Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SA DX & TX II > Exam 3 - Pancreatitis > Flashcards

Exam 3 - Pancreatitis Flashcards

1
Q

what is more common - acute or chronic pancreatitis?

A

chronic pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are some challenges for diagnosing pancreatitis on ultrasound in regards to sensitivity?

A

sensitivity is largely operator dependent!!!!!

sensitivity is lower with less severe disease & limited operator skill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some challenges for diagnosing pancreatitis on ultrasound in regards to specificity?

A

specificity is limited by other conditions being associated with similar changes - hyperplastic nodules on the pancreas, pancreatic edema, & peritoneal effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some possible ultrasound findings for a patient with pancreatitis?

A

enlargement of the organ

fluid around the pancreas

echogenicity changes of the pancreas - if decreased, necrosis & if increased, peripancreatic fat necrosis

dilation of the pancreatic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are 4 components that make up the challenges encountered in using ultrasound to diagnose pancreatitis?

A

severity of disease

quality of the equipment used

level of suspicion

skill of the operator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T/F: MRI is used for routine diagnosis of pancreatitis

A

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the best diagnostic imaging used in humans for diagnosing pancreatitis? is it the same in companion animals?

A

ct in humans

no - the organ is so small, CT isn’t too great

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

the CBC & chemistry on a pancreatitis patient will have a variety of changes observed & none of which are specific for pancreatitis - why is it still important to run?

A

you need to evaluate the patient for systemic complications!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

is serum amylase activity useful in diagnosing pancreatitis in dogs & cats? why?

A

no - can be elevated in some dogs with pancreatitis but rarely in cats, can also be elevated in dogs with non-pancreatic conditions

low sensitivity & specificity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T/F: most point of care analyzers for lipase activity are based on dry chemistry

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the most specific assay used for the measurement of pancreatic lipase?

A

spec cPL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

is serum lipase activity useful for diagnosing a dog or cat with pancreatitis? why?

A

NO - none of the substrates are truly specific for pancreatic lipase/pancreatitis

depends on the substrate elevated in dogs/cats with spontaneous pancreatitis

limited diagnostic value in dogs & cats - sensitivity/specificity are dependent on the substrate & cut-off values

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the most sensitive & specific test available for canine/feline pancreatitis?

A

canine pancreatic lipase immunoreactivity - cPLI, both spec & SNAP tests

feline pancreatic lipase immunoreactivity - fPLI, both spec & SNAP tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what does a negative SNAP cPLI/fPLI tell you?

A

rules out pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does it mean if you have a patient that has a positive cPLI/fPLI SNAP test? what should you do next?

A

need to run a spec cPL/fPL to confirm your diagnosis & to get a baseline value for monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which of these cPLI/fPLI tests suggests an abnormal result?

A

the one on the right is abnormal - dot on the right is darker than the control dot on the left

17
Q

is the VetScan cPL test useful? why?

A

assay shows poor linearity - may be clinically relevant because the assays working range is only up to 600-700 ug/L

poor precision & poor reproducibility

18
Q

what is a pancreatic cytology useful for confirming? what is it not useful for ruling out?

A

high specificity for confirming an inflammatory process

not very useful to rule out an inflammatory process - low sensitivity

19
Q

what is the safest way to get cytology of the pancreas in dogs & cats?

A

FNA - safe

20
Q

why are multiple biopsies needed of the pancreas when trying to diagnose pancreatitis?

A

pancreatitis is highly localized - need to biopsy for confirmation of diagnosis

21
Q

what are the components of management for acute pancreatitis in dogs/cats?

A

treatment of identified risk factors - hypercalcemia, hypertriglyceridemia

treatment of hypovolemia - aggressive fluid therapy

limit exposure to unnecessary drugs - especially those associated in causing pancreatitis

nutritional support

rigorous monitoring & early intervention against complications

analgesia

antiemetics

22
Q

what are some complications seen in cats & dogs with acute pancreatitis?

A

electrolyte & acid/base imbalances

DIC

myocarditis

acute renal failure, pulmonary failure, & multi-organ failure

23
Q

T/F: routine NPO is no longer suggested for patients with acute pancreatitis

A

true

24
Q

how is nutritional support used in patients with pancreatitis?

A

enteral nutrition is preferred to parenteral nutrition

pre-pancreatic nutrition

25
Q

why is analgesia important for patients with pancreatitis?

A

abdominal discomfort is the key clinical sign in humans with pancreatitis but isn’t commonly noted in veterinary patients

becomes apparent after analgesic therapy has been started

26
Q

why not use metoclopramide in patients with pancreatitis?

A

weak anti-emetic & is a dopamine inhibitor, so it may have negative effects on pancreatic perfusion

27
Q

are antibiotics commonly used for patients with pancreatitis?

A

no - rare infectious causes

dogs & cats with severe acute pancreatitis usually don’t reach the late stage of disease

28
Q

what is fuzapladib?

A

novel drug that acts as a LFA-1 inhibitor that is approved for canine pancreatitis in Japan that has shown promise

29
Q

how is chronic pancreatitis managed?

A

treatment of the cause

treatment of the concurrent conditions - such as IBD, hepatitis, & diabetes mellitus

analgesia

nutritional support - very important in dogs, very low fat diet & only low-fat treats

anti-nausea drugs & appetite stimulants

30
Q

what drug is a very effective choice for appetite stimulation in cats?

A

mirtazapine

31
Q

what drug is a very effective choice for appetite stimulation that is licensed for use in dogs & cats?

A

capromorelin

32
Q

how are patients with chronic pancreatitis monitored?

A

serum spec cPL in dogs/serum spec fPL in cats

every 2-3 weeks after resolution of pancreatitis with decreasing frequency

33
Q

what is the pathogenesis of autoimmune pancreatitis?

A

associated with lymphoplasmacytic infiltrates that is mostly centered around the pancreatic ducts with inflammatory cells staining positive for IgG

associated with severe swelling of the pancreas - patients often suspected of having pancreatic neoplasia

34
Q

how are patients with autoimmune pancreatitis treated?

A

corticosteroids

35
Q

T/F: many dogs & cats with chronic pancreatitis have a lymphocytic-plasmacytic infiltration of the pancreas

A

true

36
Q

why are dogs & cats with chronic pancreatitis treated with immunosuppressive doses of steroids or cyclosporine instead of azathioprine?

A

azathioprine is associated with pancreatitis

SA DX & TX II (62 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions