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Small animal nursing II > Gastroenterology > Flashcards

Gastroenterology Flashcards

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
small bowel diarrhea
large volume, normal - increased frequency of defecation, flatulence or steatorrhea (increased fat excretion), melena, weight loss, vomiting may occur
26
large bowel diarrhea
small volume, increased frequency of defecation, mucus in feces, hematochezia, tenesmus, pain/urgency to defecate, vomiting less common
27
what fecal score it considered diarrhea?
7/7, 3-6 are just considered loose stool
28
constipation
infrequent, incomplete, or difficult defecation with passage of hard/dry feces
29
obstipation
intractable constipation caused by prolonged retention of hard, dry feces defecation impossible
30
CS of constipation/obstipation
straining with small or no fecal volume, infrequent defecation, small amount of liquid/mucoid stool (+/- blood after prolonged tenesmus), occasional vomiting, inappetence +/- lethargy
31
treatment for constipation/obstipation
enema, manual de-obstipation (sedated), chronic dietary management (fiber: pumpkin, metamucil, balanced with stool softener- lactulose, enulose)
32
megacolon
persistently increased large bowel diameter associated with chronic constipation/obstipation with low/absent chronic motility
33
CS of megacolon
reduced, absent, or painful defecation, tenesmus (with small or no fecal volume produced), vomiting, anorexia, prolonged constipation/obstipation, lethargy
34
treatment for megacolon
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
colitis
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
diagnosis of colitis
fecal analyses, endoscopy for severe or prolonged cases
37
treatment of colitis
symptomatic, prescription diets
38
inflammatory bowel disease (IBD)
idiopathic intestinal inflammation antigenic hypersensitivity believed to be main cause
39
what are the forms of IBD?
lymphocytic plasmocytic enteritis (most common), eosinophilic enteritis, granulomatous enteritis
40
cause of IBD
believed to be a mix of genetics, mucosal immunity, and environment factors
41
CS of IBD
dogs: chronic intermittent vomiting, and/or small bowel diarrhea, weight loss cats: anorexia, weight loss, vomiting, diarrhea, flatulence, hematochezia, abdominal pain
42
diagnosis of IBD
eliminate other causes, dietary elimination trials, intestinal biopsy
43
treatment for IBD
symptomatic, IVF if needed, depends on the form (varies from steroids to immunosuppressants to antibiotics)
44
what is a drug that is commonly used in diarrhea cases?
Metramidazole
45
performing an elimination dietary trial for IBD
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
what are hydrolyzed diets labeled as?
z/d
47
bloat and gastric dilation and volvulus (GDV)
stomach rotates on its short axis most associated with ingesting large amounts of air, water, or food causes delayed gastric emptying
48
bloat
stomach dilates beyond normal capacity
49
CS of GDV
vomiting, anxious behavior, drooling (ptyalism), collapse, lethargy, possible distended abdomen, tachycardia, tachypnea/dyspnea, weak pulse/pale mm with prolonged CRT
50
what happens systemically with GDV?
rapidly progresses whole body suffers poor ventilation ischemia, potential rupture of stomach wall, pressure on diaphragm= lungs can't expand
51
diagnosis for GDV
radiograph
52
treatment for GDV
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
GI obstruction/foreign body CS
signs may wax and wane if its a shifting foreign body obstruction vomiting (acute or severe), abdominal pain, diarrhea, sepsis, shock
54
diagnosis of GI obstruction
radiographs +/- ultrasound
55
treatment for GI obstruction
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
intussusception
telescoping of intestine requiring surgical intervention
57
CS of intussusception
presents like foreign body: vomiting, diarrhea, anorexia, weight loss symptoms may wax and wane if intestine is sliding and partially correcting itself
58
diagnosis for intussusception
ultrasound preferred, radiographs with barium, palpation, exploratory surgery
59
physical exam findings for intussusception
lethargy, ADR, palpable sausage-shaped abdominal mass
60
causes of intussusception
foreign body, mass, obstruction, intestinal parasites, viral or bacterial infection, previous bowel surgery, organophosphate toxicity
61
pancreatitis
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
acute pancreatitis
occurs abruptly with little or no permanent pathological changes
63
chronic pancreatitis
continuing inflammatory disease that is accompanied by irreversible changes
64
what are a few breeds that are more prone to pancreatitis?
mini schnauzers, pugs, siamese cats
65
CS of pancreatitis
vague GI signs, "prayer position"
66
possible causes of pancreatitis
dietary indiscretions (usually from eating something high in fat), pancreatic trauma, pancreatic duct obstruction (cats), hypercalcemia, infectious agent like babesiosis
67
diagnosis of pancreatitis
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
treatment for pancreatitis
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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