MS- SA Myopathies

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MS- SA Myopathies
2015-04-14 17:48:47
vetmed myopathies

vetmed SA myopathies
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  1. 5 clinical signs of diffuse muscle disease.
    short stride/ choppy gait, weakness, decreased muscle tone, atrophy (often severe and rapid), "elephant on a beach ball" posture
  2. 4 blood values that are commonly elevated with diffuse muscle disease?
    CK, ALT, LDH, cardiac troponin
  3. Why does a normal value for CK not rule out diffuse muscle disease?
    CK is only elevated when muscles are ruptured through degeneration or necrosis; there are many inflammatory muscle diseases that do not cause rupture and are therefore accompanied by normal CK
  4. How does an electromyocardiogram (EMG) work?
    measures spontaneous electrical activity of muscle; under general anesthesia, muscles should have low/no spontaneous electrical activity (unless there is pathology)
  5. How can you describe the different types of spontaneous electrical activity found on EMG?
    fibrillation potentials, positive sharp waves, myotonic potential
  6. EMG cannot distinguish __________ from ___________; _________ is required to make a specific diagnosis.
    nerve dz; muscle dz; biopsy
  7. What are the 2 types of polymyositis, and in what species are they most common?
    autoimmune- dogs, infectious- cats
  8. With polymyositis, there is ___________ inflammation that is primarily ___________.
    mixed; lymphocytic
  9. With infectious polymyositis, what 2 etiologic agents are most common?
    toxoplasma, neospora
  10. Immune-mediated polymyositis is ___________ inflammation of multiple muscle groups; it is diagnosed by...
    idiopathic; muscle biopsy and ruling out infectious causes.
  11. Autoimmune polymyositis affecting laryngeal mm may present with ______________; affecting laryngeal and pharyngeal mm may present with ___________; with esophageal involvement, may present with ___________.
    increased upper airway sounds;change to the tone of bark; passive vomiting
  12. How do you treat immune-mediated polymyositis?
    immunosuppressive drugs
  13. Masticatory myositis is a(n)____________ inflammatory condition of the muscles innervated by the ______________.
    autoimmune; mandibular branch of the trigeminal nerve
  14. The onset of masticatory myositis is relatively ___________, and it usually presents as ____________.
    acute; inability to open the jaw
  15. Masticatory myositis involves atrophy of... (3)
    masseter, digastricus, and temporalis mm.
  16. Describe the pathogenesis of masticatory myositis.
    autoimmune attack on 2M muscle fibers, which are unique to the muscles of mastication.
  17. Acutely, masticatory myositis involves __________ muscles; chronically, there is _____________.
    swollen, painful; marked atrophy and fibrosis
  18. How do you diagnose masticatory myositis? (2)
    serum 2M antibody titer, temporalis muscle biopsy
  19. How do you treat masticatory myositis? (2)
    immunosuppressive prednisone, supportive care
  20. Steroid myopathy can result from ____________ or ___________ and presents as _____________.
    Cushing disease; iatrogenic steroids long-term; muscle wasting
  21. A small number of animals with cushings disease end up with idiopathic cushings myotonia, which is...
    when sustained, abnormal contraction of skeletal muscle leads to hypertrophy.
  22. What are characteristic clinical findings associated with cushings myotonia? (3)
    characteristic gait, large muscles proximally, myotonic discharges on EMG
  23. How do you treat cushings myotonia? (2)
    (if not inherited form) treat underlying cushings, give chloride channel inhibitors (procainamide, mexilitine)
  24. Hypokalemic myopathy in cats has a relatively _________ onset of... (4)
    acute; weakness, muscle pain, ventroflexion of the neck, elevated CK.
  25. Hypokalemic myopathy in cats is very commonly associated with ____________.
    chronic renal failure
  26. How do you treat hypokalemic myopathy in cats?
    K+ supplementation
  27. Muscular dystrophy is a ___________ disease with a hallmark ____________.
    congenital; severely elevated CK
  28. Muscular dystrophy may present with... (4)
    progressive weakness, atrophy or hypertrophy of muscles, dysphagia, trouble breathing
  29. Muscular dystrophy is life-threatening when it causes _________.
    congestive heart failure
  30. Muscular dystrophy is caused by...
    X-linked (mostly males) mutation in dystrophin gene, leading to destabilization of muscle membranes