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Gastrointestinal and hepatic Flashcards

1
Q

What are the broad causes of acute diarrhoea?

A

Diet
Drugs
Infection
Inflammatory disease
Metabolic disease
Anatomical disease
Neoplasia
Anomalous - stress/anxiety

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2
Q

What is the pre-disposition to getting canine parvovirus (CVP-2)?

A

Young puppies with low maternal immunity
Older unvaccinated dogs

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3
Q

What is the incubation period of canine parvovirus?

A

3-6 days

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4
Q

What cells does canine parvovirus infect?

A

Rapidly dividing cells

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5
Q

What is the general management for canine parvovirus?

A

Fluid therapy
Antibiotics
Anti-emetics
Pro-motility meds
Antacid drugs and ulcer coating medication
Immunomodulators and ancillary therapies
Oral fluids/nutrients

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6
Q

What are the general prevention measures for parvovirus?

A

Vaccination, cleaning and disinfection

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7
Q

What are the clinical signs of haemorrhagic gastroenteritis?

A

Foetid diarrhoea including protein loss. Causes depression and anorexia.

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8
Q

What is the treatment for haemorrhagic gastroenteritis?

A

Fluid therapy
Colloid/plasma/whole blood

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9
Q

In what cats is feline panleukopenia most common?

A

Kittens and colonies

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10
Q

What part of the GI tract does coronavirus affect?

A

Villus destruction of the small bowel

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11
Q

What dogs are pre-disposed for campylobacter?

A

Usually young, immunocompromised animals or those with additional infectious agents

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12
Q

What are the clinical signs of acute enterocolitis from campylobacter?

A

D+, blood and mucus
Vomiting
Straining
Fever, abdominal pain

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13
Q

What four routes can salmonella take in the dog?

A

Transient asymptomatic diarrhoea
Acute gastroenteritis
Carrier state
Bacteraemia

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14
Q

What are the first choice antibiotics for treatment of clostridial enteritis?

A

Metronidazole - alternatives of Ampicillin and Tylosin

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15
Q

What are the clinical signs of ascarids infections in puppies and kittens?

A

Failure to gain weight and pot bellied

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16
Q

What are the clinical signs of hookworms in kennelled dogs?

A

Weight loss and diarrhoea. Anaemia, interdigital dermatitis

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17
Q

How do you diagnose cryptosporidium?

A

Faecal smear, IFA or PCR

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18
Q

What is the action of prebiotics?

A

Selective substrate used by beneficial species and can alter the intestinal flora.

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19
Q

What is the action of probiotics?

A

Living organism that exert benefit beyond nutrition

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20
Q

What are the major differentials for chronic diarrhoea?

A

Food responsive enteropathy
Dysbiosis
Steroid responsive
Non-responsive
PLE
EPI
Neoplasia
IBD
Non-GI causes

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21
Q

What is a food responsive enteropathy?

A

Any clinically abnormal response attributed to ingestion of a food or additive. Categorised as either an allergy or intolerance.

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22
Q

What responses can the body have to a food responsive enteropathy?

A

Intolerance
Toxicity
Disturbed microflora
Dysmotility
Pharmacologic reactions
Maldigestion/malabsorption
Physical

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23
Q

What are the consequences of secondary dysbiosis?

A

Utilise nutrients/interfere with absorption
Damage epithelium and microvillar enzymes dysfunction
Increase mucosal permeability/fluid loss
Deconjugate bile acids
Hydroxylate fatty acids
Stimulate colonocyte secretion

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24
Q

What are the clinical signs of steroid responsive enteropathy?

A

Persistent/recurrent GI signs with histopathological evidenc4e for inflammation

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25
Q

What dogs are predisposed to SRE/IBD?

A

Middle aged animals over 12 months old

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26
Q

What are the clinical signs of SRE/IBD?

A

Weight loss with more severe mucosal disruption. Appetit very variable and variable abdominal discomfort.

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27
Q

What conditions make up the feline triaditis complex?

A

Chronic Enteritis
Pancreatitis
Cholangiohepatitis

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28
Q

What is a protein-losing enteropathy?

A

Loss of protein through the GIT. `

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29
Q

What are the 3 major differentials for protein-losing enteropathy?

A

IBD
Lymphangiectasia
Neoplasia

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30
Q

What is the management of EPI?

A

Pancreatic enzyme supplementation
Freeze chopped pig/cow pancreas
Dietary management
Vitamin supplementation

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31
Q

What are the clinical signs of dehydration?

A

Skin tent, tacky mms, sucken eyes

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32
Q

What techniques can be used to measure fluid losses?

A

Weigh the patient
Urinary catheter
Weight the bedding
Faecal catheter

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33
Q

What is the best fluid choice for dehydration?

A

Hartmann’s

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34
Q

What are the clinical signs of hypovolaemia?

A

Increased CRT, pale mm, cold rectal
Increased HR, RR and weak pulses

35
Q

What are the clinical signs of sepsis?

A

Decreased CRT, congested MMs, pyrexia, increased HR, RR, bounding/poor pulses

36
Q

What vasopressors can be used in hypovolaemic shock?

A

Dobutamine, noradrenaline, dopamine

37
Q

What are the roles of the liver?

A

Digestion/metabolism/nutrient storage
Waste management
Protein metabolism
Production an activation of coagulation factors
Drug metabolism/detoxification
Immunoregulation

38
Q

In what zone of the liver lobes does hypoxic damage typically occur?

A

Zone 3

39
Q

What zone of the liver is typically affected by metabolic and toxic damage?

A

Zone 1

40
Q

What are specific signs of liver disease?

A

Jaundice, hepatic encephalopathy, ascites, drug intolerance, coagulopathy

41
Q

What neurological signs can be associated to hepatic encephalopathy?

A

Hyperactive and/or depressed/dull/clumsy
Circling, pacing, central blindness
Salivation in cats
Seizures and coma

42
Q

Why can liver enzymes be within normal limits with end stage liver disease?

A

Decreased liver mass

43
Q

What markers are relevant in hepatocellular injury?

A

ALT, AST, GLDH

44
Q

What markers are relevant in cholestasis?

A

ALP and GGT

45
Q

What are negative prognostic indicators of acute liver disease?

A

Ascites and splenomegaly

46
Q

What is the main encephalopathic toxin involved in hepatic encephalopathy?

A

Ammonia

47
Q

How do you manage hepatic encephalopathy?

A

Identify, remove and treat causes
IVFT
Glucose
Diet
Ampicillin IV

48
Q

What is the most common liver disease in dogs?

A

Idiopathic chronic hepatitis

49
Q

What breeds are pre-disposed to copper-associated liver disease?

A

Lab, Dalmatian, Skye terrier, Doberman pinscher, WHWT

50
Q

What is the typical histopathology of chronic hepatobiliary disease?

A

Variable mononuclear or mixed inflammatory infiltrate, apoptosis/necrosis, regeneration and fibrosis

51
Q

What are the important clinical findings in chronic hepatobiliary disease?

A

Poor BCS, jaundice and ascities

52
Q

What treatment should be used for chronic hepatobiliary disease?

A

Urodeoxycholic acid, antioxidants, corticosteroids, antibiotics, diuretics

53
Q

What are the common clinical signs of neutrophilic cholangitis?

A

Lethargy, pyrexia, vomiting, jaundice

54
Q

What are some causes of extrahepatic bile duct obstruction?

A

Pancreatitis, tumour, local trauma, cholelithiasis

55
Q

What is bilirubin a product of?

A

Haemoglobin metabolism

56
Q

What causes the yellow colour of urine?

A

Urobilin

57
Q

What causes the brown colour of faeces?

A

Stercobilin

58
Q

What is the pathophysiology of pre-hepatic breakdown of haemoglobin?

A

Oversupply of precursors into the system, flooding the body with bilirubin that can’t be excreted quickly enough

59
Q

What are the clinical signs of post-hepatic haemoglobin breakdown?

A

Ecchymoses/bruising
Peripheral oedema
Pain
Neurological exam
BCS
Abdominal enlargement

60
Q

Where is the endocrine tissue located in the pancreas?

A

Islets of Langerhans

61
Q

What are the clinical signs of acute pancreatitis?

A

Lethargy/weakness
Anorexia
Vomiting and diarrhoea
Severe: Shock and collapse

62
Q

What are the risk factors for pancreatitis?

A

Hereditary
Hyperlipidaemia
High fat meal and obesity
Pancreatic ischaemia and hypoxia
Trauma

63
Q

How do you treat pancreatitis?

A

IVFT, electrolytes, underlying cause, analgesia, antiemetics, antibiotics, steroids

64
Q

What are the three basic principles of toxin exposure?

A

Decontamination, assessment of effects and treatment of symptoms

65
Q

How can toxins be absorbed?

A

Through mucus membranes, intestinal mucosa, skin, inhalation

66
Q

What are the time frames in which emesis or gastric decontamination can be performed after toxin exposure?

A

2-8 hours in the dog
2-12 hours in the cat

67
Q

What are the clinical signs of ibuprofen/NSAID exposure?

A

Haemorrhagic vomiting, diarrhoea, AKI

68
Q

What specific treatments can be used for ibuprofen/NSAID exposure?

A

H2 blockers
Proton pump inhibitors
Prostaglandin analogue
Intralipid infusion

69
Q

What are the clinical signs of paracetamol toxicity?

A

Brown mucus membranes
Jaundice, abdominal pain, lethargy, vomiting
AKI
Signs of hypoxia to tissues

70
Q

How do you treat paracetamol toxicity?

A

N/acetyl cysteine, H2 receptor antagonists
Ascorbic acid
Liver, AKI and GI support

71
Q

What are the clinical signs of chocolate toxicity?

A

Hyperactivity, vomiting/diarrhoea, arrythmias, seizures, coma and death

72
Q

What is the treatment for chocolate toxicity?

A

Charcoal every 4-6 hours. May need intubation and urinary catheterisation

73
Q

What common products can contain xylitol?

A

Chewing gum and peanut butters

74
Q

What are the clinical signs of xylitol toxicity?

A

Prolonged hypoglycaemia, liver failure, weakness, collapse, seizures, coma, jaundice, death

75
Q

What are the specific treatments for xylitol toxicity?

A

Hepato-protectants
Glucose supplementation

76
Q

What are the clinical signs of pyrethroids toxicity?

A

Ataxia, tremors, disorientation, seizures, dyspnoea, hypersalivation, vomiting

77
Q

What are the specific treatments for ethylene glycol (anti-freeze)?

A

Medical ethanol
Vodka diluted with saline

78
Q

What is the biggest issue with rat poison/warfarin ingestion?

A

Inhibits vitamin K epoxide reductase so caused coagulopathy 36-72hours post injection

79
Q

What is the definition of regurgitation?

A

Passive expulsion of food from pharynx/oesophagus

80
Q

What is the definition of dysphagia?

A

Failure to prehend/bite and initially swallow
Pain on closing or opening of mouth

81
Q

What is the breed pre-disposition of megaoesophagus?

A

Labrador, newfoundland, Shar Pei

82
Q

What is the breed pre-disposition of vascular ring anomaly?

A

GSD, Irish setter, Great Dane

83
Q

What is intussusception?

A

Vigorous contraction of a segment of intestine into the lumen of the adjacent relaxed segment

Small (Chloe) (11 decks)

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