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Small animal nursing II > Gastroenterology > Flashcards

Gastroenterology Flashcards

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1
Q

GI functions

A

motility, secretion, digestion, and absorption

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2
Q

patient history questions to ask when dealing with a GI issue

A

describe vomitus, how long has patient been vomiting, recent trauma, how frequently is patient vomiting, other concurrent signs, habits of patient, diet, environmental changes, medications

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3
Q

signs of GI dysfunction

A

vomiting, regurgitation, diarrhea, constipation, anorexia

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4
Q

vomiting

A

forceful neurologically mediated reflex expulsion of gastric content from oral cavity

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5
Q

signs of vomiting

A

active abdominal heaving, occurs after eating, food at least partially digested, linked with a prodromal phase

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6
Q

causes of vomiting

A

diet, systemic disease, abdominal disorders, neurologic disease, parasites, randoms (fear, pain, motion sickness, anaphylaxis)

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7
Q

stages of vomiting

A
  1. saliva, bicarbonate
  2. retching and pressure changes: (negative pressure intrathoracic, positive pressure intra-abdominal)
  3. expulsion: pressure changes to positive pressure intrathoracic to prevent aspiration
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8
Q

acute vs chronic vomiting

A

acute: short duration (< 5-7 days) and variable frequency
chronic: longer duration (> 5-7 days) or vomiting that occurs intermittently several days or weeks

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9
Q

hematoemesis

A

blood in vomitus

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10
Q

hematochezia

A

blood in stool

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11
Q

melena

A

digested blood, darker in color

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12
Q

tenemus

A

straining to defecate

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13
Q

frank

A

bright red blood color

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14
Q

regurgitation

A

passive, retrograde movement of undigested gastric or esophageal contents into oral cavity

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15
Q

signs of regurgitation

A

little to no abdominal effort, no prodromal phase, increased amount of mucus, occurs shortly after or while eating, presence of undigested food

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16
Q

causes of regurgitation

A

congenital pharyngeal/esophageal issue or acquired pharyngeal/esophageal issue

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17
Q

megaesophagus

A

generalized or focal enlargement of the esophagus with loss/absence of peristalsis

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18
Q

causes of megaesophagus

A

congenital defect, idiopathic, excessive vomiting, toxicity (lead), esophageal obstruction (vascular ring anomaly, neoplasia), underlying disease- neuromuscular (myasthenia gravis, lupus)

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19
Q

CS of megaesophagus

A

bad breath, dysphagia, agitation with eating, weight loss/nasal discharge with aspiration

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20
Q

treatment for megaesophagus

A

treat underlying cause, H2 blockers for esophagitis (ranitidine or famotidine), proton pump inhibitors in severe cases (omeprazole), feed in an elevated position (45-90 degrees from floor) and remain upright for 10-15 minutes after, intermittent esophageal suctioning can reduce or eliminate aspiration pneumonia

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21
Q

diarrhea

A

rapid movement of fecal matter through the intestine resulting in poor absorption of water, nutrients and electrolytes, and producing abnormal frequent evacuations of watery droppings

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22
Q

acute vs chronic diarrhea

A

acute: sudden onset
chronic: > 3 weeks

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23
Q

causes of diarrhea

A

primary or secondary from disorders associated with maldigestion, dietary, metabolic, and congenital factors

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24
Q

diagnostics for diarrhea

A

fecal analyses: float, cytologic examination, virus detection, cultures
plain and contrast radiographs, ultrasonography, surgical examination, endoscopy, biopsies

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25
Q

small bowel diarrhea

A

large volume, normal - increased frequency of defecation, flatulence or steatorrhea (increased fat excretion), melena, weight loss, vomiting may occur

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26
Q

large bowel diarrhea

A

small volume, increased frequency of defecation, mucus in feces, hematochezia, tenesmus, pain/urgency to defecate, vomiting less common

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27
Q

what fecal score it considered diarrhea?

A

7/7, 3-6 are just considered loose stool

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28
Q

constipation

A

infrequent, incomplete, or difficult defecation with passage of hard/dry feces

29
Q

obstipation

A

intractable constipation caused by prolonged retention of hard, dry feces
defecation impossible

30
Q

CS of constipation/obstipation

A

straining with small or no fecal volume, infrequent defecation, small amount of liquid/mucoid stool (+/- blood after prolonged tenesmus), occasional vomiting, inappetence +/- lethargy

31
Q

treatment for constipation/obstipation

A

enema, manual de-obstipation (sedated), chronic dietary management (fiber: pumpkin, metamucil, balanced with stool softener- lactulose, enulose)

32
Q

megacolon

A

persistently increased large bowel diameter associated with chronic constipation/obstipation with low/absent chronic motility

33
Q

CS of megacolon

A

reduced, absent, or painful defecation, tenesmus (with small or no fecal volume produced), vomiting, anorexia, prolonged constipation/obstipation, lethargy

34
Q

treatment for megacolon

A

correct dehydration, de-obstipation, enema, control reoccurrence (high fiber diet: more bulk or low residue diet: less bulk, stool softeners- lactulose, DSS and prokinetic drugs- cisapride), colectomy surgery

35
Q

colitis

A

inflammation of the colon
show CS of large bowel diarrhea (fecal consistency variable from semi-formed to liquid, usually marked increased in frequency ~6-15 times a day)

36
Q

diagnosis of colitis

A

fecal analyses, endoscopy for severe or prolonged cases

37
Q

treatment of colitis

A

symptomatic, prescription diets

38
Q

inflammatory bowel disease (IBD)

A

idiopathic intestinal inflammation
antigenic hypersensitivity believed to be main cause

39
Q

what are the forms of IBD?

A

lymphocytic plasmocytic enteritis (most common), eosinophilic enteritis, granulomatous enteritis

40
Q

cause of IBD

A

believed to be a mix of genetics, mucosal immunity, and environment factors

41
Q

CS of IBD

A

dogs: chronic intermittent vomiting, and/or small bowel diarrhea, weight loss
cats: anorexia, weight loss, vomiting, diarrhea, flatulence, hematochezia, abdominal pain

42
Q

diagnosis of IBD

A

eliminate other causes, dietary elimination trials, intestinal biopsy

43
Q

treatment for IBD

A

symptomatic, IVF if needed, depends on the form (varies from steroids to immunosuppressants to antibiotics)

44
Q

what is a drug that is commonly used in diarrhea cases?

A

Metramidazole

45
Q

performing an elimination dietary trial for IBD

A

used for diagnosis to eliminate adverse food reactions
can take up to 8-12 weeks to perform trial
if GI signs resolve within 2 weeks then a diagnosis of adverse food reaction is made
use a novel protein or hydrolyzed protein diet
must eliminate the ingredient you are trialing as a possible adverse reaction to from all food sources (even preventative meds- can have a meat flavoring to the chew)

46
Q

what are hydrolyzed diets labeled as?

A

z/d

47
Q

bloat and gastric dilation and volvulus (GDV)

A

stomach rotates on its short axis
most associated with ingesting large amounts of air, water, or food
causes delayed gastric emptying

48
Q

bloat

A

stomach dilates beyond normal capacity

49
Q

CS of GDV

A

vomiting, anxious behavior, drooling (ptyalism), collapse, lethargy, possible distended abdomen, tachycardia, tachypnea/dyspnea, weak pulse/pale mm with prolonged CRT

50
Q

what happens systemically with GDV?

A

rapidly progresses
whole body suffers poor ventilation
ischemia, potential rupture of stomach wall, pressure on diaphragm= lungs can’t expand

51
Q

diagnosis for GDV

A

radiograph

52
Q

treatment for GDV

A

stabilize with IVF right away: only use jugular or cephalic catheter because condition of stomach will block fluids from going where it needs to go
need to decompress the stomach: pass an orogastric tube
trocar (aka percutaneous gastrocentesis): do if can’t pass an orogastric tube, large needle/catheter inserted behind the last rib
surgery: gastropexy, organs evaluated too and anastomosis performed if necessary
monitor ECG for PVC arrhythmias

53
Q

GI obstruction/foreign body CS

A

signs may wax and wane if its a shifting foreign body obstruction
vomiting (acute or severe), abdominal pain, diarrhea, sepsis, shock

54
Q

diagnosis of GI obstruction

A

radiographs +/- ultrasound

55
Q

treatment for GI obstruction

A

surgery if obstructed, may try to rehydrate with IVF then recheck rads
caution with antiemetics: metoclopramide contraindicated, Cerenia safe but may mask symptoms
treat symptoms as needed

56
Q

intussusception

A

telescoping of intestine requiring surgical intervention

57
Q

CS of intussusception

A

presents like foreign body: vomiting, diarrhea, anorexia, weight loss
symptoms may wax and wane if intestine is sliding and partially correcting itself

58
Q

diagnosis for intussusception

A

ultrasound preferred, radiographs with barium, palpation, exploratory surgery

59
Q

physical exam findings for intussusception

A

lethargy, ADR, palpable sausage-shaped abdominal mass

60
Q

causes of intussusception

A

foreign body, mass, obstruction, intestinal parasites, viral or bacterial infection, previous bowel surgery, organophosphate toxicity

61
Q

pancreatitis

A

inflammation of pancreas most often of unknown causes
early trypsin activation causes it but we don’t know what causes the early trypsin activation

62
Q

acute pancreatitis

A

occurs abruptly with little or no permanent pathological changes

63
Q

chronic pancreatitis

A

continuing inflammatory disease that is accompanied by irreversible changes

64
Q

what are a few breeds that are more prone to pancreatitis?

A

mini schnauzers, pugs, siamese cats

65
Q

CS of pancreatitis

A

vague GI signs, “prayer position”

66
Q

possible causes of pancreatitis

A

dietary indiscretions (usually from eating something high in fat), pancreatic trauma, pancreatic duct obstruction (cats), hypercalcemia, infectious agent like babesiosis

67
Q

diagnosis of pancreatitis

A

difficult, most are non-specific
biochemistries: often a serum-amylase and lipase are run but can be unreliable
snap fPL (feline pancreatic lipase) or snap cPL (canine pancreatic lipase) test from Idexx
imaging: ultrasonography and needle biopsies can confirm diagnosis (pancreas will appear white on imaging if hyperechoic)

68
Q

treatment for pancreatitis

A

aggressive fluid therapy, anti-emetics (Cerenia), analgesics, diet (avoid high fat and high protein foods)

Small animal nursing II (18 decks)

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