Brainscape's Knowledge GenomeTM

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


See full index

Gastroenterology > G9&10 > Flashcards

G9&10 Flashcards

1
Q

Which organ secretes Cu?

A

Liver

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

What is the consequence of a Cu excretion defect?

A

Secondary inflam

Fibrosis

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

6 breeds prone to Cu storage hepatitis

A 
Bedlington terrier
Lab
Dalmatian
Doberman Pinscher
WHWT
Skye Terrier
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pattern of Cu distribution in primary Cu storage disease?

A

Centrilobular

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

Pattern of Cu distribution in Cu storage disease secondary to chronic hepatitis

A

Periportal

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

A Bedlington Terrier has elevated ALT. What diagnostic test do you plan on doing and why?

A

Liver biopsy
Quantify Cu
Prone to Cu storage disease

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

Discuss medical management of Cu storage disease

A

Zinc acetate or glauconate added to diet
Binds dietary Cu
Cu chelation if systemically ill or v high Cu levels

Later maintained on hepatic diet and zinc supplement

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

What is vacuolar hepatopathy?

A

Glycogen accumulate in hepatocytes

Swelling and cholestasis

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

What drug class can cause vacuolar hepatopathy?

A

Steroids

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

What breed of dog is prone to primary vacuolar hepatopathy

A

Scottish terriers

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

What diagnostic results point to vacuolar hepatopathy?

A

Elevated:

ALP
GGT
Bile acids

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

In a case of vacuolar hepatopathy, what would ultrasound reveal?

A

Hepatomegaly

Hyperechoic liver

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

How is vacuolar hepatopathy diagnosed?

A

Presumptive based on; characteristic changes and absence of other changes on US
Cytology will show change.
Biopsy = Definitive diagnosis

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

Tx for vacuolar hepatopathy?

A

No treatment

Withdraw assaulting agent - e.g. steroid

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

What causes hepatic lipidosis?

A

Anorexia —> -ve energy balance —> Peripheral fat to liver

Dietary deficiencies in; methionine, carnitine and taurine —> Inability to process fats

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

What are the clinical signs of hepatic lipidosis?

A 
Jaundice
V+
D+
Hepatomegaly
Signs of hepatic encephalopathy
Underlying disease that led to anorexia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What blood and biochem results point to hepatic lipidosis? (Think about function)

A 
Elevated ALP, GGT, ALT
Increased bilirubin
Decreased urea
Hypokalaemia - poorer prognosis
Hypophosphataemia
Hypomagnesaemia
Prolonged PT/aPTT
Decreased Vit K recycling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What diagnostic test results (excluding bloods and biochem) point to hepatic lipidosis?

A

Rx and US - Hepatomegaly, hyperechoic liver

Cytology - Vacuolar change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is hepatic lipidosis treated?

A 
Feeding - restore +Ve energy balance GRADUALLY
Feeding tube often needed
IVFT + electrolytes
Vit K - coag
Anti-oxidants —> Replace glutathione
Prognosis good
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List examples of hepatic NPs

A 
Hepatoma
Hepatocellular carcinoma
Biliary carcinomas
Lymphoma
MCT
Haemangiosarcomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is an important differential for NP of the liver?

A

Regenerative nodules

FNA to diagnose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the 2 types of cholecystitis/cholangitis in cats

A

Neutrophilic - acute, ascending infection, E. coli

Lymphocytic - Chronic sequal to infection/immune mediated disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is triaditis and in which species is it most commonly seen?

A

Inflammation of the:
Liver
Intestines
Pancreas

Cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the most important DDx for FIP in cats and why?

A

Lymphocytic cholangitis

Due to hyperglobulinaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What diagnostic results are associated with cholangitis?

A

Neutrophilic leukocytosis
Liver enz elevation
Bilirubin and bile acids sometimes elevated
Bile cytology and culture - ± neutrophilic inflam, ±bac infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is abd US used to rule out in cholangitis?

A

Extrahepatic bile duct obstruction
Mucocele- dog
Choleliths - rare
NP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Cholangitis Tx

A

AB based on C&S
Empirical - potentiated amoxicillin
Nutritional support - risk of hepatic lipidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is extrahepatic bile duct obstruction?

A

Compression of bile duct - intra- or extraluminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Potential causes of extrahepatic biliary obstruction

A

Triaditis - or any individual component
Biliary NP
Choleliths - rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Blood work changes with extrahepatic biliary obstruction

A

Elevated cholestatic liver enzs
Elevated bilirubin
Abnormal coag panel - Decreased fat soluble Vit abs —> Vit K deficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What changes might be visible on Rx or US in extrahepatic biliary obstruction

A

Dilation of gall bladder and bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Extrahepatic bile duct obstruction Tx

A

Vit K supplementation
Anti-cholelithic drugs
Anti-oxidants
Surgery avoided

Prognosis guarded

33
Q

What is a gallbladder mucocele

A

Mucoid concentrations in gall bladder

Lead to biliary obstruction

34
Q

Gall bladder mucocele predisposing factors

A

Endocrinopathies

Some breeds - Shetland Sheepdog, Cocker Spaneil, Miniature Schnauzers

35
Q

Mucocele Clin signs

A 
Anorexia
Lethargy
V+
Jaundice
Abd pain if bile peritonitis from rupture
Often incidental diagnosis
36
Q

Gallbladder mucocele - bloods

A

Elevated cholestatic enzs

Elevated bile acids

37
Q

Gallbladder mucocele - US appearance

A

‘Kiwi’ shape

38
Q

Gallbladder mucocele Tx

A

Surgery - cholecystectomy

Medical - Ursodeoxycholic acid, low fat diet, tx underlying endocrinopathies

39
Q

What is a congenital PSS

A

Congenital vascular anomaly connecting portal circulation directly to systemic circ
Intrahepatic or extrahepatic

40
Q

Which type of PSS is more common in small breeds

A

Extrahepatic

41
Q

Which type of PSS is more common in large breeds

A

Intrahepatic

42
Q

What are the main presenting signs of PSS

A

Neurological
GI
Urinary
General body condition - small, underweight

43
Q

Congenital PSS - Discuss neurological signs

A

Hepatic encephalopathy
Due to metabolic waste products building up
Ammonia (NH3) - commonly assessed

Depression, lethargy, circling, blindness, seizures

44
Q

Congenital PSS - Discuss GI signs

A

V
D
Anorexia

45
Q

Congenital PSS - Urinary signs

A

PUPD
Urate crystals
Cystoliths

46
Q

Congenital PSS - Blood work

A

Microcytic, hypochromic anaemia
Normal to mildly elevated liv enzs
Bile acid stim test v sensitive for PSS —> Abnormal = Could be PSS, normal ≠ Not PSS

47
Q

Congenital PSS - US

A

If seen = Shunt confirmed

Not seen ≠ Not present

48
Q

Congenital PSS - How is CT used to Dx

A

Angiography

49
Q

Extrahepatic PSS - surgery

A

Attenuation of vessel

50
Q

Intrahepatic PSS - Surgery

A

Transjugular coil embolisation

51
Q

PSS surgery may not always be possible (animal/finance). Discuss PSS medical management

A

General aim to reduce ammonia production - reduce HE risk

Hepatic diet
Oral lactulose - reduces ammonia-producing bac and changes gut pH to prevent ammonia —> Ammonium (enters cells easily)
ABs
Anti-epileptics

52
Q

What are the 3 features of a hepatic diet

A

Good quality, easily digested prot
Low Cu
High Zn

53
Q

How can chronic liver disease lead to an acquired PSS?

A

Liver disease —> Fibrosis over time
Portal hypertension —> Ascites
Multiple PSSs form to alleviate hypertension
Ascites resolves

54
Q

Which region is common to find acquired PSSs?

A

R kidney region

55
Q

Acquired PSS - Tx

A

Shunt closure NOT indicated - keeping animal alive

Medical management of underlying hepatic condition or more likely supportive measures

56
Q

Acquired PSS - Medical management

A

Treat ascites - spironolactone
Anti-oxidants
Hepatic diet
Treat HE

Anti-fibrotics rarely used - side effects common

57
Q

Which species is more prone to chronic hepatitis?

A

Dogs

58
Q

Which species is more prone to suppurative cholangitis/cholangiohepatitis?

A

Cats

59
Q

Which species is more prone to EHBDO? Why?

A

Cat

Anatomical differences

Follows severe inflam/infection/NP

60
Q

Which species is more prone to hepatic lipidosis?

A

Only cats show clinical signs

61
Q

Which species is more prone to PSS?

A

Dogs

62
Q

What distinctive feature does a cat with a PSS have?

A

Cu coloured eyes

63
Q

Leptospirosis infection has what effects?

A

Hepatitis

Acute/acute-on-chronic renal failure

64
Q

Which species is more prone to leptospirosis?

A

Dogs

Cats do not show clinical signs

65
Q

When is leptospirosis more likely?

A

Autumn and Winter

In dogs in endemic areas

66
Q

What are the 2 advantages of vaccination against leptospirosis?

A 
Prevent infection (Not 100%)
Less severe clinical signs if infected
67
Q

What are the clinical signs of leptospirosis infection?

A

Acute or chronic
Liver function effected
Systemic infection

Severe cases - pulmonary pathology and blood loss anaemia

68
Q

What are the clinical signs of leptospirosis?

A 
Acute hepatitis
Hepatocellular destruction
Jaundice
Hyperbilirubinaemia
Coagulopathy - prolonged PT/aPTT
PUPD
Reticulated interstitial lung or alveolar pattern - due to bleeding
69
Q

How is leptospirosis definitively diagnosed?

A

PCR - urine&raquo_space;> blood

Serology - can be -ve in v acute infection

Either

70
Q

Why is it better to test for leptospirosis in urine over blood?

A

Leptospira not in blood for long

Urine more likely true +ve

71
Q

Leptospirosis Tx

A

Immediate amoxicillin/potentiated amoxicillin - stops shedding by 24hrs
First take urine and blood for PCR
Full eradication in confirmed cases 2 weeks doxycycline

72
Q

Why is it important to give immediate AB treatment even before PCR results confirm leptospirosis infection?

A

Zoonotic

Amoxicillin/potentiated amoxicillin stops shedding in 24 hrs

73
Q

What is the prognosis with leptosirosis infection?

A

Variable
Pulmonary involvement - Poor, may req artifical vent
Acute kidney injury - Can recover, may req. haemodialysis

74
Q

What is the prevalence of leptospirosis?

A

Becoming more common

75
Q

Why are special measures in place when dealing with leptospirosis patients? What are these measures?

A

Zoonotic

Gloves and apron min
Urine sample handled w/ gloves
Aerosols avoided
Airway protection if surgery
Flu-like symptoms - see GP
76
Q

In cats, what are the 2 most common infectious causes to rule out in hepatic parenchyma/biliary disease?

A

Toxoplasmosis (rarer in dogs)

Feline infectious hepatitis (FIP)

77
Q

In infectious hepatobiliary disease of the cat, how is toxoplasmosis tested for?

A

Serology
-ve result and acute signs, repeat 7-14 days after
Rising titers = acute infection

78
Q

Infectious hepatobilairy disease in cats - How is FIP tested for?

A

Ascites present - ‘wet form’ - PCR ascites fluid = +ve for coronavirus

‘Dry form’ - Liver biopsy to differentiate from cholangitis

Gastroenterology (4 decks)

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