Test 4: questions Flashcards
You perform a physical exam and you find dimpling of the skin overlying the lumbar region of the spinal column (image), an easily expressed bladder, absent anal sphincter tone, and analgesia to the skin of the perineum.
Given the signalment of the patient and the location of the lesion, what do you think is the most likely disease process —
, most likely specific type of disease —?
congenital
neural tube defect
On histologic examination of the spinal cord you see the changes depicted below:
What area of the spinal cord does this represent —?
What characteristic pathologic change to neurons are the arrows pointing to?
white matter
axonal swelling (spheroids)
What is the pathogenesis of this lesion?
Degeneration of the nucleus pulposus, annulus fibrosis and/or dorsal longitudinal ligament —> extrusion or herniation of disc material into spinal canal –> trauma to spinal cord and occlusion of blood vessels –> demyelination –> leukomalacia, hemorrhage (and poliomalacia if severe enough)
What is the name of this disease?
IVDD
Intervertebral disc disease
What serologic test(s) will you submit with the serum sample you collected antemortem, given the nature and distribution of the gross lesions in the spinal cord?
Equine herpes virus 1 and 4
Sarcocytis neurona
Equine Eastern Encephalitis virus
West Nile virus
Equine herpes virus 1 and 4
Sarcocytis neurona
On histologic examination of the spinal cord you find the changes below:
What etiologic agent is responsible for this disease?
What is the disease called?
Sarcocystis neurona
Equine protozoal myeloencephalitis (EPM)
What disease process do you suspect this represents?
what neoplasm does this most likely represent?
neoplasia
Peripheral nerve sheath tumor
Anatomic location and Gross: Multiple masses arising at the spinal nerve roots
Histology: Slender, fusiform cells arranged in bundles and plexiform nodules with bland oval nuclei.
Glaucoma is a diverse group of pressure dependent neurodegenerative disorders that all result in loss of normal function of the retinal ganglion cells and their axons in the optic nerve and ultimately lead to loss of vision. What is the single most consistently recognized feature of all glaucomas in veterinary patients?
Elevation in intraocular pressure (IOP)
While causes of glaucoma may vary (including causes of secondary glaucoma, covered below), sequelae of glaucoma may be consistently seen, and depend on the duration and severity of the disease. List the common sequelae of glaucoma and be able to describe why you would see these lesions.
Buphthalmia
Scleral thinning
Corneal edema
Corneal striae (breaks in Descemet’s membrane)
Exposure keratitis (secondary to buphthalmos)
Lens luxation or subluxation due to zonule damage
Cataract (lens malnutrition?)
Atrophy of iris and ciliary body
Retinal atrophy (inner layers first)
Retinal separation (after buphthalmos)
Optic disc cupping
What layers are missing in glaucoma related atrophy? What about PRA?
All cases of retinal atrophy (except glaucoma) begin in outer layer and progress inward: photoreceptors -> outer nuclear -> inner nuclear -> ganglion cell layer.
Can you list the reactions of the cornea to injury? Why do we see corneal opacities in a damaged cornea?
Damage to the corneal epithelium includes erosion or ulcers; healing can lead to cutaneous metaplasia (“squamitization”) and melanosis. The corneal stroma can become edematous (both due to loss of epithelium and loss of corneal endothelium which regulates water regulation in the stroma), neovascularization (from the limbus), necrosis, fibrosis, and inflammation (keratitis).
Opacities occur anytime there is loss of clarity and are caused by these responses to injury, usually a combination of these. One can also see a focal corneal opacity with anterior synechia (adherence of iris tissue to the cornea/corneal endothelium).
what do you see?
There is a focal corneal ulcer (fluorescein test; ulcer is green) and the surrounding cornea is grey-white (opacity), likely due to regional edema and keratitis.
what do you see?
Diffuse corneal opacity with metaplasia, neovascularization, possible melanosis. This dog has chronic corneal injury due to KCS.
What are the sequelae of uveitis?
Corneal opacities due to edema, keratitis, etc.
Anterior or posterior synechia
Retinal atrophy; possible separation
Cataracts
PIFM - may lead to intraocular hemorrhage
Secondary glaucoma
Eventual phthisis bulbi
Oh boy. Lots happening here. There is a diffuse corneal opacity, both anterior and posterior synechia, cataract, intraocular hemorrhage, complete retinal separation.
Define secondary glaucoma. List causes and be able to reason out why each of these causes leads to glaucoma (hint: how does it disrupt aqueous flow)?
Uveitis (inflammatory cells fill filtration angle, and/or leads to other lesions listed below).
Anterior and/or posterior synechiae (possible iris bombe)
PIFM
Lens luxation
Intraocular hemorrhage
Neoplasia
What is the most likely diagnosis in this cat? What is the clinical behavior?
Cat: Feline Diffuse Iris Melanoma most common; prediction of clinical behavior is difficult but there is a risk of distant metastasis.
- Diffuse iris melanoma more common than solitary masses
- May obstruct filtration angle and cause glaucoma
- Greater risk for distant metastasis with longer latency (3-5 years)
What is the most likely diagnosis dog? What is the clinical behavior?
Dog: Anterior uveal melanocytoma or malignant melanoma; diagnosis depends on histologic features but melanocytomas are more common.
- Prognosis based on histologic criteria (anaplasia, mitoses, invasion)
- Sites: iris - common - 90% benign; choroid - rare - usually benign
what kind of cancer spreads to these places
histiocytic
label
what do the arrows point to ?
what is their function?
Epiphysis- 1
Metaphysis- 2
Diaphysis- 3
Metaphyseal growth plates
Provide length to the bone
1) Identify this cell, provide its general lineage and primary function.
OsteobBLASTS (OBs): Mesenchymal lineage. Build bone (secrete the majority of osteoid and hydroxyapatite crystals during bone new formation (ie growth, remodeling/modeling, repair).
2) Identify this cell, provide its general lineage and primary function.
OsteoCYTES (OCs): Mesenchymal lineage. Maintains bone (can resorb and secrete small amounts bone matrix in their immediately surrounding lacunae.
3) Identify this cell, provide its general lineage and primary function
OsteoCLASTS (OCLs): Monocyte lineage. Breakdown bone. Differentiation & activation is stimulated by OB production of RANKL
Designated by the asterisk, name the extracellular matrix components (organic and inorganic)
Osteoid (organic) Hydroxyapatite (inorganic)