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99 Cards in this Set
- Front
- Back
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Systemic Lupus Erythematosus (SLE) results from which of the following?
a) Type 1 hypersensitivity b) Type 2 hypersensitivity c) Type 3 hypersensitivity d) Type 4 hypersensitivity |
b) Type 2 hypersensitivity (antiobody mediated cytotoxicity)
c) Type 3 hypersensitivity (immune complex deposition) d) Type 4 hypersensitivity (cell mediated immune response) |
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Which of the following are correct regarding SLE?
a) poorly regulated B cell function b) autoantibodies produced to cell components c) immune complexes are deposited in the vessel wall d) immune complexes activate complement and attract macrophage resulting in tissue damage |
a) NO poorly regulated T cell function
b) autoantibodies produced to cell components c) immune complexes are deposited in the vessel wall d) NO immune complexes activate complement and attract NEUTROPHILS resulting in tissue damage |
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Which of the following are predisposing factors for dogs with SLE?
a) DLA A7 b) DLA A1 and B5 c) C4 (fourth complement) d) IgA deficiency |
a) DLA A7
b) NO THESE ARE PROCETIVE DLA A1 and B5 c) C4 (fourth complement) d) IgA deficiency |
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T/F: purebred dogs and cats have increased prevalence and incidence respectively
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true
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T/F: exposure to UV light exacerbates signs of SLE in dogs and cats
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true
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In cats what are 3 infectious a gens associated with positive ANA's?
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FeLV, FIV and feline erhlichiosis
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What medications may play a role in SLE etiology?
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propythiouracil
methimazole hydralazine sulfas tetracycline penicillins procainamide |
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Which of the following is true regarding SLE?
a) typically middle aged b) females more commonly diagnosed c) collies, german shepherds, shelties increased incidence |
a) typically middle aged
b) MALES more commonly diagnosed c) collies, german shepherds, shelties increased incidence |
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Which of the followings the most frequent clinical finding w/ SLE?
a) fever b) glomerular dz c) skin lesions d) leukopenia, hemolytic anemia, thrombocytopenia e) non erosive polyarthritis |
All are clinical findings but most frequent = e) non erosive polyarthritis
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T/F: In SLE, affected joints have a supprative septic arthritis
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false: non supprative, non septic arthritis
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What is an early Cx in SLE seen on a UA?
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proteinuria
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T/F: CNS signs are seen in cats with SLE
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true
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How do you Dx SLE?
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2 autoimmune dz in addition to positive ANA OR
3+ autoimmune dz and negative ANA |
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T/F: Normal animals may have a low ANA titer
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true
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What is an LE cell? Where will you see them in SLE?
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neutrophil that has phagocytized nuclear material
Seen in: bone marrow, buffy coat, joint fluid, CSF, other effusions |
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T/F: LE is more sensitive than ANA
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False: LE is LESS sensitive than ANA
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What is the most utilized test for SLE despite poor overall sensitivity and specificity?
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ANA
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There is a list of the criteria for dx of SLE
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look at gordon's packet too lazy to type
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Tx for SLE?
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Avoid sunlight
NSAIDs for mild arthropathies Glucocorticoids (immunosuppressive doses) |
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In tx of SLE glucocorticoids + _______ has a high remission rate?
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leflunomide
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If additional immunosuppression is desired in cats w/ SLE what can you give?
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chlorambucil
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What can be used in unresponsive cases of SLE?
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plasmapheresis
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T/F: positive ANA titers may persist even w/ resolution of SLE
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true
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How often should you recheck SLE patients in remission? What should you check?
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every 1-3 months
CBC, Chem, UA, ANA |
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What is the most common polyarthropathy in dogs and cats?
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idiopathic polyarthritis
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Which of the following are correct regarding idiopathic polyarthritis?
a) young, male dogs b) Stilfe, elbow, carpus most affected c) ANA positive, RF negative d) Erosive, non septic supprative w/ 4 types |
a) yound, male dogs
b) Stilfe, elbow, carpus most affected c) ANA NEGATIVE, RF negative d) NON Erosive, non septic supprative w/ 4 types |
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For idiopathic polyarthritis, pick Type 1-4 ........ associated w/ GI dz
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Type 3
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For idiopathic polyarthritis, pick Type 1-4 ........ uncomplicated, no underlying dz
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type 1
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For idiopathic polyarthritis, pick Type 1-4 ........ associated with remote infection and a reactive polyarthropathy
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type 2
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For idiopathic polyarthritis, pick Type 1-4 ........ associated with neoplasia that is not related to the joint
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type 4
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Which of the following are correct regarding Type 1 idiopathic polyarthropathy?
a) akitas b) older c) acute lameness, fever, lethargy |
a) akitas
b) YOUNGER c) acute lameness, fever, lethargy |
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Tx of idiopathic polyarthropathies?
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tx underlying dz
glucocorticoids luflunomide |
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Which of the following are try regarding polyarthritis/polymyositis
a) non erosive b) older spaniels c) stiffness, abnormal posture, exercise intolerance d) non septic, supprative |
Which of the following are try regarding polyarthritis/polymyositis
a) non erosive b) YOUNG spaniels c) stiffness, abnormal posture, exercise intolerance d) non septic, supprative |
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How do you dx and tx polyarthritis/polymyositis?
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dx= biopsy
tx= glucocorticoids (immunosuppression) |
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T/F: polyarthritis/meningitis syndrome is rare
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true: see handout for more information
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Which of the following are true regarding rheumatoid arthritis (RA)?
a) adults usually b) lymphocytic synovitis c) non septic supprative polyarthritis d) damage to articular cartilage and subchondral bone |
all are correct
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Which of the following are true regarding RA?
a) erosive b) proximal joints affected more c) Autoantibodies to IgG d) presence of rheumatoid factor (RF) is pathognomonic |
a) erosive
b) DISTAL joints affected more c) Autoantibodies to IgG d) RF may be present in OTHER immune mediated polyarthropathies (heartworm, lyme) |
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The dx of RA has need 4+ of the following
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see handout there are a ton
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What is an important ddx for RA that should be ruled out?
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SLE
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Tx of RA?
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NSAIDs (early)
corticosteroids methotrexate Sx (fuse joints) |
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What is a EROSIVE athropathy of the carpi and hocks young male cats with higher serioprevalence of FSV and FeLV?
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periosteal proliferative arthritis/feline polyarthritis
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T/F: periosteal proliferative arthritis/feline polyarthritis is progressive but corticosteroids can be used to tx pain
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true
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Which of the following vx has been associated with polyarthropathies?
a) feline herpes virus b) feline calicivirus c) canine distemper d) canine parvo |
b) feline calicivirus
c) canine distemper |
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What are 4 common abx that are associated with a polyarthropathy?
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sulfas
penicillins cephalosporins macrolides |
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T/F: polyathropathies due to drug administration rapidly resolve once the drug is discontinued and usually occurs on first exposure
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false: polyathropathies due to drug administration rapidly resolve once the drug is discontinued. ANIMAL HAS HAD PREVIOUS EXPOSURE
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Which of the following is true regarding masticatory myositis?
a) antiobies against muscle fiber type 2M b) painful c) increased CK and leukopenia d) present for decreased appetite |
a) antiobies against muscle fiber type 2M
b) painful c) increased CK and leukoCYTOSIS d) present for decreased appetite |
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Dx and tx of masticatory myositis?
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dx- muscle biopsy
tx: immunosuppressive glucocorticoids, supportive care (enteral nutrition if necessary) |
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T/F: polymyositis is more common in cats
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false dogs
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T/F: roughly 50% of patients with a splenic mass have benign lesion
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true
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What RBC change is highly suggestive of neoplastic splenic dz?
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schistocytes
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What is the leukoerthroblastic response?
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increased nucleated RBC and immature WBC
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On rads, what part of the spleen is located in the left cranial abdomen and on VD is btwn the stomach and left kidney in the dog?
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head of the spleen
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On rads, what part of the spleen is located along the left abdominal wall or cranial midabdomen
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body of the spleen
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On rads, what part of the spleen is seen on lateral? What spp is this not true?
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tail
Cats should see tail on lateral if so may indicate splenomegaly |
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Normal splenic aspirates will have large number of ______. Few ____ and _____ and rarely _______. (these are all cell types)
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Normal splenic aspirates will have large number of LYMPHOCYTES. Few MACROPHAGE and PLASMA CELLS and rarely NEUTROPHILS.
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T/F: Evaluation of hemorrhagic effusion of the spleen are useful diagnotics
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false: rarely diagnostic
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In reality, if you want to biopsy the spleen what are you most likely going to do?
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splenectomy
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It would behoove you to look at some causes of splenomegaly for each subcategory.....
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ehhhh see packet if you care
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T/F: nodular hyperplasia is hyperechoic on US
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false HYPOechoic
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T/F: hematoma can be found in healthy animals
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true
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What is the treatment of choice for hematomas? and why?
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splenomegaly b/c can't ddx it from HSA
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T/F: diffuse splenomegaly will have a hypo echoic appearance on US
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true
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Extramedullary hematopoiesis can result from what 4 things?
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Increased removal of abnormal cells
Increased activity of mononuclear-phagocytic system increased activity of lymphoid tissue increased blood cell production |
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What are 2 drugs that can cause congestion of the spleen? 3 dz?
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Drugs: acepromazine and barbiturates
Dz: portal hypertension, Right sided CHF, caudal vena caval occlusion |
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A dog presents to your clinic in shock, it is vomiting and appears to have abdominal pain. On rads you see decreased detail in the abdomen and the bowel looks slightly displaced. What gives?
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splenic torsion
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Which of the following are part of the immune system?
a) physical barriers/defenses b) innate responses c) acquired immune responses d) cell mediated immunity |
all of em
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Autoimmune disease is a result of abnormalities in what two cells? (Hint Lindsy: it is not retinal proteins or keratinocytes)
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B cell and T cell
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Which of the following are glucocorticoids used for?
a) immunosuppression b) anti- inflammatory c) antineoplatic d) metabolic stuff (hypoadrenocorticisim, hypercalcemia) |
all of them!
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T/F: glucocorticoids are lipid soluble
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true
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Do dogs or cats require higher doses of glucocorticoids for immunosuppression?
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cats
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What is the most potent glucocorticoid?
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dexamethasone
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Which of the following are short acting glucocorticoids (< 1hr)?
a) cortisone b) prednisone c) dexamethsone d) hydrocortisone |
a) cortisone
d) hydrocortisone |
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Which of the following are long acting (> 48 hr)?
a) prednisone b) dexamethasone c) flumethasone d) betamethasone e) triamcinolone |
b) dexamethasone
c) flumethasone d) betamethasone |
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What are 3 intermediate acting (12-36 hours) glucocorticoids?
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prednisone/olone
methylprednisolone tiamcinolone |
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T/F: the suffix sodium succinate and sodium phosphate implies rapid onset of action and are water soluble
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true
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What suffix implies a formulation that is slowly absorbed? What administration route is not suitable for these drugs?
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acetate
no IV |
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Which of the following are true regarding azathiprine?
a) purine analog disrupts DNA and RNA synthesis b) affects resting and dividing cells c) affects T and B cells d) can be combined with glucocorticoids e) can be used in cats |
a) disrupts DNA and RNA synthesis
b) NO just dividing cells c) affects T and B cells d) can be combined with glucocorticoids e) NO NO NO cats |
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T/F: azathioprine is less potent that cyclophosphamide
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true: cyclophosphamide disrupts dividing and resting cells
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Azathioprine is most commonly used to tx?
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IMHA
IMTP |
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How long does azathioprine take to see clinical responses?
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at least 6 weeks
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What are 2 things that should be monitored every 1-3 months while using azathioprine?
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CBC and liver tests
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Which of the following are true regarding cyclophosphamide?
a) alkylating agent preventing cell replication b) activated in liver, excreted in urine c) bone marrow suppression uncommon d) typically administered for neoplasia |
a) alkylating agent preventing cell replication
b) activated in liver, excreted in urine c) bone marrow suppression COMMON (unfavorable) d) typically administered for neoplasia |
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What metabolite of cyclophosphamide is toxic to the urinary epithelium?
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acrolein
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Cyclosporine blocks ____ cells response by inhibiting ___ and ____
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Cyclosporine blocks T helper cells response by inhibiting IL-2 and IFN-gamma
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T/F: cyclosporine is directed at the humoral immunity with little affect on cell mediated immunity
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false: directed at cell mediated with little affect on humoral
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T/F: cyclosporine can be combined with glucocorticoids
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true
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T/F: cyclosporine comes in multiple formulations all of which are equally bioavailable
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false!
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What drugs is commonly administered with cyclosproine to increase serum levels and decrease cost? why?
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ketoconazole
(this inhibits P450 which is what cyclosporine uses) |
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What are some side effects of cyclosporine?
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gingival hyperplasia
GI upset nephrotoxic hepatotoxic increased hair growth in cats |
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CBC/Chem should be preformed ___ into cyclosporine tx and every ____ for monitoring
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CBC/Chem should be preformed 1 weeks into cyclosporine tx and every 3 months for monitoring
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What is the alkylating agent most commonly used in cats with immune dz in which prednisolone is not enough?
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chlorambucil
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What is chlorambucil most commonly used for (3)?
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chronic lymphocyctic leukemia
multiple myeloma LSA |
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_____ is the removal of immunoglobulins/antibody complexes from the blood
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plasmapheresis
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What drug results in failure to synthesize thymidine and purine nucleotides by competitively binding dihyrdofolate reductase?
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methotrexate
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Methotrexate is most commonly used as rescue therapy for _____
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Lymphoma
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What drus is a reversible inhibitor of enzyme iodine monophosphate dehydrogenase and is used to tx IMHA, IMTP, apalastic anemia in dogs and prevents organ rejection in humans?
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mycophenolate mofetil
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What drug inhibits dihyroorotate dehydrogenase in pyrimidine synthesis and used to tx portly responsive IMHA, IMTP, and immune mediate polyarthropathy
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leflunomide
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What is an sx tx option that would reduce MPS, IMHA, ITP and help with neutropenia?
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splenectomy
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There is info on bacteria (toll like receptors), probiotics, interferon, and gold salts.....
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I literally don't understand her words or know what she is talking about
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