Ortho Basics (Y3)

Question 1

What are the radiographic signs of OA?

Answer 1

ST swelling
Osteo/Enthesiophytes
Subchondral bone sclerosis
IA mineralisation
Fragments/joint mice
Collapsed joint space
Subchondral Bone cysts

Question 2

How do Cox inhibitors aid OA?

Answer 2

Reduce PGE and NO levels in chrondrocytes & synoviocytes

Question 3

Apart from NSAIDs, what drug is often used in equine OA?

Answer 3

Corticosteroids - MPA/TA

Question 4

Which drug results in a reduction of articular cartilage fibrillation, but must NOT be used with NSAIDs?

Answer 4

Cartrophen

Question 5

Which new drug class has shown promise at reducing OA?

Answer 5

Autologous Conditioned Serum

Question 6

What is the MOA of bisphosphonates?

Answer 6

Inhibition of osteoclasts.

Possible inhibition of NO/IL-1.

Question 7

In which Dz process are bisphosphonates licenced?

Answer 7

Navicular
Small Tarsal OA
EQ ONLY

Question 8

Which neutraceutical has shown some OA benefit in human studies?

Answer 8

Glucosamine/chondroitin sulphate

Question 9

What are the 3 surgical approaches that may be taken to OA?

Answer 9

Arthroscopy (+ debride)
Joint Replacement
Arthrodesis

Question 10

Which type of IM joint disease had the poorest prognosis?

Answer 10

Erosive

Question 11

What are the signs of IMPA?

Answer 11

PUO
Stiffness
Joint pain/swelling
Lameness

Question 12

How do we diagnose IMPA?

Answer 12

Synoviocentesis

Haem/Biochem: high globulin, low alb. TCP, leucopenia, anaemia.

Question 13

How is IMPA treated?

Answer 13

Azathioprine or Cyclosporine

Question 14

What is the major cause of synovial sepsis in:
Dog
Cat
Horse
Cattle?

Answer 14

Dog: Iatrogenic (sometimes haematogenous)
Cat: Bites
Horse: Trauma (occ FPT)
Cattle: Haematogenous (occ adjacent infection)

Question 15

Describe the 3 steps of Synovial sepsis.

Answer 15

Inflammatory Response
Fibrin Clots
Cartilage Destruction

Question 16

How would you diagnose Synovial Sepsis?

Answer 16

Synoviocentesis:

• Serosanguinous
• Turbid
• Reduced VIscosity
• WBC >10-20
• TP >30-40
• > 90% Neutrophils

Question 17

What are the 2 approaches to joint lavage in the horse?

Answer 17

Arthroscopy

Through and Through needle lavage

Question 18

What medical treatments can be given in cases of synovial sepsis? (EQ)

Answer 18

Systemic AB (pen/gent)
IA AB (gent/amik)
IVRLP (gent)

Question 19

Which spirochaete may cause an inflammatory, non-erosive PA? (SA)

Answer 19

Lyme Disease (80-90% PMN on synoviocentesis)

Question 20

How do you treat borrelia burgdorferi?

Answer 20

Doxycycline 30d

Question 21

Name 3 #s that would have a hopeless px in the horse.

Answer 21

Long bone w/severe ST injury
Severely contaminated #
>300kg with: femoral, tibial, humeral & radial #

Question 22

what must you do before a horse with a # is transported?

Answer 22

Stabilise bone ends

Control Bleeding

Question 23

What is the golden period for a compound fracture?

Answer 23

8h

Question 24

What needle and syringe should be used to lavage a compound fracture site?

Answer 24

18G 20ml

Question 25

What are the 3 types of compound #?

Answer 25

1: bone punctures skin
2: Fracture end exposed
2: significant ST damage and bone loss

Question 26

Name 2 common sites for avulsion #s.

Answer 26

Tibial tuberosity

Lateral malleolus

Question 27

What is the prognosis for an extensor tendon injury?

Answer 27

Good

Question 28

What is the prognosis for a flexor tendon injury?

Answer 28

Poor

Question 29

From which tendon does the manica flexoria arise? (EQ)

Answer 29

SDFT

Question 30

What changes can be seen to a damaged tendon on US?

Answer 30

Hypoechoic
Enlargement
Poor fibre alignment