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Alimentary Exam 1 > Alimentary-exam 3 > Flashcards

Alimentary-exam 3 Flashcards

1
Q

What is the difference between segmentation and peristalsis?

A

Segmentation is rhythmic contraction of circular muscle- mixes the enzymes and nutrients, allows adequate time for digestion/absorption

Peristalsis- longitudinal wave of constriction that moves ingesta in the aborad direction

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2
Q

You don’t see diarrhea, can you rule out intestinal disease?

A

No. Small intestinal disease is frequently quite severe before diarrhea occurs

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3
Q

What is the definition of diarrhea?

A

an increase in frequency, fluid content, or volume of feces

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4
Q

What percentage of absorptive function in the GI tract happens in the small intestine?

A

80%

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5
Q

With osmotic diarrhea, do you have to worry about loss of electrolytes?

A

Generally not so much.

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6
Q

What other problem can osmotic diarrhea lead to?

A

Dysbiosis

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7
Q

What are three clinical causes of osmotic diarrhea?

A

EPI, SI lymphoma, IBD

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8
Q

What is secretory diarrhea generally caused by? Name four clinical causes?

A

caused by an increase in mediators such as endogenous hormones or cytokines.
Specifically- Salmonella, E. coli, Campylobacter, or IBD

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9
Q

Where is integrity of the tight junction between enterocytes the loosest?

A

At the crypts where fluid secretion occurs

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10
Q

Why is exudative diarrhea clinically important?

A

Leads to increased risk of bacterial translocation and sepsis

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11
Q

What are three clinical causes of exudative diarrhea?

A

Inflammatory disease, neoplasia, Lymphangiectasia

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12
Q

What is the general cause of exudative diarrhea?

A

altered permeability from structural damage to the gut wall.

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13
Q

What does blood in the feces typically equal?

A

compromised gut function

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14
Q

What is the primary function of the colon?

A

To absorb water/electrolytes from the intestinal contents

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15
Q

What general causes of diarrhea would you think of in a neonate or juvenile patient?

A

Infectious

-Infectious, obstructive, nutritional

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16
Q

What are some characteristics of small bowel diarrhea?

A

normal to increased volume, urgency is uncommon, tenesmus is absent, weight loss can be severe, vomitting is common (esp in cats)

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17
Q

What are some characteristics of large bowel diarrhea?

A

Normal to decreased volume, mucus common, tenesmus and dyschezia common, weight loss and vomitting are uncommon

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18
Q

Is a general fecal culture a good idea?

A

No, it is a waste of money, most have an organism in mind that you want to target.

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19
Q

When would you see decreased cobalamin and folate?

A

with ileal malabsorptive disease

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20
Q

What is the main goal with survey radiographs?

A

to determine if the condition is surgical or non-surgical. they do NOT rule out significant disease

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21
Q

What kind of things can you evaluate on survey radiographs?

A

foreign body, abdominal fluid, organomegally, free gas, mass lesion, ileus

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22
Q

What is a good general deworming protocol? When should you use it?

A

fenbendazole for five days. Use on pretty much every patient

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23
Q

What is the MINIMUM amount of time you should do a food trial to see if that is the cause of your diarrhea?

A

3 weeks. NPO except prescribed food and water- no treats, flavored meds, etc.

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24
Q

What is the most common location of intussesception in dogs? In cats?

A

In dogs= ileocolic junction or jejunojejunum

In cats= jejunojejunal

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25
Q

In what age of animal is intussesception more common?

A
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26
Q

What is the cause for most intussesceptions?

A

Idiopathic, maybe neoplasia or IBD in older cats

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27
Q

Would you expect rapid gas and fluid accumulation with high or low GI obstruction?

A

High

low has more slow accumualtion

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28
Q

What signs would fluid and gas accumlation associated with obstruction cause?

A

Dehydration, electrolyte and acid-base imbalances (hyopchloremic metabolic alkaloisi and hypokalmeia). Hypovolemic shock can occur in 48-72 hrs.

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29
Q

What signs would a patient with an obstruction might have?

A

Anorexia, abdominal pain, depression, vomiting. Can lead to dehydration, collapse, and death.

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30
Q

What is the treatment for intestinal obstruction?

A

stablize and normalize hydration status, treat shock and electrolyte abnormalities, start antibiotics ASAP. Surgery.

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31
Q

Name three metabolic causes of diarrhe

A

Addisons, hyperthyroidism, EPI

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32
Q

Name three viruses that can cause viral enteritis in dogs

A

Parvo, Coronavirus, distemper

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33
Q

How long is parvovirus shed? How long can it persist in the environment?

A

Shed for 3-14 days.

Can persist in the environment for 6mo.

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34
Q

What is the general treatment for parvo?

A

Aggressive fluids and antibiotics

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35
Q

How do you calculate a fluid deficit?

A

%dehydrationx BW in kg

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36
Q

What type of antibiotics do you want to use in a dog with parvo?

A

Broad spectrum- ampicillin in combo with enrofloxacin, 3rd gen cephalosporin or aminoglycoside

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37
Q

What probiotic should you use for parvo?

A

VSL#3

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38
Q

What are some potential complications of parvovirus?

A

esophagitis, aspiration, intussusception, sepsis, hypovolemia

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39
Q

What is the prognosis for parvo both treated and untreated?

A

Untreated= 90% mortality

aggressviely treated= 0-30% mortality

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40
Q

What is the vaccination schedule for parvo?

A

start at 6wks and vaccinate q 3-4 weeks until 12 weeks of age (or 18 weeks in predisposed breeds.- Does not provide complete protection

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41
Q

What are the other names for feline parvovirus?

A

feline panleukopenia and feline distemper

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42
Q

What are the clinical signs of feline parvovirus?

A

anorexia, and pain, vomiting and watery to blood diarrhea

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43
Q

What type of WBC abnormality is seen most commonly with feline parvovirus?

A

absolute neutropenia

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44
Q

How do you diagnose feline parvovirus?

A

You can use the ELISA test used in dogs

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45
Q

What types of cells does coronavirus invade?

A

mature absorptive cells along sides and tips of villi

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46
Q

How does coronavirus cause its effects? How serious of a disease is it usually?

A
  • causes Na+ and water secretion and mild malabsorption.
  • commonly causes dubclincal infection in dogs
  • most severe in puppies 6-12wks of age
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47
Q

What is the incubation period for coronavirus? How long is it shed?

A

Incubation is 1-4 days
Can be shed for months.
-It is highly contagious

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48
Q

What are the common clinical signs associated with coronavirus?

A

mild, self-limiting diarrhea. Anorexia, vomiting and lethargy can occur. Fever is uncommon.

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49
Q

How is coronavirus diagnosed?

A

Usually by clinical signs and elimination of other causes. Definitive dignosis requires electron microscopic exam of feces.

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50
Q

Would you expect to see leukopenia with coronavirus?

A

No, but you would with parvovirus.

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51
Q

How is coronavirus generally treated?

A

witholding food and water for 12-24hr and gradual introduction of low-fat diet. SQ fluids generally sufficient

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52
Q

What is the typical signalment you would expect for an animal with Campylobacter?

A
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53
Q

How severe is the disease typically caused by Campylobacter. How would you diagnosis it?

A

Usually subclinical, diagnosed through culture of fresh feces.

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54
Q

What i the most common Campylobacter isolate?

A

C. jejuni

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55
Q

When is treatment indicated for campylobacter?

A

when animals have severe hemorrhagic muccoid diarrhea

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56
Q

Is treatment with antibiotics reccomened for most patients with Salmonellosis?

A

Not in healthy animals or stable animals with acute diarrhea.
- can promote bacterial resistance and a carrier state.

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57
Q

What type of antibiotics are commonly used for salmonellosis?

A

Fluoroquinolones. Choice should be made based on culture and sensitivity

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58
Q

What type of drugs to clostridial diarrheas generally respond well too?

A

Metronidazole or penicillins

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59
Q

How would you diagnose clostridial diarrhea?

A

cytology, fecal culture or toxin presence, but finding the organism does NOT mean it is the cause of diarrhea

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60
Q

What is the severity of clostridial diarrhea, generally?

A

Rarely cause systemic disease

-many clinically normal animals have it in feces. Usually causes large intestine diarrhea.

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61
Q

At what age do signs of boxer colitis typically arise?

A
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62
Q

What is trichomonad related diarrhea caused by in cats?

A

Tritrichomonas foetus

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63
Q

What are the clinical signs of trichomonad diarrhea?

A

Primarily large bowel diarrhea.
May appear under nourished
May appear normal systemically

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64
Q

How do you diagnose trichomonad diarrhea?

A

with fecal culture or PCR. Direct smear is very insensitive

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65
Q

What is the reccomended treatment for T. foetus?

A

Ronidazole- relapse after stopping treatment is common

-Infection usually self limiting after 6-36mo

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66
Q

What protozoal disease is one of the most common causes of small bowel diarrhea in dogs and cats?

A

Giardia

67
Q

What type of diarrhea does giardia cause?

A

Small bowel

68
Q

giardia affects ______ animals more than ____ ones

A

young more than old

69
Q

Diagnosis of giardia is done how?

A

zinc sulfate centrifugation test on 3 seperate fecal samples

  • ELISA tests also avialable
  • direct smear diagnostic in ~40% of cases
70
Q

What is one reason it might be difficult to find giardia in an infected animal?

A

cysts are shed intermittently

71
Q

What should you do if you suspect giardia but you cannot document it?

A

Do a therapeutic trial. Important to treat due to zoonotic potential

72
Q

Should you treat an animal with giardia if it doesn’t have symptoms?

A

Yes

73
Q

What drug should you use to treat giardia if you don’t have confirmation of diagnosis?

A

Fenbendazole +/- metronidazole

74
Q

What is a common reason for signs of giardia to not resolve?

A

Re-infection

75
Q

What is Histoplasma capsulatum? How is it acquired?

A

It is a dimorphic fungus acquired through inhalation

76
Q

What is the difference between H. capsulatum infection in dogs and cats?

A

In dogs, small and large bowel infection is common. In cats, cutaneous problems are more common

77
Q

How is diagnosis of H. capsulatum done?

A

finding the organism in cytologic or histopatholigic samples

-a urine antigen test is available

78
Q

is serologic testing reliable for H. capsulatum infection?

A

No- lacks sensitivity and specificity

79
Q

What should you do if cytology of H. capsulatum is non-diagnostic?

A

biopsy

80
Q

What is the treatment to H. capsulatum?

A

Itraconazole, Amphotericin B if severe intestinal disease is present because absorption may be affected

81
Q

What is the prognosis for histoplasma?

A

Fair to poor

82
Q

What parasitic organism is one of the most common causes of acute and chronic large bowel diarrhea in dogs?

A

Trichuris vulpis

83
Q

What abnormalities can Trichuris vulpis cause?

A

severe electrolyte disturbances with hyperkalemia and hyponatremia= “pseudo-Addisonian syndrome”

84
Q

What is the age of dogs generally affected with an adverse food reaction?

A

Young (~3yrs)

85
Q

What other, non-GI sign might tip you off to adverse food reaction?

A

Dermatologic disease

86
Q

What type of food should you use for a food trial in a food adverse reaction case?

A

Hydrolyzed protein or limited antigen (hydrolyzed may be better)

87
Q

How is diagnosis of IBD made?

A
  • BIOPSY
  • finding GI inflammation without an underlying cause
  • Normal abdominal imaging does NOT rule out IBD
88
Q

What type of pathologist should you send you biopsy samples too if you are suspicious of IBD?

A

One who follows the WASAVA standards

89
Q

What is the treatment for IBD

A

Diet change, antibiotics, and immunosuppression

90
Q

What additional medicines might be helpful for IBD?

A

metronidazole or tylosin

91
Q

What vitamins specifically should you keep an eye on with IBD?

A

Cobalamin and folate

92
Q

If the patient with IBD doesn’t have good improvement with corticosterioids, or doesn’t tolerage them, what other treatments would you consider?

A 
Chlorambucil
Cyclosporine
Azathioprine
with colitis- sulfasalazine
Consider adding probiotics
93
Q

What is a neoplastic cause of diarrhea?

A

Lymphosarcoma

94
Q

What is ARD?

A

Antibiotic responsive diarrhea- chronic small bowel diarrhea that is responsive to antibiotics

95
Q

What breeeds typically ahve ARD

A

Young, large breed dogs, particularly German shepherds. Not recognized in cats, but may occur

96
Q

Which antibiotics are used to treat ARD?

A

tylosin, metronidazole, and oxytetracycline for 4-8wks

97
Q

What is IL?

A

Intestinal lymphangiectasia- dilated intestinal lymphatis that rupture and leak protein-rich lymph into the lamina and lumen.

98
Q

Which type of IL is more common?

A

Acquired much more common than congenital

99
Q

What breed is particularly predisposed to IL?

A

Yorkies

100
Q

What causes acquired IL?

A

mechanical lymphatic obstruction due to chronic inflammatory, infectious or neoplastic causes or can be idiopathic.

101
Q

Does a dog with IL have to have diarrhea?

A

No. Other sings are edema due to hypoalbuminemia and emaciation due to malabsorption

102
Q

What are the common laboratory abnormalities associated with IL?

A 
Lymphopenia
Panhypoproteinemia
Hypocholesterolemia
Hypocalcemia and hypomagnesemia
Possible cobalamin and folate deficiencies
103
Q

How is IL diagnosed?

A

biopsy

104
Q

What is the treatment for IL?

A

Fat restriced diet, anti-inflammatory dose of pred may help

105
Q

What is HGE?

A

Hemorrhagic gastroenteritis of dogs- peracute, necrotizing hemorrhagic enteritis

106
Q

What clinical signs is HGE assocaited with?

A

severe vomitting, bloody diarrhea “raspberry jam”, and rapid dehydration with marked hemoconcentration and hypoproteinemia

107
Q

What is the typical signalment for a dog with HGE?

A

Young, small breed dog.

But can be diagnosed in anyone

108
Q

What is the treatment for HGE?

A

The same as for parvovirus

109
Q

Why or why shouldn’t you use antibiotics in cases of HGE.

A

You should use antibioctis because of high risk of bacterial translocation. Protection against all types, but especially anaerobes is important.

110
Q

What type of antibiotics might you want to use in a case of HGE?

A

IV metronidazole and a penicillin

111
Q

Which type of megacolon is more common?

A

Acquired is much more common

112
Q

What are some causes of megacolon?

A

any disease that obstructs the normal passage of feces, causing chronic constipation.
Idiopathic is is common in cats

113
Q

What are the clinical signs of megacolon?

A

recurrent episodes of constipation of increasing severity

PE- depression, dehydration, unthriftyness and emaciation

114
Q

What is phase I of the deglutition reflex?

A

Oropharyngeal phase

  1. Oral (voluntray)
  2. Pharyngeal
  3. Pharyngoesophageal (UES relaxation
115
Q

What is phase II of the deglutition reflex?

A

Esopageal phase

  • primary peristalsis
  • secondary peristalsis
116
Q

What is phase III of the deglutition reflex?

A

Gastroesophageal phase

  • LES relaxation
  • tonically active but relaxes when swallowing
117
Q

What is the definition of “deglutition”?

A

The transport of food and liquids from the oral cavity to the stomach

118
Q

What is the only voluntary phase of swallowing?

A

the oral phase (the first part of the oropharyngeal phase)

119
Q

What is the purpose of the soft palate elevating when you swallow?

A

keeps food from going into your nose

120
Q

What number is the hypoglossal nerve?

A

12

121
Q

What things need to be coordinated for the oropharyngeal phase of swallowing to work?

A

tongue, teeth (for prehension), hard palate, mandible, salivary glands, CN I, II, V, XII, and cerebral cortex

122
Q

What does anisognathic mean?

A

Dogs and cats have a smaller mandible than maxilla- needed for ripping and tearing food

123
Q

the oral phase of swallowing?

A

prehension

  • mastication
  • formation of a food bolus
124
Q

What are the three parts of the pharynx?

A

nasopharynx (resp), oropharynx (digestive), laryngopahrynx (gate keeper to guide food or air to appropriate location)

125
Q

Where is the nasopharynx?

A

Dorsal to the hard palate

126
Q

Where is the oropharynx?

A

dorsal to the tongue and ventral to the soft palate (contains the epiglottis)

127
Q

What happens in the pharyngeal phase of swallowing?

A

bolus is propelled from oropharynx to upper esophageal sphincter

128
Q

What state are the pharyngeal openings in during the pharyngeal phase of swallowing?

A

They are closed to prevent aspiration

129
Q

What cranial nerves are involved in the pharyngeal phase of swallowing?

A

V, VII, IX, X, XII, and the medulla oblongata

130
Q

What are the hallmarks oforopharyngeal disease?

A

Dysphagia, ptyalism, gagging, reluctance to eat, dysphonia, dropping food, immediate “regurg”

131
Q

What is the hallmark of the pharyngoesophageal phase?

A

the upper esophageal sphincter will relax

132
Q

If an animal has regurgitation, what type of dysphagia do you know it has?

A

Esophageal- but there may also be other problems

133
Q

What structures can be involved in “oropharyngeal disorders”?

A

oral cavity, pharynx, salivary glands

134
Q

What are the two classes of oropharyngeal dysphagia. Which is more common

A

Anatomic- way more common
Functional
-If you don’t identify it through physical exam and rads, you can say its funtional

135
Q

What is the function of the esophagus?

A

to provide uninterrupted and unidirectional flow of food into the stomach

136
Q

What are the three segements of the esophagus?

A

Cervial (extra-thoracic)
Thoracic (body)
Abdominal

137
Q

What is different about the feline esophagus?

A

It has smooth muscle in the lower 1/3 (canine is all striated muscle)

138
Q

What is the visceral afferent sensory nerve to the esophagus?

A

The vagus

139
Q

What three anatomic structures contribute to the LES?

A

Gastric smooth muscle
Diaphragm
Gastric oblique fibers

140
Q

What does parasympathetic innervation to the LES cause it to do?

A

relax

141
Q

If you suspect esophageal dysmotility, what areas in particular should you palpate?

A

the cervical esophagus and the salivary glands

142
Q

Can you generally identify an anatomical cause of esophageal dysmotility on PE?

A

Usually no, need some more advanced techniques

143
Q

What are some causes of megaesophagus

A 
Immune mediated- SLE, polymyosistis, dermatomyosistis
Endocrine-Addisons
Inflammatory-GERD
Neuromuscular-myasthenia
Dysautonomia
144
Q

What is the major complication you worry about with megaesophagus?

A

Aspiration pneumonia

145
Q

What are the four portions of the stomach?

A

Cardia
Fundus
Body
Pyloric antrum

146
Q

What doe the stomach do?

A

initiates digestion of proteins and fats and absortion of vitamins and minerals (esp B12)

147
Q

What is the job of the fundus?

A

“relative relaxation” during swallowing

-stretches out to let you eat a lot

148
Q

What is the function of the body of the stomach?

A

Reservoir, mixes

149
Q

What is the function of the antrum of the stomach?

A

Grinding/churning, more frequent, vigorous mixing

150
Q

What “syndrome” can animals with no antrum have?

A

a “dumping syndrome”

151
Q

What is the function of the pylorus?

A

“sieve” function- delays gastric emptying and minimizes reflux

152
Q

What six things contribute to gastric emptying

A

Water- liquids exit way faster
Nutrient composition- carbs and protiens empty more rapidly than fat
Osmolarity- osmorecectors in proximal duodenum inhibit gastric emptying by swelling. Tells body “I need more time”
pH- duodenal and jejunal receptors slow emptying of low pH foods
Temp- cold and hot things empty slower
Pyloric resistance and pressure differential

153
Q

Where do the acid producing cells of the stomach live?

A

in the proximal part of the stomach

154
Q

What type of cells would you find in the caudal part of the stomach?

A

“Pyloric glands”:
mucus
G cells-gastrin (helps to produce acid)
D cells- somatostatin

155
Q

What is the main function of the parietal cell?

A

to produce HCl

-an active, energy dependent process

156
Q

What are the three main secretogos (stimulants) for HCl production?

A

Histamine
Gastrin (from G cell)
Acetylcholine (from nerves)

157
Q

How does the body regulate acid secretion in the stomach?

A

When the pH drops below 3, your body releases somatostatin (SST) from D cells, feeds back and inhibits the secretogogs

158
Q

Name four potential causes of GI ulceration

A

Impared mucosal bloodflow- GDV, chirrhosis
Decreased PG production- NSAIDs
Damaged epithelium-GI neoplasia
Increased gastric acid- gastrinoma

159
Q

What are the signs of gastric disease?

A 
Vomiting is most common
-hyporexia (esp if painful)
-weight loss
Hematemesis
Melena
Abdominal distension and pain
160
Q

What four things can feed into the vomiting center?

A

Abdominal cortex
Vestibular apparatus
Chemoreceptor trigger zone (floor of fourth ventricle)
Cerebral cortex

161
Q

Where is the vomiting center?

A 
Medulla oblongata
(so is the swallowing center)
162
Q

Name one cause of vomiting that would cause vomiting through the CTZ

A

Apomorphine

-also uremia or other blood borne toxins

163
Q

What is the difference between the vestibular apparatus causing vomiting in dogs and cats?

A

Cats go straight to the vomiting center, dogs go through the CTZ

Alimentary Exam 1 (2 decks)

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