Term
| ______________ describes the clinical signs that result from the presence of cancer but at a site distant from it. They are mediated by hormones or polypeptides released from tumor cells into circulation, or induced from normal cells by tumor cells. |
|
Definition
|
|
Term
| Approximately _____ of canine and feline patients have PND. |
|
Definition
|
|
Term
| What is the most commonly recognized paraneoplastic disorder in vet med? |
|
Definition
| Hypercalcemia: serum calcium >12mg/dl |
|
|
Term
| What cancers are associated with hypercalcemia? |
|
Definition
Lymphoma
Apocrine gland adenocarcinoma
Multiple myeloma
Thymoma |
|
|
Term
| T/F: non-neoplastic causes of hypercalcemia are more commonly recognized than neoplastic causes. |
|
Definition
True
Lab error
Young/growing dog
Vitamin D toxicosis
Hyperparathyroidism
Granulomatous disease
Bone Disorders
Hypoadrenocorticism
Cats: idiopathic, chronic renal failure |
|
|
Term
| What tests can be run for diagnosis of hypercalcemia PND? |
|
Definition
Minimum database: *ionized calcium*
Physical exam
Thoracic/Abdominal Radiographs
Abdominal US
Bone marrow cytology
Michigan State Panel: PTHrp, PTH, ionized calcium, vitamin D
If suspect lymphoma: L-asparaginase challenge |
|
|
Term
| What is the treatment for moderate hypercalcemia? |
|
Definition
0.9% NaCl
Furosemide
Prednisone--get dx first! |
|
|
Term
| What is the treatment for severe hypercalcemia? |
|
Definition
| Bisphosphonate pamidronate |
|
|
Term
| What is the mechanism of action for bisphosphonate pamidronate? |
|
Definition
| Adsorbs to CaPO4 crystals in bone and blocks the dissolution of crystals by inhibiting osteoclastic activity. |
|
|
Term
| T/F: lasting control of hypercalcemia can only be managed with elimination of the tumor if it is considered a PND. |
|
Definition
|
|
Term
| An animal is considered hypoglycemic if blood glucose reaches what level? |
|
Definition
|
|
Term
| What are some non-neoplastic causes of hypoglycemia? |
|
Definition
liver disease
sepsis
small breed issues
adrenal cortical insufficiency |
|
|
Term
| What are some neoplasms that can cause hypoglycemia? |
|
Definition
Pancreatic islet cell tumor
Insulinoma |
|
|
Term
| What are some clinical signs of hypoglycemia? |
|
Definition
Seizures
Weakness
Lethargy
Tremors
Behavioral changes
Coma
Death |
|
|
Term
| What diagnostic tests can be run to diagnose hypoglycemia? |
|
Definition
Lab error--most common
Physical exam
Radiography
US
*Insulin/glucose ratio when blood glucose <60 mg/dl |
|
|
Term
| Describe the treatment for hypoglycemia: |
|
Definition
Emergency: bolus 20% dextrose
Low-dose glucose containing fluids for maintenance
Glucagon for non-insulin secreting tumors
Chronic therapy: frequent meals and low-dose prednisone (pred causes insulin resistance, which raises blood glucose) |
|
|
Term
| What is the cause of fever? |
|
Definition
IL1 production by tumor-activated macrophages
IL1 production by tumor |
|
|
Term
| How should pyrexia be managed? |
|
Definition
Look for septic focus (more common in sepsis than neoplasms)
Antipyretics and mechanical cooling NOT recommended unless fever >106 or anorexia inhibits eating |
|
|
Term
| What is the signalment for hypertrophic osteopathy? |
|
Definition
Older, large breed dogs
History of pain, gradual onset of generalized lameness with firm, warm swelling of limbs that starts distally and moves proximally |
|
|
Term
| What is the treatment for hypertrophic osteopathy? |
|
Definition
resolve primary disease with surgical excision
manage periosteal proliferation with mass excision and GC/NSAIDS (NOT together)
Bisphosphonate will help downregulate osteoclasts |
|
|
Term
| List the various anemias that can occur as PND: |
|
Definition
Anemia of chronic dz
Microangiopathic anemia: HSA
IMHA: lymphoma
Aplastic anemia: sertoli cell tumor
Hemorrhagic anemia: carcinoma |
|
|
Term
| Leukocytosis is classified as granulocytes > ____________ cells/ul and can be caused by what cancers? |
|
Definition
>75,000 cells/ul
Renal tubular carsinoma
HSA
Rectal adenomatous polyp
Metastatic FSA |
|
|
Term
| T/F: PND thrombocytopenia is often associated with hemorrhage. |
|
Definition
|
|
Term
| Thrombocytopenia is found in ___% of veterinary patients with cancer. |
|
Definition
|
|
Term
| Thrombopathia is associated with what neoplasm? |
|
Definition
|
|
Term
| Hyperviscosity syndrome is associated with what neoplasm? |
|
Definition
| Plasma cell tumors--produce large amount of protein |
|
|
Term
| Hyperglobulinemia is associated with what neoplasms? |
|
Definition
Multiple myeloma
Lymphoma
Other lymphoid neoplasms |
|
|
Term
|
Definition
| Weight loss with adequate food intake, caused by ineffective host metabolism and inability to absorb/digest. |
|
|
Term
| T/F: weight loss may precede tumor detection. |
|
Definition
|
|
Term
| ___% of dogs and ___% of cats have muscle wasting associated with cancer cachexia. |
|
Definition
|
|
Term
| What are the three phases of cancer cachexia? |
|
Definition
1. silent biochemical change: IL1, IL6, IFN, TNF-alpha
2. Weight loss, anorexia
3. marked weakness and negative nitrogen balance |
|
|
Term
| To counter cancer cachexia, dogs like to be fed _________ and cats like ___________. |
|
Definition
|
|
Term
| What dietary supplement inhibits tumorigenesis? |
|
Definition
| N-3 fatty acids (fish oil) |
|
|
Term
| Cancer dogs have an increased need for which amino acids? |
|
Definition
| Arginine, cysteine, glutamine |
|
|
Term
| What appetite stimulants can be used to counter the effects of cancer cachexia? |
|
Definition
Mirtazapine (cats)
Steroids (dogs)
Diazepam and cyproheptadine not often used |
|
|
Term
| What anti-nausea medication can be used to counter the effects of cancer cachexia? |
|
Definition
|
|
Term
| What is the most common cause of hypercalcemia PND in cats? |
|
Definition
|
|
