MSK

Question 1

What is the accepted definition of suppurative inflammation in synovial fluid?

Answer 1

Nucleated cell count > 2 cells/hpf
Neutrophil counts >10-12%

Question 2

What are the 3 types of arthritis

Answer 2

Degenerate
Immune mediated
Infective

Question 3

Does a normal joint sample have low or high values of the following:
Total cell count
% of mononuclear cells
% of neutrophils

Answer 3

Low total cell count
High % of mononuclear cells
Low % of neutrophils

Question 4

If you have a joint tap that is highly cellular with 1% monocytes and 99% neutrophils, what diease are you most concerned about

Answer 4

Infective arthritis

Question 5

What is the dominant cytokine in human rheumatoid arthritis

Answer 5

TNF alpha

Question 6

What is the general pathophysiology that occurs in IMPA

Answer 6

Antigen forms and causes a normal immune response
Phagocytosis of immune complexes
Persistent antigenic stimulation OR problem in normal down regulation of immune system

Question 7

What is the most common cause of IMPA

Answer 7

Idiopathic

Question 8

What dog gene has been associated with canine IMPA

Answer 8

DLA-DRB1
(DLA = dog leukocyte antigen)

Question 9

Is it typically for dogs with IMPA to have one or multiple joints affected?

Answer 9

Multiple

Question 10

When making a diagnosis of IMPA, how many joints should be sampled

Answer 10

At least 3

Question 11

What is the main differential for IMPA prior to cytology results?

Answer 11

Infective arthritis

Question 12

What other test could be pursued if you are unable to obtain enough synovial fluid for diagnosis

Answer 12

Synovial biopsy

Question 13

True/False: Canine rheumatoid factor assays are specific for canine RA

Answer 13

No, the Rh factors can show up with any chronic inflammatory condition

Question 14

What is type 1 IMPA

Answer 14

Idiopathic

Question 15

What is type 2 IMPA

Answer 15

Infection remote from the joint

Question 16

What is type 3 IMPA

Answer 16

Associated with GI disease

Question 17

What is type 4 IMPA

Answer 17

Paraneoplastic

Question 18

What types of cancer have been reported in dogs with IMPA TYPE 4

Answer 18

Seminoma
Mammary carcinoma
Renal carcinoma
Tonsillar carcinoma
Sertoli cell tumor
Leiomyoma

Question 19

What immune suppressive medication has been well studied in polyarthritis on dogs/cats?

Answer 19

Leflunomide

Question 20

What is the reported response rate for IMPA?
Relapse rate?

Answer 20

56%
1/3rd

Question 21

What is systemic lupus erythematosus

Answer 21

A multisystem immune mediated disorder associated with the appearance of antinuclear antibodies

Question 22

What are “major” signs of SLE?

Answer 22

Skin lesions
Polyarthritis
Hemolytic anemia
Glomerulonephrotis
Proteinuria
Polymyositis
Leukopenia
Thrombocytopenia

Question 23

What are “minor” signs of SLE?

Answer 23

Pyrexia w/ CNS signs
Oral ulceration
Lymphadenopathy
Pericarditis
Pleuritis

Question 24

What is a definite diagnosis of SLE based on?

Answer 24

2 major signs
Or
ANA > 160, 1 major and 2 minor

Question 25

What breeds have been reported to have specific forms of breed associated IMPA

Answer 25

Chinese shar pei Japanese Akita

Question 26

What is the main difference between IMPA and rheumatoid arthritis on dogs?

Answer 26

IMPA is non-erosive; RA is erosive

Question 27

Three causes of bacterial infective arthritis

Answer 27

Hematogenous Penetration Spread from local tissues

Question 28

Common bacterial causes of septic arthritis

Answer 28

Dogs: Staphylococcus Strep Cats: Pasteurella Bacteroides

Question 29

What are the two types of post op infective arthritis infections?

Answer 29

Type 1 - acute Type 2 - delayed/chronic (6-24 mo after SX)

Question 30

Most common antibiotics used for infective arthritis

Answer 30

Clavamox Cephalexin +/- metro

Question 31

What are 3 juvenile ortho diseases

Answer 31

HOD CMO Panosteitis

Question 32

Describe the radiographic appearance of HOD

Answer 32

Radiolucent line parallel to the physis in the long bone metaphysis (severe cases, metaphyseal flare)

Question 33

Describe the radiographic appearance of HO

Answer 33

Pallisade periosteal reaction on long bones

Question 34

What is HO associated with

Answer 34

Neoplasia (most commonly pulmonary carcinoma)

Question 35

Age range for panosteitis

Answer 35

6-12 mo

Question 36

Age range for HOD

Answer 36

2-6 mo

Question 37

Radiographic appearance of CMO

Answer 37

Unilateral or bilateral symmetric irregular bone proliferation of caudal mandible, ramus, +/- bulla

Question 38

Breed most commonly seen with HOD

Answer 38

Weimeriners

Question 39

Type 1 salter harris fracture

Answer 39

The epiphysis separates from the rest of the long bone

Question 40

Type 2 salter Harris

Answer 40

breaks at an angle, cutting through most of the growth plate and the metaphysis

Question 41

Type 3 saltar harris fracture

Answer 41

Segment of epiphysis breaks off

Question 42

Type 4 saltar harris fracture

Answer 42

Runs vertically through the growth plate, segment of metaphysis and epiphysis (eg like a corner breaks off, think tibia)

Question 43

Type 5 saltar harris

Answer 43

Compression of growth plate