Gastroenterology Flashcards
Risk factors for acute pancreatitis ?
- dietary indiscrétion
- hypertriglyceridemia
- hypercalcemia
- drugs & toxins
- endocrinopathies (cush, diabète)
- breed predilection ( min schnauzer)
- advance âge (> 7 yo)
- overweight
Name and role of a specific treatment of pancreatitis ?
Fuzapladib : leukocyte function-associated antigen type 1 activation inhibitor
JVIM sept 2023 : administration safe and favorable clinical response
What campylobacters are supposed to be pathogenic (diarrhea)?
Campylobacter jejuni and coli
How is absorbed alimentary folate?
Folate polyglutamate is deconjugated by folate deconjugase on the proximal small intestine and then absorbed via the folate carriers in the proximal intestine
What is the goal of testing fecal alpha1-proteinase inhibitor?
To look for gastrointestinal albumin losses (same weight but not digested)
What is the target of antibodies in masticatory muscle myositis in dogs ?
2M fibers (antibody positive or immune complexes on biopsy are diagnostic)
What is craniomandibular osteopathy?
Woven bone proliferation of the mandibles and temporomandibular joints affecting small breed dogs
What is the main difference in oesophageal musculature between dogs and cats?
One third of striated muscles of the oesophagus are replaced by smooth muscles in cats
What are the four phases of swallowing?
Oral preparatory, oral, pharyngeal and oesophageal phases
True or false: cervical oesophageal transit is significantly delayed in lateral recumbency vs sternal recumbency in dogs
True
Name 2 main host pattern recognition receptor systems of the gastrointestinal tract
Toll-like receptors (TLR, transmembranaires) et Nucleotide-binding oligomerization domain (NOD1 et NOD2, intracellulaires)
Name a gastric parasite of cats
Ollulanus tricuspis that can be transmitted via ingested vomitus
Name a gastric parasite of dogs (and cats)
Physaloptera spp. that can be transmitted by intermediate and paratenic hosts (cockroaches, beetles, lizards…)
What is the prognosis of gastric pythiosis (Pythium insidiosum)?
Poor (<25% of cure with medical therapy alone)
What is the prokinetic effect of erythromycin?
Release of motilin
What are the pacemaker cells of the small intestine ?
Interstitial cells of Cajal
What are the three phases of fasted small intestinal cycle?
Quiescent phase, minor contractile activity phase and migrating myoelectric complexes (MMC, stimulated by motilin)
What type of T cells is prevalent in the lamina propria of dogs ? And cats?
Dogs CD4 T cells
Cats CD8 T cells
True or false: pathogenic bacteria induced differentiation to Th17 cells
True
True or false: digestive viruses induce differentiation to Th1 cells
True
True or false: digestive parasites induce differentiation to Th2 cells
True
True or false: IBD is related to abnormal induced Th17 response
True
What are large volume of stool, melena, steatorrhoea, absence of tenesmus or mucus or urgency suggestive of?
Small intestine diarrhea
What is the point of fecal calprotectin assay?
Measure intestinal inflammation (neutrophil elastase activity)
What are EPEC, ETEC and EHEC ?
Enteropathic E.coli, enterotoxigenic E.coli and enterohemorrhagic E.coli
What type of E.coli is associated with granulomatous colitis?
AIEC (adherent invasive E.coli)
What is salmon poisoning in dogs?
Ingestion of Neorickettsia helminthoeca in the fluke Nanophyetus salmincola of the salmon (high fever, GI troubles, polyadenomegaly and high mortality)
What type of hypersensitivity reaction should not be possible with an hydrolyzed diet?
Type I (IgE) but type IV (delayed) should still be possible (not with annalergenic)
True or false: LPE of Basenjis is severe and occurs with concomitant hyperglobulinemia
True
Where are encountered more frequently adenoma and carcinoma of the GI tract in dogs ? And in cats ?
Dogs: Large intestine (then duodenum)
Cats: Small intestine
Where is the preferential localisation of smooth muscle tumors of the GI tract in dogs ? And in cats?
Dogs: jejunum and caecum
Cats: small intestine
Name causes of intestinal pseudo-obstruction
Leiomyositis, sclerosing enteropathy, alimentary lymphoma (cats)
What is the short bowel syndrome ?
The consequences of the absence/resection of 66-85% of small intestine
What part of the GI tract does irrigate the caudal mesenteric artery?
Rectum and descending colon with anastomosis to the middle coloc artery (cranial mesenteric artery)
What part of the GI tract does irrigate the cranial mesenteric artery?
All the GI tract (with anastomosis to le the left colic artery for descending colon and rectum)
Which nerves supply the colon ?
Pelvic nerve for the distal colon and vagus nerve for the proximal colon
What nervous plexus is present in the submucosa of the large intestine?
The submucosal plexus (Meissner’s plexus) with also interstitial cells of Cajal
What nervous plexus is present in the muscularis of the large intestine?
Myenteric nerve plexus (Auerbach’s plexus)
How is absorber water in the (proximal) colon?
Passive diffusion thanks to active absorption of sodium
What are the 3 major contractions of the large intestine?
Ascending: rhythmic phasic contraction (mixing and absorption)
Transverse: retrograde giant contraction (antiperistaltis)
Descending: Giant migrating contraction
What does the sympathetic nervous system on the large intestine?
Restrict progression of the content and contracting the sphincters
What might trigger the defecation reflex ?
Ingestion of a meal (gastrocolic reflex) or distension of the distal colon and rectum
True or false: FIP can present as a pyogranulomatous mass at the ileocolic junction
True
Where is found the highest concentration of giardia in dogs? And cats?
Dogs: duodenum
Cats: ileum
By what cecal inversion may be predisposed (dog)?
Trichuris infection
What is the sympathetic innervation of the rectoanal apparatus?
Via the hypogastric nerve (L1-L4+L5)
Inhibition of rectum and colon, stimulation of internal sphincter
What is the parasympathetic innervation of the rectoanal apparatus?
Pelvic nerve(S1-S3) stimulates the colon and rectum
What is the somatic innervation of the rectoanal apparatus?
Pudendal nerve, contraction of the external anal sphincter
What is the rectosphincteric inhibition reflex?
Inhibition of the internal anal sphincter due to intrarectal increased pressure
True or false: a higher expression of relaxin receptors has been found in the muscles of the pelvic diaphragm of dogs with perineal hernia?
True (synthesized in the prostate gland)
What C. Perfringens enterotoxin genes are associated with AHDS ?
NetE and NetF
How is absorbed cobalamin ?
B12 is released from dietary proteins by pepsin and HCL in the stomach. It is then bound to the R-protein and released from it by pancreatic proteases in the duodenum. It is then bound to the intrinsic factor and absorbed with it in the ileum.
Who is more frequently affected by juvenile hyperplastic gingivitis ?
Young adult cats (+/- animals on drug: calcium channel blockers, cyclosporine, phenobarbital)
What is the only autoantigen recognized in mucous membrane pemphigoid in cats ?
Laminine 5
(Dogs: Laminine 5, collagen XVII, integrin alpha6-beta4)
What are the risk factors for oral squamous cell carcinoma in cats ?
Flea collars, canned tuna, canned cat food, exposure to tobacco smoke
What is the most common cause of oesophageal stricture in dogs ?
GER during anesthesia
What sign regarding the trachea is indicative of persistent right aortic arch in dogs on thoracic radiograph ?
Focal leftward deviation
What tumor may arise from granulomas of Spirocerca lupi in dogs ?
Oesophageal fibrosarcoma and osteosarcoma
Where in the stomach and by which cell is produced gastrin ?
By G cells in the pyloric antrum
Where in the stomach and by which cell is produced HCl?
By parietal cells in the fundus
What is the equivalent of Migrating Motor Complexes in cats ?
Migrating Spike complexes which are not initiated by motilin
What are the two subunits of the cubam receptor of cobalamin ?
Amnionless (AMN) and cubilin (CUBN)
What does recognize TLR-2 ?
LPS of gram- bacterias
What does recognize TLR-5 ?
Flagellin
What does recognize NOD2 ?
LPS
What is the impact of depletion of Clostridium hiranonis in the digestive microbiome ?
Decreased secondary bile acids proportion in the colon
What is the most sensitive test to detect Heterobilharzia Americana: fecal sedimentation or fecal PCR ?
Fecal PCR
True or false: a progression from small cell intestinal lymphoma to large cell lymphoma has been reported in 10% of cats.
True
True or false: in familial PLE/PLN of SCWT, the detection of Perinuclear antineutrophilic cytoplasmic autoantibodies (PANCA) allow for the detection of the syndrome 2 years before hypoalbuminemia
True
What are the characteristics of the measurement of IgG anti gliadin and IgA anti transglutaminase 2 for the diagnosis of paroxysmal gluten-sensitive dyskinesia in Border Terrier ?
Highly specific but lack sensitivity
What is the location of predilection of digestive adenomas/adenoK in dogs ? And in cats ?
Dogs: Large intestine then duodenum
Cats: small intestine
What do secrète enterochromaffin cells in the colon ?
Serotonin (5-HT) which stimulates the motility of the colon
What form of Protothecosis is more frequent in dogs ? And in cats ?
Dogs: disseminated
Cats: cutaneous
How does the hepatocytes clear NH3 from portal blood ?
By conversion of NH3 in urea in periportal areas and conversion of glutamate in glutamine through hepatic sinusoides
What other organ may also present cystic disease in Caroli’s disease or Caroli’s syndrom in dogs ?
The kidneys
What are the main histologic abnormalities of congenital hepatic fibrosis ?
Periportal fibrosis and numerous small irregular bile ducts
What is the half life of ALT in dogs and cats ?
Dogs: 40-61 hours
Cats: 3.5 hours
Name 3 causes of acute liver injury without increase in hepatocellular leakage enzymes due to inhibition of transcription.
Blue-green algae (Microcystis, Nodularia), Cycads and Aflatoxins
What are the 3 most frequent etiologies of centrilobular necrosis in case of acute liver injury ?
Ischemic, toxic and viral
Which Aflatoxin is the most hepatotoxic ?
B1 (vs B2, G1, G2)
Who produces aflatoxins?
Aspergillus flavus and Aspergillus parasiticus
In case of chronic cholangitis due to fluke infestation in cats, where are most concentrated the eggs ?
Bile (>feces)
Name 2 risk factors for Domestic Cat Hepadnavirus viremia.
Retrovirus infection and increased ALT
Which molecules are important for the function of the pancreatic lipase ?
Biliary acids and colipase
What are the main pathophysiological processes of the development of pancreatitis in cats ?
- Autoactivation of trypsinogen or trypsinogen activation by cathepsin B,
- Zymogens activation by thrombin,
- Colocalisation of Zymogens and lysosomes
- Enterokinases from portal blood or reflux
Trypsinogen activation is the believed inciting event
What are the main pathophysiological processes of the development of pancreatitis in cats ?
- Autoactivation of trypsinogen or trypsinogen activation by cathepsin B,
- Zymogens activation by thrombin,
- Colocalisation of Zymogens and lysosomes
- Enterokinases from portal blood or reflux
Trypsinogen activation is the believed inciting event
Once incited, is pancreatic inflammation dependant on trypsin activation or NF-kappabeta pathway ?
NF-KAPPABETA pathway
What is possibly the best biomarker (at least most specific) to detect persistent PSS after surgery?
Fasted NH3
What does recognize NOD2?
Bacterias LPS
What does recognize TLR-5 ?
Flagellin
Which breeds with immerslund grasbeck have a mutation of the AMN gene?
Australian shepherd and Giant Schnauzer
Which breeds with immerslund grasbeck have a mutation of the CUBN gene?
Beagle, Border Collie and Komondor
