joint diseases (McCarrel) Flashcards

Question

Neutraceuticals

Answer 1

* Don't require FDA approval for safety and efficacy * May include * glucosamine * Chondroitin sulfate * ASU * MSM * Fatty acids * Collagen * Herbs * Anti-oxidants * Questionable quality

Answer 2

* Traumatic * Iatrogenic * Hematogenous \***always an emergency**

Answer 3

* S-type * synovial membrane and fluid * E-type * subchondral bone of epiphysis =\> extends into joint * P-type * physis * may extend into joing

Answer 4

* CS * Radiographs * Synovial fluid * clinical pathology * culture * ultrasound (joint, primary source) * advanced imaging

Answer 5

* Lameness * heat and swelling * synovial effusion * foals * febrile * primary septicemia * physeal infection painful on palp * +/- depression, inappetance

Answer 6

* Rads * rule out fracture * bone involvement * chronic changes * joint space narrowing * subchondral bone lysis * caution foals * periosteal proliferation

Answer 7

* Aerobic, anaerobic * consider fungal if traumatic * negative culture doesn't rule out infection * collect sample prior to antibiotics * still attempt if antibiotics have been started * enrichment broth * PCR

Answer 8

* Cattle * A pyogenes, strep, salmonella, E. coli, mycoplasma * Adult horse * staph aureus (iatrogenic) * enteric gram negatives (trauma) * Foal * enterobacteriacea, strep, rhodococcus equi, actinobacillus equuli

Answer 9

* Appearance * Color: anything other than straw colored is abnormal * Clarity: anything besides clear is abnormal * Viscosity: sticky is normal * WBC * \> 30,000 with \> 90% neutrophils * degenerate neutrophils * rarely see bacteria * caution with very acute and very chronic cases * TP \> 2g/dl * +/- synovial fluid lactate: \> 4.9 mmol/L * often no bacteria even in septic arthritis

Answer 10

* Multimodal * broad spectrum systemic antimicrobials * synoval lavage * intra-articular antimicrobials * regional antibiotic perfusion * bandage * analgesia * +/- arthrotomy \***initiate therapy immediately, do not wait for culture results**

Answer 11

* Large volume BES * DMSO * General anesthesia vs standing * Technique * Arthoscopic * chronic infection * Bone involvement * Traumatic injury - foreign material * Large guage needle lavage * often sufficient in acute cases * switch to arthroscope if large amount of fibrin

Answer 12

* Delivery * intermittent: concentration dependent * continuous: time dependent * Results in highest antimicrobial conc in synovium

Answer 13

* Intravenous regional perfusion * most common * Intraosseous regional perfusion * when vein is not accessible * complications * Place tourniquet for 30 minutes * wide tourniquet, minimal movement * Achieve very high concentrations locally * less expensive * avoid complications of systemic administration

Answer 14

* NSAIDS * Opiates * Continuous rate infusion * Lidocaine * Detomidine * Butorphanol * Ketamine * Epidural catheter (hind limb) * morphine and detomidine * Bandage

Answer 15

* Rarely indicated * Only very severe chronic cases that have not resolved using other methods

Answer 16

* Return of WBC count to normal is not an accurate guid * Significant improvement in effusion and lameness * **never** stop antimicrobials until * lameness and effusion resolved * substantially improved after removing * drastically decreasing analgesic therapy

Answer 17

* Primarily small animal * Numerous causes * idiopathic most common * CS * effusion of multiple joints * pain * lameness/stiffness * may have other signs assoc with primary dz

Answer 18

* Three criteria * **inflammatory process affecting synovium of two or more joints** * **no identifiable infectious component** * **responsive to immunosupressive therapy** * Synovial fluid * protein \> 2.5 g/dl * NCC \> 3000 cells/ul * **non-degenerate neutrophils** predominate * not in all cases * Radiography * erosive vs nonerosive * Tests to rule in/out primary disease process

Answer 19

* Treat underlying disease * Immunosuppressants * Immunomodulating drugs \*No cookbook treatment plan