Question 1
Question
Which of the following is TRUE?
Answer
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when the horse is walking past you, you are watching for a head bob
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when the horse is walking toward you, you are watching the hips and pelvis
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when the horse is walking away, you are watching for fetlock drop
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it is important that the horse is always walking in a straight line
Question 2
Question
Which of the following tend to have acute onset? Check all that apply.
Answer
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tendon injuries
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ligament injuries
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fractures
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degenerative problems
Question 3
Question
Effusion is fluid in a synovial structure. Edema is fluid in tissue.
Question 4
Question
Which of the following is FALSE?
Answer
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worn heels predispose for navicular disease
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having a steep angle to the foot means the horse is club footed and may develop suspensory problems
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if the coronary band is higher on one side of the heel it indicates weight bearing toward that side of the foot
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having a less steep angle to the front feet indicates that the horse is bearing too much weight in the front limbs
Question 5
Question
Having a post legged stance predisposes a horse to flexor tendon issues.
Question 6
Question
A dropped hip could be due to muscle atrophy or a fractured hip.
Question 7
Question
Which of the following is FALSE?
Answer
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horses will only flex their neck away from you if they are having cervical vertebral issues
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high lameness is uncommon
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a hot splint bone area means there is active inflammation, the horse will respond to palpation of the swelling
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a foot may feel hot if it is covered by the bedding/hay/etc. in the stall
Question 8
Question
By placing the leg in this position, the tendons are relaxed. This make it easier to tell the difference between the superficial and deep digital flexors. However, it makes it a little more difficult to palpate the suspensory.
Question 9
Question
What is a positive Churchill test?
Answer
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aduction of limb, means proximal hock pain
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abduction of limb, means proximal hock pain
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aduction of limb, means distal hock pain
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abduction of limb, means distal hock pain
Question 10
Question
Which of the following is CORRECT?
Answer
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Grade 1 lameness: lameness not perceptible under any circumstance
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Grade 2 lameness: lameness is consistently observable
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Grade 3 lameness: lameness is obvious at a walk
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Grade 5 lameness: lameness produces minimal weight bearing in motion and/or at rest or a complete inability to move
Question 11
Question
Which of the following are watched for ONLY with hind limb lameness? Check all that apply. (Please don't curse me too much)
Question 12
Question
It is best to focus on specific landmarks while observing a horse walk past you.
Question 13
Question
When a horse is lame the fetlock drop will be deeper.
Question 14
Question
During a carpal flexion test hold for 30 seconds, a normal horse's fetlock will contact the caudal surface of the radius (or the heel bulb will touch the elbow). If this is not the case, there is decreased range of motion.
Question 15
Question
Which of the following is FALSE?
Answer
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upper forelimb flexion: this test is better for elbow issues than shoulder issues
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digital flexion in hindlimb: must try to keep foot close to the ground to limit amount of hock and stifle flexion
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upper hind limb flexion: hold for 90 seconds, keep leg underneath the horse to help the horse maintain balance
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hock extension test: tries to exacerbate pressure on hock, usually the horse will not tolerate for more than 1 minute so you can substitute multiple short times of extension in place of a single long time period
Question 16
Question
Which of the following is TRUE about the navicular wedge test?
Answer
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stretches the back of the leg
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increases pressure on navicular
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use for 60 seconds
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can also use it at the medial and lateral sides to check the collateral ligaments
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All of the above are true
Question 17
Question
What is the correct order of sensations lost?
Answer
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cold, warmth, touch, pressure, pain
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pressure, touch, pain, cold, warmth
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pain, cold, warmth, touch, pressure
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touch, pressure, cold, warmth, pain
Question 18
Question
Which of the following structures is NOT blocked by the palmar digital nerve block?
Question 19
Question
Which of the following is a common lameness that can be isolated by the palmar digital nerve block? (Remember that further diagnosis is required for a definitive diagnosis)
Question 20
Question
The structures blocked by the abaxial sesamoid block are dorsal hoof wall, coronary band, coffin joint, pastern joint, sesamoidian ligaments.
Question 21
Question
Which of the following blocks requires sterile preparation of the skin because of the high likelihood of the needle to enter a joint space?
Answer
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low 4-point
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high 4-point
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wheat
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tibial and peroneal
Question 22
Question
It is ok to do the tibial and peroneal blocks to both hindlimbs.
Question 23
Question
Which of the following are correct? Check all that apply.
Answer
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valgus- lateral deviation of limb distal to site of pathology
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valgus- medial deviation of limb distal to site of pathology
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Varus- medial deviation of limb distal to site of patholgy
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varus- lateral deviation of limb distal to site of pathology
Question 24
Question
Which of the following is FALSE regarding etiology of angular limb deformity?
Answer
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incomplete ossification of cuboidal bones
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laxity of periarticular structures (usually in one joint)
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unbalanced nutrition (trace mineral balance, crib feeding)
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excessive exercise/trauma (microfractures)
Question 25
Question
To determine if a horse has a valgus or varus deformity you should stand perpendicular to the horse's midline.
Question 26
Question
If manipulation leads to straightening of the limb, the deformity is due to perinatal causes.
Question 27
Question
Which of the following is FALSE about management strategy of limb deformities?
Answer
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stall rest is a good conservative therapy option for periarticular laxity
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transphyseal bridging is used for growth acceleration
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splints/casts are used for incomplete ossification
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hoof trimming is a conservative therapy that may help
Question 28
Question
Which of the following is TRUE regarding hoof trimming as management of angular limb deformity?
Answer
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trim the medial side for a valgus deformity
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trim the lateral side for a varus deformity
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trim flat if both valgus and varus deformities are in the same limb
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All of the above are true
Question 29
Question
Which of the following are true of periosteal transection and elevation? Check all that apply.
Answer
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short side surgery
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long side surgery
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can't over correct
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can overcorrect
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requires second procedure
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doesn't require second procedure
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used in more aggressive cases
Question 30
Question
Which of the following is CORRECT?
Answer
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osteoarthritis- chronic disease of the joint which may or may not involve inflammation
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osteoarthopathy- disorder of movable joints characterized by degeneration and loss of articular cartilage
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osteoarthrosis- any disease of the joints and bones
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degenerative joint disease- any disease state inducing degeneration of a joint
Question 31
Question
Which of the following is FALSE about mechanisms of OA?
Answer
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Theory #1- defective cartilage with abnormal biomechanical properties, assumes normal mechanical forces are encountered by the joint
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Theory #2- abnormal change in subchondral bone (cartilage doing all the work b/c the bone cartilage interface is more stiff)
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Theory #3- normal cartilage exposed to abnormal forces (seen in joint incongruity secondary to trauma, altered chondrocyte metabolism)
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All of the above are true
Question 32
Question
The synovial membrane regulates inflammatory cell access. It also secretes anabolic and catabolic enzymes (prostaglandins, cytokines, MMPs).
Question 33
Question
Which of the following is FALSE about "primary" synovitis/capsulitis?
Answer
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can be secondary to chip fragment debris/mediators or OCD
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repair is by fibrosis and results in acute decreased range of motion that resolves after a few months
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involves biomechanical damage due to continuum of repetitive trauma or a single incident
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mediators released from the affected joint's cartilage or bone will alter the metabolism of the synoviocytes
Question 34
Question
Which of the following is NOT seen histologically with synovitis?
Question 35
Question
Chondrocytes release the same mediators as the synovium.
Question 36
Question
Which of the following is FALSE about matrix metalloproteinases?
Answer
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secreated by synoviocytes and chondrocytes
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capable of breaking down extracellular matrix and fluid components
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they are all "bad guys"
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MMPs are secreted as inactive protein
Question 37
Question
Which of the following is FALSE about matrix metalloproteinases?
Answer
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secreated by synoviocytes and chondrocytes
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capable of breaking down extracellular matrix and fluid components
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they are all "bad guys"
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MMPs are secreted as inactive protein
Question 38
Question
ADAM stands for A Disintegrin And Metalloproteinase.
Question 39
Question
Which of the following cytokines are modulatory? Check all that apply.
Answer
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IL-1
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TNF-alpha
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IL-4
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IL-10
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IL-13
Question 40
Question
Which of the following is FALSE regarding the IL-1 family?
Answer
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IL-1 alpha amplifies the inflammatory process by stimulating an increase in monocyte infiltration
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Monocytes produce IL-1 beta
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IL-1 beta up regulates the production of IRAP as a positive feedback to make more IL-1 alpha
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matrix metalloproteinases are inhibited by IL-1s
Question 41
Question
Anabolic cytokines include insulin-like growth factor and transforming growth factor. These promote chondrocyte production of prostaglandins and type 2 collagen.
Question 42
Question
Which of the following is FALSE?
Answer
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nitric oxide degrades hyaluronan and collagen, IL-1 promotes its production
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PGE-2 is associated with synovitis and pain
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IRAP is a naturally occurring inhibitor derived from the animal's own body
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tissue inhibitors of metalloproteinases (TIMPs) bind 1:1 with MMPs forming inactive complexes, research is very promising
Question 43
Question
Which of the following is FALSE regarding therapy?
Answer
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cold therapy is more useful in acute injury
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phenylbutazone seems better in the treatment of orthopedic issues, banamine seems better for visceral pain
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corticosteroids are effective for OA treatment with intra-articular administration as well as systemic administration
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if give a horse carprofen make sure it is the horse formulation, not the dog formulation
Question 44
Question
Which of the following whole body doses of the common corticosteroids is INCORRECT?
Question 45
Question
Post-injection flare and joint sepsis are easily distinguished from each other.
Question 46
Question
IA polysulfated glycosaminoglycans (adequan) makes it easier for an infection to develop by reducing the number of bacteria needed to induce an infection.
Question 47
Question
What is my favorite flavor of ice cream?
Answer
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strawberry
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chocolate
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cookie dough
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moose tracks