Muscle Flashcards
What does CK/CPK stand for?
creatinine phosphokinase
How many isoenzymes are there for CK? What is their location?
CK1 - brain, CSF
CK2 - cardiac muscle
CK3 - skeletal and cardiac muscle
What are 6 conditions that may affect CK levels?
- Myositis, polymyositis
- Trauma (surgery, accidents, downers, seizures)
- Strenuous exercise
- Equine rhabdomyolysis
- Hypokalemia
- secondary to arthritis
Do levels of CK increase correlate with severity of myocyte injury?
No
T/F
Hemolysis, traumatic venipuncture can increase values
True
Small amount in RBC
Damage to underlying muscles
What is CK half life?
4 hours
What are CK values in puppies?
5x higher than normal
How long will it take puppies to reach adult levels of CK?
7 months
What are other diagnostic modalities for detecting muscle injury besides CK?
muscle biopsy
serology for specific etiologies
electrodiagnostics
Why do we use CK values to assess if AST levels are muscle or liver injury?
CK is very muscle specific
if there is a mild increase in CK with no explanation, what could be considered?
Hemolysis of sample
Very small amounts in RBC
When would it be a waste of the client’s money to purse additional dx testing for myopathies?
When follow up on CK values are not showing persistent increases
What liver enzyme is strongly associated with muscle injury? Not b/c it is coming from the liver during muscle injury but b/c it is also located in the muscle
AST
What may be helpful in documenting a point in time injury?
CK + AST
Why is it useless to use LDH as a marker for muscle injury?
5 isoenzymes
Very unspecific
What enzymes are increased with severe muscle injury?
CK
AST
ALT
What enzymes are increased with mild muscle injury?
CK
AST
What is the half life for ALT?
2.5 days
T/F
ALT is used as a routine marker for muscle injury
False
It is primarily for hepatocellular injury
Besides enzymes, what other components can be used?
Myoglobin
Potassium
When will you consider hypokalemia as a cause for muscle injury? What happens?
values < 2
cause CK release and eventually muscle necrosis
What does progression of hypokalemic myopathy look like?
weakness –> increased CK –> necrosis –> myoglobinuria
What is one condition in cats that you may be concerned about hypokalemia causing muscle damage?
Chronic kidney disease
What are three major conditions that may lead to hypokalemic muscle injury?
- Feline CKD
- Diabetes mellitus
- Post partum dairy cows with ketosis
