SAM II Final Exam - Oncology Flashcards
(112 cards)
1
Q
T/F: Use of Doxorubicin is a prognosticator in cats with lymphoma
A
True
Better outcome in cats with doxorubicin use
2
Q
If the standard of care is recommended to treat an osteosarcoma (curative intent), what is the expected cure rate (2 year survival)?
- 0-5%
- 5-10%
- 15-25%
- 30-40%
A
15-25%
3
Q
________ is a neoplastic proliferation of hematopoietic stem cells in the bone marrow
A
leukemia
4
Q
What chemotherapeutic drugs are affected by multidrug resistance?
A
vinca alkyloids, anthracyclines, actinomycin D
5
Q
What lymph nodes typically experience the most dramatic enlargement in a case of multicentric lymphoma?
A
mandibular and superficial cervical
Diagnosis in these patients is usually very easy (fine needle aspirate), but it is important to immunophentype!
6
Q
CD79a-positive stain. Is this a B cell or T cell lymphoma in this dog?
A
B cell lymphoma
B cells have a fair response to chemotherapy. Once these patients reach remission, it is usually a very durable remission and these patients have a much higher chance (than T cell) of being cured
7
Q
What type of chemotherapeutic drug is Toceranib?
A
Tyrosine kinase inhibitor
8
Q
After treatment with Doxorubricin, how many days should you wait to look for myelosupression?
A
7 days
9
Q
What is a side effect of cyclophosphamide therapy caused by acrolein?
- Vesicant
- Sterile hemorrhagic cystitis
- Gastrointestinal toxicity
- Neurotoxicity
A
Sterile hemorrhagic cystitis
10
Q
‘Petal’, the 12 year old FN Siamese presents with a mammary mass. What is the first thing you recommend?
- FNA
- Biopsy
- Radical bilateral, staged mastectomy
- Three thoracic radiographs
- Coagulation profile
A
Three thoracic radiographs
11
Q
Some side-effects are specific to a particular chemotherapeutic agent or group of agents. Renal damage is most associated with what chemotherapeutic drug?
A
Cisplatin
12
Q
Joey (who is a dog) has peripheral lymphadenopathy with a T-cell lymphoma but is otherwise healthy. Lymphoma cells are found in his spleen and liver with FNA but not in the bone marrow. The lymphoma is classified as a Multicentric, T cell, stage IV, substage A. You decide to treat Joey with a 19 week protocol.
He went into remission 1 month after starting CHOP, completed his 19 week protocol. 6 months later he relapsed. What rescue protocol would you use, and what is the expected RR and remission time?
- Doxorubicin, 70-90% RR, remission of 7-9 months
- Cyclophosphamide and Prednisolone combo, 60% RR, 3 months remission
- CCNU (Lomustine) or LOPP, 40% RR, 5 months remission time
A
CCNU (Lomustine) or LOPP, 40% RR, 5 months remission time
13
Q
Some side-effects are specific to a particular chemotherapeutic agent or group of agents. Cardiomyopathy is most associated with what chemotherapeutic drug?
A
Doxorubicin
14
Q
What drug may be used as a single agent protocol for multicentric lymphoma?
A
Doxorubicin
- 50-75% complete remission*
- Median survival of 6-8 months*
15
Q
When staging an oral tumor, what would it mean to say a tumor is a T2a?
A
The tumor is 2-4 cm in diameter, without bone invasion
- T1: Tumor
- T2: Tumor 2-4 cm diameter
- T3: Tumor >4 cm diameter
- A: without bone invasion
- B: with bone invasion
16
Q
T/F: Paraneoplastic syndromes often precede the onset of the primary cancer by weeks to months
A
True
17
Q
T/F: This presentation is consistent with lymphadenitis
A
False
This presentation is consistent with _lymphoma_. Note the homogenous population of lymphoblasts (~3-5x the size of RBCs) occupying more than 50% of the cell population
Lymphadenitis would be characterized by a large population of neutrophils
18
Q
Joey (who is a dog) has peripheral lymphadenopathy with a T-cell lymphoma but is otherwise healthy. Lymphoma cells are found in his spleen and liver with FNA but not in the bone marrow. The lymphoma is classified as a Multicentric, T cell, stage IV, substage A.
When we consider Joey’s lymphoma, which is a negative prognosticator?
- Stage
- Location (multicentric)
- Immunophenotype (T cell)
- Grade
A
Immunophenotype (T cell)
19
Q
T/F: Mediastinal lymphoma is most common in younger FIV-positive cats
A
False
Mediastinal lymphoma is most common in younger _FeLV-positive_ cats
20
Q
The most commonly used chemotherapeutic drug associated with thrombocytopenia is:
A
lomustine (CCNU®)
If this toxicity occurs, you MUST stop using the drug
21
Q
T/F: Oral melanoma may be treated by vaccination
A
True
- Canine melanoma vaccine - fully licensed for Stage II and III oral melanoma
- Sensitize the dog to Tumor Associated Antigen (TAA) – unique or a mutation
- Xenogeneic DNA vaccine - tyrosinase
-
Dosage
- 0.4 mL dose administered with the Canine Transdermal Device
- Injection site: muscles of the medial thigh just caudal to the femur
- Initial treatment: 4 doses of vaccine at two week intervals
- Booster dose at six month intervals
22
Q
Refer to the images below. What is the correct criticism for this chemotherapy administration protocol?
- No mask, eye shield, double gloving (nitrile) gloves used
- A catheter does not necessarily need to be placed for Vincristine
- The vet should not be smiling, cancer is serious business
- I don’t see a Phaseal system in place
A
No mask, eye shield, double gloving (nitrile) gloves used
23
Q
In dogs, Stage ___ lymphoma is characterized by generalized lymph node involvement
A
In dogs, Stage III lymphoma is characterized by generalized lymph node involvement
24
Q
It is important to check hematology prior to chemotherapy and 7 days post-chemotherapy, except when using __________ or __________, which both have a severe delay in the myelosuppressive effect (so we’ll check them 2-3 weeks post-chemo).
A
It is important to check hematology prior to chemotherapy and 7 days post-chemotherapy, except when using carboplatin or lomustine, which both have a severe delay in the myelosuppressive effect (so we’ll check them 2-3 weeks post-chemo).
25
Refer to the diagram and indicate at what point CT/MR would be able to detect cancer:
**B**
26
Joey (who is a dog) has peripheral lymphadenopathy with a T-cell lymphoma but is otherwise healthy. Lymphoma cells are found in his spleen and liver with FNA but not in the bone marrow. The lymphoma is classified as a Multicentric, T cell, stage IV, substage A.
What treatment would you recommend for Joey if the owner elects curative intent?
* Prednisolone
* Single agent CCNU
* Single agent Doxorubicin
* Multi-agent COP
* Current CHOP (19 week protocol)
**Current CHOP (19 week protocol)**
27
T/F: The majority of mammary gland tumors in cats are malignant
**True**
*In cats, MGTs have a tendency to move into the lungs and are associated with high prevalence of developing pleural effusion. We don't really even biopsy mammary tumors in cats... we just cut them out.*
28
T/F: The use of TMS for 14 days post-doxorubicin markedly reduces the likelihood of needing gastrointestinal antibiotics
**True**
29
T/F: Alopecia is the most common side effect associated with chemotherapeutic agents
**False**
Gastrointestinal effects account for the majority of the side effects
* Anorexia, vomiting, diarrhea, colitis
* Direct effect on gut lining
* Pancreatitis (L-asparaginase)
* Central effect (CTZ) (Cisplatin)
30
In cats, presentation can be similar for **inflammatory bowel disease (IBD)** and **alimentary lymphoma**. Because veterinarians have racked up some sort of good karma throughout the years, the treatment for both of these conditions is essentially the same! Woo!
What is the treatment?
**Chlorambucil and prednisolone**
31
What chemotherapeutic agent MUST be included in any chemotherapy protocol for **hemangiosarcoma**?
**Doxorubicin**
*Note: there doesn't seem to be much difference in whether Doxorubicin is used alone or as part of a multi-agent therapy*
32
8 year old Golden Retreiver with generalized lymphadenopathy. On FNA, this is what you see.
What is your diagnosis?
**lymphoma**
*There are \>50% blasts (consistent with lymphoma). The best treatment for this dog would likely be chemotherapy*
33
Which is correct regarding feline intestinal lymphoma?
* The most common form is high grade, lymphoblastic
* Mostly FeLV positive
* Young siamese are predisposed
* Characterized by diffuse thickening of the muscularis propria on ultrasonography
**Characterized by diffuse thickening of the muscularis propria on ultrasonography**
34
T/F: If your patient has **normal PTHrp** levels, you're able to easily rule out malignant cancer
**False**
*Normal PTHrp DOES NOT RULE OUT CANCER*
35
What _dog_ breeds are predisposed to developing **mammary gland tumors**?
**poodles, dachshunds, spaniels**
36
What method of administration is NOT associated with reduced risk of the sterile hemorrhagic cystitis (as the result of acrolein toxicity)?
* Divided doses orally over three days
* Administration of Mesna at the same time as IV drug
* Administration of Furosemide period to Cyclophosphamide
* Giving the drug at night
* Salty snacks to encourage drinking
**Giving the drug at night**
37
In dogs, **_Stage_** **\_\_\_** **_lymphoma_** is characterized by liver and spleen involvement
In dogs, **_Stage IV lymphoma_** is characterized by liver and spleen involvement
38
Nasal lymphoma can often mimic nasal adenocarcinoma. One big difference is sensitivity to radiotherapy. Which tumor type is sensitive to radiotherapy?
**lymphoma**
39
Joey (who is a dog) comes to your clinic for a 7 day follow-up check post-cyclophosphamide (CHOP). He is due to receive vincristine. His neutrophil count is 1200 cells/uL (1.2.10^9/L: \>3.10^9/L). What do you suggest to Joey’s owner?
* Give the vincristine, but at a 25% reduced dose
* Substitute with a non-myelotoxic drug
* Postpone chemotherapy for 7 days and prescribe antibiotics (TMS)
* Stop chemotherapy altogether
**Postpone chemotherapy for 7 days and prescribe antibiotics (TMS)**
40
Anaplastic carcinoma tends to infect the ________ mammary glands in dogs
**inguinal (5th set of mammary glands)**
*Anaplastic carcinomas are highly aggressive and nasty, but only make up ~4%*
41
There are really only two instances in which we utilize **bone marrow biopsy** in the diagnosis of lymphoma. What are they?
1. **If we see cytopenias**
2. **If there is an extranodal lymphoma and we think surgery alone could cure**
1. (want to be sure there is no cancer anywhere else)
42
With regard to cancer treatment, what does it mean in veterinary medicine for an animal to be 'cured'?
**Two years of remission while not receiving chemotherapy**
43
In a general sense, what type of tumor is present in this patient?
**carcinoma**
44
\_\_\_\_\_\_\_\_ is the most common metastatic intracranial neoplasm
**hemangiosarcoma**
*mechanism of metastasis is hematogenous*
45
How many radiographic views should be taken to assess tumor metastasis?
**Three**
*right lateral, left lateral, and dorsoventral views*
46
Pilot, 14 yr, MN, Chow presents with an ulcerated, swollen mass on the muzzle. FNA confirms it is a MCT. The owner decides that she would like to proceed with definitive treatment for the MCT. The grade is Patnaik III, or grade II on the 2-tiered system, c-kit PCR positive. What treatment do you recommend after staging?
* Radiation: LINAC
* Chemotherapy: CCNU & Vinblastine
* Chemotherapy: Masivet
* Surgery/radiation for locoregional control and chemotherapy for distant (L and M) and long-term Masivet
**Surgery/radiation for locoregional control and chemotherapy for distant (L and M) and long-term Masivet**
*Masitinib (Masivet®) is a tyrosine kinase inhibitor*
47
Some side-effects are specific to a particular chemotherapeutic agent or group of agents. **Cystitis** is most associated with what chemotherapeutic drug?
**Cyclophosphamide**
48
What is the highest predictor for a dog developing **osteosarcoma**?
**wither height (size of the dog)**
* The bigger the dog, the higher the chance of developing osteosarcoma*
* Exceptions: Poodles and Pekingese are also at high risk of developing osteosarcoma*
49
Pilot, 14 yr, MN, Chow presents with an ulcerated, swollen mass on the muzzle. FNA confirms it is a MCT. The owner has very limited funds. What is the best option for him?
* Curative intent - surgery, radiation, and vinblastine/CCNU
* TKI - Toceranib
* Palliative steroid therapy with H1 and H2 blockers
* NSAID and tramadol
* Doxorubicin single agent chemotherapy
**Palliative steroid therapy with H1 and H2 blockers**
50
T/F: **Alimentary lymphoma** is most commonly seen in dogs
**False**
* Alimentary lymphoma is most commonly seen in _cats_*
* Full thickness biopsy is the best technique for diagnosis*
51
T/F: The majority of mammary gland tumors in dogs are malignant
**False**
*Mammary gland tumors in dogs are ~50% benign, ~50% malignant*
52
When staging an oral tumor, what would it mean to say a tumor is a **T3b**?
**The tumor is \>4 cm in diameter, with bone invasion**
* *T1: Tumor \<2 cm diameter*
* *T2: Tumor 2-4 cm diameter*
* *T3: Tumor \>4 cm diameter*
* *A: without bone invasion*
* *B: with bone invasion*
53
T/F: Biopsy is almost always indicated for feline mammary gland tumors
**False**
*~90% of feline mammary gland tumors are malignant - don't need to biopsy*
54
T/F: Nasal squamous cell carcinoma in dogs and cats is very sensitive to radiotherapy
**False**
*Nasal squamous cell carcinoma _in cats_ is very sensitive to radiotherapy. Not in dogs.*
55
T/F: The majority of **lymphomas** in canines are multicentric
**True**
*80-85% of lymphomas in dogs are multicentric*
56
What PCR test can provide information about whether a **lymphoma** is monoclonal or polyclonal?
**PARR**
***_P_**CR for **_a_**ntigen **_r_**eceptor **_r_**earrangement*
* *Helpful for differentiating monoclonal vs. polyclonal*
* *Benign - polyclonal*
* *Malignant - monoclonal*
* *Can monitor for cellular remission (residual disease)*
* *Ideal for relapse, pleural fluid, and bone marrow*
57
When is it recommended to give recombinant granulocyte colony stimulating factor (**rG-CSF**)?
**if you've accidentally and severely overdosed your patient**
## Footnote
*and you know that in 7-10 days time there will be a massive myelosuppression*
58
Vincristine and Vinblastine are specific to what phase of the cell cycle?
**Mitosis**
* Vincristine and Vinblastine are plant alkaloids*
* The benefit of knowing this is that you can predict when the maximum side effects will occur. So if you know that a drug works in a specific stage of the cycle, toxicity to the host will predictably occur ~7 days after.*
59
\_\_\_\_\_\_\_\_ is the most common form of cutaneous neoplasia in the dog
**mast cell tumor (MCT)**
60
What type of chemotherapeutic drug is **cyclophosphamide**?
**alkylating agent**
*creates cross-linked DNA with strand breaks*
61
Joey, 6 yo, MN Golden Retreiver is diagnosed with an osteosarcoma. The owner wants curative intent. What are your treatment recommendations?
* Start him on chemotherapy only
* Amputate the limb or limb sparing surgery
* Amputation/limb sparing + chemotherapy combination
* Radiation therapy of the sarcoma - stereostatic “gamma knife”
* Pain killer including biphosphonates - it is a poor prognosis
**Amputation/limb sparing + chemotherapy combination**
62
What class of chemotherapeutics are most often used as **rescue drugs**?
**Alkylating agents**
*They don't have cross-reactivity with MDR resistance*
63
\_\_\_\_\_\_\_\_ is the most common clinical sign associated with **multiple myeloma**
**anemia**
64
The __________ refers to the proportion of proliferating cells within a tumor
**growth fraction (GF)**
65
What is **anatomical staging** of a tumor?
**Defining the anatomical extent of the tumor in terms of primary site and distant spread**
66
What is the term to describe a neoplasm associated alteration in bodily structure or function that occurs *distant to a tumor*?
**paraneoplastic syndrome**
parallels the underling malignancy, with resolution of paraneoplastic syndrome after successful treatment of the tumor
67
T/F: Elevated ALKP is associated with a poorer prognosis in dogs with **osteosarcoma**
**True**
68
What is the most common site of origin for **hemangiosarcomas**?
**spleen (50%)**
69
T/F: Alkylating agents and anti-tumor antibiotics are _cell cycle non-specific_
**True**
*Because of this, it can be difficult to predict when the maximum side effects will occur.*
70
How do you definitively differentiate between **lymphoma** and **acute leukemia**?
**bone marrow aspirate**
* Acute leukemia will have more than 30-40% lymphoblasts in the bone marrow. Lymphoma will have less than 30% lymphoblasts.*
* *In addition to bone marrow aspirate, there will be a much more pronounced lymphadenopathy with lymphomas. Splenomegaly will be seen with acute leukemia*
71
T/F: The majority of splenic masses are malignant and the majority of malignancies are **hemangiosarcomas**
**True**
*2/3 of splenic masses are malignant and 2/3 of malignancies are hemangiosarcomas*
72
Joey (who is a dog) comes to your clinic for a 7 day follow up check post-doxorubicin (CHOP). His neutrophil count is 300 cells/uL and he has a fever. What do you suggest to Joey’s owner?
* Recommend repeat sampling in 7 days to see if he has recovered from his nadir
* Substitute doxorubicin in the future with dactinomycin
* Send Joey home with TMS for a course of antibiotics
* Admit Joey to the isolation facility and start with broad spectrum antibiotics
**Admit Joey to the isolation facility and start with broad spectrum antibiotics**
73
In a general sense, what type of tumor is present in this patient?
**round cell tumor**
74
If your patient is still persistently **hypoglycemic** after surgery, what is the drug of choice for medical management?
**Diazoxide**
* *Prevents the release of insulin into circulation*
* *Very expensive and usually requires a compounding pharmacist for formulation*
75
Joey has peripheral lymphadenopathy with a T-cell lymphoma but is otherwise healthy. Lymphoma cells are found in his spleen and liver with FNA but not in the bone marrow. The lymphoma is classified as a Multicentric, T cell, stage IV, substage A.
What is the estimated response rate and remission time if we treated Joey with a 19 week protocol?
* 30%, 3 months
* 60%, 6 months
* 80%, 12 months
* 90%, 2 years
**80%, 12 months**
76
Joey has peripheral lymphadenopathy with a T-cell lymphoma but is otherwise healthy. Lymphoma cells are found in his spleen and liver with FNA but not in the bone marrow. The lymphoma is classified as a Multicentric, T cell, stage IV, substage A. You decide to treat Joey with a 19 week protocol.
He relapses in the middle of his 19 week CHOP protocol. What do you recommend?
* Reinduce with CHOP, week 1
* CCNU
* Prednisolone
* Euthanize
**Reinduce with CHOP, week 1**
77
The chemotherapeutic agent of choice for **transmissible venereal tumor (TVT)** is:
**Vincristine**
78
T/F: Prednisolone may be indicated in the treatment of **hypercalcemia**
**True**
*but ONLY after you have ruled out the possibility of cancer. You will forever mask the cancer if you give prednisolone and you haven't diagnosed it. Also , if the patient has lymphoma and you give prednisolone, you will worsen the prognosis because the patient will be more likely to be resistant to chemotherapy*
79
T/F: The majority of patients with **lymphoma** are asymptomatic
**True**
80
What is the most important prognosticator for **lymphoma** in the _dog_?
**substage**
* *Substage a: no systemic signs*
* *Substage b: systemic signs***
*Prognosis is much worse for dogs showing clinical signs. These patients do not do as well with chemotherapy and have a predictably shorter mean survival time*
81
‘Petal’, the 12 year old FN Siamese presents with a mammary mass. Petal’s MGT: single, left cranial thoracic MG mass, 4.7 cm diameter, LNN normal size. What is the correct negative prognosticator?
* Size: \>4 cm is bad
* Tumor type: sarcoma vs. carcinoma
* MG location: thoracic good
* Only one mass - good
* N0 - good
**Size: \>4 cm is bad**
82
T/F: There is no difference in outcome in cats between T cell and B cell lymphoma
**True**
83
T/F: The presence of **cancer cachexia** is a negative prognosticator
**True**
* *Cancer cachexia: weight loss and metabolic alterations observed despite _adequate_ nutritional intake*
* *(whereas alterations observed due to poor nutritional intake is termed _cancer anorexia_)*
84
The chemotherapeutic agent of choice for **mast cell tumors and relapse lymphoma** is:
**Lomustine (CCNU®)**
*Lomustine is an alkylating agent*
85
The chemotherapeutic of choice for **multiple myeloma** is:
**Melphalan**
* Melphalan is an alkylating agent*
* Treatment for multiple myeloma involves Melphalan and prednisone*
86
T/F: When using an emetogen (Cisplatin), it is recommended to withhold food on the morning of chemo treatment
**True**
*This will help to avoid food aversion*
87
Which is an example of a **paraneoplastic syndrome**?
* Peripheral neuropathy due to vincristine
* Microcytic hypochromic anemia in a cat from intestinal MCT
* Microcytic hypochromic anemia in a dog due to dermal MCT
* Thrombocytopenia due to a splenic hemangiosarcoma
**Microcytic hypochromic anemia in a dog due to dermal MCT**
88
In terms of predicting outcome with **mast cell tumors**, the most important aspect of staging is:
**lymph node evaluation (FNA or biopsy)**
89
What is the main treatment for **mammary tumors**?
**SURGERY**
*Chemotherapy and endocrine therapy is unproven*
90
T/F: Ovariohysterectomy does not play a role in the development of mammary tumors
**False**
* Ovariohysterectomy _does_ play a role in the development of mammary tumors. Ovariohysterectomy can _reduce_ risk in both cats and dogs*
* Note, however, that if you're surgically removing a mammary gland tumor, performing OVH concurrently has no effect on progression of malignant tumors, time to metastasis, or overall survival*
91
What is the general guideline for osteosarcoma predilection sites?
**away from the elbows, toward the knees**
*distal radius is most common (except in small dogs, where the femur is most common). The site with the worst prognosis is the _proximal humerus_ (one of the rarest locations)*
92
What is the expected MST in a dog that has had a splenectomy for hemoabdomen but no follow-up chemotherapy?
* 3 weeks - 3 months
* 3 months - 6 months
* 6 months - 12 months
* 2 years
**3 weeks - 3 months**
93
How do you differentiate **acute** vs. **chronic** leukemia?
* **Acute:** Neoplastic transformation _early_ in the cell lineage (proliferation of blasts)
* *Easier to diagnose (it's not normal to see lymphoblasts in circulation)*
* *Poor prognosis*
* **Chronic:** Neoplastic transformation _late_ in the cell lineage (proliferation of mature cells)
* *The distinguishing characteristic for chronic leukemia is a massive lymphocytosis*
* *Good prognosis*
94
What is _not_ a prognosticator for OSA in a dog?
* Age, \>7 year is worse
* Location, proximal humerus is worse
* ALKP, failure to decline to normal by D40 is worse
* Metastasis, presence has a shorter MST
**Age, \>7 year is worse**
95
What is a specific hematological feature of hemangiosarcoma?
* Anemia
* Heinz bodies
* Schistocytes
* Spherocytes
* Hypochromic RBC
**Schistocytes**
96
What therapeutic agents are registered for c-kit positive mast cell tumors?
**Masitinib/Toceranib**
*Tyrosine kinase inhibitors*
97
What type of chemotherapeutic drug is **carboplatin**?
**platinum compound**
*mechanism is similar to alkylating agents (cross-link DNA)*
98
What is the chemotherapeutic agent of choice for treatment of **hypoglycemia**?
**Streptozocin**
* *Islet cell specific chemotherapy*
* *Typically used in conjunction with surgery for best prognosis.*
* *Remember that this drug is associated with nephrotoxicity, so it requires diuresis beforehand*
99
What is NOT a clinical complication of a multiple myeloma?
* CVA (Cerebrovascular accident)
* Retinal detachment
* CKD
* Hypertrophic cardiomyopathy
* Hypercalcemia
* Thromboembolism
**Thromboembolism**
100
T/F: When chemotherapy and amputation are combined, we can acheive curative intent in patients with **osteosarcoma**
**True**
*~20% of dogs treated with amputation + chemotherapy survive past 24 months (curative)*
101
CD3-positive stain. Is this a B cell or T cell lymphoma in this dog?
**T cell lymphoma**
*T cell lymphomas MAY respond to chemotherapy, but they usually develop a relapse very quickly and they have a very short clinical remission*
102
You recheck a Pug you referred for radiation therapy (LINAC) for a muzzle MCT after the second week. What is the correct assessment?
* The dramatic response is a good sign
* Too early to make a decision, the tumor may recur
* This is a highly aggressive tumor and carries a grave prognosis
* The cancer is cured… go home, Pug
**Too early to make a decision, the tumor may recur**
103
Depigmented nose with bilateral discharge. What is your diagnosis?
**aspergillosis**
104
Joey has peripheral lymphadenopathy with a T-cell lymphoma but is otherwise healthy. Lymphoma cells are found in his spleen and liver with FNA but not in the bone marrow. Classify this lymphoma:
* Multicentric ,T cell, stage IV, substage A
* Multicentric, T cell, stage V, substage A
* Multicentric, T cell, stage IV, substage b
* Extranodal lymphoma
* Acute lymphocytic leukemia
**Multicentric, T cell, stage IV, substage A**
105
Gastroduodenal ulcers are due to an excess amount of ________ in MCTs (a negative prognosticator) or ________ in gastrinomas
Gastroduodenal ulcers are due to an excess amount of **_histamine_** in MCTs (a negative prognosticator) or **_gastrin_** in gastrinomas
106
What cat breed is predisposed to developing **mammary gland tumors**?
**Siamese**
107
T/F: Radiotherapy can provide definitive treatment for osteosarcomas
**False**
*Osteosarcomas are radioresistant. Radiotherapy would be used for palliative treatment only*
108
Some side-effects are specific to a particular chemotherapeutic agent or group of agents. **Neuropathy** is most associated with what chemotherapeutic drug?
**Vincristine**
109
T/F: **Multiple myeloma** is associated with polyclonal gammopathy
**False**
*Multiple myeloma is associated with **_monoclonal gammopathy_** ("finger of death")*
110
A dog receives 6 Gy of radiation weekly for 4 weeks, weekly, before chemotherapy for an osteosarcoma. There is no amputation. Describe the type of radiation course:
* Definitive, hypofractionated, adjuvant
* Definitive, hyperfractionated, adjuvant
* Palliative, hypofractionated, neoadjuvant
* Palliative, hyperfractionated, adjuvant
**Palliative, hypofractionated, neoadjuvant**
111
What platinum compound is known to cause **fatal** **pulmonary edema** in cats?
**Cisplatin**
*"Cisplatin splats cats"*
112
T/F: Alkylating agents and Carboplatin are not affected by **multidrug resistance**
**True**
*Alkylating agents (Melphalan, Lomustine) and Carboplatin are not affected by multidrug resistance*
