Final Exam Flashcards

1
Q

What are causes of acute colitis in adult horses?

A
Salmonella
Clostridum difficile and perfringens
Enterotoxemia
Potomac Horse Fever (late spring to early fall)
Antimicrobial induced diarrhea
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2
Q

What are causes of acute colitis in foals?

A
Salmonella
Clostridium difficile and perfringens
Gastric ulcers
Rota virus
Compromised GIT
Antimicrobial induced diarrhea
Foal heat diarrhea
Equine proliferative enterotoxemia (L. intracellularis)
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3
Q

What are causes of chronic colitis in adult horses?

A

Cyathostomiasis
Sand impaction
IBD**

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4
Q

What are causes of chronic colitis in foals?

A
Villous atrophy (secondary to clostridium)
Lactose intolerance
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5
Q

What are clinical signs of acute colitis?

A
Explosive watery diarrhea
Malodorous feces
Colic
Dehydration (skin tent, prolonged CRT and jugular refill)
Depression (electrolyte imbalances in the neurons)
Laminitis
Anorexia
Pyrexia
Tachycardia
Dry or toxic mucous membranes
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6
Q

In what percent of adult colitis cases is a definitive diagnosis reached?

A

Definitive diagnosis is obtained in only about 30-50% of cases

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7
Q

Clinical pathology, biochemistry, and hematology abnormalities with acute colitis (same as for salmonellosis)

A

Leukopenia (left shift, toxic neutrophils, lymphopenia)
Metabolic acidosis (losing bicarb, hyponatremia, hypochloremia, hypokalemia, hypocalcemia)
Increase PCV and lactate
Protein and fibrinogen may be up or down
Azotemia

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8
Q

Salmonella colitis

A

ALWAYS has to be ruled out due to zoonotic potential and risk of hospital outbreak

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9
Q

Associated patient abnormalities with Salmonella

A
Acute profuse diarrhea
Endotoxemia
CV shock
Vascular leaking
Coagulopathy
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10
Q

Clinical signs of salmonellosis

A

Febrile
Tachycardic (± tachypnic)
Dehydrated

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11
Q

How can we test for Salmonella?

A

Multiple culture or PCR as it is shed intermittently, each sample needs to be minimum 5-10g of feces

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12
Q

Treatment and prevention of salmonellosis

A
Aggressive supportive care
Antimicrobials
Endotoxemia therapeutic protocol
High biosecurity
Repeat fecal culture and PCR
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13
Q

Potomac Horse Fever causative agent

A

Neorickettsia risticii

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14
Q

Clinical signs of Potomac Horse Fever

A

Biphasic fever
Laminitis
Colitis

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15
Q

Diagnosis of PHF

A

Paired serum titers and IFAT; confirmation with identification of parasite in WBCs in acute phase

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16
Q

Treatment of PHF

A

IV oxytetracycline
Supportive therapy
Laminitis prevention (ice bandages)

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17
Q

T or F: There is a vaccine for PHF.

A

True

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18
Q

Etiology of Equine Proliferative Enteritis

A

Lawsonia intracellularis

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19
Q

Clinical signs of Equine Proliferative Enteritis

A
Lethargy
Depression
Peripheral edema
Diarrhea
Colic
Weight loss
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20
Q

Typical age for horses affected by Equine Proliferative Enteropathy

A

Young (6 months old)

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21
Q

Diagnosis of EPE

A

Clinical signs
Ultrasound showing thickening of SI wall
Hypoproteinemia
Positive serology or molecular detection in feces

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22
Q

Treatment of EPE

A

Antimicrobial (macrolide + oxytetracycline/chloramphenicol) for 2-3 weeks
Correct hydration, electrolyte derangements, and azotemia if present

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23
Q

Etiology of pyogranulomatous pneumonia

A

Rhodococcus equi

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24
Q

If Rhodoccus equi is causing enterocolitis, where in the GIT is the lesion?

A

Ulcerative enteritis in the Peyer’s patches of the ileum (may extend to cecum and colon)

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25
Q

Treatment of Rhodoccus equi

A

Macrolides

Supportive therapy

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26
Q

Clostridial colitis (antimicrobial associated enterocolitis) histories

A

Farm outbreak in foals
Horse recently treated with antimicrobials
Mares when foal is being treated for R. equi
Untreated horse with diarrhea

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27
Q

Clostridial toxin A does what?

A

Induces release of substance P (neurotransmitter) at the dorsal root ganglia
This is cytotoxic

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28
Q

Clostridial toxin B does what?

A

Enterotoxigenic activity and is cytotoxic (necrotizing and hemolytic)

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29
Q

What might be visible on a radiograph of clostridial colitis?

A

Gas and fluid distended intestine with intramural gas

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30
Q

Diagnosis of clostridial colitis

A
Quantitative culture (normal flora)
PCR
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31
Q

How can we differentiate C. difficile from other clostridium?

A

Immediate submission of samples
Sending in large samples
Transportation of sample frozen and in air-tight containers
Cytotoxin assay [differentiates from C. perfringens]

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32
Q

Treatment of clostridial colitis

A

Supportive care

Metronidazole (or vancomycin if resistant to metronidazole)

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33
Q

Which two organisms are more commonly associated with neonatal enterocolitis than with adult acute colitis?

A

Cryptosporidium spp

Giardia spp

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34
Q

Inflammatory bowel disease is named based on what?

A

Histopathological findings

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35
Q

Clinical presentation of IBD

A
Progressive diarrhea
Weight loss
Good appetite
Intermittent colic
Dermatitis
Peripheral edema (hypoproteinemia)
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36
Q

Treatment of IBD

A

Steroids

Probiotics

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37
Q

Blister beetle toxicosis is caused by what?

A

Cantharidin absorption consumed in beetle infested alfalfa

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38
Q

What is the fatality rate of blister beetle toxicosis?

A

> 50%

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39
Q

How does cantharidin cause ulceration?

A

It is an irritant causing cell damage and necrosis on contact

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40
Q

What electrolyte derangements associated with cantharidin toxicosis have not been explained?

A

Hypomagnesemia

Hypocalcemia (may be loosely associated with hypoalbuminemia)

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41
Q

Diagnosis of cantharidin toxicosis via…

A

Beetle ID
History
Concentration of cantharidin in gastric juice, intestinal content, and urine

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42
Q

Treatment of cantharidin toxicosis

A
Supportive care
Electrolyte supplementation
Oral absorbents (mineral oil)
Laminitis prevention
Endotoxemia treatment protocol
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43
Q

Other things that can cause diarrhea

A
Acorn toxicity
NSAID toxicity
Grain overload
Intestinal LSA
Peritonitis
Heavy metal toxicosis
Sand colic
Enteric pythiosis
Anaphylaxis
Stress (don't we all know it...)
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44
Q

When treating a colitis patient, after normovolemia has been attained what are two tests that can help us determine adequate fluid delivery?

A

Serial central venous pressure

Serial lactate

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45
Q

Endoserum (endotoxin neutralizer) is made how?

A

Horses are vaccinated with a recombinant mutant of S. typhimurium and the antibodies are harvested

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46
Q

How does Polymyxin B work?

A

Polymyxin B binds to the lipid A region of the endotoxin, thus neutralizing it

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47
Q

What is the most effective NSAID for preventing endotoxin-induced prostanoid synthesis?

A

Flunixin meglumine

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48
Q

What drug may be beneficial in preventing laminitis?

A

Pentoxifylline

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49
Q

What are functions of the liver

A

Process nutrients from food
Store glucose, vitamins, and minerals
Maintain immune function
Remove toxins from the blood

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50
Q

What percentage of the liver has to be damaged for clinical signs to present?

A

70-80% of the liver being damaged will result in abnormal function or failure

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51
Q

Clinical abnormalities associated with liver damage

A
Icterus
Photosensitization
Hepatoencephalopathy
Coagulopathies
Colic
Pruritus
Ascites
Weight loss
Diarrhea
Rectal prolapse
Fecal color change
Dyspnea (pharyngeal or laryngeal collapse)
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52
Q

Clinical signs of acute liver dysfunction

A
Depression
Hepatic encephalopathy
Icterus
Colic
Anorexia
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53
Q

What substance can be used to test the excretory function of the liver?

A

Bromsulphalein dye

54
Q

Liver enzymes and how to interpret

A

SDH: elevation may indicate ongoing parenchymal damage
ALP: not liver specific
AST: not liver specific
GGT: elevation my indicate chronic liver disease

55
Q

What coagulation factors are produced in the liver?

A

I, II, V, VII, IX, X

56
Q

What toxicity and disease have been associated with type III photosensitization in horses?

A

Pyrrolizidine alkaloid toxicity

Theiler’s disease

57
Q

Treatment of photosensitization

A

Eliminate photodynamic agent
Provide cover from the sun
Treat as a skin burn (fluids, electrolytes, antibiotics, anti-inflammatories, pain control)

58
Q

Hepatic encephalopathy clinical signs

A
Frequent yawning
Abnormal behavior
Aimless wandering (apparent blindness) and foot stomping
Head pressing
Circling
Seizures
59
Q

How might aromatic amino acids cause hepatic encephalopathy?

A

Increase inhibitory neurotransmitters (GABA and L-glutamate)
Alter catecholamines
Alter MAOs

60
Q

What drug (and class) improves the neurologic state of hepatic encephalopathy?

A

Flumazenil (benzodiazepine antagonist)

61
Q

Etiologies of Idiopathic Acute Hepatic Disease aka “Serum sickness” aka “Theiler’s Disease”

A

Viral infection with Theiler’s disease
Hypersensitivity type III
Dietary factor (pastured horses)
Pyrrolizidine alkaloid toxicosis

62
Q

Clinical signs of IAHD

A
6-8 weeks post-vaccination
CNS signs
Icterus
Yawning (early sign)
Photodermatitis
Intravascular hemolysis w/ or w/o hemoglobinuria
Weight loss
Ventral edema
63
Q

What liver enzyme is helpful to monitor in outbreaks of IAHD

A

GGT (increased before onset of clinical signs)

64
Q

Histopathology of IAHD

A

Hepatocellular central and mid-zonal necrosis
Accumulation of mononuclear cells and neutrophils in the portal region
Bile ductule proliferation

65
Q

On necropsy, how is the liver of a patient with IAHD often described?

A

Flaccid liver or “Dishrag liver”

66
Q

Signalment for cholelithiasis

A

Middle age to older

No sex or breed predilection

67
Q

Define choledocholithiasis

A

Stone found in the common bile duct (most common biliary obstruction in equine patients)

68
Q

Composition of choleliths includes…

A
Bilirubin
Bile pigment
Cholesterol esters
Ester of cholic and carboxylic acid
Calcium phosphate
Sodim taurodeoxycholate
69
Q

Pathogenic mechanisms proposed for cholelithiasis

A
Ascending biliary infection (cholangitis)
Parasitism (ascarid)
Biliary stasis
Change in bile composition
Foreign body
70
Q

Clinical signs of cholelithiasis

A

Colic with pyrexia and icterus ongoing for 2 weeks

71
Q

Diagnosis of cholelithiasis

A

Ultrasound (75% diagnosed via this method) of the R 14-16 ICS
Hepatomegaly
Increased hepatic echogenicity

72
Q

What bacteria can be cultured in cases of cholelithiasis?

A

Bacterioides vulgatus

E. coli

73
Q

Histopathology with cholelithiasis

A

Periportal fibrosis
Bile duct hyperplasia
(Suppurative cholangitis)

74
Q

Treating cholelithiasis

A
Medical:
-broad spectrum abx
-fluids
-NSAIDs
-DMSO
-Diet
Surgical:
-choledocholithotomy
-choledocholithotripsy
75
Q

With which liver disease can we see moist exfoliative dermatitis and necrotic leathery skin along the coronary band?

A

Chronic active hepatitis

Moist exfoliative dermatitis: aseptic vasculitis

76
Q

Treatment of chronic active hepatitis

A

Supportive care
Corticosteroids (if LPC infiltrate seen on biopsy)
Antimicrobials
Anti-inflammatories
Colchine (inhibit collagen production and reduce inflammation caused by macrophages/cytokines)

77
Q

Etiology of Tyzzer’s disease

A

Clostridium piliformis (gram - anaerobic spore forming intracellular rod shaped)

78
Q

Who is most commonly affected by Tyzzer’s disease

A

Foals (7-14 d old) ESPECIALLY foals born in the spring

Rapidly fatal

79
Q

Hematology abnormalities with Tyzzer’s disease

A
Elevated liver enzymes
Severe hypoglycemia (<20mg/dL)
80
Q

Diagnosis of Tyzzer’s disease

A

PCR

Necropsy (Warthin-starry stain)

81
Q

What medications can decrease blood ammonia?

A
Mineral oil
Oral neomycin
Oral lactulose
Metronidazole
Low protein diet and small meals
82
Q

Atopic dermatitis type of reaction and clinical signs

A
Type I (IgE)
Pruritus, alopecia, erythema, urticaria, papules
83
Q

Erythema multiforme is death of what type of cells?

A

Keratinocytes

84
Q

Where does leukocytoclastic vasculitis occur and what is the age of the patient?

A

Lower extremities (pasterns) lacking pigment, mature horses

85
Q

Pemphigus foleaceus definition

A

Intra-epidermal acantholysis and intracellular deposition of immunoglobulins

86
Q

With pemphigus foleaceus, what are type of antibodies are involved and what do they target?

A

Autoantibodies targeting transmembrane proteins (releases proteolytic enzymes which destroy cell attachments causing vesicles and intraepidermal clefts)

87
Q

How is pemphigus treated?

A

Immunosuppressives

88
Q

Pemphigus vulagaris, what immunoglobulin and what is is directed against?

A

IgG against epidermal transmembrane proteins (same as pemphigus foliaceous)

89
Q

What is the common name of dermatophytosis?

A

Ringworm

90
Q

What is the causative agent of ringworm in horses?

A

Microsporum equine and Trichophyton verrucosum

91
Q

How is ringworm spread and what is the incubation period?

A
Direct contact (or grooming equipment)
Incubation period is 1-6 weeks
92
Q

What is the prognosis of dermatophytosis?

A

It is a self-limiting infection, lasting 1-4 months

93
Q

What is the treatment for dermatophytosis?

A

Topical ketoconazole shampoo
Anti-inflammatory agents
Systemic griseofulvin
Equipment disinfection

94
Q

What is the common name for dermatophilosis?

A

Rain rot

95
Q

What is the causative agent of rain rot in horses?

A

Dermatophilus congolensis, a gram +, branching, filamentous anaerobic bacteria

96
Q

What are the three conditions required for development of rain rot?

A
  1. Carrier animal
  2. Moisture
  3. Skin abrasion
97
Q

When is dermatophilosis seen most commonly?

A

Fall and winter months

98
Q

Where are dermatophilosis lesions located on the patient?

A

Dorsal aspect

99
Q

What is the treatment for dermatophilosis?

A

Remove from wet environment
Remove all crusts
Wash patient with ionophores or lime sulfur
Prescribe antimicrobials

100
Q

What part of the body is affected by equine staphylococcal cellulitis?

A

Usually the hind limbs, one limb at a time

101
Q

Clinical signs of equine staphylococcal cellulitis

A
Prominent limb swelling, warm and painful to the touch, ± pitting edema
Lameness
Pyrexia
(Lethargy)
(Anorexia)
102
Q

What leads to equine staphylococcal cellulitis?

A

Injury or trauma (including procedures)

103
Q

Treatment of staphylococcal cellulitis

A

Eliminate infection (broad spectrum abx)
NSAIDs (pain modulation)
Hydrotherapy

104
Q

T or F: surgical debridement is necessary for the treatment of equine staphylococcal cellulitis

A

If medical management fails, surgical debridement and drainage is necessary

105
Q

Who is affected by chronic progressive lymphedema most commonly

A

Draft horses

106
Q

Where on the patient is chronic progressive lymphedema noted?

A

Distal limb

107
Q

What is the causative agent of Pigeon fever?

A

Corynebacterium pseudotuberculosis (gram +)

108
Q

Where on the patient are Pigeon fever lesions found?

A

Pectoral region (rupture in 1-4 weeks)

109
Q

What is the common name for Pythium infection?

A

Swamp cancer/Florida horse leech/Kunker

Casused by Pythium insidiosum (protozoa)

110
Q

Cutaneous habronemiasis lesions are found where

A

Wound sites

111
Q

When there is a cutaneous habronemia lesion at the medial canthus of the eye, what is it called?

A

Dracocystitis

112
Q

Papillomatosis affects what age group and what is the etiology

A

Young animals most affected

BPV 1-10

113
Q

What causes aural plaques

A

Possibly viral papilloma

114
Q

T or F: aural plaques resolve spontaneously

A

F

115
Q

How are aural plaques treated?

A

Imiquimod topical

Cryosurgery

116
Q

How is SCC treated in the equine patient

A

Surgical excision
5-FU (5-flurouracil)
Intralesional cisplatin

117
Q

What is the most common tumor in horses?

A

Equine sarcoids

118
Q

What organism is associated with pathogenesis of equine sarcoids?

A

Bovine papilloma virus

119
Q

What is equine sarcoids?

A

Fibroblastic tumor, slow growing, no metastasis; NOT a benign tumor

120
Q

What are the types of equine sarcoids and what do the lesions look like?

A

Occult (circular alopecia)
Verrucous (sessile or pedunculate)
Nodular (invasive, destroying adjacent tissue)

121
Q

Treatment of equine sarcoids

A
PCR for BPV 5-6 on margin after surgical excision
Topical caustic ointment
5-FU
Intralesional chemo
Radiation
122
Q

Equine melanoma is associated with what horses

A

Gray horses

123
Q

Where are melanoma lesions commonly found

A

Ventral tail, perineum, external genitalia, lip, udder, periocular

124
Q

Treatment of melanoma

A

Excise dermal tumors
Cimetidine PO for 16wk
Cisplatin intralesional

125
Q

How is eosinophilic granuloma diagnosed?

A

Biopsy histopath reveals collagen surrounded by granulomatous inflammation (eosinophils, lymphocytes, histiocytes)

126
Q

Who is affected by hereditary equine regional asthenia

A

QH and related breeds

127
Q

What is the cause of HERDA

A

mutation in the pro collagen I N-proteinase (cyclophilin B–PPIB defect)

128
Q

What is a clinical sign of HERDA?

A

Skin on back/neck easily torn or stretched (seroma, hematoma)

129
Q

Equine B cell LSA has been demonstrated to be caused by what?

A

Estrogen secreting ovarian tumor

130
Q

What scale is used to body condition score horses?

A

Henneke (1-9)