Muscle Flashcards

1
Q

What does CK/CPK stand for?

A

creatinine phosphokinase

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2
Q

How many isoenzymes are there for CK? What is their location?

A

CK1 - brain, CSF
CK2 - cardiac muscle
CK3 - skeletal and cardiac muscle

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3
Q

What are 6 conditions that may affect CK levels?

A
  1. Myositis, polymyositis
  2. Trauma (surgery, accidents, downers, seizures)
  3. Strenuous exercise
  4. Equine rhabdomyolysis
  5. Hypokalemia
  6. secondary to arthritis
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4
Q

Do levels of CK increase correlate with severity of myocyte injury?

A

No

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5
Q

T/F

Hemolysis, traumatic venipuncture can increase values

A

True
Small amount in RBC
Damage to underlying muscles

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6
Q

What is CK half life?

A

4 hours

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7
Q

What are CK values in puppies?

A

5x higher than normal

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8
Q

How long will it take puppies to reach adult levels of CK?

A

7 months

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9
Q

What are other diagnostic modalities for detecting muscle injury besides CK?

A

muscle biopsy
serology for specific etiologies
electrodiagnostics

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10
Q

Why do we use CK values to assess if AST levels are muscle or liver injury?

A

CK is very muscle specific

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11
Q

if there is a mild increase in CK with no explanation, what could be considered?

A

Hemolysis of sample

Very small amounts in RBC

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12
Q

When would it be a waste of the client’s money to purse additional dx testing for myopathies?

A

When follow up on CK values are not showing persistent increases

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13
Q

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

A

AST

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14
Q

What may be helpful in documenting a point in time injury?

A

CK + AST

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15
Q

Why is it useless to use LDH as a marker for muscle injury?

A

5 isoenzymes

Very unspecific

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16
Q

What enzymes are increased with severe muscle injury?

A

CK
AST
ALT

17
Q

What enzymes are increased with mild muscle injury?

A

CK

AST

18
Q

What is the half life for ALT?

A

2.5 days

19
Q

T/F

ALT is used as a routine marker for muscle injury

A

False

It is primarily for hepatocellular injury

20
Q

Besides enzymes, what other components can be used?

A

Myoglobin

Potassium

21
Q

When will you consider hypokalemia as a cause for muscle injury? What happens?

A

values < 2

cause CK release and eventually muscle necrosis

22
Q

What does progression of hypokalemic myopathy look like?

A

weakness –> increased CK –> necrosis –> myoglobinuria

23
Q

What is one condition in cats that you may be concerned about hypokalemia causing muscle damage?

A

Chronic kidney disease

24
Q

What are three major conditions that may lead to hypokalemic muscle injury?

A
  1. Feline CKD
  2. Diabetes mellitus
  3. Post partum dairy cows with ketosis
25
Q

How can Diabetes mellitus cause hypokalemia?

A

Lost through osmotic diuresis
Insulin administration
Ketosis decreases GI uptake of K

26
Q

What may lead to a hypokalemic crisis?

A

insulin + hypokalemia

27
Q

What are treatments for ketosis that can contribute to hypokalemia?

A

glucose
insulin
propylene glycol
corticosteroids (some have mineralicorticoid activity)

28
Q

Under what acid-base condition is hypokalemia most predictive of depleted body stores?

A

Acidosis

29
Q

What could cause hyperkalemia related to muscle?

A

secondarily to muscle necrosis (release of intracellular stores)
Possible with tumor rupture – may be fatal