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74 Cards in this Set

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What are causes of non-infectious meningitis and/or encephalitis in small animals? Which is most common?
Immune-mediated (most common)
Lymphoma maybe
What are common infectious causes of meningitis or encephalitis in small animals? Which look the most similar to granulomatous meningoencephalomyelitis?
Toxoplasma, Neospora (look like GME)
Fungal infections
Distemper
How will CSF taps look in meningitis in the following:
- Toxoplasma infection
- Histoplasma infection
- CNS form of distemper
Increased protein & cell count - Toxoplasma infection
may see organisms - Histoplasma infection
100% lymphocytes - CNS form of distemper
How can you discern lymphoma from GME?
PCR for antigen receptor arrangement (malignant lymphocytes have screwy receptors)
What are the most common locations for GME? Which has the WORST prognosis?
Cervical spinal cord
Vestibulo-cerebellar system (WORST)
Optic nerve
Cerebral cortex
What are the 3 FORMS of GME?
Focal
Disseminated/multifocal
Ocular
Which of the following are NOT true regarding GME?
a) unknown cause but characteristic of a type I hypersensitivity reaction
b) impacts white matter
c) perivascular mononuclear lymphocytic cuffing
d) thoracolumbar distribution is common
e) neutrophils are commonly elevated
a) unknown cause but characteristic of a type I hypersensitivity reaction (NO; type IV delayed hypersensitivity)
d) thoracolumbar distribution is common (NO; CERVICAL)
What is the histopathological lesion associated with GME?
Perivascular mononuclear lymphocytic cuffing
If you suspect GME and find high lymphocytes on a CSF tap, what is your next step?
Run PCR and seology for infectious disease; if negative, IMMUNOSUPPRESS
What are the possible treatments for GME?
Prednisone
Cytosine arabinoside
Procarbazine HCl
Cyclosporine A (only works when BBB is open though)
Which GME treatment has the following effect?
Hepatotoxicity
Capsules are too potent for most dogs
Doesn't normally cross blood/brain barrier
Severe halitosis
Hepatotoxicity (Pred and Cytosine arabinoside)
Capsules are too potent for most dogs (Procarbazine)
Doesn't normally cross blood/brain barrier (Cyclosporine A)
Severe halitosis (Cytosine arabinoside)
Which GME treatment has the following effect?
A safe antineoplastic drug
Not good for long-term use
PROFOUND immunosuppressant
Conjunctivitis
A safe antineoplastic drug (Cytosine arabinoside)
Not good for long-term use (Prednisone)
PROFOUND immunosuppressant (Cyclosporine A)
Conjunctivitis (Cytosine arabinoside)
Which drug is the BEST for the optic form of GME?
Cytosine arabinoside
What are some of the major differences between normal GME and Pug encephalitis?
Pug encephalitis affects cerebrum mostly, has more necrosis, and affects gray and white matter! Poor to hopeless prognosis...
What is the common sign of GME in the CSF?
Mononuclear pleiocytosis!
Which breeds have "breed-associated" GME? Which one has the worst prognosis?
Yorkies (worst)
Maltese
Chihuahua
Who gets steroid-responsive suppurative meningitis? What is the prognosis?
<2 yo medium to large-breed dogs; very good to excellent prognosis with pred (maybe add cytosine arabinoside)
Which of the following are NOT true regarding steroid-responsive suppurative meningitis?
a) non-painful
b) ataxia but not seizures
c) fever
d) pred is often curative
e) mononuclear pleiocytosis
a) non-painful (NO - vertebral pain)
b) ataxia but not seizures (NO - neuro deficits rare)
e) mononuclear pleiocytosis (NO - neutrophilic pleiocytosis)
Who gets necrotizing vasculitis?
the B's (beagles, BMD, Boxers)
Also German short-haired, Irish wolfhounds
Which of the following are NOT associated with necrotizing vasculitis?
a) rare tetraparesis
b) poor prognosis
c) brainstem signs rare
d) fever
e) peripheral neutrophilia
a) rare tetraparesis (NO)
c) brainstem signs rare (NO, common)
Choose bacterial or aseptic meningitis for the following:
- steroids are effective
- brainstem/cerebral involvement more common
- slower progression
- more severe
- high protein and high neutrophils
BOTH - steroids are effective
Bacterial - brainstem/cerebral involvement more common
Aseptic - slower progression
Bacterial - more severe
Both - high protein and high neutrophils
Which of the following cross the BBB well? Which do not cross well?
a) Cephalexin
b) Fluoroquinolones
c) Metronidazole
d) Doxycycline
e) Aminoglycosides
c) Metronidazole (cross well)
d) Doxycycline (cross well)
b) Fluoroquinolones (intermediate)
a) Cephalexin (poor)
e) Aminoglycosides (poor)
You see an older doberman with a painful neck, stiff, stilted gait in front and wobbly ataxic back legs. Where is the most likely location of the lesion?
C5/6 or C6/7 (Cervical Spondylopathy)
Which dogs get Wobbler's syndrome? Which are worse off?
Young dogs
Mastiffs and Boerbels (WORST)
Great danes (not as bad)
What are clinical signs of Wobbler's syndrome?
Cervical hyperesthesia & neck ventroflexion
Asynchronous thoracic and pelvic gait (pelvic limbs more affected than thoracic)
Choose older or younger dogs with caudal cervical spinal disease for the following:
- hypertrophic ligamentum flavum
- dorsolateral cord compression
- DJD lesions
- no disc degeneration
- thickened dorsal and lateral laminae
older - hypertrophic ligamentum flavum
young - dorsolateral cord compression
older - DJD lesions
young - no disc degeneration
young - thickened dorsal and lateral laminae
How is caudal cervical instability treated in young and old dogs? What is the prognosis?
Young (dorsal continuous laminectomy - good prognosis)
Old (ventral slot; decent prognosis)
Which dog breed has hypothyroidism associated with caudal cervical instability?
Dobies
What are the most common sites for discospondylitis?
C6/7
Mid thoracic (T5-T8)
L7-S1
How is discospondylitis acquired?
Hematogenous spread from skin or bladder infection
What are common bacteria implicated in discospondylitis? Which is most common?
S. intermedius (most common)
Also S. aureus, Strept, Brucella canis, E. coli
What are the most common signs associated with discospondylitis?
Pain
Kyphosis
Stiff-stilted gait
Who gets discospondylitis?
Middle-aged large breed males!
T or F:
Discospondylitis rarely strays from the disc space.
True!
Which of the following is NOT true regarding discospondylitis?
a) meningitis is often concurrent
b) Urine culture isn't often positive
c) Only antibiotic therapy is necessary with minimal neuro deficits
d) A brucella infection is rarely cured fully
e) S. intermedius is the most common and most severe cause
a) meningitis is often concurrent (NO)
e) S. intermedius is the most common and most severe cause (NO; Strept is most severe but S. intermedius is most common)
Choose an antibiotic to treat discospondylitis caused by the following:
- Staph
- Strept
- Brucella
Staph (cephalosporins, clindamycin, TMS)
Strept (amoxicillin, ampicillin)
Brucella (tetracyclines and streptomycin)
How is discospondylitis treated with significant neuro signs?
Surgical decompression + long-term abx
Hip dysplasia is often mistakenly diagnosed for...
...lumbosacral stenosis
How is lumbosacral stenosis treated? What is the prognosis?
Surgical decompression/stabilization
GREAT prognosis
What are common clinical signs of lumbosacral stenosis?
Spinal pain, kyphosis, stiff-stilted gait
Sciatic nerve dysfunction
Urinary/fecal incontinence and loss of tail fxn (severe)
What are differentials for acute generalized FLASSID tetraparesis and exercised induced weakness?
Myasthenia gravis
Tick paralysis
Botulism
Coonhound paralysis (polyradiculoneuritis)
Black widow envenomation
Which dogs get congenital myasthenia gravis? Which one has a good prognosis?
Jack russell
Springer spaniel
Wire hair fox
Mini Dachshund (good prognosis - spontaneous remission)
Why is thymoma linked to myasthenia gravis?
Thymocytes structurally identical to Ach receptor
Which diseases are associated with acquired myasthenia gravis?
Thymoma
LSA
Osteosarc
Anal sac adenocarcinoma
Cutaneous lymphoma
Addisons
What are common signs of myasthenia gravis?
Focal or generalized exercise-induced neuromuscular weakness
Megaesophagus/regurg
Voice change
How is myasthenia gravis diagnosed? How is it treated?
Dx (anti-AchR antibodies; edrophonium response test)
Tx (elevated feeding, physostigmine)
What is the prognosis for myasthenia gravis in dogs? Cats?
Dogs - BAD
Cats - GOOD (don't have megaesophagus really)
Which of the following diseases have megaesophagus?
a) myasthenia gravis
b) tick paralysis
c) coonhound paralysis
d) botulism
a) myasthenia gravis
d) botulism
Rapidly progressing myasthenia gravis is known as..
...FULMINANT MG
Which of the following diseases are characterized by hyperesthesia?
a) myasthenia gravis
b) tick paralysis
c) coonhound paralysis
d) botulism
c) coonhound paralysis
Which of the following diseases has abnormal CSF?
a) coonhound paralysis
b) tick paralysis
c) myasthenia gravis
d) polyradiculoneuritis
e) botulism
a) coonhound paralysis
d) polyradiculoneuritis
(they're the same thing)
Which of the following diseases produces autonomic signs?
a) coonhound paralysis
b) tick paralysis
c) myasthenia gravis
d) polyradiculoneuritis
e) botulism
e) botulism
Which of the following diseases has hyporeflexia?
a) coonhound paralysis
b) tick paralysis
c) myasthenia gravis
d) polyradiculoneuritis
e) botulism
a) coonhound paralysis
b) tick paralysis
d) polyradiculoneuritis
e) botulism
Which of the following diseases should self-resolve with appropriate supportive therapy?
a) coonhound paralysis
b) tick paralysis
c) myasthenia gravis
d) polyradiculoneuritis
e) botulism
a) coonhound paralysis
d) polyradiculoneuritis
e) botulism
Which of the following diseases resolves in 14 days?
a) coonhound paralysis
b) tick paralysis
c) myasthenia gravis
d) polyradiculoneuritis
e) botulism
e) botulism
How is tick paralysis diagnosed? Treated?
Dx - clinical signs and find the tick
Tx - remove tick or use Frontline
Choose myopathy, neuropathy, or both:
- hypo to areflexia
- acute muscle atrophy
- may have CP deficits
- no paresis/paralysis
- muscle tremors/cramping
Neuro - hypo to areflexia
Neuro - acute muscle atrophy
Neuro - may have CP deficits
Myo - no paresis/paralysis
Myo - muscle tremors/cramping
What are some aspects of the CBC/chem panel that can help in diagnosing a myopathy or neuropathy?
Eosinophilia
Glucose
CK
K
T4/TSH
If you see an old cat with litter on its feet, what might you find in the bloodwork? What might be the cause?
High glucose d/t diabetic neuropathy
Facial nerve weakness is a common sign of...
...hypothyroidism
If you see a cat with cervical ventroflexion, what might you find in the bloodwork? What is the cause?
Hypo-K and increased CK d/t chronic renal failure
What chem values are high in Cushing's disease?
High ALP, ALT, and Cholesterol
Which two feline viruses can cause LMN dz?
FeLV and FIV
You see a 10 week pup with weak hind limbs progressing to rigidity. What do you think?
Neospora!
How can carnitine aid in diagnosing myopathies?
High carnitine in urine and low in muscle shows a secondary carnitine issue, indicating a functional muscle disease
Which of the following muscles are biopsied for a neuropathy?
a) triceps
b) cranial tibial
c) quadriceps
d) extensor carpi radialis
b) cranial tibial
d) extensor carpi radialis
Which of the following muscles are biopsied for a myopathy?
a) triceps
b) cranial tibial
c) quadriceps
d) extensor carpi radialis
a) triceps
c) quadriceps
What is a good nerve to biopsy?
distal tibial nerve or ulnar nerve
T or F:
You can put nerve biopsies in formalin but not muscle biopsies.
True!
T or F:
You should cut proximally first in a muscle biopsy.
True!
If you see massive balloons of myelin in a nerve, what might the diagnosis be? What other tests could have been done instead?
Diabetic neuropathy
(fructosamine/glucose levels + clinical signs)
Choose trigeminal disorder or masticatory myositis:
- can't open jaw
- can't close jaw
- 2M fiber atrophy
- painful
- no palpebral response
MYOSITIS - can't open jaw
TRIGEMINAL - can't close jaw
MYOSITIS - 2M fiber atrophy
MOSITIS - painful
TRIGEMINAL - no palpebral response
How is masticatory myositis diagnosed?
2M myofiber antibody assay
Which rule-out diagnosis causes severe atrophy of peripheral muscles?
Chronic progressive peripheral axonopathy