
Cachexia
Immune-mediated disorders
Hyperviscosity syndrome
Hypertrophic oesteopathy
Dermatological changes (very rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most common form of paraneoplastic syndrome?

A

Hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the three forms of serum calcium?

A

Ionised calcium
Protein-bound calcium
Complexed calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

(T/F) Serum calcium levels can be influenced by serum protein levels

A

TRUE. Serum calcium levels can be influenced by serum protein levels as serum calcium is approximately 50% plasma protein bound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which three hormones are involved in calcium homeostasis?

A

Parathyroid hormone (PTH)
1,25 vitamin D3 (calcitriol)
Calcitonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the process of calcium homeostasis when there is hypocalcaemia

A

In response to hypocalcaemia, the parathyroid gland will release parathyroid hormone which will act on the kidneys to reabsorb calcium and produce calcitriol which increases calcium absorption by the gastrointestinal tract. Parathyroid hormone also stimulates osteoclasts to mobilise calcium in the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the process of calcium homeostasis when there is hypercalcaemia

A

In response to hypercalcaemia, calcitonin is released from the thyroid gland and acts on the osteoblasts to stimulate calcium storage in the bone, inhibits renal reabsorption of calcium which increases renal excretion of calcium and inhibits calcium absorption in the gastrointestinal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is a patient classfied as hypercalcaemic?

A

If the total serum calcium is more than 3mmol/l and the ionised calcium is more than 1.4mmol/l, the patient is hypercalcaemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the differential diagnoses for hypercalcaemia?

A

Neoplasia
Hyperparathyroidism (caused by parathyroid adenoma)
Addison’s disease
Severe renal failure
Hypervitaminosis D
Feline leukaemia virus (FeLV)
Granulomatous inflammation
Idiopathic hypercalcaemia
Laboratory error
Young animal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is hypervitamindiosis D?

A

Hypervitamindiosis D is a toxic state of excess vitamin D within the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What can cause hypervitamindiosis D?

A

Nightshade plants
Topical creams
Rodenticides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Which species can get idiopathic hypercalcaemia?
Cats
26
How do you diagnose idiopathic hypercalcaemia in cats?
Idiopathic hypercalcaemia in cats is a diagnosis of exclusion
27
How do you manage idiopathic hypercalcaemia in cats?
Dietary modification Prednisolone
28
What is the most common differential diagnosis for hypercalcaemia?
Neoplasia
29
How can neoplasia cause hypercalcaemia?
Tumours can secrete parathyroid hormone (PTH) Tumours can secrete parathyroid hormone related peptide (PTHrP) Cytokines
30
Which cytokines can stimulate hypercalcaemia?
IL-1 IL-6 TNF
31
Which neoplasms can cause hypercalcaemia?
Lymphoma Leukaemia Anal sac adenocarcinoma Bone tumours Multiple myeloma Parathyroid adenoma *(causes hyperparathyroidism)*
32
How does lymphoma cause hypercalcaemia?
Lymphoma releases parathyroid hormone related peptide (PTHrP)
33
How does anal sac adenocarcinoma cause hypercalcaemia?
Anal sac adenocarcinoma releases parathyroid hormone related peptide (PTHrP)
34
How do bone tumours cause hypercalcaemia?
Bone tumours cause disruption of and breakdown of bone which results in excess mobilisation of calcium
35
How does multiple myeloma cause hypercalcaemia?
Multiple myeloma releases parathyroid hormone related peptide (PTHrP)
36
What are the clinical signs of hypercalcaemia?
PUPD Anorexia Vomiting Constipation Muscle weakness Tremors Lethargy Hypovolaemia Bradycardia
37
How should you approach the investigation of causes of hypercalcaemia?
Determine if it is a true hypercalcaemia Rule out non-neoplastic causes of hypercalcaemia Investigate for neoplasia
38
How can you determine if a patient is presenting with a true hypercalcaemia?
Patients presenting clinical signs are much more likely to have a true hypercalcaemia, however sometimes hypercalcaemia can be detected on biochemistry without clinical signs and thus it is important to determine if this is a true hypercalcaemia. Repeat the bloods to rule out laboratory error, check the ionised calcium levels as well as the total serum calcium levels and assess the age of the patient - if they are young and growing, this could account for the hypercalcaemia
39
How can you rule out non-neoplastic causes of hypercalcaemia?
History Clinical examination Haematology and biochemistry Urinalysis ACTH stimulation test Test FeLV in cats
40
How should you approach investigation of neoplastic causes of hypercalcaemia?
Clinical examination *(inc. rectal palpation for anal sac adenocarinoma)* Radiography Ultrasound FNA/biopsy PTH and PTHrP assays Bone marrow biopsy
41
Which factors should you play close attention to during a clinical exam to investigate neoplastic causes of hypercalcaemia?
Palpate lymph nodes Rectal examination Assess for lameness/bone pain Assess for ocular changes *(can be caused by multiple myeloma)* Palpate the parathyroid gland *(very challenging so may require ultrasound)*
42
What is the indicator for PTH and PTHrP assays?
PTH and PTHrP assays are indicated only if there is no obvious indicator of hypercalcaemia, as they are expensive tests to run and provide delayed results
43
How do you treat hypercalcaemia?
Intravenous fluid therapy Diuretics Bisphosphonates Corticosteroids Calcitonin Treat underlying disease
44
What are the purposes of intravenous fluid therapy when managing hypercalcaemia?
Replace fluid deficits Maintenance fluids Replenish ongoing losses Support the kidneys Promote further calcium excretion
45
Which type of fluid should you use when treating hypercalcaemia?
0.9% NaCl at two or three times maintenance
46
Which diuretic should you use when treating hypercalcaemia? | Only use diuretics when the patient is rehydrated
Frusemide
47
What are bisphosphonates?
Bisphosphantes prevent further loss of bone density by inhibiting osteoclast-mediated bone resorption
48
List three examples of biphosphonates
Pamidronate Zoledronate Oral alendronate *(used in cats)*
49
What should you be aware of when administering pamidronate?
Pamidronate is nephrotoxic and thus should be administered along side IV fluid therapy
50
When are corticosteroids indicated in the treatment of hypercalcaemia?
Corticosteroids are indicated when there is a definitive diagnosis of the cause of hypercalcaemia as corticosteroids have a cytotoxic effect on lymphoma and thus can obscure the diagnosis
51
What are the benefits of corticosteroids in the treatment of hypercalcaemia?
Decrease bone reabsorption Decrease gastrointestinal absorption of calcium Increase renal excretion of calcium Cytotoxic to lymphoma
52
(T/F) Calcitonin can only be administered to hospitalised patients
TRUE. Calcitonin requires regular subcutaneous injections and thus can only be done in hospitalised patients
53
What are the differential diagnoses for hypoglycaemia?
Neoplasia *(insulinoma, hepatic neoplasia)* Insulin overdose Addison's Severe hepatic failure Xylitol toxicity Inflammation Infection Laboratory error
54
What is the clinical presentation of hypoglycaemia?
Polyphagia Hyperaesthesia Trembling Ataxia Seizures Episodic collapse
55
What are the neoplastic causes of hypoglycaemia?
Insulinoma Hepatic neoplasia
56
What are the clinical signs of hyperoestrogenism?
Gynaecomastia Bilateral symmetrical, non-pruritic, alopecia Decreased libido Pendulous prepuce Attractive to other males Hyperpigmentation of the skin/scrotum Bone marrow hypoplasia *(pancytopenia)*
57
What is gynaecomastia?
Gynaecomastia is enlargement of the mammary chain
58
Which tumour causes hyperoestrogenism in male dogs?
Sertoli cell tumour *(produces oestrogen)*
59
What are sertoli cell tumours often associated with?
Sertolic cell tumours are often associated with retained testicles however they can be seen in normal testicles, with one often being much larger than the other due to atrophy of the non-neoplastic testicle
60
What is the most serious complication of sertoli cell tumours?
Sertoli cell tumours cause bone marrow suppression resulting in anaemia, thrombocytopenia and leukopenia
61
What is hypertrophic osteopathy?
Hypertrophic osteopathy is a diffuse periosteal proliferative condition of the long bones
62
Which tumours is hypertrophic osteopathy most commonly associated with?
Primary lung tumours or pulmonary metastases
63
Which immune-mediated syndromes can be seen as a result of neoplasia?
Immune-mediated neuropathies Myasthenia gravis Immune-mediated haemolytic anaemia (IMHA) Immune-mediated thrombocytopenia (IMTP)
64
Which tumours can cause myasthenia gravis?
Thymomas can produce antibodies against acetylcholine receptors resulting in myasthenia gravis
65
What is hyperviscosity syndrome?
Hyperviscosity syndrome is where the blood is very thick and viscous
66
What are the main causes of hyperviscosity syndrome?
Polycythaemia Excessive serum proteins
67
What are the two classifications of polycythaemia?
Polycythaemia vera *(primary neoplasia)* Secondary polycythaemia
68
How can neoplasia cause excessive serum protein production and hyperviscosity syndrome?
B-lymphocyte/plasma cell tumours can cause excessive production of immunoglobulins resulting in hyperviscosity syndrome
69
What is tumour grading?
Tumour grading is the assessment of the degree of malignancy
70
Who carries out tumour grading?
Tumour grading is carried out by pathologists
71
Which factors are assessed by pathologists to determine tumour grading?
Cellular differentiation Cellular pleomorphism Mitotic index Invasiveness Necrosis Inflammation Overall cellularity Stromal reaction
72
How should you treat low grade (grade I) tumours?
Low grade tumours have a low chance of metastasis so local surgery should be sufficient treatment
73
How should you treat intermediate grade (grade II) tumours?
Intermediate grade tumours have an intermediate risk of local recurrence and metastasis so local surgery with or without chemotherapy should be sufficient treatment
74
How should you treat high grade (grade III) tumours?
High grade tumours have a high risk of local recurrence and metastasis, so require aggressive treatment and chemotherapy
75
What is tumour staging?
Tumour staging is the assessment of the anatomical extent of the tumour within the body in terms of the primary site and any metastases
76
Who carries out tumour staging?
Tumour staging is carried out by clinicians
77
What are the purposes of tumour staging?
To determine the extent of treatment required To help to determine prognosis Provides a precise record of tumour extent at that period of time Monitor how to tumour changes over time
78
What is the TNM classification system used for tumour staging?
The TNM system is a system used to descibe the extent and spread of neoplasia throughout the body. T describes the size and extent of the primary tumour; N describes the extend of the spread of neoplasia to nearby lymph nodes; and M describes metastasis
79
What do you use to determine the size of the primary tumour for tumour staging?
Calipers Rulers
80
How do you determine the invasiveness of the primary tumour for tumour staging?
Assess the primary tumour for local invasion using palpation and diagnostic imaging such as radiography, ultrasound, CT and MRI
81
How should you investigate for neoplasia in nearby lymph nodes for tumour staging?
Palpate lymph nodes Diagnostic imaging Fine needle aspirate (FNA) Biopsy
82
What is the best diagnostic imaging technique to visualise lymph nodes?
CT
83
What are sentinel lymph nodes?
Sentinel lymph nodes is a term used to describe the local lymph nodes most likely to drain the primary tumour and this the most likely to become neoplastic
84
What should you do if the sentinel lymph nodes are neoplastic?
If the sentinel lymph nodes are neoplastic, surgically remove the lymph node and begin more aggressive treatment
85
How should you investigate for external metastasis for tumour staging?
Clinical examination
86
How should you investigate for internal metastasis for tumour staging?
Diagnostic imaging such as endoscopy, radiography, ultrasound, CT and/or MRI
87
Which techniques can be used to confirm metastasis?
Fine needle aspirate (FNA) Biopsy
88
What is the most useful technique for determining the prognosis for neoplasia?
Clinical staging
89
What is clinical staging?
Clinical staging groups tumours according to their likely prognosis using the TNM staging system and the clinical behaviour of the tumour type, grade and location

MODULE 17 - Urinary, Endocrine and Oncological Disease (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions