Gastrointestinal Medicine

Question 1

What are the 4 signs of oropharyngeal or oesophageal disease?

Answer 1

1. Dysphagia
2. Odynophagia
3. Drooling
4. Halitosis

Question 2

What is the difference betweeen ptyalism and pseudopytalism?

Answer 2

Ptyalism: increased saliva production
Pseudoptyalism: failure to swallow saliva

Question 3

What are two causes of secondary megaoesophagus?

Answer 3

1. Oesophagitis

2. Myasthenia gravis

Question 4

What are 3 drugs used in the treatment of oesophagitis?

Answer 4

1. Sucralfate
2. Antacids
3. Metoclopramide

Question 5

What is oesophageal stricture?

What can cause it in cats?

Answer 5

Fibrosis after ulceration of mucosa

Doxycycline

Question 6

Why should you not use Barium in radiographic diagnosis of an oesophageal foreign body?

Answer 6

Oesophagus may be perforated

Barium may mask the foreign body

Question 7

What is the treatment for functional causes of gastric retention?

Answer 7

Metoclopramide
Ranitidine
Erythromycin

Question 8

What bacteria is involved in peptic ulcers?

Answer 8

Helicobacter

Question 9

What is Omeprazole?

Answer 9

Proton pump inhibitor (PPI)

Question 10

What is the triple therapy for Helicobacter?

Answer 10

Two antibiotics + acid blocker

E.g. amoxicillin, metronidazole + omeprazole

Question 11

Where do gastric adenocarcinomas often occur?

Answer 11

Lesser curvature/distal stomach

Question 12

What is the difference between small intestinal and large intestinal diarrhoea?

Answer 12

Small intestine: Increased volume, colour change

Large intestine: Reduced volume, increased frequency, urgency + tenensmus, mucus + haematochezia

Question 13

What is melaena?
What does it indicate?
What is haematochezia?
What does it indicate?

Answer 13

Black, tarry faeces (partially digested blood)
Upper GI disease (e.g. stomach ulcers)
Fresh blood
Lower GI disease

Question 14

When should you used supplemental fiber in treatment of GI disease?

Answer 14

Large intestinal disease

NOT SI disease (fibre affects absorption)

Question 15

What LI disease is common in multi-cat households?

Answer 15

Tritrichomonas foetus

Question 16

What do you test in the diagnosis of Malabsorption?

Answer 16

Folate

Cobalamin

Question 17

What are the 4 layers of the intestine?

Answer 17

Serosa (outside)
Muscularis
Submucosa
Mucosa (inside)

Question 18

Which biopsy procedure is best for cats?

Answer 18

Coeliotomy

Question 19

What is idiopathic megacolon?

What species is it common in?

Answer 19

Neuromuscular dysfunction of the colon
Reduced ability to pass faeces
Results in colon enlargement and distension, further reducing its ability
CATS

Question 20

What is the (salvage) treatment for idiopathic megacolon?

Answer 20

Subtotal colectomy

Question 21

What is the pathogenesis of acute pancreatitis?

Answer 21

Activation of Trypsin causes direct tissue damage and cascade initiation

Question 22

What are the 3 aetiologies of EPI?

Answer 22

1. Pancreatic acinar atrophy
2. Pancreatic hypoplasia
3. Chronic pancreatitis

Question 23

What is pancreatic acinar atrophy?

Answer 23

Immune mediated lymphocytic infiltration and destruction of pancreatic tissue
Replacement by fibrous tissue

Question 24

What clinical signs would you expect with EPI?

What breed is predisposed?

Answer 24

WEIGHT LOSS/poor growth
Depraved, increased appetite
Large volumes, foul smelly, greasy faeces
Vomiting
Poor coat condition
GSDs (rare in cats)

Question 25

What is the best test for EPI? | What is a test result for dogs with EPI?

Answer 25

Trypsin-like immunoreactivity | TLI < 2.5ug/L

Question 26

What prognosis does lack of cobalamin (Vit B12) have in EPI?

Answer 26

Poor prognostic indicator | Shorter survival time

Question 27

What do low cobalamin and folate indicate?

Answer 27

Malabsorption in the small intestine

Question 28

What are Cimetidine and Ranitidine?

Answer 28

H2 receptor antagonists | Ranitidine is much more potent

Question 29

What age do you typically see IBD?

Answer 29

> 2 years old

Question 30

What does a low creatinine indicate?

Answer 30

Decreased muscle mass

Question 31

What can high folate and low cobalamin indicate?

Answer 31

Bacterial dysbiosis (more substrate for bacteria to feed on due to lack of pancreatic enzyme, bacterial imbalance/growth)

Question 32

What is antibiotic responsive diarrhoea? What age and breed of dog is predisposed? What is the treatment?

Answer 32

Diarrhoea that is responsive to antibiotics, but relapses when stopped. Young GSDs Long term low dose oxytetracycline

Question 33

What does protein loosing enteropathy present with?

Answer 33

``` Ascites Lethargy, variable appetite Low TP, hypoalbuminaemia, low cholesterol, thrombocytosis Low folate and cobalamin Normal TLI ```

Question 34

What is a specific test for pancreatitis?

Answer 34

Pancreatic lipase immunoreactivity (PLI)

Question 35

What are 3 possible aetiologies of PLE?

Answer 35

1. IBD 2. Alimentary Lymphoma 3. Lymphangiectasia

Question 36

What is the prognosis and treatment for PLE?

Answer 36

Poor prognosis | Prednisolone and Chlorambucil (or ciclosporin if no response)

Question 37

Which pancreatic and lymphatic diseases are RARE in cats? | How do they present with pancreatitis differently to dogs?

Answer 37

EPI and Lymphangiectasia (disease of lymphatic vessles, lacteal dilation) Non-specific signs, no abdominal pain

Question 38

What is a common disease in cats, causing inflammation of the bile ducts?

Answer 38

Cholangitis (cholangiohepatitis)

Question 39

What can low calcium and high glucose suggest?

Answer 39

Acute pancreatitis

Question 40

What is the treatment for pancreatitis?

Answer 40

``` Nil per os until vomiting stops (oesophageal tube, nutritional support) Maropitant (anti-emetic) Omeprazole IV fluids Low fat diet ```