Block 2 Flashcards
(170 cards)
1
Q
What are the 2 types of rhabdomyolysis?
A
Sporadic exertional rhabdomyolysis
Recurrent exertional rhabdomyolysis (ER) and (RER)
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)
3
Q
What is PSSM?
A
Polysaccharide storage myopathy
4
Q
What is HYPP?
A
Hyperkalemia periodic paralysis
5
Q
What is RER?
A
Recurrent exertional rhabdomyolysis
6
Q
What is ER?
A
Sporadic exertional rhabdomyolysis
7
Q
What is the horsemen’s term for rhabdomyolysis?
A
Tied up
8
Q
What are clinical symptoms of rhabdomyolysis?
A
Muscle stiffness after exercise
Reluctance to move
Tachypnea, tachycardia, sweating
9
Q
What do you see in bloodwork for rhabdomyolysis?
A
Elevated CK, AST, K, Phos
Decreased Na, Cl, and Ca
Azotemia
10
Q
What do you see in urine for rhabdomyolysis?
A
Myoglobinuria - pigmented urine (brown/red/black)
11
Q
What are the 2 most important things to see on bloodwork for rhabdo?
A
High CK and ALT
12
Q
When is peak CK after rhabdo?
When is clearance?
A
4-6 hours
1 day
13
Q
When is peak ALT after rhabdo?
When is clearance?
A
12-24 hours
2-3 weeks
14
Q
What would high ALT but normal CK mean?
A
Myonecrosis has stopped
15
Q
What is sporadic rhabdomyolysis?
A
Associated with exhaustive running
16
Q
What is HYPP?
A
Hyperkalemic periodic paralysis
17
Q
What is an association of HYPP?
A
hyperkalemia
18
Q
What is the manifestation of HYPP?
A
episodic weakness
19
Q
What is the physiology behind HYPP?
A
Defect in fast Na channels of skeletal muscles
20
Q
What is glycogen-storage disease of skeletal muscle?
A
PSSM
21
Q
Which form of PSSM is heritable?
A
Type I
22
Q
What are clinical signs of PSSM?
A
Repeated rhabdomyolysis from very mild exercise
Exercise intolerance
Muscle atrophy
23
Q
How do you diagnose PSSM?
A
Muscle biopsy
24
Q
What is seen in the muscle biopsy of PSSM?
A
PAS-postive
Amylase-resistent
Abnormal glycogen in muscle
25
What does a toxic line indicate in a horse's mouth?
Endotoxemia
26
What does CaTnI mean?
Cardiac Troponin I
Shows signs of cardiac damage
27
What happens when muscles breakdown and heme goes to the kidney?
Causes kidney damage called pigment nephropathy
28
What is nephropathy?
deterioration of kidney function
29
What often causes pigment nephropathy?
Rhabdomyolyis
30
What bone does the bovine walk on?
P3
31
What bone does the camelid walk on?
P3, P2, and proximal interphalangial joint
32
What interdigitates with the hoof wall?
The laminar corium
33
What provides support to the dorsal 1/2 of the hoof?
Laminar corium
34
What provides support to the plantar/palmar 1/2 of the hoof?
Digital cushion
35
What may trigger laminitis?
Endotoxins, inflammation, hormones
36
Describe pathogenesis of laminitis
Endotoxemia->vasocontriction>edema>hypoxia>failure of suspensory system
37
What are 3 endotoxic causes of laminitis?
Mastitis
Rumen acidosis
Metritis
38
Does laminitis commonly occur in all 4 hooves?
Yes
39
What are some symptoms of laminitis?
Arched back and increased digital pulse
40
What is a typical foot ulcer called?
Rusterholtz
41
Describe a Rusterholtz ulcer
In the hind lateral claw
42
What are risk factors for a rusterholtz ulcer (3)
Laminitis, overgrown feet, concrete
43
Where are toe ulcers found?
On the front feet
44
What 2 things cause toe ulcers?
Laminitis and concrete
45
What is white line disease?
Separation/cracks in white line
46
What causes a sole abscess?
ALWAYS secondary
-white line disease
-sole ulcer
-foreign body
47
What is a false sole?
Layer of horn separated from underlying horn
48
What is another name for a horizontal wall fissure?
Hardship grooves
49
What are horizontal wall fissures caused by?
metritis
mastitis
laminitis
50
What is a thimble?
Full thickness horizontal fissure
51
What is a corkscrew claw?
Misalignment of P2 and P3
52
Where does corkscrew claw most commonly occur?
Lateral claw of pelvic limb
53
What is another name for interdigital hyperplasia/fibroma?
Corns
54
What does a corn look like?
A tissue shoot out in the interdigital space
Shouldn't do anything about it
55
What are the 2 types of footrot?
Interdigital dermatitis
Interdigital phelgmon
56
What is interdigital dermatitis?
Inflammatory condition of interdigital skin
57
What is interdigital phlegmon?
Infection of interdigital skin and soft tissue
58
What are the symptoms of interdigital dermatitis?
Dry, less severe
59
What are the symptoms of interdigital phlegmon?
Exudative, more severe
60
What is hairy heal wart also known as?
Digital dermatitis
61
What is the leading cause of lameness in dairies?
Digital dermatitis / hairy heal wart
62
What is the lameness scoring of lameness in cattle
1-5 mostly based off back arch
63
What is the 90% rule?
90% the hoof
90% the hind limb
90% the lateral claw
64
What is osteoarthritis
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
65
What is primary osteoarthritis?
Genetic
Mutation in collagen II and lubricin
66
What is the etiology of osteoarthritis?
(8 of them)
Genetics
Age
Bodyweight
Obesity
Sex
Exercise
Trauma
67
What is the pathophysiology of osteoarthritis?
Activation of IL-1 and TNF-alpha in synovial fluid > activation of MMPs in articular cartilage > matrix degradation
68
What are the 3 mediators of osteoarthritis?
IL-1
MMP
PGE2
69
What is an MMP?
Collagenases
(degrades collagen)
70
Where do the OA mediators come from?
Chondrocytes
synovial cells
71
What are the pathological manifestations of joint disease?
Subchondral bone sclerosis
osteophytes
Osteochondral fragment
enthesiophyte
decreased joint space
ankylosis
72
What is a bone spur at a tendon or ligament insertion site?
Enthesiophyte
73
What is the fusion of joint space?
Ankylosis
74
How is osteoarthritis diagnosed?
History
PE
Radiographs: osteophytes, enthesiophytes, sclerosis
Other: scintigraphy, arthroscopy, joint fluid analysis
75
Under joint fluid analysis, what would mononuclear cells suggest?
Degenerative joint disease
76
Under joint fluid analysis, what would degenerative neutrophils suggest?
Septic arthritis
77
Under joint fluid analysis, what would non-degenerative neutrophils suggest?
IMPA (canine immune mediated polyarthritis)
78
Under joint fluid analysis, what would unusual cells suggest?
Neoplasia
79
Is OA an inflammatory disease?
YES
80
What is Wolff's Law?
Bone will adapt when needed
81
What is osteoporosis?
Clinical disease where bone resorption>bone formation
82
What is the difference between osteoporosis and osteopenia?
Osteopenia is reduced bone mass without clinical signs
83
What is the etiology of osteoporosis?
Glucocorticoids causes longer lifespan of osteoclasts and shorter lifespan of osteoblasts
84
How might starvation cause osteoporosis?
Decreased energy so osteoblasts produce less bone and bone resorption occurs as normal
85
What is the failure of mineralization of bone and growth plate cartilage in the young?
Rickets
86
What is the failure of mineralization of bone in the adult?
Osteomalacia
87
What is the common cause of osteomalacia/rickets?
Vitamin D deficiency
88
Why does a vitamin D deficiency cause rickets/osteomalacia?
Decreased P and Ca absorption
Not enough UV
89
Is rickets/osteomalacia a calcium deficiency disease?
What type of deficiency is it normally?
NO
Phosphorous
90
What occurs in fibrous osteodystrophy?
Up regulation of PTH which hyper activates osteoclasts. Bone is replaced with fibrous connective tissue
91
What are the 4 major causes of fibrous osteodystrophy?
-idiopathic
-adenoma
-pseudohyperparathyroidism
-Nutritional secondary hyperparathyroidism
92
What is "big head disease" or "bran disease"
From diets high in phosphorous
Pure grain in pigs, all meat in cats/dogs, bran in horses (FOD)
93
What does FOD stand for?
Fibrous osteodystophy
94
What is the most common clinical manifestation of fibrous osteodystrophy?
Rubber jaw
95
What is the benefit to doing an ultrasound?
Visualize soft tissue
96
Does MRI or CT evaluate bone and soft tissue?
MRI
97
What are the 7 diagnostic tools for bone diseases?
Clinical signs
Radiographs
MRI
CT
Ultrasound
Cytology
Culture
98
What are the 4 metabolic bone disease?
Osteoporosis
Rickets
Osteomalacia
Fibrous Osteodystrophy
99
What 3 things make up the extracellular matrix of bone?
Collagen
Hydroxyapatite
Osteoid
100
What happens if there are a lot of RANK/RANKL?
Activation of osteoclasts
101
What does OPG do?
Inhibits RANKL and thus osteoclasts
102
What do osteoclasts secrete to lyse bone?
Hydrogen ions and cathepsin K
103
What is inflammation of bone due to a microbial organism?
Osteomyelitis
104
What is an S-type infection?
Associated with synovial membrane
105
What is a P-type infection?
Infection localized in the long bone physis
106
What is an E-type infection?
Articular epiphysis infection
107
What is a T-type infection?
Associated with bones of tarsus/carpus
108
What is a sequestrum?
Separated piece of bone
109
What are the 3 phases of tendon healing?
Acute inflammation
Reparative phase
Remodeling phase
110
What happens in the acute inflammatory phase of tendon healing?
Edema, hemorrhage, inflammatory cells
111
What happens in the reparative phase of tendon healing?
Angiogenesis and fibroblast proliferation
112
What happens in the remodeling phase of tendon healing?
Gradual increase in collagen I
113
What is inflammation/injury in tendon?
Tendonitis
114
What is inflammation/injury in ligament?
Desmitis
115
What is chronic inflammation/injury to tendon?
Tendinopathy
116
How do tendons/ligaments heal?
Scar formation / fibrosis
117
What are diagnostic levels for tendon injury?
1. Ultrasonography
2. MRI
118
What are the 3 parts to the achilles?
Paired gastrocnemius
Superficial digital flexor
Common tendon
119
What are the 3 tendons of the common tendon?
Biceps femoris
Semitendinosus
Gracilis
120
If the SDF is intact, what will the toes appear as?
"bear claw" / club foot
121
What will happen if the SDF and gastrocnemius is torn?
Dropped hock / plantigrade stance
122
What is SDF tendinitis called?
Bowed tendon
123
What are the sizes of tendon components?
Fibril
124
Where do bowed tendons usually occur?
Mid-metacarpal region (racehorses)
125
What is most common deep digital flexor injury?
Navicular syndrome
126
Tarsal/carpal sheath
127
What are the 3 heads of the DDF muscle
humoral, radial, ulnar
128
Ligaments connect ______ to _____
bone to bone
129
What does proximal suspensory desmitis look like in horses?
Fetlock drops towards the ground
130
What is a bowed tendon caused by?
Recurrent, persistent microstrain
131
What are the 3 pathologic forms of muscle atrophy?
Denervation atrophy
Disuse atrophy
Malnutrition and cachexia
132
What causes denervation muscle atrophy?
Trauma, neoplasia, inflammation, compression of nerve
133
How fast acting is denervation muscle atrophy?
FAST
134
What is an example of inflammation causing denervation muscle atrophy?
EPM
135
What muscles are atrified due to the denervation muscle atrophy?
Muscle associated with the nerve that is affected
136
What is muscle atrophy of the horse shoulder called?
Sweeny shoulder
137
What nerve is affected in Sweeny shoulder?
Suprascapular nerve (blunt for trauma)
138
Laryngeal hemiplasia is denervation syndrome also called what?
Roaring
139
What nerve is affected in roaring?
left recurrent laryngeal (affects left crycoarytendoidious)
140
What are the 3 most important cytokines of Cachexia?
TNF alpha. IL-6. IFN gamma
141
What are the 2 types of categories to put myonecrosis into?
Focal or multifocal
Monophasic or polyphasicW
142
What does polyphasic mean?
Multiple insults/injuries
143
What are most multifocal monophasic myonecrosis caused by?
Toxins
144
What type of myonecrosis is white muscle disease?
Multifocal polyphasic
145
What is white muscle disease?
Deficiency in either/both vitamin E and selenium
146
What type of horse most typically gets PSSM?
Quarterhorse and draft horses
147
What bacteria causes myositis?
Clostridium myositis
148
What are the 2 forms of clostridial myositis?
Malignant edema
Blackleg
149
What type of pathogenesis is malignant edema?
"Outside-in"
150
What type of pathogenesis is blackleg?
"Inside-out"
151
What type of clostridium is blackleg caused by?
Clostridium chauvoei
152
***What is the pathogenesis of blackleg?
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
What is typical presentation of diffuse muscle loss?
Elephant on the ball-look
154
What will abnormal muscle show on EMG?
Increased spontaneous activity
155
Are EMG specific to a diagnosis?
NO
156
What is needed in addition to EMG to make a diagnosis?
Muscle biopsy
157
What is seen on EMG with immune-mediated polymyositis?
Diffuse neuropathy
Diffuse muscle disease
158
What breed is important in immune-mediated polymyositis?
Boxers!
159
What biopsy findings are indicative of immune-mediated polymyositis?
Mostly lymphocytes
160
How is muscle dystrophy diagnosed?
Markedly elevated CK
Characteristic muscle biopsy
161
What is cause of muscle dystrophy?
Dystrophin gene mutation
162
What is the hallmark of muscle dystrophy?
Markedly elevated CK
163
What are the 3 small animal muscle diseases to know?
Muscle dystrophy
immune-mediated polymyositis
Masticatory myositis
164
What does masticatory myositis affect?
Mandibular branch of trigeminal nerve
165
What fibers of the trigeminal nerve?
2M fibers
166
What are the clinical symptoms of masticatory myositis?
Can't open mouth
167
What muscles are involved in masticatory myositis?
Masseter
digastricus
temporalis
168
How is masticatory myositis diagnosed?
serum 2M autoantibody titer or temporalis muscle biopsy
169
What type of disease is masticatory myositis?
Immune-mediated
170
