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Colic I Flashcards

1
Q

Two most common causes of GI colic:

A
  1. Bad management

2. Intestinal “accidents”

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2
Q

Common management factors that can cause GI colic:

1.
2.
3.
4.
5.
A
  1. sand
  2. high quality
  3. excessive CHO
  4. enough water
  5. fecals/deworming performed
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3
Q

Two most broad causes of non-strangulating lesions:

1.
2.

A
  1. Impactions

2. Displacements

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4
Q

Most common places for impactions:

1.
2.
3.
4.
5.
A
  1. Pelvic flexure
  2. right dorsal colon
  3. transverse colon
  4. small colon
  5. gastric impaction
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5
Q

Sand impactions:

Dx methods:
1.
2.
3.

A
  1. auscultation
  2. Fecal float/sink
  3. Abdominocentesis reveals sand
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6
Q

Sand impactions:

Most common location for impaction?

A

RIGHT DORSAL COLON

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7
Q

Sand impactions:

Clinical presentation

A

chronic MASSIVE and HEAVY lump

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8
Q

Cecal Impactions:

Clinical presentation

A

mild to moderate pain, usually acute but can be chronic.

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9
Q

Cecal Impactions:

  1. most common type affected?
  2. Prognosis with sx?
  3. ___% can rupture
A
  1. cecal base/cupula impactions
  2. excellent
  3. 57
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10
Q

Fecal impactions: Tx options?

A

Medical = fluid therapy

Surgical = pelvic flexure enterotomy***

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11
Q

What parasite can cause ascarid GI impaction? when?

A

Parascaris equorum. 24hrs after deworming

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12
Q

What parasite can cause verminous arteritis that leads to thromboembolic disease induced ischemic bowel?

How do you treat it?

A

Strongylus vulgaris

anthelmintic/ivermectin

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13
Q

What parasite causes problems at the ileocecal junction? What disease does it cause?

A

Anoplocephala perfoliata (tapeworm).

Ileocecal intussusception

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14
Q

Bezoars / Enteroliths:

  1. Name if caused by hair? By fiber?
  2. Where do they impact?
A
  1. trichobezoars. phytobezoars.

2. Transverse colon

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15
Q

Stangulating lesions:

  1. Usually broadly caused by ______
  2. cause of ___-___% of SI colic are caused by strangulating lesions
A
  1. intestinal “accidents”

2. 58-85%

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16
Q

4 Main types of strangulating lesions:

1.
2.
3.
4.

A
  1. Lipoma
  2. volvulus/torsion of large colon
  3. EFE (epiploic foramen entrapment
  4. Mesenteric volvulus
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17
Q

Strangulating Lipoma:

Prognosis?

A

short term survival in 48-85% of cases

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18
Q

Lipoma:

  1. Most common location?
  2. Average age affected?
  3. Tx via
A
  1. > 90% in small intestine
  2. 14-19 yr
  3. Exploratory celiotomy to perform resection/anastomosis
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19
Q

Epiploic Foramen Entrapment

  1. EF aka _____
  2. Boundaries of EF?
A
  1. Foramen of Winslow

2. Caudate process of the liver, Portal vein, Gastropancreatic fold

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20
Q

EFE:

  1. Usually strangulates the (small/large) intestine?
  2. Usually (left to right / right to left)?
  3. Ages?
  4. Predisposing behavior?
A
  1. small
  2. left to right
  3. all ages
  4. cribbing
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21
Q

EFE Surgery:

  1. surgical technique?
  2. Main complication?
A
  1. manual reduction

2. Portal vein tear

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22
Q

EFE Surgery:

  1. __x more likely to require repeat surgery.
  2. EFE associated with
A
  1. 4x

2. decreased survival

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23
Q

Volvulus is (common/rare) in large colon?

A

common

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24
Q

Clinical presentation of Large Colon volvulus?

A

severe unrelenting pain with rapid CV compromise.

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25
Q

Risk factors for large colon torsion:

1.
2.
3.

A
  1. Post parturient mare
  2. diet change
  3. recent access to lush pasture
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26
Q

In addition to PE for colic exam, ALWAYS _____

A

insert NG tube

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27
Q

Rectal Exam: what can be palpated in the middle?
1.
2.
3.

A
  1. Aorta = dorsal midline
  2. Inguinal rings = ventral
  3. Small colon
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28
Q

Rectal Exam: what can be palpated on the right?

1.
2.
3.

A
  1. cecum
  2. colon
  3. right ovary
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29
Q

Rectal Exam: what can be palpated on the left?

1.
2.
3.

A
  1. left kidney
  2. spleen
  3. left ovary
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30
Q

T/F: abdominal ultrasound is a routine part of the colic exam?

A

T

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31
Q

Things abdominal ultrasound can confirm:

1.
2.
3.
4.

A
  1. LDD
  2. SI distension
  3. bowel thickening
  4. free fluid
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32
Q

FLASH technique:

left side:

1.
2.
3.
4.

A
  1. Ventral abdomen
  2. Gastric window
  3. Spleno-renal window
  4. Left middle 1/3rd of abdomen
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33
Q

FLASH technique:

right side:

1.
2.
3.

A
  1. Duodenal window
  2. Right middle 1/3rd of abdomen
  3. cranial ventral thorax
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34
Q

Therapeutic uses for Nasogastric Intubation:

1.
2.
3.

A
  1. gastric decompression
  2. Esophageal choke
  3. Administration of medication
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35
Q

NG tube placement:

You want to place your thumb and forefinger of your non-dominant hand (ventrally/dorsally) and (medially/laterally) into the ventral meatus

A

ventrally and medially

36
Q

NG tube placement:

  1. Place with tube facing (down/up)?
  2. What do you do when you reach the pharynx?
A
  1. down.

2. rotate 180 degrees and gently bump the pharynx to stimulate swallowing

37
Q

NG tube intubation complications:

1.

A
  1. Iatrogenic epistaxis
38
Q

How to create a siphon using an NG tube?

A

Pump water down the tube, disconnect, than pull the tube back in short jerky motions to create a siphon

39
Q

T/F: Spontaneous reflux is never normal

40
Q

Net increase in reflux via NG tube can be due to :

1.
2.
3.

A
  1. Ileus
  2. Obstruction
  3. Strangulation
41
Q

T/F: If net reflux or spontaneous reflex is present, you cannot give medication through an NG tube

42
Q

Copious amounts of net reflux is probably coming from (small/large) intestine, and is probably due to:
1.
2.
3.

A

small intestine

  1. anterior enteritis
  2. Impaction
  3. Strangulation
43
Q

Response to NG decompression if colic is due to Ileus?

A

HR decrease, pain relief that leads to depression

44
Q

Response to NG decompression if due to mechanical obstruction or strangulation?

A

Persistent pain and tachycardia

45
Q

Why is it important to remove NG tube asap?

A

It can be irritating to mucosa and pharynx/esophagus

46
Q

Location for abdominocentesis for colic?

A

** on or to the right of ventral midline, caudal to xyphoid (most ventral)

47
Q

Abdominocentesis: Cannula Technique:

  1. (is/is not) aseptic?
  2. Anesthetic?
A
  1. is.

2. local block - carbocaine and 25 ga needle

48
Q

Abdominocentesis: Cannula technique:

  1. Incision technique?
A
  1. Use #15 blade through skin and SQ and into linea alba/external sheath
49
Q

Abdominocentesis: Needle Technique:

  1. (is/is not) aseptic?
  2. Insertion technique?
A
  1. is

2. 18-20 ga needle through skin, SQ, linea, and peritoneum

50
Q

Peritoneal fluid analysis:

Lactate:

  1. ***Normal levels?
  2. 30% survival if what level?
A
  1. < 2.0

2. > 7.0

51
Q

T/F: Normal abdominocentesis does not rule out the need for surgery

52
Q

Signs of early shock due to colic:

1.
2.
3.
4.

A
  1. elevated HR
  2. Pale mm
  3. Slow prolonged CRT
  4. Decreased pulse pressure
53
Q

Signs of late shock due to colic:

1.
2.
3.
4.
5.
6.
A
  1. elevated HR
  2. weak/thready pulse
  3. muddy/red mm
  4. SLOW as shit CRT
  5. cool/cold extremities
  6. acid/base abnormalities
54
Q

Multimodal options for pain management in colic:

1.
2.
3.
4.

A
  1. NSAIDs
  2. Alpha-2 agonists
  3. Opioids
  4. Spasmolytics
55
Q

NSAIDs for pain mangement of colic:

  1. Which is given most commonly? What is the main rule of it’s administration
A

Flunixin meglumin

Do not give more often than every 12 hours

56
Q

Alpha 2 agonists for pain management of colic:

Drug options:

1.
2.
3.

A
  1. Xylazine
  2. detomidine
  3. Romifidine
57
Q

Pain management of colic:

  1. Main opiod you can give?
  2. Main spasmolytic you can give?
A
  1. Butorphanol

2. Buscopan

58
Q

U/S of umbilicus and abdomen for PE of colicky foal:

What are the normal sizes of the:

  1. Umbilical vein?
  2. Umbilical artery?
  3. Arteries/urachus combo?
A
  1. < 1 cm
  2. < 1.3 cm
  3. < 2.5 cm
59
Q

Umbilical U/S:

  1. Probe size?
A
  1. > 5MHz probe
60
Q

Most common umbilical infectious agent?

A

Gram - and B- hemolytic strep infections

61
Q

Etiologies of newborn foal colic:

1.
2.
3.
4.
5.
A
  1. Meconium impaction
  2. Gastric ulceration
  3. Enteritis
  4. Inguinal hernia with ruptured tunic
  5. Sepsis
62
Q

Etiologies of colic in 2-5 day old foal:

1.
2.
3.

A
  1. Ruptured bladder
  2. Gastric ulcers
  3. Enteritis
63
Q

Etiologies of colic in older foals:

1.
2.
3.
4.
5.
A
  1. Gastroduodenal ulcers
  2. Enteritis
  3. SI volvulus
  4. Intussusception
  5. Ascarid impaction
64
Q

Etiologies of Colic in Foals: Gender disposition:

Colts more likely to get ____ and ___

Fillies more likely to get ____ and ___

A
  1. Meconium impaction and inguinal hernia

Ruptured bladders and ureteral abnormalities

65
Q

Sedative Options for Pain Management in a Colicky Foal:

1.
2.
3.

A
  1. Benzos - Diazapam
  2. Alpha 2 agonists (MUST BE 2 WEEKS OF AGE MINIMUM) - Xylazine
  3. NSAIDs - Banamine
66
Q

Newborn Foal Colic - Meconium Impaction:

  1. Typical end result?
  2. A (common/rare) cause of colic in newborns?
A
  1. Passes w/i 3 hours

2. common

67
Q

Newborn Foal Colic - Meconium Impaction:

Treatment method?

A

Fleet enema using warm soapy water, 4% acetylcysteine. DO NOT FORCE IT IN

68
Q

Newborn Foal Colic - Inguinal Hernia

  1. (acute/chronic) onset?
  2. (mild/severe)?
A
  1. acute

2. severe

69
Q

Newborn Foal Colic - Inguinal Hernia

Treatment methods?

A
  1. Inguinal approach surgery
  2. IgG admin
  3. Antibiotics
  4. Pain control
70
Q

2-5 Day old foal - Ruptured Bladder:

  1. Where is rupture likely to happen in males? in females?
  2. Three main aspects of clinical presentation?
A
  1. dorsal aspect of bladder. Urachal rupture

2. Abdominal distension, colic, and electrolyte derangement

71
Q

Diagnosis of Ruptured Bladder in foal: Options

1.
2.
3.
4.
5. 
6.
A
  1. Signalment
  2. History
  3. Bloodwork = ELECTROLYTES
  4. ECG abnormalities!
  5. U/S
  6. Measure Peritoneal creatinine
72
Q
  1. U/S of Ruptured bladder in a foal will reveal…

2. Peritoneal Creatinine levels in a foal with ruptured bladder?

A
  1. Free fluid in abdomen with no/very small bladder

2. Elevated. Serum: PEritoneal Creatinine ratio > 1:2

73
Q

T/F: Ruptured Bladder is not a surgical emergency

74
Q

How would you medically stabilize a ruptured bladder before surgery?

A

Ensure K+ > 5.5mEq/L

75
Q

Ruptured Bladder: Surgical Treatment:

  1. Approach?
  2. Describe initial Incision?
A
  1. Ventral Midline

2. Elliptical incision around umbilicus

76
Q

Ruptured Bladder: Surgical Treatment:

  1. Remove _____
  2. Double ligate what structures?
  3. Trim ____
A
  1. Urachal remnants
  2. 2 umbilical arteries and vein
  3. edges of the tear
77
Q

Ruptured Bladder Surgery:

  1. Closure technique?
  2. Suture type?
  3. DO NOT USE WHAT SUTURE TYPE? WHY
A
  1. Two layer closure: simple continous followed by cushing/lembert pattern
  2. Absorbable monofilament 3-0
  3. Dexon - may create urolith
78
Q

Ruptured Bladder: Aftercare/Prognosis:

  1. (Do/Do not) give antibiotics?
  2. Prognosis is (bad/good)?
A
  1. Do! Broad spectrum

2. Excellent

79
Q

Atresia Coli:

  1. (common/rare)?
  2. Diagnosis method?
A
  1. rare

2. Radiographs +/- Barium enema

80
Q

Intussusception in Older Foals:

  1. Colic presentation?
A
  1. acute severe colic
81
Q

Intussusception: in Older foals: Best ways to dx?

1.
2
3.

A
  1. PE
  2. Bloodwork
  3. U/S = Bullseye appearance with distended amotile SI proximal to lesion
82
Q

Intussusception in Foals: Prognosis?

A

Fair to guarded, depending upon severity, whether or not you had to R/A, and if adhesions formed

83
Q

SI Volvulus in Foals:

  1. “___” formation.
  2. Twists where?
A
  1. Corkscrew

2. At root of mesentery.

84
Q

SI Volvulus in Foals:

  1. Treatment?
A
  1. R/A the compromised bowel
85
Q

Gastric outflow obstruction in foals:

  1. Secondary to…
  2. Treatment?
  3. Prognosis?
A
  1. Pyloric stenosis from ulceration
  2. Bypass - Gastroduodenostomy
  3. Guarded

LAS - RUSS (32 decks)

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