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Diseases and Diagnosis > Block 2 > Flashcards

Block 2 Flashcards

1
Q

What are the 2 types of rhabdomyolysis?

A

Sporadic exertional rhabdomyolysis
Recurrent exertional rhabdomyolysis (ER) and (RER)

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2
Q

What are the 4 types of equine myopathies?

A

Sporadic exertional rhabdomyolysis (ER)
Recurrent exertional rhabdomyolysis (RER)
Polysaccharide storage myolysis (PSSM)
Hyperkalemia periodic paralysis (HYPP)

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3
Q

What is PSSM?

A

Polysaccharide storage myopathy

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4
Q

What is HYPP?

A

Hyperkalemia periodic paralysis

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5
Q

What is RER?

A

Recurrent exertional rhabdomyolysis

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6
Q

What is ER?

A

Sporadic exertional rhabdomyolysis

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7
Q

What is the horsemen’s term for rhabdomyolysis?

A

Tied up

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8
Q

What are clinical symptoms of rhabdomyolysis?

A

Muscle stiffness after exercise
Reluctance to move
Tachypnea, tachycardia, sweating

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9
Q

What do you see in bloodwork for rhabdomyolysis?

A

Elevated CK, AST, K, Phos
Decreased Na, Cl, and Ca
Azotemia

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10
Q

What do you see in urine for rhabdomyolysis?

A

Myoglobinuria - pigmented urine (brown/red/black)

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11
Q

What are the 2 most important things to see on bloodwork for rhabdo?

A

High CK and ALT

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12
Q

When is peak CK after rhabdo?
When is clearance?

A

4-6 hours
1 day

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13
Q

When is peak ALT after rhabdo?
When is clearance?

A

12-24 hours
2-3 weeks

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14
Q

What would high ALT but normal CK mean?

A

Myonecrosis has stopped

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15
Q

What is sporadic rhabdomyolysis?

A

Associated with exhaustive running

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16
Q

What is HYPP?

A

Hyperkalemic periodic paralysis

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17
Q

What is an association of HYPP?

A

hyperkalemia

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18
Q

What is the manifestation of HYPP?

A

episodic weakness

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19
Q

What is the physiology behind HYPP?

A

Defect in fast Na channels of skeletal muscles

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20
Q

What is glycogen-storage disease of skeletal muscle?

A

PSSM

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21
Q

Which form of PSSM is heritable?

A

Type I

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22
Q

What are clinical signs of PSSM?

A

Repeated rhabdomyolysis from very mild exercise
Exercise intolerance
Muscle atrophy

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23
Q

How do you diagnose PSSM?

A

Muscle biopsy

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24
Q

What is seen in the muscle biopsy of PSSM?

A

PAS-postive
Amylase-resistent
Abnormal glycogen in muscle

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25
Q

What does a toxic line indicate in a horse’s mouth?

A

Endotoxemia

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26
Q

What does CaTnI mean?

A

Cardiac Troponin I
Shows signs of cardiac damage

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27
Q

What happens when muscles breakdown and heme goes to the kidney?

A

Causes kidney damage called pigment nephropathy

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28
Q

What is nephropathy?

A

deterioration of kidney function

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29
Q

What often causes pigment nephropathy?

A

Rhabdomyolyis

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30
Q

What bone does the bovine walk on?

A

P3

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31
Q

What bone does the camelid walk on?

A

P3, P2, and proximal interphalangial joint

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32
Q

What interdigitates with the hoof wall?

A

The laminar corium

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33
Q

What provides support to the dorsal 1/2 of the hoof?

A

Laminar corium

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34
Q

What provides support to the plantar/palmar 1/2 of the hoof?

A

Digital cushion

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35
Q

What may trigger laminitis?

A

Endotoxins, inflammation, hormones

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36
Q

Describe pathogenesis of laminitis

A

Endotoxemia->vasocontriction>edema>hypoxia>failure of suspensory system

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37
Q

What are 3 endotoxic causes of laminitis?

A

Mastitis
Rumen acidosis
Metritis

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38
Q

Does laminitis commonly occur in all 4 hooves?

A

Yes

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39
Q

What are some symptoms of laminitis?

A

Arched back and increased digital pulse

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40
Q

What is a typical foot ulcer called?

A

Rusterholtz

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41
Q

Describe a Rusterholtz ulcer

A

In the hind lateral claw

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42
Q

What are risk factors for a rusterholtz ulcer (3)

A

Laminitis, overgrown feet, concrete

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43
Q

Where are toe ulcers found?

A

On the front feet

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44
Q

What 2 things cause toe ulcers?

A

Laminitis and concrete

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45
Q

What is white line disease?

A

Separation/cracks in white line

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46
Q

What causes a sole abscess?

A

ALWAYS secondary
-white line disease
-sole ulcer
-foreign body

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47
Q

What is a false sole?

A

Layer of horn separated from underlying horn

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48
Q

What is another name for a horizontal wall fissure?

A

Hardship grooves

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49
Q

What are horizontal wall fissures caused by?

A

metritis
mastitis
laminitis

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50
Q

What is a thimble?

A

Full thickness horizontal fissure

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51
Q

What is a corkscrew claw?

A

Misalignment of P2 and P3

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52
Q

Where does corkscrew claw most commonly occur?

A

Lateral claw of pelvic limb

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53
Q

What is another name for interdigital hyperplasia/fibroma?

A

Corns

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54
Q

What does a corn look like?

A

A tissue shoot out in the interdigital space

Shouldn’t do anything about it

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55
Q

What are the 2 types of footrot?

A

Interdigital dermatitis
Interdigital phelgmon

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56
Q

What is interdigital dermatitis?

A

Inflammatory condition of interdigital skin

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57
Q

What is interdigital phlegmon?

A

Infection of interdigital skin and soft tissue

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58
Q

What are the symptoms of interdigital dermatitis?

A

Dry, less severe

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59
Q

What are the symptoms of interdigital phlegmon?

A

Exudative, more severe

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60
Q

What is hairy heal wart also known as?

A

Digital dermatitis

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61
Q

What is the leading cause of lameness in dairies?

A

Digital dermatitis / hairy heal wart

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62
Q

What is the lameness scoring of lameness in cattle

A

1-5 mostly based off back arch

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63
Q

What is the 90% rule?

A

90% the hoof
90% the hind limb
90% the lateral claw

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64
Q

What is osteoarthritis

A

Non-inflammatory disorder of moveable joints characterized by degeneration and loss of articular cartilage and the development of new bone on joint surfaces and margins

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65
Q

What is primary osteoarthritis?

A

Genetic
Mutation in collagen II and lubricin

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66
Q

What is the etiology of osteoarthritis?
(8 of them)

A

Genetics
Age
Bodyweight
Obesity
Sex
Exercise
Trauma

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67
Q

What is the pathophysiology of osteoarthritis?

A

Activation of IL-1 and TNF-alpha in synovial fluid > activation of MMPs in articular cartilage > matrix degradation

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68
Q

What are the 3 mediators of osteoarthritis?

A

IL-1
MMP
PGE2

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69
Q

What is an MMP?

A

Collagenases
(degrades collagen)

70
Q

Where do the OA mediators come from?

A

Chondrocytes
synovial cells

71
Q

What are the pathological manifestations of joint disease?

A

Subchondral bone sclerosis
osteophytes
Osteochondral fragment
enthesiophyte
decreased joint space
ankylosis

72
Q

What is a bone spur at a tendon or ligament insertion site?

A

Enthesiophyte

73
Q

What is the fusion of joint space?

A

Ankylosis

74
Q

How is osteoarthritis diagnosed?

A

History
PE
Radiographs: osteophytes, enthesiophytes, sclerosis
Other: scintigraphy, arthroscopy, joint fluid analysis

75
Q

Under joint fluid analysis, what would mononuclear cells suggest?

A

Degenerative joint disease

76
Q

Under joint fluid analysis, what would degenerative neutrophils suggest?

A

Septic arthritis

77
Q

Under joint fluid analysis, what would non-degenerative neutrophils suggest?

A

IMPA (canine immune mediated polyarthritis)

78
Q

Under joint fluid analysis, what would unusual cells suggest?

A

Neoplasia

79
Q

Is OA an inflammatory disease?

A

YES

80
Q

What is Wolff’s Law?

A

Bone will adapt when needed

81
Q

What is osteoporosis?

A

Clinical disease where bone resorption>bone formation

82
Q

What is the difference between osteoporosis and osteopenia?

A

Osteopenia is reduced bone mass without clinical signs

83
Q

What is the etiology of osteoporosis?

A

Glucocorticoids causes longer lifespan of osteoclasts and shorter lifespan of osteoblasts

84
Q

How might starvation cause osteoporosis?

A

Decreased energy so osteoblasts produce less bone and bone resorption occurs as normal

85
Q

What is the failure of mineralization of bone and growth plate cartilage in the young?

A

Rickets

86
Q

What is the failure of mineralization of bone in the adult?

A

Osteomalacia

87
Q

What is the common cause of osteomalacia/rickets?

A

Vitamin D deficiency

88
Q

Why does a vitamin D deficiency cause rickets/osteomalacia?

A

Decreased P and Ca absorption
Not enough UV

89
Q

Is rickets/osteomalacia a calcium deficiency disease?

What type of deficiency is it normally?

A

NO

Phosphorous

90
Q

What occurs in fibrous osteodystrophy?

A

Up regulation of PTH which hyper activates osteoclasts. Bone is replaced with fibrous connective tissue

91
Q

What are the 4 major causes of fibrous osteodystrophy?

A

-idiopathic
-adenoma
-pseudohyperparathyroidism
-Nutritional secondary hyperparathyroidism

92
Q

What is “big head disease” or “bran disease”

A

From diets high in phosphorous
Pure grain in pigs, all meat in cats/dogs, bran in horses (FOD)

93
Q

What does FOD stand for?

A

Fibrous osteodystophy

94
Q

What is the most common clinical manifestation of fibrous osteodystrophy?

A

Rubber jaw

95
Q

What is the benefit to doing an ultrasound?

A

Visualize soft tissue

96
Q

Does MRI or CT evaluate bone and soft tissue?

A

MRI

97
Q

What are the 7 diagnostic tools for bone diseases?

A

Clinical signs
Radiographs
MRI
CT
Ultrasound
Cytology
Culture

98
Q

What are the 4 metabolic bone disease?

A

Osteoporosis
Rickets
Osteomalacia
Fibrous Osteodystrophy

99
Q

What 3 things make up the extracellular matrix of bone?

A

Collagen
Hydroxyapatite
Osteoid

100
Q

What happens if there are a lot of RANK/RANKL?

A

Activation of osteoclasts

101
Q

What does OPG do?

A

Inhibits RANKL and thus osteoclasts

102
Q

What do osteoclasts secrete to lyse bone?

A

Hydrogen ions and cathepsin K

103
Q

What is inflammation of bone due to a microbial organism?

A

Osteomyelitis

104
Q

What is an S-type infection?

A

Associated with synovial membrane

105
Q

What is a P-type infection?

A

Infection localized in the long bone physis

106
Q

What is an E-type infection?

A

Articular epiphysis infection

107
Q

What is a T-type infection?

A

Associated with bones of tarsus/carpus

108
Q

What is a sequestrum?

A

Separated piece of bone

109
Q

What are the 3 phases of tendon healing?

A

Acute inflammation
Reparative phase
Remodeling phase

110
Q

What happens in the acute inflammatory phase of tendon healing?

A

Edema, hemorrhage, inflammatory cells

111
Q

What happens in the reparative phase of tendon healing?

A

Angiogenesis and fibroblast proliferation

112
Q

What happens in the remodeling phase of tendon healing?

A

Gradual increase in collagen I

113
Q

What is inflammation/injury in tendon?

A

Tendonitis

114
Q

What is inflammation/injury in ligament?

A

Desmitis

115
Q

What is chronic inflammation/injury to tendon?

A

Tendinopathy

116
Q

How do tendons/ligaments heal?

A

Scar formation / fibrosis

117
Q

What are diagnostic levels for tendon injury?

A
  1. Ultrasonography
  2. MRI
118
Q

What are the 3 parts to the achilles?

A

Paired gastrocnemius
Superficial digital flexor
Common tendon

119
Q

What are the 3 tendons of the common tendon?

A

Biceps femoris
Semitendinosus
Gracilis

120
Q

If the SDF is intact, what will the toes appear as?

A

“bear claw” / club foot

121
Q

What will happen if the SDF and gastrocnemius is torn?

A

Dropped hock / plantigrade stance

122
Q

What is SDF tendinitis called?

A

Bowed tendon

123
Q

What are the sizes of tendon components?

A

Fibril<fibre<fasicle<tendon

124
Q

Where do bowed tendons usually occur?

A

Mid-metacarpal region (racehorses)

125
Q

What is most common deep digital flexor injury?

A

Navicular syndrome

126
Q

Tarsal/carpal sheath

A
127
Q

What are the 3 heads of the DDF muscle

A

humoral, radial, ulnar

128
Q

Ligaments connect ______ to _____

A

bone to bone

129
Q

What does proximal suspensory desmitis look like in horses?

A

Fetlock drops towards the ground

130
Q

What is a bowed tendon caused by?

A

Recurrent, persistent microstrain

131
Q

What are the 3 pathologic forms of muscle atrophy?

A

Denervation atrophy
Disuse atrophy
Malnutrition and cachexia

132
Q

What causes denervation muscle atrophy?

A

Trauma, neoplasia, inflammation, compression of nerve

133
Q

How fast acting is denervation muscle atrophy?

A

FAST

134
Q

What is an example of inflammation causing denervation muscle atrophy?

A

EPM

135
Q

What muscles are atrified due to the denervation muscle atrophy?

A

Muscle associated with the nerve that is affected

136
Q

What is muscle atrophy of the horse shoulder called?

A

Sweeny shoulder

137
Q

What nerve is affected in Sweeny shoulder?

A

Suprascapular nerve (blunt for trauma)

138
Q

Laryngeal hemiplasia is denervation syndrome also called what?

A

Roaring

139
Q

What nerve is affected in roaring?

A

left recurrent laryngeal (affects left crycoarytendoidious)

140
Q

What are the 3 most important cytokines of Cachexia?

A

TNF alpha. IL-6. IFN gamma

141
Q

What are the 2 types of categories to put myonecrosis into?

A

Focal or multifocal
Monophasic or polyphasicW

142
Q

What does polyphasic mean?

A

Multiple insults/injuries

143
Q

What are most multifocal monophasic myonecrosis caused by?

A

Toxins

144
Q

What type of myonecrosis is white muscle disease?

A

Multifocal polyphasic

145
Q

What is white muscle disease?

A

Deficiency in either/both vitamin E and selenium

146
Q

What type of horse most typically gets PSSM?

A

Quarterhorse and draft horses

147
Q

What bacteria causes myositis?

A

Clostridium myositis

148
Q

What are the 2 forms of clostridial myositis?

A

Malignant edema
Blackleg

149
Q

What type of pathogenesis is malignant edema?

A

“Outside-in”

150
Q

What type of pathogenesis is blackleg?

A

“Inside-out”

151
Q

What type of clostridium is blackleg caused by?

A

Clostridium chauvoei

152
Q

***What is the pathogenesis of blackleg?

A

Cows on pasture consume C. chauvoei, it replicates in the gut then disseminates through the blood stream. They are attacked by macrophages then C. chauvoei remain dormant. Unknown causes cause it to proliferate and release endotoxins

153
Q

What is typical presentation of diffuse muscle loss?

A

Elephant on the ball-look

154
Q

What will abnormal muscle show on EMG?

A

Increased spontaneous activity

155
Q

Are EMG specific to a diagnosis?

A

NO

156
Q

What is needed in addition to EMG to make a diagnosis?

A

Muscle biopsy

157
Q

What is seen on EMG with immune-mediated polymyositis?

A

Diffuse neuropathy
Diffuse muscle disease

158
Q

What breed is important in immune-mediated polymyositis?

A

Boxers!

159
Q

What biopsy findings are indicative of immune-mediated polymyositis?

A

Mostly lymphocytes

160
Q

How is muscle dystrophy diagnosed?

A

Markedly elevated CK
Characteristic muscle biopsy

161
Q

What is cause of muscle dystrophy?

A

Dystrophin gene mutation

162
Q

What is the hallmark of muscle dystrophy?

A

Markedly elevated CK

163
Q

What are the 3 small animal muscle diseases to know?

A

Muscle dystrophy
immune-mediated polymyositis
Masticatory myositis

164
Q

What does masticatory myositis affect?

A

Mandibular branch of trigeminal nerve

165
Q

What fibers of the trigeminal nerve?

A

2M fibers

166
Q

What are the clinical symptoms of masticatory myositis?

A

Can’t open mouth

167
Q

What muscles are involved in masticatory myositis?

A

Masseter
digastricus
temporalis

168
Q

How is masticatory myositis diagnosed?

A

serum 2M autoantibody titer or temporalis muscle biopsy

169
Q

What type of disease is masticatory myositis?

A

Immune-mediated

170
Q
A

Diseases and Diagnosis (23 decks)

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