Equine GI 1 Flashcards
What are the most important features of IL-6?
a. Pyrogenic, promotes function of C3, increase macrophage activity in tissues
b. Promotes function of C3 and C5, decrease monocyte diapedesis, pyrogenic
c. WBC activation, pyrogenic, production of acute phase proteins
d. Pyrogenic, production of acute phase proteins, anemia of chronic disease
c. WBC activation, pyrogenic, production of acute phase proteins
Major endogenous pyrogens
- IL-6
- IL-1
- TNF-a
- IFN
Some gastroprotectants like ranitidine and cimetidine work by competing at the level of the histamine receptors, thus inhibiting the release of histamine, which is considered the main stimulus for HCl secretion. In which specific cells of the gastric mucosa does histamine inhibitors work?
a. Zymogen cells
b. Parietal cells
c. Chief cells
d. Enterochromaffin-like cells
b. Parietal cells
- Zymogen cells –> pepsinogen
- Chief cells –> pepsinogen
- Enterochromaffin-like cells –> Histamine, serotonine
Which is the most likely electrolyte and acid-base status after chronic esophageal obstruction?
- Low Na, Low Cl, Low K, Metabolic acidosis
- Low Na, Low Cl, High K, Metabolic acidosis
- Low Na, Low Cl, Low K, Metabolic alkalosis
- Low Na, Low Cl, High K, Metabolic alkalosis
c. Low Na, Low Cl, Low K, Metabolic alkalosis
- Acutely lose Na, Cl, K, Bicarb in saliva.
- After some time, even lower K due to lack of feed and renal compensation for low Cl makes them have metabolic alkalosis
Which coagulation factor is stimulated by endotoxin to trigger intravascular coagulation by the intrinsic pathway?
- Heparin
- Factor II
- Factor X
- Factor XII
d. Factor XII
Factor XII (Hageman’s factor) is triggered by endotoxin, producing bradykinin and triggering intravascular coagulation
APTT (best for DIC) is specific for intrinsic pathway, very sensitive to collection. Independent of platelet function.
What is the main reason for treatment failure in cases of EGGUS?
a. The lack of use of mucosal protectants such as sucralfate or pectin-lecithin
b. Inadequate dosing of the PG analogue misoprostol
c. Fail to add antimicrobials to the therapy, for example doxycycline or TMS
d. Short treatment duration with omeprazole
d. Short treatment duration with omeprazole
EGGUS has an inferior response to tx. w/ omeprazole, needs longer tx. – generally, more than 28 days. Also, in refractory cases there might be a need to add ATB to tx. (Doxycycline) and also add mucosal protectants: sucralfate or pectin-lecithin complexes.
What radiographic findings for a supernumerary incisor are used to differentiate it from a permanent incisor?
a. Longer reserve crown and uniform opacity
b. Shorter reserve crown and uniform opacity
c. Longer reserve crown and mature root
d. Shorter reserve crown and mature root
d. Shorter reserve crown and mature root It may be clinically difficult wheter an extra tooth is a retained deciduous or a supernumerary. It is important to compare with the adjacent permanent teeth.
What are main risk factors for the developement of ESGUS and EGGUS respectively?
a. Race horse in competition eating a high concentrate/low roughage diet; stalled filly eating a mixture of oats, rice bran and cracked corn
b. Race horse in pasture supplemented with alfalfa based pellets; stalled colt eating alfalfa and commercial 12% grain
c. Pasture geriatric horse eating high concentrate/low roughage diet; pasture filly eating a mixture of oats, rice bran and cracked corn
d. Pasture yearling eating a low concentrate/high roughage diet; brood mare eating alfalfa and commercial 12% grain
a. Race horse in competition eating a high concentrate/low roughage diet; stalled filly eating a mixture of oats, rice bran and cracked corn
* ESGUS: mainly related to exercise intensity, also management changes – feeding: high-concentrate/low-roughage diets. EGGUS: in a study in thoroughbreds – gender (colts are at reduced risk, but not really sure why), trainer, no grass turnout, horses not fed haylage, feeding unprocessed grain, infrequently fed a complete diet, fast exercise in a short period of time (days_), horses that went swimming & that have been in direct contact with each other (???)._ So, diet is also a risk factor with EGGUS, but there appears to be NO direct correlation with exercise and intensity in this case.
What is the main stimulus for HCl secretion in the stomach?
a. Gastrin
b. Histamine
c. Somatostatin
d. Pepsinogen
b. Histamine
The parietal cells, mostly located in the gastric fundus, have abundant H2 receptors. These receptors once activated will initiate the production of HCl.
You present with a horse that has mild inttermitent colic and decreased fecal output. It is summer and the owners don’t check the water that often, the horse is kind of an “easy keeper”; you also notice that the grass in the pasture is quite dry. There is only a shed to protect from the sun but no natural shade from trees.
On rectal exam you can feel on the left side, with just the tip of your fingers a hard viscous, you are thinking that maybe is a cow and not a horse! On ultrasound the stomach reaches the 17th ICS. What is the most appropriate diagnosis?
a. Left dorsal displacement and impaction of the large colon
b. A type III gastric impaction and a pelvic flexure impaction
c. A type II gastric impaction most likely due to an underlying motility disorder
d. A type I gastric impaction secondary to persimmon ingestion
c. A type II gastric impaction most likely due to an underlying motility disorder
There are 3 types of gastric impactions
- Type I: is when there´s feed material impacted & the size of the stomach is NOT increased.
- Type II: it´s also feed material impacted BUT compared to Type I, the size of the stomach is much increased & possibly there´s an underlying motility disorder.
- Type III: happens with presence of a phytobezoar secondary to Persimmon seed ingestion
What is a ranula?
- Feed type associated with slaframine toxicity, causing hypersalivation
- Smooth, firm stone obstructing the parotid salivary duct
- Infection of the salivary gland, typically secondary to foreign bodies / G – bacteria
- Pocket of saliva and secretions secondary to ruptured sublingual salivary duct
d. Pocket of saliva and secretions secondary to ruptured sublingual salivary duct
a is clover, b is sialolith, c is sialoadenitis.
Ranula is specific type of salivary mucocoele
Asign the pathogen associated molecular pattern (PAMP) to the respective PRR (pathogen recognition receptor)
LPS from Gram neg bacteria –>
Lipoprotein and peptidoglycan –>
Flagellin –>
- LPS –> TLR-4 –> monocytes
- Lipoprotein (RAGE) and peptidoglycan (Nod1/Nod2) –> TLR-2
- Flagellin –> TLR-5 –> neutrophils
What is the most common adverse effect associated with the use of metoclopramide as a prokinetic agent in the horse?
- Gastroesophageal reflux
- Diarrhea
- Hindlimb paresis
- Extrapyramidal neurologic signs
d. Extrapyramidal neurologic signs
Metoclopramide can cause extrapyramidal neuro signs in horses- can reduce risk by using CRI instead of intermittent boluses.
Lolita is an 8-year-old Colombian Paso Fino mare that was imported to the United States 1 month ago and has been in training since. She has been experiencing acute abdominal pain episodes after each meal. The owners also reported that they have noticed mild weight loss in the face of the “amazing” sweet feed diet the mare is receiving.
You’re very smart indeed, therefore you suspect poor Lolita has gastric ulcers and refer her for gastroscopy. With the clinical signs mentioned, what grade of squamous ulceration are you suspecting?
At least a grade III-IV/IV
Many horses with grades I-II/IV are subclinical.
What is the primary benefit for low molecular weight heparin over unfractioned heparin in treating horses with endotoxemia?
a. Decreased cost
b. Decreased toxicity
c. Decreased agglutination
d. Decreased fever
c. Decreased agglutination
LMHW is nonagglutinating and retains anticoagulant activity via inhibition of factor Xa.
**Remember to study the coagulation cascade**
When managing a septic horse, many factors come into play, however, from the list below, which one should be managed first for a better treatment success.
a. Remove the cause of sepsis
b. Inhibit pathogen-associated molecular pattern (PAMP)-induced inflammation
c. Neutralize circulating endotoxin and PAMPs
d. Cardiovascular resuscitation
e. Prevent laminitis.
d. Cardiovascular resuscitation
- Prevent laminitis.
- Remove the cause of sepsis
- Neutralize circulating endotoxin and PAMPs
- Inhibit pathogen-associated molecular pattern (PAMP)-induced inflammation
Which intracellular process is triggered within enterocytes after bacterial infection in enteritis, causing hypersecretion and diarrhea?
- Upregulation of cyclic nucelotides (cAMP + cGMP) –> Secrete Cl into the crypt –> water follows
- Downregulation of cyclic nucelotides (cAMP + cGMP) –> Secrete Cl into the crypt –> water follows
- Upregulation of cyclic nucelotides (cAMP + cGMP) –> secrete albumin into lumen –> water follows
- Downregulation of cyclic nucelotides (cAMP + cGMP) –> Secrete albumin into lumen –> water follows
a. Upregulation of cyclic nucelotides (cAMP + cGMP) –> Secrete Cl into the crypt –> water follows
Neutrophils + other inflammatory cells interact with apical membrane, triggers intracellular pathway by making 5’-AMP –> upregulates cAMP + cGMP –> activates protein kinases – in absorptive cells, it blocks the Na + Cl absorption from the lumen, and in secretory cells, it promotes secretion of Cl into the lumen, and water follows that through the paracellular route (made more leaky by TNF-alpha) –> diarrhea.
Which of the following congenital abnormalities is associated with esophageal obstruction?
a. wry nose (campylorrhinus lateralis)
b. patent ductus arteriosus
c. persistent right aortic arch
d. pyloric stenosis
c. Persistent right aortic arch
Is the following statement true or false?
Abnormalities that involve dental development can involve tooth number, morphology, or position in the dental arcades. When talking about enamel hypoplasia, even though an association with certain drugs/ chemicals administered to the dam during gestation has not been confirmed, an underlying cause is identified in all cases.
FALSE. It CAN be idiopathic in origin, and it is believed that can be related to some drugs administered to the dam during gestation.
Which cellular signaling molecule is produced by macrophages after TLR 4 recognizes LPS, and is the central trigger for pathophysiology of septic shock?
- IL-1
- IL-6
- Interferon gamma (IFN-γ)
- Nuclear Factor K Beta (NF-KB)
Nuclear Factor K Beta (NF-KB)
NF-kB is a transcription factor that drives production of variety of pro-inflammatory mediators that wreak havoc and cause lots of bad things (see above). Macrophages produce IL-12 and IL-18, which make natural killer cells and T lymphocytes produce interferon, stimulating the cell-mediated immune response
