FELLOWSHIP EXAMINATION
JUNE/JULY 2005
VETERINARY ONCOLOGY
PAPER 1
Perusal time: 20 minutes
Time allowed: FOUR (4) Hours after perusal
Answer only SIX (6) of the seven questions.
All questions are of equal value
Subsections of Questions are of equal value unless stated otherwise
VETERINARY ONCOLOGY 2005 – FELLOWSHIP – PAPER 1
Answer only SIX (6) of the seven questions.
1.
List and discuss the forms of anaemia seen in the cancer patient and for each
outline in depth the pathogenesis of the anaemia (80%). Discuss veterinary
examples that illustrate each mechanism. (20%)
2.
Metastasis is a complex phenomenon with many factors having a role.
a.
b.
c.
d.
3.
The study of viral carcinogenesis has been used to understand the process of
carcinogenesis.
a.
b.
4.
Define and discuss the THREE (3) stages of carcinogenesis. (30%)
Regarding viral carcinogenesis:
 Describe and discuss the mechanism (s). (50%).
 Discuss THREE (3) examples from the veterinary literature. (20%)
Write brief notes on FOUR (4) of the following:
a.
b.
c.
d.
e.
5.
Outline in detail the steps involved. (40%)
Describe and discuss the role of platelets in this process. (20%)
What is the role of endothelial cells?. (20%)
Describe and critically appraise the ‘soil and seed’ theory. (20%)
The role of Bcl-2.
The role of c-kit in the normal cell.
The pathogenesis of hypertrophic osteopathy.
The role of IL-2 in tumour immunity.
The physiology of the telomere.
Answer ONLY part (a) OR part (b) of this question, using examples from the
veterinary literature where appropriate to illustrate your answer.
a.
Discuss the pathogenesis and pathophysiologic consequences of cancer
cachexia.
OR
b.
Discuss the pathogenesis and pathophysiologic consequences of
hypercalcaemia of malignancy.
Continued over/Veterinary Oncology Paper 1 2005
Continued/Veterinary Oncology Paper 1 2005
6.
Answer ALL parts of this question:
a.
Briefly define intermediate filaments and discuss their molecular
biological role in cells and implications for oncology. (30%)
b.
For each of the following immunohistochemical markers, list the tissue
or cell type(s) that they identify (each worth equal marks) (35%):
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
ix.
x.
xi.
xii.
xiii.
xiv.
Cytokeratin
Vimentin
Desmin
GFAP
S-100 protein
Factor VIII
Melan-A
Alpha-1-antitrypsin
CD-3
CD-79a
CD-18
Lysozyme
Chromogranin
Ki-67
c.
A 7-year-old Siamese cat has a mediastinal mass that is biopsied as a
well-differentiated lymphoma. It fails to respond to chemotherapy.
Name another disease that could be responsible for this presentation
(5%). What immunohistochemical stain(s) would be helpful in
confirming the diagnosis? (5%)
d.
A 14-year-old Cocker Spaniel has an ulcerated oral tumour. The
histopathology report is of an undifferentiated oral neoplasm. What
are the THREE (3) most likely tumour types? (5%)
Name FOUR (4) immunohistochemical stains that would help in
diagnosing this tumour and the expected result for each differential
diagnosis. (20%)
7.
Radiation therapy is becoming of increasing importance in veterinary
oncology. Write brief notes on FOUR (4) of the following focusing on their
application to radiotherapy
a.
b.
c.
d.
e.
Hyperfractionation.
Shoulder of the curve.
Therapeutic ratio.
The four ‘Rs’.
High LET radiation
END OF PAPER
FELLOWSHIP EXAMINATION
JUNE/JULY 2005
VETERINARY ONCOLOGY
PAPER 2
Perusal time: 20 minutes
Time allowed: FOUR (4) Hours after perusal
Answer only SIX (6) of the seven questions.
All questions are of equal value
Subsections of Questions are of equal value unless stated otherwise
VETERINARY ONCOLOGY 2005 – FELLOWSHIP – PAPER 2
Answer only SIX (6) of the seven questions.
1.
Answer BOTH part (a) AND part (b)
a.
Topoisomerase inhibitors are important chemotherapeutic agents.
i.
What is the mechanism of cell killing by topoisomerase II
inhibitors? Use a diagram or a narrative. (20%)
Give TWO (2) examples of drugs with this mechanism of action.
(5%)
ii. What is the mechanism of cell killing by topoisomerase I
inhibitors? Use a diagram or a narrative. (20%)
Give TWO (2) examples of drugs with this mechanism of action.
(5%)
b.
Microtubules are an important target for anticancer chemotherapy.
i. Briefly describe microtubule structure and homeostasis. (20%)
ii. Name TWO (2) classes of agents that affect microtubules, and
for each class give TWO (2) examples of a drug. (20%)
iii. For each of the TWO (2) classes of drugs, outline the mechanism
of action on tubules. (10%)
2.
Amputation has been the most common therapy used for treatment of
appendicular osteosarcoma in the dog. There are alternatives.
a.
b.
c.
d.
List the alternatives that are currently used.
What criteria must the patient meet for each of these alternatives?
What is the prognosis for each outcome?
What are the major adverse events associated with each alternative?
Continued over/Veterinary Oncology Paper 2 2005
Continued/Veterinary Oncology Paper 2 2005
3.
Answer BOTH part (a) AND part (b).
a.
b.
There are many substances that can function as radiation and
chemotherapy sensitizers or protectors. Thiols are an important group
of substances in this regard.
i.
Discuss the role of glutathione. In your answer include the
mechanism of action, and TWO (2) clinical strategies involving
glutathione. (15%)
ii.
Discuss the role of Amifostine. In your answer include the
mechanism of action, potential toxicities, and TWO (2) clinical
strategies for use. (20%)
iii.
Discuss mesna. In your answer include the mechanism of action
and two clinical strategies for use. (15%)
Oral melanomas in the dog are reported as treated by radiation therapy
using TWO (2) protocols.
i.
Theon et al (JAVMA 210: 778-784) reported use of 48Gy total dose in
12 x 4Gy fractions given 3 times a week. What would be the expected
acute and late toxicities for this protocol and why? (25%)
ii.
Blackwood et al (JAVMA 209: 98-102) reported use of 36Gy total
dose in 4 x 9Gy fractions given 3 times a week. What would be the
expected acute and late toxicities for this protocol and why? (25%)
4.
List and discuss EIGHT (8) patient or tumour factors thought to improve or
worsen the outcome for dogs with malignant mammary tumors. In your
answer, specify how each factor affects patient outcome.
5.
Dogs can develop cardiomyopathy when treated with doxorubicin at a
standard dosage and schedule (30mg/m2 body surface area every 3 weeks).
Cumulative doses of 60-240 mg/m2 have been associated with
cardiomyopathy.
a.
What role do free
cardiomyopathy? (20%)
radicals
play
in
doxorubicin-induced
b.
List THREE (3) clinical strategies for administering doxorubicin to
reduce the risk of developing doxorubicin-induced cardiomyopathy
(not including dexrazoxane, below). What is the rationale for each
example? (60%)
c.
Describe the rationale for use of dexrazoxane (ICRF-187) to reduce or
circumvent doxorubicin-induced cardiomyopathy. In your answer
include the proposed molecular mechanism for its protective effect.
(20%)
Continued over/Veterinary Oncology Paper 2 2005
Continued/Veterinary Oncology Paper 2 2005
6.
7.
Answer ALL parts of this question
a.
List FOUR (4) tumors in veterinary medicine for which grade is
important? (20%)
b.
For each tumor, briefly outline the histologic criteria used to grade
them. (40%)
c.
For each tumor, briefly outline the prognostic effect of grade, but be
specific. (40%)
Answer BOTH part (a) AND part (b).
a.
b.
Provide a brief (1-2 paragraph) definition of the following terms as
they relate to cancer chemotherapy:
i.
Worst drug rule (10%)
ii.
Goldie-Coldman hypothesis. In your answer include THREE
(3) impacts of this theory on chemotherapy protocol design.
(20%)
iii.
Dose intensity. How can dose intensity be increased? In your
answer comment on the clinical utility of “received dose
intensity”. (10%)
Body surface area (BSA) is commonly used to determine dosage of
chemotherapeutics in dogs.
The formula is BSA=10 x W2/3 (W = Body Weight)
i.
For many drugs, the BSA method does not work. List
THREE(3) drugs from the veterinary literature for which the
BSA method of dose calculation in dogs does not work. (5%)
ii.
How does using the BSA method of dose calculation affect
dosing of dogs with chemotherapeutics. (5%) What are specific
weaknesses of the BSA dosing formula in dogs, and in cats?
(20%)
iii.
List FOUR (4) pharmacokinetics factors that affect dosing of
chemotherapeutics in dogs? Include an example of a drug
affected by each of these factors. (20%)
iv.
In determining the effect of excretion on drug dosing what is
meant by the term, “the Calvert formula”? To which drug is it
commonly applied? (10%)
END OF PAPER