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Maltese terrier cross with enlarged abdomen (view source)
Revision as of 18:10, 4 October 2012
, 18:10, 4 October 2012no edit summary
:abdominal enlargement, lethargy, inappetance for 3 months. Your physical exam shows an obviously distended abdomen with a very large (>10 cm diameter) firm palpable abdominal mass, mucous membranes pink but paler than normal, periodontal disease. Otherwise clinical exam within normal limits, and she seems surprisingly alert and responsive. The clients say the abdominal enlargement has only happened in the past month.
:abdominal enlargement, lethargy, inappetance for 3 months. Your physical exam shows an obviously distended abdomen with a very large (>10 cm diameter) firm palpable abdominal mass, mucous membranes pink but paler than normal, periodontal disease. Otherwise clinical exam within normal limits, and she seems surprisingly alert and responsive. The clients say the abdominal enlargement has only happened in the past month.
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<center><WikiQuiz
<center><WikiQuiz
<center><WikiQuiz
<center><WikiQuiz
questionnumber="12"
questionnumber="12"
question=""
question="How would you manage your patient’s arrhythmia?"
choice1=""
choice1="Lidocaine"
choice2=""
choice2="Procainamide"
choice3=""
choice3="Beta-blocker"
choice4="Angiotensin-converting enzyme (ACE) inhibitor"
choice5="Pimobendan"
correctchoice="1"
feedback1="'''Correct'''."
feedback2="'''Incorrect'''. There is a better drug choice. Choose again."
feedback3="'''Incorrect'''. You selected the wrong drug and your patient did not respond to treatment. Choose again."
feedback4="'''Incorrect'''. You selected the wrong drug and your patient did not respond to treatment. Choose again."
feedback5="'''Incorrect'''. You selected the wrong drug and your patient did not respond to treatment. Choose again."
image= "">
</WikiQuiz></center>
{| class="mw-collapsible mw-collapsed wikitable"
! Histopathology Report
|-
| [[File:Case 22 histopathology.jpg]]
|}
<center><WikiQuiz
questionnumber="13"
question="You send samples of the mass off to histopathology. Now that you have the results of histology, what do you do next?"
choice1="Advise she should receive adjuvant doxorubicin chemotherapy as the next step, to begin once the wound has healed. You also advise regular follow-ups for 12 months after surgery."
choice2="Offer nothing further as therapy and advise a recheck in 10−14 days for suture removal, then further rechecks every 3−6 months for 12 months after surgery."
choice3="Advise the clients that this kind of tumour is reported to occur infrequently as a splenic mass. However the prognosis is expected to be good with surgery alone, with a low metastatic rate. Adjuvant doxorubicin chemotherapy could be considered the more aggressive next step. This may be beneficial but data to prove this conclusively are lacking. A valid option is no further therapy as the surgery is potentially curative. Removing such a large abdominal mass is a strongly palliative option. Schedule a recheck in 10−14 days for suture removal, then further rechecks every 3−6 months for 12 months after surgery."
choice4=""
choice4=""
choice5=""
correctchoice="3"
feedback1="'''Incorrect'''. You should discuss with the clients that chemotherapy may be of use to extend survival time, but this has not been proven. Strongly recommending adjuvant chemotherapy without sufficient data to support its benefit is controversial. Choose again."
feedback2="'''Incorrect'''. There is insufficient evidence to exclude or include adjuvant chemotherapy as part of the treatment options for this kind of tumour. You should give the clients the option of considering adjuvant chemotherapy. Choose again."
feedback3="'''Correct'''. This is the option that allows the clients to make their own decision knowing all the current information."
feedback4=""
feedback5=""
image= "">
</WikiQuiz></center>
<center><WikiQuiz
questionnumber="14"
question="With respect to other splenic masses seen in dogs, what do we understand by the term ‘nodular fibrohistiocytic proliferation’?"
choice1="This is another name for nodular hyperplasia "
choice2="These nodules have characteristics of splenic lymphoid hyperplasia and malignant splenic stromal tumours "
choice3="This is another name for histiocytic sarcoma "
choice4="These nodules are characterized by malignant lymphoid cells "
choice5="These nodules are characterized by high ratios of benign lymphoid cells and aggressive mesenchymal cells "
correctchoice="2"
feedback1="'''Incorrect'''. Choose again."
feedback2="'''Correct'''."
feedback3="'''Incorrect'''. Choose again."
feedback4="'''Incorrect'''. Choose again."
feedback5="'''Incorrect'''. Choose again."
image= "">
</WikiQuiz></center>
<center><WikiQuiz
questionnumber="15"
question="Infiltrative disease of the spleen, e.g. lymphoma or metastatic mast cell tumour, can appear ultrasonographically like what non-neoplastic condition affecting the spleen?"
choice1="Extramedullary haematopoiesis "
choice2="Splenic infarct "
choice3="Splenic torsion "
choice4="Splenitis"
choice5=""
choice5=""
correctchoice="4"
correctchoice="4"
feedback1=""
feedback1="'''Incorrect'''. Choose again."
feedback2=""
feedback2="'''Incorrect'''. Choose again."
feedback3=""
feedback3="'''Incorrect'''. Choose again."
feedback4=""
feedback4="'''Correct'''."
feedback5=""
feedback5=""
image= "">
image= "">
</WikiQuiz></center>
</WikiQuiz></center>
[[Category:Neoplasia]]
<center><WikiQuiz
questionnumber="16"
question="What are the most common tumours seen in the spleen of cats?"
choice1="Lymphoma: haemangiosarcoma "
choice2="Mast cell tumour: haemangiosarcoma "
choice3="Lymphoma: mast cell tumour "
choice4="Haemangiosarcoma: liposarcoma "
choice5="Histiocytic sarcoma: mast cell tumour "
correctchoice="3"
feedback1="'''Incorrect'''. Choose again."
feedback2="'''Incorrect'''. Choose again."
feedback3="'''Correct'''."
feedback4="'''Incorrect'''. Choose again."
feedback5="'''Incorrect'''. Choose again."
image= "">
</WikiQuiz></center>
<center><WikiQuiz
questionnumber="17"
question="In cats, what is the treatment of choice for splenic mast cell tumour and what is the prognosis with treatment?"
choice1="Splenectomy; poor prognosis"
choice2="Chemotherapy; poor prognosis "
choice3="Splenectomy; good prognosis "
choice4="Chemotherapy; good prognosis "
choice5="No treatment; grave prognosis"
correctchoice="3"
feedback1="'''Incorrect'''. Choose again."
feedback2="'''Incorrect'''. Choose again."
feedback3="'''Correct'''."
feedback4="'''Incorrect'''. Choose again."
feedback5="'''Incorrect'''. Choose again."
image= "">
</WikiQuiz></center>
<br><br>
{{Elsevier
|url = http://www.elsevierhealth.co.uk/product.jsp?isbn=9780702042508
|book = North and Banks, Small Animal Oncology
|image = North and Banks SA Oncology.jpg
}}
[[Category:Case-based Quizzes]]