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62 Cards in this Set
- Front
- Back
In horses, lameness d/t joint injury or dz is the most common cause for...
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inability to race
loss of performance wastage in racing horses |
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OA is basically the ___ failure of the _____
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organ
organ joint |
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What makes up the "organ joint"
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ligaments
fibrous joint capsule synovial membrane cartilage subchondral bone menisci |
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What is OA?
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progressive, irreversible breakdown of articular cartilage
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Name the changes in the following joint tissues
subchondral bone: Joint capsule: Synovial membrane: |
subchondral bone: sclerosis, lysis
joint capsule: fibrosis synovial membrane: hyperplasia, hyperemia, increased synovial fluid production |
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3 common causes for OA
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trauma (most common)
infection developmental/congenital cartilage or joint abnormalities |
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Describe the two relationships between force and cartilage that result in OA
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Abnormal forces on normal cartilage
Normal forces on abnormal cartilage |
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What IL is secreted by synoviocytes and chondrocytes?
a) IL-1 b) IL-2 c) IL-3 d) IL-4 e) IL-6 |
IL-1
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What is the major pro-inflammatory cytokine in OA?
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IL-1
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IL-1 increases the production of what?
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aggrecanases
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What do aggrecanases do?
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degrade cartilage matrix proteoglycans
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Production of what other substance that degrades cartilage matrix proteoglycans and collagen is increased during OA
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matrix metalloproteinases (MMP)
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Articular cartilage is 80% what?
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water
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Which collagen type is articular cartilage?
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type 2
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T or F
Collagen has compressive strength while proteoglycans has tensile strenght |
false
collagen has tensile proteoglycans have compressive |
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Are proteoglycans highly positively or negatively charged?
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negatively
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Cx of OA
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Lameness localized to a joint
+/- joint effusion decreased ROM pain on joint flexion fibrosis/thickening of peri-articular tissues |
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What are the rad signs of OA?
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osteophytosis
subchondral bone sclerosis joint space narrowing (+/- lysis in distal hock joints) |
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Where does the pain originate in each of the following?
synovial membrane: fibrous joint capsule: subchondral bone: |
synovial membrane: inflammatory
fibrous joint capsule: inflammatory subchondral bone: inflammatory, increased subchondral bone pressue, mechanical |
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Sx for OA is usually done how?
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arthroscopic
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When is medical tx for OA indicated?
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adjunct therapy for surgical tx
if there is no "mechanical" reason for OA that could be addresed surgically trauma not amenable for surgical intervention synovitis, capsulitis |
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objective for medical tx of OA
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decrease pain (lameness)
minimize progression of OA |
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What does is the purpose of a SMOAD?
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symptom modifying so therefore decrease pain (lameness)
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What is the purpose of a DMOAD
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Disease modifying...therefore minimize progression of oA
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Does improving pain= slowing down cartilage breakdown?
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no
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Does slowing down cartilage breakdown = pain relief?
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no
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Name methods of medical tx for OA
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regular exercise
NSAIDs Corticosteroids hyaluronan polysulfated polysaccharides oral supplements extracorporeal shock wave therapy |
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Is stall rest an answer to OA
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nooooooooooo! only use for up to 7 days. Regular exercise is the best you can do!!!
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NSAIDs decrease what associated pain?
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joint
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Name some NSAIDs and whether they are SMOADS or DMOADS
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Phenylbutazone (SMOAD)
flunixin meglumine (SMOAD) firocoxib (didn't say) dicrofenac (SMOAD and DMOAD!) |
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How long can you use the max dose of phenylbutazone?
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1-2 days
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You shouldn't use banamine for more than how many days?
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3-5
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What are the side effects of bute and banamine?
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GI ulcers
renal damage |
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Is firocoxib a COX-1 or 2 inhibitor?
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2
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With firocoxib you should expect improvement in lameness > grade 1 after how many days?
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6
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Does firocoxib have more or less GI side effects than bute?
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fewer
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How is dicrofenac administered?
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as a topical...1" strip over the joint
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T or F
Dicrofenac has minimal systemic absorption |
ture
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Does dicrofenac have more or less subchondral bone sclerosis and cartilage bone erosion than bute?
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more
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Does dicrofenac have more or less analgesia than bute?
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less
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How are corticosteroids administered when txing OA?
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intra-articularly
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Corticosteroids act as strong ______ and ____ medications and therefore are definitely (SMOAD/DMOADS)
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analgesics
anti-inflammatory SMOADS |
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Which 2 corticosteroids are chondroprotective? Does that make them SMOADS or DMOADS?
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betamethasone
triamcinolone DMOADs |
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What is zellmers first line corticosteroid?
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triamcinolone
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What is zellmers last resort corticosteroid?
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methylprednisone
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How often can corticosteroids be injected?
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every 3 mos
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How many days does the horse need to rest after getting a corticosteroid injection?
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3-7 days
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After giving corticosteroid injections owners need to watch for signs of what other pathology? How can this be prevented?
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septic arthritis
combine with amikacin or gentamicin |
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What can you combine corticosteroids with that will decrease negative side effects and will have additive positive effects?
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HA
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What is a naturally occurring constituent of synovial fluid, cartilage matrix?
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HA
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Is HA considered to be a SMOAD or DMOAD?
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DMOAD...provides only some analgesia
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The intra-articular cartilage dose of HA can be given once a week for how many weeks?
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3
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The intra-articular dose of HA will result in less cartilage _____ but will have no influence on _____
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fibrillation, lameness
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The IV dose of HA can be given once a week for how many weeks?
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3
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The IV dose of HA will result in improved ____ and improved _____ changes
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lameness
soft tissue |
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Name some polysulfated polysaccharides
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adequan (PSGAGs)
pentosan polysulfate |
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How is adequan usually administered?
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IM
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What do you need to be aware of when you give adequan intra-articularly?
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Increases risk of infection....give it with amikacin!!!!
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Are polysulfated polysaccharides considered SMOADs or DMOADs
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DMOADs
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What do most oral supplements for OA contain?
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chondroitin sulfate
glucosamine some have HA |
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Are CS and glucosamine absorbed will in the GI tract?
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nope
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What foods that rindsy eats have shown promising effects for OA?
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soy and avacado oil unsaponifiables
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