Shared Flashcard Set

Details

Exam 1
Problem-based neuro (L3)
61
Veterinary Medicine
Professional
01/24/2017

Additional Veterinary Medicine Flashcards

 


 

Cards

Term
Describe the typical history of Fibrocartilagenous Embolic Ischemic Myelopathy (FCE)?
Definition
-large to giant breeds mainly
-peracute onset: mins to hrs
-no history of trauma
-not progressive
Term
What are the Ddx of FCE?
Definition
-type I disc herniation
-trauma
-gunshot wound
-other vascular dz
Term
What differentials do we run to diagnose FCE?
Definition
-rads: rule out trauma
-myelogram: rule out a compressive lesion
-dx is made by ruling out other causes of cord damage
Term
What is the prognosis of FCE?
Definition
-hemiparetic and monoparetic dogs have a better chance for recovery than paraparetic or tetraparetic dogs
=LMN damage worse than UMN
-loss of deep pain = worse
-improvement should be seen w/in 2-3w if recovery is going to occur
-nursing care is problematic
Term
Definition
-
Term
How do we initially eval trauma to the spinal cord?
Definition
-spinal reflexes
-voluntary movement
-anal sphincter
-tail function
-pain perception
Term
How do we medically manage trauma to the spinal cord?
Definition
-avoid further damage to cord, give rigid support
-steroids: caution beginning steroids 8h post injury
Term
What is the prognosis of spinal cord trauma?
Definition
-LMN damage worse prognosis
-retention of voluntary movement is positive sign
-loss of deep pain perception is vry poorsign
-rad findings do not always equate w/ severity
Term
Which dog breeds are most commonly affected by cervical vertebral instability (wobbler dz)?
Definition
-Doberman pinschers
-infrequently in the GReat Dane too
Term
What is the basic defect behind Wobblers?
Definition
-malformation of the cervical vertebrae resulting in a narrowed canal in the Great Dane and instability of the vertebrae in the Doberman
-this results in changes in the ligamentum flavum, dorsal longitudinal ligament, and dorsal annulus
Term
Which animals are most commonly affected by atlanto-axial disorders?
Definition
-toy breeds
-onset of signs usually prior to 18m
Term
What are the common complaints from owners about atlanto-axial disorders?
Definition
-animal cries out in pain w/out being touched
-reluctant to look up
-cries when petted on the head
-holds neck rigidly
-episodes of motor weakness
Term
What are the clinical findings of atlanto-axial disorders?
Definition
-animal holds neck rigidly
-reluctance to move head
-neck mm may be tense
-animal resists neck flexion: BE CAREFUL
-pain may be intense
-can see all degrees of weakness
Term
How do we diagnose atlanto-axial disorders?
Definition
-radiology
Term
How do we treat atlanto-axial disorders?
Definition
-surgery
-neck brace?
Term
What are some examples of brainstem diseases that cause tetraparesis?
Definition
-GME
=FIP
-neoplasia
-distemper
-mycotic dz
-toxoplasmosis
-neuroaxonal dystrophy
Term
Once it has been established that brain dz exists which tests are used?
Definition
-CSF w/ titers
-imaging: MRI, CAT scan
-skull rads
Term
What is granulomatous meningoencephalitis (GME)?
Definition
-proliferation of elements of the RE system occurs w/in the CNSn due to inflammation
Term
What is the typical signalment of GME?
Definition
-small breed problem
-middle-aged animal
Term
What neuro findings do we see w/ GME?
Definition
-central vestibular signs very common
-motor deficits
-seizures
-mentation changes
Term
Why is there a variety of signs due to BME?
Definition
-focal or disseminated
Term
What diagnostics do we see w/ GME?
Definition
-CSF analysis
-MRI
-brain biopsy
-necropsy
Term
What do we see on CSF analysis w/ GME?
Definition
-inc protein
-inc WBCs
-lymphocytes, macrophages
Term
How do we treat GME?
Definition
-Glucocorticoids
-therapy is required for duration of life
-Leflunomide, cyclosporine, cytosine arabinoside, probarbazine
Term
What is the prognosis of GME?
Definition
-poor for long term but they will survive for a few months
Term
What are some examples of generalized muscle dz?
Definition
-lab retriever myopathy
-golden retriever myopathy
-polymyositis
-hypokalemic polymyopathy in cats
-tetanus
Term
What diagnostics do we run for generalized muscle dz?
Definition
-serum muscle enzymes
-serum electrolytes
-EMG: electromyogram
-muscle biopsy
Term
What is the typical histry + signalment of lab retriever myopathy?
Definition
-black and yellow labs, not chocolate
-signs begin w/ 3-5m of age
-pup as difficulty holding head up
-progresses to severe exercise intolerance
-cold, excitement aggravae problem
Term
What are our clinical findings of lab retirever myopathy?
Definition
-stiff, stilted gait
-tires on exercise w/in 5 min
-no muscle pain
-poor patellar tendon reflexes
Term
How do we diagnose lab retriever myopathy?
Definition
-hx, breed, exam
-muscle biopsy: type 2 fiber deficiency
-DNA test: autosomal recessive
Term
What is the prognosis for lab retriever myopathy?
Definition
-good for life, bad for Strenuous activity
Term
What is the etiology behind tetanus?
Definition
-exotoxin of C. tetani introduced bia deep puncture wounds/surgical wounds
Term
Is the dog or horse more resistant to tetanus?
Definition
-dog is approx 300X more resistant than horse
Term
What is the typical history of a dog w/ tetanus?
Definition
-signs usually 5-8 d after intro of organism
-owner complains dog has stiff gait (funny look to eyes)
-some think that head is swollen due to abnormal ear carriage
Term
What are the typical clinical signs of tetanus?
Definition
-generalized muscle hyperexcitability
-pathognomonic facial expression: eyes asian, ears standing up, lips pulled back
-protrustion of 3rd eyelid
-FOCAL TETANUS TO MUSCLE GROUPS
-opisthotonus in severe cases
-diarrhea
Term
How do you treat tetanus?
Definition
-Antitoxin
-Abx: penicillin, metronidazole, Clindamycin
-sedation, quiet, dark environment
-excise any apparent necrotic tissue
Term
What is the prognosis of tetanus?
Definition
-mild signs don't usually progress
-if dog is still alive after 5 d, usually recover
-opisthotonus is a grave sign
Term
In which way are coondog and tick paralysis similar?
Definition
-both disorders cause a generalized LMN problem: beneralized weakness may progress to paralysis w/ poor-absent tendon reflexes in all four lims
Term
How do we differentiate coondog and tick paralysis?
Definition
-hx
-response to tx
-recovery time
Term
Describe coondog paralysis.
Definition
-disorder causes an inflammatory response in ventral roots of entire spinal cord
-allergic rxn to raccoon saliva Ag
Term
What is the typical hx of coondog paralysis?
Definition
-access to raccoon 7-14d prior to signs
-initial signs = rear limb weakness
-w/in 48h TL affected
-may be nonambulatory
-at worse 7-10 d
-change in pitch of bark
Term
What are the clinical signs of coondog paralysis?
Definition
-alert adn a febrile
-all degrees of weakness: symmetric in all 4 limbs
-hypo to a reflexia
-hypotonia
-painful when tension put on spine or abdomen
-severe m atrophy in 10-14d
Term
How do you differentiate m dz and generalized LMN dz?
Definition
-reflexes remain intact w/ muscle dz
Term
How do we treat coondog paralysis?
Definition
-good nusring care!!
-keep warm
-turn animal 4-6 times a day
-help them eat and drink
-prevent decubital ulcers
-bladder function is fine
-TAKE WEEKS TO RECOVER (tick paralysis is better w/in 24h)
Term
What is the prognosis of coondog paralysis?
Definition
-95% recovery rate
-no evidence of immunity
Term
What causes tick paralysis?
Definition
-toxic releasd from an engorged female tick that inh ACh synth
-spp: Ixodes + Dermacentor
Term
What is the hx of tick paralysisi?
Definition
-signs begin 5-7 after tick attachment
-very acute onset of posterior weakness to front limbs that progresses w/ 24-48h
Term
What are the clinical findings of tick paralysis?
Definition
-symetric posterior weakness to tetraparesis
-tenden refles are hypo to areflexia
-pain perception remains intact BUT NO PAIN ON TENSION OF ABDOMEN
-find tick?
Term
How do we treat tick paralysis?
Definition
-direct removal of tick
-insectiside, acaricide
Term
What is the prognosis of tick paralysis?
Definition
-excellent, almost all should recover
-w/in 24-48h: should be close to normal
-more severe form in Australia
Term
What is myasthenia gravis?
Definition
-autoimmune dz against ACh rc
Term
What is the typical hx of myasthenia gravis?
Definition
-exercise intolerance
-cannot swallow
-regurgitation
-excessive salivation
-coughing secondary to pneumonia
-Breed predisposition: Goldens GSD, G shorthair pointer
Term
What are the clinical findings of myasthenia gravis?
Definition
-may be normal in exam room
-varying degrees of weakness
-exercise intolerance
-excessive salivation
-coughing/resp crackles
-tendon reflexes normal
Term
How do we diagnose myasthenia gravis?
Definition
-Tensilon test: edrophonium chloride
-serum ACh rc AB test
-chest rads: megaesophagus +/- asp pneumonia
-tendon reflexes normal
Term
How do we treat myasthenia gravis?
Definition
-ACh inh: mestinon syrup or sustained release mestinon tablets
-glucocorticoids
-immunosuppressive agents: Cyclosporine, mycophenolate
Term
What is the prognosis of myasthenia gravis?
Definition
-guarded for long term
-megaesophagus & pneumonia = worse
Term
What is the typical history/signalment of steroid responsive meningitis?
Definition
-large breed problem
-acute onset of neck pain
-reluctance to walk
-poor appetite
-usually young dog
-reluctant to look up
Term
What diagnostics do we use for steroid responsive meningitis?
Definition
-CSF analysis
-neutrophilic cytolosy
-CSF culture neg
Term
What are the clinical signs of steroid responsive meningitis?
Definition
-fever
-cervical rigidity
-vertebral column pain
Term
HOw do we treat steroid responsive meningitis?
Definition
-signs not responsive to Abx
-Pred for 6-10w
Term
What is the prognosis for steroid responsive meningitis?
Definition
-usually excellent response in 24-48h
-prognosis excellent
Supporting users have an ad free experience!