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SAM 2 scs RUSVM > Final: GI - vomiting, SI, LI > Flashcards

Final: GI - vomiting, SI, LI Flashcards

1
Q

What is the preferred test for T. foetus ?

A

Fecal PCR

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2
Q

The large intestine is characterized by deep, straight _____ in which there are large numbers of _______.

A

Crypts

Goblet cells

*Stressed in class*

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3
Q

Why is the antigen ELISA for giardia not recommended as a recheck test?

A

Can remain positive for a long time after clearance of the disease

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4
Q

What emperic therapy do you try for a stable patient with chronic disease in which you suspect a primary enteropathy?

A

Deworming

Diet change

Antibiotic trial

+/- Pre or pro-biotics

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5
Q

A young shelter cat presents with waxing and waning LI diarrhea and a very painful edematous rectum. What is the likely diagnosis and how would you treat it? What symptoms, that usually resolve, can you expect?

A

Tritrichomonas foetus

Tx: Ronidazole (SID q2 weeks)

Neuro signs

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6
Q

Whatever the histologic type of IBD, treatment usually involves a combination of ________ with ______and/or ______ therapy.

A

Dietary modification

Antibacterial

Immunosuppressive

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7
Q

What is the most important treatment modality in idiopathic IBD?

A

Immunosuppression

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8
Q

What drugs do you give a dog with Salmon Poisoning?

A

Oxytetracycline or Doxycycline (for neorickettsia)

Praziquantel (for fluke)

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9
Q

What are the 2 most important considerations when choosing a diet to feed an animal with GI disease?

A

Nutrient content

Digestibility

*Starred on slide*

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10
Q

A young dog has developed acute colitis due to dietary indiscretion. What is your first course of therapy?

A

Withhold food temporarily and modify diet (low fat, highly digestible)

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11
Q

What cause of large bowel colitis also causes ocular and CNS signs in dogs? What is the treatment?

A

Prototheca (toxic algae)

Amphotericin B + Intraconazole

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12
Q

T/F: Most cats affected with feline idiopathic megacolon eventually require a colectomy.

A

True

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13
Q

What is the major substrate for bacteria that is not digested by the SI?

A

Fermentable fiber

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14
Q

Why should TLI/PLI, serum cobalamin and/or folate be run on a dog presenting with colitis?

A

Extension of pancreatic inflammation can cause inflammation of the adjacent regions of the colon and cause signs of colitis

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15
Q

Histoplasmosis causes chronic LI diarrhea in young dogs and cats. What stains can you use to help demonstrate the organism in fixed tissues? What is the treatment?

A

PAS and Gomori’s Methenamine silver stain

Intraconazole for 4-6 months

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16
Q

What is the term for repeated unsuccesful attempts to defecate or pain on defecation? What usually precedes this (clinical sign)?

A

Dyschezia

Staining to urinate and/or blood in urine

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17
Q

Enterotoxigenic E.coli (ETEC) causes ____ (SI/LI) disease, while enterohemorrhagic E.coli (EHEC) causes _____(SI/LI) disease.

A

ETEC= SI

EHEC= LI

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18
Q

Renal disease causes a loss of _____, with GI disease ______ and _______ are lost.

A

Albumin

Globulins and Albumin

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19
Q

What must you give a dog with Heterobilharzia americana who has hypercalcemia?

A

Praziquantel

*Starred on sides*

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20
Q

What medications can you use to treat mild histoplasmosis? Severe?

For how long do you treat?

A

Mild: Intraconazole, Fluconazole, Ketoconazole (can cause Addision’s)

Severe: Amphotericin B

Treat 6mo - 1 yr

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21
Q

What are the 3 main functions of the colonic microbiome?

A

Immune system interface

Energy for colonocytes

Synthesizing AAs and vitamins

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22
Q

If you have neuro signs accompanying GI signs in a cat, what parasite do you suspect? What eye clinical sign can this also cause?

A

T. gondii

Chorioretinitis

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23
Q

What is the diet indicated for a dog with lymphangiectasia?

A

Fat-restricted

Calorie-dense

Highly digestible

+ Fat-soluble vitamin supplements

(Do not feed weight-reduction diet)

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24
Q

What disease associated with intracellular E.coli (AIEC) occurs frequently in young Boxer dogs and causes disease limited almost exclusively to the colon? How is it characterized histologically? What is the treatment?

A

Granulomatous Colitis

(formely known as Histiocytic Ulcerative Colitis (HUC))

Histo: Presence of macrophages full of PAS-positive stain

Tx: Enrofloxacin

(Do not give immunosuppressives!)

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25
Q

In what part of the GIT are most nutrients broken down?

A

Jejunum (microvilli of the)

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26
Q

Is cell turnover faster or slower in the large intestines (compared to SI)? How long is turnover?

A

Slower

LI= 4-7 days

(SI=3 days)

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27
Q

Impairement of Pattern Recognition Receptors, found on _____, are thought to be involved in IBD.

A

Phagocytes

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28
Q

What is the main energy requirement of enterocytes? What occurs when this is absent (4 things) ? What does this look like clinically?

A

Glutamine

Decline in villi structure, loss of epithelial integrity, decreased immune function, decreased absorptive function

CS: Weight-loss, secondary bacterial infections (-> sepsis), unthrifty

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29
Q

What are the most common biopsy diagnoses?

A

Inflammatory bowel disease (several types)

Lymphangectasia

Lymphoma

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30
Q

What are the 2 reasons a dog with colonic disease may be losing weight?

A

Concurrent small intestinal disease

Advanced disease

(Things that cause inappetence)

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31
Q

What are the fat soluble vitamins?

A

Vit A, D, E, and K

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32
Q

What kinds of antidiarrheals may bind bacterial toxins and produce firmer stool? What can you give to reduce tenesmus?

A

For diarrhea: Kaolin-based

For tenesmus: Diphenoxylate or Loperamide

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33
Q

T/F: The long-term prognosis for lymphangiectasia is poor and patients almost invariably succumb ultimately to severe malnutrition, incapacitating effusions, and intractable diarrhea.

A

True

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34
Q

Tenesmus, increased urgency, and watery diarrhea is indicative of _________ disease.

A

Large bowel/intestine

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35
Q

You have a feline patient with severe pancreatitis. On the blood work you have elevated bilirubin and mildly elevated AST. What is causing the elevated bilirubin?

A

Cholestasis due to duct obstruction

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36
Q

Sher Pai, Giant Schnauzers, Beagles, and Border Collies get a congenital deficiency of which vitamin?

A

B-12

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37
Q

What 2 lipases digest short and medium chain fatty acids?

A

Lingual

Gastric

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38
Q

Which dog breed(s) get(s) gluten-sensitive enteropathy?

A

Irish Setter

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39
Q

Which 4 breeds commonly get PLE?

A

Wheaton Terrier

Lundehund

Yorkie

Rotties (in Europe)

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40
Q

How long does a dog with parvovirus shed?

A

While sick and up to 8-10 days after acute illness

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41
Q

What can you use in combination with pred to treat IBD when the initial response to therapy is poor or the steroid side effects are marked?

A

Azathioprine

Make sure you warn owner that drug is toxic also must monitor CBC (myelosuppressive)

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42
Q

T/F: Most cats affected with feline idiopathic megacolon eventually require a colectomy.

A

True

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43
Q

Which of the following is not associated with large bowel diarrhea?

Fecal volume normal to mildly increased

Urgency and marked increase in frequency

Steatorrhea

Tenesmus

Hematochezia

Melena

A

Melena

Steatorrhea

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44
Q

The large intestine secretes mucus and _______.

A

Bicarbonate

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45
Q

What is the preferred diagnostic test for T. gondii in a sich pet?

A

Antibody titers for IgG and IgM

However note, positive titers do not indicate oocyst shedding or clinical diseae esp if only IgG is +

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46
Q

T/F: Performing a canine parvo SNAP test on a kitten showing parvo signs can help diagnose feline panleukopenia.

A

True

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47
Q

What makes the prognosis for AHDS poor?

A

Hypoproteinemia and sepsis

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48
Q

What drug can be used off-label to treat IBD by immunosuppression in a diabetic patient?

A

Apoquel (need ihgh dose, does not affect glucose metabolism)

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49
Q

What are the 2 drugs you can use to treat Giardia duodenalis? For how long do you treat?

A

Fenbendazole

Metronidazole

5 days

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50
Q

What is associated with peri-natal infection with feline panleukopenia?

A

Cerebellar hypoplasia

Can improve clinically over time

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51
Q

This radiograph is from a dog that presented for coughing. What are your 3 DDx/rule-outs?

A

Neoplasia

Heart failure

Fungal disease

52
Q

What must you give a dog with Heterobilharzia americana who has hypercalcemia?

A

Praziquantel

*Starred on sides*

53
Q

A dog presents to you with high fever, hematochezia, hematemsis, enlarged lymph nodes as well as ocular discharge. The CBC shows thrombocytopenia. He has lost so much blood that a transfusion is indicated. You have ruled out fungal disease. What is your top DDx?

A

Salmon Poisoning Disease

54
Q

What clinical staple item can decrease the sensitivity of the parvo SNAP test?

A

Lubricant

55
Q

Which virus can mutate to manifest as FIP?

A

Feline Enteric Coronavirus

56
Q

T/F: Coccidiosis can be self-limiting in healthy adults, but in young or immunocompromised animals can cause ilness including anorexia, vomiting and diarrhea.

A

True

57
Q

Why are antibiotics indicated with parvovirus infeciton?

A

To decrease the risk of sepsis - GIT protection is striped by the virus so secondary bacterial infection is facilitated

58
Q

Where does Ondansetron work to inhibit vomiting?

A

Directly in the stomach

59
Q

Which of the following is found in the small intestines but NOT in the colon?

Intestinal crypts

Intestinal villi

Muscularis

Myenteric nerve plexus

Goblet cells

A

Intestinal villi

*Stressed in class*

60
Q

What zoonotic anaerobic bacterium destroys the intestinal villi in young, parasitized, immunocompromised, or stressed kennel dogs?

A

Salmonella

61
Q

Colitisis considered chronic if it lasts longer than _____ days/weeks/months

A

3 weeks

62
Q

What are the 2 most common clinical signs of colonic disease? Name some signs that are unique to colonic disease.

A

1 Diarrhea

CS: Frank blood, mucus, tenesmus, dyschezia, urgency

63
Q

The large intestine secretes mucus and _______.

A

Bicarbonate

64
Q

T/F: The gut mucosa hosts the largest population of immune cells in the body.

A

True

65
Q

What are the 2 pathologic mechanims through which megacolon develops? What is the underlying cause of each?

A

Dilation- caused by obstruction

Hypertrophy - caused by e-lyte abnormalities, neuromuscular disorders (or idiopathic)

66
Q

The neurotransmitter subtance ___ binds to _____ receptors in the CRTZ, creating a lock and key effect that initiates vomiting.

Which drug directly targets the NK1 receptor to stop vomiting?

A

P

NK1

Cerenia (which also helps to control pain)

67
Q

Which of these is not a clinical sign associated with small intestinal disease?

Vomiting

Tenesmus

Melena

Increased fecal volume per defecation

Weight-loss

Skin and coat changes

A

Tenesmus

68
Q

What is one action that ranitidine has that other H2 blockers (Femotidine) and Omeprazole do not?

A

Mildly increases GI motility

69
Q

T/F: Salmon Poisoning is a self-limiting disease and can be treated wih supportive theray.

A

False, death in up to 90% of untreated animals

70
Q

T/F: You should advise an owner who had a puppy with parvo at home not to get another puppy for at least 1 year.

A

True

Remains infectious in the environment for long time

71
Q

What are the 2 medications you can use to trat pythiosis? Are there any side effects to either medication? How long must you treat?

A

Intraconazole

Terbinafine - hepatotoxic

2-3 months

Note: Low chance of survival with meds alone

72
Q

What is the term for repeated unsuccesful attempts to defecate or pain on defecation? What usually precedes this (clinical sign)?

A

Dyschezia

Staining to urinate and/or blood in urine

73
Q

What are the 2 most common types of IBD?

A

Lymphocytic-Plasmacytic Enteritis (LPE) - more common

Eosinophilic Enteritis (EE)

74
Q

What 2 drugs can be used to treat C. parvum?

A

Tylosin

Paromomycin

75
Q

A 3 year old King Charles presents to you with profuse hemorrhagic diarrhea resembling raspberry jam, vomiting, and lethargy. You notice a marked increase in PCV with a normal TP. What is your suspected diagnosis?

A

Acute Hemorrhagic Diarrhea Sydrome

(old name= Hemorrhagic gastroenteritis (HGE))

76
Q

Which of the following is not associated with large bowel diarrhea?

Fecal volume normal to mildly increased

Urgency and marked increase in frequency

Steatorrhea

Tenesmus

Hematochezia

Melena

A

Melena

Steatorrhea

77
Q

A young shelter cat presents with waxing and waning LI diarrhea and a very painful edematous rectum. What is the likely diagnosis and how would you treat it? What symptoms, that usually resolve, can you expect?

A

Tritrichomonas foetus

Tx: Ronidazole (SID q2 weeks)

Neuro signs

78
Q

What do you call intractable constipation that has become refractory to cure or control? What does it imply? What is the end stage?

A

Obstipation

Implies permanent loss of function

End stage: Dilated megacolon

79
Q

T/F: ARD is the name given to the condition in which SIBO is a clinical sign or secondary pathogenic mechanism. This is because a positive response to a range of antibiotics is usually seen.

A

True

*Starred on slide*

80
Q

What does low cobalamine cause in the SI?

A

Blunting of microvilli

81
Q

What toxin produced by Clostridium perfringens causes acute and often hemorrhagic enterocolitis in dogs? How is it treated? What is it often resistant to?

A

Type A toxin + Enterotoxin, aka Clostridium Perfringens Enterotoxin (CPE)

Metronidazole, Amoxicillin, Erythromycin, Tylosin

Commonly resistant to Tetracyclines

82
Q

What are the 5 criteria for diagnosing IBD?

A
  1. Chronic (>3wks) GI signs
  2. Histopathologic evidence of mucosal inflammation
  3. All other diagnostic tests negative (inability to document other causes of gastroenterocolitis by thorough diagnostic evaluation)
  4. aInadequate response to therapeutic trials (ppropriately designed and implemented ) (meds and diet)
  5. Clinical response to anto-inflammatory or immunosuppressive drugs
83
Q

T/F: Campylobacter and Clostridium species can be cultured from both healthy and diarrheic dogs.

A

True

84
Q

What do you expect on your CBC/Chem from a dog with pythiosis? How is pythiosis diagnosed pre-treatment?

A

CBC: eosinophilia, anemia

Chem: hypoALB, hyperGLOB

Dx: ELISA (for antibody)

85
Q

Which form of E.coli produces a Shiga-like tocin which kills colonocytes resulting in hemorrhagic diarrhea? How can you differentiate this from the other types of E.coli?

A

EHEC (Enterohemorrhagic)

PCR

*Stressed in lecture*

86
Q

What is commonly seen on laboratory analysis of blood in a dog with lymphangiectasia?

A

Panhypoproteinemia

Hypocholesterolemia

Lymphopenia

(Due to leakage of lymph)

87
Q

Hyperechoic mucosal striations on US in a dog with weight-loss, diarrhea, steatorrhea and polyphagia indicate which disease?

A

Lymphangiectasia

88
Q

What do you call intractable constipation that has become refractory to cure or control? What does it imply? What is the end stage?

A

Obstipation

Implies permanent loss of function

End stage: Dilated megacolon

89
Q

What kinds of antidiarrheals may bind bacterial toxins and produce firmer stool? What can you give to reduce tenesmus?

A

For diarrhea: Kaolin-based

For tenesmus: Diphenoxylate or Loperamide

90
Q

When providing fluid therapy, what do you monitor to make sure the kidneys are not being adversly affected?

A

Azotemia

91
Q

What will you find on your blood test results in a dog with whipworm?

A

Hyperkalemia

Hyponatremia

Pseudo-Addison’s Disease (Do ACTH stim - results will be normal)

92
Q

T/F: Bacterial organisms represent approximately 90% of fecal dry matter.

A

False, 50%

93
Q

What are the top 3 bacteria associated with intestinal disease?

A

Salmonella

Escherichia coli

Campylobacter

94
Q

What is at the top of you DDx list if you see a dog with vomiting, weight-loss, apparent back pain, SI diarrhea, and non-healing skin lesions?

A

Pythium insidiosum

95
Q

Which hypersensitivity reaction is not food related?

A

Type III

(Immune-complex mediated)

96
Q

Enlargement of which lymph nodes is indicative of fungal disease rather than lung neoplasia?

A

Hilar

Sternal

Tend to not be enlarged w/cancer

97
Q

When palpating a dog you note pain in the right dorsal area. What 2 organs could be the origin of the pain?

A

Duodenum

Pancreas

98
Q

T/F: Giardia, Tritrichomonas foetus, Coccidia, Cryptosporidium and Toxoplasma gondii are all bacteria which can cause small intestinal disease.

A

False, they’re protozoa

99
Q

T/F: Bacterial organisms represent approximately 90% of fecal dry matter.

A

False, 50%

100
Q

Enterotoxigenic E.coli (ETEC) causes ____ (SI/LI) disease, while enterohemorrhagic E.coli (EHEC) causes _____(SI/LI) disease.

A

ETEC= SI

EHEC= LI

101
Q

In which species are the bile and pancreatic duct usually fused?

A

Feline

102
Q

Which opportunistic infection is accociated with disruption of mucosal integrity, and can cause peritonitis in dogs and pyothorax in cats?

A

Candidiasis

103
Q

How long is the turnover time of enterocytes?

A

3 days

104
Q

What 3 reasons are there for a dog with colonic diseasse to be vomiting?

A

Constipation

Systemic illness

Concurrent small intestinal disease

105
Q

What are your 3 DDx etiologies for a dog with hematemesis or hematochezia with a PCV >60% and a normal TP?

A

Viral

Hypersensitivity reaction

Infection (Clostridium perfringens)

106
Q

What are the 3 main functions of the colonic microbiome?

A

Immune system interface

Energy for colonocytes

Synthesizing AAs and vitamins

107
Q

What do you need to add to your IBD treatment if you have PLE?

A

Cytotoxic drugs

108
Q

T/F: Stress colitis can cause acute small or large bowel diarrhea.

A

False, large bowel only

109
Q

Which of the following is found in the small intestines but NOT in the colon?

Intestinal crypts

Intestinal villi

Muscularis

Myenteric nerve plexus

Goblet cells

A

Intestinal villi

*Stressed in class*

110
Q

What is the diseasethat occurs segmentally in the gut and causes marked dilation and dysfunction of intestinal lymphatics?

A

Lymphangiectasia

111
Q

Which species is small cell lymphoma more common? What is the indicated treatment?

A

Felines

Chlorambucil + Prednisolone

112
Q

T/F: Feeding a fiber-free diet has been shown to induce colitis.

A

True

113
Q

A young dog has developed acute colitis due to dietary indiscretion. What is your first course of therapy?

A

Withhold food temporarily and modify diet (low fat, highly digestible)

114
Q

What are the 3 most common causes of PLE?

A

Lymphoma

IBD

Lymphangiectasia

115
Q

The cells on the tips of the intestinal villi are formed in the ____ and migrate up.

A

Intestinal crypts/ Crypts of Lieberkuehn

116
Q

T/F: Feeding a fiber-free diet has been shown to induce colitis.

A

True

117
Q

What effect, rather than its antibacterial activity, makes Metronidazole a good choice for a cat with IBD?

A

Immunomodulatory effects on cell-mediated immunity

118
Q

What are the 2 pathologic mechanims through which megacolon develops? What is the underlying cause of each?

A

Dilation- caused by obstruction

Hypertrophy - caused by e-lyte abnormalities, neuromuscular disorders (or idiopathic)

119
Q

The mucosa of the colon is made up of simple columnar epithelium in addition to immune system cells. The epithelium is made up of 2 cell types. What are these?

A

Mucus secreting cells

Absorpive epithelial cells

*Stressed in class*

120
Q

What disease associated with intracellular E.coli (AIEC) occurs frequently in young Boxer dogs and causes disease limited almost exclusively to the colon? How is it characterized histologically? What is the treatment?

A

Granulomatous Colitis

(formely known as Histiocytic Ulcerative Colitis (HUC))

Histo: Presence of macrophages full of PAS-positive stain

Tx: Enrofloxacin

(Do not give immunosuppressives!)

121
Q

How many days afer infection do you expect a puppy who has contracted parvo to show clinical signs?

A

4-7 days

122
Q

Aside from bacteria, what can Metronidazole kill?

A

Parasites (certain)

123
Q

What are 2 drugs that can be used to treat toxoplasmosis? For how long do you treat?

A

Trimethoprim-suphonamide (preferred)

Clindamycin

4 weeks

124
Q

What is defined as an increase in the absolute number of bacteria in the upper SI during the fasted state?

A

SIBO (Small Intestinal Bacterial Overgrowth)

125
Q

A young German Shepherd presents to you with stunted growth, large volume but normal frequency diarrhea, flatulence, and vomiting. The owner says she can hear the stomach growling and gurgling a lot. What condition is on top of your DDx? How can you diagnose it?

A

Antibiotic Responsive Diarrhea

Response to treatment trial: Metronidazole or Tylosin

126
Q

What is the difference between a prebiotic and a probiotic?

A

Prebiotic = promote bacterial growth

Probiotic= the actual bacteria

SAM 2 scs RUSVM (14 decks)

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