Equine GI 2 Flashcards
Which of the following forms of IBD is most likely to have an acute presentation with colic signs and normal plasma protein concentration?
a. Multisystemic eosinophilic epitheliotrophic disease (MEED)
b. Lymphocytic-plasmacytic enterocolitis
c. Idiopathic focal eosinophilic enteritis (IFEE)
d. Granulomatous enteritis
c. Idiopathic focal eosinophilic enteritis (IFEE)
- Lesions –> intramural masses or cincunferential mural bands
- Eosinophils and lymphocytes infiltrating all layers
- Most likely a focal exacerbation of diffuse eosinophilic enteritis
In horses with duodenitis-proximal jejunitis, which of the following is NOT a negative prognostic indicator?
a. Elevated serum GGT activity
b. Abdominal fluid protein concentration > 3.5 g/dL
c. Presence of hemorrhagic gastric reflux
d. Anion gap > 15 mEq/L
a. Elevated serum GGT activity
- Horses with DPJ may also have increase in D-dimer
- The increase in GGT activity can be also used to differentiate with SISO
- Histopathologic evidence of liver pathology is a common feature in DPJ
First target of salmonella once in the GI system
a. Crypt cells of distal ileum and cecum
b. Intestinal lymphoid tissue (M cells)
c. Peyer patches and submucosal cells
d. Kupffer cells for replication prior to colonization of enterocytes
b. Intestinal lymphoid tissue (M cells)
Which of the following is the primary control for the inherent rhythmicity and primarily responsible for generation of slow waves within the intestine?
a. Vagus nerve
b. Sympathetic root
c. Interstitial cells of Cajal
d. Migrating motility complexes
c. Interstitial cells of Cajal
Responsible for generation and propagation of slow waves and pacemaker activity.
Reduction of ICC has been demonstrated in equine grass sickness
Main target cells of N. risticii
a. Monocytes, macrophages
b. Monocytes, mast cells
c. Submucosal lymphocytes
d. Submucosal neutrophils
a. Monocytes, macrophages
- Colonic and small intestinal epithelial cells
- Colon mast cells
Which of the following is NOT bordering the epipolic foramen?
a. caudate lobe of the liver
b. caudal vena cava
c. diaphragm
d. portal vein
c. diaphragm
- Caudate process of the liver and caudal vena cava
- Pancreas, hepatoduodenal ligament, portal vein
What is the mechanism of action of bethanechol within the GI tract?
a. Ach receptor agonist –> binds to muscarinic receptors @ myenteric plexus + smooth muscle cells –> Promotility
b. Ach receptor agonist –> binds to adrenergic receptors @ myenteric plexus + smooth muscle cells –> Promotility
c. Ach receptor antagonist –> binds to muscarinic receptors @ myenteric plexus + smooth muscle cells –> Slows motility
d. Ach receptor antagonist –> binds to adrenergic receptors @ myenteric plexus + smooth muscle cells –> Slows motility
a. Ach receptor agonist –> binds to muscarinic receptors @ myenteric plexus + smooth muscle cells –> Promotility
- > M3 receptors
- Not degraded by anticholinestherase
- Efffect throughout the GI tract
What is the most important feature that differentiate DPJ from a strangulating intestinal obstruction?
a. Peritoneal fluid is turbid but not sanguineous
b. Disproportion of increase in TP compared to WBC in peritoneal fluid (increase TP relative to WBC)
c. Relative increase in peritoneal lactate is less than SIO
d. Peritoneal fluid glucose decrease is less sensitive than SIO
b. Disproportion of increase in TP compared to WBC in peritoneal fluid (increase TP relative to WBC)
* In strangulating lesion, peritoneal fluid WBC/TP is usually >3
What is the best diagnostic test for Potomac Horse Fever?
a. Acute + convalescent samples for titers by ELISA
b. Acute + convalescent samples for titers by IFA
c. Fecal PCR + serum ELISA at presentation
d. Whole blood PCR at presentation
d. Whole blood PCR at presentation
Where do you expect to find the DNA?
Why not serology?
Toxic dose for cantharidin toxicity
a. < 0.5 mg/kg; 2 g of dead beetles (~50)
b. < 2 mg/kg; 8-10 g of dead beetles (~200)
c. <1 mg/kg; 4-6 g of dead beetles (~100)
d. >10 mg/kg; 45-50 g of dead beetles (~1,200)
c. <1 mg/kg; 4-6 g of dead beetles (~100)
What is the causative agent and treatment of choice for atypical septic peritonitis that is markedly responsive to medical therapy and has 100% short-term survival?
a. Streptococcus equi - Penicillin
b. Actinobacillus equuli - Penicillin + gentamicin
c. Rhodococcus equi - Clarithromycin
d. Lawsonia intracellularis - Oxytetracycline
b. Actinobacillus equuli - Penicillin + gentamicin
Thought to be secondary to translocation of the bacteria from the GI tract or associated with Strongylus migration
An owner wants you to vaccinate his horse for PHF. The horse lives in the SE, and you are hesitant to give the vaccine. How can you justify your position? I know you are stubborn, but the owner is even worse!
a. The vaccine is efficacious, but it is expensive and there is very low prevalence of the disease
b. The vaccine is efficacious, but the adverse effects in the face of a low prevalence justify not to use it
c. The vaccine fails due to the presence of different strains, which is higher in areas with low prevalence
d. The vaccine fails due to the presence of different strains, and it is recommended only in endemic areas
d. The vaccine fails due to the presence of different strains, and it is recommended only in endemic areas
* Failure up to 89%
What is the optimal diagnostic testing plan in a foal suspected to have Lawsonia intracellularis?
a. Fecal PCR & Serum PCR
b. Fecal PCR & Serum serology (ELISA or IPMA)
c. Fecal ELISA & Serum PCR
d. Fecal PCR alone
b. Fecal PCR & Serum serology (ELISA or IPMA)
- Both have high specificity but variable sensitivity
- Negative PCR: previous ATB treatment or advanced disease
- Real-tiime PCR > sensitivity
- Negative serology: early stage of disease
- IPMA has > sensitivity
Which characteristic electrolyte derangement is associated with Cantharidin toxicity?
a. Hypocalcemia
b. Hypercalcemia
c. Hypokalemia
d. Hyperkalemia
a. Hypocalcemia
- Both hypocalcemia and hypomagnesemia are common features
- Synchronous diaphragmatic flutter is often observed
Best disinfectant to kill the clostridium spores
a. Iodine
b. Sodium hypochlorite
c. Formalin
d. Hydrogen peroxide
b. Sodium hypochlorite
What is the mechanism for heparin to prevent intra-abdominal adhesions?
a. Decrease fibrin formation by inhibiting thrombin
b. Decrease fibrin formation by promoting thrombin
c. Decrease fibrin formation by increasing endothelial tight junctions in capillaries
d. Increase fibrin formation by inhibiting thrombin
a. Decrease fibrin formation by inhibiting thrombin
Which one is less likely a possible etiologic agent of DPJ in horses?
- Clostridium perfringes
- Clostridium dificile
- Clostridium novyi
- Salmonella
- Fusarium moniliforme
c. Clostridium novyi
All of the others are possible agents, but the disease is likely multifactorial.
In equine proliferative enteropathy, which is the most characteristic lesion?
a. Hyperplasia of the enterocytes of the distal duodenum
b. Proliferative adenomatosis of the distal jejunum and ileum
c. Increase mitosis of cells in the crypt cells of proximal duodenum
d. hyperplasia of the muscularis and lamina propria of the distal jejunum and ileum
b. Proliferative adenomatosis of the distal jejunum and ileum
- Invasion of proliferative crypt cells in the ileum → ↑ mitotic division → hyperplasia
- Weight loss is usually the first sign observed
How can a horse acquire PHF?
a. Contact of infected fluke larvae with open wound
b. Ingestion of N. risticii carried in houseflies secretions
c. Ingestion of aquatic insects or ingestion of infected fluke larvae
d. Ingestion of contaminated deer feces or ingestion of aquatic insects
c. Ingestion of aquatic insects or ingestion of infected fluke larvae
* Contaminated fluke is available from snail secretions
What is the pathologic lesion in lethal overo white syndrome?
a. Blind-ended, non-continuous segment of large colon, from mutation in endothelin receptor type B gene
b. Blind-ended, non-continuous segment of large colon, from ischemic vascular event during embronic development
c. Continuous intestinal tract with myenteric aganglionosis, from mutation in endothelin receptor type B gene
c. Continuous intestinal tract with myenteric aganglionosis, from ischemic vascular event during embronic development
c. Continuous intestinal tract with myenteric aganglionosis, from mutation in endothelin receptor type B gene
- What is the mutation trait?
- Which phenotype of mare and sire is at higher risk?
The incidence of duodenal ulcer disease is greater in foals <1 yo and it’s believe to be associated with rotavirus infection and/or H. Pylori infection.
a. True
b. False
False. In the 80’s it was thought to be associated with rotavirus infections however it has been proven that most foals with duodenal ulcer disease are not infected with rotavirus. Also, the relation to H. pylori infection it’s in humans but has not been proven in equines.
In weanlings infected with L. Intracellularis, the mechanism of enteritis involves:
a. There’s severe edema of the small intestines and secondary hypoalbuminemia due to protein loss via the gastrointestinal tract.
b. Invasion of the proliferating crypt cells in the ileum by the bacteria causes excessive mitotic division and severe hyperplasia, which leads to limited brush border development and decrease absorptive capacity.
c. The main differential diagnosis is salmonellosis as it can also cause ulceration in the areas of the Peter patches throughout the small intestine, cecum and colon.
b. Invasion of the proliferating crypt cells in the ileum by the bacteria causes excessive mitotic division and severe hyperplasia, which leads to limited brush border development and decrease absorptive capacity.
The crypts are elongated and tortuous with marked proliferation of enterocytes and occasionally goblet cells
What is the most sensitive testing protocol for Lawsonia?
a. IPMA serology alone
b. fecal PCR alone
c. fecal PCR + IgM titer ELISA
d. fecal PCR + IPMA serology
d. fecal PCR + IPMA serology
Best to do molecular AND serology to increase sensitivity (increased chances of detection)- fecal shedding low after treatment or in late-stage disease, and serology low early in disease. Immune peroxidase monolayer assay works better than ELISA in horses.
Which one is NOT a risk factor for shedding of salmonella in hospitalized horses?
a. Horses admitted for colic
b. Diarrhea and antibiotic use
c. Presence of reflux
d. Severe GI disease
b. Diarrhea and antibiotic use
What is the most consistent finding of clinical equine proliferative enteropathy (EPE)?
a. hyperlactatemia
b. hyponatremia, hypochloremia
c. hyperglobulinemia, hyperfibrinogenemia
d. hypoalbuminemia
d. hypoalbuminemia
The horse from the picture has a history of weight loss and intermittent diarrhea. The owner is worried about sand enteropathy, however no sand is seen on radiographs. What is the most likely cause of the horse’s condition?
a. Parasitemia due to small strongyles
b. Lymphocytic-plasmacytic enterocolitis
c. Pemphigos foliaceous
d. Multisystemic eosinophilic epitheliotropic disease (MEED)
Which other tests might be useful to support your diagnosis?
d. Multisystemic eosinophilic epitheliotropic disease (MEED)
- Liver enzymes (GGT)
- Abdominocentesis (↑TP ↑WBC)
- +/- glucose absorption test (LI>SI)
