Gastrointestinal/Hepatobiliary Flashcards
1
Q
Which nerve carries sacral parasympathetic information to the GIT?
A
Pelvic
2
Q
Which cell is the pacemaker of the GIT?
A
Interstitial cells of Cajal
3
Q
Name the two types of glands in the stomach
A
Oxyntic
Pyloric
4
Q
Which gastric cells secrete pepsinogen?
A
Chief cells
5
Q
Which gastric cells secrete HCl?
A
Parietal cells
6
Q
Which gastric cells secrete gastrin?
A
G-cells in the antrum
7
Q
Which phase of gastric secretion accounts for the majority of gastric acid production?
A
Gastric (mediated by gastrin)
8
Q
Which phase of pancreatic secretion accounts for the majority of pancreatic enzyme secretion?
A
Intestinal
9
Q
Name 3 stimuli for pancreatic enzyme secretion
A
CCK
Secretin
Acetylcholine
10
Q
Which hormone stimulates gallbladder contraction and relaxes the sphincter of Oddi?
A
CCK
11
Q
Which glands secrete mucus in the small intestine?
A
Brunner’s glands
12
Q
Which enzyme is responsible for the initiation of carbohydrate metabolism?
A
Ptyalin (alpha-amylase)
13
Q
Lactose= ___ + ____
A
Glucose
Galactose
14
Q
Sucrose= _____ + _____
A
Fructose + glucose
15
Q
Which enzyme is responsible for the initiation of protein digestion?
A
Pepsin
16
Q
What is the major stimulus for CCK release?
A
Fat in the duodenum
17
Q
How do bile salts aid in fat digestion?
A
Emulsification of lipid droplets, increasing surface area
18
Q
Glucose is absorbed in the intestine via co-transport of what ion?
A
Sodium (via SGLT1 transporter)
19
Q
Intracellular triglycerides form which structure following intestinal absorption?
A
Chylomicron
20
Q
Which protein is critical for intestinal cobalamin absorption?
A
Intrinsic factor
21
Q
Where is cobalamin primarily absorbed?
A
Ileum
22
Q
Which enzyme is required for dietary folate absorption?
A
Folate deconjugase
23
Q
Which carrier protein is responsible for absorption of ferrous iron (Fe2+)?
A
DMT1
24
Q
Which intracellular protein binds to iron in enterocytes?
A
Ferritin
25
Which protein carries iron in circulation?
Transferrin
26
Which hormone enhances intestinal sodium absorption?
Aldosterone
27
Which of the following is not a function of somatostatin?
A) Inhibits release of insulin
B) Potentiates release of glucagon
C) Inhibits gastric acid secretion
D) Inhibits bile secretion
B
28
Which hormone is responsible for stimulating hunger?
Ghrelin
29
Which cells produce CCK?
I cells (duodenum)
30
Which hormone enhances pancreatic and biliary HCO3 secretion?
Secretin
31
Which cells produce motilin?
M cells (duodenum and jejunum)
32
Name 2 incretins
GLP-1
GIP
33
What is the major function of incretin hormones?
Stimulates insulin release in response to intestinal glucose
34
Where is the CRTZ located?
Area postrema
35
What is the mechanism of apomorphine?
D1/D2 receptor agonist in the CRTZ
36
4 mechanisms of diarrhea
Motility disturbance
Osmotic
Secretory
Permeability
37
Which fecal analysis method is best for identifying lighter helminth ova (e.g., hookworms)?
Centrifugal floatation
38
What are the 3 zones of hepatocytes?
1: periportal
2: transitional
3: centrilobular
39
Which cells act as macrophages in the liver?
Kupffer cells
40
Which cells are responsible for storage of vitamin A in the liver?
Stellate cells
41
What type of reactions are phase I metabolism?
Oxidation reactions (via CYP450 enzymes)
42
What type of reactions are phase II metabolism?
Conjugation
43
Name 4 types of conjugation reactions
Glucuronidation (UGT)
Glutathione (GST)
Sulfation (SLT)
Acetylation (NAT)
44
Which enzyme converts hemoglobin to biliverdin?
Biliverdin reductase
45
Which enzyme converts cholesterol to the first step in bile acid synthesis?
Cholesterol-7a-hydroxylase (CYP7A
46
What are the 2 primary bile acids?
Cholic acid
Chenodeoxycholic acid
47
Where are secondary bile acids produced?
In the intestine by bacterial-7-alpha-hydroxylase
Deoxycholic and lithocholic acid
48
Which enzyme is responsible for activation of trypsinogen?
Enteropeptidase (duodenal brush border)
49
What is the mechanism of action of omeprazole?
Binds H/K ATPase on parietal cells to inhibit H+ secretion
50
What is the mechanism of action of famotidine?
Inhibits H2 receptors on parietal cells to reduce H+ secretion
51
Name two drugs that inhibit 5-HT3 receptors in the CRTZ?
Ondansetron, metoclopramide
52
Mechanism of action of maropitant
NK1 receptor antagonist in the CRTZ and emetic center
53
What is the mechanism of action of capromorelin?
Ghrelin receptor agonist
54
What is SAMe converted to in the liver?
Glutathione (dependent on folate, cobalamin, pyridoxine)
55
What % of functional hepatic mass must be loss to see an elevation in ammonia?
70%
56
Which protein can be used to differentiate microvascular dysplasia from PSS?
Protein C
57
What is the mechanism of PU/PD in PSS?
Renal medullary washout (low BUN, increased renal blood flow, psychogenic PD from HE)
58
Which clinical sign is commonly seen in cats with PSS?
Ptyalism
59
What type of congenital PSS is most common?
Extrahepatic
60
Consequence of hepatic fibrosis
Acquired PSS
61
Which test is 100% sensitive for PSS?
Bile acids
62
Risk of acute, complete PSS attenuation
Portal hypertension, ascites, GI congestion
63
Treatment options (2) for EHPSS
Ameroid constrictor
Cellophane band
64
Treatment for IHPSS
Transvenous coil embolization
65
Name 4 drugs which are hepatotoxic
Phenobarbital
Azole antifungals
Amiodarone
Sulphonamides
Acetaminophen
NSAIDs
L-asparaginase
Doxorubicin
Methimazole
66
Which metabolite accumulates in acetaminophen toxicity?
NAPQI
67
Which type of hepatic necrosis is most common in ischemic, viral, and toxic insults?
Centrilobular
68
Common cause of chronic hepatitis in dogs
Copper hepatopathy
69
Mutation associated with copper hepatopathy in Bedlington Terrier
COMMD1
70
Treatment for copper hepatopathy
D-penicillamine
71
Common bacterial etiologies associated with cholangitis/cholecystitis (4)
E coli
Enterococcus
Clostridium
Bacteroides
72
2 endocrinopathies associated with the development of gallbladder mucoceles
Hyperadrenocorticism
Hypothyroidism
73
Which cholestatic parameter is normal in 75% of cats with hepatic lipidosis?
GGT
74
Which plasma metabolite increases during periods of decreased intracellular cobalamin?
MMA (methylmalonic acid)
75
Increased folate levels are seen with what condition?
SI dysbiosis
76
Test used to detect intestinal protein loss
Fecal alpha-1 protease inhibitor
77
Bacteria associated with AHDS
Clostridium perfringens
78
Which enterocytes are targeted by parvovirus?
Crypt enterocytes
79
Which strain of E coli is associated with production of Shiga-like toxin?
EHEC
80
Which E coli strain is associated with granulomatous colitis in boxers?
AIEC (adherent-invasive)
81
Which fluke causes deposition of eggs within the intestinal wall?
Heterobilharzia america (canine schistosomiasis)
82
Which parasite involves shedding of oocysts which are immediately infective?
Cryptosporidium
83
Most common histopathology finding associated with steroid-responsive enteropathy in dogs
Lymphoplasmacytic enteritis
84
Which IHC marker is used to stain T lymphocytes in feline low-grade intestinal T cell lymphom?
CD3
85
Most frequent location of lesions associated with chronic enteropathy (IBD, lymphoma) in the cat
Jejunum
86
First-line treatment for chronic enteropathies
Diet trial (novel protein, hydrolyzed protein)
87
Mainstay of treatment for lymphangiectasia
Low fat diet
88
Most common causes (2) of PLE in the dog
CIE
Lymphangiectasia
89
Treatment for granulomatous colitis in boxers
Fluoroquinolones 6-8wk
90
Severe segmental thickening of GI with eosinophilic and pyogranulomatous inflammation on biopsy
Pythium
91
Dimorphic fungus with predilection for the large intestine
Histoplasma
92
Protozoal organism with predilection for the large intestine in young cats
Tritrichomonas foetus
93
Treatment for T. foetus infection in cats
Ronidazole
94
Antagonism of which receptor may mediate pain associated with acute pancreatitis?
NK1 (e.g., maropitant)
95
Which cell type is activated in chronic pancreatitis?
Stellate cells
96
Most sensitive and specific test for the diagnosis of acute pancreatitis?
cPL/fPL
97
Most common cause of EPI in dogs and cats
Chronic pancreatitis
98
Gold standard for diagnosis of EPI
Serum TLI
99
Deficiency in which vitamin is seen with EPI?
Cobalamin (B12)
100
Cause of PRAA
Formation of aorta from the right (rather than left) 4th aortic arch, leading to circumferential constriction of the esophagus
101
Medication used in the management of congenital and acquired idiopathic megesophagus
Sildenafil
102
Most common oral malignancy in the dog
Malignant melanoma
103
Most common oral malignancy in the cat
SCC
104
Location of SCC associated with worse prognosis
Tonsillar
105
Hypoglycemia is associated with which intestinal malignancy?
Leiomyosarcoma
106
Most common type of small intestinal neoplasia in cats and dogs
Lymphoma
107
Second most common small intestinal malignancy in cats and dogs
Adenocarcinoma
108
Common biochemistry finding in dogs with small intestinal neoplasia
Hypoalbuminemia
109
Which type of feline intestinal lymphoma has the shortest survival?
Granular cell lymphoma (21 days)
110
AGASACA is classically associated with what paraneoplastic syndrome?
Humoral hypercalcemia of malignancy (elevated PTHrp)
111
T/F: primary liver tumors are more common than metstatic liver tumors in cats
TRUE
112
Most common malignant hepatobiliary tumor in cats
Bile duct carcinoma (cholangiocarcinoma)
113
Most common primary liver tumor in dogs
HCC
114
Most common cause of megaesophagus in dogs
Myasthenia Gravis
115
Lipemia on fasted blood sample. What does that indicate?
Elevated VLDLs
116
8 week old GSD gagging, regurgitating, failing to thrive. Most likely diagnosis?
PRAA
117
Best treatment for GSD with peri-anal fistula?
Cyclosporine
118
Which antiemetic inhibits peristalsis?
Ondansetron
119
What facilitates cleavage of ALP from the biliary membrane? (3)
bile acids, phospholipase D, proteases
120
Dog with chronic GI signs, low cobalamin, normal TLI/folate/PLI
IBD/CIE
121
What is secreted in the stomach of fasted horses and dogs?
A) Secretin
B) Gastrin
C) IF
D) Somatostatin
Gastrin
122
What is the most important controller of intestinal motility?
Myenteric plexus
123
Essential fatty acid in dogs
Linoleic acid (omega-6)
124
Cause of pre-hepatic portal hypertension
Portal vein atresia
125
Which toxin is silymarin particularly effective for?
Amanita mushrooms
126
Which drug route is most affected by first pass metabolism?
A) Transmucosal
B) Intramuscular
C) Intravenous
D) Rectal
Rectal
127
Major stimuli for gastric acid secretion (3)
Gastrin
Acetylcholine
Histamine
128
Which electrolyte abnormality can worsen hepatic encephalopathy?
Hypokalemia
