FELLOWSHIP EXAMINATION - Microsoft
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. Outline in detail the steps involved. (40%)
b. Describe and discuss the role of platelets in this process. (20%)
c. What is the role of endothelial cells?. (20%)
d. Describe and critically appraise the ‘soil and seed’ theory. (20%)
3. The study of viral carcinogenesis has been used to understand the process of carcinogenesis.
a. Define and discuss the THREE (3) stages of carcinogenesis. (30%)
b. Regarding viral carcinogenesis:
• Describe and discuss the mechanism (s). (50%).
• Discuss THREE (3) examples from the veterinary literature. (20%)
4. Write brief notes on FOUR (4) of the following:
a. The role of Bcl-2.
b. The role of c-kit in the normal cell.
c. The pathogenesis of hypertrophic osteopathy.
d. The role of IL-2 in tumour immunity.
e. The physiology of the telomere.
5. 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. Cytokeratin
ii. Vimentin
iii. Desmin
iv. GFAP
v. S-100 protein
vi. Factor VIII
vii. Melan-A
viii. Alpha-1-antitrypsin
ix. CD-3
x. CD-79a
xi. CD-18
xii. Lysozyme
xiii. Chromogranin
xiv. 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. Hyperfractionation.
b. Shoulder of the curve.
c. Therapeutic ratio.
d. The four ‘Rs’.
e. 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. List the alternatives that are currently used.
b. What criteria must the patient meet for each of these alternatives?
c. What is the prognosis for each outcome?
d. 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. 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%)
b. 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 radicals play in doxorubicin-induced cardiomyopathy? (20%)
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. 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%)
7. Answer BOTH part (a) AND part (b).
a. 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%)
b. 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
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