Gastroenterology - Gastric Diseases

Question 1

Which part of the stomach expands for food?

Answer 1

fundus and body

Question 2

What are the components of the mucosa layer of the stomach?

Answer 2

• superficial epithelium
• lamina propria
• gastric glands
• neuroendocrine cells
• muscularis mucosa

Question 3

Which cells make up the gastric glands of the stomach?

Answer 3

mucous neck cells
parietal cells
chief cells

Question 4

What is the lamina propria of the stomach made up of?

Answer 4

loose connective tissue
immune system cells
nutritional support

Question 5

What is produced by the gastric neuroendocrine cells?

Answer 5

• enterocromafin (serotonin, histamine)
• somatostatin
• gastrin

Question 6

What is the submucosa of the stomach made up of?

Answer 6

• dense connective tissue: structural support
• blood vessels
• lymphatics
• Meissner’s plexus

Question 7

What is the muscularis of the stomach made up of?

Answer 7

• layers of perpendicular smooth muscle

- Auerbach’s (myenteric) plexis

Question 8

Which enzyme is responsible for protein digestion?

Fat digestion?

Answer 8

protein - pepsin

fat - gastric lipase

Question 9

What influences/controls motility of the GIT?

Answer 9

• migrating motility complex
• neural and hormonal stimulus
• pressure/distension (mechanoreceptors)
• nutritional content of food

Question 10

What is acute gastritis?

Answer 10

inflammation of the stomach lining

Question 11

What is the pathology associated with GDV?

Answer 11

• compression of CVC > impaired venous return > hypovolemic shock
• gastric wall necrosis
• splenic torsion or avulsion
• congestion of viscera
• endotoxic shock
• DIC

Question 12

What are the clinical signs associated with GDV?

Answer 12

• acute, non-productive retching
• pytalism
• abdominal distension
• collapse

Question 13

What is found on physical exam of a dog with GDV?

Answer 13

• abdominal distension
• tachycardia, poor pulses
• hypothermia
• depression

Question 14

How is GDV diagnosed?

Answer 14

radiographs

• right lateral view most important
• “popeye arm”

Question 15

How is GDV treated?

Answer 15

• aggressive fluid therapy
• decompression
• surgery ASAP

Question 16

What is the treatment for food bloat?

Answer 16

• fluid support
• withhold food
• walk frequently
• pain management
• +/- lavage or surgery

Question 17

What are the possible causes of mucosal barrier injury?

Answer 17

• disruption of normal gastroprotection
• decreased blood flow
• hypersecretion of acid
• decreased mucous or bicarbonate

Question 18

What conditions can cause secondary gastric ulcers/erosion?

Answer 18

• neoplasia
• hypovolemic shock/hypotension
• trauma
• medication (NSAIDs)
• uremic gastritis

Question 19

What are the clinical signs associated with gastric ulceration/erosion?

Answer 19

vomiting, hematemesis, melena, retching, inappetence

Question 20

How is gastric ulceration/erosion diagnosed?

Answer 20

• radiographs with contrast
• ultrasound
• endoscopy for confirmation
• MDB and fecal

Question 21

How is gastric ulceration/erosion treated?

Answer 21

• treat primary disease
• mucosal protectants
• proton pump inhibitors
• pain management
• blood transfusion
• nutrition

Question 22

What type of bacteria is Helicobacter pylori?

Answer 22

spiral

gram negative

Question 23

How is Helicobacter gastritis treated?

Answer 23

Clorithromycin
Amoxicillin
Metronidazole

Question 24

Which parasites can cause gastric disease?

Answer 24

• Toxocara
• Physalloptera
• Ollulanus tricuspi

Question 25

Describe gastric pythiosis

Answer 25

• chronic vomiting
• thickened gastric outflow tract
• pyogranulomatous inflammation
• cause by fungus: P. insidiosum

Question 26

What are the clinical signs associated with gastric esophageal reflux?

Answer 26

• chronic vomiting

- lip licking, hard swallow, pytalism, halitosis, esophagitis

Question 27

What is the usual cause of gastric esophageal reflux?

Answer 27

secondary to gastric or small intestinal disease

Question 28

How is gastric esophageal reflux treated?

Answer 28

• proton pump inhibitor
• treat primary disease
• sucralfate

Question 29

What is the main clinical signs of inflammatory gastritis?

Answer 29

chronic vomiting

Question 30

How is inflammatory gastritis diagnosed?

Answer 30

endoscopy or surgical biopsy

- infiltrate of inflammatory cells in mucosa and lamina propria

Question 31

How is lymphoplasmacytic and eosinophilic gastritis treated?

Answer 31

• symptomatic therapy (antacid and antiemetics)
• empiric deworming (Fenbendazole or Pyrantel pamoate)
• diet trial
• immune modulation

Question 32

What pathology is found with atrophic gastritis?

Answer 32

• marked mononuclear cell infiltrate
• thinning of gastric mucosa
• atrophy of gastric glands
• replacement by fibrous tissue
• impaired ingestion

Question 33

What pathology is found with hypertrophic gastropathy?

Answer 33

• diffuse or focal hypertrophy of mucosa and/or muscularis

- inflammatory infiltrates

Question 34

What is pyloric stenosis?

Answer 34

• muscular thickening of pyloric sphincter

- delayed gastric emptying

Question 35

What pathology and clinical signs are found with gastrinoma?

Answer 35

• thickened gastric wall
• hypertrophy of pylorus
• gastric ulceration
• reflux esophagitis
• chronic vomiting
• +/- diarrhea

Question 36

What is gastrinoma?

Answer 36

• tumor in pancreas of the APUD cells

- hypersecretion of gastric acid

Question 37

How is gastrinoma diagnosed?

Answer 37

• gastrin levels
• low pH of gastric juice with a high gastrin level
• ultrasound, CT, scintigraphy
• biopsy

Question 38

How is gastrinoma treated?

Answer 38

• surgical removal
• proton pump inhibitor
• Octreotide to inhibit gastrin