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Preeti: SAM II > Gastric Diseases > Flashcards

Gastric Diseases Flashcards

1
Q

Which parts of the stomach expand to accomodate food?

A

Fundus and Body

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2
Q

Which part of the stomach acts as the grinder?

A

Antrum

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3
Q

The outermost layer of the stomach is the

A

serosa

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4
Q

What 3 types of cells comprise the Gastric Glands

in the mucosa of the stomach?

A

Mucous neck cells

Parietal cells

Chief cells

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5
Q

What 3 cell types are considered neuroendocrine cells and

are found in the mucosa of the stomach?

A

ECL cells

D cells

G cells

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6
Q

This cells is responsible for secreting HCl and intrinsic factor

A

Parietal cells

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7
Q

What is the function of parietal cells?

A

Kill microbes, activate pepsinogen, and bind Vit B12

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8
Q

What do Chief Cells secrete?

A

Pepsinogen and Gastric Lipase

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9
Q

What is the function of Chief Cells?

A

Protein and fat digestion

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10
Q

What do Mucus-Neck Cells secrete?

A

Mucus and Bicarbonate

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11
Q

What is the function of mucus-neck cells?

A

To protect the stomach epithelium from acid

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12
Q

What do ECL Cells (Enterochromaffin Cells) secrete?

A

Histamine and Serotonin

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13
Q

What is the function of ECL Cells (Enterochromaffin Cells)?

A

to stimulate gastric acid secretion

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14
Q

What do D-cells secrete?

A

Somatostatin

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15
Q

What is the function of D-cells?

A

To inhibit gastric acid secretion

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16
Q

What do G-cells secrete?

A

Gastrin

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17
Q

What is the function of G-cell secretion?

A

Stimulates gastric acid secretion

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18
Q

Which substances are responsible for stimulating gastric acid secretion?

A

Gastrin and Histamine

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19
Q

What substance is responsible for protein digestion?

A

Pepsinogen (secreted by chief cells)

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20
Q

What substance is responsible for fat digestion?

A

Gastric lipase (secreted by chief cells)

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21
Q

Which substance inhibits gastric acid secretion?

A

Somatostatin (secreted by D-cells)

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22
Q

What substance is responsible for binding Vit. B12

allowing for its absorption?

A

Intrinsic factor (secreted by parietal cells)

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23
Q

What substance is responsible for activating pepsinogen?

A

HCl (secreted by Parietal Cells)

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24
Q

Meissner’s Plexus (nervous system component) is found

in which layer of the stomach?

A

Submucosa

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25
Q

Auerbach’s (Myenteric) Plexus is

found in this layer of the stomach

A

Muscularis

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26
Q

The H/K ATPase Pump is found in parietal cells,

which are part of this layer of the stomach

A

Mucosa

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27
Q

On a CHEM panel the following changes are noted:

BUN elevated and disproportionally higher than Creatinine

What does this finding suggest?

A

Bleeding in upper GI tract

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28
Q

On a CHEM panel the following changes are noted:

Metabolic alkalosis with increased bicarb, but decreased chloride

What does this finding suggest?

A

Gastric outflow obstruction

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29
Q

Endoscopy is unhelpful for any disease

deeper than the _________ (layer of the stomach)

A

mucosa

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30
Q

_______ is the best way to evaluate for

inflammation, ulcers, FB, and mucosal neoplasia

A

Endoscopy

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31
Q

_________ are contraindicated in treatment of gastric foreign bodies

A

Antiemetics

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32
Q

Inflammation of the mucosa is known as

A

Gastritis

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33
Q

Dramatic gastric distension of the stomach is known as

A

Dilatation

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34
Q

When the stomach twists and moves on its axis

usually to the left of the fundus, it is known as

A

Volvulus

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35
Q

GDV results in compression of the ________

which results in impaired venous return to the heart

which can cause hypovolemic shock

A

CVC (Caudal Vena Cava)

36
Q

What are the common sequela of GDV?

A

Gastric wall necrosis

Splenic torsion or avulsion

Endotoxic shock

DIC

37
Q

What condition would you be concerned with

in a large breed barrel chested dog that

eats quickly and then plays immediately?

A

GDV

38
Q

A great dane presents with acute non-productive retching

and painful abdominal distension. He is tachycardic and has weak pulses.

What is the first thing you do?

A

FLUIDS FIRST! (GDV)

Then Rads

39
Q

In GDV, what type of radiograph is the most important for diagnosis?

A

RIGHT lateral

40
Q

What do you expect to see on a right-lateral rad

in an animal with GDV?

A

“Popeye arm”

41
Q

What are the steps (in order) in treating GDV?

A

FLUIDS

Decompression (orogastric tube)

Trocharization

SURGERY ASAP

42
Q

The mortality rate in GDV is _____%

A

15 - 30% (higher end in gastric necrosis or splenectomy)

43
Q

T/F:

In cases of food bloat, it is ok to leave it alone for 24 to 36 hours

A

TRUE (sx is not rarely required)

44
Q

How are gastric ulcers confirmed?

A

Endoscopy

45
Q

How are gastric ulcers treated?

A

Sucralfate, Proton Pump Inhibitors (Omeprazole), Pain meds

46
Q

T/F:

An animal with gastric ulcers can present with

hematemesis, melena, anemia, and elevated BUN

A

true

47
Q

T/F:

Helicobacter Gastritis can result in acute or chronic vomiting

A

TRUE

48
Q

Where would you look for spiral

gram negative bacteria in the case of helicobacter gastritis?

A

In crypts and gastric glands

49
Q

How is helicobacter gastritis treated?

A

Clarithromycin + Amoxicillin + Metronidazole

(resistance has been documented!!!)

50
Q

A dog from a tropical location presents with chronic vomiting.

U/S and Endoscopy reveal a thickened gastric outflow tract

with pyogranulomatous inflammation. What is your primary ddx?

A

Gastric Pythiosis (P.Insidiosum)

51
Q

What is the prognosis for a dog with Gastric Pythiosis (P.Insidiosum)?

A

VERY POOR!

Fatal in all dogs, MST- 26.5 days) :(

52
Q

Toxocara canis and T. cati are this type of parasite

A

roundworms

53
Q

How are Toxocara canis and T. cati diagnosed?

A

Visual or fecal

54
Q

How are Toxocara canis and T. cati treated?

A

Fenbendazole or Pyrantel Pamoate

55
Q

T/F:

Fecal float is the best way to dx Physalloptera infection

A

FALSE!

Difficult to see on fecal, may see on endoscopy

56
Q

How is Physalloptera treated

A

Pyrantel Pamoate (2 doses, 2 weeks apart)

57
Q

This parasite only infects cats and grows to be

about 1mm in length. They can be seen on

biopsy, gastric juice evaluation, and in vomitus

What is this parasite?

A

Ollulanus tricuspi

58
Q

How is Ollulanus tricuspi treated?

A

Fenbendazole

59
Q

T/F:

Acute vomiting is seen in cases of gastric esophageal reflux

A

FALSE!

CHRONIC vomiting

60
Q

How is Gastric Esophageal Reflux treated?

A

PPI (Omeprazole) and Sucralfate

(or tx the primary disease)

61
Q

How is inflammatory gastritis diagnosed?

A

Endoscopy or Biopsy!

62
Q

What is the most common type of inflammatory gastritis?

A

Lymphoplasmacytic

63
Q

In a case of chronic vomiting, surgical biopsy was performed and

and infiltrate of inflammatory cells were found. If this is

inflammatory gastritis, what layers of the stomach will these

cells been seen in?

A

Mucosa and Lamina Propria

64
Q

In a case of chronic vomiting, surgical biopsy was performed and

a marked infiltrate of mononuclear cells were seen

(lymphocytes and macrophages).

Thinning of the gastric mucosa and atrophy of the gastric glands

was also noted. What is your primary ddx?

A

Atrophic Gastritis

65
Q

Atrophic Gastritis can progress to ACA

in this species of dog

A

Norwegian Lundehund

66
Q

How is inflammatory gastritis treated?

A

Antacid, gastroprotectants

Diet trial

Empiric deworming (Fenbendazole and Pyrantel Pamoate)

Immunemodulators (Prednisone in dogs, Prednisolone in cats)

Cyclosporine

67
Q

What is the most common clinical sign seen

in dogs with Hypertrophic Gastropathy?

A

Chronic vomiting, projectile, hours after eating

68
Q

What is the signalment of a dog with Hypertrophic Gastropathy?

A

Older, small breed dogs, especially Lhasa Apso and Shih Tzu

69
Q

What would you expect to see on biopsy diagnosis

of a dog with Hypertrophic Gastropathy?

A

Diffuse or focal hypertrophy of

the mucosa and/or muscularis

with inflammatory infiltrates

70
Q

What hypergastrinemic conditions are associated with

Hypertrophic Gastropathy?

A

Decreased clearance from liver or renal disease

or

Gastrin secreting tumor

71
Q

Hypertrophic Gastropathy is pronounced in the

_______ _______ region

A

pyloric outflow

72
Q

How is Hypertrophic Gastropathy treated?

A

By treating the primary disease or

surgical resection of the thickened tissue

73
Q

What breeds are predisposed to

Congenital Pyloric Stenosis and Hypertrophy?

A

Boxers, Boston Terriers, English Bulldogs, Siamese Cats

74
Q

A boxer presents with vomiting several hours after a meal (delayed gastric emptying).

He is not gaining weight and is depressed and dehydrated.

Endoscopy reveals muscular thickening of the pyloric sphincter.

What is your primary ddx?

A

Congenital Pyloric Stenosis and Hypertrophy

75
Q

How is congenital pyloric stenosis and hypertrophy treated?

A

Surgical correction

76
Q

What are 2 acquired causes of pyloric stenosis and hypertrophy?

A

Inflammation

and Gastrinoma

77
Q

What would you expect to see on endoscopy in an

animal with Gastrinoma?

A

Thickened gastric wall

Hypertrophy of Pylorus

Gastric ulceration

78
Q

Describe the pathology of Gastrinoma

A

Tumor in the pancreas of APUD cells

stimulates hypersecretion of GASTRIN

79
Q

How is Gastrinoma diagnosed?

A

Gastrin levels after withholding antacids for 48 hours

reveals

LOW pH of gastric juices + HIGH gastrin level

80
Q

How is Gastrinoma treated?

A

Surgical removal of tumor (often mets at dx though)

PPIs (Omeprazole)

and OCTREOTIDE- inhibits gastrin

81
Q

What is the prognosis of Gastrinoma?

A

Guarded to Poor

82
Q

What are the 2 most common benign tumors of the stomach?

A

Leiomyoma

Adenomatous Polyps

83
Q

What are the 2 most common malignant tumors of the stomach?

A

Adenocarcinoma (DOGS) - 70%

Lymphosarcoma (CATS)

84
Q

Delayed gastric emptying motility disorders like

GERD or Bilious Vomiting Syndrome

are seen secondary to what 6 causes?

A

Inflammation

Infection

Obstruction

Electrolyte Disturbance

Opioids

Surgery!

85
Q

How are Delayed gastric emptying motility disorders diagnosed?

A

Rads and contrast studies on a fasted patient

(takes longer than 8 hours to empty)

86
Q

How are Delayed gastric emptying motility disorders treated?

A

CISAPRIDE (compounding pharmacies)

(Also: Metoclopramide, Erythromycin, Ranitidine, Low protein and fat diet)

Preeti: SAM II (6 decks)

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