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Nerd Book > Gastrointestional > Flashcards

Gastrointestional Flashcards

1
Q

Main lymphatic duct is located where?

A

Thoracic duct

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2
Q

Reglan affects what part of the GI?

A

gastric motility (to empty stomach)

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3
Q

COX 1 enhances blood flow to what?

A

the gut

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4
Q

What does the spleen hug?

A

The stomach - left side

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5
Q

Common pancreatitis CBC changes

A

high WBCS (neuts) w/ left shift

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6
Q

inflammatory cascade of events - start with neuts/macrophages

A

neuts/macrophages attack bacteria
Activation releases cytokines
Cytokines signal to t-cells
T-cells signal macrophages and it begins again

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7
Q

Hepatic lipidosis prognosis

A

75%

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8
Q

RER calculation

A

70(k)^3/4

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9
Q

Maintenance fluid rate - dog

A

66ml/kg/day

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10
Q

parenteral nutritrion risks (3)

A
  • infection
  • fluid shifts (high osmolality)
  • refeeding syndrome including HYPERglycemia
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11
Q

A neurokinin receptor antagonist that affects substance P

A

cerenia

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12
Q

What does the liver do if it has not glycogen to convert to glucose?

A

Glucogenesis - create glucose from amino acids/pyruvic acid or glycerol

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13
Q

LPE characterized by what?

A

increase in lymphs and plasma cells overpopulating the mucosa of the GI

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14
Q

TPN must be administered via what? Why?

A

Central line, high osmolality (700)

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15
Q

Is it usually best to over feed or underfeed?

A

Underfeed - HYPER ailmentation leads to refeeding syndrome

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16
Q

Does Cerenia or Ondansetron affect GI motility?

A

Cerenia

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17
Q

Megaesophagus common disorder

A

myasthenia gravis

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18
Q

GIT water flow is ____ times that of blood volume or what % of body weight

A

1-2 x blood volume, 7% body weight

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19
Q

Treatment for IBD

A

steroids - calm down the attacking of the GI

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20
Q

Glucogenesis uses what for energy?

A

Amino Acids

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21
Q

How do you choose an enteral feeding tube?

A

Bypass the area of concern

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22
Q

Metoclopramide is a what type of drug

A

dopamine antagonist

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23
Q

Lymphangiectasia definition

A

Dilation of the lymph vessels

Lymph/anig/ectasia
Lymph/vessel/dilation

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24
Q

What percent dehydration should require IV fluids instead of SQ?

A

5% dehydration

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25
Q

Three common signs of mega esophagus

A
  • big esophagus
  • vomiting/regurge
  • esophagitis
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26
Q

In a normal state, glucose is used for ___ and protein for ____

A

Glucose - energy

Protein - growth

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27
Q

PLE can cause DIC - why?

A

Uses all the clotting factors to plug the holes, less protein

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28
Q

Four chemistry changes besides Amy/lip with panc

A

low calcium
low albumin
high BG
high liver

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29
Q

You should avoid hyperailmentation in refeeding syndrome cases - why?

A

Need to re-feed slowly

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30
Q

The panc secreted digestive enzymes through the pancreatic duct into the what?

A

Duodenum

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31
Q

Name a serotonin antagonist antiemetic

A

ondansetron

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32
Q

Elemental diets should be used with what type of tube

A

J- tube - food should already be broken down by the time it reaches the jejunum

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33
Q

Three forms of IBD

A

LPE (lymphocytic plasmacytic enteritis)
EE (eosinophilic)
GE (granulomatous)

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34
Q

Refeeding syndrome is characterized by what three lab abnormalities?

A

Damn glucose scoops up everything: K+, Mg, Phos

  • Hypokalemia
  • hypomagnesaemia
  • hypophosphatemia
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35
Q

What is hyperailmentation?

A

total parenteral nutrition apparently

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36
Q

What happens when the panc releases the hormone glucagon?

A

The liver converts glycogen to glucose

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37
Q

Shock dose dogs

A

90ml/kg total

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38
Q

Cat vs. dog protein requirement

A

Cat 6g/100kcal

Dog 4g/100kcal

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39
Q

Why do 26% of panc cases develop icterus

A

panc inflames and blocks bile duct (rude)

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40
Q

With acute gastritis, patients should be fasted for how long before reintroducing a bland diet?

A

12 hours

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41
Q

When to increase protein in diet?

A

burns, sepsis

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42
Q

A lactate decrease by _____% in _____ hours is good prognostic indicator for GDV patients

A

50% in 12 hours

43
Q

Elemental vs. polymeric diets

A

elemental are broken down already - polymeric require breakdown

44
Q

EE is characterized by what?

A

Eosinophils overtaking the mucousa

45
Q

Abdominocentesis will yield fluid when >__ml/kg of fluid is present?

A

> 6ml/kg

46
Q

GDVs with a lactate greater than _____ are associated with gastric necrosis

A

> 6mmol/L

47
Q

Glutamine and arginine are what?

A

essential amino acids

48
Q

Approx what percent of hepatic blood flow comes from the GI tract?

A

80%

49
Q

What type and kind of enteral feeding should be used with a jejunostomy tube?

A

CRI - elemental liquid

CRI to mimic slow moving from stomach

50
Q

Two mega E treatment meds

A
  • sucralfate

- famotidine

51
Q

Effects of lymphagiectasia?

A

Lymph vessels dilate/leak or are obstructed –> loss of protein

52
Q

What sided heart failure affects the GIT?

A

right sided

53
Q

What’s the gallbladder’s job?

A

Store bile between meals/reabsorb water

54
Q

What part of the SI is most permeable?

A

Duodenum

55
Q

How do NSAID toxicities cause DIC?

A

GI bleeding uses up all of the coag factors

56
Q

What side should you trocharize a GDV?

A

patient in Left lateral - trocharize right side (avoid the spleen)

57
Q

Hypertonic saline dosing

A

4ml/kg over 2 min

58
Q

Malfunction in the transmission of signals between the nerves and muscles … what disorder?

A

myasthenia gravis

59
Q

Patients in sever malnutrition (5 days) should get 60-90% of energy from what?

A

lipids

60
Q

When to decrease protein in diet?

A

renal disease

61
Q

Partial parenteral nutrition vs total percentages

A

Partial 40-60%

62
Q

Where does the pancreas live?

A

Along the stomach and duodenum V shaped

63
Q

GE characterized by what?

A

Macrophages taking over mucousa

64
Q

Dolasetron can cause what

A

arrythmias

65
Q

Colloid shock doses

A

10-20ml/kg

66
Q

How much and what type of fluid should be used in a diagnostic peritoneal lavage?

A

10-20ml/kg of something isotonic

67
Q

Why do some TPN avoid lipids?

A

pro-inflammatory and immunosuppressive

68
Q

Shock dose cats

A

45-60ml/kg total

69
Q

Replacement fluid calculation… how long do you replace over?

A

% dehydrated x body weight

replace 75% over 24 hours

70
Q

CO2 enhances what?

A

mucosal healing

71
Q

Body tries to plug big floppy vessel holes with what? leading to ________

A

plug w/ clotting factors, leading to DIC

72
Q

E-tube diet type

A

thicker - less diarrhea

73
Q

How often should open-abdomen bandages be changed?

A

3-4 times a day or when soiled

74
Q

COX inhibitors regulate what?

A

renal function

75
Q

Ace should be used cautiously in what breeds?

A

Sighthounds, giant breeds

76
Q

COX inhibitors cause GI upset - HOW (2 things)?

A

blocks blood flow to the guts

blocks mucosal healing

77
Q

Dogs vs. cats in RER use during malnutrition - where do they prefer to get calories?

A

Dogs - 90% dextrose

Cats - 60-90% lipids

78
Q

VES daily rates - dogs vs cats

A

Dogs 20ml/kg/day

Cats 10-15ml/kg/day

79
Q

Within 24 hours of no nutrition, what happens to the mucosal lining?

A

atrophy and increased permeability

80
Q

LPE common in what breed

A

basenjis

81
Q

hyperglycemia with PN or TPN can be managed how?

A

insulin CRI 0.5u/kg/day

82
Q

Lymphatic system transports what?

A

transport of fatty acids, immune cells

83
Q

How do NSAIDS cause GI ulcers?

A

Inhibit bicarb production (which balances GI acidity)

84
Q

Approx 50% of cats with _____ have prolonged coags

A

hepatic lipidosis

85
Q

Why does HYPERglycemia occur in refeeding syndrome cases?

A

Less efficient at converting glucose –>glycogen

86
Q

Where does the breakdown of protein begin?

A

The stomach

87
Q

The large intestines have no ______

A

villa or digestive glands

88
Q

The liver destroys what?

A

old RBCs

89
Q

The liver stores excess glucose in the form of what?

A

glycogen

90
Q

J-tube benefits for panc

A

j-tube feeding does not stimulate pancreatic enzyme production

91
Q

Parvo develop hypoglycemia - why?

A

Can’t absorb any glucose

92
Q

Phenothiazine antiemetics act on what? Two examples

A

CNS blocking dopamine
Acepromazine
Chlorpromazine

93
Q

Maintenance fluid rate - cat

A

50-60ml/kg/day

94
Q

RER adjustments for refeeding syndrome

A

1/4 to 1/3 RER and adjust up over 3-4 days

95
Q

The liver metabolizes what 3 things?

A

Carbs, fat, protein

96
Q

How does Panc cause petichia?

A

Loss of albumin -> loss of antithrombin -> uses up clotting factors

97
Q

Antiemetics are better absorbed how?

A

Orally…

98
Q

Refeeding syndrome - main issue

A

Low Lytes

Insulin scoops up glucose AND LYTES - causing low phos, k, etc

99
Q

RER adjustments for burn victims, cancer patients, head trauma and sepsis

A

1.1-1.5x RER

100
Q

Since 80% of hepatic blood flow comes from the GIT - alterations in GIT can affect perfusion - including

A

mechanical ventilation, heart failure

101
Q

Can TPN or PN be stopped suddenly?

A

NO - wean it off over several days

102
Q

What is osmotic diarrhea?

A

Leaky GI - osmotic pressure pulls in fluid

103
Q

Abdominal radiograph finding with panc:

A

loss of detail right cranial quadrant

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