Alimentary Diseases

Question 0

What is a hiatal hernia? What clinical symptom is it associated with?

Answer 0

When stomach herniated through the oesophageal hiatus in the diaphragm. Associated with regurgitation.

Question 1

What are the advantages and disadvantages of laparoscopy in comparison with endoscopy?

Answer 1

Larger samples can be collected, better visualisation of structures. More invasive, so more dangerous in a critically ill patient.

Question 2

Describe how you would nurse an animal with oral ulcers. Including which drug groups you’d be likely to administer.

Answer 2

Soft foods, tube feeding management may be needed if remains anorexic. Administer antibiotics as prescribed by vet, 0.1% chlorohexidine mouthwash. Administer corticosteroids.

Question 3

What nutrition advice would you give to owners of an animal that regurgitates it’s food regularly.

Answer 3

Feed in position where head and neck are extended, eg on the stairs. Ideally head and neck should be raised for 10-15 minutes after meals too. Small amounts of concentrated food should be given at intervals, little and often as opposed to large bolus meals.

Question 4

Which dogs breeds are most likely to develop idiopathic megaoesophagus?

Answer 4

Great Danes, Irish setters

Question 5

Other than idiopathic megaoesophagus, what conditions cause dilation of the oesophagus?

Answer 5

oesophageal stricture, sometimes caused by oesophagitis. neuromuscular conditions eg myasthenia gravis, persistent right aortic arch

Question 6

How would you manage an inpatient that’s been diagnosed with reflux oesophagitis? Including types of drugs you’d be administering.

Answer 6

Dietry management: low fat, highly digestible foods. Small meals often. If more severe then PEG tube is fitted, so PEG tube management necessary.
Administer mucosal Protestants, eg Sucralfate
Administer acid-blocking drugs eg cimetidine

Question 7

Give four examples of primary GI disease.

Answer 7

Parasitism, GI obstruction, GI inflammatory disease, FB, adverse reaction to food (allergy), gastric neoplasia, gastric ulceration, gastrointestinal ischaemia

Question 8

What are the six symptomatic treatment options for vomiting patients?

Answer 8

Stop food for 24 hours, oral rehydration if mild, I/v fluids if severe vomiting, adjust diet=if vomiting stops, low fat foods can be given in small amounts (boiled chicken, rice), antiemetic drugs administered, gastric Protectants administered, antacids administered.

Question 9

What are the treatment options for patients with acute gastritis?

Answer 9

Symptomatic treatment

Question 10

What treatment is used for patients with chronic gastritis? No erosive and non-erosive

Answer 10

Erosive: Gastric Protectants (Sucralfate), acid blockers, treatment of underlying cause (eg antibiotics for sepsis), misoprostol used when NSAIDs is cause of ulceration
Non-erosive: antacids, mucosal Protectants, corticosteroids, immunosuppressive drugs, low fat hypoallergenic diet.

Question 11

If a Pekingese is bringing up food 10 hours after eating, what is likely to be the cause?

Answer 11

Gastric outflow obstruction, due to oriental breed, likely to be antral mucosal hypertrophy.

Question 12

A Great Dane has just been admitted as an emergency with GDV. What treatment will you need to prepare?

Answer 12

Stomach tubes (to relieve gastric pressure), large bore catheter incase twist doesn’t allow tube in (for trocharisation), 500mls fluids, 2 catheters for aggressive shock therapy, prepare for abdominal surgery (gastroplexy, potential splenectomy and gastric resection), set up ECG on oatient and monitor for arrythmias for 3-5 days. Monitor patient and change eating routine, postural eating, wet food. Educate owners.

Question 13

What is it called when a catheter must be placed to relieve gastric pressures from the outside in a GDV patient? Why might this be necessary?

Answer 13

Trocharisation. When the vet is unable to pass a stomach tube, do to severity of gastric torsion.

Question 14

During GDV treatment, aggressive shock therapy is needed. How much fluid is required? In mls/kg

Answer 14

10-20mls/kg

Question 15

What would you write on clinical notes if you found fresh blood in a patients faeces?

Answer 15

“Haematochezia”

Question 16

What at the nursing care considerations for a patient with HGE?

Answer 16

Place in isolation and barrier nurse, as could be infectious cause. Colloid fluid therapy administration, as patient will be hypoproteinaemic. Administer antibiotics as prescribed, administer antiemetic a as prescribed. Starve patient initially until vomiting stops, or until 48 hours is reached. Then give small amounts of bland food over 3-5 days. Ensure bedding is clean, ensure patient is kept clean (if washed, must not become hypothermic).

Question 17

What are the nursing considerations for a patient with acute diarrhoea?

Answer 17

Dietry modification: starve 24-48hrs, small portions of bland food, reintroduce diet after 3-5 days over 3-5days. Administer fluid therapy, oral or I/V depending on losses. Potentially aid administration of activated charcoal or barium, binds to bacteria and toxins, administer antibiotics (only if proven this is cause), keep bedding clean, keep patient clean and dry, barrier creams may be necessary to avoid fluid burns, clip hair around flank if feathered bread.

Question 18

What clinical signs would you expect to see in a dog with exocrine pancreatic insufficiency?

Answer 18

Progressive weight loss, failure to put on weight, therefore cachexic (thin and wasted), poor coat quality, polyphagia, pica, coprophagia, diarrhoea

Question 19

What is characteristic of acute pancreatitis?

Answer 19

Severe abdominal pain ‘praying position’

Sudden onset lethargy. The rest are similar to other GI conditions.

Question 20

What predisposes animals to getting acute pancreatitis?

Answer 20

Obesity, high fat diet, drug therapies.

Question 21

What treatment options are available for acute pancreatitis?

Answer 21

Initially starve to give pancreas break, feeding tube in a cat. Oral rehydration when vomiting stops, analgesics as is a painful condition, surgery could be required if abscess or bile duct obstruction is present, DIET - low fat bland diet, high carbs, small frequent meals.

Question 22

Why might NSAIDs be contraindicated in a foal?

Answer 22

They reduce prostaglandin production which reduces gastric mucosal perfusion. Foals have poor perfusion anyway, so are more likely to have gastric ulceration when given NSAIDs.

Question 23

How would you assess a horse with colic symptoms? Hint, there are 13…

Answer 23

1.CV status (RR, HR, temp, TP, PCV) 2. Abdominal exam (abdominal distension, stethoscope) 3. Rectal exam (distension, displacement, impaction), 4. Stomach tubing (gastric distension), 5. Ultrasound, 6. Abdominoparacentesis (assess grossly, cytology), 7. Oral exam, 8. Gastroscopy, 9. Radiography, 10. Blood tests, 11. Faecal tests, 12. Glucose absorption test 13. Surgery (laparotomy, laparoscopy).