Clinical Approach To Diagnosing Disease Flashcards
What are the 14 signs of GI disease?
- Vomiting
- Regurgitation
- Diarrhea
- Abdominal pain
- Tenesmus
- Dyschezia
- Hematochezia
- Constipation
- Flatus
- Salivation
- Shock
- Weight loss
- Anemia
- Change in appetite
How do you differentiate between vomiting and regurgitation?
Vomiting
- Abdominal contractions
- Retching
- premonitory signs present
- ptyalism, pacing, swallowing, tachycardia (nausea)
Regurgitation
- effortless expulsion
- few premonitory signs
- ptyalism in esophageal inflammatory or obstructive dz
*
How might you classify small bowel diarrhea?
- Normal to incr volume, mucus and blood are rare
- Normal to mildly incr freq (2-3x), dychezia and tenesmus are absent
- Weight loss is common
- Halitosis, vomiting, and flatulence can occur
How might you classify large bowel disease?
- Normal to decr volume
- Mucus and hematochezia often seen
- Urgency and tenesmus commonly occur, dyschezia occasionally
- Marked incr in frequency (>5x)
- Weight loss is rare, vomiting is uncommmon
- Halitosis and flatulence are absent
What are the five mechanisms of weight loss?
- Decr nutrient intake
- Maldigestion/malabsorption
- Malassimilation
- Excessive utilization
- Incr loss of nutrients
What are the essential diagnostics for a GI workup?
- Hemogram
- Blood chemistry
- Urinalysis
- Fecal exam
Define dyschezia
painful or difficult defecation
What is the difference between hematochezia and melena?
- Hematochezia: fresh blood in feces
- Melena: digested dark red/black blood in feces
What is dysentery?
bloody diarrhea (e.g. parvovirus)
Define constipation
- infrequent defecation, excessively dry or hard feces, increased straining to defecate with a passage of too small volumes of fecal matter
- often equated with tenesmus by owners
What are some normal and pathological causes of flatus (ie. flatulence)?
Normal:
- Brachycephalics - swallowed air
- Colonic fermentation - mostly soy carbs
Pathologic:
- Nutrient malabsorption - Colonic bacterial degradation
- Dietary insensitivity
What are some examples of confirmatory diagnostics for GI disease?
- Canine and feline pancreatic lipase immunoreactivity (cPLI, fPLI)
- Serum trypsin-like immunoreactivity (TLI)
- Serum cobalamin and folate
- Fecal alpha proteinase inhibitor
What are some radiographic signs of GI disease?
- Ileus (obstructive or paralytic)
- Effusion
- Foreign body
- Mass or visceral displacement
- Pneumoperitoneum
- Abnormal contrast study
- Often normal with chronic dz
What are the benefits of endoscopy for GI diagnosis?
- Direct observation
- Non-invasive
- Can obtain biopsies
T or F: Exploratory laparotomies are diagnostic procedures
true
Is ultrasound clinically useful for GI diagnostics?
Moderately helpful for acute GI dz, but typically won’t be diagnostic for chronic diseases
