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Orthopedics > EQ Arthritides > Flashcards

EQ Arthritides Flashcards

1
Q

What is an arthritide?

A

A condition causing pain and dysfunction related to joints

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2
Q

Define arthritis

A

Inflammation/ degeneration of the joint

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3
Q

What is osteoarthritis?

A

A degenerative condition which leads to cartilage breakdown and loss of joint function

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4
Q

Describe the structure of articular cartilage.

A
  • Mainly ECM
    • Collagen (mainly type 2) - shear resistance
    • Proteoglycans (compressability
  • Chondrocytes - maintain ECM
  • Avascular
  • Aneural
  • Hypoxic
  • Limited repair
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5
Q

Name some possible predisposing factors to osteoarthritis.

A
  • Exercise/ trauma
  • Developmental orthopedic disease
  • Obesity
  • Genetics
  • Sepsis
  • Ageing
  • Medication - steroids
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6
Q

What radiographic signs are seen with osteoarthritis?

A
  1. Soft tissue swelling
  2. Osteophytosis
  3. Enthesiophytosis
  4. Subchondral bone sclerosis
  5. Intra-articular mineralisation
  6. Fragmentation/joint mice
  7. Collapsed joint space
  8. Subchondral bone cysts
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7
Q

Osteophyte

A

A boney protrusion of new tissue

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8
Q

Enthesiophyte

A

Abnormal boney projection at the site of muscle attachment

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9
Q

How can osteoarthritis be managed?

A
  1. Rest/restricted activity
  2. Weight loss if necessary
  3. Exercise
  4. Block joint
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10
Q

What is the mechanism of action of NSAIDS?

A

COX inhibition - reduce PGE2 and NO levels in chondro and synoviocytes

Also inhibit PMN migration

Central analgesia effects

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11
Q

Name three NSAIDs used in small animal and equine practice.

A
  1. Small animal
    1. Carprofen
    2. Meloxicam
    3. Firocoxib
  2. Equine/LA
    1. Phenylbutazone
    2. Flunixin
    3. Ketoprofen
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12
Q

Outline the mechanism of action of corticosteroids.

A

Bind to cytoplasmic and nuclear receptors and hence inhibit IL1 , TNFa and prostaglandin release.

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13
Q

Name two corticosteroids which are popular for use in equine practice.

A

Methylprednisolone acetate

Triamcinolone acetonide

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14
Q

What is the mechanism of action of Cartrophen?

A

Enhances proteoglycan synthesis

Reduce articular cartilage fibrillation

Improves synovial fluid viscosity

Increased free radical scavengers

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15
Q

What is the mechanism of action of hyaluronic acid?

A

Reduces PGE release and chemotaxis

Steric hinderance

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16
Q

What is the mechanism of action of IRAP?

A

Upregulation of IL-1 receptor antagonists

17
Q

What is the mechanism of action of Bisphosphonates?

A

Potent inhibitors of bone resorption by:

  • inhibiting osteoclasts
  • inhibits NO and IL-1 induced collagenase release
18
Q

Name a polyunsaturated fat. What substance are they a precursor of?

What is their mechanism of action?

A

Omega-3

Eicosapentaenoic acid analogues of arachidonic acid

They are anti-aggrecanases and stabilise cell membranes. They also reduce MMPs COX-2 IL1b and TNFa levels

19
Q

What is the proposed mechanism of action of Glucosamine/ chondroitin sulphate?

A
  • Reduced PGE2 and NO
  • Reduced PG loss
  • Increased joint motility
20
Q

How can surgical methods be used to treat OA?

A
  1. Arthroscopy
    1. Assess, debride and flush inflammatory mediators
  2. Joint replacement
  3. Arthrodesis - artificial induction of joint fusion
21
Q

What is the pathophysiology of immune-mediated joint disease?

A

Early changes to synovium

Chronic antigenic stimulation

Inappropriate immune response

22
Q

Clinical signs associated with IMPA.

A
  • Multiple limb joint pain/ swelling
  • Generalised stiffness
  • Shifting lameness
  • Neck pain
  • Lethergy
  • Pyrexia of unknow origin
  • Secondary OA/ fibrosis of joints
23
Q

Which diagnostic techniques are used in the diagnosis of IMPA?

A
  • Synoviocentesis
  • Full clinical exams
  • Bloods - anaemia, leucopenia, thrombocytopenia, raised globulins, low albumin
  • Urinalysis - proteinuria
  • Diagnostic imaging
24
Q

Name pharmacological agent which are used in the treatment of IMPA.

A
  • Corticosteroids
  • Azathioprine
  • Cyclosporine
  • Apaquel
25
Q

Name three aetiological agents involved in infective arthritis.

A
  • Staph. intermedius
  • Pateurella multocida
  • Truperella pyogenes
  • Mycoplasma
  • Salmonella
26
Q

Outline the pathophysiology of of infective arthritis.

A
  • Marked inflammatory response
    • Vasodilation
    • Neutrophil influx
    • Cytokine release - IL1/ TNFa
  • Fibin clots trap bacteria
  • Cartilage destruction and extension to subchondral bone
27
Q

What clinical signs are associated with infective arthritis?

A
  • Acute, severe lameness
  • Stiffness
  • Lying down
  • Pyrexia
  • Wound near/over joint
  • Pain on palpatoin
  • Articular swelling
28
Q

Ddx. for infective arthritis

A

Traumatic joing/ soft tissue injury

Osteochondritis

Bursitis

Hygroma

Cellulitis

29
Q

How would synovial fluid from an infected joint compare to that of a normal, healthy one?

A
  1. Normal
    1. Pale yellow
    2. Highly viscous
    3. WBC <1X10^9, TP <20g/L
  2. Septic synovial fluid
    1. Serosanguinous
    2. Turbid
    3. Reduced viscosity
    4. wbc >10-20x10^9, TP >30-40g/L
30
Q

Outline the treatment plan for infective arthritis.

A
  1. Antibiotics - dependant on aetiological agent
    1. Sytemic
    2. Intra-articular - gentamycin
  2. Joint lavage - ensure environment is sterile
  3. Arthroscopy - remove debris/ fb
31
Q

Lyme disease is caused by which tick-borne spirochaete?

A

Borrelia burgdorferi

32
Q

Clinical signs associated with lyme disease in dogs.

A
  • Inflammatory non-errosive arthropathy
  • Shifting lameness
  • Swollen lameness
33
Q

What antibiotic is used in treatment of lyme disease?

A

Doxycycline

Orthopedics (6 decks)

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