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RUSVM LAM I > E2: Muscle Diseases > Flashcards

E2: Muscle Diseases Flashcards

1
Q

Serum CK offers remarkable sensitivity as aan indicator of __________.

A

Myonecrosis (of heart and skeletal muscle)

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2
Q

What is the expected CK range for a horse that has just begun training or in response to moderate exercise?

A

400-500 IU/L

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3
Q

Which enzyme, CK or AST, rises more slowly in response to myonecrosis?

A

AST

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4
Q

What does it indicate if AST is increased in conjunction with decreasing or normal CK activity? What is CK remains elevated?

A

Myonecrosis has occured but is not continuing

CK remaining elevated = ongoing myonecrosis

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5
Q

What does a poitive Hemastic test n the absence of hemolysis or RBCs in urine suggest?

A

Myoglobinuria

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6
Q

In the exercise challenge test, a horse should be kept at a constant slow trot for ____ minutes. When must you take the sample?

A

15 minutes

4-6 hours after exercise (not immediately!)

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7
Q

What is a normal result for a healthy host post- Exercise challenge test? What result indicates exertional rhabdomyolysis?

A

Normal: Rarely >3x CK

Abnormal: >5x CK

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8
Q

What will a electromyography of a healthy horse show? What about a horse with muscle abnormalities?

A

Normal: little to no spontaneous electrical activity until muscles contract

Abnormal: spontaneous electrical activity

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9
Q

Electromyography (EMG) and __________ are used to classigy the disease Neuropathic or Myopathic.

A

Nerve conduction velocity (NCV)

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10
Q

What element isused in nuclear scintigraphy to ID some forms of muscle damage?

A

Technetium 99m methylene diphosphonate (MDP)

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11
Q

On US, does muscle fiber disruption appear hyper- or hypoechoic? How does increased connective tissue or loss of muscle cell mass look?

A

Hypoechoic

Hyperechoic

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12
Q

Responses to ____ and ______ are used to diagnose recurrent exertional rhabdomyolysis and susceptibility to malignant hypethermia.

A

Caffeine

Halothane

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13
Q

Complete denervation of a muscle results in a >50% loss of muscle mass within ______ weeks.

A

2-3

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14
Q

What nerve is damaged in a horse with Sweeney?

A

Suprascapular

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15
Q

T/F: A QH sire who is heterozygous for HYPP who is bred with a mare who is lacking the trait has a 1/4 chance of having offspring with HYPP.

A

True

It is autosomal dominant genetic disorder

(QHs, American Paint, Appaloosas, and QH crossbreeds)

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16
Q

At what age do clinical signs usually begin in a horse with HYPP?

A

2-3 yrs

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17
Q

Why can alfalfa hay, soybean meal, and molasses trigger HYPP?

A

High in potassium

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18
Q

T/F: During a HYPP episode, CK will be greatly elevated.

A

False

CK shows no change or only modest increase during episodic fasciulations and weakness.

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19
Q

In a horse with HYPP, where does sweating and muscle fascilation commonly occur?

A

Flanks

Neck

Shoulders

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20
Q

How do you control HYPP longterm? How do you treat a horse wtih recurrent episodes?

A

Longterm: Diet

Acute: Acetazolamide, Hydrochlorothiazide

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21
Q

What type of tick infestation cause sintermittent painful muscle cramps that are not associated with exercise? Will CK levels be elevated?

A

Otobius megnini

Yes, CK will be elevated 4k-17k IU/L

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22
Q

IM injections of ______ ______ can trigger ______ myonecrosis.

A

Flunixin meglumine

Clostridial

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23
Q

How do you make a definitive diagnosis of clostridial myonecrosis? (What samples would you need and what tests would you run)

A

Aspirates from affected tissue - direct smear exxam + fluorescent antibody testing + anaerobic bacterial culture

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24
Q

The toxins from this species of clostridium are thr most potent and myonecrosis caused by this organism is fatal.

A

C. sordelli

25
Q

What antibiotics do you use to (try to) treat clostridial myonecrosis? What else in conjunction with supportive care is indicated?

A

Rx: Penicillin (high dose CRI), Metronidazole PO, analgesics

Tx/Sx: Fasciotomy

26
Q

What hematologic abnormalitied are associated with S. equi rhabdomyolysis?

A

Mature neutrophilia

Hyperfibrinogenemia

Marked increase in CK (115k-587k U/L)

Marked increase in AST (600-14.5k U/L)

27
Q

What are the 2 proposed etiologies associated with S. equi rhabdomyolysis?

A
  1. Toxic shock-like reaction from profound nonspecific T cell stimulation by strep superantigens with release of +++ inflammatory cytokines
  2. Bacteremia w/local multiplication and exotoxinprotease production in skeletal muscle
28
Q

T/F: Unrelanting pain caused by S. equi (Strangles) rhabdomyolysis necessitates euthanasia within 24-48 hours of hospitalization.

A

True

29
Q

In what breed has immune-mediated polymyositis recently been reported?`

A

Quarter horses

30
Q

What does IMM (immune-mediated polymyositis) cause?

A

Muscular atrophy (rapid onset, especially affecting back and croup muscles + stiffness)

31
Q

What can you expect when you submit a muscle biopsy from a horse with IMM? Which muscles would you sample?

A

Lymphocyte vasculitis

Angular atrophy

Fiber necrosis w/ macrophage infiltration

Regeneration

Muscles: Epaxial and gluteals

32
Q

Which viruses can cause clinical signs similar to those seen in horses with rhabdomyolysis?

A

Equine influenza A2

EHV-1

33
Q

What is seasonal pasture myopathy? What are the clinical signs?

A

Highly fatal acquired lipid storage myopathy (Europe and Central-NE N. America)

CS: Acute muscle weakness, sweating, fasciculations, stiffness, tachycardia, tachypnea, recumbence, myoglobinuria

34
Q

How is seasonal pasture myopathy diagnosed?

A

Isolation of methylenecyclopyopyl acetic acid (MCPA) in blood or urine

35
Q

What tree species have speeds than contain the toxic amino acid hypoglycin A? Where is it metabolized? What type of myopathy is this toxin linked to?

A

Acer

Liver (to MCPA)

Atypical/Seasonal Pasture myopathy

36
Q

What is the prognosis for seasonal pasture myopathy?

A

<75% survival rate

37
Q

What are the 2 forms of post-anesthetic myoneuropathy?

A
  1. Localized
  2. Generalized (worse)
38
Q

T/F: Generalized postanesthetic myoneuropathy is caused by compartmental syndrome.

A

False, cannot be the sole cause

39
Q

What can you give a horse with postanesthetic myoneuropathy to help relax the muscles (in conjunction with pain meds)? How does it work?

A

Dantrolene sodium

Decreases release of calcium from sarcoplasmic reticulum

40
Q

What is a classic feature of severe exertonal rhabdomyolysis?

A

Myoglobinuria

41
Q

What diet imbalances can trigger and exacerbate sporadic exertional rhabdomyolysis?

A

High nonstructural cabs contant + low forage contant + low e-lytes

Exacerbated by inadequate selenium and vit E

42
Q

What diet is recommended for a horse with recurrent exertional rhabdomyolysis?

A

Low-Starch, High-Fat Concentrates

43
Q

Why are days off training in a stall discouraged in a horse with RER?

A

Post-exercise CK activity is higher following 2 days of rest compared to if performing consecutive days of the same amount of submaximal exercise

44
Q

What 2-3 drugs are recommended to treat RER?

A

Reserpine

Fluphenazine

Dantrium sodium

45
Q

What causes type 1 polysaccharide storgae myopathy and how is it diagnosed?

A

Genetic mutation in GYS1 gene

Muscle biopsy

46
Q

What are the 2 types/etiologies of non-exertional rhabdomyolysis?

A

Inflammatory

Nutritional

47
Q

Is clostridial myonecrosis contagious? Is it frequently fatal?

A

No

Yes (close to 100% mortality)

48
Q

What procedure can you perform to diminish the bacterial load in a horse with Strangles?

A

Flush infecred guttural pouches and drain abscessed LNs

49
Q

What are the treatments for immune-mediated polymyositis?

A

Corticosteriods (help CS and prevent progression)

50
Q

What 3 conditions put horses at a high risk of developing generalized anesthetic reactions/myoneuropathy?

A

Malignant hyperthemria

Recurrent exertional rhabdomyolysis

Polysaccharide storage myopathy?

51
Q

What are the clinical signs associated with sporadic exertional rhabdomyolysis? What is a classic feature of severe cases?

A

Stiff gait

Excessive sweating

High respiratory rate during or after exercise

Firm, painful muscles

Severe: Myoglobinuria (nephrotoxic) (also colic and recumbence)

52
Q

What are some causes of sporadic exertional rhabdomyolysis?

A

Level of exercise too high

Exhaustion (hot, humid weather)

Diet imbalance (high carb diets, e-lyte imbalance, inadequate vit E/sel)

53
Q

What can be included in the treatment for sporadic exertional rhabdomyolysis?

A

Anti-inflammatories

Sedative/tranquilizer

Fluids

Muscle relaxants (Methocarbamol)

Nutrition

Stall rest

54
Q

What are some risk factors associated with RER development?

A

Breed- TBs

Females

Young horses

Diet (High carb in TBs)

A few days of rest before exercise

55
Q

T/F: Mares appear to exhibit signs of rhabdomyolusis durng estrus, thus it may be beneficial to use progesterone inhections to suppress estrus.

A

True

56
Q

T/F: Marbles in the uterus to mimic a pregnancy is an alternative to progesterone injections to prevent estrus-driven rhabdomyolysis.

A

False, don’t do that

57
Q

How are the types of polysaccharide stroage myopathy determined? What do types 1 and 2 mean? Which is more aggressive?

A

Sensitivity to amylase digestion and GYS1 gene mutation

PSSM1= resistant + mutation = more aggressive CS

PSSM2= sensitive without mutation

58
Q

How is PSSM managed?

A

Diet and exercise!

Low-starch, high-fat supplemented diets + regular exercise program

59
Q

T/F: One common adaptation to daily training is an increase in oxidative capacity in skeletal muscle.

A

True

RUSVM LAM I (19 decks)

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