Acute GI medicine (Yr 3)

Question 1

what are the severe potentially life threatening forms of diarrhoea?

Answer 1

enteric infection
haemorrhagic gastroenteritis
intestinal obstruction

Question 2

what are some possible surgical GI diseases?

Answer 2

intussusception
volvulus
incarceration
stricture/partial obstruction
foreign body

Question 3

where is the majority of water absorbed?

Answer 3

jejunum and ileum

Question 4

what is the main clinical sign associated with acute enteropathies?

Answer 4

vomiting and diarrhoea

Question 5

what is inflammation of the small intestines called?

Answer 5

enteritis

Question 6

what is inflammation of the large intestine called?

Answer 6

colitis

Question 7

what are the features of small intestinal diarrhoea?

Answer 7

large volume
normal/mild increase in frequency
no tenesmus
no blood/mucous
some weight loss present

Question 8

what are the features of large intestinal diarrhoea?

Answer 8

normal/increased volume
more frequent defaecation
tenesmus present
some blood/mucous
not usually weight loss

Question 9

what are some possible causes of acute gastritis?

Answer 9

dietary indiscretions (garbage…)
foreign material
hairballs (bezoars) in cats
some drugs
acute systemic disease

Question 10

what are the features of diarrhoea associated with acute enteritis?

Answer 10

profuse diarrhoea
normal/increased frequency
no tenesmus
possible melaena (digested blood)
large volumes

Question 11

what is melaena?

Answer 11

digested blood in the faeces (dark coffee grounds)

Question 12

what are the features of diarrhoea associated with acute colitis?

Answer 12

frequent small volume diarrhoea
tenesmus
mucoid and possible fresh blood (haematochezia)

Question 13

what is haematochezia?

Answer 13

fresh blood in faeces

Question 14

what are some possible causes of acute colitis?

Answer 14

idiopathic
garbage ingestion
whipworms
protozoa (giardia, cryptosporidia…)

Question 15

what are some symptomatic treatments for diarrhoea?

Answer 15

hydration
restrict feed intake
anti-emetics
gastric mucosal protectants

Question 16

how should feed intake be restricted in diarrhoea cases?

Answer 16

fasting for minimum of 12 hours
followed by frequent feeding of small amounts of bland low-fat food

Question 17

what are the two types of anti-emetics?

Answer 17

centrally acting
anticholinergics

Question 18

what are some centrally acting anti-emetics?

Answer 18

maropitant
metoclopramide

Question 19

what are some anticholinergic anti-emetics?

Answer 19

atropine
methylscopolamine

Question 20

what is the major contraindication for using an anti-emetic?

Answer 20

if obstruction hasn’t been ruled out

Question 21

when should gastric mucosal protectants be used?

Answer 21

persistant vomiting
evidence/risk of ulceration

Question 22

what drugs are contraindicated in acute enteropathies?

Answer 22

NSAIDs

Question 23

why are NSAIDs contraindicated in gastric enteropathies?

Answer 23

damage GI mucosa
damage to kidneys if hypovolaemic

Question 24

what are the pros of antibiotic use in gastric enteropathies?

Answer 24

natural flora is already upset
prevent sepsis if mucosal barrier is compromised

Question 25

what are the cons of antibiotic use in gastric enteropathies?

Answer 25

upset natural flora
cause diarrhoea
promotes resistance

Question 26

what are indications for antibiotic use in gastric enteropathies?

Answer 26

haemorrhagic diarrhoea
diarrhoea with pyrexia
known infection (salmonella, E. coli, campylobacter)

Question 27

what breeds are predisposed to acute haemorrhagic diarrhoea syndrome?

Answer 27

toy and miniature breeds

Question 28

what are the clinical signs of acute haemorrhagic diarrhoea syndrome?

Answer 28

sudden onset vomiting (blood)
severe bloody diarrhoea
depression
shock
haemoconcentration (high PCV due to massive loss of fluid)

Question 29

how is acute haemorrhagic diarrhoea syndrome treated?

Answer 29

prompt vigorous fluid therapy (80ml/kg/hr until CRT is normal)
withhold food/water
broad-spectrum antibiotics
protectants

Question 30

what is the prognosis for acute haemorrhagic diarrhoea syndrome?

Answer 30

untreated - death (shock)
treated - low mortality